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Sample records for net teaching hospital

  1. Teaching Tennis for Net Success.

    Science.gov (United States)

    Young, Bryce

    1989-01-01

    A program for teaching tennis to beginners, NET (Net Easy Teaching) is described. The program addresses three common needs shared by tennis students: active involvement in hitting the ball, clearing the net, and positive reinforcement. A sample lesson plan is included. (IAH)

  2. Teaching and Learning with the Net Generation

    Science.gov (United States)

    Barnes, Kassandra; Marateo, Raymond C.; Ferris, S. Pixy

    2007-01-01

    As the Net Generation places increasingly greater demands on educators, students and teachers must jointly consider innovative ways of teaching and learning. In this, educators are supported by the fact that the Net Generation wants to learn. However, these same educators should not fail to realize that this generation learns differently from…

  3. MAIDUGURI TEACHING HOSPITAL.

    African Journals Online (AJOL)

    Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria. ABSTRACT . Background: Incisional hernias (IH) represent a breakdown or loss of continuity of a fascial closure. They are thus unique as the only external wall hernias that are iatrogenic in aetiology. Incisional hernias are ...

  4. in a Nigerian teaching hospital

    African Journals Online (AJOL)

    The study was conducted at the University of llorin. Teaching Hospital (U1TH) llorin between May and June 2002. The Hospital is a second generation Teaching Hospital es- tablished on 2nd May, 1980. Currently, the hospital has a total bed space of 515 distributed as follows: i. General Hospital Wing, llorin with 304 beds;.

  5. Readmissions at a public safety net hospital.

    Directory of Open Access Journals (Sweden)

    Eri Shimizu

    Full Text Available OBJECTIVE: We aimed to determine factors related to avoidability of 30-day readmissions at our public, safety net hospital in the United States (US. METHODS: We prospectively reviewed medical records of adult internal medicine patients with scheduled and unscheduled 30-day readmissions. We also interviewed patients if they were available. An independent panel used pre-specified, objective criteria to adjudicate potential avoidability. RESULTS: Of 153 readmissions evaluated, 68% were unscheduled. Among these, 67% were unavoidable, primarily due to disease progression and development of new diagnoses. Scheduled readmissions accounted for 32% of readmissions and most (69% were clinically appropriate and unavoidable. The scheduled but avoidable readmissions (31% were attributed largely to limited resources in our healthcare system. CONCLUSIONS: Most readmissions at our public, safety net hospital were unavoidable, even among our unscheduled readmissions. Surprisingly, one-third of our overall readmissions were scheduled, the majority reflecting appropriate management strategies designed to reduce unnecessary hospital days. The scheduled but avoidable readmissions were due to constrained access to non-emergent, expensive procedures that are typically not reimbursed given our system's payor mix, a problem which likely plague other safety net systems. These findings suggest that readmissions do not necessarily reflect inadequate medical care, may reflect resource constraints that are unlikely to be addressable in systems caring for a large burden of uninsured patients, and merit individualized review.

  6. University of Benin Teaching Hospital

    African Journals Online (AJOL)

    110 million with a blindness prevalence rate of 1%. Cataract is responsible ... contribution of teaching hospitals to the prevention of blind- ness. Several factors ... All the adult patients before the age of 40 had extracapsular cataract extraction; those above had intracapsular cataract extraction. The children all had congenital ...

  7. At Major Teaching Hospitals, Lower Death Rates

    Science.gov (United States)

    ... fullstory_165869.html At Major Teaching Hospitals, Lower Death Rates Researchers assess 30-day survival for older ... dies," said lead author Dr. Laura Burke. If death rates at non-teaching hospitals were similar to ...

  8. Developing Marketing Strategies for University Teaching Hospitals.

    Science.gov (United States)

    Fink, Daniel J.

    1980-01-01

    University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, consumerism, and a declining urban population base. New marketing strategies are seen as ways in which teaching hospitals can achieve better relationships with institutions, practitioners, and surrounding communities and…

  9. Neurocysticercosis - experience at the teaching hospitals ofthe ...

    African Journals Online (AJOL)

    Neurocysticercosis - experience at the teaching hospitals ofthe University ofCape Town . A. J. G~ THOMSON. Abstract In the 15 years 1975-1989, 239 patients attending the associated teaching hospitals ofthe University of Cape Town have been identified retrospectively as having neurocysticercosis. One hundred and.

  10. Auditing Autopsies: Lagos University Teaching Hospital Experience ...

    African Journals Online (AJOL)

    antemortem diagnosis) with autopsies (post-mortem diagnosis) on patients managed at Lagos University Teaching Hospital (LUTH) between October 1999 and November, 2000. In the study period, a total of 1843 deaths were registered out of which ...

  11. Implementing medical teaching policy in university hospitals.

    Science.gov (United States)

    Engbers, Rik; Fluit, Cornelia R M G; Bolhuis, Sanneke; de Visser, Marieke; Laan, Roland F J M

    2017-10-01

    Within the unique and complex settings of university hospitals, it is difficult to implement policy initiatives aimed at developing careers in and improving the quality of academic medical teaching because of the competing domains of medical research and patient care. Factors that influence faculty in making use of teaching policy incentives have remained underexplored. Knowledge of these factors is needed to develop theory on the successful implementation of medical teaching policy in university hospitals. To explore factors that influence faculty in making use of teaching policy incentives and to develop a conceptual model for implementation of medical teaching policy in university hospitals. We used the grounded theory methodology. We applied constant comparative analysis to qualitative data obtained from 12 semi-structured interviews conducted at the Radboud University Medical Center. We used a constructivist approach, in which data and theories are co-created through interaction between the researcher and the field and its participants. We constructed a model for the implementation of medical teaching policy in university hospitals, including five factors that were perceived to promote or inhibit faculty in a university hospital to make use of teaching policy incentives: Executive Board Strategy, Departmental Strategy, Departmental Structure, Departmental Culture, and Individual Strategy. Most factors we found to affect individual teachers' strategies and their use of medical teaching policy lie at the departmental level. If an individual teacher's strategy is focused on medical teaching and a medical teaching career, and the departmental context offers support and opportunity for his/her development, this promotes faculty's use of teaching policy incentives.

  12. Implementing Medical Teaching Policy in University Hospitals

    Science.gov (United States)

    Engbers, Rik; Fluit, Cornelia Cornelia R. M. G.; Bolhuis, Sanneke; de Visser, Marieke; Laan, Roland F. J. M.

    2017-01-01

    Within the unique and complex settings of university hospitals, it is difficult to implement policy initiatives aimed at developing careers in and improving the quality of academic medical teaching because of the competing domains of medical research and patient care. Factors that influence faculty in making use of teaching policy incentives have…

  13. Safer caesarean sections at Juba Teaching Hospital

    African Journals Online (AJOL)

    2012-05-02

    May 2, 2012 ... procedures in South Sudan. Following some “powerpoint” teaching on spinal anaesthesia, alongside the provision of practical advice and support, rates of spinal anaesthesia for caesarean section at Juba Teaching Hospital increased significantly. Although the rates for emergency caesarean sections did.

  14. Predicting financial distress in teaching hospitals.

    Science.gov (United States)

    Langabeer, Jim

    2006-01-01

    Despite the prestige and reputation of teaching hospitals, as a group they are in financial distress. If this trend continues, one would expect to see a higher incidence of mergers and acquisitions or divestitures of assets and services, and other strategies designed to combat failing businesses. Nearly one out of every six teaching hospitals sampled was predicted to be near immediate bankruptcy, and the overwhelming majority was not far behind. It will take a significant effort for these hospitals to continue to treat their operations as a clinical and research "business," but they must do just that if they are to survive the continually turbulent market.

  15. Reasons for discharge delays in teaching hospitals.

    Science.gov (United States)

    Silva, Soraia Aparecida da; Valácio, Reginaldo Aparecido; Botelho, Flávia Carvalho; Amaral, Carlos Faria Santos

    2014-04-01

    To analyze the causes of delay in hospital discharge of patients admitted to internal medicine wards. We reviewed 395 medical records of consecutive patients admitted to internal medicine wards of two public teaching hospitals: Hospital das Clínicas of the Universidade Federal de Minas Gerais and Hospital Odilon Behrens. The Appropriateness Evaluation Protocol was used to define the moment at which notes in the medical records indicated hospital stay was no longer appropriate and patients could be discharged. The interval between this estimated time and actual discharge was defined as the total number of days of delay in hospital discharge. An instrument was used to systematically categorize reasons for delay in hospital discharge and frequencies were analyzed. Delays in discharge occurred in 60.0% of 207 hospital admissions in the Hospital das Clínicas and in 58.0% of 188 hospital admissions in the Hospital Odilon Behrens. Mean delay per patient was 4.5 days in the former and 4.1 days in the latter, corresponding to 23.0% and 28.0% of occupancy rates in each hospital, respectively. The main reasons for delay in the two hospitals were, respectively, waiting for complementary tests (30.6% versus 34.7%) or for results of performed tests to be released (22.4% versus 11.9%) and medical-related accountability (36.2% versus 26.1%) which comprised delays in discussing the clinical case and in clinical decision making and difficulties in providing specialized consultation (20.4% versus 9.1%). Both hospitals showed a high percentage of delay in hospital discharge. The delays were mainly related to processes that could be improved by interventions by care teams and managers. The impact on mean length of stay and hospital occupancy rates was significant and troubling in a scenario of relative shortage of beds and long waiting lists for hospital admission.

  16. Ectopic Pregnancy: Lagos University Teaching Hospital Experience ...

    African Journals Online (AJOL)

    Ectopic pregnancy remains one of the commonest gynaecological emergencies in developing countries. In a retrospective study of ectopic pregnancy carried out at Lagos University Teaching Hospital (LUTH), Lagos, Nigeria, over a five year period, 272 cases were managed with an incidence of 43.8/1000 deliveries.

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

    African Journals Online (AJOL)

    Culinary and hospitality teaching is henceforth referred to by the inclusive term hospitality. Hospitality is not currently a research-based profession. If it were, I have no doubt that culinary and hospitality teaching would be more effective and much more satisfying for both teachers and students, and be acknowledged by ...

  18. Aggressive periodontitis in a Nigerian teaching hospital.

    Science.gov (United States)

    Nwhator, Solomon Olusegun; Uhunmwangho, Iyobosa; Chukwuma, Benedict; Ikponmwosa, Osagie

    2014-07-01

    These case series were aimed at highlighting late presentations of aggressive periodontitis (AP) in a teaching hospital as well as proffering possible reasons for such presentations which would serve as part of the solution to prevent such presentations in the future. Aggressive periodontitis is a severe form of destructive periodontitis traditionally believed to present around puberty. However, many cases seen in a teaching hospital presented much later for yet-to-be explained reasons. Seven patients referred to the specialist periodontal clinic of a Nigerian teaching hospital presented with clinical features consistent with AP. Most of the patients were over twenty and some over thirty years of age. Aggressive periodontitis patients seen in our center were often outside the traditional age brackets. The range of treatment options available to the patients were under-utilized due to serious financial constraints. Aggressive periodontitis comes with serious psychological challenges and severe morbidity. Prompt diagnosis and effective management hold the key to success It is important to investigate why many of the cases seen in our center presented that late. Could be due to ignorance and poverty or could be due to failure of dentists recognize these cases and consequent misdiagnosis? Further studies are needed to answer these questions.

  19. Possible consequences of regionally based bundled payments for diabetic amputations for safety net hospitals in Texas.

    Science.gov (United States)

    Newhall, Karina; Stone, David; Svoboda, Ryan; Goodney, Philip

    2016-12-01

    Ongoing health reform in the United States encourages quality-based reimbursement methods such as bundled payments for surgery. The effect of such changes on high-risk procedures is unknown, especially at safety net hospitals. This study quantified the burden of diabetes-related amputation and the potential financial effect of bundled payments at safety net hospitals in Texas. We performed a cross-sectional analysis of diabetic amputation burden and charges using publically available data from Centers for Medicare and Medicaid and the Texas Department of Health from 2008 to 2012. Using hospital referral region (HRR)-level analysis, we categorized the proportion of safety net hospitals within each region as very low (0%-9%), low (10%-20%), average (20%-33%), and high (>33%) and compared amputation rates across regions using nonparametric tests of trend. We then used charge data to create reimbursement rates based on HRR to estimate financial losses. We identified 51 adult hospitals as safety nets in Texas. Regions varied in the proportion of safety net hospitals from 0% in Victoria to 65% in Harlingen. Among beneficiaries aged >65, amputation rates correlated to the proportion of safety net hospitals in each region; for example, patients in the lowest quartile of safety net had a yearly rate of 300 amputations per 100,000 beneficiaries, whereas those in the highest quartile had a yearly rate of 472 per 100,000 (P = .007). Charges for diabetic amputation-related admissions varied almost 200-fold, from $5000 to $1.4 million. Using reimbursement based on HRR to estimate a bundled payment, we noted net losses would be higher at safety net vs nonsafety net hospitals ($180 million vs $163 million), representing a per-hospital loss of $1.6 million at safety nets vs $700,000 at nonsafety nets (P amputations in Texas. Changes to traditional payment models should account for the disproportionate burden of high-risk procedures performed by these hospitals. Copyright © 2016

  20. AN EMPIRICAL STUDY OF THE DETERMINANTS OF SAFETY-NET HOSPITAL FAILURES

    OpenAIRE

    Devin Alan Daugherty; Ernesto Escobedo

    2013-01-01

    Several safety-net hospitals have closed in the United States, but the scholarly literature does not adequately explain why. This study examines the relationship between the operational status (open or closed) of safety-net hospitals and unemployment, median household income, gross profit margin, efficiency ratio, operating margin, excess margin, and salary and benefit expenses per full-time equivalent. Study data were collected and analyzed by means of a logistic regression analysis. A signi...

  1. Benzodiazepine prescribing in a Sydney teaching hospital.

    Science.gov (United States)

    Howes, J B; Ryan, J; Fairbrother, G; O'Neill, K; Howes, L G

    1996-09-16

    To determine the pattern of benzodiazepine prescribing in hospital and at discharge in relation to prior benzodiazepine therapy. Patient interview within 48 hours of admission to determine benzodiazepine, alcohol and other psychotropic drug use before admission and review of medical records after discharge to document drugs prescribed in hospital and at discharge. Tertiary teaching hospital, January to August 1995. 1453 patients (mean age, 60 [SD, 19] years; 52.7% female) were interviewed; 277 patients (19.1%) were taking benzodiazepines regularly (one or more doses per week) before admission. Of these, 28.5% did not have benzodiazepine therapy continued while in hospital and 63.9% did not receive benzodiazepines at the time of discharge. Of the remaining 1176 patients (those not previously taking benzodiazepines), 277 (23.6%) were prescribed them for the first time in hospital and 5.3% received benzodiazepines at the time of discharge. Older age, female sex, marital status (single, divorced or widowed) and the use of antidepressants and Schedule 8 narcotic analgesics were all statistically significant predictors of benzodiazepine use before admission, but alcohol consumption was not. A substantial number of patients do not have their benzodiazepine therapy continued in hospital and at the time of discharge, and are thus at risk of developing benzodiazepine withdrawal syndromes, including delirium. A small but clinically significant number of patients who do not usually take benzodiazepines receive them at the time of discharge and may be at risk of becoming long term users.

  2. Bed net related burns at Mulago national referral hospital, Uganda: a case series report.

    Science.gov (United States)

    Kalanzi, Edris W; O'Hara, Lyndsay M; O'Hara, Nathan N; Boyle, James C

    2014-05-01

    Insecticide-treated bed nets are essential tools to prevent malaria in endemic regions, however, increasing trends in bed net related burns in Kampala, Uganda are concerning. Data were collected from burns unit admission records at Mulago National Referral Hospital in Kampala, Uganda for the years 2008-2011 inclusive. Retrospective analyses on the characteristics of patients admitted with bed net related burns within this period were conducted. A total of 45 patients were admitted to the burns unit with bed net related burns during the study period. Most burns occurred among individuals who were 0-1 years old (33.3%) and 26-35 years old (24.2%) and the majority were male (71%). Bed net related burns at Mulago Hospital are severe, as evidenced by the fact that 15 of 45 patients died (crude mortality rate=33%) and that 26 patients (57.8%) had total body surface area burn percentages that were greater than 20%. The average length of stay in hospital for patients with bed net related burns was 30.4 days. Organizations responsible for malaria prevention should consider incorporating fire and burn prevention awareness, strategies and training into their bed net distribution programs. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  3. A two-dimensional equity proposal for self-sufficiency in municipal safety-net hospitals.

    Science.gov (United States)

    Tataw, David Besong

    2011-01-01

    This article advances a two-dimensional equity approach for self-sufficiency in municipal safety-net hospitals that will strengthen provider self-sufficiency and protect the safety-net mission of providing a dignified floor of health services to the most disadvantaged members of the society. The model responds to the failure of current delivery strategies to effectively cope with the changing market configurations in safety-net systems that have eliminated the possibility of cross-subsidization which has long been the mainstay of safety-net systems. The identified pathway to self sufficiency is made up of (1) a differential service delivery framework which includes a two-tier patient system, uniform standards of care and service levels, and the creation of a community health campus; (2) independent sector ownership; and (3) intergovernmental policy actions restricting ownership of safety-net hospitals to nonprofit entities. Although this model is explained by demonstrating potential application in safety-net hospitals, it is believed that the model is applicable in ambulatory care settings. Future work can focus on the construction of an ambulatory variation of the model and the empirical testing of the hospital and ambulatory models.

  4. Is different better? Models of teaching and their influence on the net financial outcome for general practice teaching posts

    Directory of Open Access Journals (Sweden)

    Cheah Carolyn

    2011-07-01

    Full Text Available Abstract Background In Australia, training for general practice (GP occurs within private practices and their involvement in teaching can have significant financial costs. At the same time there are growing demands for clinical places for all disciplines and for GP there is concern that there are insufficient teaching practices to meet the demand at the medical student, prevocational and vocational training levels. One option to address this may be to change how teaching occurs in the practice. A question that arises in posing such an option is whether different models of teaching change the costs for a teaching practice. The aim of this study is to determine the net financial outcome of teaching models in private GP. Methods Modelling the financial implications for a range of teaching options using a costing framework developed from a survey of teaching practices in South Australia. Each option was compared with the traditional model of teaching where one GP supervisor is singularly responsible for one learner. The main outcome measure was net financial outcome per week. Decisions on the model cost parameters were made by the study's Steering Group which comprised of experienced GP supervisors. Four teaching models are presented. Model 1 investigates the gains from teaching multiple same level learners, Models 2 and 3, the benefits of vertically integrated teaching using different permutations, and Model 4 the concept of a GP teacher who undertakes all the teaching. Results There was a significant increase in net benefits of Aus$547 per week (95% confidence intervals $459, $668 to the practice when a GP taught two same level learners (Model 1 and when a senior registrar participated in teaching a prevocational doctor (Model 3, Aus$263, 95% confidence intervals $80, $570. For Model 2, a practice could significantly reduce the loss if a registrar was involved in vertically integrated teaching which included the training of a medical student (Aus

  5. * Department of Radiology, University of Benin Teaching Hospital ...

    African Journals Online (AJOL)

    Department of Radiology, University of Benin Teaching Hospital, Benin City, Edo State,. Nigeria. **Department of Radiodiagnosis, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria. ABSTRACT. Fibular hemimelia is the congenital absence of the fibula and it is the most common congenital absence of long.

  6. Stroke Risk Factors among Patients in a Nigerian Teaching Hospital ...

    African Journals Online (AJOL)

    Background and Purpose: Epidemiological studies have identified modifiable and non-modifiable risk factors for stroke. The aim of this study was to describe the risk factors in stroke patients admitted in a Nigerian teaching hospital. Methods: This is a prospective study carried out in the Jos University Teaching Hospital in ...

  7. Presentation of Colorectal Cancer in Khartoum Teaching Hospital ...

    African Journals Online (AJOL)

    Aims: To determine the age and gender distribution in Sudanese patients with colorectal cancer, as seen in Khartoum Teaching Hospital, and to study its emergency presentation. Patients and Methods: This retrospective study was conducted in Khartoum Teaching Hospital (Sudan). Two hundred and seventy seven (277) ...

  8. Elective Hysterectomy at the University of Uyo Teaching Hospital: A ...

    African Journals Online (AJOL)

    Elective Hysterectomy at the University of Uyo Teaching Hospital: A 3-Year Review. AM Abasiattai, EA Bassey, AJ Umoiyoho. Abstract. A 3-year review of elective hysterectomies performed at the University of Uyo Teaching Hospital was carried out. The aim was to determine the indications and outcome of elective ...

  9. Neurocysticercosis - experience at the teaching hospitals of the ...

    African Journals Online (AJOL)

    Neurocysticercosis - experience at the teaching hospitals of the University of Cape Town. AJG Thomson. Abstract. In the 15 years 1975-1989, 239 patients attending the associated teaching hospitals of the University of Cape Town have been identified retrospectively as having neurocysticercosis. One hundred and ...

  10. Gynecological malignancies in Aminu Kano Teaching Hospital Kano ...

    African Journals Online (AJOL)

    Objective: To study the pattern of gynecological malignancies in Aminu Kano Teaching Hospital. Materials and Methods: This was a retrospective observational study carried out in the Gynecology Department of Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria between October 2008 and September 2011. Case

  11. Frequency of endodontic treatment in a Nigerian Teaching Hospital ...

    African Journals Online (AJOL)

    Objective: To determine the frequency of endodontic treatment in dental patients treated in a Nigerian Teaching Hospital. Method: A survey of 470 patients undergoing endodontic treatment at the conservative clinic of the department of restorative dentistry of Lagos University Teaching Hospital was conducted to determine ...

  12. Hydatidiform mole in Aminu Kano teaching hospital, northwestern ...

    African Journals Online (AJOL)

    Objective: This study is aimed at determining the incidence of hydatidiform mole in Aminu Kano Teaching Hospital (AKTH), its age distribution, complication and outcome. Study Design: A retrospective review of case of hydatidiform mole managed in Aminu Kano Teaching Hospital, Kano between 1st January, 2009 and 31st ...

  13. Net Income of Pharmacy Faculty Compared to Community and Hospital Pharmacists.

    Science.gov (United States)

    Chisholm-Burns, Marie A; Gatwood, Justin; Spivey, Christina A; Dickey, Susan E

    2016-09-25

    Objective. To compare the net cumulative income of community pharmacists, hospital pharmacists, and full-time pharmacy faculty members (residency-trained or with a PhD after obtaining a PharmD) in pharmacy practice, medicinal chemistry, pharmaceutics, pharmacology, and social and administrative sciences. Methods. Markov modeling was conducted to calculate net projected cumulative earnings of career paths by estimating the costs of education, including the costs of obtaining degrees and student loans. Results. The economic model spanned 49 years, from ages 18 to 67 years. Earning a PharmD and pursuing an academic career resulted in projected net cumulative lifetime earnings ranging from approximately $4.7 million to $6.3 million. A pharmacy practice faculty position following public pharmacy school and one year of residency resulted in higher net cumulative income than community pharmacy. Faculty members with postgraduate year 1 (PGY1) training also had higher net income than other faculty and hospital pharmacy career paths, given similar years of prepharmacy education and type of pharmacy school attended. Faculty members with either a PharmD or PhD in the pharmacology discipline may net as much as $5.9 million and outpace all other PhD graduates by at least $75 000 in lifetime earnings. Projected career earnings of postgraduate year 2 (PGY2) trained faculty and PharmD/PhD faculty members were lower than those of community pharmacists. Findings were more variable when comparing pharmacy faculty members and hospital pharmacists. Conclusion. With the exception of PGY1 trained academic pharmacists, faculty projected net cumulative incomes generally lagged behind community pharmacists, likely because of delayed entry into the job market as a result of advanced training/education. However, nonsalary benefits such as greater flexibility and autonomy may enhance the desirability of academic pharmacy as a career path.

  14. 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.

  15. Juba Teaching Hospital College of Nursing and Midwifery Health ...

    African Journals Online (AJOL)

    Angel_D

    more trained staff, particularly nurses and midwives. In March 2008 a team from the St Mary's Hospital, Isle of Wight,. UK working with staff at Juba Teaching Hospital identified several problems related to nursing and midwifery in the hospital. Apart from the lack of sufficient trained staff, particularly midwives, the most serious ...

  16. Case control study of episiotomy in the University Teaching Hospital ...

    African Journals Online (AJOL)

    The aim of the study was to determine the incidence and identify the factors influencing the practice of episiotomy during delivery in the University Teaching Hospital, Yaounde. It is a retrospective review of all vaginal deliveries conducted in this hospital between January 2001 and December 2002 was undertaken to identify ...

  17. Post-neonatal tetanus in University of Maiduguri Teaching Hospital ...

    African Journals Online (AJOL)

    Background: Tetanus is a public health problem in Nigeria. This study examines the demographic and clinical profile of postneonatal tetanus (PNT) seen in University of Maiduguri Teaching Hospital (UMTH), North- eastern Nigeria. Methods: This is a hospital-based prospective study of PNT. All children beyond the neonatal ...

  18. Safety-net Hospitals Face More Barriers Yet Use Fewer Strategies to Reduce Readmissions.

    Science.gov (United States)

    Figueroa, Jose F; Joynt, Karen E; Zhou, Xiner; Orav, Endel J; Jha, Ashish K

    2017-03-01

    US hospitals that care for vulnerable populations, "safety-net hospitals" (SNHs), are more likely to incur penalties under the Hospital Readmissions Reduction Program, which penalizes hospitals with higher-than-expected readmissions. Understanding whether SNHs face unique barriers to reducing readmissions or whether they underuse readmission-prevention strategies is important. We surveyed leadership at 1600 US acute care hospitals, of whom 980 participated, between June 2013 and January 2014. Responses on 28 questions on readmission-related barriers and strategies were compared between SNHs and non-SNHs, adjusting for nonresponse and sampling strategy. We further compared responses between high-performing SNHs and low-performing SNHs. We achieved a 62% response rate. SNHs were more likely to report patient-related barriers, including lack of transportation, homelessness, and language barriers compared with non-SNHs (P-valuesbarriers, SNHs were less likely to use e-tools to share discharge summaries (70.1% vs. 73.7%, Pbarriers to reducing readmissions, SNHs were less likely to use readmission-reduction strategies. This combination of higher barriers and lower use of strategies may explain why SNHs have higher rates of readmissions and penalties under the Hospital Readmissions Reduction Program.

  19. Traumatic haemoperitoneum at Butare University Teaching Hospital ...

    African Journals Online (AJOL)

    The time interval between the trauma and the patient arrival at the hospital and management varied between 30 minutes and 24 hours with the medium of 12.7 hours. The majority (71.6%) of the patients were received in hospital within the first 6 hours after the trauma. Abdominal paracentesis or diagnostic peritoneal lavage ...

  20. High priority for hepatitis C screening in safety net hospitals: Results from a prospective cohort of 4582 hospitalized baby boomers.

    Science.gov (United States)

    Turner, Barbara J; Taylor, Barbara S; Hanson, Joshua; Liang, Yuanyuan; Veerapaneni, Poornachand; Villarreal, Roberto; Perez, Mary; Hernandez, Ludivina; Sandhu, Jasdeep; Fiebelkorn, Kristin

    2015-11-01

    Low-income populations are disproportionately affected by hepatitis C virus (HCV) infection. Thus, implementing baby boomer screening (born 1945-1965) for HCV may be a high priority for safety net hospitals. We report the prevalence and predictors of HCV infection and advanced fibrosis or cirrhosis based on the Fibrosis-4 score plus imaging for a baby boomer cohort admitted to a safety net hospital over a 21-month interval with >9 months of follow-up. Anti-HCV antibody testing was performed for 4582, or 90%, of all never-screened patients, of whom 312 (6.7%) tested positive. Adjusted odds ratios of testing anti-HCV-positive were 2.66 for men versus women (Pbaby boomers were diagnosed with chronic HCV, nearly twice the rate in the community; one-third had noninvasive testing that indicated advanced fibrosis or cirrhosis, which was significantly more likely for Hispanics, those of older age, those with obesity, those with alcohol abuse/dependence, and those who lacked insurance. © 2015 by the American Association for the Study of Liver Diseases.

  1. Impact of teaching intensity and academic status on medical resource utilization by teaching hospitals in Japan.

    Science.gov (United States)

    Sato, Daisuke; Fushimi, Kiyohide

    2012-11-01

    Teaching hospitals require excess medical resources to maintain high-quality care and medical education. To evaluate the appropriateness of such surplus costs, we examined the impact of teaching intensity defined as activities for postgraduate training, and academic status as functions of medical research and undergraduate teaching on medical resource utilization. Administrative data for 47,397 discharges from 40 academic and 12 non-academic teaching hospitals in Japan were collected. Hospitals were classified into three groups according to intern/resident-to-bed (IRB) ratio. Resource utilization of medical services was estimated using fee-for-service charge schedules and normalized with case mix grouping. 15-24% more resource utilization for laboratory examinations, radiological imaging, and medications were observed in hospitals with higher IRB ratios. With multivariate adjustment for case mix and academic status, higher IRB ratios were associated with 10-15% more use of radiological imaging, injections, and medications; up to 5% shorter hospital stays; and not with total resource utilization. Conversely, academic status was associated with 21-33% more laboratory examinations, radiological imaging, and medications; 13% longer hospital stays; and 10% more total resource utilization. While differences in medical resource utilization by teaching intensity may not be associated with indirect educational costs, those by academic status may be. Therefore, academic hospitals may need efficiency improvement and financial compensation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Relationship of Hospital Teaching Status with in-Hospital Outcomes for ST-Segment Elevation Myocardial Infarction.

    Science.gov (United States)

    Gupta, Tanush; Patel, Kavisha; Kolte, Dhaval; Khera, Sahil; Villablanca, Pedro A; Aronow, Wilbert S; Frishman, William H; Cooper, Howard A; Bortnick, Anna E; Fonarow, Gregg C; Panza, Julio A; Weisz, Giora; Menegus, Mark A; Garcia, Mario J; Bhatt, Deepak L

    2017-10-13

    Prior analyses have largely shown a survival advantage with admission to a teaching hospital for acute myocardial infarction. However, most prior studies report data on patients hospitalized over a decade ago. It is important to re-examine the association of hospital teaching status with outcomes of acute myocardial infarction in the current era. We queried the 2010 to 2014 National Inpatient Sample databases to identify all patients aged ≥18 years hospitalized with the principal diagnosis of ST-segment elevation myocardial infarction (STEMI). Multivariable logistic regression models were constructed to compare rates of reperfusion and in-hospital outcomes between patients admitted to teaching vs. non-teaching hospitals. Of 546,252 patients with STEMI, 273,990 (50.1%) were admitted to teaching hospitals. Compared with patients admitted to non-teaching hospitals, those at teaching hospitals were more likely to receive reperfusion therapy during the hospitalization (86.7% vs. 81.5%; adjusted OR, 1.41; 95% CI, 1.39-1.44; P<0.001) and had lower risk-adjusted in-hospital mortality (4.9% vs. 6.9%; adjusted OR, 0.84; 95% CI, 0.82-0.86; P<0.001). After further adjustment for differences in use of in-hospital reperfusion therapy, the association of teaching hospital status with lower risk-adjusted in-hospital mortality was significantly attenuated but remained statistically significant (adjusted OR, 0.97; 95% CI, 0.94-0.99; P=0.02). Patients admitted to teaching hospitals are more likely to receive reperfusion and have lower risk-adjusted in-hospital mortality after STEMI compared with those admitted to non-teaching hospitals. Our results suggest that hospital performance for STEMI continues to be better at teaching hospitals in the contemporary era. Copyright © 2017. Published by Elsevier Inc.

  3. [Teaching and research in high specialty hospitals].

    Science.gov (United States)

    Lifshitz, Alberto

    2011-01-01

    Education and research are strategic activities leading to development and progress of a hospital, so planning on this matter is fundamental, both in terms of structure and infrastructure. Investment on faculty development and on researchers should be considered beyond the short term. Education should respond to the necessities and research to health priorities through formal agreements with universities and institutes.

  4. Head injury: Calabar Teaching Hospital experience | Ikpeme ...

    African Journals Online (AJOL)

    The pattern and distribution of head injuries shows that a typical head injured patient in our locality is a male, aged between 21 and 30 years involved in a motorcycle related accident. Accidents frequently occured between 7 and 9pm and though 75% of patients arrived in hospital within 6 hours of injury, 17% of all cases ...

  5. Singleton preterm births in Korle bu teaching hospital, Accra, Ghana ...

    African Journals Online (AJOL)

    Objective: To determine the singleton preterm birth rate, the relative proportions of the clinical categories of preterm births and to compare the outcomes in these categories. Setting: Department of Obstetrics & Gynaecol-ogy, Korle Bu Teaching Hospital. Participants: Preterm births from 1st July to 31st December 2003.

  6. Experience with norplant at a Nigerian Teaching Hospital | Mutihir ...

    African Journals Online (AJOL)

    Experience with norplant at a Nigerian Teaching Hospital. ... Conclusion: Norplant implants provided contraceptive protection with high reliability, safety, independence from user compliance, rapid return of pre-existing fertility after removal, good tolerability, and relatively simple and quick insertion and removal.

  7. Retention of Medical Records in Ghanaian Teaching Hospitals ...

    African Journals Online (AJOL)

    Retention of Medical Records in Ghanaian Teaching Hospitals: Some International Perspectives. ... The study revealed that the problems inherent in the retention of management of non-current medical records are due to the absence of formal guidelines and procedures, and to the fact that those that exist are not properly ...

  8. Trends in Maternal Morlility in Tamale Teaching Hospital, Ghana ...

    African Journals Online (AJOL)

    ... of Obstetrics and Gynaecology, Tamale Teaching Hospital Methods: Data on maternal deaths that occurred over the review period were obtained from the patient folders, departmental monthly reports, midwifery monthly returns, audit reports, theatre, intensive care unit, maternity, gynaecology and the labour ward records.

  9. Stroke mortality and its predictors in a Nigerian teaching hospital ...

    African Journals Online (AJOL)

    Background: Stroke is the third leading cause of death worldwide. Stroke mortality has been noted to be higher in blacks in biracial studies. There have been few studies on stroke mortality and its predictors in Nigeria. This study examines mortality of stroke and its predictors in a Northern Nigerian teaching hospital.

  10. Paediatric Hand Injuries At The Lagos University Teaching Hospital ...

    African Journals Online (AJOL)

    Background: Paediatric hand trauma represents a subset of hand injury that can be quite challenging to manage. Local studies on this injuries are few therefore a 4 year retrospective study at the Trauma and hand rehabilitation unit of the Lagos University teaching hospital was carried out. Objectives: To determine the ...

  11. Hypospadias Surgery at Korle-Bu Teaching hospital, Ghana: A ...

    African Journals Online (AJOL)

    This study aimed to review experience in the management of hypospadias at a tertiary Paediatric Surgery Centre,Accra,Ghana. This was a prospective study of patientsmanaged for hypospadias at the Paediatric Surgery Unit of the Korle-Bu Teaching hospital, between 1st January 2004 and 30th September 2005.

  12. 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: ...

  13. Utilization of oral anticoagulation in a teaching hospital in Nigeria ...

    African Journals Online (AJOL)

    Background: Anticoagulation is an essential lifesaving management practice indicated for arterial, venous and intracardiac thromboembolism. Aim: This study was undertaken to examine the utilization of anticoagulation services in University of Nigeria Teaching Hospital, Enugu (UNTH) Nigeria. Materials and Methods: This ...

  14. Utilization of Oral Anticoagulation in a Teaching Hospital in Nigeria

    African Journals Online (AJOL)

    or patients monitored outside the teaching hospital were excluded from this survey. Anticoagulation monitoring was with INR. Recommended therapeutic ranges of INR are 2.0-3.0 for most disease indications, and 2.0-3.5 with cardiac valve prostheses.[1,2]. Target INR was defined by the attainment of therapeutic ranges of ...

  15. Abdominal Injuries in University of Port Harcourt Teaching Hospital

    African Journals Online (AJOL)

    Amabra Dodiyi‑Manuel, Nze Japhet Jebbin, Patrick Okechukwu Igwe. Department ... Dodiyi‑Manuel, et al.: Abdominal injuries in university of Port Harcourt Teaching Hospital. 19. Nigerian Journal of Surgery. Jan‑Jun 2015 | Volume 21 | Issue 1. RESULTS ... continues to pose a major public health challenge in every country.

  16. TEACHING AND REFERRAL HOSPITAL, ELDORET, KENYA _ v v

    African Journals Online (AJOL)

    2004-08-01

    Aug 1, 2004 ... Design: This was a prospective case control study. Study site: The study ... Ethics Committee of the Moi Teaching and Referral Hospital. The study was ... the attending clinicians. RESULTS. Demographic data: A total of 132 children (66 cases and 66 controls) and their mothers were included in the study.

  17. Ovarian malignancy at the Jos University Teaching Hospital, Jos ...

    African Journals Online (AJOL)

    To establish the relative frequency, age distribution, socio-demographic risk factors, clinical presentation, management and histological variants of ovarian cancerseen within the study period. METHODOLOGY: A retrospective review of all cases of ovarian cancer seen at the Jos University TeachingHospital, Jos, Plateau ...

  18. Paediatric cancers at Butare University Teaching Hospital in Rwanda

    African Journals Online (AJOL)

    Paediatric cancers at Butare University Teaching Hospital in Rwanda. ... Background: Cancer is an important cause of mortality in many of the economically developed nations of the world. More than 10% of all ... The peak incidence of cancer was found in the 0-5 years age group and accounted for 21 patients (58, 3%).

  19. 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 ...

  20. 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.

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

    African Journals Online (AJOL)

    Background/Objectives: Pneumonia is a leading cause of morbidity and mortality in children and thus this study was designed to document the sociodemographic, clinical features as well as the bacterial agents responsible for pneumonia in children seen at University of Ilorin Teaching Hospital. Methodology: A descriptive ...

  2. 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 ...

  3. experience with norplant at a nigerian teaching hospital

    African Journals Online (AJOL)

    2010-11-11

    Nov 11, 2010 ... contraceptive methods in the family planning clinic of Jos University Teaching Hospital,. Nigeria. Norplant ... range of family planning methods. ..... Segal, S.J. and Croxatto, H.B. Single administration of Hormones for long-term control of Reproductive function. Paper presented at meeting of the American.

  4. Responsibly managing the medical school--teaching hospital power relationship.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2005-07-01

    The relationship between medical schools and their teaching hospitals involves a complex and variable mixture of monopoly and monopsony power, which has not been previously been ethically analyzed. As a consequence, there is currently no ethical framework to guide leaders of both institutions in the responsible management of this complex power relationship. The authors define these two forms of power and, using economic concepts, analyze the nature of such power in the medical school-teaching hospital relationship, emphasizing the potential for exploitation. Using concepts from both business ethics and medical ethics, the authors analyze the nature of transparency and co-fiduciary responsibility in this relationship. On the basis of both rational self-interest, drawn from business ethics, and co-fiduciary responsibility, drawn from medical ethics, they argue for the centrality of transparency in the medical school-teaching hospital relationship. Understanding the ethics of monopoly and monopsony power is essential for the responsible management of the complex relationship between medical schools and their teaching hospitals and can assist the leadership of academic health centers in carrying out one of their major responsibilities: to prevent the exploitation of monopoly power and monopsony power in this relationship.

  5. Abdominal Hysterectomy at University of Ilorin Teaching Hospital: A ...

    African Journals Online (AJOL)

    Abdominal Hysterectomy at University of Ilorin Teaching Hospital: A 5-year Review. ... Conclusion: Abdominal hysterectomy is a safe operative procedure and i/t is a viable treatment option to a variety of gynaecological disorders. Adequate preoperative assessment, intraoperative and post operative measures to reduce ...

  6. 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 ...

  7. 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 ...

  8. Laryngeal cancer at the Korle Bu Teaching Hospital, Accra, Ghana ...

    African Journals Online (AJOL)

    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. Method: One hundred and fifteen (115) patients who were managed for laryngeal cancer from 1 st January 1998 ...

  9. Gestational age at booking in Imo State University Teaching Hospital.

    African Journals Online (AJOL)

    Gestational age at booking in Imo State University Teaching Hospital. E Ojiyi, E.I Dike. Abstract. No Abstract Available. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading ... Metrics powered by PLOS ALM

  10. Utilization of Oral Anticoagulation in a Teaching Hospital in Nigeria

    African Journals Online (AJOL)

    vitamin K-dependent clotting factors, which include factors. II, VII, IX, and X, and the anticoagulant proteins C and S. Vitamin K is an essential cofactor for the post ribosomal synthesis of the vitamin K-dependent clotting factors. Utilization of Oral Anticoagulation in a Teaching. Hospital in Nigeria. Anakwue RC, Ocheni S1, ...

  11. Audit of stillbirths in a Nigerian teaching hospital

    African Journals Online (AJOL)

    Kuti, et al.: Audit of stillbirth in a Nigerian teaching hospital. 193. Tropical Journal of Obstetrics and Gynaecology / Volume 34 / Issue 3 / September‑December 2017. 4. Obstetrics complication. 1. Pregnancy induced hypertension. 2. Gestational diabetes. 3. Polyhydramnios. 4. Prolonged pregnancy. 5. Infection. 1. Malaria. 2.

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

    African Journals Online (AJOL)

    owner

    Johnson WBR. Adeboye MAN. Childhood pneumonia at the. University of Ilorin Teaching. Hospital, Ilorin Nigeria. Accepted: 9th January 2013. Abdulkarim AA. Ibraheem RM, Adegboye AO,. Johnson WBR, Adeboye MAN ..... lobar pneumonia. Ann Trop Paedi- atr 1997;17:315-19. 7. Fagbule D, Parakoyi DB, Spiegel.

  13. vanishing bone disease in a tertiary teaching hospital in uganda

    African Journals Online (AJOL)

    do not have pathologists or radiologists. We therefore present a case of Gorham's disease which was initially thought to be a malignant disease, diagnosed in Mulago. Teaching Hospital in Uganda. CASE REPORT. A 27 year-old male presented to the Orthopaedic out- patient clinic with a 5 month history of a painful mass.

  14. Prevalence of ototoxicity in University of Benin Teaching Hospital ...

    African Journals Online (AJOL)

    Background: Ototoxicity refers to damage of the cochlea and/or vestibular apparatus from exposure to chemical substances, resulting in hearing impairment and or disequilibrium. An earlier study carried out at University of Benin Teaching Hospital (UBTH) in 2000 implicated chloramphenicol as the commonest ototoxic drug ...

  15. Prevalence of ototoxicity in University of Benin Teaching Hospital ...

    African Journals Online (AJOL)

    2012-01-23

    Jan 23, 2012 ... Background: Ototoxicity refers to damage of the cochlea and/or vestibular apparatus from exposure to chemical substances, resulting in hearing impairment and or disequilibrium. An earlier study carried out at University of Benin Teaching. Hospital (UBTH) in 2000 implicated chloramphenicol as the ...

  16. Childhood malignancies in University of Abuja Teaching Hospital ...

    African Journals Online (AJOL)

    Prof Ezechukwu

    2011-12-20

    Dec 20, 2011 ... Abstract: Background: Mortality from malignancies in children re- mains high. Creating awareness of the disease and advocacy for fund- ing of a cancer research center are pertinent. Objective: To determine the inci- dence and outcome of children with cancers at the University of Abuja. Teaching Hospital ...

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

    African Journals Online (AJOL)

    Eight hundred and eighty two slides of cases of endometrial disorders recorded in the register of the Department of Pathology, University of Ilorin Teaching Hospital, Ilorin, North Central Nigeria were reviewed. Clinical data on each of the cases was retrieved from request cards. The pathological reports and clinical data ...

  18. 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 ...

  19. Limb amputations in adults in an Ivorian Teaching Hospital | Essoh ...

    African Journals Online (AJOL)

    Objective: To determine the pattern of limb amputations and preventable indications. Design: A retrospective study. Setting: Department of orthopaedic surgery, Yopougon Teaching Hospital, Abidjan, Côte d\\'Ivoire. Patients and methods: One hundred fifty-six patients with amputations over an 11-year period from January ...

  20. The Intensive Care Unit of the University Teaching Hospital, Ilorin ...

    African Journals Online (AJOL)

    A retrospective study was conducted on all patients admitted to the Intensive Care Unit (ICU) of the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria, over a 10 - year period (October 1991 - Sept. 2001). This period marks the first decade of the establishment of our ICU. The purpose of this study is to describe the ...

  1. The nurse in the management of materials in teaching hospitals

    Directory of Open Access Journals (Sweden)

    Priscila Conde Bogo

    2015-08-01

    Full Text Available OBJECTIVETo present the nurse's integration within materials management of six teaching hospitals of Paraná - Brazil, and to describe the activities performed by nurses within this process.METHODA study of a qualitative approach and descriptive nature, conducted in teaching hospitals in Paraná, between June and August of 2013. The data collection was conducted through semi-structured interviews with eight nurses who worked in materials management; data were analyzed using content analysis.RESULTSThese showed that nurses perform ten categories of activities, distributed into four of the five steps of the materials management process.CONCLUSIONThe nurse, in performing of these activities, in addition to favoring the development of participative management, contributes to the organization, planning, and the standardization of the hospital supply process, giving greater credibility to the work with professionals who use the materials, and to the suppliers.

  2. 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.

  3. From striving to thriving: systems thinking, strategy, and the performance of safety net hospitals.

    Science.gov (United States)

    Clark, Jonathan; Singer, Sara; Kane, Nancy; Valentine, Melissa

    2013-01-01

    Safety net hospitals (SNH) have, on average, experienced declining financial margins and faced an elevated risk of closure over the past decade. Despite these challenges, not all SNHs are weakening and some are prospering. These higher-performing SNHs provide substantial care to safety net populations and produce sustainable financial returns. Drawing on the alternative structural positioning and resource-based views, we explore strategic management as a source of performance differences across SNHs. We employ a mixed-method design, blending quantitative and qualitative data and analysis. We measure financial performance using hospital operating margin and quantitatively evaluate its relationship with a limited set of well-defined structural positions. We further evaluate these structures and also explore the internal resources of SNHs based on nine in-depth case studies developed from site visits and extensive interviews. Quantitative results suggest that structural positions alone are not related to performance. Comparative case studies suggest that higher-performing SNH differ in four respects: (1) coordinating patient flow across the care continuum, (2) engaging in partnerships with other providers, (3) managing scope of services, and (4) investing in human capital. On the basis of these findings, we propose a model of strategic action related to systems thinking--the ability to see wholes and interrelationships rather than individual parts alone. Our exploratory findings suggest the need to move beyond generic strategies alone and acknowledge the importance of underlying managerial capabilities. Specifically, our findings suggest that effective strategy is a function of both the internal resources (e.g., managers' systems-thinking capability) and structural positions (e.g., partnerships) of organizations. From this perspective, framing resources and positioning as distinct alternatives misses the nuances of how strategic advantage is actually achieved.

  4. 78 FR 32663 - Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for...

    Science.gov (United States)

    2013-05-31

    ... Process CMS has learned of the closure of two teaching hospitals; Infirmary West Hospital of Mobile, AL... 5'') of the application and selection process. The table below identifies the two closed teaching... Teaching Hospitals and Opportunity To Apply for Available Slots AGENCY: Centers for Medicare & Medicaid...

  5. Circumcision: Perspective in a Nigerian teaching hospital

    Directory of Open Access Journals (Sweden)

    L O Abdur-Rahman

    2013-01-01

    Full Text Available Background: The practice and pattern of male infants circumcised is influenced by culture, religion and socio-economic classification. The debate about the benefits and risks of circumcision has made a hospital-based practice the most acceptable. Objective: The objective of this study is to evaluate the ages, indications, co-morbidity, types and methods of circumcision, usage and mode of anaesthesia and outcome of male circumcision at a tertiary health centre in Nigeria. Materials and Methods: A retrospective review of male circumcision in a paediatric surgery unit was done from January 2002 to December 2007. The data was analysed using SPSS software version 15. Results: There were 438 boys with age ranged between 6 days and 10 years (median 28 days, mean 53.6 days standard deviation 74.2. Neonatal circumcision (<29 days was 201 (46% and 318 (72.6% of the children were circumcised by the 3 rd month of live. Religion or tradition were the major indicators in 384 (87.7% patients while phimosis 38 (8.7%, paraphimosis 4 (1%, redundant post circumcision skin 10 (2.3% and defective prepuce in 2 (0.5% were other indications. Plastibel™ (PD was used in 214 (48.9%, classical circumcision 194 (44.2%, guillotine technique (GT and Gomco™ 10 (2.3% cases each while 10 (2.3% had a refashioning/re-excision post previous circumcision. There was an increase in use of PD, drop in the use of GT; and increase in the number of circumcision done over the years. Only 39.7% had anaesthesia administered and complication rate was 6.7%. Conclusion: Neonatal circumcision was highest in the hospital-based circumcision practice, which allowed the expected ideals in the use of devices in a tertiary health centre. However, the low rate of anaesthetic use is unacceptable.

  6. Evaluation of Parenteral Opioid Analgesics Utilization in Patients Hospitalized in a Referral Teaching Hospital

    OpenAIRE

    Rasool Soltani; Hossein Vatanpour; Fatemeh Shafiee; Niloofar Sadeghian

    2016-01-01

    Background: Opioid drugs are the most effective drugs for the treatment of moderate to severe pain. Rates of opioid use are influenced by a variety of factors. The aim of this study was to determine the pattern of use of parenteral opioid drugs in hospitalized patients in a referral teaching hospital. Methods: In a retrospective study, required data were extracted from medical records of adult patients who had received any parenteral opioid analgesic in the 6-month period from March 2013 to S...

  7. Hip fractures in a tropical teaching hospital.

    Science.gov (United States)

    Ogunlade, S O; Alonge, T O; Idowu, O E

    2003-03-01

    The pattern of hip fractures, treatment, outcome of treatment, and complications of forty-four consecutive patients treated over a five-year period were retrospectively studied. This represents 3.5% of the hospitalised patients in orthopaedic services. The male:female ratio was 1:1.3. Seventy percent of the fractures occurred in those over 65 years of age. The fractures were the result of low energy trauma in 81.8% of patients. Intracapsular (cervical) fractures accounted for 79.5% of the total cases. Only two patients had associated injuries on admission. Austin Moore hemiarthroplasty was the choice of hip replacement for intracapsular fractures, while ORIF (Open reduction and internal fixation using fixed angle blade plate) was done for patients with (extracapsular) trochanteric fractures. Anaesthesia (general or regional) was uneventful. Non-fatal pulmonary embolism occurred in one patient post-hemiarthroplasty while in the hospital. This study shows that hip fractures are not uncommon in our environment although far less common than what obtains in the Caucasians.

  8. Humanized Care: insertion of obstetric nurses in a teaching hospital.

    Science.gov (United States)

    Medeiros, Renata Marien Knupp; Teixeira, Renata Cristina; Nicolini, Ana Beatriz; Alvares, Aline Spanevello; Corrêa, Áurea Christina de Paula; Martins, Débora Prado

    2016-01-01

    to evaluate the care provided at an Antepartum, Intrapartum, Postpartum (AIP) unit at a teaching hospital following the inclusion of obstetric nurses. transversal study, performed at a AIP unit at a teaching hospital in the capital of the Brazilian state of Mato Grosso. The sample comprised data regarding the 701 childbirths that took place between 2014 and 2016. The data were organized using Excel and analyzed using version 7 of Epi Info software. the results suggest that including obstetric nurses contributed towards qualifying the care provided during labor and childbirth, followed by a reduction in the number of interventions, such as episiotomy caesareans sections, and resulting in encouragement to employ practices that do not interfere in the physiology of the parturition process, which in turn generate good perinatal results. inserting these nurses collaborated towards humanizing obstetric and neonatal care.

  9. Assessing hospital disaster preparedness in Shiraz, Iran 2011: teaching versus private hospitals.

    Science.gov (United States)

    Mahdaviazad, Hamideh; Abdolahifar, Gholam Reza

    2013-01-01

    In disasters, hospitals play a crucial role in supplying essential medical care to the society but there is no standardized checklist for assessing hospital disaster preparedness. The objective of this study was to recognize and compare almost all the components of disaster preparedness between teaching and private hospitals in Shiraz, Iran, focusing on incident command systems (ICS), communications, surge capacity, human resources, supply management, logistic service, case management, surveillance, laboratory and operating room management. From May to August 2011, we assessed the preparedness of teaching and private hospitals in Shiraz, using the 10-key component World Health Organization checklist. Twenty four out of 31 hospitals responded. The scores for preparedness of ICS, communication, surge capacity and human resources was 73.9 percent, 67.3 percent, 49 percent, and 52.6 percent respectively. The preparedness scores for supply management and logistic services were 68.5 percent and 61.8 percent. While the levels of preparedness of laboratory and operating room management were low, preparedness of the surveillance system and case management were 66.7 percent and 70.8 percent, respectively. The average total preparedness of all hospitals was 59.5 percent, with scores of 62.2 percent in teaching hospitals and 55 percent in private hospitals. At the time of our study, the total preparedness among hospitals was at the intermediate level, but in some key components such as operating room management, surge capacity, and human resources, the total preparedness was very limited and at an early stage of development, therefore, requiring urgent attention and improvement.

  10. Utilization of PMTCT services at Juba Teaching Hospital, South Sudan

    African Journals Online (AJOL)

    and ART treatment;. Testing positive who delivered in a facility and were. 3. Utilization of PMTCT services at Juba Teaching. Hospital, South Sudan. Idyoro Joseph .... Alive. Yes. No. 297. 3. 99.0. 1.0. Educational level. None. Primary. Intermediate. Secondary. College/university. 14. 46. 11. 118. 111. 4.7. 15.3. 3.7. 39.3. 37.0.

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

    OpenAIRE

    Siman, Andréia Guerra; Cunha, Simone Graziele Silva; Brito, Maria José Menezes

    2017-01-01

    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...

  12. Patient and disease profile of emergency medical readmissions to an Irish teaching hospital

    OpenAIRE

    Moloney, E.; Bennett, K.; Silke, B

    2004-01-01

    Objective: To determine whether there was a relationship between coded diseases at the time of hospital discharge, a pattern of ordering investigations, and hospital readmission in a major teaching hospital.

  13. Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital

    Directory of Open Access Journals (Sweden)

    Fabiana Rossi Varallo

    2014-03-01

    Full Text Available OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to December 2008. All patients aged ≥18 years with a length of stay ≥24 hours were interviewed about the drugs used prior to hospital admission and their symptoms/complaints/causes of hospitalization. RESULTS: In total, 248 patients were considered eligible. The prevalence of hospitalization due to potential adverse drug events in the ward was 46.4%. Overprescribed drugs and those indicated for prophylactic treatments were frequently associated with possible adverse drug events. Frequently reported symptoms were breathlessness (15.2%, fatigue (12.3%, and chest pain (9.0%. Polypharmacy was a risk factor for the occurrence of possible adverse drug events. CONCLUSION: Possible adverse drug events led to hospitalization in a high-complexity hospital, mainly in polymedicated patients. The clinical outcomes of adverse drug events are nonspecific, which delays treatment, hinders causality analysis, and contributes to the underreporting of cases.

  14. Epidemiology of systemic inflammatory response syndrome and sepsis in cats hospitalized in a veterinary teaching hospital.

    Science.gov (United States)

    Babyak, Jonathan M; Sharp, Claire R

    2016-07-01

    OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate.

  15. Prescription writing quality in paediatric teaching hospitals in Khartoum.

    Science.gov (United States)

    Abdellah, Amira E; Abdelrahman, Sirageldin M K

    2012-01-01

    This study was conducted to analyze the quality of prescription writing of doctors in outpatient departments of paediatric teaching hospitals in Khartoum. This study is a descriptive cross- sectional, prospective, hospital based study. Nine hundred paediatric prescriptions collected from three paediatric teaching hospitals were analyzed. Three hundred prescriptions were also collected from doctors after giving them a case scenario for which they were asked to write appropriate prescriptions. These prescriptions were also analyzed for their completeness. Inadequate writing of the sex of the patient, weight, and height were notable regarding patient information. Generic names, concentration of the drug and treatment duration of the drug were poorly mentioned. Designation and identification of the prescriber were not adequately mentioned. In the case scenario 65.3 % of doctors wrote low quality prescriptions. Registrars wrote better prescriptions than medical officers who wrote better than house officers. Outpatient department prescriptions were unsatisfactory due to lack of necessary information for the ideal prescription. Also doctors, in response to case scenario, wrote low quality prescriptions. To improve prescription writing skills, we suggest that hospitals should provide standard prescription forms that contain the necessary fields for identification of both, patient and doctor.

  16. 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.

  17. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... services furnished in a teaching hospital. (g) Aggregate per diem methods of apportionment—(1) For the... 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...

  18. Social Support Behaviors and Work Stressors among Nurses: A Comparative Study between Teaching and Non-Teaching Hospitals.

    Science.gov (United States)

    Amarneh, Basil Hameed

    2017-01-29

    The concept of "work stressors" has been well studied. However, in the field of nursing, studies concerning social support behaviors are limited. The aim of this study was to compare nurse work stressors, social support behaviors, and predictors of these variables among nurses in Jordanian teaching and non-teaching hospitals. A convenience sampling technique and a comparative quantitative research design were used in the current study. Two hundred and ninety-one nurses were recruited from five teaching hospitals, and 172 were recruited from eight non-teaching hospitals in Jordan. The Nursing Stress Scale (NSS) and the Inventory of Social Supportive Behaviors (ISSB) were used to collect data. The studied variables differed across hospitals. In some subscales, as well as in some individual items of the scales, nurse work stressors and social support behaviors differed between teaching and non-teaching hospitals. In teaching hospitals, the work shift was the only predictor of nurses' work stressors, whereas the work shift and model of nursing care were predictors of social support behaviors. In non-teaching hospitals, the work shift, level of education, and model of nursing care were predictors of nurse work stressors. Predictors of social support behaviors were marital status, model of nursing, and organizational structure. Regardless of the type of hospital, nurse stressors should be assessed and, once identified, managed by providing various social support behaviors. By turning a work environment into a healthy workplace, researchers and nurse leaders believe that improvements can be realized in recruitment and patient safety and quality.

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

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    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

  20. [Kluyvera bacteriemia: an epidemic in a Moroccan teaching hospital].

    Science.gov (United States)

    Bellaoui, N; Belabbes, H; Lahsoune, M; El Mdagrhri, N

    2009-02-01

    Kluyvera Spp is an enterobacterium rarely isolated in medical microbiology, an opportunistic pathogen the clinical significance of which remains unclear. Four strains of Kluyvera Spp were isolated for the first time in the Ibn Rochd Teaching Hospital microbiology laboratory. These strains were isolated in hemocultures of four patients hospitalized in the same medical ward, at the same time, and presenting with bacteriemia. An antibiotic susceptibility study allowed identifying the wild phenotype in the first isolate, the three next isolates had acquired resistance to trimethoprim-sulfamethoxazole, gentamycin, tobramycin, and ciprofloxacin, and produced broad-spectrum betalactamase. The epidemiological investigation in the patients' environment made after isolating the fourth strain was negative. The four patients evolved uneventfully without antibiotic treatment. This raises the question of the real pathogenic capacity of these strains, their epidemic power, and their ability to acquire resistance.

  1. The influence of perceived neighborhood disorder on smoking cessation among urban safety net hospital patients.

    Science.gov (United States)

    Ma, Ping; Businelle, Michael S; Balis, David S; Kendzor, Darla E

    2015-11-01

    Although research has shown that objective neighborhood characteristics are associated with health behaviors including smoking, little is known about the influence of perceived neighborhood characteristics on a smoking cessation attempt. Participants (N=139) enrolled in a Dallas safety-net hospital smoking cessation program were followed from 1 week pre-quit through 4 weeks post-quit. Logistic regression analyses were conducted to evaluate the impact of perceived neighborhood order and disorder on the likelihood of achieving biochemically verified point prevalence and continuous smoking abstinence 4 weeks following a scheduled quit attempt. Analyses were adjusted for demographic characteristics, cigarettes per day, intervention group, and pharmacological treatment. Participants were primarily non-White (72.7%) and female (56.8%) with a mean age of 52.5 (SD=3.7) years. Most reported an annual household income of ≤$25,000 (86.3%). Logistic regression analyses indicated that greater neighborhood physical (p=.048) and social order (p=.039) were associated with a greater likelihood of achieving point prevalence smoking abstinence at 4 weeks post-quit. Greater perceived physical (p=.035) and social disorder (p=.039) and total neighborhood disorder (p=.014), were associated with a reduced likelihood of achieving point prevalence abstinence. Social disorder (p=.040) was associated with a reduced likelihood of achieving continuous abstinence at 4 weeks post-quit, while social order (p=.020) was associated with an increased likelihood of continuous abstinence. Perceptions of neighborhood order and disorder were associated with the likelihood of smoking cessation among socioeconomically disadvantaged smokers making a quit attempt. Findings highlight the need to address perceptions of the neighborhood environment among disadvantaged smokers seeking treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

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    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. Acute kidney injury in a teaching hospital in Oman

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    Farida Balushi

    2011-01-01

    Full Text Available To determine the incidence, etiology and outcome of acute kidney injury (AKI at a teaching hospital in Oman, we studied all adult cases that developed AKI at our hospital from July 2006 to June 2007. Data from the hospital information system (HIS for all adult admissions in the wards and intensive care units for the study period were obtained, and included baseline serum creatinine, serum creatinine on the day of diagnosis, peak serum creatinine, urine output in the last six and 12 hours at the time of diagnosis, etiology of acute renal failure, presence of any co-morbid conditions, and renal replacement therapy and outcome. Of the 19,738 adult admissions, there were 108 episodes of AKI in 100 patients. The incidence of acute renal failure was 0.54%. The etiology of AKI was pre-renal in 55 (50.9%, obstructive in 5 (4.6% and acute tubular necrosis (ATN in the remaining 48 (44.4% patients. Renal replacement therapy (RRT was required in 24.1% of cases. Of the patients who developed AKI, 36 (33.33% died during same hospital admission, 37 (34.26% recovered to discharge with no renal impairment, 32 (29.63% recovered with residual renal impairment and 2 (1.85% recovered with dialysis dependence.

  4. Access to care after Massachusetts' health care reform: a safety net hospital patient survey.

    Science.gov (United States)

    McCormick, Danny; Sayah, Assaad; Lokko, Hermione; Woolhandler, Steffie; Nardin, Rachel

    2012-11-01

    Massachusetts' health care reform substantially decreased the percentage of uninsured residents. However, less is known about how reform affected access to care, especially according to insurance type. To assess access to care in Massachusetts after implementation of health care reform, based on insurance status and type. We surveyed a convenience sample of 431 patients presenting to the Emergency Department of Massachusetts' second largest safety net hospital between July 25, 2009 and March 20, 2010. Demographic and clinical characteristics, insurance coverage, measures of access to care and cost-related barriers to care. Patients with Commonwealth Care and Medicaid, the two forms of insurance most often newly-acquired under the reform, reported similar or higher utilization of and access to outpatient visits and rates of having a usual source of care, compared with the privately insured. Compared with the privately insured, a significantly higher proportion of patients with Medicaid or Commonwealth Care Type 1 (minimal cost sharing) reported delaying or not getting dental care (42.2 % vs. 27.1 %) or medication (30.0 % vs. 7.0 %) due to cost; those with Medicaid also experienced cost-related barriers to seeing a specialist (14.6 % vs. 3.5 %) or getting recommended tests (15.6 % vs. 5.9 %). Those with Commonwealth Care Types 2 and 3 (greater cost sharing) reported significantly more cost-related barriers to obtaining care than the privately insured (45.0 % vs. 16.0 %), to seeing a primary care doctor (25.0 % vs. 6.0 %) or dental provider (58.3 % vs. 27.1 %), and to obtaining medication (20.8 % vs. 7.0 %). No differences in cost-related barriers to preventive care were found between the privately and publicly insured. Access to care improved less than access to insurance following Massachusetts' health care reform. Many newly insured residents obtained Medicaid or state subsidized private insurance; cost-related barriers to access were worse for these patients than

  5. [Foreign body aspiration in Kigali University Teaching Hospital, Rwanda].

    Science.gov (United States)

    Van Steirteghem, S; Umuhoza, C; Casimir, G

    2013-01-01

    We present the case of a 12-year-old girl referred to Kigali University Teaching Hospital (KUTH) for persistent cough, fever and haemoptysis. Respiratory symptoms started acutely with a stridor at age 4. Thereafter she developed a chronic cough with intermittent fever. She was treated ambulatory in the health care centre with oral antibiotics and finally referred to the district hospital at age 7. The chest X-ray then suggested tuberculosis for which a 6 month treatment was given with no improvement. The cough persisted and haemoptysis appeared so the patient was referred to the reference hospital (KUTH). Chest X-ray showed diffuse lesions of the left lung with bronchiectasis. Bronchoscopy revealed the presence of a foreign body in the left intermediary bronchus and a piece of plastic was extracted. Symptoms rapidly disappeared with antibiotic treatment. This case illustrates how important it is to include foreign body inhalation in the differential diagnosis of respiratory disease in children. Bronchoscopy plays a key role in diagnosis and treatment. The authors point out the advantages of the joint efforts of the Belgian Development Aid Agency (BTC) and the Université libre de Bruxelles (ULB) in the development of this activity in the Rwandese context.

  6. Profile of hip arthroplasty patients in a teaching hospital

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    Vania Regina Goveia

    Full Text Available OBJECTIVE: to characterize the epidemiological profile of patients undergoing hip replacement, primary or revisional. METHODS: we conducted a retrospective, descriptive study, including hip arthroplasties performed from January 2009 to June 2012 in a Belo Horizonte teaching hospital, Minas Gerais State - MG, Brazil. Data were analyzed using descriptive statistics. RESULTS: orthopedic procedures represented 45% of the operations at the hospital in the period, 1.4% hip arthroplasties. There were 125 hip replacements, 85 total, 27 partial and 13 reviews. Among the patients, 40% were male and 60% were female. Age ranged between 20 and 102 years, mean and median of 73 and 76 years, respectively. The most frequent diagnosis (82% was femoral neck fracture by low-energy trauma caused by falling form standing position. In 13 revision operations, 12 required removal of the prosthesis. The infectious complication led to revision in 54% of the time, followed by dislocation (15%, peri-prosthetic fracture (15% and aseptic loosening (15%. The infection etiologic agent was identified in 43% of occasions. The average length of the prosthesis to a revision operation was eight months. CONCLUSION: patients undergoing hip arthroplasty are elderly, with femoral neck fracture caused by falling form standing position, affecting more women. The incidence of hip prosthesis loosening was 10%. The main cause of the infection was loosening. The incidence of revisional hip arthroplasty was 10% and the incidence of hospital mortality in patients undergoing hip arthroplasty was 7.2%.

  7. 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

  8. Net Operating Working Capital, Capital Budgeting, and Cash Budgets: A Teaching Example

    Science.gov (United States)

    Tuner, James A.

    2016-01-01

    Many introductory finance texts present information on the capital budgeting process, including estimation of project cash flows. Typically, estimation of project cash flows begins with a calculation of net income. Getting from net income to cash flows requires accounting for non-cash items such as depreciation. Also important is the effect of…

  9. 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

  10. 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.

  11. Veterinary teaching hospitals: current challenges and pathways for the future.

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    Hubbell, John A E

    2008-01-01

    University-based veterinary teaching hospitals must change to maintain their viability. A number of factors both internal and external to universities and the veterinary profession have contributed to the need for change. A task force formed by the Association of American Veterinary Medical Colleges and the American Association of Veterinary Clinicians was convened to identify the issues and propose individual and collective strategies for the future. Primary issues include a shortage of faculty and staff, the nature of the case load, the need for fiscal management strategies, and the need to manage stakeholder expectations. The majority of the proposed strategies for the future will be managed individually by the colleges. Proposed collective strategies center on increasing the number of specialists and improving recruitment and retention of faculty and staff.

  12. Quality of Life in Emergency Medicine Specialists of Teaching Hospitals

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    Afshin Amini

    2014-08-01

    Full Text Available Introduction: Quality of life (QOL of emergency medicine specialists can be effective in providing services to patients. The aim of the present study was evaluating the lifestyle of emergency medicine practitioners, understanding their problems, and addressing the solutions to enhance and improve their lifestyles, in teaching hospitals in Iran. Method: This descriptive cross-sectional study was conducted on emergency medicine physicians in 10 teaching hospitals of Iran in 2011. Emergency physicians with at least three years of experience who interested in the study, were enrolled in the project. All participants filled out the consent form and QOL questionnaires, then underwent physical examinations and some medical laboratory tests. Categorical variables were reported as percentages, while continuous variables expressed as means and standard deviations. p <0.05 was considered statistically significant. Results: Totally, 100 subjects participated in the study, of whom 48 were male. The mean and standard deviation of the physicians’ age were 38.7±5.1 years. 43% of physicians had an average QOL, while 37% good. 96% of studied physicians had a good condition regarding habitual history, while 93% of them had a poor condition in performing screening tests. Exercise program and personal health in individuals with normal BMI were correlated with higher levels of QOL. BMI was higher in 40-50 years old subjects than youngers. Hypertension was present in five cases (5%, hypercholesterolemia in six (6%, hypertriglyceridemia in six (6%, increased LDL in four (4%, low HDL in four (4%, and impaired FBS in 4 (4%. Conclusion: The findings showed that 63% of studied emergency physicians had an average level of QOL and other ones good. The majority of physicians had undesirable situation regarding the performance of screening tests.

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

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    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

  14. Using CSCW for developing problem-oriented teaching and learning in a net environment

    DEFF Research Database (Denmark)

    Cheesman, Robin; Heilesen, Simon

    Roskilde University’s master’s programme in computer-mediated communication combines face-to-face seminars with net seminars focusing on collaborative project work. Net-based learning based on CSCW offers both advantages and pitfalls: (i) it helps to activate all students, (ii) it fosters complex...... complexity in organising tasks, (iii) asynchronous environment generates a need for synchronous communication, and (iv) exaggerated structuring limits self-organising and motivation....

  15. Nutritional status among hospitalized children with mixed diagnoses at a referral teaching hospital in Manizales, Colombia.

    Science.gov (United States)

    Santafé Sánchez, L R; Sánchez Rodríguez, D A; Villegas Galarza, A L; González-Correa, C H

    2012-01-01

    Despite advances in the treatment of malnutrition in pediatric hospitals, this remains a problem that must be recognized and to call the attention of academia and health authorities to be handled in time. To evaluate the nutritional status of hospitalized children at a referral teaching hospital and to describe the current prevalence of malnutrition. The study was conducted during the months of February, March and April 2010 at the University Hospital Rafael Henao Toro Colombian Red Cross in Manizales, Colombia, South America. We evaluated all patients admitted to a day of each month by calculating the Z score of the, weight for age, height or length for age, body mass index, mid-arm circumference, triceps and subscapular folds for children under 5 years and height for age and body mass index for school children and adolescents. A total of 174 children (age 1-216 mo) were evaluated during the 3-days survey. There were 52.8% children less than 60 months old, 17.2% between 61 and 120 months and 29.9% over 121 months. There were 44.3% females and 55.7% males. Children from the urban residence were 83.3% and 16.6% were rural. The overall prevalence of underweight was 27%, stunting 22.4%, wasting 16.6% and overweight and obesity 6.3%. Males less than five years old were more affected than older children. Rural children were more affected than urban children. The prevalence of overweight children was greater in children 61-120 months than other ages. Given the observed levels of malnutrition, it takes up a system for early identification of children hospitalized with nutritional risk in order to provide adequate and timely support and prevent hospital-acquired malnutrition. This requires the use of previously validated pediatric protocols.

  16. Complications of central venous catheter insertion in a teaching hospital

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    Pedro Henrique Comerlato

    Full Text Available Summary Introduction: Central venous catheters are fundamental to daily clinical practice. This procedure is mainly performed by residents, often without supervision or structured training. Objective: To describe the characteristics of central venous catheterization and the complication rate related to it. Method: Retrospective cohort study. Adult patients undergoing central venous catheter insertion out of the intensive care unit (ICU of a teaching hospital were selected from March 2014 to February 2015. Data were collected from medical charts using an electronic form. Clinical and laboratory characteristics from patients, procedure characteristics, and mechanical and infectious complications rates were assessed. Patients with and without complications were compared. Results: Three hundred and eleven (311 central venous catheterizations were evaluated. The main reasons to perform the procedure were lack of peripheral access, chemotherapy and sepsis. There were 20 mechanical complications (6% of procedures. Arterial puncture was the most common. Procedures performed in the second semester were associated with lower risk of complications (odds ratio 0.35 [95CI 0.12-0.98; p=0.037]. Thirty-five (35 catheter-related infection cases (11.1% were reported. They were related to younger patients and procedures performed by residents with more than one year of training. Procedures performed after the first trimester had a lower chance of infection. Conclusion: These results show that the rate of mechanical complications of central venous puncture in our hospital is similar to the literature, but more attention should be given to infection prevention measures.

  17. Research Utilization among Nurses at a Teaching Hospital in Kenya

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    Albanus Kyalo Mutisya

    2015-06-01

    Full Text Available Introduction: In the era of evidence based practice (EBP, health care delivery should be grounded on new or validated knowledge and evidence from research. The aim of the study was to assess research utilization by nurses and the influencing factors at Kenyatta National Hospital (KNH, the largest teaching hospital in Kenya. Methods: The study employed a descriptive design that utilized both quantitative and qualitative methods of data collection. It incorporated the Barriers to Research Utilization Scale. It was conducted in six specialized care areas at KNH. Data was collected using questionnaires, Focus Group Discussion and in-depth interviews. Data was analyzed using SPSS version 13 and qualitative data analyzed using themes. Results: The study found that 20.6% of the nurses were participating in research related to their work and 53.6% of these were implementing research findings to practice. Over 2/3 (70.5% of the respondents were basing their evidence for practice on the knowledge gained during their nursing school. The three greatest barriers to research utilization were that research reports are not readily available (68.7%, unclear implications for practice (66.5% and inadequate facilities for implementation (66.4%.Conclusion: It is recommended that sensitization trainings on nursing research/ utilization of findings in nursing practice be established to create awareness, motivate and enhance nurses’ abilities and also facilities should be provided to enable implementation.

  18. 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.

  19. A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida.

    Directory of Open Access Journals (Sweden)

    Hansel Tookes

    Full Text Available Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs. Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated.IDUs discharged from Jackson Memorial Hospital were identified using the International Classification of Diseases, Ninth Revision, codes for illicit drug abuse and endocarditis, bacteremia or sepsis, osteomyelitis and skin and soft tissue infections (SSTIs. 349 IDUs were identified for chart abstraction and 92% were either uninsured or had publicly funded insurance. SSTIs, the most common infection, were reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients (4.9% died during their hospitalization. The total cost for treatment for injection drug use-related infections to Jackson Memorial Hospital over the 12-month period was $11.4 million.Injection drug use-related bacterial infections represent a significant morbidity for IDUs in Miami-Dade County and a substantial financial cost to the county hospital. Strategies aimed at reducing risk of infections associated with injection drug use could decrease morbidity and the cost associated with these common, yet preventable infections.

  20. Non-pharmacological management of patients hospitalized with heart failure at a teaching hospital.

    Science.gov (United States)

    Rabelo, Eneida R; Aliti, Graziella B; Goldraich, Lívia; Domingues, Fernanda B; Clausell, Nadine; Rohde, Luis E

    2006-09-01

    To describe non-pharmacological management of patients admitted with heart failure (HF) in a teaching hospital. A cohort longitudinal study of patients diagnosed with HF according to the Boston score. Within the first 72 hours of admission, the nursing staff of the HF clinic conducted structured interviews and medical chart reviews. Two hundred and eighty-three admissions of 239 patients (age = 64 +/- 15 years) were evaluated; approximately 50% of the patients were male and 37% had heart failure of ischemic etiology Non-pharmacological measures included salt restriction in 97%, urine output monitoring in 85%, fluid balance in 75%, weight monitoring in 61%, and fluid restriction in only 25% of the patients. However, they were often not carried out by the team in charge (p < 0.01 for all comparisons). Irregular use of prescribed drugs in the week prior to admission was 22% and 21% in non-readmitted and readmitted patients, respectively (p = 1.00). Readmitted patients (n = 38) had severe systolic dysfunction, more previous hospitalizations, and longer duration of HF symptoms, as compared to those non-readmitted; in addition they had better knowledge related to self-care (p values < 0.05). In the multivariate analysis, only duration of symptoms remained as an independent predictor of re-admissions. Our data suggest that, even at a teaching hospital, important gaps exist between prescribing non-pharmacological measures for HF patients and their being carried out. Readmitted patients seem to have good understanding of their condition; this finding, however, is significantly associated with HF severity and time of onset.

  1. Evaluation of Parenteral Opioid Analgesics Utilization in Patients Hospitalized in a Referral Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Rasool Soltani

    2016-05-01

    Full Text Available Background: Opioid drugs are the most effective drugs for the treatment of moderate to severe pain. Rates of opioid use are influenced by a variety of factors. The aim of this study was to determine the pattern of use of parenteral opioid drugs in hospitalized patients in a referral teaching hospital. Methods: In a retrospective study, required data were extracted from medical records of adult patients who had received any parenteral opioid analgesic in the 6-month period from March 2013 to September 2013. The Anatomical Therapeutic Chemical Classification/Defined Daily Doses (ATC/DDD system method was used for evaluation of opioid analgesic use in patients.Results: The overall usage of parenteral opioid analgesics was 730.51 DDDs with meperidine (Pethidine having the most amounts of use (588.69 DDDs and 33.23 DDDs/100 bed-days. Overall, the male surgery ward and emergency department had the most amounts of use based on the number of DDDs (445.8 DDDs and per 100 bed-days (1046 DDDs/100 bed-days, respectively. Methadone use was most in the infectious diseases ward.Conclusion: The trend of parenteral opioid analgesics consumption is increasing in this hospital. Therefore, better adherence to pain treatment guidelines by medical staff is necessary for rational use of these drugs.

  2. Incidence of extreme hyperglycemia and hypoglycemia in hospitalized patients during the month of July in teaching hospitals

    Directory of Open Access Journals (Sweden)

    Mansur Shomali

    2012-07-01

    Full Text Available Introduction: Blood glucose control has been found to be an important component in the care of hospitalized patients. Maintaining blood glucose within a target range using insulin intensively is a challenging task for physicians and requires skill and experience. We hypothesized that there may be more hyper- and hypoglycemia in July in teaching hospitals when new resident physicians begin their training. Methods: We reviewed point-of-care blood glucose data from hospitalized patients at four community teaching hospitals for 2010. We defined severe hypoglycemia as blood glucose < 41 mg/dL and severe hyperglycemia as blood glucose > 399 mg/dL. Occurrence of hyper- and hypoglycemic events was assessed overall at the particular hospital globally and based on individual nursing units. Monthly occurrence rates were compared against the annual mean for that unit. Results: The occurrence of hyper- and hypoglycemic events in July 2010 did not differ from the mean annual percentage of events at the applicable hospital. However, when the data were analyzed by the nursing unit, these extreme glucose events were significantly more common in 4 of the 11 units studied. Three of those four units were resident teaching units. Conclusions: These data suggest that there is some potential for increased risk of extreme hyper- and hypoglycemia at teaching hospitals in July, when new residents begin training.

  3. Becoming Baby-Friendly and Transforming Maternity Care in a Safety-Net Hospital on the Texas-Mexico Border.

    Science.gov (United States)

    Eganhouse, Deborah J; Gutierrez, Leticia; Cuellar, Lorena; Velasquez, Cecilia

    2016-01-01

    Nurse leaders used the Centers for Disease Control and Prevention's survey on Maternity Practices in Infant Nutrition and Care, as well as Baby-Friendly Hospital Initiative guidelines, to transform maternity care in a safety-net hospital with more than 3,500 births annually. Implementing evidence-based guidelines to support breastfeeding was essential for a vulnerable population characterized by minimal prenatal care and high rates of diabetes, hypertension, obesity, and poverty. Research showing the importance of breastfeeding in protecting against these factors guided extensive changes in our maternity care model. The nursing and medical teams changed long-held practices that separated women from their newborns and observed substantial improvements in breastfeeding initiation and exclusive breastfeeding rates at discharge. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  4. Experience of Laparoscopic Cholecystectomy at Lumbini Medical College Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Nabin Pokharel

    2013-06-01

    surgeons all over the world and the potential one that places the patient at significant risk. The present study aimed to study all the cases of laparoscopic cholecystectomy conducted in current setup at Lumbini Medical College and Teaching Hospital, to compare the results with the published literature and also analyze the complications and ways to decrease the incidence of conversion to open procedure.   Methods: Five hundred twenty five patients age 10-90 years, male:female ratio of 1:3.86 with body weight 45-65 kilogram, who had undergone laparoscopic cholecystectomy for symptomatic cholelithiasis without choledocholithiasis from April 2011 to April 2013 were studied.   Results: All the laparoscopic cholecystectomy (LC were without major complications. Only nineteen out of five hundred twentyfive (3.6% required conversion to open cholecystectomy (OC. Reasons for conversion included: dense omental or visceral adhesions; two (0.38%, unclear anatomy; 16 (3.04%, common bile duct injury; one (0.19%. There were 20 cases of shrunken gallbladder suspicious of malignancy but didn’t required conversion.   Conclusion: Laparoscopic cholecystectomy is the preferred method in our setup even in difficult cases.

  5. Pattern of congenital orthopaedic malformations in an African teaching hospital.

    Science.gov (United States)

    Omololu, B; Ogunlade, S O; Alonge, T O

    2005-01-01

    Congenital Orthopaedic malformations are common malformations that are usually unacceptable to the common populace in the West African sub-region. There is paucity of knowledge about the common types of Orthopaedic congenital malformations in our environment This study was undertaken to determine the pattern of congenital Orthopaedic malformations in a Teaching Hospital. This was a prospective study of all the Orthopaedic congenital malformations seen in our surgical outpatient departments and the inpatient referrals from the wards between January 1995 and December 2003. There were 284 patients in total with a male to female ratio of 2:1 and age range between two days to nine years. Clubfoot (CTEV) accounted for 52.8% of all the malformations while Congenital knee dislocation (CDK) and calcaneovalgus deformity accounted for 8%. Congenital hip dislocation (CDH) accounted for only 2.2% of all the cases. Congenital talipes equinovarus deformity is the most common congenital orthopaedic malformation in this environment while congenital hip dislocation (CDH) is rare when compared with the Caucasians.

  6. Examining non-structural retrofitting status of teaching hospitals in Kerman against disasters.

    Science.gov (United States)

    Moghadam, Mahmood Nekooi; Moradi, Seyed Mobin; Amiresmaili, Mohammadreza

    2017-05-01

    Continuous services provision of a hospital before and after a disaster is one of the most prominent issues that all people, especially the authorities must take into huge consideration. Concerning the experiences of previous earthquakes, the role and importance of nonstructural components becomes increasingly clear in the uninterrupted services of hospitals. In this study, non-structural retrofitting status of Kerman teaching hospitals was evaluated against natural disasters. This cross-sectional study was carried out in the second half of 2014 on the teaching hospitals in Kerman (Iran). The study population consisted of all Kerman teaching hospitals. The research instrument was World Health Organization/Pan American Health Organization (WHO/PAHO) standard checklist. Data analysis was carried out using descriptive statistics through SPSS 19. One hospital had a low retrofitting level, two hospitals had an average level and one had a high level. In the examined hospitals in this study, the medical gas section had the lowest preparedness against natural disasters, while the office, warehouse and furniture section had the highest resistance. Generally, the non-structural retrofitting status was 50% in one hospital and was between 65% and 85% in other hospitals. Generally, the retrofitting status of hospitals was not at the ideal condition, most hospitals were in average condition. Concerning the high risk of hospitals in disasters, it is necessary that senior executives and managers of Kerman Province and Kerman University of Medical Sciences take some measures to retrofit these buildings and to reduce the risk of vulnerability.

  7. 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.

  8. Hospital Managers’ Perception of Recent Health Care Reform in Teaching Hospitals of Qazvin, Iran

    Directory of Open Access Journals (Sweden)

    Zakaria Kiaei

    2015-11-01

    Full Text Available Background The main purpose of any government from a healthcare reform is to improve the service quality and raised public satisfaction. Objectives As the important role of managerial human resources in any organizational changes, this paper tried to examine the point of view of this group about the recent reform in governmental hospitals of Qazvin. Patients and Methods This cross-sectional study was conducted in January 2015. The statistical population consisted of 50 executive managers of Qazvin teaching hospitals. The data gathering instrument was a research-made questionnaire with approved reliability and validity (α = 0.84. Data analyse was performed in SPSS version 20 using descriptive and analytic statistics (analysis of variance (ANOVA, Pearson correlation test and one sample t-test. Results A total of 43.2% of managers believed that this reform was a good restrictor for malpractices in healthcare and 31.8% believed that it will not be so useful to improve the society health status. The average score of resource preparation, insurance companies coordination, changing the routine workflows, and finally achieving the goals, had a meaningful difference (P ˂ 0.05 and the average score of these fields were upper than average. Conclusions The findings showed that based on the managers’ point of view, the reform plan was able to achieve its primary goals; however, it could not meet their exceptions in improving the society health status. Therefore, it is necessary to design some interventions for changing this perception.

  9. Situation analysis of patients attending TU Teaching Hospital after medical abortion with problems and complications

    National Research Council Canada - National Science Library

    Ojha, Neebha; Bista, Kesang D B

    2013-01-01

    In Nepal medical abortion has been approved for use since 2009. There were many cases coming to Tribhuvan University Teaching Hospital coming with problems and complications following medical abortion...

  10. Physicians' attitudes towards treatment guidelines : differences between teaching and nonteaching hospitals

    NARCIS (Netherlands)

    Greving, JP; Denig, P; de Zeeuw, D; Haaijer-Ruskamp, FM

    Objective: To investigate whether physicians' attitudes towards treatment guidelines for primary and secondary care differ between teaching and nonteaching hospitals shortly before and 4 years after the guidelines' introduction. Methods: Possible barriers and facilitators of joint treatment

  11. Diffusion of innovation I: Formulary acceptance rates of new drugs in teaching and non-teaching British Columbia hospitals--a hospital pharmacy perspective.

    Science.gov (United States)

    D'Sa, M M; Hill, D S; Stratton, T P

    1994-12-01

    Lag times in the diffusion of new drugs in the hospital setting have both patient care and pharmaceutical industry implications. This two-part series uses diffusion theory to examine differences in the adoption rates of new drugs in British Columbia teaching and non-teaching hospitals. Formulary addition of a new drug by a hospital's Pharmacy and Therapeutics Committee was considered the adoption indicator. Time for adoption was defined as the difference between a drug's Canadian market approval date and the date of formulary addition. Surveys were mailed in September 1990 to 41 hospital pharmacies (response rate = 88%), asking respondents to provide formulary inclusion dates of 29 drugs marketed between July 1987 and March 1990. A significant difference (Mann-Whitney U Test, p < 0.0358) in median adoption time was observed between the six teaching and 25 non-teaching study hospitals, with the former adopting a new drug in 7.5 months versus the latter adopting a new drug in 12.1 months.

  12. RESTful NET

    CERN Document Server

    Flanders, Jon

    2008-01-01

    RESTful .NET is the first book that teaches Windows developers to build RESTful web services using the latest Microsoft tools. Written by Windows Communication Foundation (WFC) expert Jon Flanders, this hands-on tutorial demonstrates how you can use WCF and other components of the .NET 3.5 Framework to build, deploy and use REST-based web services in a variety of application scenarios. RESTful architecture offers a simpler approach to building web services than SOAP, SOA, and the cumbersome WS- stack. And WCF has proven to be a flexible technology for building distributed systems not necessa

  13. Self-efficacy and postpartum depression teaching behaviors of hospital-based perinatal nurses.

    Science.gov (United States)

    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 (postpartum depression continuing education and teaching experience); and vicarious experience (observing other nurses teach new mothers about postpartum depression). Teaching new mothers about postpartum depression can assist mothers in overcoming barriers to depression treatment. Nurse educators and managers play an important role in encouraging postpartum depression education for perinatal nurses.

  14. Antifungal agent utilization evaluation in hospitalized neutropenic cancer patients at a large teaching hospital

    Directory of Open Access Journals (Sweden)

    Vazin A

    2015-06-01

    Full Text Available Afsaneh Vazin,1 Mohammad Ali Davarpanah,2 Setareh Ghalesoltani3 1Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; 2HIV Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 3International Branch of Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran Abstract: To evaluate pattern of using of three antifungal drugs: fluconazole, amphotericin B and voriconazole, at the hematology–oncology and bone marrow transplant wards of one large teaching hospital. In a prospective cross-sectional study, we evaluated the appropriateness of using antifungal drugs in patients, using Infectious Disease Society of America (IDSA and National Comprehensive Cancer Network (NCCN guidelines. All the data were recorded daily by a pharmacist in a form designed by a clinical pharmacist and infectious diseases specialist, for antifungals usage, administration, and monitoring. During the study, 116 patients were enrolled. Indications of prescribing amphotericin B, fluconazole, and voriconazole were appropriate according to guidelines in 83.4%, 80.6%, and 76.9% respectively. The duration of treatments were appropriate according to guidelines in 75%, 64.5%, and 71.1% respectively. The dose of voriconazole was appropriate according to guidelines in 46.2% of patients. None of the patients received salt loading before administration of amphotericin B. The most considerable problems with the mentioned antifungals were about the indications and duration of treatment. In addition, prehydration for amphotericin B and dosage of voriconazole were not completely compatible with the mentioned guidelines. A suitable combination of controlling the use of antifungals and educational programs could be essential for improving the general process of using antifungal drugs at our hospital. Keywords: utilization evaluation, fluconazole, amphotericin B, voriconazole, neutropenia

  15. 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 ...

  16. 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…

  17. 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.

  18. 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 ...

  19. Improved blood culture identification by FilmArray in cultures from regional hospitals compared with teaching hospital cultures.

    Science.gov (United States)

    Inglis, Timothy J J; Bzdyl, Nicole; Chua, I-Ly Joanna; Urosevic, Nadezda M; Leung, Michael J; Geelhoed, Elizabeth

    2016-01-01

    Rapid identification of bacteria isolated from blood cultures by direct matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is now in wide spread use in major centres but is not yet feasible in smaller hospital laboratories. A FilmArray multiplex PCR panel for blood culture isolate identification (BCID) provides an alternative approach to near point-of-care microbial identification in regional hospitals. We assessed the accuracy and time to identification of the BCID FilmArray in a consecutive series of 149 blood cultures from 143 patients in a teaching hospital and smaller regional hospitals, currently identified by direct MALDI-TOF and proprietary molecular methods. The BCID FilmArray contained 18 of 34 species and 20 of 23 species isolated from teaching and regional hospital, respectively. Overall, 85 % of the teaching hospital and 100 % of the regional hospital monomicrobial blood cultures were identified, compared with 60 and 68 %, respectively, for direct MALDI-TOF on the same cultures. There were no incorrect results from blood cultures containing Staphylococcus aureus, streptococci, Pseudomonas aeruginosa or Enterobacteriaceae. The three discrepant results were all in mixed cultures. The mean reduction in time to identification of blood culture isolates was 53 h, which did not include the time required to transport cultures from regional centres to a central laboratory. The overall performance of the BCID FilmArray is stronger in blood cultures from smaller regional hospitals that encounter a narrower range of bacterial species dominated by the commonest species. This approach is more suited to smaller clinical laboratories than the MALDI-TOF direct method.

  20. Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study.

    Science.gov (United States)

    Lee, Kun Yun; Wan Ahmad, Wan Azman; Low, Ee Vien; Liau, Siow Yen; Anchah, Lawrence; Hamzah, Syuhada; Liew, Houng-Bang; Mohd Ali, Rosli B; Ismail, Omar; Ong, Tiong Kiam; Said, Mas Ayu; Dahlui, Maznah

    2017-01-01

    The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH). This cross-sectional study was conducted from the healthcare providers' perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test. The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients' comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost. The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and

  1. Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study.

    Directory of Open Access Journals (Sweden)

    Kun Yun Lee

    Full Text Available The increasing disease burden of coronary artery disease (CAD calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI, a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH and a general hospital (GH.This cross-sectional study was conducted from the healthcare providers' perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test.The mean hospitalization cost was RM 12,117 (USD 3,366 at GH and RM 16,289 (USD 4,525 at TH. The higher cost at TH can be attributed to worse patients' comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost.The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure

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

    OpenAIRE

    Bahrami, Mohammad Amin; Barati, Omid; Ghoroghchian, Malake-sadat; Montazer-alfaraj, Razieh; Ranjbar Ezzatabadi, Mohammad

    2015-01-01

    Objective 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. Methods 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 ...

  3. 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

  4. 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.

  5. EcoCasting: Using NetLogo models of aquatic ecosystems to teach scientific inquiry

    Science.gov (United States)

    Buzby, C. K.; Jona, K.

    2010-12-01

    The EcoCasting project from the Office of STEM Education Partnerships (OSEP) at Northwestern University has developed a computer model-based curriculum for high school environmental science classes to study complexity in aquatic ecosystems. EcoCasting aims to deliver cutting edge scientific research on bioaccumulation in invaded Great Lakes food webs to high school classes. Scientists and environmental engineers at Northwestern are investigating unusual bioaccumulation patterns in invaded food webs of the Great Lakes. High school students are exploring this authentic data to understand what is causing the anomalies in the data. Students use a series of NetLogo agent-based models of an aquatic ecosystem to study how toxins accumulate in the food web. Using these models, students learn about predator-prey relationships, bioaccumulation, and invasive species. Students are confronted with contradictory data collected by scientists and investigate alternative food web mechanisms at work. By studying the individual variables, students learn common scientific principles. When multiple variables are combined in a unifying model, students learn that the interactions lead to unexpected outcomes. Students learn about the complexity of the ecosystem and gain proficiency interpreting computer models and scientific data collection in this curriculum. Model of aquatic food chain

  6. 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

  7. 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.

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

    African Journals Online (AJOL)

    This is not just an academic paper, it is a resource. It addresses the topic of how hospitality and tourism education is likely to change in 5, 10 and 15 years' time. The principal function of a hospitality academy is to design, plan, prepare and deliver a programme of learning in ways that foster and support student learning.

  9. Effects of ownership, subsidization and teaching activities on hospital costs in Switzerland.

    Science.gov (United States)

    Farsi, Mehdi; Filippini, Massimo

    2008-03-01

    This paper explores the cost structure of Swiss hospitals, focusing on differences due to teaching activities and those related to ownership and subsidization types. A stochastic total cost frontier with a Cobb-Douglas functional form has been estimated for a panel of 148 general hospitals over the six-year period from 1998 to 2003. Inpatient cases adjusted by DRG cost weights and ambulatory revenues are considered as two separate outputs. The adopted econometric specification allows for unobserved heterogeneity across hospitals. The results suggest that teaching activities are an important cost-driving factor and hospitals that have a broader range of specialization are relatively more costly. The excess costs of university hospitals can be explained by more extensive teaching activities as well as the relative complexity of the offered medical treatments from a teaching point of view. However, even after controlling for such differences university hospitals have shown a relatively low cost-efficiency especially in the first two or three years of the sample period. The analysis does not provide any evidence of significant efficiency differences across ownership/subsidy categories.

  10. 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.

  11. Accelerated discharge of patients in the event of a major incident: observational study of a teaching hospital

    National Research Council Canada - National Science Library

    Challen, Kirsty; Walter, Darren

    2006-01-01

    ... from PCTs in order to achieve this. Repeated survey over 12 days in 3 months of hospital bed occupancy by type of condition and discharge capacity in an 855-bed UK tertiary teaching hospital also providing secondary care services...

  12. Teaching Hospitals and the Disconnect Between Technology Adoption and Comparative Effectiveness Research: The Case of the Surgical Robot.

    Science.gov (United States)

    Makarov, Danil V; Li, Huilin; Lepor, Herbert; Gross, Cary P; Blustein, Jan

    2017-06-01

    The surgical robot, a costly technology for treatment of prostate cancer with equivocal marginal benefit, rapidly diffused into clinical practice. We sought to evaluate the role of teaching in the early adoption phase of the surgical robot. Teaching hospitals were the primary early adopters: data from the Healthcare Cost and Utilization Project showed that surgical robots were acquired by 45.5% of major teaching, 18.0% of minor teaching and 8.0% of non-teaching hospitals during the early adoption phase. However, teaching hospital faculty produced little comparative effectiveness research: By 2008, only 24 published studies compared robotic prostatectomy outcomes to those of conventional techniques. Just ten of these studies (41.7%) were more than minimally powered, and only six (25%) involved cross-institutional collaborations. In adopting the surgical robot, teaching hospitals fulfilled their mission to innovate, but failed to generate corresponding scientific evidence.

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

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 2 (2015) >. Log in or Register to get access to full text downloads.

  14. Hospital

    African Journals Online (AJOL)

    treatment modality. Design: It is a retrospective study of all confirmed. Burkitt's lymphoma of the head and neck region seen at the Obafemi Awolowo University Teaching Hospital Ile. Ife (OAUTHC) between 1986 and 2002. Patients and methods: The medical records of all the patients with the histopathologically confirmed ...

  15. Trainees' feedback on the prevailing teaching methods in postgraduate medical institute, Lady Reading Hospital, Peshawar, Pakistan.

    Science.gov (United States)

    Ali, Irum Sabir; Khan, Mumtaz; Khan, Atifullah; Shah, Muhammad Fahd; Ali, Gohar

    2012-05-01

    To determine the feedback of postgraduate (PG) trainees on their current teaching methods and their level of satisfaction with those at a tertiary care hospital in Pakistan. Cross-sectional study. Department of Surgery, Lady Reading Hospital, Peshawar, from January to May 2010. A semi-structured proforma was filled by the trainees regarding teaching methods and preferences. Level of satisfaction was measured by five points Likert scale. Results were processed through SPSS 17.0 for descriptive statistics. The response rate was 260 out of the total 268 trainees. Lecture / tutorials were reported as the major method of teaching by 239 (91.9%), bedside teaching by 229 (88.1%), journal club by 217 (83.5%), e-learning by 157 (60.4%), audit meetings by 152 (58.5%), interactive sessions by 144 (55.4%), radiology meeting by 101 (38.8%) and TOACS by 39 (15%) trainees. Out of 28 units, TOACS were practised as a teaching method in 3 units. It was noted that 47 trainees (18.1%) graded the current training to be unsatisfactory, 127 as fair (48.8%), 77 as good (29.6%), 9 as very good (3.5%) while none considered it to be excellent. TOACS was the most preferred method of teaching, reported by 239 PGs (91.9%). Excessive work load as a cause for the dissatisfaction was reported by 229 trainees (88.1%), inadequate teaching by 157 (60.4%), lack of motivation 124 (47.7%), inappropriate teaching 122 (46.9%) and personal problems by 118 (45.4%). Lecture is the most commonly used method of teaching in the Lady Reading Hospital, Peshawar, while TOACS is the most preferred method amongst trainees, but it is the least practiced.

  16. Is leadership compatible with hospitals? Lessons from 10 years of teaching leadership to hospital managers.

    Science.gov (United States)

    Georges, Patrick M; Samson, Julien

    2012-01-01

    Leadership methods can be understood and applied by hospital managers in the same way teachers and the seminar's participants respect certain conventions. Each method should be discussed and adapted, recognizing its limitations for use within hospitals. This article first presents what is taught in a traditional leadership course and then, discusses ways the course can be adapted for use by hospital managers.

  17. 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

  18. The language of "Circule": discursive construction of false referral in Iranian teaching hospitals.

    Science.gov (United States)

    Mirhosseini, Seyyed-Abdolhamid; Fattahi, Hossein

    2010-09-01

    This article explores the practice of false patient out-referral by medical students in Iranian teaching hospital emergency departments. Drawing on participant-observations and interviews during eight months in six hospitals in Tehran, we investigate how discourse is appropriated to construct and legitimate out-referrals through four general strategies of sympathy, mystification, intimidation, and procrastination. Based on a critical approach to false out-referral discourse, we revisit the medical and educational functioning of teaching hospitals in Iran: Focusing on medical students involved in false out-referrals, their discursive reproduction of deception is examined along with their legitimate challenges to institutional structures. Moreover, focusing on the institution of hospital, institutional corruption is discussed along with the problematic of covert cultural defiance faced by a modernist organizational construct in a nonmainstream cultural context. Finally, we argue that the discourse of false out-referral calls for more profound public awareness in dealing with health institutions.

  19. A comparison of congestive heart failure readmissions among teaching and nonteaching hospital services.

    Science.gov (United States)

    Palacio, Carlos; House, Jeffrey; Ibrahim, Saif; Touchan, Jean N; Mooradian, Ariana

    2014-08-01

    Heart failure (HF) is a leading cause of hospitalization in the United States. With the population trend shifting to a higher volume of elderly adults, the efficient management of HF will become increasingly essential. The development and implementation of The Patient Protection and Affordable Care Act and subsequent changes in reimbursement practices have made 30-day readmission rates a topic of much interest and relevance. The aim of the study was to compare rates of readmission among teaching and nonteaching hospitals. The authors gathered retrospective data on HF quality measures and readmission rates between August 2011 and July 2012, extracted from the institution's managerial accounting database. These data were compared among teaching and nonteaching hospitals. Patient demographics, readmission rates, readmission diagnoses, severity of illness, patient disposition, medications prescribed, cost of services, and mortality were reviewed. Analysis of variance was used for continuous variables; χ(2) analysis was used for evaluating categorical variables. A higher proportion of patients on the cardiology teaching service were men than on either the medicine teaching service or the medicine nonteaching service. Length of stay, case costs, and care costs were lowest for the cardiology teaching service; however, patient illness severity was lower on this service than on the other two services. Overall, readmissions and mortality were similar among all groups, but readmission for the same diagnosis was more likely on the cardiology service than on the medicine teaching and nonteaching services. Studies comparing teaching and nonteaching providers for an HF diagnosis are needed. Hospital readmission and mortality rates were similar across services and compared favorably with national data. Opportunities that target cost reduction and length of stay may be leveraged.

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

    African Journals Online (AJOL)

    HP

    Purpose: To assess the prescribing and utilization pattern of vancomycin in Sultan Qaboos University. Hospital (SQUH) in Oman. Methods: A retrospective study that included in-patients at SQUH who had used vancomycin from. January 1 2009 to December 31 2009 was conducted to determine the utilization patterns of the ...

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

    African Journals Online (AJOL)

    community health centre (Site B day hospital) in. Khayelitsha; (iil) ... patients' folders. Criteria for determining appropriateness of attendance by level of care were developed a priori via a modification of published measures. Main outcome ... children who were infants; (iJ) no other domestic child care responsibilities for the ...

  3. Patients' assessment of efficiency of services at a teaching hospital ...

    African Journals Online (AJOL)

    Eight–five percent and 76.8% of patients were satisfied with the X–ray and catering departments respectively. However, patients' rating of the level of sanitation was poor (46%). Conclusion: Areas of need identified include, waiting time prior to consultation, sanitation of the hospital and pharmacy department. Although ...

  4. Stroke Admission to Tikur Anbassa Teaching Hospital: With ...

    African Journals Online (AJOL)

    Background: Although the burden of cerebrovascular accident is not known in Africa, including Ethiopia, it s a frequent cause of mortality and morbidity in hospital practice. Stroke in the young is associated with different spectrum of risk factors and treatment outcome as compared to stroke in the older age group. Method: To ...

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

    African Journals Online (AJOL)

    Purpose: To assess the prescribing and utilization pattern of vancomycin in Sultan Qaboos University Hospital (SQUH) in Oman. Methods: A retrospective study that included in-patients at SQUH who had used vancomycin from January 1 2009 to December 31 2009 was conducted to determine the utilization patterns of the ...

  6. 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 ...

  7. 35 Patterns of Mango Tree Trauma in Juba Teaching Hospital

    African Journals Online (AJOL)

    user

    2006-12-02

    Dec 2, 2006 ... study, included splenic rapture (3 patients), severe head injury (3 patients) and spinal injury (2 patients). One patient died of severe head injury, one patient had post traumatic epilepsy and the patients with spinal injury were discharged from the hospital on wheel chair. Conclusion: Mango tree injury is a ...

  8. Urological Tumours in Jos University Teaching Hospital, Jos, Nigeria

    African Journals Online (AJOL)

    This is a hospital based retrospective histopathological study of urological tumours in 10 years. Specimens consisted of all surgical excisions, trucut and fine needle biopsies of kidney, prostate, urinary bladder, testis and penis. Urological tumours accounted for 11.45% of all malignant tumours during the period of study.

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

    African Journals Online (AJOL)

    Esem

    Patients with bladder cancer who presented to the hospital during this period were recruited and parameters studied included patients demographics, HIV status .... prevalence of schistosomia infection isolated in malignant tissues. Table 2: Distribution of variables among patients. Gender number. Percentage. Mean age.

  10. Goitre in a Teaching Hospital in North Western Ethiopia | Bekele ...

    African Journals Online (AJOL)

    The patients' history, physical findings and relevant laboratory results were recorded using a standard uniform format. Operative findings, postoperative course and follow up ... Cosmetic disfigurement and respiratory symptoms were the leading reasons for hospital visit. Simple goitres, thyroid carcinoma and toxic goitres ...

  11. 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 ...

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

    African Journals Online (AJOL)

    METHODS: The microbial quality of indoor air of seven wards of Jimma University Specialized Hospital was determined. Passive air sampling technique, using open Petri-dishes containing different culture media, was employed to collect sample twice daily. RESULTS: The concentrations of bacteria and fungi aerosols in ...

  13. Performance of US teaching hospitals: a panel analysis of cost inefficiency.

    Science.gov (United States)

    Rosko, Michael D

    2004-02-01

    This research summarizes an analysis of the impact of environment pressures on hospital inefficiency during the period 1990-1999. The panel design included 616 hospitals. Of these, 211 were academic medical centers and 415 were hospitals with smaller teaching programs. The primary sources of data were the American Hospital Association's Annual Survey of Hospitals and Medicare Cost Reports. Hospital inefficiency was estimated by a regression technique called stochastic frontier analysis. This technique estimates a "best practice cost frontier" for each hospital that is based on the hospital's outputs and input prices. The cost efficiency of each hospital was defined as the ratio of the stochastic frontier total costs to observed total costs. Average inefficiency declined from 14.35% in 1990 to 11.42% in 1998. It increased to 11.78% in 1999. Decreases in inefficiency were associated with the HMO penetration rate and time. Increases in inefficiency were associated with for-profit ownership status and Medicare share of admissions. The implementation of the provisions of the Balanced Budget Act of 1997 was followed by a small decrease in average hospital inefficiency. Analysis found that the SFA results were moderately sensitive to the specification of the teaching output variable. Thus, although the SFA technique can be useful for detecting differences in inefficiency between groups of hospitals (i.e., those with high versus those with low Medicare shares or for-profit versus not-for-profit hospitals), its relatively low precision indicates it should not be used for exact estimates of the magnitude of differences associated with inefficiency-effects variables.

  14. A Case Study of the Implementation of a Competency-based Curriculum in a Caribbean Teaching Hospital

    NARCIS (Netherlands)

    Koeijers, J. J.; Busari, J. O.; Duits, A. J.

    2012-01-01

    Objective: Several teaching hospitals are currently modifying their curriculum to comply with the changing demands in medical education. As a result, we decided to evaluate whether a competency-based curriculum implemented in a Caribbean teaching hospital fulfilled the requirements as defined by the

  15. Data Envelopment Analysis for estimating Health Care Efficiency in the Southwest Teaching Hospitals in Niger

    Directory of Open Access Journals (Sweden)

    Bilqis Bolanle Amole,

    2016-01-01

    Full Text Available Health care services in Nigerian teaching hospitals have been considered as less desirable. In the same vein, studies on the proper application of model in explicating the factors that influence the efficiency of health care delivery are limited. This study therefore deployed Data Envelopment Analysis in estimating health care efficiency in six public teaching hospitals located in southwest Nigeria. To do this, the study gathered secondary data from annual statistical returns of six public teaching hospitals in southwest, Nigeria, spanned five years (2010 - 2014. The data collected were analysed using descriptive and inferential statistical tools. The Inferential statistical tools used included Data Envelopment Analysis (DEA with the aid of DEAP software version 2.1, Tobit model with the aid of STATA version 12.0. The results revealed that the teaching hospitals in Southwest Nigeria were not fully efficient. The average scale inefficiency was estimated to be approximately 18%. Result from the Tobit estimates showed that insufficient number of professional health workers, especially doctors, pharmacist and laboratory technicians engineers and beds space for patient use were responsible for the observed inefficiency in health care delivery, in southwest Nigeria. This study has implication for decisions on effective monitoring of the entire health system towards enhancing quality health care service delivery which would enhance health system efficiency.

  16. An outbreak of psittacosis due to Chlamydophila psittaci genotype A in a veterinary teaching hospital

    NARCIS (Netherlands)

    Heddema, Edou R.; van Hannen, Erik J.; Duim, Birgitta; de Jongh, Bartelt M.; Kaan, Jan A.; van Kessel, Rob; Lumeij, Johannes T.; Visser, Caroline E.; Vandenbroucke-Grauls, Christina M. J. E.

    2006-01-01

    An outbreak of psittacosis in a veterinary teaching hospital was recognized in December 2004. Outbreak management was instituted to evaluate the extent of the outbreak and to determine the avian source. Real-time PCR, serologic testing and sequencing of the ompA gene of Chlamydophila psittaci were

  17. Case-fatality of adult Tetanus at Jimma University Teaching Hospital ...

    African Journals Online (AJOL)

    Background: Tetanus remains a major health problem in Ethiopia like in most other developing countries. Objectives: To assess the clinical presentation, complications and outcome of tetanus patients. Methods: In this retrospective study, patients (age > 13 years) who were admitted to Jimma University Teaching Hospital ...

  18. Tetanus: A 10-year review of cases in a teaching hospital in ...

    African Journals Online (AJOL)

    Aim/Objectives: The objective of this study was to present the descriptive characteristics of non-neonatal tetanus cases seen in a teaching hospital in Northwestern Nigeria over a 10-year period and to discuss the implications of the study findings for anti-tetanus vaccination policy and implementation in developing countries.

  19. The practice of episiotomy in a university teaching hospital in Nigeria

    African Journals Online (AJOL)

    Background: Episiotomy is essentially a surgical procedure but it is often relegated to the least experienced member of the obstetric team with possible untoward consequences to the mother. Aim: This study set out to appraise how episiotomy was practiced in the University of Calabar Teaching Hospital during the period of ...

  20. Approaching Hospital-Bound/Home-Bound Special Education as an Opportunity for Innovation in Teaching

    Science.gov (United States)

    Trentin, Guglielmo

    2014-01-01

    Paradoxically some "extreme" didactic needs, such as those of students who are unable to attend normal education regularly (e.g., hospitalized and/or homebound students), have shown themselves to be ideal for the development of a teaching style aimed at stimulating the active role of the student, at fostering a learning process based…

  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. Cancer of the Cervix at the University of Benin Teaching Hospital ...

    African Journals Online (AJOL)

    Objective: To evaluate the incidence and clinical presentation of cervical cancer in a Nigerian tertiary health institution. Methods: A review of retrieved retrospective data relating to patients managed for cancer of the cervix at the University of Benin Teaching Hospital (UBTH), Benin City between January 1991 and December ...

  3. Social impact of HIV/AIDS on clients attending a teaching hospital in ...

    African Journals Online (AJOL)

    Ofonime E. Johnson * Ofonime E. Johnson is a Nigerian, married with four Children. The higher educational institutions that she attended along with the dates are as follows: University of Calabar, Calabar, Nigeria, 1979–1985; University of Lagos, Lagos, Nigeria, 2004–2005 [MPH]; and University of Ibadan, Ibadan, Nigeria, 2006–2009. Her qualifications along with the dates are as follows: MBBch (1985) and MPH (2005). She is a fellow of the West African College of Physicians (FWACP) and a fellow of the Medical College of Public Health, Nigeria (FMCPH), 2009. She is a consultant public health physician working as a residency training coordinator in the Department of Community Health, University of Uyo Teaching Hospital, Uyo, Nigeria (2009–to date). drjohnsonoe@yahoo.com

    2012-06-20

    Jun 20, 2012 ... PLEASE SCROLL DOWN FOR ARTICLE. For full terms and conditions of use, see: http://www.tandfonline.com/page/terms-and-conditions esp. Part II. .... Methodology. A descriptive study was carried out on PLWHA attending a clinic at the University of Uyo Teaching Hospital, Uyo, Akwa Ibom. State, Nigeria ...

  4. An audit of spirometry at the University of Ilorin Teaching Hospital ...

    African Journals Online (AJOL)

    Background: Spirometry is a noninvasive and cost-effective physiologic test that greatly complements other investigative procedures in evaluation of respiratory conditions. This study was aimed at auditing the spirometry performed at the University of Ilorin Teaching Hospital (UITH) Ilorin, Nigeria, and highlighting some of ...

  5. Penile Injuries In Lagos State University Teaching Hospital Ikeja: A 7 ...

    African Journals Online (AJOL)

    Background: Injuries to the penis are not frequent events and usually not life threatening. However, they may be associated with significant long term psychological and functional impairment. This study elucidates the clinical spectrum of penile injuries in the Lagos State University Teaching Hospital and how they were ...

  6. Historical evidence for the origin of teaching hospital, medical school and the rise of academic medicine.

    Science.gov (United States)

    Modanlou, H D

    2011-04-01

    Historical progression and the development of current teaching hospitals, medical schools and biomedical research originated from the people of many civilizations and cultures. Greeks, Indians, Syriacs, Persians and Jews, assembled first in Gondi-Shapur during the Sasanian empire in Persia, and later in Baghdad during the Golden Age of Islam, ushering the birth of current academic medicine.

  7. 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.

  8. Audit of child and adolescent psychiatry in a teaching hospital in ...

    African Journals Online (AJOL)

    Objective. This study aimed to identify the socio-demographic characteristics, pattern of psychiatric disorders and management of children and adolescents before the setting up of a dedicated child and adolescent unit at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Method. A retrospective study, carried out at the ...

  9. 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.

  10. 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.

  11. [Practical training for paramedics : Transformation at the Leipzig University teaching hospital].

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    Girrbach, F F; Bernhard, M; Wessel, M; Gries, A; Bercker, S

    2017-01-01

    The "Notfallsanitätergesetz" (the law pertaining to paramedics), which came into effect in January 2014, has fundamentally changed the training of health personnel in German prehospital emergency medicine. The apprenticeship now takes 3 years including 720 h of practical training in eligible hospitals. To date, however, there has been little experience of how the contents of the guidelines for practical training ("Ausbildungs- und Prüfungsverordnung") can be reasonably applied in the teaching hospitals. In a total of nine interdisciplinary working group meetings between October 2014 and June 2016, we developed a curriculum concerning the practical training of paramedics to implement the contents of the guidelines for practical training in a didactically and an organizationally meaningful way. The implementation of the practical training of paramedics is an excellent chance for the teaching hospitals to contribute to higher quality prehospital emergency medicine. Otherwise, the teaching hospitals face an organizational and personal effort that is not to be underestimated. Thus, a modular curriculum constitutes the possibility of standardizing practical training and simultaneously reducing the time and expenditure for the participating hospitals. The development of a unique curriculum for the practical training of paramedics may contribute to standardized, high-quality, and cost-efficient training.

  12. Costs of reusable and disposable aprons in a public teaching hospital

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    Paloma de Souza Cavalcante Pissinati

    2014-10-01

    Full Text Available Objective To analyze the direct cost of reusable and disposable aprons in a public teaching hospital. Method Cross-sectional study of quantitative approach, focusing on the direct cost of reusable and disposable aprons at a teaching hospital in northern Paraná. The study population consisted of secondary data collected in reports of the cost of services, laundry, materials and supplies division of the institution for the year 2012 Results We identified a lower average cost of using disposable apron when compared to the reusable apron. The direct cost of reusable apron was R$ 3.06, and the steps of preparation and washing were mainly responsible for the high cost, and disposable apron cost was R$ 0.94. Conclusion The results presented are important for hospital managers properly allocate resources and manage costs in hospitals
.

  13. Comparison of the Utilization of Endoscopy Units in Selected Teaching Hospitals Across Canada

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    E Lalor

    1996-01-01

    Full Text Available There is no information on the number of endoscopic procedures performed at major teaching hospitals across Canada. The directors of endoscopy units at eight teaching hospitals from Halifax to Vancouver volunteered demographic information on the unit at their location. There was a very wide range of endoscopic utilization, with approximately comparable rates of out-patient versus in-patient procedures and of gastroscopies versus colonoscopies, but there was no obvious linking of the ratios of in-patients:out-patients versus total number of designated gastrointestinal beds or total number of hospital beds. Thus, the appropriateness of endoscopic procedures needs to be based on standards of practice and accepted indications. The number of endoscopies performed per endoscopy unit support staff varied widely (from 323.7 to 1065.3 per year, and it would be interesting to learn whether this represents an opportunity for cost-saving in some units.

  14. Characteristics of quality and patient safety curricula in major teaching hospitals.

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    Pingleton, Susan K; Davis, David A; Dickler, Robert M

    2010-01-01

    The authors recently discovered 2 quality and patient safety curricula for internal medicine and general surgery residents in major teaching hospitals: an infrequent formal curriculum developed by the university and a positive informal curriculum found in the teaching hospital. A hidden curriculum was postulated. These data were gathered through applied qualitative research methodology. In this article, curricular characteristics of the formal, informal, and hidden curricula are described and analyzed. Themes evaluated were planning, delivery, evaluation, drivers, responsible entity, and resources. The data show different curricular characteristics in each theme, especially for the formal and informal curricula. Understanding curricular characteristics represents the next step in understanding the environments of resident quality and safety learning, especially in the academic hospital setting. Aligning the formal and informal curricula as well as leveraging all curricula could improve educational venues for quality and safety and institutional clinical performance, and promote a learning health care system.

  15. [Cataract extraction with intraocular lenses in a teaching hospital].

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    Jara, R; Charlín, R; Schweikart, A; Stoppel, J; Maul, E

    1991-07-01

    One hundred and twelve primary posterior chamber intraocular lens implants from a series of 560 eyes operated on at the Eye Service of Hospital Salvador in Santiago, Chile, were analyzed to determine the postoperative visual acuity. The follow up time varied between 3 and 26 months. Lenses were implanted by experienced ophthalmologists and residents in training. Visual acuity was 0.5 or better in 79.5% of cases. The postoperative visual acuity varied with age, being worse in patients over 70 years old.

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

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    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

  17. 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.

  18. Proton pump inhibitor use in a university teaching hospital

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    Maria Meli

    2012-10-01

    Full Text Available Introduction Proton pump inhibitors (PPIs are highly prescribed drugs in Italy and in particular in the Sicilian region but little is known about their use in the hospital setting.Materials and methods PPI utilization and related costs were reviewed retrospectively by examining the pharmaceutical records of drug dispensation to the various wards of the Policlinico Universitario P. Giaccone of Palermo in 2010. Differences in the prescribing rates and drug preferences among the different clinical wards were analyzed.Results A total of 20,420 patients were hospitalized at the Policlinico of Palermo in 2010. Overall, the consumption of PPIs was 120 DDD/100 bed-days for the year 2010 with a total cost of 42,780 euros. Omeprazole and esomeprazole were the most commonly prescribed molecules accounting for over 70% of all prescriptions: nevertheless, wide differences in drug choices were noted even within the same ward. As expected, greater utilization rates were registered in the Internal Medicine and General Surgery departments. In particular, the highest consumption was observed in the Oncology, Geriatry and Obesity Surgery wards, with about 250 DDD/100 bed-days. All wards reported intravenous PPI administration suggesting some inappropriate use.Discussion From our data, PPIs appear to be moderately over-used at the Policlinico of Palermo. This practice may lead to the inappropriate continuation of therapy in primary care, further increasing costs and risks of adverse events. A survey evaluating in more detail the appropriateness of prescriptions is advisable.

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

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    Marco Marchetti

    2005-12-01

    Full Text Available

    Introduction The risk management project of The University Hospital “A. Gemelli” aims to define the necessary procedures to manage clinical risk, by identifying the structures involved within this process, so that all of the personnel can contribute to a measurable improvement in the safety of both patients and staff.

    Methods The Risk Management Program is comprised of 5 long-term phases: Phase 1 - Strategy Definition and Communication: a clear and shared Risk Management Strategy is indispensable to guarantee a coordinated action plan, in order to focus all of the interventions towards the achievement of common and measurable results. Phase 2 - Risk Management System Governance: all of the organisational structures have been activated in order to effectively manage the Risk Management System. The system has been introduced to interact within all areas of the hospital and to transfer information. Phase 3 - Promotion within the Organisation: this phase fosters the aims of the project within the whole organisation, by stressing the concept of “learning from errors”. This is crucial if organisational and healthcare workers are to understand the true aims of risk prevention and protection and offer to contribute to the process. Phase 4 - Risk Assessment: a data survey system was created and institutionalized. This phase begins with an analysis of the information flow, in order to estimate the probabilities that certain risks occur, and ends with defining the interventions to undertake. Risk assessment makes it possible to forecast the consequences of certain risks and thus prioritise those for prevention. Phase 5 - Risk Management: this consists of planning and implementing all of the actions necessary to prevent risks, protect and finance (in terms of prevention A. Gemelli University Hospital.

    Results The results achieved are remarkable especially when one

  20. 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

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    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

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

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    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.

  2. Epidemiology of burns in a teaching hospital in south India

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    Shanmugakrishnan R

    2008-01-01

    Full Text Available Despite many medical advances, burns continue to remain a challenging problem due to the lack of infrastructure and trained professionals as well as the increased cost of treatment, all of which have an impact on the outcome. There is very little information on the pattern of outcomes among burn patients in relation to clinical aspects in India. Hence, the present study was undertaken in a burns unit to determine selected epidemiological variables, assess the clinical aspects (etiology, extent and anatomical location and first aid measures adopted and finally to analyse the outcomes in cases of burn injuries. In addition, we have sought to suggest measures to remove myths about pre-hospital burn treatment and provide recommendations to healthcare professionals.

  3. Organ donation after circulatory death in a university teaching hospital.

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    Sidiropoulos, S; Treasure, E; Silvester, W; Opdam, H; Warrillow, S J; Jones, D

    2016-07-01

    Although organ transplantation is well established for end-stage organ failure, many patients die on waiting lists due to insufficient donor numbers. Recently, there has been renewed interest in donation after circulatory death (DCD). In a retrospective observational study we reviewed the screening of patients considered for DCD between March 2007 and December 2012 in our hospital. Overall, 148 patients were screened, 17 of whom were transferred from other hospitals. Ninety-three patients were excluded (53 immediately and 40 after review by donation staff). The 55 DCD patients were younger than those excluded (P=0.007) and they died from hypoxic brain injury (43.6%), intraparenchymal haemorrhage (21.8%) and subarachnoid haemorrhage (14.5%). Antemortem heparin administration and bronchoscopy occurred in 50/53 (94.3%) and 22/55 (40%) of cases, respectively. Forty-eight patients died within 90 minutes and proceeded to donation surgery. Associations with not dying in 90 minutes included spontaneous ventilation mode (P=0.022), absence of noradrenaline infusion (P=0.051) and higher PaO2:FiO2 ratio (P=0.052). The number of brain dead donors did not decrease over the study period. The time interval between admission and death was longer for DCD than for the 45 brain dead donors (5 [3-11] versus 2 [2-3] days; Porgan transplants due to DCD. Introducing a DCD program can increase potential organ donors without reducing brain dead donors. Antemortem investigations appear to be acceptable to relatives when included in the consent process.

  4. Introducing caesarean section audit in a regional teaching hospital in The Netherlands.

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    van Dillen, Jeroen; Lim, Frans; van Rijssel, Evert

    2008-08-01

    The increase in caesarean section rates is considered a reason for serious public health concern. With the objective to create awareness and initiate local discussion, obstetric audit was introduced in a regional teaching hospital in The Netherlands. Caesarean section audit was introduced during the existing daily reports meetings from August 1, 2005 to June 1, 2006 in The Haga hospital, a large teaching hospital in The Hague, The Netherlands. All caesarean sections were discussed with regard to indication, classification and audited for 'lack of necessity'. For comparing intervention rates with the period prior to audit, Chi-square test with Yates correction for 2 x 2 tables was used. Of 1221 deliveries, 228 were caesarean sections (18.7%) while prior to the audit period there were 1216 deliveries with 284 were caesarean sections (23.4%). The caesarean section rate is significantly lower during the audit period. Assisted vaginal deliveries, neonatal outcome, and induction of labor rates were comparable. Concerning the audit question 'could caesarean section have been prevented', there was discussion in 24.4% of cases. In 6.7% of caesarean sections, consensus about lack of necessity was achieved. Introducing caesarean section audit during the existing structure of daily report meetings in a regional teaching hospital is both feasible and practical. It creates awareness and encourages discussion among staff members concerning indications for caesarean sections and lack of necessity. Furthermore, there was a significant decrease in caesarean section rate during the audit period.

  5. The intricate relationship between a medical school and a teaching hospital: A case study in Uganda.

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    Mubuuke, Aloysius Gonzaga; Businge, Francis; Mukule, Emmanuel

    2014-01-01

    The relationship between medical schools and teaching hospitals is full of opportunities but also challenges even though they have complementary goals that could enhance each other. Although medical schools and teaching hospitals may face some similar challenges around the world, there could be context-specific observations that differ in resource-rich versus resource-limited settings. The purpose of this study was to investigate factors that are perceived to have influenced the relationship between a medical school and a teaching hospital in Uganda, a resource-limited setting. This was a cross-sectional, descriptive study in which key informant individual interviews were conducted with senior administrators and senior staff members of the Mulago Hospital and Makerere University Medical School. The interviews explored factors perceived to have favoured the working relationship between the two institutions, challenges faced and likely future opportunities. Both quantitative and qualitative data were generated. Thematic analysis was used with the qualitative data. Respondents reported a strained relationship between the two institutions, with unfavourable factors far outweighing the favourable factors influencing the relationship. Key negative reported factors included having different administrative set-ups, limited opportunities to share funds and to forge research collaborations, unexploited potential of sharing human resources to address staff shortages, as well as a lack of a memorandum of understanding between the two institutions. This study identifies barriers in the existing relationship between a teaching hospital and medical college in a resource-poor country. It proposes a collaborative model, rather than competitive model, for the two institutions that may work in both resource-limited and resource-rich settings.

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

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    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

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

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    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.

  8. 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.

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

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    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

  10. 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.

  11. Antifungal stewardship: implementation in a French teaching hospital.

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    Alfandari, S; Berthon, C; Coiteux, V

    2014-04-01

    Invasive fungal infections are responsible for severe morbidity and mortality in immunocompromised patients. New, more effective antifungal drugs have been available for more than a decade but are extremely expensive suggesting the need for judicious prescribing. Infectious diseases physicians had been closely collaborating with hematologists on antimicrobial use since 2000. In 2002, an antifungal stewardship program (ASP) was implemented. It included discussing antifungal prescriptions with a dedicated infectious diseases physician twice weekly, telephone counseling 5 days a week from 9 A.M. to 7 P.M., and training meetings for junior/senior prescribers organized at least once yearly. The same year, a multidisciplinary group drafted evidence-based local guidelines on the use of antifungals in the hematology unit, which were published in 2004. These guidelines included decision algorithms and preprinted prescription forms that allowed only guideline-recommended drugs for a given indication. These guidelines have been updated and simplified at least every 2 years (current version 7.0; 2012). Between 2003 and 2012, in the 20-bed isolated hematology sector (allograft and acute leukemia induction chemotherapy patients), antifungal consumption decreased by 40% (from approximately 1000 to 620 defined daily doses per 1000 hospitalization days). Invasive fungal infections (IFI) remained stable in the whole 51-bed department, during the study period, with 1 to 2 IFI per month. In 2005, the 12-week survival rate for 29 cases of invasive aspergillosis was 72%. Early IFI related mortality has decreased recently. A permanent collaboration between hematologists and an infectious diseases physician can improve antifungal prescribing. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

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

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    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.

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Surveillance of nosocomial infections in the Yaounde University Teaching Hospital, Cameroon.

    Science.gov (United States)

    Nouetchognou, Julienne Stéphanie; Ateudjieu, Jérôme; Jemea, Bonaventure; Mesumbe, Edmond Nzene; Mbanya, Dora

    2016-12-08

    Nosocomial infections (NI) represent a real public health problem in developing countries. Their surveillance is recommended to provide needed information for better control. The aim of this study was to describe the frequency and distribution of NI in the Yaoundé University Teaching Hospital (YUTH). It was a longitudinal and descriptive study targeting hospitalized patients in the intensive care, gynaecological, surgical and neonatal units. Each consenting patient was administered a questionnaire at the beginning of the study and followed up daily for the duration of their hospitalization using a standardized grid to detect all nosocomial infections. Cumulative incidence was used to estimate NI frequency. There were 307 patients included. The cumulative incidence and specific mortality rate of NI were 19.21% (16.9-21.5) and 28% (16.2-42.5) respectively. Septicaemia (20.34%), infection of the skin and soft tissues (20.34%) and urinary tract infections (15.25%) were the most frequent type of NI. Klebsiella spp. was the most frequently isolated bacterium (27%). Nosocomial infections contribute to high hospital morbidity in the Yaounde University Teaching Hospital. Strategies need to be identified for a sustainable and continuous monitoring of NI in all health facilities of Cameroon. In addition, Further studies should identify NI determinants and interventions for efficient and better control.

  16. FACTORS INFLUENCING CHOICE OF ORAL HYGIENE PRODUCTS BY DENTAL PATIENTS IN A NIGERIAN TEACHING HOSPITAL

    OpenAIRE

    Opeodu, O. I.; Gbadebo, S.O.

    2017-01-01

    Background: Several factors, such as cost, branding, packaging and family influence, had been implicated as influencing the choice of toothpastes and toothbrushes by individuals. Media advertisement is also considered a very strong factor influencing consumer's choice. Aim: To assess the extent to which some factors influenced the choice of toothpastes and toothbrushes among dental patients in a Nigerian teaching hospital. Materials and methods: Two-hundred and two patients were interviewed o...

  17. Perceptions of doctors to adverse drug reaction reporting in a teaching hospital in Lagos, Nigeria

    OpenAIRE

    Oshikoya, Kazeem A; Awobusuyi, Jacob O

    2009-01-01

    Background Spontaneous adverse drug reaction (ADR) reporting is the cornerstone of pharmacovigilance. ADR reporting with Yellow Cards has tremendously improved pharmacovigilance of drugs in many developed countries and its use is advocated by the World Health Organization (WHO). This study was aimed at investigating the knowledge and attitude of doctors in a teaching hospital in Lagos, Nigeria on spontaneous ADR reporting and to suggest possible ways of improving this method of reporting. Met...

  18. Health seeking behavior of physicians at the Jos University Teaching Hospital

    OpenAIRE

    P A Agaba; A N Ocheke; M O Akanbi; C A Daniyam; S O Ugoya; E N Okeke; E I Agaba

    2011-01-01

    Background: Physicians who have the task of caring for the sick also need to be cared for when they take ill. Healthseeking habits of physicians have been found to be poor in most developed countries. Utilization of health services by physicians in developing countries is not known. We sought to describe the health seeking habits of physicians in Nigeria. Materials and Methods: A cross-sectional survey was carried out among physicians at the Jos University Teaching Hospital, a tertiary referr...

  19. Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital

    OpenAIRE

    Carolina Justus Buhrer Ferreira Neto; Caroline Koga Plodek; Franciny Kossemba Soares; Rayza Assis de Andrade; Fernanda Teleginski; Maria Dagmar da Rocha

    2016-01-01

    Abstract Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: 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 f...

  20. Internal quality assurance activities of a surgical pathology department in an Australian teaching hospital.

    OpenAIRE

    Zardawi, I M; Bennett, G.; Jain, S; Brown, M.

    1998-01-01

    AIM: To assess the role of a quality assurance programme in improving the service provided by a surgical pathology department. METHODS: A continuous internal quality assurance study of the activities of an anatomical pathology department in an Australian teaching hospital was undertaken over a five year period. This addressed all steps involved in the production of a surgical pathology report. These were addressed in an open forum which included technical, scientific, clerical, and medical st...

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

    OpenAIRE

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

    2015-01-01

    Background 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. Methods A cross sectional survey design was used. The Registered and ...

  2. Incidence of rotavirus infection in children with gastroenteritis attending Jos university teaching hospital, Nigeria

    OpenAIRE

    Olabode Atanda O; Umeh Chijioke; Junaid Surajudeen A; Banda Jim M

    2011-01-01

    Abstract This study was conducted to determine the incidence of rotavirus infection in children with gastroenteritis attending Jos university teaching hospital, Plateau State. A total of 160 children with acute diarrhea were selected by random sampling. Stool samples were obtained and assayed for rotavirus antigens by enzyme linked immunosorbent assay technique using standard diagnostic BIOLINE Rotavirus kit. Demographic data of parents were also recorded. Rotavirus were detected in faeces of...

  3. Patient safety culture in teaching hospitals in Iran: assessment by the hospital survey on patient safety culture (HSOPSC

    Directory of Open Access Journals (Sweden)

    Mohammad Zakaria Kiaei

    2016-04-01

    Full Text Available Introduction: Patient safety culture is an important part of improvement in the safety of health care. Knowing its present status is required for development of safety culture. The present study aimed to evaluate the current status of Patient safety culture in hospitals of three central provinces of Iran. Method: The present cross-sectional study was performed in teaching hospitals of Tehran, Alborz, and Qazvin provinces. The standard HSOPSC questionnaire was used for evaluation of the patient safety culture from the viewpoint of 522(Qazvin: 200, Tehran: 312, Alborz: 40 individuals who were randomly selected as workers of the hospitals. The collected data were analyzed using Chi-square and ANOVA tests. Results:The mean positive response to 12 aspects of the patient safety was 62.9%. “Organizational learning” had the highest proportion of positive response (71.18% and “Handoffs & Transitions” had the lowest (54.49%. There was a statistically significant difference in scores of “Teamwork within Units”(p=0.006(,”Manager Expectations & actions promoting”(p=0.014,”organizational learning and continuous improvement”(p=0.001, “Management support”(p=0.007, “Feedback and communication”(p=0.012, and “Communication openness”(p=0.003 among the provinces, respectively. Conclusion: We performed a full assessment of the patient safety culture in the studied provinces. Organizational learning was satisfactory in the hospitals. The studied hospitals need arrangement of safety-based programs and supports of senior administrators to perform more sophisticated efforts and improve the patient safety culture.

  4. The Boston Children's Hospital Academy: Development and Initial Assessment of a Hospital-Based Teaching Academy.

    Science.gov (United States)

    Gooding, Holly C; McCarty, Caitlin; Millson, Rebecca; Jiang, Hungyu; Armstrong, Elizabeth; Leichtner, Alan M

    2016-01-12

    Medical education academies play an important role in the recognition and career advancement of educators. However, hospital-based clinical faculty have unique professional development needs that may not be met by medical-school-based academies. The Boston Children's Hospital Academy was founded in 2008 to serve the needs of its clinician-educators. It was open to junior faculty scholars and to senior faculty scholars and mentors, including interprofessional educators. To maintain membership, individuals must propose and work toward an education project or serve as a project mentor. In 2012, a survey was sent to all members, and annual project reports were reviewed to assess the academy's impact. Sixty-five members completed the survey. The majority agreed that the academy created a community of educators, provided opportunities for networking and scholarship, contributed to their personal identity as an educator, and led to recognition by their chief. Projects addressed curriculum development, faculty development, learner assessment, program assessment, and resource development. They largely focused on graduate medical education and on patient safety and quality. During their tenure in the academy (mean length of membership = 2.4 years), members produced an average of 4.4 education presentations and 1.9 education publications, and 11 members were promoted. A hospital-based academy provides opportunities for interprofessional faculty development. Next steps include increasing interprofessional membership, wider dissemination of members' successes, better integration with the hospital's mission, specifically regarding graduate medical education and patient safety, and additional evaluation of the academy's impact on project completion and members' accomplishments.

  5. Review of cardiac pacing at Maribor teaching hospital since 1972

    Directory of Open Access Journals (Sweden)

    Zlatko Pehnec

    2005-12-01

    Full Text Available Background: Number of implanted pacemakers is in continuous increase in Maribor General Hospital. The first four pacemakers in 1972 were followed by 50 pacemakers annually in the first 10 years. In 1988 the number first exceeded 100 implanted pacemakers and in the year 2004 achieved number 372. Altogether, till the end of the year 2004 there were 4232 pacemakers implanted. Analyses of the implanted pacemakers according to pacing mode since 1986 shows small number of DDD/VDD(R pacemakers till the year 1995. Since that year its number was increasing and in the year 1998 and 1999 exceeded half of all implanted pacemakers. In period of thirty years, there were 48.3% VVI, 22.3%VVIR, 16.4% DDD, 5.8% DDDR, 6.1% VDD and 1% AAIR pacemakers implanted. We have done analysis of the all outpatients within the 30-year period (1972–2001. For this purpose 2206 records were reviewed and 2176 patients analysed. According to gender, there were 51.4% male and 48.6% female. Average age at the time of implantation was 71 years (range from 13–96 years. Most patients (58% were between 65 and 79 years of age, there were 20% younger than 65 years and 22% older than 80 years of age. There were more men in the group till 79 years of age and more women in the group older than 80 years. Average survival of the patients with pacemaker (1771 was 94.7% after one year, 56.9% after five years and 31.5% after ten years. Survival is influenced by the age of the patients and accompanying diseases of the patients at the time of implantation, especially heart failure. In patients younger than 65 years, five years survival from implantation, was 75.4% and after ten years 54.3%. In older than 80 years, five years survival from implantation was 34.4% and after ten years 11.5%. Survival of the patients with heart failure, five years after implantation was 10% and after ten years 8% worse than those without it. In 30-year period, 271 patients had two or more pacemakers implanted

  6. 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 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.

  7. [Pneumocystis pneumonia biological diagnosis at Fann Teaching Hospital in Dakar, Senegal].

    Science.gov (United States)

    Dieng, Y; Dieng, T; Sow, D; Wlouhou, S; Sylla, K; Tine, R; Ndiaye, M; Ndiaye, J L; Faye, B; Faye, O; Gaye, O

    2016-03-01

    Data relative to Pneumocystis pneumonia in sub-Saharan Africa are not well known. Weakness of the technical material and use of little sensitive biological tools of diagnosis are among the evoked reasons. The objective of this study is to update the data of the disease at the Fann Teaching Hospital in Dakar and to estimate biological methods used in diagnosis. A descriptive longitudinal study was carried out from January 5th, 2009 to October 31st, 2011 in the parasitology and mycology laboratory of the Fann Teaching Hospital in Dakar. The bronchoalveolar lavages received in the laboratory were examined microscopically for Pneumocystis jirovecii by indirect fluorescent assay or after Giemsa or toluidine blue O staining. One hundred and eighty-three bronchoalveolar lavages withdrawn from 183 patients were received in the laboratory. Sixteen were positive for P. jirovecii at 9% frequency. Four among these patients were HIV positive. Indirect fluorescent assay allowed finding of P. jirovecii among 16 patients while Giemsa staining discovered P. jirovecii only in a single patient. No case was diagnosed by toluidine blue O staining. Pneumocystis pneumonia in Parasitology and Mycology Laboratory of Fann Teaching Hospital at Dakar was mainly diagnosed among HIV patients. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Awareness and Knowledge of Glaucoma Among Adult Patients at the Eye Clinic of a Teaching Hospital.

    Science.gov (United States)

    Nkum, G; Lartey, S; Frimpong, C; Micah, F; Nkum, B

    2015-09-01

    Primary open angle glaucoma (POAG) is an irreversible blinding disease that often presents late because it is symptomless in the early stages. Prognosis depends on early diagnosis and treatment and patient understanding of their condition. Many patients present late because of poor awareness and knowledge. This study was conducted to assess patient's awareness and knowledge of glaucoma in a referral Teaching Hospital. Descriptive cross-sectional study conducted among glaucoma patients aged 40 years and above attending the Komfo Anokye Teaching Hospital (KATH). Patients were selected by simple random sampling. They were recruited after informed consent had been given. A questionnaire on demographics, socio-economics and awareness of glaucoma was administered. There were a total of 117 participants, 61 males and 56 females. The median and modal age group was 50 and 59 years. Amongst the participants, 74% were aware of glaucoma. There were no significant statistical difference in the various age groups, sex, ethnic group or religion and their awareness of glaucoma (P > 0.05).There were statistically significant differences between those who had higher education and their awareness of glaucoma (P < 0.001). Yet only 27% of these had accurate knowledge of glaucoma. Glaucoma awareness in patients attending Komfo Anokye Teaching Hospital is high. Higher education was associated with higher awareness yet this was not translated into accurate knowledge as there were significant misconceptions. There is the need to review the contents of health education with the aim of reducing dangerous misconception of glaucoma and targeting the lower socioeconomic population.

  9. Case study: the Stanford University School of Medicine and its teaching hospitals.

    Science.gov (United States)

    Pizzo, Philip A

    2008-09-01

    There is wide variation in the governance and organization of academic health centers (AHCs), often prompted by or associated with changes in leadership. Changes at AHCs are influenced by institutional priorities, economic factors, competing needs, and the personality and performance of leaders. No organizational model has uniform applicability, and it is important for each AHC to learn what works or does not on the basis of its experiences. This case study of the Stanford University School of Medicine and its teaching hospitals--which constitute Stanford's AHC, the Stanford University Medical Center--reflects responses to the consequences of a failed merger of the teaching hospitals and related clinical enterprises with those of the University of California-San Francisco School of Medicine that required a new definition of institutional priorities and directions. These were shaped by a strategic plan that helped define goals and objectives in education, research, patient care, and the necessary financial and administrative underpinnings needed. A governance model was created that made the medical school and its two major affiliated teaching hospitals partners; this arrangement requires collaboration and coordination that is highly dependent on the shared objectives of the institutional leaders involved. The case study provides the background factors and issues that led to these changes, how they were envisioned and implemented, the current status and challenges, and some lessons learned. Although the current model is working, future changes may be needed to respond to internal and external forces and changes in leadership.

  10. Postgraduate trainees’ perceptions of the learning environment in a Nigerian teaching hospital

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    P I Idon

    2017-10-01

    Full Text Available Background. The learning environment represents various factors that describe the learner’s experiences in that setting. The learning environment of junior doctors undergoing training programmes in hospitals is considered a major factor determining both academic success and health service delivery performance. Increased performance in both areas requires routine assessment of the learning environment to identify components that need attention. Objective. To evaluate the perception of junior doctors undergoing specialist training regarding the learning environment in a teaching hospital. Methods. This was a single-centre, cross-sectional study, using the Postgraduate Hospital Educational Environment Measure (PHEEM. The questionnaire was used to collect data on the learning environment of junior doctors in all 10 clinical departments at the University of Maiduguri Teaching Hospital, Nigeria. All of the junior doctors (n=148 in the hospital at the time of the study received the questionnaire; they constituted the sample size for the survey. Data collected were analysed to assess junior doctors’ perceptions of the overall learning environment and of the individual factors in the learning environment as measured by the individual items of PHEEM. Results. The hospital educational environment was rated high, with a score of 98.25. The domains of the environment measure also showed positive perceptions, but revealed specific areas in need of attention as measured by the items of the questionnaire. Significant (p<0.05 differences were noted in the perceptions of some items of the environment in the clinical departments. Conclusions. The junior doctors’ perceptions of their educational environment were positive. The study was able to identify areas of strengths and weaknesses in the overall hospital learning environment and the specialty departments. Overall, it identified the absence of an informative handbook for junior doctors and quality

  11. Use of potentially inappropriate medications in hospitalized elderly at a teaching hospital: a comparison between Beers 2003 and 2012 criteria.

    Science.gov (United States)

    Momin, Taufik G; Pandya, Rushi N; Rana, Devang A; Patel, Varsha J

    2013-01-01

    To detect the prevalence and pattern of use of Potentially inappropriate medications (PIMs) in hospitalized elderly patients of a tertiary care teaching hospital using Beers 2012 criteria and to compare the same with Beers 2003 criteria. Prescriptions of the elderly patients aged 65 years and above were collected from the medicine ward and analyzed. PIMs were identified with help of Beers 2003 and Beers 2012 criteria and comparison was made between the two criteria. Predictors associated with use of PIM were identified using bivariate and multivariate logistic regression analysis. A total of 210 patients received 2,267 drugs. According to Beers 2003 criteria, 60 (28.57%) elderly patients received at least one PIM and 2.9% drugs were prescribed inappropriately. According to Beers 2012 criteria, 84 (40%) elderly received at least one PIM while 22 (10.47%) received multiple PIMs and about 5% drugs were prescribed inappropriately. The most commonly prescribed PIM was mineral oil-liquid paraffin (30, 14.3%) followed by spironolactone (25, 11.9%), digoxin (19, 9%), and benzodiazepines (14, 6.7%). There was a significant association between the number of patients receiving more than six drugs and the use of PIMs (P PIMs in the elderly. The study shows high prevalence of prescribing PIMs in hospitalized elderly patients. Beers 2012 criteria are more effective in identifying PIMs than Beers 2003 criteria.

  12. The Relation of Work, Family Balance, and Life Quality of Nurses Working at Teaching Hospitals of Kerman-Iran

    National Research Council Canada - National Science Library

    Sedoughi, Zeynab; Sadeghi, Masoumeh; Shahraki, Sedigheh Khodabaneh; Anari, Seyed Hossein Saberi; Amiresmaili, Mohammadreza

    2016-01-01

    .... 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...

  13. DENTAL ANXIETY AMONG CHILDREN OF AGE BETWEEN 5 TO 10 YEARS VISITING A TEACHING DENTAL HOSPITAL IN ISLAMABAD, PAKISTAN

    National Research Council Canada - National Science Library

    Raja, Gulrez Hanif; Malik, Faisal Shafiq; Bashir, Ulfat; Attaullah

    2015-01-01

    .... There is no study available from Pakistan on dental anxiety in children. The aim of this study was to assess the prevalence of dental anxiety in children attending a teaching dental hospital in Islamabad, Pakistan...

  14. The health of safety net hospitals following Massachusetts health care reform: changes in volume, revenue, costs, and operating margins from 2006 to 2009.

    Science.gov (United States)

    Mohan, Arun; Grant, Jennifer; Batalden, Maren; McCormick, Danny

    2013-01-01

    Massachusetts health care reform, designed to expand coverage and access to care for vulnerable populations, serves as the model for national health reform in the United States that will be implemented in 2014. Yet, little is known about how the reform may have affected the demand for and the financial performance of safety net hospitals (SNH), the primary source of care for such populations before the reform. Using a quasi-experimental design that included all acute care hospitals in the state, we calculated changes in mean inpatient and outpatient volumes, revenue, and operating margins at SNH from the pre-reform (Fiscal Year 2006) to the post-reform (Fiscal Year 2009) period. We contrasted these changes with contemporaneous changes occurring among non-safety net hospitals (NSNH) using a difference-in-differences approach. We found that SNH in Massachusetts continue to play a disproportionately large role in caring for disadvantaged patients after reform, but that their financial performance has declined considerably compared with NSNH. Ongoing reform efforts in the United States should account for continued SNH demand among the most vulnerable patients and should be designed so as not to undermine the financial stability of SNH that meet this demand.

  15. 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...

  16. Authority and leadership: the evolution of nursing management in 19th century teaching hospitals.

    Science.gov (United States)

    Helmstadter, Carol

    2008-01-01

    This study shows why some 19th century nursing managers were successful and some were not. With the exception of Florence Nightingale, almost nothing has been written about 19th century nursing managers. Classical historical method is used. Extensive use is made of secondary sources. Primary sources are found in the archives of the 12 London teaching hospitals, the Radcliffe Infirmary, the Convents of St John the Divine and the All Saints Sisters, and 16,000 Nightingale documents in the Collected Works of Florence Nightingale. Success in delivering a highly competent nursing service depended on the matron's leadership and legitimate authority but she also had to have the support of her hospital board to gain access to allocation of scarce resources. While the 19th century hospital environment was very different, how nurses directed under different circumstances clarifies our knowledge of successful nursing management in 2007.

  17. Hospital practice versus evidence-based obstetrics: categorizing practices for normal birth in an Egyptian teaching hospital.

    Science.gov (United States)

    Khalil, Karima; Elnoury, Amr; Cherine, Mohamed; Sholkamy, Hania; Hassanein, Nevine; Mohsen, Lamia; Breebaart, Miral; Aziz Shoubary, Abdel

    2005-12-01

    Little is known of common normal labor hospital practices in Egypt or of their relationship to evidence-based obstetrics. This study documented facility-based practices for normal labor and delivery in Egypt for the first time by categorizing 44 practices observed in a busy obstetric teaching hospital according to the World Health Organization (WHO) Technical Working Group on Normal Birth classification of normal birth practices. A multidisciplinary approach combined directly observing practices that were applied to individual laboring women and their newborns, observing ward activities, interviews, and focus groups. One hundred seventy-five normal births were observed in their entirety, over 28 days and nights, by medically trained observers using an observation checklist that documented 537 variables for each woman. Mothers were interviewed postpartum, and findings were shared with practitioners for their feedback. Observed practices were categorized according the 1999 WHO classification of 59 practices for normal birth, depending on their usefulness, effectiveness, or harmfulness. There was infrequent use of beneficial practices that should be encouraged and an unexpectedly high level of harmful practices that should be eliminated. Some beneficial practices were applied inappropriately, and practices of unproved benefit were also documented, some of which are potentially harmful to childbearing mothers and their babies. Hospital practices for normal labor were largely not in accordance with the WHO evidence-based classification of practices for normal birth. The findings are worrying, given the increasing proportion of hospital-based births in Egypt and the country's improved but relatively high maternal and neonatal mortality rates. Obstacles to following evidence-based protocols for normal labor require examination.

  18. Equipment and Energy Usage in a Large Teaching Hospital in Norway.

    Science.gov (United States)

    Rohde, Tarald; Martinez, Robert

    2015-01-01

    This article presents a study of how equipment is used in a Norwegian University hospital and suggests ways to reduce hospital energy consumption. Analysis of energy data from Norway's newest teaching hospital showed that electricity consumption was up to 50% of the whole-building energy consumption. Much of this is due to the increasing energy intensity of hospital-specific equipment. Measured power and reported usage patterns for equipment in the studied departments show daytime energy intensity of equipment at about 28.5 kBTU/ft2 per year (90 kWh/m2 per year), compared to building code standard value of only 14.9 kBTU/ft2 (47 kWh/m2 per year) for hospitals. This article intends to fill gaps in our understanding of how users and their equipment affect the energy balance in hospitals and suggests ways in which designers and equipment suppliers can help optimize energy performance while maintaining quality in the delivery of health services.

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

    Science.gov (United States)

    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

  20. 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

  1. 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.

  2. Neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program in provincial hospitals in Laos.

    Science.gov (United States)

    Schmidt, S; Bounnack, S; Hoehn, T

    2018-01-01

    Aim of this study was to analyze neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program to examine a possible impact on neonatal outcomes. This study is a retrospective data analysis of all neonatal patients treated in five provincial hospitals in Laos after implementation of a neonatal teaching program. A simulation-based teaching program aims to have positive impact on the theoretical and practical skill of hospital staff in the field of newborn care. A comparison between pre-implementation and post-implementation data of newborns admitted to provincial hospitals in Laos was used to quantify the effect of repetitive teaching on neonatal outcomes. Neonatal mortality and morbidity as well as case fatality rates of infections and asphyxia decreased in the post-implementation period. In contrast, neonatal mortality rate as well as case fatality rate of prematurity increased. The total neonatal mortality rate increased in the post-implementation period. The pre-implementation and post-implementation data enable longitudinal comparisons between hospitals and highlight the differences between hospitals concerning neonatal mortality and morbidity in provincial hospitals in Laos. These data can serve as a basis for an individual adaption of the teaching program to the unique requirements of each single hospital. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Healthcare Associated Infections: educational intervention by "Adult Learning" in an Italian teaching hospital.

    Science.gov (United States)

    Rinaldi, A; Marani, A; Montesano, M; Berdini, S; Petruccioli, M C; Di Ninno, F; Orioli, R; Ferretti, F; Tarsitani, G; Napoli, C; De Luca, A; Orsi, G B

    2016-01-01

    An educational intervention for HAI prevention based on a combination of training, motivation and subsequent application in the current clinical practice in an Italian teaching hospital. In 2015-2016 a pilot mandatory training on HAI targeted to HCWs was organized in the 450 bed teaching hospital Sant'Andrea in Rome. By adopting the "Impact/control matrix" prioritization tool, the relative level of impact (risk in causing or favoring HAI) and control (possibility for HCWs to prevent HAI) attributed by the participants to the issues associated to HAI during their working groups was evaluated. Overall, 34 physicians, 43 nurses and 15 non clinical professionals participated actively in seven courses, identifying 58 different issues related to HAI, which were reported 128 times. Results showed frequently that, within the same type of issue, HCW referred various levels of impact (risk in causing or favoring HAI) and personal control (possibility for HCW to prevent HAI). Overall staff shortage was the most reported problem by HCW in our hospital. Also hand washing was regarded as a main problem, but HCW expressed the feeling that individuals could act more successfully on this issue (high or medium control). Results showed that staff frequently did not know how to handle correctly visitors, similarly many colleagues expressed some difficulty in communicating information to patients and relatives on HAI. Surprisingly, "antimicrobial therapy" and "excessive invasive procedures" were not particularly highlighted by the personnel. HCW expressed satisfaction for the course approac. The study showed an overall good level of knowledge regarding the importance and principles of infection control in our teaching hospital HCW. However personnel perceived a variability in the impact of many issues on HAI and even more on the personal possibility to control their effect. In order to improve HCW compliance with HAI prevention programs, the "Adult Learning" model seems to be very

  4. TEACHING HOSPITAL

    African Journals Online (AJOL)

    2006-08-04

    Aug 4, 2006 ... Objective: Intraoperative cardiac arrests are not uncommon and are related to both surgical and anaesthetic factors. This study aimed to examine the factors which predispose to a periopeartive cardiac arrest, to assess the appropriateness of therapy and the outcome. Materials and Methods: All ...

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

    Science.gov (United States)

    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.

  6. Can We Do That Here? Establishing the Scope of Surgical Practice at a New Safety-Net Community Hospital Through a Transparent, Collaborative Review of Physician Privileges.

    Science.gov (United States)

    O'Neill, Sean M; Seresinghe, Sarah; Sharma, Arun; Russell, Tara A; Crawford, L'Orangerie; Frencher, Stanley K

    2018-01-01

    Stewarding of physician privileges wisely is imperative, but no guidelines exist for how to incorporate system-level factors in privileging decisions. A newly opened, safety-net community hospital tailored the scope of surgical practice through review of physician privileges. Martin Luther King, Jr. Community Hospital is a public-private partnership, safety-net institution in South Los Angeles that opened in July 2015. It has 131 beds, including a 28-bed emergency department, a 20-bed ICU, and 5 operating rooms. Staff privileging decisions were initially based only on physicians' training and experience, but this resulted in several cases that tested the boundaries of what a small community hospital was prepared to handle. A collaborative, transparent process to review physician privileges was developed. This began with physician-only review of procedure lists, followed by a larger, multidisciplinary group to assess system-level factors. Specific questions were used to guide discussion, and unanimous approval from all stakeholders was required to include a procedure. An initial list of 558 procedures across 11 specialties was reduced to 321 (57.5%). No new cases that fall outside these new boundaries have arisen. An inclusive process was crucial for obtaining buy-in and establishing cultural norms. Arranging transfer agreements remains a significant challenge. Accumulation of institutional experience continues through regular performance reviews. As this hospital's capabilities mature, a blueprint has been established for expanding surgical scope of practice based explicitly on system-level factors. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  7. 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

    OpenAIRE

    ŞENER, Yelda; BEHDİOĞLU, Sema

    2014-01-01

    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 service...

  8. Qualitative study on perceptions of hand hygiene among hospital staff in a rural teaching hospital in India.

    Science.gov (United States)

    Joshi, S C; Diwan, V; Tamhankar, A J; Joshi, R; Shah, H; Sharma, M; Pathak, A; Macaden, R; Stålsby Lundborg, C

    2012-04-01

    Hand hygiene is a simple but underutilized measure to control healthcare-associated infections. To explore staff perceptions of hand hygiene using focus group discussions (FGDs) in a teaching hospital in India. Qualitative study. The FGD guide included questions on transmission of infections, hand hygiene practices and problems with implementation, and ways to improve adherence to hand hygiene recommendations. The FGDs were recorded, transcribed verbatim, translated into English (when conducted in Hindi) and analysed using content analysis. Two themes emerged: 'inter-relationship of knowledge, beliefs, motivation, practices and needs' and 'roles and responsibilities for sustainable and efficient implementation of context-relevant approaches and interventions'. Staff were generally aware of the importance of hand hygiene for the prevention of healthcare-associated infections, but perceived practical problems with implementation. The staff suggested various interventions and appeared to be prepared to follow hand hygiene guidelines if the hospital provided the necessary facilities. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  9. Supervisory needs of research doctoral students in a university teaching hospital setting.

    Science.gov (United States)

    Caldwell, Patrina Hy; Oldmeadow, Wendy; Jones, Cheryl A

    2012-10-01

    Teaching hospitals affiliated with universities are now common sites for research higher degree supervision. We hypothesised that the hospital environment poses unique challenges to supervision compared with the traditional university research institute setting. This study aimed to identify and rank important supervision issues in a clinical setting from the students' perspective. Using the Delphi method to explore issues and facilitate consensus, small group discussions were conducted with 10 research doctoral students from a tertiary teaching hospital. We identified supervision issues that are unique to the hospital-based context. These include the demands placed on supervisors combining clinical and supervisory roles, the challenges of academic medical/scientific writing and career issues for students who are already established in their professions. Other issues identified, common to all doctoral students, include differing expectations between students and supervisors (with students wanting support for their career plans, training in research skills and increasing autonomy and responsibility), supervisor access, quality and frequency of meetings, lack of training in writing and dealing with conflicts. Our research identified that postgraduate students of supervisors who combine clinical and supervisory roles report significant issues with supervision, some of which are unique to the clinical setting. Clinician researchers who supervise postgraduate students need to balance clinical and supervisory responsibilities, identify and negotiate student expectations early in candidature and provide career counselling to students who are already highly experienced. Furthermore, clinician supervisors should undertake postgraduate supervisor training programme tailored to the hospital setting to better support their students. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of

  10. 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.

  11. Activities, functions, and structure of pharmacy and therapeutics committees in large teaching hospitals.

    Science.gov (United States)

    Mannebach, M A; Ascione, F J; Gaither, C A; Bagozzi, R P; Cohen, I A; Ryan, M L

    1999-04-01

    The results of a survey on the activities and functions of hospital-based pharmacy and therapeutics (P&T) committees are presented. Questionnaires were mailed to the pharmacy director or the person responsible for the pharmacy's drug information service at 267 teaching hospitals throughout the United States in 1994 and 1995. The survey questions covered P&T committee composition, functions, roles of members, policies and procedures, and formulary-maintenance activities. The overall response rate was 70%. The mean number of members on the P&T committees was 19.3, of whom 91% were allowed to vote. There was an average of 12.3 physicians on the committees. Each P&T committee had at least one pharmacist member, with an average of 3.2 pharmacist members; 69.5% of the institutions reported having a committee secretary, who was almost always a pharmacist. On almost all committees, pharmacists wrote the minutes, prepared the formulary review documents, and were responsible for monitoring formulary activities outside the meeting. The P&T committee functioned in a very formal manner. Most (87.7%) of the respondents reported that their institutions had a closed formulary. At all hospitals, the attending medical staff could request additions to the formulary, but at only 62.4% of the hospitals could pharmacy staff make a similar request. The committees were active in changing the formulary. P&T committees in large teaching hospitals are active in formulary management, are large and diverse, and consist mainly of physicians, although pharmacists play an important role in the meetings.

  12. Development of a medication review service for patients with enteral tubes in a community teaching hospital.

    Science.gov (United States)

    Li, Tracey; Eisenhart, Alison; Costello, Jennifer

    2017-06-01

    The results of a study to develop a hospital-wide medication review service for patients with enteral tubes to improve patient safety are presented. Inappropriate enteral administration of medications can result in occluded tubes, altered clinical response, and an increase in adverse effects. At Saint Barnabas Medical Center, a 600-bed community teaching hospital located in Livingston, New Jersey, a medication review service for patients with an enteral tube was developed. A phased approach was used. In phase 1, a retrospective chart review revealed that 43% of our patients with enteral tubes received at least one medication that should not be crushed. In phase 2, we identified formulary medications that should not be crushed based on guidance from the Institute for Safe Medication Practices. We added a "do not crush" warning to the identified medications in our electronic medication administration record and automated medication dispensing system. In phase 3, we created an automatic substitution list of medications. Phase 4 involved the development of the program in our health information technology platform. An electronic task list alerted pharmacists about patients with enteral tubes who required medication review and potential medication substitutions, as well as patients with newly removed enteral tubes who can be placed back on their original medications. In phase 5, we provided education to prescribers, nurses, and pharmacists. A hospital-wide medication review service for patients with enteral tubes at our community teaching medical center was developed. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  13. Prevalence and causes of blindness in Otibhor Okhae Teaching Hospital, Irrua, Edo State, Nigeria.

    Science.gov (United States)

    Dawodu, O A; Osahon, A I; Emifoniye, E

    2003-12-01

    This hospital-based retrospective study was aimed at providing baseline information on the causes of blindness in the locality. The case notes of all new patients attending the Eye Clinic of Otibhor Okhae Teaching Hospital, Irrua, Edo State, Nigeria, over a six-year period (January 1995-December 2000) were retrieved and analyzed. Over 6% (555) of new patients seen during this period were uniocularly blind while 3.9% (354) were binocularly blind. The leading causes of uniocular blindness were cataract, open-angle glaucoma and corneal ulceration/leucoma. Binocular blindness was mainly due to cataract, open-angle glaucoma and aphakia. The prevalence of blindness in the study population is high. Cataract, as the main cause of blindness, will require surgical relief, either in the teaching hospital or preferably in the patient's locality. Appropriate interventions need to be evolved (in the form of either mobile clinics or a series of surgical eye camps) to stem the present trend toward high prevalence of avoidable blindness. Prevention of ocular trauma is an essential factor in the reduction of blindness in children. Health education and bringing ophthalmological care to the doorstep of underprivileged rural dwellers will improve their level of awareness.

  14. 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.

  15. 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

  16. Genetic characterization of Pseudomonas aeruginosa-resistant isolates at the university teaching hospital in Iran.

    Science.gov (United States)

    Fazeli, Hossein; Sadighian, Hooman; Esfahani, Bahram Nasr; Pourmand, Mohammad Reza

    2015-01-01

    Pseudomonas aeruginosa is an opportunistic pathogen that is commonly responsible for nosocomial infections. The aim of this study was to perform a genotyping analysis of the Pseudomonas aeruginosa-resistant isolates by the multilocus sequence typing (MLST) method at the university teaching hospital in Iran. Antimicrobial susceptibility was analyzed for P. aeruginosa isolates. Ceftazidime-resistant (CAZres) isolates with a positive double-disc synergy test were screened for the presence of extended-spectrum β-lactamase-encoding genes. Phenotypic tests to detect the metallo-β-lactamase strains of P. aeruginosa were performed on imipenem-resistant (IMPres) isolates. Selected strains were characterized by MLST. Of 35 P. aeruginosa isolates, 71%, 45% and 45% of isolates were CAZres, IMPres and multidrug resistant (MDR), respectively. Fifty-seven percent of the isolates carried the bla OXAgroup-1. All the five typed isolates were ST235. Isolates of ST235 that were MDR showed a unique resistance pattern. This study shows a high rate of MDR P. aeruginosa isolates at the university teaching hospital in Iran. It seems MDR isolates of P. aeruginosa ST235 with unique resistance pattern disseminated in this hospital.

  17. Incidence of pneumonia in an intensive care unit of a teaching hospital in Fortaleza - CE

    Directory of Open Access Journals (Sweden)

    Emanuela Lima Bezerra

    2012-06-01

    Full Text Available Objectives: To evaluate the prevalence of pneumonia in an intensive care unit (ICU of a teaching hospital in Fortaleza - CE, Brazil, verifying the mortality of patients with ventilatorassociatedpneumonia (VAP and identifying possible risk factors for VAP. Methods: A quantitative, case series, and observational study conducted from January 2007 to January 2009 in an ICU of a teaching hospital of Fortaleza, attended by patients of both sexes, agedabove 18 years, intubated or tracheostomized by making use of mechanical ventilation (MV with a minimum of 24 hours. The data collection instrument was composed of items: age, sex, length of stay, diagnosis, hospital course, cultures requested, infectious microorganisms and antibiotics. The subjects were 74 patients on MV, 29 (38.03% men and 45 (61.97% women, with an average age of 58 years, remaining in the ICU on average 19.45 days and under ventilation, on average, 15.78 days. Results: It was found that 70 (94.6% patients had pneumonia (PN, and the most frequent microorganisms were Pseudomonas aeruginosa and Actinobacter Balmani. Only 4 (5.4% were not infected, 34 (45.9% patients subsequentlydied and 40 (54.1% were transferred from the ICU, 42 patients used nasoenteral tube and / or nasogastric tube. Conclusions: VAP was present in most of the population studied. The nasoentereal tube, as well as the nasogastric tube, represents risk factor for the development of VAP, however, was not possible to determine the factors that probably cause the PN.

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

    Science.gov (United States)

    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.

  19. Primary malignant bone tumour in a tropical African University teaching hospital.

    Science.gov (United States)

    Omololu, A B; Ogunbiyi, J O; Ogunlade, S O; Alonge, T O; Adebisi, A; Akang, E E

    2002-01-01

    Bone tumours are relatively rare tumours as compared with all other tumours. The relative frequency has not been well documented in this environment. The aim of the study was to define the frequency of primary malignant bone tumours in an African University teaching hospital in Ibadan. The medical records of 114 patients with malignant bone tumours recorded in the Cancer Registry of the University College Hospital, Ibadan, Nigeria between January 1977 and December 2000 were reviewed retrospectively. Primary malignant bone tumours represented 0.53% of all the 21390 cancers seen in the teaching hospital in the period studied, with a male female ratio of 1.4:1. About 45% oftumours occurred among patients < 20 years of age. Osteogenic sarcoma was the most common primary malignant bone tumour while the mandible was the most commonly affected bone. In contrast to previous studies, Burkitt's lymphoma affected the mandible more commonly than the maxilla. The relative frequency of primary malignant bone tumours is low in our environment as observed in other developing countries.

  20. Patient safety in obstetrics and gynecology departments of two teaching hospitals in Delhi

    Directory of Open Access Journals (Sweden)

    Bindiya Gupta

    2016-01-01

    Full Text Available Background: A healthy safety culture is integral to positive health care. A sound safety climate is required in Obstetrics and Gynecology to prevent adverse outcomes. Objective: The objective of this study was to assess and compare patient safety culture in two departments of Obstetrics and Gynecology. Materials and Methods: Using a closed-ended standard version of Hospital Survey on Patient Safety Culture (HSOPS, respondents were asked to answer 42 survey items, grouped into 10 dimensions and two outcome variables in two tertiary care teaching hospitals in Delhi. Qualitative data were compared using Fisher's exact test and chi-square test wherever applicable. Mean values were calculated and compared using unpaired t-test. Results: The overall survey response rate was 55%. A positive response rate of 57% was seen in the overall perception of patient safety that ranged from very good to acceptable. Sixty-four percent showed positive teamwork across hospital departments and units, while 36% gave an affirmative opinion with respect to interdepartmental handoffs. However, few adverse events (0-10 were reported in the last 12 months and only 38% of mistakes by doctors were reported. Half of the respondents agreed that their mistakes were held against them. There was no statistical difference in the safety culture between the two hospitals. Conclusions: Although the perception of patient safety and standards of patient safety were high in both the hospitals' departments, there is plenty of scope for improvement with respect to event reporting, positive feedback, and nonpunitive error.

  1. Role and Structure of Morning Report in Children’s Teaching Hospitals in Iran

    Directory of Open Access Journals (Sweden)

    Maliheh Kadivar

    2011-07-01

    Full Text Available Background: Morning report is an integral component of medical training programs. It is conducted as "evidence based" or "problem based". It takes an efficient time of all members of the medical team in teaching hospitals, it seems necessary to evaluate its role in the education. Because of the importance of morning report in education, we evaluated the current and ideal conditions of morning report according to the opinions of medical teams in teaching children’s hospitals. Methods: A cross- sectional descriptive study conducted in three children’s teaching hospitals in Tehran in 2005. The opinion and perception of 358 participants, including faculties, residents, fellows, interns, and medical students, were collected by a questionnaire regarding the importance and structure of morning report. The data were presented as frequency and percentage. Results: 78% of respondents expected a high educational role for morning report. Although 317(88.54% had a regular attendance in morning report, only 34.1% were satisfied from current condition. The majority believed that faculty had better to lead the sessions, and voted for case presentation to be selected by senior resident on call, despite the prominent current leadership of the faculty. Most of the participants (88.6% preferred complicated and unusual cases for presentation. Current morning reports predominantly based on the presentation of the interesting or complicated cases were admitted on the previous day. A few number of cases were reintroduced after achieving the final diagnosis. In addition out-patients and those under observation in emergency room were usually ignored in the meetings. Conclusion: Regarding the educational role of morning report, there is a far distance between the present and ideal condition. Unattractiveness of presentations and poor participation in discussion might have negative impact on achieving the goals.

  2. Perceptions of doctors to adverse drug reaction reporting in a teaching hospital in Lagos, Nigeria.

    Science.gov (United States)

    Oshikoya, Kazeem A; Awobusuyi, Jacob O

    2009-08-11

    Spontaneous adverse drug reaction (ADR) reporting is the cornerstone of pharmacovigilance. ADR reporting with Yellow Cards has tremendously improved pharmacovigilance of drugs in many developed countries and its use is advocated by the World Health Organization (WHO). This study was aimed at investigating the knowledge and attitude of doctors in a teaching hospital in Lagos, Nigeria on spontaneous ADR reporting and to suggest possible ways of improving this method of reporting. A total of 120 doctors working at the Lagos State University Teaching Hospital (LASUTH), in Nigeria were evaluated with a questionnaire for their knowledge and attitudes to ADR reporting. The questionnaire sought the demographics of the doctors, their knowledge and attitudes to ADR reporting, the factors that they perceived may influence ADR reporting, and their levels of education and training on ADR reporting. Provision was also made for suggestions on the possible ways to improve ADR reporting. The response rate was 82.5%. A majority of the respondents (89, 89.9%) considered doctors as the most qualified health professionals to report ADRs. Forty (40.4%) of the respondents knew about the existence of National Pharmacovigilance Centre (NPC) in Nigeria. Thirty-two (32.3%) respondents were aware of the Yellow Card reporting scheme but only two had ever reported ADRs to the NPC. About half (48.5%) of the respondents felt that all serious ADRs could be identified after drug marketing. There was a significant difference between the proportion of respondents who felt that ADR reporting should be either compulsory or voluntary (chi2 = 38.9, P Education and training was the most recognised means of improving ADR reporting. The knowledge of ADRs and how to report them are inadequate among doctors working in a teaching hospital in Lagos, Nigeria. More awareness should be created on the Yellow Card reporting scheme. Continuous medical education, training and integration of ADR reporting into the

  3. Pattern and outcome of congenital malformations in newborn babies in a Nigerian teaching hospital.

    Science.gov (United States)

    Ambe, J P; Madziga, A G; Akpede, G O; Mava, Y

    2010-01-01

    Several types of congenital malformations have been seen in our settings, but the frequencies and pattern are not known. To review the prevalence and pattern of congenital malformation in the Special Care Baby Unit (SCBU) of the University of Maiduguri Teaching Hospital, Maiduguri, over a 10-year period. This was a retrospective study carried out in a semi-urban Nigerian Teaching Hospital. All admissions into SCBU from 1991 to 2000 were reviewed, using both the admission and discharge records. The information extracted from the case note of each patient included sex, age and weight on presentation, maternal age and parity, gestational age, presence of associated neonatal illnesses such as jaundice, sepsis and the type of malformation on physical examination only. Three hundred and ten (13.9%) of 2233 admissions had major congenital malformation. Thirty one (10%) gave a history of antenatal care while 279(90%) had no record of receiving antenatal care. Of the 310 babies, 140 (45.2%) abnormalities were of the gastro-intestinal system and 75 (24.2%) of central nervous system. Anterior abdominal wall defect 77(24.8%) was the commonest type of malformation seen followed by neural tube defect 63(20.3%) and imperforate anus 31(10.0%). Gastro-intestinal malformations were associated with a mortality rate of 60.9% as compared with 21.1% in those with central nervous system malformations. The high prevalence of malformation seen in this study could be associated with the fact that majority (75.4%) of the mothers delivered their babies outside the teaching hospital, whose antenatal care are unknown. The occurrence of congenital malformations is very high in North Eastern Nigeria, Environmental factors may have a role.

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

    Directory of Open Access Journals (Sweden)

    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

  5. Using ActivHeal dressings in a London teaching hospital: a cost analysis.

    Science.gov (United States)

    Lewis, Sarah

    Lower-cost 'generic' wound dressings are now available in the dressing categories of foams, films, alginates, gels and hydrocolloids. This offers the possibility of achieving significant financial savings while retaining good clinical standards of wound care. To test the potential for cost saving in a typical London teaching hospital, the ActivHeal range of dressings was substituted for normal 'branded' dressings over a 3-month period, during which dressing cost and clinical effectiveness were assessed. The result was an equivalent yearly cost saving of pound55 221 (54%), with retention of performance standards across the dressing range. Two years after the trial, wards in University College London Hospitals NHS Foundation Trust continue to benefit from significant annual cost savings on dressings by using the ActivHeal range of products, while maintaining a high standard of clinical care.

  6. 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.

  7. Predictors of preoperative anxiety among surgical patients in Jimma University Specialized Teaching Hospital, South Western Ethiopia.

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    Nigussie, Seifu; Belachew, Tefera; Wolancho, Wadu

    2014-09-05

    Hospitalization and surgery are critical negative life events that lead to the experience of considerable anxiety in patients. Patients may perceive the day of surgery as the biggest and the most threatening day in their lives. There is paucity of information on predictors of anxiety in the current study area. The main objective of this study is to assess predictors of preoperative anxiety among patients scheduled for surgery in Jimma University Specialized Teaching Hospital. A facility based cross-sectional study was conducted using quantitative data collection technique in Jimma University Specialized Teaching Hospital from February 13 to April 13, 2012 on 239 patients scheduled for surgery. The data were collected by five trained diploma nurses using structured interviewer administered questionnaires that were prepared based on state trait anxiety inventory measurement scale. The quantitative data were entered into SPSS for windows version 16. 0 and descriptive, simple and multiple linear regression analyses were performed. A total of 239 patients were enrolled in the study with a response rate of 93.0%. Their mean age was 42.7 ± 1.8 years (range 16 to 85 years). Nearly over half 53.6% were females, while 48.1% illiterate, 72.4% Oromo and 56.5% were Muslim followers. Significant preoperative anxiety was seen in 70.3% patients. The most common factors that lead to anxiety were fear of death 38.1% and fear of unknown origin 24.3% and the most common strategy mentioned by patient in reducing anxiety were talking to other patient 79.8% and religious belief. In the present study, two third 70.3% of preoperative patients had anxiety. Factors which were positively correlated with anxiety were trait anxiety, single and divorced, time of operation and income. Factors which were shown to reduce anxiety were preoperative anxiety related information provision and afternoon operation. Health professionals working in the hospital should provide anxiety related

  8. Do-not-resuscitate orders for terminal patients with cancer in teaching hospitals of Korea.

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    Kim, Do Yeun; Lee, Kyoung Eun; Nam, Eun Mi; Lee, Hye Ran; Lee, Keun-Wook; Kim, Jee Hyun; Lee, Jong Seok; Lee, Soon Nam

    2007-10-01

    To examine the current practices relating to do-not-resuscitate (DNR) orders for terminal patients with cancer at teaching hospitals in Korea. The records of 387 deaths from January 1 to December 31, 2005 at four cancer centers were identified and reviewed to assess the DNR delineation. Basic demographics, circumstances surrounding the establishment of the DNR directive, the percentage of orders for identified populations, and the time interval between DNR consent and death were evaluated. An order of DNR consent was obtained from 296 patients (76%) of a total of 387 patients. All DNR consents were made between the physician and family, without involving the patient. Written preprinted DNR consent forms were used in 169 (57%) cases and 127 patients (43%) had verbal DNR permission. DNR consent was interpreted in two ways: one forbade resuscitation in two hospitals and the other implied limited care in two other hospitals. A unilateral physician decision to withhold cardiopulmonary resuscitation (CPR) was decided for 62 (16%) patients. Terminal CPR was performed on 29 (7%) patients. DNR discussion was made within 7 days of the day of death on 228 (77%) patient among the 296 DNR consenting patients. From our teaching-hospital-based analysis of terminal cancer patients in Korea, consent for a DNR order was common. However, DNR order forms were not standardized and lacked room to document patient involvement in the decision. Usually the DNR decision was made within last days of the patient's life. Our results reflect the need for the improvement of end-of-life care decisions in Korea.

  9. 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.

  10. Documentation of Rectal Examination Performance in the Clinical Teaching Unit of a University Hospital

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    Hugh James Freeman

    2000-01-01

    Full Text Available Digital rectal examination is used to evaluate the distal rectum and other organs, including the prostate gland. It may be combined with fecal screening for occult blood loss, and annual performance has been recommended for asymptomatic individuals over age 40 years for cancer screening. In this study, documentation of digital rectal examinations was assessed through a review of hospital medical records of a randomly selected group of 100 patient discharges (55 females and 45 males from a total of 896 patients admitted through a hospital emergency room to a medical clinical teaching inpatient unit of a university hospital during a six-month period. In this group, 26% were admitted for a gastrointestinal disorder, but only 17% of all hospitalized patients had rectal examinations done by the medical resident house staff and/or attending medical staff directly responsible for the care of these patients. Occult blood testing was done in 15 patients. Pelvic and breast examinations were rarely documented. The majority of rectal examinations (ie, 13 of 17 were ’same sex’ examinations, appeared to be used largely for testing or confirmation of grossly visible blood loss and were never confirmed by attending staff. The presence or absence of nursing staff during examinations was not documented. The prostate examination was normal in one patient but not documented in the other 44 males (ie, 26 patients over age 60 years. In conclusion, rectal examinations (as well as breast and pelvic examinations were rarely documented in the medical teaching unit by medical resident house staff or their attending staff.

  11. How one teaching hospital system and one medical school are jointly affirming their academic mission.

    Science.gov (United States)

    Rosenblatt, M; Rabkin, M T; Tosteson, D C

    1997-06-01

    The economic forces that are reshaping the practice of medicine and the funding of medical research will have great impact on clinical education and research in teaching hospitals and their associated medical schools. Changes in the setting of and approach to medical education will need to be made in order to continue to train physicians at the same high level as in the past and to maintain the productivity of our national biomedical research enterprise and its contributions to health. Academic leaders, such as department chiefs who have clinical service responsibilities, are finding it more and more difficult to manage simultaneously the demands of the clinical business, education, and research. In an effort to organize a teaching hospital and a medical school in a manner that would position them to maintain more effectively their common academic mission front and center with the clinical business, Harvard Medical School and the Beth Israel Hospital created a joint venture in 1996. The new nonprofit Institute for Education and Research has education and research as its top (and only) mission. It is designed to provide additional and specific academic leadership and to enable the joint venture to undertake strategic planning for the academic mission. In addition to the challenges it faces from changes in the external environment, the Institute for Education and Research will need to establish a new pattern of interactions internally within the parent institutions. Collaborations with department chairs and faculty are an essential ingredient for its success. It is hoped that this structure will prove to be a useful template for organizing other medical school-hospital collaborations on behalf of the academic mission.

  12. An ethnographic investigation of junior doctors' capacities to practice interprofessionally in three teaching hospitals.

    Science.gov (United States)

    Milne, Jacqueline; Greenfield, David; Braithwaite, Jeffrey

    2015-01-01

    Collaborative practice among early career staff is at the bedrock of interprofessional care. This study investigated factors influencing the enactment of interprofessional practice by using the day-to-day role of six junior doctors in three teaching hospitals as a gateway to understand the various professions' interactive behaviours. The contextual framework used for the study was Strauss' theory of negotiated order. Ethnographic techniques were applied to observe the actions and interactions of participants on typical working days in their hospital environments. Field notes were created and thematic analysis was applied to the data. Three themes explored were culture, communication, and collaboration. Issues identified highlight the bounded organisational and professional cultures within which junior doctors work, and systemic problems in interprofessional interaction and communication in the wards of hospitals. There are indications that early career doctors are interprofessional isolates. The constraints of short training terms and pressure from multi-faceted demands on junior doctors can interfere with the establishment of meaningful relationships with nurses and other health professionals. The realisation of sustained interprofessional practice is, therefore, practically and structurally difficult. Enabling factors supporting the sharing of expertise are outweighed by barriers associated with professional and hospital organisational cultures, poor interprofessional communication, and the pressure of competing individual task demands in the course of daily practice.

  13. A cost analysis of an introduction to clinical medicine course in a non-university teaching hospital.

    Science.gov (United States)

    Tai, L W; Tulley, J E

    1997-01-01

    To determine the major direct costs associated with teaching the Introduction to Clinical Medicine (ICM) course at a non-university teaching hospital. The major direct costs were calculated for ICM, a ten-week course taught at the Columbia Michael Reese Hospital and Medical Center, a non-university teaching hospital, to second-year students from the University of Illinois College of Medicine at Chicago. The major components of ICM are physical diagnosis, clinical pathology, and radiology, as well as some pediatrics; the bulk of the costs for these components is incurred for physician staff time. Physician time was reported by component coordinators, who also estimated preparation and teaching times. Physician cost per hour was chosen as that equivalent to assistant professors' salaries. Resident cost per hour was determined from the average resident salary at the hospital. Miscellaneous direct costs (of basic life-support certification, gift certificates, and standardized patients) were calculated from the receipts and bills submitted for payment. In the spring of 1995 the hospital conducted ICM for 26 students. The attending physicians worked a total of 736.5 hours, for a cost of $37,303. The residents worked a total of 314 hours, for a cost of $4,396. Miscellaneous costs totaled $2,019. The total of these major direct costs was $43,718, or $1,681 per student. These results can help medical educators and policymakers as they investigate innovative teaching methods and funding sources.

  14. 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.

  15. Use of complementary and alternative medicine by cancer patients at Zhejiang University Teaching Hospital Zhuji Hospital, China.

    Science.gov (United States)

    Teng, Lisong; Jin, Ketao; He, Kuifeng; Bian, Chunge; Chen, Weili; Fu, Kaiyan; Zhu, Tieming; Jin, Zhigang

    2010-01-01

    Complementary and alternative medicine (CAM) is garnering increasing interest and acceptance among the general population throughout the world. The use of CAM by cancer patients is very common in China. The referenced English literature has no rural community-based study from China on this subject. This study was conducted to define the prevalence, pattern of use, and reasons for using CAM by cancer patients at Zhejiang University Teaching Hospital Zhuji Hospital (ZUTH-ZJH), China. Face-to-face interviews using a structured questionnaire were used to determine the use of CAM by cancer patients. All consenting cancer patients were interviewed as they presented at the Department of Surgical Oncology of ZUTH-ZJH, from September 2009 to February 2010. One hundred and twenty one patients were interviewed; 64 (52.9%) were males and 57 (47.1%) were females. One hundred and thirteen patients (93.4%) have used CAM at some time during their current cancer illness, fifty two (46.0%) are female and sixty one (54.0%) are male patients; 8 (6.6%) patients have not used any form of CAM. Chinese medicine (73.5.0%) was the most commonly reported CAM modality. Over 71.7% of those who used CAM were satisfied, only 28.3% were disappointed. Twenty eight users (24.8%) did not see any benefit from the CAM, but eighty one patients (71.7%) could describe some specific benefits. Only one patient will use orthodox medicine instead of CAM in the future, almost all patients will continue to use CAM in the future. CAM use is very common among cancer patients in local area of China. Most users obtain the expected benefits, and adverse events are uncommon. It is imperative that oncologists should explore the use of CAM with their cancer patients and work towards an integrated model of health-care provision. This knowledge will enable oncologists to better counsel the patients.

  16. 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.

  17. 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.

  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. Etiology of strokes and hemiplegia in children presenting at Ayub Teaching Hospital, Abbottabad.

    Science.gov (United States)

    Siddiqui, Tahir Saeed; Rehman, Anis ur; Ahmed, Basharat

    2006-01-01

    Strokes in pediatric age group are not common. However diagnosing the cause of stroke will help in providing preventive and curative treatment. Present study was conducted to find etiology of strokes/hemiplegia in children. This study was conducted in Department of Pediatrics, Ayub Teaching Hospital Abbottabad from December 2002 to December 2005. All children from two months to fifteen years of age were included in the study. Children with weakness due to acute poliomyelitis and Guillan barre syndrome were excluded. Investigations were based on findings on history and clinical examination and included full blood count, PT, APTT, Platelets count, ECG, Echocardiography, hematocrit, lumber puncture with CSF analysis and culture and CT-scan skull. Data of all the patients presenting with strokes/hemiplegia was entered on prepared proforma. The main etiology of strokes was intracranial infection causing strokes in 23(56.09%)children and majority of children (78.26%) in this group were below five years. Etiology was un-known in 7(17.07%) children after necessary available investigations. Intracranial infection Infections that is meningitis and encephalitis are commonest etiology of strokes and hemiplegia in paediatrics patients presenting at Ayub Teaching Hospital, Abbottabad.

  20. Obstetric outcomes of booked teenage pregnancies at University of Calabar Teaching Hospital, Nigeria

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    Ago BU

    2012-10-01

    Full Text Available Boniface Uji Ago, Sylvester Abeshi, Charles Njoku, Thomas Udagbor Agan, John EkabuaDepartment of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, NigeriaBackground: Teenage pregnancy is high-risk and associated with complications due to adverse physiological, anatomical, and socioeconomic factors. The purpose of this study was to determine the patterns and obstetric outcomes of booked teenage pregnancies at the University of Calabar Teaching Hospital (UCTH in Nigeria.Methods: A retrospective comparative analysis of teenage pregnancies and mature mothers at UCTH was carried out from January 2011 to December 2011. A total of 82 teenage pregnancies and 72 mature pregnancies were compared.Results: There were 145 teenage deliveries from a total of 2313 deliveries, ie, 6.3% of total deliveries. There was no statistically significant difference in the mode of delivery (cesarean section, spontaneous vaginal delivery, instrumental delivery between the groups of mothers. There was also no difference in risk of complications, including obstructed labor, retained placenta, uterine atony, pre-eclampsia/eclampsia, and antepartum hemorrhage. However, teenage mothers had more perineal lacerations (P = 0.02 and more preterm labor (P = 0.05, and delivered more low-birth-weight babies (P = 0.02.Conclusion: Supervised teenage pregnancy may not be as hazardous as previously thought.Keywords: teenage pregnancy, booked pregnancy, obstetric outcome

  1. Toward Safer Transitions: A Curriculum to Teach and Assess Hospital-to-Hospice Handoffs.

    Science.gov (United States)

    Darrah, Neha J; O'Connor, Nina R

    2016-06-01

    Patient handoffs are an increasingly emphasized skill in medical and nursing education, and handoff education is required by the Accreditation Council for Graduate Medical Education. Traditional handoff tools lack content that is unique to hospice and palliative medicine. The objective of the study was to develop a comprehensive curriculum to teach and assess patient handoffs in hospice and palliative medicine fellowships. Eight hospice physicians, nurse practitioners, and nurses were interviewed to determine core content for a hospital-to-hospice handoff. This content was used to create a verbal handoff template and direct observation assessment tool, which were reviewed by the same hospice providers for content validity. The handoff template was taught to two groups of palliative medicine fellows and one group of internal medicine residents using an interactive didactic and role play, and feedback was obtained to further refine the curriculum. After refinement, the complete handoff curriculum (verbal handoff template, didactic with role play, assessment by faculty using direct observation tool) was successfully integrated into a hospice and palliative medicine fellowship, satisfying Accreditation Council for Graduate Medical Education requirements related to transitions in care. The hospital-to-hospice handoff is a unique opportunity to teach patient safety in a palliative medicine context. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  2. The role of teaching and research hospitals in improving global health (in a globalized world).

    Science.gov (United States)

    Leggat, Sandra G; Tse, Nancy

    2003-01-01

    Globalization is impacting on Hong Kong and Australia in different ways, but the experience of the public healthcare systems in both jurisdictions suggests a need for teaching and research hospitals to refocus from the management of international patients to better meet the needs for global health. Traditional globalization suggests a stockpiling of capital--a focus on improving global health suggests dismantling the stockpiles and sharing access to the necessary data, information, knowledge and discoveries to further develop local health expertise. Consistent with its position as a leading healthcare provider, the University Health Network (UHN) has been reflecting on the impact of increasing globalization on hospitals. The goals of the UHN paper on globalization are threefold--to suggest how the external and internal environments of hospitals will change as a result of globalization; to suggest a role for hospitals in a globalized world; and to stimulate discussion and debate. Given our perspective, from the other side of the world, we are pleased to contribute to the discussion and debate but will limit our comments to the future role of teaching and research hospitals based on some of the experiences of Australia and Hong Kong. The citizens of Hong Kong have been acutely aware of the issue of globalization--the excellent deep-water harbour has ensured the position of Hong Kong as a major trading hub. Hong Kong has also had a continually evolving role as a financial centre and gateway to China, and with China's accession to the World Trade Organization the impact of globalization will be even greater. On the other hand, the citizens of Australia have lived with geographic isolation, relatively limited natural resources and a small population, all of which have limited their role in global trade and financial markets. However, both Hong Kong and Australia have seen recent benefits from the increasing speed of communication and information transfer and exchange

  3. Measles among healthcare workers in a teaching hospital in central Italy.

    Science.gov (United States)

    Barbadoro, Pamela; Marigliano, Anna; Di Tondo, Elena; De Paolis, Maria; Martini, Enrica; Prospero, Emilia; D'Errico, Marcello Mario

    2012-01-01

    The aim of this report is to describe a measles cluster involving health-care workers (HWCs) that occurred in a teaching hospital in central Italy during winter 2011 and the efforts made to promptly identify all the susceptible contacts in order to stop, as soon as possible, transmission of the infection within the hospital. An epidemiological investigation took place. The immunization status of all the exposed individuals was assessed by personal interviews (history of measles or measles vaccine). Serologie screening for personnel not immune to measles was performed. Four cases of measles infection in HCWs were identified; of the 72 HCWs tested for measles immunity, 50 reported a past history of measles, while 22 underwent serological screening, which showed that all were IgG positive except for one case, which was excluded from duty as recommended. Strict adherence to use of alcohol-based hand rub and rapid implementation of appropriate isolation precautions are essential but insufficient to prevent measles outbreaks in hospital settings. Vaccination is the only reliable protection against nosocomial spread of measles. Therefore, assessing the immunization status of HCW and implementing vaccination strategies are needed in order to virtually set to zero the risk of acquiring and spreading measles in healthcare settings.

  4. Factors associated with hand hygiene compliance at a tertiary care teaching hospital.

    Science.gov (United States)

    Kowitt, Benjamin; Jefferson, Julie; Mermel, Leonard A

    2013-11-01

    To identify factors associated with hand hygiene compliance during a multiyear period of intervention. Observational study. A 719-bed tertiary care teaching hospital. Nursing, physician, technical, and support staff. Light-duty staff performed hand hygiene observations during the period July 2008-December 2012. Infection control implemented hospital-wide hand hygiene initiatives, including education modules; posters and table tents; feedback to units, medical directors and the executive board; and an increased number of automated alcohol hand hygiene product dispensers. There were 161,526 unique observations; overall compliance was 83%. Significant differences in compliance were observed between physician staff (78%) and support staff (69%) compared with nursing staff (84%). Pediatric units (84%) and intensive care units (84%) had higher compliance than did medical (82%) and surgical units (81%). These findings persisted in the controlled multivariate model for noncompliance. Additional factors found to be significant in the model included greater compliance when healthcare workers were leaving patient rooms, when the patient was under contact precautions, and during the evening shift. The overall rate of compliance increased from 60% in the first year of observation to a peak of 96% in the fourth year, and it decreased to 89% in the final year, with significant improvements occurring in each of the 4 professional categories. A multipronged hand hygiene initiative is effective in increasing compliance rates among all categories of hospital workers. We identified a variety of factors associated with increased compliance. Additionally, we note the importance of continuous interventions in maintaining high compliance rates.

  5. Integration of complementary and alternative medicine in a major pediatric teaching hospital: an initial overview.

    Science.gov (United States)

    Highfield, Ellen Silver; McLellan, Mary C; Kemper, Kathi J; Risko, Wanessa; Woolf, Alan D

    2005-04-01

    To describe the establishment of a multidisciplinary team of complementary and alternative medicine (CAM) providers and educators in an urban pediatric hospital and affiliated medical school. Pediatric CAM use is increasing. Physicians are interested in CAM-related education but few programs had been developed in pediatrics. In 1998, Children's Hospital Boston established the Center for Holistic Pediatric Education and Research (CHPER), a CAM multidisciplinary team providing clinical services, education, and research. A retrospective review describing data from patient consultation notes, CAM lectures, clinical practice guidelines, curriculum materials, team meeting minutes, and team member manuscripts and publications. Over 5.5 years, CHPER staff provided over 2100 consults: acupuncture, massage, holistic pediatrician, relaxation therapies, biofeedback, hypnosis, and bio-pharmaceutics. Acupuncture and massage therapies were incorporated into a Clinical Practice Guideline. Formal education was delivered through didactic sessions, workshops, self-learning modules, clinical observation, and clinical practice. CHPER faculty published 1 book and 64 articles on CAM-related topics. An interdisciplinary team of CAM clinicians and educators can be integrated into an urban pediatric teaching hospital to provide CAM medical education and clinical services.

  6. Paediatric urologic pathologies at the national teaching hospital in Cotonou: A etiological and therapeutic aspects

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    Augustin Karl Agossou-Voyeme

    2013-01-01

    Full Text Available Background: Urological pathologies of children are dominated by congenital malformations of the kidneys and urinary tract. Their management is often surgical. The objective of this survey was to study etiological and therapeutic aspects of urological presentations in children. Patients and Methods: Data for aetiology, treatment, and results in children hospitalized at the Paediatric Surgery service of National Teaching Hospital (CNHU in Cotonou were retrospectively analyzed from January 1999 to December 2008. Results: A total of 214 patients with complete data were evaluated. Urological pathologies represented 4.8% of the hospitalizations in paediatric surgery, with an incidence of 21 cases per year. The mean age was 4.9 ± 3.2 years (age 1 week to 14 years. The male to female ratio was 14:14. Cryptorchidism, hydrocele, nephroblastoma, the posterior urethral valves, ureteropelvic junction obstructions, post-circumcision haemorrhage and hypospadias were the most frequent pathologies. Congenital urological malformations represented 81.3%, followed neoplastic pathologies (7.9%, traumatic pathologies (6.1% and others (4.7%. The disorders of male genitalia were more frequent and constituted 68.2% of the cases. The anomalies of the urinary tract were 30.8% and intersex disorders were 0.9%. The average age of the children urological pathologies at the time of consultation was 8.85 ± 4.6 years. The treatment was often surgical with a mortality of 2.8%.

  7. Do not attempt resuscitation orders at the emergency department of a teaching hospital.

    Science.gov (United States)

    Vancini-Campanharo, Cássia Regina; Vancini, Rodrigo Luiz; Machado Netto, Marcelo Calil; Lopes, Maria Carolina Barbosa Teixeira; Okuno, Meiry Fernanda Pinto; Batista, Ruth Ester Assayag; Góis, Aécio Flávio Teixeira de

    2017-01-01

    To identify factors associated with not attempting resuscitation. A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (pcardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole. Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors.

  8. Inverse correlation between level of professional education and rate of handwashing compliance in a teaching hospital.

    Science.gov (United States)

    Duggan, Joan M; Hensley, Sandra; Khuder, Sadik; Papadimos, Thomas J; Jacobs, Lloyd

    2008-06-01

    To evaluate educational level as a contributing factor in handwashing compliance. Observation of hand washing opportunities was performed for approximately 12 weeks before an announced Joint Commission on Accreditation of Healthcare Organizations (JCAHO) visit and for approximately 10 weeks after the visit. Trained observers recorded the date, time, and location of the observation; the type of healthcare worker or hospital employee observed; and the type of hand hygiene opportunity observed. University of Toledo Medical Center, a 319-bed teaching hospital. A total of 2,373 observations were performed. The rate of hand washing compliance among nurses was 91.3% overall. Medical attending physicians had the lowest observed rate of compliance (72.4%; Psurgical intensive care unit was more than 90%, greater than that in other hospital units (P = .001). Statistically, the compliance rate was better during the first part of the week (Monday, Tuesday, and Wednesday) than during the latter part of the week (Thursday and Friday) (P = .002), and the compliance rate was better during the 3 PM-11 PM shift, compared with the 7 AM-3 PM shift (P<.001). When evaluated by logistic regression analysis, non-physician healthcare worker status and observation after the JCAHO accreditation visit were associated with an increased rate of hand hygiene compliance. An inverse correlation existed between the level of professional educational and the rate of compliance. Future research initiatives may need to address the different motivating factors for hand hygiene among nurses and physicians to increase compliance.

  9. 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.

  10. Game Theory .net.

    Science.gov (United States)

    Shor, Mikhael

    2003-01-01

    States making game theory relevant and accessible to students is challenging. Describes the primary goal of GameTheory.net is to provide interactive teaching tools. Indicates the site strives to unite educators from economics, political and computer science, and ecology by providing a repository of lecture notes and tests for courses using…

  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

    Purpose: 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. Materials and methods: 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. Results: 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. Conclusion: 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

  12. Very high prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in bacteriemic patients hospitalized in teaching hospitals in Bamako, Mali.

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    Samba Adama Sangare

    Full Text Available The worldwide dissemination of extended-spectrum beta-lactamase producing Enterobacteriaceae, (ESBL-E and their subset producing carbapenemases (CPE, is alarming. Limited data on the prevalence of such strains in infections from patients from Sub-Saharan Africa are currently available. We determined, here, the prevalence of ESBL-E/CPE in bacteriemic patients in two teaching hospitals from Bamako (Mali, which are at the top of the health care pyramid in the country. During one year, all Enterobacteriaceae isolated from bloodstream infections (E-BSI, were collected from patients hospitalized at the Point G University Teaching Hospital and the pediatric units of Gabriel Touré University Teaching Hospital. Antibiotic susceptibility testing, enzyme characterization and strain relatedness were determined. A total of 77 patients had an E-BSI and as many as 48 (62.3% were infected with an ESBL-E. ESBL-E BSI were associated with a previous hospitalization (OR 3.97 95% IC [1.32; 13.21] and were more frequent in hospital-acquired episodes (OR 3.66 95% IC [1.07; 13.38]. Among the 82 isolated Enterobacteriaceae, 58.5% were ESBL-E (20/31 Escherichia coli, 20/26 Klebsiella pneumoniae and 8/15 Enterobacter cloacae. The remaining (5 Salmonella Enteritidis, 3 Morganella morganii 1 Proteus mirabilis and 1 Leclercia adecarboxylata were ESBL negative. CTX-M-1 group enzymes were highly prevalent (89.6% among ESBLs; the remaining ones being SHV. One E. coli produced an OXA-181 carbapenemase, which is the first CPE described in Mali. The analysis of ESBL-E relatedness suggested a high rate of cross transmission between patients. In conclusion, even if CPE are still rare for the moment, the high rate of ESBL-BSI and frequent cross transmission probably impose a high medical and economic burden to Malian hospitals.

  13. Very high prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in bacteriemic patients hospitalized in teaching hospitals in Bamako, Mali.

    Science.gov (United States)

    Sangare, Samba Adama; Rondinaud, Emilie; Maataoui, Naouale; Maiga, Almoustapha Issiaka; Guindo, Ibrehima; Maiga, Aminata; Camara, Namory; Dicko, Oumar Agaly; Dao, Sounkalo; Diallo, Souleymane; Bougoudogo, Flabou; Andremont, Antoine; Maiga, Ibrahim Izetiegouma; Armand-Lefevre, Laurence

    2017-01-01

    The worldwide dissemination of extended-spectrum beta-lactamase producing Enterobacteriaceae, (ESBL-E) and their subset producing carbapenemases (CPE), is alarming. Limited data on the prevalence of such strains in infections from patients from Sub-Saharan Africa are currently available. We determined, here, the prevalence of ESBL-E/CPE in bacteriemic patients in two teaching hospitals from Bamako (Mali), which are at the top of the health care pyramid in the country. During one year, all Enterobacteriaceae isolated from bloodstream infections (E-BSI), were collected from patients hospitalized at the Point G University Teaching Hospital and the pediatric units of Gabriel Touré University Teaching Hospital. Antibiotic susceptibility testing, enzyme characterization and strain relatedness were determined. A total of 77 patients had an E-BSI and as many as 48 (62.3%) were infected with an ESBL-E. ESBL-E BSI were associated with a previous hospitalization (OR 3.97 95% IC [1.32; 13.21]) and were more frequent in hospital-acquired episodes (OR 3.66 95% IC [1.07; 13.38]). Among the 82 isolated Enterobacteriaceae, 58.5% were ESBL-E (20/31 Escherichia coli, 20/26 Klebsiella pneumoniae and 8/15 Enterobacter cloacae). The remaining (5 Salmonella Enteritidis, 3 Morganella morganii 1 Proteus mirabilis and 1 Leclercia adecarboxylata) were ESBL negative. CTX-M-1 group enzymes were highly prevalent (89.6%) among ESBLs; the remaining ones being SHV. One E. coli produced an OXA-181 carbapenemase, which is the first CPE described in Mali. The analysis of ESBL-E relatedness suggested a high rate of cross transmission between patients. In conclusion, even if CPE are still rare for the moment, the high rate of ESBL-BSI and frequent cross transmission probably impose a high medical and economic burden to Malian hospitals.

  14. Knowledge, Attitude and Practice of Vitamin Supplementation among Patients visiting Out-Patient Physicians in a Teaching Hospital in Karachi

    OpenAIRE

    Iqbal Azam; Zahra Aziz Samani; Waris Qidwai; Saima Lalani

    2012-01-01

     Objective: To determine the knowledge, attitude and practices regarding the use of vitamin supplements among patients visiting Out-Patient clinics of a teaching hospital.Methods: Four hundred patients were interviewed during the period of July to September 2008, at the Out-patient clinics, Aga Khan University hospital, Karachi. A pre-tested and structured questionnaire was used to collect information. It consisted of questions regarding demographics, awareness of vitamin supplements and its ...

  15. 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

    2014-01-01

    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 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. PMID:25396205

  16. 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.

  17. 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.

  18. Maternal and fetal outcomes of emergency obstetric referrals to a Nigerian teaching hospital.

    Science.gov (United States)

    Akaba, Godwin O; Ekele, Bissallah A

    2017-01-01

    Our study sought to determine the maternal and fetal outcomes of emergency obstetric referrals to a Nigerian teaching hospital as well as assess reasons for these referrals. We enrolled women referred or who presented themselves to the emergency obstetric unit for management of complications of pregnancy, labour, delivery or the puerperium. The majority presented late, their mean duration of stay at the referring facility being 22.25 h. Only nine (7.3%) were transported by ambulance. Severe pre-eclampsia and eclampsia (in 33, 26.8%) were the commonest obstetric indications for referral. Stillbirths occurred in 20/122(16.4%). There were eleven maternal deaths, giving an emergency referral fatality rate of 8.9%. Both maternal and fetal outcomes of these emergency obstetric referrals were poor owing mainly to late presentation, this being the result, among other factors, of an inefficient referral system.

  19. Survey of the major sources of waste in the health care units of a teaching hospital.

    Science.gov (United States)

    Castilho, Valéria; Castro, Liliana Cristina de; Couto, Andréa Tamancoldi; Maia, Flávia de Oliveira Motta; Sasaki, Nair Yoko; Nomura, Felicía Hiromi; Lima, Antonio Fernandes Costa; Mira, Vera Lúcia; Loyolla, Paula Manzatti

    2011-12-01

    The objectives of this study were to survey the different types of waste, their causes and suggestions to eliminate them according to the opinion of the nursing and medical staff from the Clinical Medicine, Surgery, Pediatrics, Rooming-In, and Nursery Units; and estimate the cost of the major source of waste found in the referred units. This descriptive, explorative study was performed at the University of São Paulo Teaching Hospital using a quantitative approach. The study sample consisted of 189 medical and nursing professionals. Material waste (36%) was the most often reported by all professional categories, followed by physical structure waste (27%). The most reported wasted materials were medicines, dressing packs, stationary paper, and infusion devices The estimated annual cost of material waste in the studied units is about R$ 479.262,86.

  20. 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.

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

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    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. Needlestick and Sharps Injuries Among Nurses at a Teaching Hospital in China.

    Science.gov (United States)

    Zhang, Xujun; Gu, Yue; Cui, Mengjing; Stallones, Lorann; Xiang, Huiyun

    2015-05-01

    Needlestick and sharps injuries (NSIs) are a major occupational injury to health care workers worldwide. This study aimed to report the prevalence and risk factors of NSIs among nurses working at a Chinese teaching hospital. From 463 nurses, 402 completed questionnaires were obtained. A total of 261 (64.9%) nurses reported needlestick or sharps injuries. NSIs were more common among females, young nurses, surgical nurses, and junior nurses. Logistic regression analysis suggests that age and work department were independent risk factors for NSIs. By type of devices, syringe needles accounted for the highest proportion of all NSIs (59%), followed by glass items (22%), and trocar core/catheter wires (4%). NSIs remain an important occupational hazard issue or Chinese nurses. Programs must be developed to prevent injuries caused by needlesticks and sharps. © 2015 The Author(s).

  3. 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.

  4. [Colonization by Staphylococcus aureus among the nursing staff of a teaching hospital in Pernambuco].

    Science.gov (United States)

    da Silva, Eduardo Caetano Brandão Ferreira; Samico, Thammy Moura; Cardoso, Rodrigo Rosa; Rabelo, Marcelle Aquino; Bezerra Neto, Armando Monteiro; de Melo, Fábio Lopes; de Souza Lopes, Ana Catarina; da Silva Aca, Ivanize; Maciel, Maria Amélia Vieira

    2012-02-01

    This study was performed with the objective to identify the prevalence of colonization by Staphylococcus aureus in nursing professionals from a teaching hospital in Pernambuco, and evaluate the resistance profile of these isolates. To do this, we performed a cross-sectional study where biological samples were collected from the hands and nasal cavities of the subjects. S. aureus was identified using agar (blood agar and mannitol salt) via catalase and coagulase tests. The sensitivity profile was determined by Kirby Bauer technique and determination of methicillin resistance was performed with oxacillin screening with sodium chloride (NaCl) addition. Of the 151 professionals evaluated, 39 were colonized which showed a prevalence of 25.8%. Among the variables studied, age and use of PPE were associated with colonization by the organism. Of all the isolates, only five were resistant to methicillin.

  5. Interpretation of blood gas analysis by physicians in a community teaching hospital.

    Science.gov (United States)

    Powles, A C; Morse, J L; Pugsley, S O; Campbell, E J

    1979-07-01

    Forty-two interns and residents on the staff of a community teaching hospital were questioned to assess their understanding of blood gas abnormalities. Misunderstandings were such that 24% of the residents and interns might have given inadequate care had their interpretations dictated practice. Few therapeutic misadventures in fact occurred, largely because of supervision. Even without supervision, it is unlikely that much harm would have come about, partly because pattern recognition and rules of thumb provided adequate guidance and partly because no notice was taken of the results of the blood gas analysis anyway. Those who wish to promote rational practice should direct their educational efforts to improved understanding of the mechanisms of hypoxaemia and of the chemical, physiological and pathophysiological interactions of PCO2, bicarbonate and pH in the various acid-base disorders.

  6. Incidence of rotavirus infection in children with gastroenteritis attending Jos university teaching hospital, Nigeria

    Directory of Open Access Journals (Sweden)

    Olabode Atanda O

    2011-05-01

    Full Text Available Abstract This study was conducted to determine the incidence of rotavirus infection in children with gastroenteritis attending Jos university teaching hospital, Plateau State. A total of 160 children with acute diarrhea were selected by random sampling. Stool samples were obtained and assayed for rotavirus antigens by enzyme linked immunosorbent assay technique using standard diagnostic BIOLINE Rotavirus kit. Demographic data of parents were also recorded. Rotavirus were detected in faeces of 22(13.8% children with acute diarrhea, 90.9% of positive cases of rotavirus gastroenteritis were under 2 years of age with highest prevalence in children 7-12 months of age. Males excreted rotavirus at a significant higher rate than females (P

  7. Outcomes of Critical Limb Ischemia in an Urban, Safety Net Hospital Population with High WIfI Amputation Scores.

    Science.gov (United States)

    Ward, Robert; Dunn, Joie; Clavijo, Leonardo; Shavelle, David; Rowe, Vincent; Woo, Karen

    2017-01-01

    Patients presenting to a public hospital with critical limb ischemia (CLI) typically have advanced disease with significant comorbidities. The purpose of this study was to assess the influence of revascularization on 1-year amputation rate of CLI patients presenting to Los Angeles County USC Medical Center, classified according to the Society for Vascular Surgery Wound, Ischemia and foot Infection (WIfI). A retrospective review of patients who presented to a public hospital with CLI from February 2010 to July 2014 was performed. Patients were classified according to the WIfI system. Only patients with complete data who survived at least 12 months after presentation were included. Ninety-three patients with 98 affected limbs were included. The mean age was 62.8 years. Eighty-two patients (84%) had hypertension and 71 (72%) had diabetes. Fifty (57.5%) limbs had Trans-Atlantic Inter-Society Consensus (TASC) C or D femoral-popliteal lesions and 82 (98%) had significant infrapopliteal disease. The majority had moderate or high WIfI amputation and revascularization scores. Eighty-four (86%) limbs underwent open, endovascular, or hybrid revascularization. Overall, one year major amputation (OYMA) rate was 26.5%. In limbs with high WIfI amputation score, the OYMA was 34.5%: 21.4% in those who were revascularized and 57% in those who were not. On univariable analysis, factors associated with increased risk of OYMA were nonrevascularization (P = 0.005), hyperlipidemia (P = 0.06), hemodialysis (P = 0.005), gangrene (P = 0.02), ulcer classification (P = 0.05), WIfI amputation score (P = 0.026), and WIfI wound grade (P = 0.04). On multivariable analysis, increasing WIfI amputation score (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.0-3.39) was associated with increased risk of OYMA while revascularization (OR 0.24, 95% CI 0.07-0.80) was associated with decreased risk of OYMA. The OYMA rates in this population were consistent with those predicted by the

  8. Bacterial bloodstream infections in HIV-infected adults attending a Lagos teaching hospital.

    Science.gov (United States)

    Adeyemi, Adeleye I; Sulaiman, Akanmu A; Solomon, Bamiro B; Chinedu, Obosi A; Victor, Inem A

    2010-08-01

    An investigation was carried out during October 2005-September 2006 to determine the prevalence of bloodstream infections in patients attending the outpatient department of the HIV/AIDS clinic at the Lagos University Teaching Hospital in Nigeria. Two hundred and one patients--86 males and 115 females--aged 14-65 years were recruited for the study. Serological diagnosis was carried out on them to confirm their HIV status. Their CD4 counts were done using the micromagnetic bead method. Twenty mL of venous blood sample collected from each patient was inoculated into a pair of Oxoid Signal blood culture bottles for 2-14 days. Thereafter, 0.1 mL of the sample was plated in duplicates on MacConkey, blood and chocolate agar media and incubated at 37 degrees C for 18-24 hours. The CD4+ counts were generally low as 67% of 140 patients sampled had Salmonella spp., S. Typhimurium (4), S. Enteritidis (2); Pseudomonas fluorescens (1), Escherichia coli (1), Ochrobactrum anthropi (1), Moraxella sp. (1), and Chryseobacterium meningosepticum. Results of antimicrobial susceptibility tests showed that coagulase-negative staphylococci had good sensitivities to vancomycin and most other antibiotics screened but were resistant mainly to ampicilin and tetracycline. The Gram-negative organisms isolated also showed resistance to ampicillin, tetracycline, chloramphenicol, and septrin. This study demonstrates that coagulase-negative staphylococci and non-typhoidal Salmonellae are the most common aetiological agents of bacteraemia among HIV-infected adults attending the Lagos University Teaching Hospital, Nigeria. The organisms were resistant to older-generation antibiotics often prescribed in this environment but were sensitive to vancomycin, cefotaxime, cefuroxime, and other new-generation antibiotics.

  9. Epidemiology of Death in the Pediatric Intensive Care Unit at Five U.S. Teaching Hospitals

    Science.gov (United States)

    Burns, Jeffrey P.; Sellers, Deborah E.; Meyer, Elaine C.; Lewis-Newby, Mithya; Truog, Robert D.

    2014-01-01

    Objective To determine the epidemiology of death in pediatric intensive care units (PICUs) at 5 geographically diverse teaching hospitals across the United States. Design, Setting, and Patients In the PICUs of five teaching hospitals across the United States, we prospectively identified 192 consecutive patients who died prior to PICU discharge. Each site enrolled between 24 and 50 patients. Each PICU had similar organizational and staffing structures. Interventions None Measurements and Main Results The overall mortality rate was 2.39% (range 1.85% to 3.38%). 133 (70%) patients died following the withholding or withdrawal of life-sustaining treatments, 30 (16%) were diagnosed as brain dead, and 26 (14%) died following an unsuccessful resuscitation attempt. Fifty-seven percent of all deaths occurred within the first week of admission;these patients, who were more likely to have new onset illnesses or injuries, included the majority of those who died following unsuccessful CPR attempts or brain death diagnoses. Patients who died beyond one week length-of-stay in the PICU were more likely to have pre-existing diagnoses, to be technology dependent prior to admission, and to have died following the withdrawal of life-sustaining treatment. Only 64% of the patients who died following the withholding or withdrawing of life support had a formal DNR order in place at the time of their death. Conclusions The mode of death in the PICU is proportionally similar to that reported over the past two decades, while the mortality rate has nearly halved. Death is largely characterized by two fairly distinct profiles that are associated with whether death occurs within or beyond one week length-of-stay. Decisions not to resuscitate are often made in the absence of a formal DNR order. These data have implications for future quality improvement initiatives, especially around palliative care, end-of-life decision making, and organ donation. PMID:24979486

  10. 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.

  11. 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.

  12. Assessment of novel oral anticoagulant use within a community teaching hospital

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    Sultan Alghadeer

    2017-01-01

    Full Text Available Background: Novel oral anticoagulants (NOACs are considered to be at least as effective and safe as warfarin with several advantages such as predictable pharmacokinetics, allowing for standardized dosing without monitoring, a lack of food interactions and fewer drug interactions; however, their misuse could potentially result in patient harm. Objective: To evaluate the appropriate use of the NOACs within a community teaching hospital. Setting: A community teaching hospital in the United States. Method: A retrospective chart review of patients that were prescribed dabigatran, rivaroxaban, or apixaban at our institution from October 2012 through November 2014 was conducted. Main outcome measure: The primary objective was to determine the percentage of patients that were appropriately prescribed NOACs. Secondary objectives were to determine the number of patients who were inappropriately transitioned from warfarin or parenteral anticoagulants to a NOAC or vice versa, the number of incidents when a NOAC was held or discontinued inappropriately before a procedure and the number of bleeding or thrombotic events while taking a NOAC. Results: Of the 113 patients receiving therapy with an NOAC, appropriate prescribing was observed in 79.7%. Dabigatran, rivaroxaban, and apixaban were appropriately prescribed in 73.8%, 88.3%, and 85.8% of patients respectively. Lack of renal dose-adjustment in patients with reduced renal function was the most common reason for inappropriate use (8.8%. Ten out of 38 patients (26% were inappropriately transitioned from/to other anticoagulants. Two out of six patients underwent a procedure without holding NOACs as recommended prior to surgery. Of all patients receiving NOACs, a total of 3 bleeding incidents were observed, one with each NOAC. Conclusion: The NOACs were appropriately prescribed for the majority of patients within our institution. Future efforts however should focus on ensuring appropriate dose adjustments for

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

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    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

  14. Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience

    Directory of Open Access Journals (Sweden)

    Yaw Boateng Mensah

    2011-01-01

    Full Text Available Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great success in many countries. We present our initial experience with fluoroscopic-guided pneumatic reduction of intussusception at Korle Bu Teaching Hospital which is also the first time the technique has been used in Ghana. Materials and Methods: A total of 18 children were enrolled in the study between August 2007 and February 2008 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were given air enema under fluoroscopic-guidance using locally assembled equipment. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 120 mmHg. A total of three attempts of 3 min each were allowed. Results: There were 12 males and 6 females. The average age of the patients was 8.3 months (SD= 3 months. Twelve (67% of the cases were reduced successfully while 6 (33% failed to reduce. A majority of those that did not reduced had symptoms for at least 2 days. Bowel perforation occurred in three (16.7% cases. Conclusion: Pneumatic reduction of intussusception is a cost-effective and rapid method of management of intussusception. It however has limitations like high reported rate of bowel perforation and limited ability to identify lead points. The benefits however seem to outweigh these challenges, such as fluoroscopic-guided pneumatic reduction has a very high success rate. Fluoroscopic guided pneumatic reduction should be considered as one of the primary modes of reduction in Ghana and other neighbouring countries that are yet to practice it.

  15. Clinical and demographical profile of inpatient psychiatry referrals in a multispecialty teaching hospital

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    Vijay Niranjan

    2017-06-01

    Full Text Available Background: Research in consultation-liaison psychiatry is important clinically because of high incidence of coexistence of psychiatric and medical disorders in patients attending psychiatry and general healthcare systems. In contrast to west, research about liaison psychiatry in India has been minimal. Thus a study about understanding clinical and sociodemographic profile patterns of inpatient psychiatry referrals was undertaken to enhance our knowledge of this field. Objective: To describe the clinical and socio-demographic profile of inpatient psychiatry referrals in a multispecialty teaching hospital. Materials and methods: The study population comprised all consecutive inpatients who were referred for psychiatric consultation from other departments of a multispecialty teaching hospital over a period of six months. In a semi-structured proforma, socio-demographic profile of patients, referring departments, reason of referral, psychiatric diagnosis, and physical illness diagnosis were recorded and analysed using descriptive statistics. Results: A total of 356 patients were referred for psychiatric consultation, 55.9% were males and 44.1% were females. Majority of patients belonged to 20-40 years age group (37.9%. Department of medicine made majority of the psychiatric referrals (50.6%; commonest reason for referral was abnormal behaviour (30.9%, followed by suicidal/self-harm acts (17.9%, and past psychiatric history (10.9%. The most commonly diagnosed psychiatric disorders were delirium (17.9%, followed by organic psychosis/mood disorder (14.8%, substance related disorder (12.9%, and depression (12.9%. Conclusion: There is an urgent need for raising awareness among all physicians and medical staff regarding early recognition and prompt referral for psychiatric problems. Also further research is warranted, especially longitudinal studies with outcome variables and various clinical processes related to consultation-liaison psychiatry.

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

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    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.

  17. The association between social capital and burnout in nurses of a trauma referral teaching hospital.

    Directory of Open Access Journals (Sweden)

    Farzin Farahbod

    2015-04-01

    Full Text Available Social capital is a multi-faceted phenomenon in social sciences that massively affects many social fields. It can be a helpful factor in promoting health. Among the groups with high burnout, nurses have always shown higher levels of burnout. Studies have revealed that social capital can be an important factor affecting burnout. This study aimed to determine the extent of the effect of social capital on burnout in nurses of a trauma referral teaching hospital in Rasht. This was a descriptive correlational study conducted on 214 nurses of a trauma referral teaching hospital. Maslach standard questionnaire and the social capital questionnaire devised by Boyas and colleagues were used. Data were analyzed using descriptive statistics, Pearson correlation coefficient, and linear regression analysis to determine the extent of the effect of social capital on burnout. The study showed an inverse association between social capital and burnout. The intensity of the relationship was -0.451 (P<0.0001. Also, the linear regression model of social capital on burnout variable showed that the regression coefficient of social capital equaled -0.34. The determination coefficient of this regression model indicated that social capital explained 20% of burnout changes. The results showed high burnout in emotional exhaustion dimension and an inverse association between social capital and burnout. Thus, attempts should be made to promote social capital dimensions among nurses. Given the inevitability of job stress in a nursing environment, and managers should plan on improving the working conditions and training techniques to deal with such stress.

  18. Audit of audit: review of a clinical audit programme in a teaching hospital intensive care unit.

    Science.gov (United States)

    Anderson, Peter; Fee, Peter; Shulman, Rob; Bellingan, Geoffrey; Howell, David

    2012-09-01

    A comprehensive review of the clinical audit programme in a teaching hospital intensive care unit. A retrospective analysis of the clinical audit projects undertaken within the intensive care unit over the preceding 2 years and compared with published national guidelines for clinical audit. A 27-bedded teaching hospital intensive care unit in the UK. Each audit project was reviewed independently by two assessors. The following questions were assessed. 1. Were the projects true audits? 2. Were they prospective of retrospective? 3. Did the projects have input from appropriate members of the multidisciplinary team. 4. How many of the audit projects were re-audits? 5. Of the re-audits how many showed evidence of service improvement? each audit project was also scored against the Audit Project Assessment Tool produced by the UK Clinical Governance Support Team. Of the twenty five audit projects reviewed twenty two were considered to be true audits. All of the projects used only retrospective data. Audit projects were contributed from all sections of the multidisciplinary critical care team but there were few truly multidisciplinary projects. Four of the audit projects were re-audits, of these three showed service improvement and one showed deterioration. Of the twenty two true audit projects reviewed, eleven were classified as good quality projects using the Audit Project Assessment Tool. Despite the clinical audit programme being active and well supported, objective evidence of clinical governance benefit was lacking. The overall clinical audit programme has been revitalised by a series of improvements since undertaking this review and this approach is recommended to other organizations who are interested in improving their clinical audit performance.

  19. Stimulated Respiration and Net Photosynthesis in Cassiopeia sp. during Glucose Enrichment Suggests in hospite CO2 Limitation of Algal Endosymbionts

    KAUST Repository

    Radecker, Nils

    2017-08-15

    The endosymbiosis between cnidarians and dinoflagellates of the genus Symbiodinium is key to the high productivity of tropical coral reefs. In this endosymbiosis, Symbiodinium translocate most of their photosynthates to their animal host in exchange for inorganic nutrients. Among these, carbon dioxide (CO ) derived fromhost respiration helps to meet the carbon requirements to sustain photosynthesis of the dinoflagellates. Nonetheless, recent studies suggest that productivity in symbiotic cnidarians such as corals is CO -limited. Here we show that glucose enrichment stimulates respiration and gross photosynthesis rates by 80 and 140%, respectively, in the symbiotic upside-down jellyfish Cassiopeia sp. from the Central Red Sea. Our findings show that glucose was rapidly consumed and respired within the Cassiopeia sp. holobiont. The resulting increase of CO availability in hospite in turn likely stimulated photosynthesis in Symbiodinium. Hence, the increase of photosynthesis under these conditions suggests that CO limitation of Symbiodinium is a common feature of stable cnidarian holobionts and that the stimulation of holobiont metabolism may attenuate this CO limitation.

  20. Stimulated Respiration and Net Photosynthesis in Cassiopeia sp. during Glucose Enrichment Suggests in hospite CO2 Limitation of Algal Endosymbionts

    Directory of Open Access Journals (Sweden)

    Nils Rädecker

    2017-08-01

    Full Text Available The endosymbiosis between cnidarians and dinoflagellates of the genus Symbiodinium is key to the high productivity of tropical coral reefs. In this endosymbiosis, Symbiodinium translocate most of their photosynthates to their animal host in exchange for inorganic nutrients. Among these, carbon dioxide (CO2 derived from host respiration helps to meet the carbon requirements to sustain photosynthesis of the dinoflagellates. Nonetheless, recent studies suggest that productivity in symbiotic cnidarians such as corals is CO2-limited. Here we show that glucose enrichment stimulates respiration and gross photosynthesis rates by 80 and 140%, respectively, in the symbiotic upside-down jellyfish Cassiopeia sp. from the Central Red Sea. Our findings show that glucose was rapidly consumed and respired within the Cassiopeia sp. holobiont. The resulting increase of CO2 availability in hospite in turn likely stimulated photosynthesis in Symbiodinium. Hence, the increase of photosynthesis under these conditions suggests that CO2 limitation of Symbiodinium is a common feature of stable cnidarian holobionts and that the stimulation of holobiont metabolism may attenuate this CO2 limitation.

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

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    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. 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.

  3. 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.

  4. Functional alignment, not structural integration, of medical schools and teaching hospitals is associated with high performance in academic health centers.

    Science.gov (United States)

    Keroack, Mark A; McConkie, Nathan R; Johnson, Erika K; Epting, Gladys J; Thompson, Irene M; Sanfilippo, Fred

    2011-08-01

    Debates continue regarding optimal structures for governance and administration between medical schools and their teaching hospitals. Structural integration (SI) for 85 academic health centers was characterized as high (single leader or fiduciary) or low (multiple leaders or fiduciaries). Functional alignment (FA) was estimated from questionnaire responses by teaching hospitals' chief executive officers, and an index was calculated quantifying organizational collaboration across several functional areas. SI and FA were examined for their association with global performance measures in teaching, research, clinical care, finance, and efficiency. AHCs with high SI had significantly higher FA, though overlap between high-SI and low-SI institutions was considerable. SI was not significantly associated with any performance measure. In contrast, FA was significantly associated with higher performance in teaching, research, and finance but not clinical care and efficiency. FA between medical schools and their primary teaching hospitals more strongly predicts academic health centers' performance than does SI. As demands for greater collaboration increase under health reform, emphasis should be placed on increasing FA rather than SI. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. 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.

  6. 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…

  7. Sub-optimal Testing and Awareness of HCV and HBV Among High Risk Individuals at an Underserved Safety-Net Hospital.

    Science.gov (United States)

    Wong, Robert J; Campbell, Brendan; Liu, Benny; Baden, Rachel; Bhuket, Taft

    2017-06-24

    Sub-optimal screening for chronic hepatitis C virus (HCV) and chronic hepatitis B virus (HBV) among high risk groups delays diagnosis and treatment. We aimed to evaluate overall rates of HCV and HBV screening and patient knowledge of their testing result. Adults age ≥18 years undergoing elective outpatient endoscopy at a large, urban safety-net hospital from July 2015 to July 2016 were prospectively evaluated to determine rates of HCV and HBV testing, the results of those completed tests, and patient knowledge of test results among high risk individuals (as determined by U.S. Preventative Services Task Force). Among 1125 patients (52.3% male, 70.4% foreign-born), 66.5% were high risk for chronic HCV; only 30.9% received prior testing. 14.7% had positive chronic HCV infection. Patients born in the 1945-1965 cohort were more likely to have received prior HCV testing compared to those born outside of this cohort (32.7 vs. 16.9%, p = 0.01). Among patients who received HCV screening, 29.3% were aware of test results. Overall, 61.6% were high risk for chronic HBV; only 25.1% received prior testing. 4.1% were positive for chronic HBV. Compared to Caucasians, Asians (19.0 vs. 44.4%, p HBV testing. Among patients who received prior HBV screening, 18.4% were aware of test results. Less than one-third of high risk patients received HCV and HBV screening among an ethnically diverse safety-net population. Equally low rates of patient knowledge of testing results were observed.

  8. Factors associated with utilization of insecticide-treated nets in children seeking health care at a Ugandan hospital: perspective of child caregivers.

    Science.gov (United States)

    Nankinga, Ziadah; Muliira, Joshua Kanaabi; Kalyango, Joan; Nankabirwa, Joaniter; Kiwuwa, Steven; Njama-Meya, Denise; Karamagi, Charles

    2012-10-01

    In Uganda malaria causes more morbidity and mortality than any other disease and children below 5 years contribute the biggest percentage of malaria related mortality. Insecticide treated nets (ITNs) are currently one of the most cost effective option for reducing malaria-related morbidity and mortality, however the factors affecting their utilization in Uganda are still not well understood. This study examined the prevalence and factors associated with ITN utilization among children of age 0-12 years seeking health care from a Ugandan hospital using caregiver's reports. A cross sectional design was used to collect data using a semi-structured questionnaire from 418 participants. Binary logistic regression was employed to determine predictors of ITN utilization. Results show that the prevalence of ITN utilization among children seeking health care was 34.2%. ITN utilization was higher among children of age children aged ≥5 years [22.9, 95% CI 13.77-32.01]. Source of mosquito net (OR = 13.53, 95% CI = 6.47-28.27), formal employment by head of household (OR = 6.00, 95% CI = 1.95-18.48), sharing a bed with parent (s) (OR = 2.61, 95% CI = 1.21-5.63) and number of children below 12 years in a household (OR = 0.80, 95% CI = 0.65-0.99), were significant predictors of utilization. ITN utilization among children was below the set national target. The predictors identified by this study reveal opportunities that can be taken advantage of by malaria control programs to achieve the desired rates of utilization and subsequently malaria prevention in children.

  9. Resistance and utilisation pattern of antibacterial agents in outpatient settings in two Teaching Hospitals in Colombo.

    Science.gov (United States)

    Senadheera, G P; Sri Ranganathan, S; Patabendige, G; Fernando, G H; Gamage, D; Maneke, R M; Fernandopulle, B M

    2016-01-01

    Antibacterial resistance (ABR) is a public threat. Sri Lanka is a country with limited surveillance of ABR in the community. The WHO methodology was adapted to identify ABR in outpatient settings (nonhospitalised patients) and its link to consumption of antibiotics. It was a cross-sectional descriptive community based study to collect ABR data from Out Patient Department (OPD) of two leading Teaching Hospitals in Colombo district. The indicator organism Escherichia coli (E. coli) was obtained from the urine specimens of patients who were suspected to have urinary tract infections. Antibiotic susceptibility testing was performed for commonly used oral antibiotics using disc diffusion method. The antibiotic consumption aggregate data were collected from the OPD pharmacies of the said hospitals and expressed as Defined Daily Doses (DDD) per 1000 inhabitants per 1000 day. Of the 2183 urine samples, pathogenic E. coli was isolated in 9.3% (204), and 8% (n=16) of them were Extended Spectrum Beta Lactamase (ESBL) producers. E.coli was most resistant to ampicillin (85%), followed by nalidixic acid (58.5%), trimethoprim/sulphamethoxazole (47.1%), ciprofloxacin (46.2%), norfloxacin (43.7%) amoxicillin /clavulanic acid (36.3%) and nitrofurantoin (15%). Multi-drug resistance was seen in 44%. Amoxicillin was the most frequently consumed antibacterial agent (2.65 DDD per 1000 inhabitants per day). There is an alarmingly high antibiotic resistance in the non-hospitalised patients indicating high prevalence of E. coli resistance in the community.

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

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    Redmond, E J; Forde, J C; Abdelrahman, M A; Kelly, N P; Akram, C; Giri, S K; Flood, H D

    2015-06-01

    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. A prospective logbook was maintained for all urology referrals from the emergency department between August 2012 and March 2013. The diagnosis and patient outcome was recorded for each referral. The emergency theatre logbook was retrospectively evaluated for all emergency urology procedures carried out over the same time period. A basic cost analysis was performed to calculate the cost of providing the on-call service. A total of 752 patients were referred to the urology service over a 12-month period. The most common reasons for referral were renal colic and scrotal pain. Approximately 41 % of referrals were discharged directly from the emergency department. There were 167 emergency operations performed in total. The majority of emergency operations and referrals from the emergency department took place outside of normal working hours. A basic cost analysis revealed an associated cost saving of €58,120. Emergency urology activity constitutes a large proportion of the workload at our institution. Restricting emergency urology cover would limit essential training opportunities for urology trainees, increases length of stay and delay treatment of urological emergencies. Urology "out of hours" cover is a cost-efficient method of service provision.

  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. Quality of nursing care and satisfaction of patients attended at a teaching hospital.

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    Freitas, Juliana Santana de; Silva, Ana Elisa Bauer de Camargo; Minamisava, Ruth; Bezerra, Ana Lúcia Queiroz; Sousa, Maiana Regina Gomes de

    2014-01-01

    assess the quality of nursing care, the patients' satisfaction and the correlation between both. cross-sectional study, involving 275 patients hospitalized at a teaching hospital in the Central-West of Brazil. The data were collected through the simultaneous application of three instruments. Next, they were included in an electronic database and analyzed in function of the positivity, median value and Spearman's correlation coefficients. among the nursing care assessed, only two were considered safe--hygiene and physical comfort; nutrition and hydration--while the remainder were classified as poor. Nevertheless, the patients were satisfied with the care received in the domains assessed: technical-professional, confidence and educational. This can be justified by the weak to moderate correlation that was observed among these variables. Despite the quality deficit, the patients' satisfaction level with the nursing care received was high. These results indicate that the institution needs to center its objectives on a continuing evaluation system of the care quality, aiming to attend to the patients' expectations.

  13. 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.

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

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    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. Mothers’ knowledge on essential newborn care at Juba Teaching Hospital, South Sudan

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    Lucy A Meseka

    2017-08-01

    Full Text Available Introduction: Globally neonatal mortality remains high and in South Sudan is estimated at 52/1000 live births. Objective: To identify the gaps in the knowledge and practices of essential newborn care among postnatal mothers at Juba Teaching Hospital and to determine the socio-demographic factors that influenced these. Methodology: A hospital-based cross-sectional study among 384 postnatal mothers using consecutive sampling, a pretested questionnaire to assess knowledge and a three point Likert scale to find out to which practices mothers did, or did not, agree. Results: 45% of mothers were aged between 25-34 years; 23.9% had some secondary school education; 70% were multiparous and 82% had attended an antenatal care clinic. 90% knew about breastfeeding on demand and 74% about exclusive breastfeeding. Only 18.2% of mothers knew the cord should be cared for while uncovered; 90% used warm clothing and 33% kangaroo care for thermoregulation. Only 20.8% identified BCG and OPV as birth vaccines; 3.4% believed vaccines were harmful. Hypothermia was the danger sign least frequently identified by the mothers (41.4%. Conclusion: Adequate knowledge was found regarding breastfeeding, with knowledge gaps existing in cord care, immunization, eye care and thermoregulation. Positive practice was found about breastfeeding, cord care, eye care and immunization. Socio-demographic factors were not found to be associated with maternal knowledge on newborn care.

  16. Hand washing practice among health care workers in a teaching hospital.

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    Joshi, S K; Joshi, A; Park, B J; Aryal, U R

    2013-01-01

    Health care associated infection has been identified as one of the major challenges of modern medicine and remains as a major health concern around the globe. Hands of the health-care workers are potential vehicle for transmission of pathogenic organisms within the healthcare environment. Hand washing is widely accepted as one of the most effective measures in prevention of health care associated infections. A descriptive cross-sectional study was conducted to assess the hand washing practice among the doctors, intern doctors, nurses, medical students and nursing students in a multi specialty, non government tertiary care teaching hospital in Kathmandu. Summary statistics and chi-square tests were performed and the type I error was set at 0.05 for analysis. Out of the total 336 participants of the study, there was significant difference in hand washing practice among the participants (PHand washing practice both before and after the patient examination was found to be highest among the nursing students followed by the nurses. The frequency of hand washing after exposure to hospital instruments, blood or other body fluids among the participants was remarkably high (more than 90%) in all groups. Nearly 99% of the participants agreed upon the fact that hand washing could be an effective measure in preventing health care associated infections. The healthcare workers understand the importance of hand washing but tend to wash their hands selectively depending upon the indications. The majority of the health care workers wash their hands after the patient care than before.

  17. Real world data of a veterinary teaching hospital in Japan: a pilot survey of prescribed medicines.

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    Tanaka, Noriko; Takizawa, Tsuyoshi; Miyamoto, Nao; Funayama, Shinji; Tanaka, Ryo; Okano, Syozo; Iwasaki, Toshio

    2017-01-01

    The prescription data from a digital accounting system of a veterinary teaching hospital collected between 2008 and 2011 in Japan were downloaded, stored in a database and analysed using a statistical analysis software, SAS. Seventy-six per cent of all prescriptions were drugs approved for human beings. The most frequently prescribed category was 'Agents against pathogenic organisms', such as antibiotics and chemotherapeutic agents, followed by 'Cardiovascular agents'. Seventy-five per cent of prescribed oral formulations in the category 'Agents against pathogenic organisms' were drugs approved for human beings, while 78 per cent of the injectable prescriptions were those for veterinary. A total of 36 oral antipathogenic products were prescribed, and among them amoxicillin was prescribed the most, followed by cephalexin for human beings and enrofloxacin for veterinary. The pattern of cyclosporin prescription, which is the most prescribed product other than 'Agents against pathogenic organisms', was surveyed. The capsule formulation was primarily used for dogs, while oral solutions were preferably used for cats. This pilot study is the first analytical data of real prescription in hospitals in Japan and one of the longest surveys in veterinary world.

  18. Students' perceptions of the relative advantages and disadvantages of community-based and hospital-based teaching: a qualitative study.

    Science.gov (United States)

    O'Sullivan, M; Martin, J; Murray, E

    2000-08-01

    To obtain the perceptions of first-year clinical medical students of the relative advantages and disadvantages of community-based and hospital-based clinical teaching. A qualitative study. A purposive sample of first-year clinical medical students who had experienced both community-based and hospital-based teaching was invited to participate in individual semistructured interviews or focus groups. Interviews and focus groups were audiotaped and transcribed to facilitate content analysis of the data. A total of 24 students participated in individual interviews and a further 18 took part in focus groups. Respondents identified advantages and disadvantages specific to teaching in each setting. Chief advantages of hospital-based learning were perceived to include learning about specialties and the management of acute conditions, and gaining experience of procedures and investigations. Community-based learning was perceived as particularly appropriate for learning about psychosocial issues in medicine, for increasing students' awareness of patient autonomy and for improving communication skills. In addition, aspects of organization and of teaching methods employed by community tutors, although not site-specific, were viewed as conducive to a positive educational experience. Students perceived some areas, such as clinical skills acquisition, to be equally well learned in either setting. As community-based teaching forms a greater proportion of the undergraduate medical experience, medical educators must find ways of determining the specific advantages that community and hospital settings can contribute to undergraduate learning and of using these resources effectively to develop comprehensive and integrated curricula. Innovations in teaching methods may also be necessary to provide an effective educational experience and promote active learning.

  19. Metabolic syndrome and associated factors among outpatients of Jimma University Teaching Hospital

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    Abda E

    2016-03-01

    Full Text Available Edris Abda,1 Leja Hamza,2 Fasil Tessema,3 Waqtola Cheneke4 1Department of Medicine, College of Medicine and Health Sciences, Madda Walabu University, Bale Robe, 2Department of Internal Medicine, 3Department of Epidemiology, 4Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia Background: Developing countries are now experiencing the epidemiologic transition, whereby the burden of chronic diseases, like metabolic syndrome, is increasing. However, no study had previously been conducted to show the status of metabolic syndrome among outpatients of Jimma University Teaching Hospital. Therefore, this study was designed to determine the prevalence of metabolic syndrome and associated factors among adult (≥20 years patients. Methods: A cross-sectional hospital-based study was conducted in July 2014 among adult (≥20 years patients attending Jimma University Teaching Hospital, outpatient department. All patients attending the outpatient department and were willing to participate in the study were included. Anthropometric and biochemical measurements were undertaken for all the study subjects to know the status of metabolic syndrome. Metabolic syndrome was identified using the National Cholesterol Education Program’s Adult Treatment Panel III criteria. Results: A total of 225 participants were included in the study, of whom 106 (47.1% were males and 119 (52.9% were females. A total of 59 (26% adults were found to have metabolic syndrome, which was seen more than twice as much in females, 42 (35%, as compared with males, 17 (16%, (P<0.01. The most frequent metabolic syndrome parameters were hypertension (45%, hyperglycemia (39%, decreased high-density lipoprotein (HDL (31%, central obesity (26%, and elevated triglycerides (18%. Elevated blood pressure is more common in females (44.5% than in males (34.9%. Decreased HDL-cholesterol was observed among 37% of females versus 24% males (P

  20. Ischaemic heart disease in Aminu Kano Teaching Hospital, Kano, Nigeria: a 5 year review.

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    Sani, M U; Adamu, B; Mijinyawa, M S; Abdu, A; Karaye, K M; Maiyaki, M B; Borodo, M M

    2006-01-01

    Socio-economic changes and rural urban migration have led to emergence of non-communicable disease including ischaemic heart disease (IHD) and many others. The actual prevalence of IHD in Nigeria is not known. The non communicable disease (NCD) survey sought to determine the prevalence of major risk factors, rather than the prevalence of the disease itself. The prevalence is generally considered low in Nigeria but the current impression about its importance stems mostly from anecdotal reports. We therefore set out to describe the prevalence as well as the spectrum of IHD at Aminu Kano Teaching Hospital, Kano. Between July 2000 and June 2005, we reviewed the prevalence as well as the spectrum of presentation of IHD in Aminu Kano Teaching Hospital. Information was obtained from the medical records of patients in the medical unit of the hospital. Age, sex, diagnosis, risk factors for IHD, other relevant clinical and laboratory data and outcome of patients for myocardial infarction (MI) were extracted from the records. Data was analyzed using SPSS version 10.0 software. There were 5124 medical patients admitted over the period under review, out of which 1347 had cardiovascular diseases. Forty six patients were diagnosed to have IHD giving it a prevalence of 0.9% of medical conditions and 3.4% of all cardiovascular cases. There were 33 males and 13 females (M : F = 2.5:1). Twenty two patients (47.8%) had myocardial infarction, 14 (30.4%) had ischemic cardiomyopathy and 10 (21.7%) had angina. The patients consist of 41 (89.1%) Nigerians, 3 (6.5%) Lebanese, 1 (2.2%) Indian and 1 (2.2%) Pakistani. The risk factors found were Hypertension in 37 (80.4%) of patients, diabetes in 16 (34.8%), and Dyslipidaemia in 20 (43.5%). Others were cigarette smoking and obesity. IHD is an important cause of morbidity and mortality in our population. There is need for us to be on the alert and prepare ourselves to manage these cases. Focus should be on preventive cardiology.

  1. Clinical teaching and learning within a preceptorship model in an acute care hospital in Ireland; a qualitative study.

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    McSharry, Edel; Lathlean, Judith

    2017-04-01

    A preceptorship model of clinical teaching was introduced to support the new all-graduate nurse education programme in Ireland in 2002. Little is known about how this model impacts upon the pedagogical practices of the preceptor or student learning in clinical practice leading to question what constitutes effective teaching and learning in clinical practice at undergraduate level. This study aimed to explore the clinical teaching and learning within a preceptorship model in an acute care hospital in Ireland and identify when best practice, based on current theoretical professional and educational principles occurred. A qualitative research study of a purposively selected sample of 13 students and 13 preceptors, working together in four clinical areas in one hospital in Ireland. Methods were semi-structured interviews, analysed thematically, complemented by documentary analysis relating to the teaching and assessment of the students. Ethical approval was gained from the hospital's Ethics Committee. Preceptor-student contact time within an empowering student-preceptor learning relationship was the foundation of effective teaching and learning and assessment. Dialoguing and talking through practice enhanced the students' knowledge and understanding, while the ability of the preceptor to ask higher order questions promoted the students' clinical reasoning and problem solving skills. Insufficient time to teach, and an over reliance on students' ability to participate in and contribute to practice with minimal guidance were found to negatively impact students' learning. Concepts such as cognitive apprenticeship, scaffolding and learning in communities of practice can be helpful in understanding the processes entailed in preceptorship. Preceptors need extensive educational preparation and support to ensure they have the pedagogical competencies necessary to provide the cognitive teaching techniques that foster professional performance and clinical reasoning. National

  2. 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

  3. 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

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

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    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.

  5. 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.

  6. Descriptions of acute transfusion reactions in the teaching hospitals of kermanshah university of medical sciences, iran.

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    Payandeh, Mehrdad; Zare, Mohammad Erfan; Kansestani, Atefeh Nasir; Pakdel, Shirin Falah; Jahanpour, Firuzeh; Yousefi, Hoshang; Soleimanian, Farzaneh

    2013-01-01

    Transfusion services rely on transfusion reaction reporting to provide patient care and protect the blood supply. Unnecessary discontinuation of blood is a major wastage of scarce blood, as well as man, hours and funds. The aim of the present study was to describe the main characteristics of acute transfusion reactions reported in the 4 hospital of Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran. The study was carried out at 4 teaching hospital of Kermanshah University of Medical Sciences, Kermanshah, Iran, over18 months from April 2010. All adult patients on admission in the hospitals who required blood transfusion and had establish diagnosis and consented were included in the study. In the year 2010 until 2012, a total of 6238 units of blood components were transfused. A total of 59 (0.94%) cases of transfusion reaction were reported within this 3 years period. The commonest were allergic reactions which presented with various skin manifestations such as urticarial, rashes and pruritus (49.2%), followed by increase in body temperature of > 1°C from baseline which was reported as febrile non-hemolytic transfusion reaction (37.2%). pain at the transfusion site (6.8%) and hypotension (6.8%). It is important that each transfusion of blood components to be monitor carefully. Many transfusion reactions are not recognized, because signs and symptoms mimic other clinical conditions. Any unexpected symptoms in a transfusion recipient should at least be considered as a possible transfusion reaction and be evaluated. Prompt recognition and treatment of acute transfusion reaction are crucial and would help in decreasing transfusion related morbidity and mortality, but prevention is preferable.

  7. Opinions of clinical veterinarians at a US veterinary teaching hospital regarding antimicrobial use and antimicrobial-resistant infections.

    Science.gov (United States)

    Jacob, Megan E; Hoppin, Jane A; Steers, Nicola; Davis, Jennifer L; Davidson, Gigi; Hansen, Bernie; Lunn, Katharine F; Murphy, K Marcia; Papich, Mark G

    2015-10-15

    To determine opinions of faculty members with clinical appointments, clinical veterinarians, residents, and interns at a US veterinary teaching hospital regarding antimicrobial use and antimicrobial-resistant infections. Cross-sectional survey. 71 veterinarians. An online questionnaire was sent to all veterinarians with clinical service responsibilities at the North Carolina State University veterinary teaching hospital (n = 167). The survey included 23 questions regarding demographic information, educational experiences, current prescribing practices, and personal opinions related to antimicrobial selection, antimicrobial use, restrictions on antimicrobial use, and antimicrobial resistance. Of the 167 veterinarians eligible to participate, 71 (43%) responded. When respondents were asked to rate their level of concern (very concerned = 1; not concerned = 5) about antimicrobial-resistant infections, most (41/70 [59%]) assigned a score of 1, with mean score for all respondents being 1.5. Most survey participants rated their immediate colleagues (mean score, 1.9) as more concerned than other veterinary medical professionals (mean score, 2.3) and their clients (mean score, 3.4). Fifty-nine of 67 (88%) respondents felt that antimicrobials were overprescribed at the hospital, and 32 of 69 (46%) respondents felt uncomfortable prescribing at least one class of antimicrobials (eg, carbapenems or glycopeptides) because of public health concerns. Findings indicated that veterinarians at this teaching hospital were concerned about antimicrobial resistance, thought antimicrobials were overprescribed, and supported restricting use of certain antimicrobial classes in companion animals. Findings may be useful in educating future veterinarians and altering prescribing habits and antimicrobial distribution systems in veterinary hospitals.

  8. 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.

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

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    O'Connor Mortimer B

    2009-03-01

    Full Text Available Abstract 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 €638 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

  10. 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

  11. Decreasing Turnaround Time and Increasing Patient Satisfaction in a Safety Net Hospital-Based Pediatrics Clinic Using Lean Six Sigma Methodologies.

    Science.gov (United States)

    Jayasinha, Yasangi

    2016-01-01

    Increasingly, health care quality indicators are focusing on patient-centeredness as an indicator of performance. The National Quality Forum lists assessment of patient experience, often conducted using patient surveys, as a top priority. We developed a patient-reported time stamp data collection tool that was used to collect cycle times in a safety net hospital-based outpatient pediatrics clinic. Data were collected using patient-reported survey to obtain cycle times in Pediatric clinic, as well as qualitative and quantitative patient satisfaction data. Several rapid-cycle improvements were performed using Lean Six Sigma methodologies to reduce cycle time by eliminating waste and revise unnecessary processes to improve operational effectiveness and patient and staff satisfaction. A total of 94 surveys were collected and revealed average cycle time of 113 minutes. Our measured patient satisfaction rating was 87%. Discharge and check-in processes were identified as the least efficient and were targeted for intervention. Following implementation, the overall cycle time was decreased from 113 to 90 minutes. Patient satisfaction ratings increased from 87% to 95%. We demonstrate that using Lean Six Sigma tools can be invaluable to clinical restructuring and redesign and results in measurable, improved outcomes in care delivery.

  12. Net Locality

    DEFF Research Database (Denmark)

    de Souza e Silva, Adriana Araujo; Gordon, Eric

    Provides an introduction to the new theory of Net Locality and the profound effect on individuals and societies when everything is located or locatable. Describes net locality as an emerging form of location awareness central to all aspects of digital media, from mobile phones, to Google Maps...... of emerging technologies, from GeoCities to GPS, Wi-Fi, Wiki Me, and Google Android....

  13. Net Neutrality

    DEFF Research Database (Denmark)

    Savin, Andrej

    2017-01-01

    Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else.......Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else....

  14. Factors associated with hospital arrival time after the onset of stroke symptoms: A cross-sectional study at two teaching hospitals in Harare, Zimbabwe.

    Science.gov (United States)

    Seremwe, Farayi; Kaseke, Farayi; Chikwanha, Theodora M; Chikwasha, Vasco

    2017-06-01

    Late presentation to hospital after onset of stroke affects management and outcomes of the patients. This study aimed to determine the factors associated with time taken to present to hospital after the onset of acute stroke symptoms. A descriptive cross sectional study was conducted at two teaching hospitals in Zimbabwe. Participants included patients admitted with stroke and their relatives. A self-administered questionnaire was used to collect information on history of stroke occurrence and time taken to present to hospital. Data was analysed for means, frequencies, percentages and Odds ratios. Less than half (33%) of the participants were able to recognize symptoms of stroke. Not having money to pay for hospital bills was a predictor of late hospital presentation (OR =6.64; 95% CI, (2.05-21.53); p=0.002). The other factors, though not statistically significant included not perceiving stroke as a serious illness (OR = 2.43; 95% CI (0.78-5.51); p=0.083) and unavailability of transport (OR=2.33; 95% CI (0.71-7.56); p=0.161). Predictors for early presentation included receiving knowledge about stroke from the community (OR=0.46; 95% CI (0.15-1.39); p=0.170); seeking help at the hospital (OR=0.50; 95% CI (0.18-1.37); p=0.177) and having a stroke while at the workplace (OR =0.46; 95% CI (0.08-2.72); p=0.389). Regarding stroke as an emergency that does not require prerequisite payment for services at hospitals and improved community awareness on stroke may improve time taken to present to hospital after the onset of stroke symptoms.

  15. Clients’ perception and satisfaction toward service provided by pharmacy professionals at a teaching hospital in Ethiopia

    Directory of Open Access Journals (Sweden)

    Teshome Kefale A

    2016-11-01

    Full Text Available Adane Teshome Kefale, Gebru Hagos Atsebah, Teshale Ayele Mega Department of Pharmacy, College of Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia Background: Evaluation of client’s perception and satisfaction with pharmacy services is important to identify specific areas of the service that need improvement in achieving high-quality pharmacy services. It also helps to detect the gaps in the current pharmaceutical services provision.Objective: To assess clients’ perception and satisfaction toward service provided by pharmacy professionals at Mizan-Tepi University Teaching Hospital.Methods: A cross-sectional study design was employed from March 8 to 24, 2016. A semistructured questionnaire was used to assess clients’ perception and satisfaction toward service provided by pharmacy professionals. The data collected were entered into Epi data 3.1, cleaned, and transported into and analyzed using SPSS version 20. Logistic regression was employed to determine associated factors, and statistical significance was considered at p-value <0.05.Results: Among 384 respondents, 53.1% were male. Of the total participants, 63.8% had good perception and 36.2% had poor perception toward pharmacy services. With regard to satisfaction, 52.6% of the respondents were satisfied and 47.4% were unsatisfied by the pharmaceutical services. Sociodemographic variables such as educational level (p=0.000, occupation (p=0.031, payment for service (p=0.002, and reasons the respondents seek service (p=0.001 showed statistically significant association with the level of perception. Clients’ satisfaction was found to be significantly associated with educational level (p=0.002 and reason for seeking service (p=0.016.Conclusion and recommendation: This study showed that the overall mean perception and satisfaction of clients in Mizan-Tepi University Teaching Hospital was low, even though it was above the mean level of perception and satisfaction. Action has to

  16. 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

  17. 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. PMID:28649565

  18. 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

  19. Mortality among High Risk Patients with Acute Myocardial Infarction Admitted to U.S. Teaching-Intensive Hospitals in July: A Retrospective Observational Study

    Science.gov (United States)

    Jena, Anupam B.; Sun, Eric C.; Romley, John A.

    2014-01-01

    Background Studies of whether inpatient mortality in U.S. teaching hospitals rises in July as a result of organizational disruption and relative inexperience of new physicians (‘July effect’) find small and mixed results, perhaps because study populations primarily include low-risk inpatients whose mortality outcomes are unlikely to exhibit a July effect. Methods and Results Using the U.S. Nationwide Inpatient sample, we estimated difference-in-difference models of mortality, percutaneous coronary intervention (PCI) rates, and bleeding complication rates, for high and low risk patients with acute myocardial infarction (AMI) admitted to 98 teaching-intensive and 1353 non-teaching-intensive hospitals during May and July 2002 to 2008. Among patients in the top quartile of predicted AMI mortality (high risk), adjusted mortality was lower in May than July in teaching-intensive hospitals (18.8% in May, 22.7% in July, pmortality (low risk), adjusted mortality was similar in May and July in both teaching-intensive hospitals (2.1% in May, 1.9% in July, p=0.45) and non-teaching-intensive hospitals (2.7% in May, 2.8% in July, p=0.21). Differences in PCI and bleeding complication rates could not explain the observed July mortality effect among high risk patients. Conclusions High risk AMI patients experience similar mortality in teaching- and non-teaching-intensive hospitals in July, but lower mortality in teaching-intensive hospitals in May. Low risk patients experience no such “July effect” in teaching-intensive hospitals. PMID:24152859

  20. Family violence among mothers seen at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

    Directory of Open Access Journals (Sweden)

    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.

  1. Maternal mortality and morbidity of unsafe abortion in a university teaching hospital of Karachi, Pakistan.

    Science.gov (United States)

    Shah, Nusrat; Hossain, Nazli; Noonari, Mukhtiar; Khan, Nusrat Hassan

    2011-06-01

    To study the mortality and morbidity of unsafe abortion in a University Teaching Hospital. 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 sociodemographic 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. 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). The high maternal mortality and morbidity of unsafe abortion in our study highlights the need for improving contraceptive and safe abortion services in Pakistan.

  2. Bacteriological features of infectious spondylodiscitis at Mohammed V Military Teaching Hospital of Rabat

    Directory of Open Access Journals (Sweden)

    A Zohoun

    2012-12-01

    Full Text Available To review the bacteriological features of infectious spondylodiscitis and provide recommendations for the initial therapy which remains empirical in our context. Retrospective study including patients diagnosed with spondylodiscitis over a period of 4 years (2006-2009 at the Rabat Military Teaching Hospital. During the study period, we analysed 30 cases: the mean age was 49.9 years and 21 cases (70% were male. The patients were predominantly hospitalized in neurosurgery department (15/30 followed by rheumatology department (10/30. The site of infection was lumbar in 21 cases (21/30, dorsal in 7 cases (7/30. 26 cultures were positive of which 19 (19/26 were monomicrobial. Tuberculosis (TB was implicated in 10 cases (10/30 including 4 cases in association with common organisms (Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis, Corynebacterium species. Brucella melitensis was isolated in 1 case. Infections caused by pyogenic bacteria were isolated in 15 cases of which 12 (12/15 revealed simple organisms including Gram-positive cocci in 9 cases (9/12 with 3 cases of S. aureus and Gram-negative bacilli in 3 cases (3/12 with 2 cases of P. aeruginosa. Blood cultures carried out for 16 patients were positive in 7 cases. The anatomopathologic exams carried out for 20 patients found in 6 cases epithelioid granulomata and giants cells with caseous necrosis in total concordance with TB culture. TB is the most frequent cause of spondylodiscitis in Morocco. Our study found the same frequency for non-specific and specific germs. Empirical treatment must take into account S. aureus and M. tuberculosis.

  3. Compliance With Guideline Statements for Urethral Catheterization in an Iranian Teaching Hospital

    Directory of Open Access Journals (Sweden)

    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.

  4. Medicine utilization review at a university teaching hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasinazari

    2013-07-01

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

  6. Surveillance of pediatric infections in a teaching hospital in Mato Grosso do Sul, Brazil

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    M.R. Chang

    Full Text Available Nosocomial infections (NI result in considerably high mortality and morbidity rates, especially among pediatric patients. Considering current worldwide changes, information about the occurrence of pathogens and susceptibility tests are now seen as decisive for optimizing treatment. The purpose of this research was to determine the frequency of microorganisms, antimicrobial and genetic profiles, and risk factors associated with nosocomial infections in a teaching hospital in Campo Grande, Mato Grosso do Sul. From January 1998 to December 1999, 108 patients were characterized as having nosocomial infection, from which 137 pathogens were isolated. Identification and antimicrobial susceptibility was determined by conventional and automated techniques. Staphylococcus aureus and Klebsiella pneumoniae strains were characterized by Pulsed Field Gel Electrophoresis (PFGE. Pathogens were most often isolated from infants one-month old or younger, and bloodstream infections were the most frequent. The main isolated agents isolated were: coagulase-negative staphylococci (38, Pseudomonas aeruginosa (19, S. aureus (26, K. pneumoniae (18, and Candida spp. (13. The risk conditions that were most closely related to NI acquisition were: prolonged hospital stays (69.4%, prematurity (60.9% and exposure to high-risk device procedures (95.4%. Ciprofloxacin and imipenem were the most effective drugs, inhibiting all or almost all of the Enterobacteriaceae, P. aeruginosa and Acinetobacter calcoaceticus isolates. Only 23% of the S. aureus samples were resistant to oxacillin. Genomic typing revealed 10 distinct patterns for S. aureus and 13 for K. pneumoniae, suggesting that most them did not belong to the same clone. PFGE was effective in differentiating the strains.

  7. Surveillance of pediatric infections in a teaching hospital in Mato Grosso do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Chang M.R.

    2003-01-01

    Full Text Available Nosocomial infections (NI result in considerably high mortality and morbidity rates, especially among pediatric patients. Considering current worldwide changes, information about the occurrence of pathogens and susceptibility tests are now seen as decisive for optimizing treatment. The purpose of this research was to determine the frequency of microorganisms, antimicrobial and genetic profiles, and risk factors associated with nosocomial infections in a teaching hospital in Campo Grande, Mato Grosso do Sul. From January 1998 to December 1999, 108 patients were characterized as having nosocomial infection, from which 137 pathogens were isolated. Identification and antimicrobial susceptibility was determined by conventional and automated techniques. Staphylococcus aureus and Klebsiella pneumoniae strains were characterized by Pulsed Field Gel Electrophoresis (PFGE. Pathogens were most often isolated from infants one-month old or younger, and bloodstream infections were the most frequent. The main isolated agents isolated were: coagulase-negative staphylococci (38, Pseudomonas aeruginosa (19, S. aureus (26, K. pneumoniae (18, and Candida spp. (13. The risk conditions that were most closely related to NI acquisition were: prolonged hospital stays (69.4%, prematurity (60.9% and exposure to high-risk device procedures (95.4%. Ciprofloxacin and imipenem were the most effective drugs, inhibiting all or almost all of the Enterobacteriaceae, P. aeruginosa and Acinetobacter calcoaceticus isolates. Only 23% of the S. aureus samples were resistant to oxacillin. Genomic typing revealed 10 distinct patterns for S. aureus and 13 for K. pneumoniae, suggesting that most them did not belong to the same clone. PFGE was effective in differentiating the strains.

  8. Patient's Perception of Nursing Care at a Large Teaching Hospital in India.

    Science.gov (United States)

    Samina, Mufti; Gj, Qadri; Tabish, Sa; Samiya, Mufti; Riyaz, R

    2008-07-01

    As focus has shifted from the healthcare providers to the healthcare consumers; patient satisfaction is being increasingly used worldwide for the assessment of quality of services provided by healthcare institutions. To understand patient satisfaction, "patient's perception" of care must first be understood. Of all the healthcare workers nurses spend maximum time with the patients. Therefore, the nurse is in a unique position to influence and promote effective consumer relationships. Though patient satisfaction surveys with nursing care are routinely conducted in the developed world to monitor and improve the quality of care, the same is not true for the developing world especially in the Indian subcontinent. To conduct a study of patient's perception of nursing care in a large teaching hospital. A prospective study spread over a period of one year was carried out. Sample size consisted of seven percent of patients each admitted as emergency and routine. All the randomly selected patients were administered questionnaires, thus obtaining a sample size of 2600. Of these 2500 questionnaires were usable for data analysis (valid response rate of 81.6%). The results of the study revealed a relatively higher percentage of patients with poor perception regarding 'explanation and information', and 'caring attitude' aspects of nursing care (31.6% and 11.5% respectively). However more than 95% patients had good perception of 'responsiveness', 'availability' and 'ward organization' capability of the nurse. Patient satisfaction surveys should become a regular outcome monitoring feature in all the hospitals. Also In-service training programs for nurses, with special emphasis on communication are need of the hour and should become a regular exercise.

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

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    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.

  11. [Impact study of an active antiflu vaccination programme on the Clermont-Ferrand Teaching Hospital staff].

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    Chamoux, A; Denis-Porret, M; Rouffiac, K; Baud, O; Millot-Theis, B; Souweine, B

    2006-03-01

    Protecting health care units from influenza epidemics has a double purpose: to decrease the mortality rate of patients at risk and to reduce work-leave in medical staff. An annual vaccination appears to be the most effective prevention against influenza. In France however the vaccinal coverage of health workers does not exceed 15%. In the 2003-2004 winter, the department of occupational health and the nosocomial disease committee of the Clermont-Ferrand Teaching Hospital initiated an active vaccination campaign. Three joint actions were carried out: date and place of vaccination sessions were individually addressed to every healthcare worker, meetings on prevention of influenza were held, as well as vaccination sessions on the work place in exposed units. Significant results were noted: vaccination rate increased 2.6 fold compared to the previous year (4.8 to 12.6%) and a vaccinal coverage rate of 29% in the exposed units. The results even if far from national objectives encourage the pursuit of the campaigns promoting information and vaccination on the work place. The high frequency of reported postinjection adverse effects (1 out of 3) should be taken into account in future information campaign.

  12. 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.

  13. FACTORS INFLUENCING CHOICE OF ORAL HYGIENE PRODUCTS BY DENTAL PATIENTS IN A NIGERIAN TEACHING HOSPITAL.

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    Opeodu, O I; Gbadebo, S O

    2017-06-01

    Several factors, such as cost, branding, packaging and family influence, had been implicated as influencing the choice of toothpastes and toothbrushes by individuals. Media advertisement is also considered a very strong factor influencing consumer's choice. To assess the extent to which some factors influenced the choice of toothpastes and toothbrushes among dental patients in a Nigerian teaching hospital. Two-hundred and two patients were interviewed on factors that influenced their choice of toothbrush and toothpaste. Some of the factors considered include the cost, packaging, brand, media advertisement and their previous experience. Factors that affected choice of toothbrush by respondents included texture (89.6%), brand (62.9%), previous experience (64.4%) and for toothpaste, fluoride content (62.4%), previous experience (69.3%), and advice by a dentist (55.0%). Media advertisement was the least influential in their choice of toothpaste (29.2%) and toothbrush (24.3%). Consideration for fluoride was a stronger factor than herbal contents in the choice of toothpaste (Ptoothbrush and toothpaste in this study, which suggest that for as long as the respondents are satisfied with a particular product, they will stick to it.

  14. 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.

  15. [Intention to breastfeed and complementary feeding of postpartum women in a teaching hospital in southern Brazil].

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    Machado, Adriana Kramer Fiala; Elert, Vanessa Winkel; Pretto, Alessandra Doumid Borges; Pastore, Carla Alberici

    2014-07-01

    This article seeks to analyze the intention of mothers to breastfeed and the prospects for introduction of complementary food in the first year of life. A cross-sectional study was conducted from September to December 2010 at the Teaching Hospital of the Federal University of Pelotas in the state of Rio Grande do Sul, Brazil. Data were obtained through a standardized questionnaire, containing questions about socioeconomic conditions, breastfeeding and complementary feeding. 170 mothers were enlisted, with a mean age of 26.5 ± 5.8 years old. Among them, 99% had received prenatal medical care and only 49% recalled having received information about breastfeeding and/or supplementary feeding during the care. All of the mothers intended to breastfeed exclusively for a mean time of 5.5 ± 1.6 months. Years of schooling, mothers who do not work outside the home, lower maternal age and receiving information about breastfeeding during prenatal care were associated with longer duration of exclusive breastfeeding. Regarding complementary food, bean soup was the food most intended for the child's first year of life, with an acceptance of 99.41%, while tea was the one with the earliest intention. The duration of breastfeeding was below the WHO guidelines, and complementary food was considered to be misguided.

  16. Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital

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    Ferreira, Carolina Justus Buhrer; Plodek, Caroline Koga; Soares, Franciny Kossemba; de Andrade, Rayza Assis; Teleginski, Fernanda; da Rocha, Maria Dagmar

    2016-01-01

    Abstract Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: 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. Results: 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. Conclusion: guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes. PMID:27276019

  17. Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital

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    Carolina Justus Buhrer Ferreira Neto

    2016-01-01

    Full Text Available Abstract Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: 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. Results: 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. Conclusion: guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes.

  18. Improving the postoperative handover process in the intensive care unit of a tertiary teaching hospital.

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    Yang, Jian-Guo; Zhang, Jun

    2016-04-01

    The aim of this study was to improve the postoperative handover process and immediate postoperative patient outcomes. The objective was to implement a postoperative handover protocol in the neurosurgical intensive care unit of a tertiary teaching hospital. Postoperative handover is a multidisciplinary collaborative medical activity that involves information transfer, sequenced tasks and high-quality teamwork. Evidence suggests that a lack of a standardised postoperative handover protocol adversely influences care quality and potentially compromises patient safety. As there is a lack of such protocols in China, there is an identified need for improvement. This was a pretest/post-test study with follow-up after three months. A postoperative handover protocol that included a postoperative handover checklist, a standardised handover pathway and core team member involvement was developed based on research evidence and expert opinions and was then implemented and evaluated. Following the implementation of this protocol, improved teamwork was achieved, surgeons were more frequently present at bedside handovers, the rate of transferring key messages increased, the rate of ventilator weaning within the first six hours of neurosurgical intensive care unit admission increased, and the ventilation duration per patient decreased without any clinical incident occurring in the first 24 hours after neurosurgical intensive care unit admission. Following the implementation of a tailored standardised handover protocol, communication, teamwork and short-term patient outcomes were improved. This clinically based research highlights the need for policy makers and administrators to create unit-specific protocols for improving postoperative handovers. © 2016 John Wiley & Sons Ltd.

  19. Detection of adverse events of transfusion in a teaching hospital in Ghana.

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    Owusu-Ofori, A K; Owusu-Ofori, S P; Bates, I

    2017-06-01

    Monitoring the whole chain of events from the blood donors to recipients, documenting any undesirable or untoward effects and introducing measures to prevent their recurrence if possible are components of haemovigilance systems. Only few sub-Saharan African countries have haemovigilance systems, and there are very little data on adverse events of transfusion. Adverse events monitoring is an integral part of a haemovigilance system. Our study aimed to establish the incidence and types of adverse events of transfusions in Ghana and to identify interventions to improve effectiveness. This prospective observational 1-year study enrolled 372 recipients of 432 transfusions in a Ghanaian teaching hospital. Vital signs were monitored at 15, 30 and 60 min intervals during the transfusion, then 8 h until 24 h post-transfusion. Three investigators independently classified any new signs and symptoms according to Serious Hazards of Transfusion definitions. The adverse events incidence was 21·3% (92/432), predominantly mild acute transfusion reactions (84%). A total of 20 transfusions (4·6%) were stopped before completion, 60% of them for mild febrile reactions, which could have been managed with transfusion in situ. This prospective study indicates a high incidence of adverse events of transfusion in Kumasi, Ghana. The significant numbers of discontinued transfusions suggest that guidelines on how to manage transfusion reactions would help preserve scarce blood stocks. Gradual implementation of a haemovigilance system, starting with monitoring adverse transfusion events, is a pragmatic approach in resource-limited settings. © 2017 British Blood Transfusion Society.

  20. Postnatal counseling on exclusive breastfeeding using video - experience from a tertiary care teaching hospital, south India.

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    Adhisivam, B; Vishnu Bhat, B; Poorna, Rachel; Thulasingam, Mahalakshmy; Pournami, Femitha; Joy, Rojo

    2017-04-01

    Adequate antenatal counseling combined with postnatal lactation support is likely to improve exclusive breastfeeding rates. To assess the impact of a postnatal video based health education program in promoting exclusive breastfeeding among primiparous mothers. This interventional study was done in a tertiary care teaching hospital, south India. Primiparous mothers in one postnatal ward (group A) received routine lactation counseling. A similar group of primiparous mothers in another postnatal ward (group B) were administered a video based health education program on exclusive breastfeeding in the local language Tamil in addition to the routine lactation counseling. The exclusive breastfeeding rates of these two groups of mothers were compared. Their knowledge and perceptions after intervention were also compared using a pretested questionnaire. Among 878 primiparous mothers, 94% fed colostrum and 43% initiated breastfeeding within one hour of delivery. Correct attachment was noted with 96% and 13% had lactation issues. Group B had marginally better exclusive breastfeeding rate at six months but not statistically significant. Mothers in group B had a statistically significant better knowledge score post-intervention compared to those in Group A. Use of gripe water was more in group A compared to group B. The video based health education program when combined with routine lactation counseling improved the knowledge regarding exclusive breastfeeding among postnatal primiparous mothers better than with routine lactation counseling alone. However, both interventions had similar effect on exclusive breastfeeding rate at six months.

  1. Pig bite in Brazil: a case series from a teaching hospital

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    Sérgio de Andrade Nishioka

    1994-03-01

    Full Text Available A retrospective survey done from 1987 till 1990 revealed that 23 patients bitten by pigs sought medical help at a teaching hospital in Uberlândia, in southeastern Brazil. Most cases (21 were from Uberlândia. The cases were evenly distributed by month and by year; most of them (14/16; 87.5% occurred between 7. OOa.m. and 7.00 p. m. The male to female ratio was 6.7:1. Age ranged from 6 to 73 (mean 38.95 ± SD 22.06, median 36. The bites were more common on the upper limbs, particularly on the forearms. In 11(47.8% cases the injury was described as deep. In most cases where information was available the injury was related to capture, transport or immobilisation ofthe pigfor slaughter. The following medical procedures were performed: local cleansing in 19(82.6% cases, rabies vaccine (12; 52.2%, antirabies serum (2; 8.7%, suturing (6; 26.1% and tetanus vaccine (12; 52.2%. There was no case of infection at the bite site, neither of rabies or tetanus. By our data, the annual incidence of pig bite in Uberlândia can be estimated to be about 1.5/100.000.

  2. Non-traumatic childhood coma in Ebonyi State University Teaching Hospital, Abakaliki, South Eastern Nigeria.

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    Ibekwe, R C; Ibekwe, M U; Onwe, O E; Nnebe-Agumadu, U H; Ibe, B C

    2011-01-01

    Coma is a medical emergency, and optimal management, especially in a resource-poor setting, would depend on the knowledge of its etiology and predictors of outcome. This communication reviews the etiology and outcome of non-traumatic childhood coma in Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki. To determine the incidence, etiology and outcome of non-traumatic coma in children seen at the EBSUTH, Abakaliki. This is a retrospective analysis of records of all children admitted to the children emergency ward of EBSUTH in coma of a non-traumatic origin between 1 st of January and 31 st of December, 2007. Forty children presented with coma out of 673 children admitted during the study period, giving an incidence rate of 5.9%. The majority of the children (62.5%) were aged between 1 and 5 years of age, and 79.5% of them were deeply comatose on admission. Most of the cases (85%) of non-traumatic coma were due to infective causes, mainly cerebral malaria (47.5%), pyogenic meningitis (17.5%) and septicemia (10%). Twenty-four (60%) children recovered while 13 (32.5%) died. Infections were the predominant causes of non-traumatic coma in EBSUTH. In view of the high mortality among this group of patients, efforts at the control of malaria and other infections would significantly reduce the incidence of non-traumatic coma in this study site.

  3. Situation analysis of patients attending TU Teaching Hospital after medical abortion with problems and complications.

    Science.gov (United States)

    Ojha, Neebha; Bista, Kesang D B

    2013-01-01

    In Nepal medical abortion has been approved for use since 2009. There were many cases coming to Tribhuvan University Teaching Hospital coming with problems and complications following medical abortion. Thus the objective of this study was to analyze the cases that came to TUTH following medical abortion with problems and complications. This is a prospective study conducted in the Department of Obstetrics and Gynecology of TUTH. Study was carried from 1st August 2011 to 30th November 2012. Women who came to TUTH with any complaints following medical abortion were interviewed, examined and treatment provided. Relevant clinical finding were noted. There were a total of 57 cases during the study. Most (66.6%) of the women were in age group 20-29 years age. There were 45 (79%) women who had abortion up to 9 weeks. Medical shop was the main place where most of the women (45.6%) directly come to know about medical abortion. More than 34 (77.2%) received the service from medical shops without any supervision. Most 31 (54.4%) presented with incomplete abortion. There were three cases of continuing pregnancy and four presented with ectopic pregnancy. Eighteen (31.6%) cases needed admission. Fifty six percent of the cases were treated with manual vacuum aspiration, six cases underwent laparotomy and there was one maternal mortality. There is a need for proper dissemination and implementation of guideline for management of these women and adequate supervision to reduce the problems and complications.

  4. Epidemiology of benign eyelid lesions in patients presenting to a teaching hospital

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    Al-Faky, Yasser H.

    2011-01-01

    Purpose This study evaluates the relative frequency of benign eyelid lesions presented to a teaching hospital in Saudi population. Patients and methods Charts of patients with benign eyelid lesions were retrospectively reviewed from January 2003 to December 2008. Clinical details included demographic data, symptoms and signs, surgical findings, primary diagnosis, and indication for biopsy were analyzed in a histopathologically confirmed benign eyelid lesions. Eyelid lesions were arranged according to their order of frequencies. Results A total of 222 biopsies were evaluated from 181 patients (male 39.2% and female 60.8%). The age of the patient at the time of biopsy ranged from 2 to 87 years old. The most common benign eyelid lesion encountered in our practice was sweat gland hidrocystoma followed by chalazion, skin tag, epidermal cyst, nevus, seborrheic keratosis, xanthelasma, and molluscum contagiosum respectively. Histopathological studies confirmed the clinical diagnosis in 95.9% (213/222) of specimens and was different from the clinical diagnosis in 4.1% (9/222) of the lesions which included seborrheic keratosis (n = 3), pilomatrixoma, steatocystoma, hemangioendothelioma, juvenile xanthogranuloma, calcinosis cutis, and syringocystadenoma papilliferum. No malignant lesion was labeled as benign. Conclusion Epidemiology of benign eyelid lesions in Saudi population is different from Far East or Western populations. Sweat gland hidrocystoma with classical clinical features and straightforward diagnosis is the most frequent lesion in our series which could be due to characteristic dry climate. PMID:23960994

  5. A pharmacovigilance study on patients of bronchial asthma in a teaching hospital

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    A N Jamali

    2010-01-01

    Full Text Available Objective : The present study was conducted to monitor adverse drug reactions in patients of bronchial asthma in outpatient department and inpatient department of a university teaching hospital in South Delhi. Materials and Methods : About 200 patients irrespective of age and sex with established asthma were interviewed during the time period of January 2006 to April 2006 using structured questionnaire. Naranjo′s adverse drug reaction probability scale was used to assess the adverse drug reactions. Results : A total of 15 adverse drug reactions were reported in 13 out of 200 asthmatic patients. Among the 13 patients reported with adverse drug reactions, 5 (38.5% were male and 8 (61.5% patients were female. Maximum percentage of ADRs (2 in 15 prescriptions, 13.3% observed with montelukast, followed by beclomethasone (1 in 12 prescriptions, 8.3%, salbutamol (6 in 109 prescriptions, 5.5%, and ipratropium (3 in 63 prescriptions, 4.8%. Conclusions : Montelukast was found to be associated with greater percentage of adverse drug reactions as compared to other antiasthamatics. The above findings are constrained by a small sample size and need to be corroborated by conducting long-term studies using a larger sample size.

  6. 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.

  7. 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.

  8. ALTERATION OF LIVER FUNCTION TESTS IN EXTRAHEPATIC BILIARY LITHIASIS: EXPERIENCE IN A TEACHING HOSPITAL OF ASSAM

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    Debabrata

    2016-05-01

    Full Text Available INTRODUCTION Basic liver function test is a part of preoperative evaluation of biliary lithiasis. It is seen in many worldwide reports about significant alterations of liver function both in pre and post-operative period. As a unique geographical placement and different dietary habit adopted by North East Indian population, this present study will stress upon the significance of alteration of liver function in biliary lithiasis cases. MATERIALS AND METHODS A total of 400 patients of extrahepatic biliary lithiasis, subjected to either open or laparoscopic procedure, are prospectively analysed by examining LFTs pre-operatively, the 1 st day after surgery and on completion of 4 weeks in a tertiary teaching hospital of North East India. RESULTS Alteration in AST, ALT, GGT were seen with minor changes in serum bilirubin and proteins on 1 st post-operative day noticed in two-third of the patients. After 4 weeks, these tests came down to almost their normal values. CONCLUSION Though mild-to-moderate alterations of LFTs are seen during initial period, after 4 weeks, values came to their base level.

  9. SELF - MEDICATION PRACTICES AMONG NON TEACHING STAFF IN A TERTIARY CARE HOSPITAL: A QUESTIONNAIRE BASED STUDY

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    Padma

    2015-01-01

    Full Text Available AIM: To assess the prevalence and pattern of self - medication use. Material and methods: It was a cross - sectional questionnaire based survey conducted by the Department of Pharmacology at Dr. B. R. Ambedkar Medical College and Hospital in September 2014. 200 non - teaching staff were included in this study. RESULTS: Headache, common cold, cough and fever were the most common conditions for which people have used OTC drugs. NSAIDs (37.93% were the most commonly used group of drugs for self - medication . Easy availability of OTC drugs was the most common cause for using self - medication . Pharmacists, showing previous prescription were the most common methods for procuring drugs by the people. CONCLUSION: This study shows that majority of the people had poor knowledge about appropriate self - medication . It emphasises the need for specific pharmacovigilance where the patient, pharmacist and physician must be encouraged to report any adverse events. Periodic studies on the knowledge, attitude and practice of self - medication may give insight into the changing pattern of drug use in societies

  10. 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.

  11. Residents' Perspectives on Patient Safety in University and Community Teaching Hospitals

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    Jones, Deborah L.

    2014-01-01

    Background Patient safety is an important concept in resident education. To date, few studies have assessed resident perceptions of patient safety across different specialties. Objective The study explored residents' views on patient safety across the specialties of internal medicine, general surgery, and diagnostic radiology, focusing on common themes and differences. Methods In fall 2012, interviews of small groups of senior residents in internal medicine, general surgery, and diagnostic radiology were conducted at 3 academic medical centers and 3 community teaching hospitals in 3 major US metropolitan areas. In total, 33 residents were interviewed. Interviews used interactive discussion to explore multiple facets of patient safety. Results Residents identified lack of information, common errors, volume and acuity of patients, and inadequate supervision as major risks to patient safety. Specific threats to patient safety included communication problems, transitions of care, information technology interface issues, time constraints, and work flow. Residents disclosed that reporting safety issues was viewed as burdensome and carrying some degree of risk. There was variability as to whether residents would report safety threats they encountered. Conclusions Residents are aware of threats to patient safety and have a unique perspective compared with other health care professionals. Transitions of care and communication problems were the most common safety threats identified by the residents interviewed. PMID:26279801

  12. Role-reversal exercise with Deaf Strong Hospital to teach communication competency and cultural awareness.

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    Mathews, Jennifer L; Parkhill, Amy L; Schlehofer, Deirdre A; Starr, Matthew J; Barnett, Steven

    2011-04-11

    To implement a role-reversal exercise to increase first-year pharmacy students' awareness of communication barriers in the health care setting, especially for deaf and hard-of-hearing patients. Volunteers from the local deaf community conducted Deaf Strong Hospital, a role-reversal exercise in which students were the "patients." Students navigated through a reception area, encounter with a physician, and having a prescription filled at a pharmacy without receiving or using any spoken language. A debriefing session was held in which small groups of students had the opportunity to ask questions of a panel of deaf and hard-of-hearing volunteers. On a survey administered to assess students' learning, 97% agreed or strongly agreed that the experience would likely impact their attitudes and behavior in future interactions with patients who did not speak English. The role-reversal exercise was an effective method of teaching students that the delivery of health care is dependent on adequate communication between health care providers and the patient.

  13. A prospective surveillance of drug prescribing and dispensing in a teaching hospital in western Nepal.

    Science.gov (United States)

    Ghimire, Saurav; Nepal, Sushil; Bhandari, Sushil; Nepal, Prabha; Palaian, Subish

    2009-10-01

    To evaluate the drug dispensing practices and patients' knowledge on drug use among the outpatients and to identify and analyze the problems in drug prescribing and dispensing. A prospective cross-sectional descriptive study was conducted using World Health Organization (WHO) core drug use indicators from July 13, 2008 to August 15, 2008 in Manipal Teaching Hospital, Pokhara, Nepal. A total of 4231 prescriptions were encountered with the total of 10591 drugs prescribed. The average number of drug per prescription was 2.5. Only 13% (n=10591) of drugs were prescribed by generic name. Percentage of drug prescribed from WHO model list of Essential drugs, Essential drug list of Nepal and Nepalese National Formulary was 21.7%, 32.8% and 42.3% respectively. Antibiotics and injections encountered were 28.3% and 3.1% respectively. Average cost per prescription was found to be Nepalese Rupees (NRs) 285.99 (US $ 3.73). Patient knowledge on correct use of drugs and appropriate labeling was found to be 81% and 1.4% respectively. Average dispensing time per prescription was 52 seconds. The finding from current study shows a trend towards irrational prescribing and dispensing. Hence, there is a need for effective intervention programme to encourage the physicians and dispensing pharmacists in promoting more rational drug use.

  14. Children with bronchial asthma assessed for psychosocial problems in a teaching hospital in Nigeria.

    Science.gov (United States)

    Tunde-Ayinmode, Mosunmola Florence

    2015-06-01

    Paediatric bronchial asthma causes respiratory related mortality and morbidity globally and elevates the risk of psychological and social problems (psychosocial problems); which may result in poorer asthma control. The rate of and associated factors for psychosocial problems among our asthmatic children was assessed in this study. Seventy five (75) children aged 7 to 14 years with bronchial asthma who were attending clinics at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, were assessed with Child behaviour questionnaire and a semi-structured questionnaire. Probable psychological morbidity was present in 25% of the children. The most frequently reported social impairments associated with the disease were: interference with play (60%), domestic work (49%), fear of dying anytime (29%) and feeling of being a burden on the family (25%). Psychological morbidity was significantly associated with lower maternal education (p=0.020) and occupation (p=0.038), polygamy (p=0.012), fathers having more than 5 children (p=0.027) and mothers having inadequate spousal support (p=0.012). Inadequate spousal support and lower maternal occupational level were the significant predictors of morbidity following logistic regression. Routine psychosocial assessment and care for children with asthma needs to be introduced into our clinics to help protect them and their families from avoidable suffering.

  15. Risk factors associated with postpartum haemorrhage at Juba Teaching Hospital, South Sudan, 2011

    Directory of Open Access Journals (Sweden)

    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.

  16. Incidence of rotavirus infection in children with gastroenteritis attending Jos university teaching hospital, Nigeria.

    Science.gov (United States)

    Junaid, Surajudeen A; Umeh, Chijioke; Olabode, Atanda O; Banda, Jim M

    2011-05-16

    This study was conducted to determine the incidence of rotavirus infection in children with gastroenteritis attending Jos university teaching hospital, Plateau State. A total of 160 children with acute diarrhea were selected by random sampling. Stool samples were obtained and assayed for rotavirus antigens by enzyme linked immunosorbent assay technique using standard diagnostic BIOLINE Rotavirus kit. Demographic data of parents were also recorded. Rotavirus were detected in faeces of 22(13.8%) children with acute diarrhea, 90.9% of positive cases of rotavirus gastroenteritis were under 2 years of age with highest prevalence in children 7-12 months of age. Males excreted rotavirus at a significant higher rate than females (PRotavirus excretion was highest when all three symptoms (diarrhea, fever and vomiting) occurred in the same child (7.5%) and lower when 2 symptoms occurred together (diarrhea and vomiting) with 3.8%, diarrhea and fever with 1.3% and lowest when diarrhea occurred alone with 1.3%. Playing with toys, attending day care, distance of source of water from toilet, eating of food not requiring cooking and playing with other children may serve as predisposing factors of rotavirus disease in these children.

  17. Vancomycin Utilization Evaluation in a teaching hospital: A case- series study in Iran.

    Directory of Open Access Journals (Sweden)

    Fanak Fahimi

    2015-10-01

    Full Text Available Background: Increasing antimicrobial resistance is now a critical point of human being in the world. Especially wide spectrum antibiotics resistance germs like vancomycin-resistant enterococci (VRE should be dealt as soon as possible as an emergency conflict. Our study tries to reveal the amount of irrational use of vancomycin in a teaching hospital in Iran.Methods: We elected the whole inpatients that received vancomycin between February 2007 and May 2008.Results: Forty four out of those 45 patients had inappropriate indication and dosing regimen of vancomycin (97.7%. The most use of vancomycin was recorded in hematology – oncology ward and then Intensive Care Unit (ICU. Culture responses were negative despite great clinical evidence of infection.Conclusion: Vancomycin irrational use was high compared to other countries and it could be concerned as a major health problem by health policy makers and physicians to deal. However more detailed researches are needed to reveal the other aspects of this problem. Implementation of antibiotic protocols and standard treatment guidelines are recommended.

  18. Awareness and perception of pregnant women about obstetrics ultrasound at Aminu Kano Teaching Hospital

    Directory of Open Access Journals (Sweden)

    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.

  19. Audit of orthopaedic audits in an english teaching hospital: are we closing the loop?

    Science.gov (United States)

    Iqbal, H J; Pidikiti, P

    2010-06-11

    Clinical audit is an important tool to improve patient care and outcomes in health service. A significant proportion of time and economic resources are spent on activities related to clinical audit. Completion of audit cycle is essential to confirm the improvements in healthcare delivery. We aimed this study to evaluate audits carried out within trauma and orthopaedic unit of a teaching hospital over the last 4 years, and establish the proportions which were re-audited as per recommendations. Data was collected from records of the clinical audit department. All orthopaedic audit projects from 2005 to 2009 were included in this study. The projects were divided in to local, regional and national audits. Data regarding audit lead clinicians, completion and presentation of projects, recommendations and re-audits was recorded. Out of 61 audits commenced during last four years, 19.7% (12) were abandoned, 72.1% (44) were presented and 8.2 % (5) were still ongoing. The audit cycle was completed in only 29% (13) projects. Change of junior doctors every 4~6 months is related to fewer re-audits. Active involvement by supervising consultant, reallocation of the project after one trainee has finished, and full support of audit department may increase the ratio of completion of audit cycles, thereby improving the patient care.

  20. Survey of Employees' Safety Attitude in a Teaching Hospital Tehran 2010

    Directory of Open Access Journals (Sweden)

    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

  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. Surveillance of device-associated infections at a teaching hospital in rural Gujarat - India

    Directory of Open Access Journals (Sweden)

    Singh S

    2010-01-01

    Full Text Available Purpose: Surveillance of hospital-acquired infection (HAI, particularly device-associated infection (DAI, helps in determining the infection rates, risk factors, and in planning the preventive strategies to ensure a quality healthcare in any hospital. The present study was carried out to know the prevalence of DAI in a tertiary care teaching hospital of rural Gujarat. Materials and Methods: A prospective, site-specific surveillance of three common DAIs that is catheter-associated urinary tract infection (CA-UTI, IV-catheter-related bloodstream infection (IV-CRBSI, and ventilator-associated pneumonia (VAP was carried out between July 2007 and April 2008, in different wards/ICUs. A surveillance plan, with guidelines and responsibilities of nurses, clinicians and microbiologist was prepared. Infection surveillance form for each patient suspected to have DAI was filled. The most representative clinical sample, depending on the type of suspected DAI, was collected using standard aseptic techniques and processed for aerobes and facultative anaerobes. All the isolates were identified and antimicrobial sensitivity testing performed as per CLSI guidelines. An accurate record of total device days for each of the indwelling devices under surveillance was also maintained. Data, collected in the prescribed formats, were analysed on monthly basis; and then, compiled at the end of the study. Descriptive analysis of the data was done and DAI rate was expressed as number of DAI per 1000 device days. Results: The overall infection rate for CA-UTI, IV-CRBSI, and VAP were found to be 0.6, 0.48, and 21.92 per 1000 device days, respectively. The organisms isolated were Staphylococcus aureus, CONS, Enterococci, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Conclusions: Duration of indwelling devices was found to be the major risk-factor for acquiring DAIs. Low DAI rate might have been due to use of antibiotics, often prophylactic. Active

  3. Puerperal sepsis, the leading cause of maternal deaths at a Tertiary University Teaching Hospital in Uganda.

    Science.gov (United States)

    Ngonzi, Joseph; Tornes, Yarine Fajardo; Mukasa, Peter Kivunike; Salongo, Wasswa; Kabakyenga, Jerome; Sezalio, Masembe; Wouters, Kristien; Jacqueym, Yves; Van Geertruyden, Jean-Pierre

    2016-08-05

    Maternal mortality is highest in sub-Saharan Africa. In Uganda, the WHO- MDG 5 (aimed at reducing maternal mortality by 75 % between 1990 and 2015) has not been attained. The current maternal mortality ratio (MMR) in Uganda is 438 per 100,000 live births coming from 550 per 100,000 in 1990. This study sets out to find causes and predictors of maternal deaths in a tertiary University teaching Hospital in Uganda. The study was a retrospective unmatched case control study which was carried out at the maternity unit of Mbarara Regional Referral Hospital (MRRH). The sample included pregnant women aged 15-49 years admitted to the Maternity unit between January 2011 and November 2014. Data from patient charts of 139 maternal deaths (cases) and 417 controls was collected using a standard audit/data extraction form. Multivariable logistic regression analysis was used to assess for the factors associated with maternal mortality. Direct causes of mortality accounted for 77.7 % while indirect causes contributed 22.3 %. The most frequent cause of maternal mortality was puerperal sepsis (30.9 %), followed by obstetric hemorrhage (21.6 %), hypertensive disorders in pregnancy (14.4 %), abortion complications (10.8 %). Malaria was the commonest indirect cause of mortality accounting for 8.92 %. On multivariable logistic regression analysis, the factors associated with maternal mortality were: primary or no education (OR 1.9; 95 % CI, 1.0-3.3); HIV positive sero-status (OR, 3.6; 95 % CI, 1.9-7.0); no antenatal care attendance (OR 3.6; 95 % CI, 1.8-7.0); rural dwellers (OR, 4.5; 95 % CI, 2.5-8.3); having been referred from another health facility (OR 5.0; 95 % CI, 2.9-10.0); delay to seek health care (delay-1) (OR 36.9; 95 % CI, 16.2-84.4). Most maternal deaths occur among mothers from rural areas, uneducated, HIV positive, unbooked mothers (lack of antenatal care), referred mothers in critical conditions and mothers delaying to seek health care. Puerperal sepsis is

  4. Medication errors in paediatric outpatient prescriptions of a teaching hospital in Nigeria.

    Science.gov (United States)

    Oshikoya, K A; Ojo, O I

    2007-01-01

    Proper and adequate pharmacovigilance is lacking in children's drug therapy, especially in developing countries. Therefore these children are at risk of developing adverse reactions to drugs as a result of medication errors. Having a better understanding of the types of error in a teaching hospital would be an important step toward quality improvement in children drug therapy. This study was aimed at identifying the medication errors most frequently committed in the paediatric outpatient prescriptions at the Lagos State University Teaching Hospital, Ikeja and to suggest effective strategies for reducing these errors. A total of 2,000 paediatric outpatient prescriptions randomly selected from five months prescriptions were studied. Information extracted from the prescription forms are age, sex and the drug prescription proper (adequacy of the dosage and duration of use; generic or trade name prescription; using abbreviation or acronym; prescribing injections in millilitres or milligram, syrup or suspensions in millilitres or milligram, tablets in unit numbers or milligram; and giving instructions on how to use the drugs in the case of drug-drug, drug-disease or drug-food interactions). A total of 1944 prescriptions met the criteria for inclusion in the study. Antimalarials (89.9%), analgesics (66.4%), vitamin B complex (61.5%) and antibiotics (41.4%) were the most prescribed drugs. Errors identified are inadequate medication dosing duration; omission of age, dosage, and duration of drug use; improper dosaging and prescription of those drugs that could adversely interact. While paracetamol, 94.6% of the analgesics, was prescribed for an average of 3.2 +/- 0.6 days, antibiotics were prescribed for an average of 6.2 +/- 1.0 days. Duration of use was omitted in 24 (2.0%) and 12 (1.5%) prescriptions for paracetamol and antibiotics respectively. Errors of overdosaging and underdosaging were common to most of the commonly prescribed drugs. Underdosage and overdosage were

  5. Characteristics of simulation activities at North American medical schools and teaching hospitals: an AAMC-SSH-ASPE-AACN collaboration.

    Science.gov (United States)

    Huang, Grace C; Sacks, Heather; Devita, Michael; Reynolds, Robby; Gammon, Wendy; Saleh, Michael; Gliva-McConvey, Gayle; Owens, Tamara; Anderson, Julie; Stillsmoking, Kristina; Cantrell, Mary; Passiment, Morgan

    2012-12-01

    In September 2011, the Association of American Medical Colleges released the results of a survey conducted in 2010 on simulation activities at its member medical schools and teaching hospitals. In this commentary, we offer a synthesis of data and conclude that (1) simulation is used broadly at Association of American Medical Colleges member institutions, for many types of learners, including other health care professionals; (2) it addresses core training competencies and has many educational purposes; (3) its use in learner assessment is more prevalent at medical schools but is still significant at teaching hospitals; and (4) it requires a considerable investment of money, space, personnel, and time. These data confirm general perceptions about the state of simulation in North America for physician training. Future endeavors should include a more granular examination of how simulation is integrated into curricula, a similar survey of other health care-related institutions and professions, and a periodic assessment to characterize trends over time.

  6. 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

    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...

  7. 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...

  8. Geo-Electrical Exploration for Groundwater within the Premises of University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

    OpenAIRE

    A. K. Olawuyi

    2012-01-01

    Schlumberger Vertical Electrical Soundings for groundwater search within the premises of University of Ilorin Teaching Hospital (UITH) situated along Ilorin- Jebba road in Kwara State, were carried out with a view to establishing the different subsurface geoelectric layers, the aquifer units and their hydrogeologic properties. Data were collected from 12 VES stations over an area of about 500 m x 650 m. From the quantitative interpretation of the data collected, using the usual method of curv...

  9. “Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

    OpenAIRE

    Bhattacharjee, Prosanta Kumar; Halder, Shyamal Kumar; Rai, Himanshu; Ray, Rajendra Pd

    2013-01-01

    Laparoscopic cholecystectomy has revolutionized the management of symptomatic gallstone disease since its introduction more than 20 years ago. It has gained widespread acceptance and is presently the gold standard for its management. This large study spanned over last 10 years and includes prospective data on 950 elective cases of laparoscopic cholecystectomy since 2002. All cases were operated personally by the author in different teaching hospitals of West Bengal. The following were looked ...

  10. Periodontal disease status and associated risk factors in patients attending a Dental Teaching Hospital in Rawalpindi, Pakistan

    OpenAIRE

    Bokhari, Syed Akhtar Hussain; Suhail, Agha Mohammad; Malik, Abdul Razzaq; Imran, Mian Farrukh

    2015-01-01

    Background: Investigators have identified an association of socio-demographic and medical factors with periodontal risk. This study observed status and association of periodontal disease and associated risk factors/indictors. Materials and Methods: All patients attending a dental teaching hospital were interviewed for socio-demographic and medical information through a structured questionnaire. Participants were examined for periodontal status using the community periodontal index (CPI), by a...

  11. Prevalence of taurodontism among the patients visiting a dental teaching hospital in Pune, India: A retrospective orthopantomogram study

    OpenAIRE

    Dipali Shah; Vikram Garcha; Janardan Garde; Devendra Ekhande

    2015-01-01

    Introduction: Taurodontism is a morpho-anatomic variation in the shape of teeth that chiefly affects molars in primary as well as secondary dentition. Aim: The aim was to assess the prevalence of taurodontism in premolars and molars by studying the orthopantomogram (OPGs) of the patients visiting a dental teaching hospital in Pune, India. Materials and Methods: A retrospective, cross-sectional study was carried out, wherein the panoramic radiographs of 525 randomly selected patients were eval...

  12. A study of knowledge assessment and competence in asthma and inhaler technique of nurses employed at university teaching hospital

    OpenAIRE

    Lalani NS

    2012-01-01

    Background: Current effective treatments available for asthma are mainly the inhalers. Nurses play a vital role in imparting correct knowledge of asthma care and teaching inhaler techniques to patients. The aims of the study were to, a) determine the knowledge of nurses regarding asthma and its management and b) evaluate the competence of nurses to use inhalers.Methods: A simple random sample of registered nurses was taken from the medical surgical units of the hospital. Data was collected by...

  13. Prevalence of Needlestick Injuries Among Healthcare Workers in the Accident and Emergency Department of a Teaching Hospital in Nigeria

    OpenAIRE

    Isara, AR; Oguzie, KE; Okpogoro, OE

    2015-01-01

    Background: Healthcare workers (HCWs) are continually exposed to hazards from contact with blood and body fluids of patients in the healthcare setting. Aim: To determine the prevalence of needlestick injuries (NSIs) and associated factors among HCWs in the Accident and Emergency Department of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Subjects and Methods: This was a cross-sectional study. Data were collected using a structured, self-administered questionnaire and ...

  14. 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.

  15. Utilization of Parenteral Morphine by Application of ATC/DDD Methodology: Retrospective Study in the Referral Teaching Hospital.

    Science.gov (United States)

    Dragojevic-Simic, Viktorija; Rancic, Nemanja; Stamenkovic, Dusica; Simic, Radoje

    2017-01-01

    Few studies analyzed the pattern of opioid analgesic utilization in hospital settings. The aim of this study was to determine the consumption pattern of parenteral morphine in patients hospitalized in the Serbian referral teaching hospital and to correlate it with utilization at the national and international level. In retrospective study, the required data were extracted from medical records of surgical patients who received parenteral morphine in the 5-year period, from 2011 to 2015. We used the Anatomical Therapeutic Chemical Classification/Defined Daily Doses (DDD) international system for consumption evaluation. While the number of performed surgical procedures in our hospital steadily increased from 2011 to 2015, the number of inpatient bed-days decreased from 2012. However, the consumption of parenteral morphine varied and was not more than 0.867 DDD/100 bed-days in the observed period. Based on the available data, parenteral morphine consumption in our hospital was lower compared with international data. The low level of morphine use in the hospital was in accordance with national data, and compared with other countries, morphine consumption applied for medical indications in Serbia was low. Adequate legal provision to ensure the availability of opioids, better education and training of medical personnel, as well as multidisciplinary approach should enable more rational and individual pain management in the future, not only within the hospitals.

  16. Utilization of Parenteral Morphine by Application of ATC/DDD Methodology: Retrospective Study in the Referral Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Viktorija Dragojevic-Simic

    2017-08-01

    Full Text Available BackgroundFew studies analyzed the pattern of opioid analgesic utilization in hospital settings. The aim of this study was to determine the consumption pattern of parenteral morphine in patients hospitalized in the Serbian referral teaching hospital and to correlate it with utilization at the national and international level.MethodsIn retrospective study, the required data were extracted from medical records of surgical patients who received parenteral morphine in the 5-year period, from 2011 to 2015. We used the Anatomical Therapeutic Chemical Classification/Defined Daily Doses (DDD international system for consumption evaluation.ResultsWhile the number of performed surgical procedures in our hospital steadily increased from 2011 to 2015, the number of inpatient bed-days decreased from 2012. However, the consumption of parenteral morphine varied and was not more than 0.867 DDD/100 bed-days in the observed period.ConclusionBased on the available data, parenteral morphine consumption in our hospital was lower compared with international data. The low level of morphine use in the hospital was in accordance with national data, and compared with other countries, morphine consumption applied for medical indications in Serbia was low. Adequate legal provision to ensure the availability of opioids, better education and training of medical personnel, as well as multidisciplinary approach should enable more rational and individual pain management in the future, not only within the hospitals.

  17. Depression and associated factors in hospitalized elderly: a cross-sectional study in a Saudi teaching hospital.

    Science.gov (United States)

    Alamri, Sultan Hassan; Bari, Abdulaziz Ihsan; Ali, Abdulrahman Talal

    2017-01-01

    Depression in the elderly is a serious and often underdiagnosed psychiatric disorder that has been linked to adverse outcomes in the hospital setting. To determine the prevalence of depression and possible associated factors among hospitalized elderly. An analytical cross-sectional study. Medical and surgical wards of King Abdulaziz University Hospital, Jeddah, Saudi Arabia. The study included 200 consecutively hospitalized patients aged 60 years and older. Participants were evaluated within 48 hours of admission using an interviewer-administered question-naire to provide basic demographic and clinical information. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) screening method and the Structured Clinical Interview for the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) mood disorder module. According to PHQ-9, 17% and 10.5% of the hospitalized patients were diagnosed with a major depressive disorder and other depressive disorders, respectively. The DSM-5 criteria identified 12% of elderly with major depression. Overall, the number of comorbidities associated with depression was signifi-cantly higher in the major depressive disorder group than in the no depression group (post hoc P=.022). Depression was also associated with female gender, unmarried status, lower income, and polypharmacy. In addition, cardiovascular disease and cancer were the most prevalent medical illnesses associated with depression among hospitalized elderly. Major depressive disorder was prevalent among hospitalized elderly, especially among those with comorbid conditions. Hospital physicians must, therefore, maintain a high index of suspicion to identify early and manage depressive symptoms in these patients. The small size of certain subgroups limits the statistical power to examine for associations of depression with particular conditions.

  18. 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...

  19. 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.

  20. 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

  1. Prescribing practice and evaluation of appropriateness of enteral nutrition in a university teaching hospital

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    Zhu XP

    2013-02-01

    Full Text Available Xiu-Ping Zhu,1 Ling-Ling Zhu,2 Quan Zhou11Department of Pharmacy, 2Cadre Department, Division of Nursing, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of ChinaBackground: A retrospective utilization study was performed to evaluate utilization patterns for enteral nutrition in a university teaching hospital.Methods: Enteral nutrition was divided into three types according to the nitrogen source, ie, total protein type [Nutrison Fibre®, Fresubin Energy Fibre®, Fresubin®, Supportan® (a special immunonutrition for cancer patients or patients with increased demands for omega-3 fatty acids, Fresubin Diabetes® (a diabetes-specific formula, Ensure®]; short peptide type (Peptison®; and amino acid type (Vivonex®. A pharmacoeconomic analysis was done based on defined daily dose methodology.Results: Among hospitalized patients taking enteral nutrition, 34.8% received enteral nutrition alone, 30% concomitantly received parenteral nutrition, and 35.2% received enteral nutrition after parenteral nutrition. Combined use of the different formulas was observed in almost all hospitalized patients receiving enteral nutrition. In total, 61.5% of patients received triple therapy with Nutrison Fibre, Fresubin Diabetes, and Supportan. Number of defined daily doses (total dose consumed/defined daily dose, also called DDDs of formulas in descending order were as follows: Nutrison Fibre, Fresubin Energy Fibre, Fresubin Diabetes > Supportan > Peptison, Ensure > Vivonex, Fresubin. The ratio of the cumulative DDDs for the three types of enteral nutrition was 35:2.8:1 (total protein type to short peptide type to amino acid type. Off-label use of Fresubin Diabetes was also observed, with most of this formula being prescribed for patients with stress hyperglycemia. Only 2.1% of cancer patients received Supportan. There were 35 cases of near misses in dispensing look-alike or sound-alike enteral

  2. Prevalence rates of infection in intensive care units of a tertiary teaching hospital

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    Toufen Junior Carlos

    2003-01-01

    Full Text Available OBJECTIVE: To determine the prevalence rates of infections among intensive care unit patients, the predominant infecting organisms, and their resistance patterns. To identify the related factors for intensive care unit-acquired infection and mortality rates. DESIGN: A 1-day point-prevalence study. SETTING:A total of 19 intensive care units at the Hospital das Clínicas - University of São Paulo, School of Medicine (HC-FMUSP, a teaching and tertiary hospital, were eligible to participate in the study. PATIENTS: All patients over 16 years old occupying an intensive care unit bed over a 24-hour period. The 19 intensive care unit s provided 126 patient case reports. MAIN OUTCOME MEASURES: Rates of infection, antimicrobial use, microbiological isolates resistance patterns, potential related factors for intensive care unit-acquired infection, and death rates. RESULTS: A total of 126 patients were studied. Eighty-seven patients (69% received antimicrobials on the day of study, 72 (57% for treatment, and 15 (12% for prophylaxis. Community-acquired infection occurred in 15 patients (20.8%, non- intensive care unit nosocomial infection in 24 (33.3%, and intensive care unit-acquired infection in 22 patients (30.6%. Eleven patients (15.3% had no defined type. The most frequently reported infections were respiratory (58.5%. The most frequently isolated bacteria were Enterobacteriaceae (33.8%, Pseudomonas aeruginosa (26.4%, and Staphylococcus aureus (16.9%; [100% resistant to methicillin]. Multivariate regression analysis revealed 3 risk factors for intensive care unit-acquired infection: age > 60 years (p = 0.007, use of a nasogastric tube (p = 0.017, and postoperative status (p = 0.017. At the end of 4 weeks, overall mortality was 28.8%. Patients with infection had a mortality rate of 34.7%. There was no difference between mortality rates for infected and noninfected patients (p=0.088. CONCLUSION: The rate of nosocomial infection is high in intensive care

  3. Triple-Negative Breast Cancer in Ghanaian Women: The Korle Bu Teaching Hospital Experience.

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    Der, Edmund M; Gyasi, Richard K; Tettey, Yao; Edusei, Lawrence; Bayor, Marcel T; Jiagge, Evelyn; Gyakobo, Mawuli; Merajver, Sofia D; Newman, Lisa A

    2015-01-01

    Breast cancers that have negative or extremely low expression of estrogen receptor and progesterone receptor and non-amplification of human epidermal growth factor receptor-2 (HER2)/neu are termed triple-negative breast cancer (TNBC). The majority of TNBC tumors belong to the biologically aggressive basal subtype, and they cannot be managed with targeted endocrine or anti-HER2/neu agents. In western, high resource environments, risk factors for TNBC include younger age at diagnosis and hereditary susceptibility. Women of African ancestry in the United States and in continental Africa have higher frequencies of TNBC, prompting speculation that this risk may have an inherited basis and may at least partially explain breast cancer survival disparities related to racial/ethnic identity. Efforts to document and confirm the breast cancer burden of continental Africa have been hampered by the limited availability of registry and immunohistochemistry resources. Our goal was to evaluate the breast cancers diagnosed in one of the largest health care facilities in western Africa, and to compare the frequencies as well as risk factors for TNBC versus non-TNBC in this large referral tertiary hospital. The Korle Bu Teaching Hospital is affiliated with the University of Ghana and is located in Accra, the capital of Ghana. We conducted an institutional, Department of Pathology-based review of the breast cancer cases seen at this facility for the 2010 calendar year, and for which histopathologic specimens were available. The overall study population of 223 breast cancer cases had a median age of 52.4 years, and most had palpable tumors larger than 5 cm in diameter. More than half were TNBC (130; 58.3%). We observed similar age-specific frequencies, distribution of stage at diagnosis and tumor grade among cases of TNBC compared to cases of non-TNBC. Ghanaian breast cancer patients tend to have an advanced stage distribution and relatively younger age at diagnosis compared to

  4. Barriers to Participation in an Online Nursing Journal Club at a Community Teaching Hospital.

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    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

  5. Quality of Morning Report at Yazd Shahid Sadoughi Teaching Hospital in 1386

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    S Zare

    2008-01-01

    Full Text Available ackground : Morning report has been the basis of educational programs for internal residents over years. It consists of various groups including instructors, trainers, and students with varying educational objectives. Yet, there is no uniform pattern for this purpose. So, the present study was conducted to evaluate the quality of morning report at Yazd Shahid Sadoughi Teaching Hospital. Methods : This was a descriptive cross-sectional study carried out on a total of 117 subjects (37 males, and 80 females including 39 assistant students, 39 attending students, and 39 trainees in the Internal Medicine, Pediatrics, and Obstetrics Wards. A questionnaire including 29 items was given to the students to survey the quality of morning report in different wards. The related data were collected and analyzed using Chi-square. Each questionnaire was scored on the basis of a predetermined criterion measure. The data were classified into "excellent" and "moderate" groups. Results : No statistically significant difference was found between questionnaire score and sex (P-value = 0.05 yet, there was a statistically significant difference between questionnaire scores relating to the three said wards (P-value = 0.019. The obstetrics ward (48% was at the excellent level. 22.2% of the students presented their morning reports including a follow-up. 55.6% of the students presented their reports at the assistant level. 66.7% of the students presented their report in the form of question-and-answer, while 33.3% of them presented it as a speech. Further, 66.3% of the students maintained that the morning report has had an effective impact on the management of the patients. Conclusion : Based on the findings, it is advisable to provide evidence as films, papers, books, etc. to promote the quality of morning report.

  6. Anthropometry of children with cerebral palsy at the Lagos University Teaching Hospital

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    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.

  7. Profile of intrauterine contraceptive device acceptors at the University of Uyo Teaching Hospital, Uyo, Nigeria.

    Science.gov (United States)

    Abasiattai, A M; Bassey, E A; Udoma, E J

    2008-03-01

    Use of modern contraceptive methods has been shown to reduce unwanted pregnancy, high parity and maternal mortality. Intrauterine contraceptive devices which are among the safest and most effective reversible contraceptives available, are particularly suitable for women in developing countries as they are affordable, convenient to use, do not require re -supply visits and are very cost-effective. The aim of this study is to determine the socio-demographic characteristics of intrauterine contraceptive device acceptors, the pattern of insertions and complications at the University of Uyo Teaching hospital, Uyo. The record cards of all clients who had intrauterine contraceptive device inserted at the family planning clinic over a six-year period were reviewed. During the study period, there were 852 new contraceptive acceptors out of which 39.7% accepted the intrauterine contraceptive device. The modal age group of the clients was 25-29 years (32.5%). Acceptance of intrauterine contraceptive device was most common among multiparous clients (65.1%). Majority of the acceptors were married (90.0%), Christians (98.8%) and 72.8% had at least secondary school education. Clinic personnel (65.7%) and friends/relatives (21.3%) were the most common sources of information on contraception. Most (93.5%) of the clients had their intrauterine contraceptive devices inserted within 7 days of menstruation. Lower abdominal pain (5.5%) and vulval/vaginal itching (5.3%) were the most common complications. The acceptors of intrauterine contraceptive devices in our center were young, multiparous and educated women. Increasing mass media involvement in the dissemination of accurate information about intrauterine contraceptive devices to the general populace, the introduction of postpartum and post-abortal intrauterine contraceptive device insertions and the encouragement of our grandmultiparous women to accept intrauterine contraceptive device would lead to an increase in its acceptance and

  8. Evaluation of Nutritional Status in a Teaching Hospital Neonatal Intensive Care Unit

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    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

  9. Elaboration of a risk map in a paediatric Emergency Department of a teaching hospital.

    Science.gov (United States)

    Mojica, Elisa; Izarzugaza, Estibaliz; Gonzalez, Maria; Astobiza, Eider; Benito, Javier; Mintegi, Santiago

    2016-10-01

    To develop a risk map in a paediatric ED of a tertiary teaching hospital, combining proactive and reactive strategies. Between June and December 2013, a multidisciplinary committee in a paediatric Emergency Department (ED) in Bilbao (Basque Country of Spain) mapped the patient's journey and identified potential risks to patients (proactive strategy). The researchers also analysed incidents reported by professionals and caregivers (mainly parents) in the paediatric ED from November 2004-December 2013 (reactive strategies). Combining the results of both strategies, we applied the 'Failure mode and effects analysis' tool to identify and prioritise high or very high-risk situations and apply them to the risk map. Using proactive strategies, 49 opportunities for failures, 60 effects and 252 causes were identified. The most common failures were related to the discharge of the patient; the most common effects were complaints by parents, long stay in the ED, delay in diagnosis/treatment and unnecessary treatment. Main causes were not including the family in the process, shift change, incorrect identification of the patient and computer errors. Using reactive strategies, 1795 reported incidents were analysed. The most common incidents were related to medical equipment (38%), resources/organisation of staff (17%), clinical process (15%), facilities (12%) and medication errors (5%). Proactive strategies identified risks in tests, treatment and discharge. The reactive strategy added risks concerning prehospital transfer, triage, medical care, tests, treatment and discharge. Proactive and reactive strategies, involving professionals and caregivers, can complement each other in identifying potential patient safety risks in a paediatric ED. 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/

  10. Acute coronary syndrome-related mortality audit in a teaching hospital at Port Blair, India

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    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.

  11. Nutritional status of children with sickle cell disease at Korle Bu Teaching Hospital, Accra, Ghana.

    Science.gov (United States)

    Osei-Yeboah, C; Rodrigues, O; Enweronu-Laryea, C

    2011-01-01

    Sickle cell disease (SCD) with its attendant increased energy requirements has an adverse effect on growth. Good nutrition is essential for normal childhood growth and development. Differences in growth between children living within the same SEC's are likely to be due to the effects of the sickle cell disease. To determine the relationship between SCD and nutritional status in children. This cross-sectional study, conducted at the Paediatric Sickle Cell Clinic of the Korle Bu Teaching Hospital, recruited 427 children aged 1-12 years: 357 SCD patients (cases) and 70 of their siblings with Hb AA (controls), over a four-month period. Their socio-demographic data, weight and height/length were documented, and the weight-for-age (WAZ) and height/length-for-age (HAZ), weight-for-height/length (WHZ) scores calculated as indices of nutritional status. The mean (SD) age of SCD participants was 7.18 (3.15) years and of controls was 5.13 (3.28) years, (p=0.8). The prevalence of malnutrition was 61.3% among SCD subjects and 28.6% among controls, (p<0.001). The WAZ (underweight) and HAZ (stunting) scores were significantly more common among SCD children than controls, but the difference in the rates of wasting (WHZ) was not significant (p=0.3). Ghanaian SCD children are more underweight and stunted than their Hb AA counterparts living under similar socio-economic conditions. Better education of families about the nutritional needs of SCD children in our community is needed.

  12. Internal quality assurance activities of a surgical pathology department in an Australian teaching hospital.

    Science.gov (United States)

    Zardawi, I M; Bennett, G; Jain, S; Brown, M

    1998-09-01

    To assess the role of a quality assurance programme in improving the service provided by a surgical pathology department. A continuous internal quality assurance study of the activities of an anatomical pathology department in an Australian teaching hospital was undertaken over a five year period. This addressed all steps involved in the production of a surgical pathology report. These were addressed in an open forum which included technical, scientific, clerical, and medical staff. Minor errors not needing immediate action were discussed and incorporated into laboratory practice. For major discrepancies with potential implications for patient management supplementary reports were issued and the relevant clinician informed of the outcome. Comprehensive peer review of 8.9% of the total workload of the department (3530 cases) and all the frozen sections (916 cases) over a period of five years, beginning in 1991, led to comments on some aspects of the original report by the reviewer in 19.6% of the cases. The great majority of the comments were minor, concerning issues related to the microscopic findings (4%), macroscopic description (3.1%), clerical aspects (3%), typographical errors (3%), coding errors (2.7%), technical errors including poor sections and incorrect labelling (1.7%), inadequate clinical history (1.2%), and incomplete or incomprehensible diagrams (0.9%). In two cases (0.05%) the original report did not state proximity of the tumour to surgical margins and in three of the frozen sections (0.3%) the original diagnosis was incorrect. However, in these cases the frozen section assessment did not alter the overall management of the cases. This study highlights the importance of a review system in detecting errors in surgical pathology reporting. Recognition of the fact that surgical pathology is not infallible has improved the end product. It has also minimised interobserver variability in the department, resulting in a uniform approach among the

  13. 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.

  14. 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.

  15. Maxillofacial and concomitant injuries in multiple injured patients at Korle Bu Teaching Hospital, Ghana.

    Science.gov (United States)

    Parkins, G; Boamah, M O; Avogo, D; Ndanu, T; Nuamah, I K

    2014-01-01

    Patients with maxillofacial injuries may sustain concomitant injuries. The presentation of other injuries may be the initial focus of attention of the primary attending surgeon who may miss the maxillofacial injuries to the detriment of the patient. To determine the incidence of injuries associated with maxillofacial injuries at Korle Bu Teaching Hospital (KBTH) from January 2009 to December 2010. A prospective study was carried out on patients who were referred to the Maxillofacial Unit of the University of Ghana Dental School and KBTH over the two years with maxillofacial injuries. Their age, sex, type of injury in the maxillofacial region, its aetiology and concomitant injuries were charted. The data was analysed using SPSS 16.0 software. Two hundred and fifty eight (258) patients were seen of which 67 (26.0%) had concomitant injuries. The average age was 29.1 years. The peak incidence was in the age group 21-30 (N=73, 28.3%). 74% were male and 26.0% female. The commonest cause of injury was road traffic accident (RTA) (N=142;55.0%). 52.7% (N=136) of the patients had injuries of the maxillofacial region. 26.7% (N=69) had mandibular fractures, 19.4% (N=50) had middle third fractures and 8.1% (N=21) had fractures of both. Concomitant injuries were mainly orthopaedic (N=31;12%) and the head and spinal region (N=29;11.2%). A significant number of patients who suffer maxillofacial injuries also sustain injuries of other parts of the body at KBTH. Prompt multidisciplinary management may contribute to improved outcomes.

  16. Work-Related Musculoskeletal Disorders among Health Workers in a Nigerian Teaching Hospital

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    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

  17. Reasons and pattern of tooth mortality in a Nigerian Urban teaching hospital.

    Science.gov (United States)

    Saheeb, B D; Sede, M A

    2013-01-01

    Studies from Nigeria have documented different reasons for tooth mortality and regular follow-up studies to determine any changes in reasons and pattern among Nigerians appears not to be common. The purpose of this study was to determine the reasons and pattern of tooth mortality among Nigerians and the changes that might have occurred after 38 years of the first report. The case records of patients seen at the Oral Surgery clinic of the University of Benin Teaching Hospital between March 2007 and February 2008 were retrieved from the Medical Records Department and analyzed for age, gender, reasons for extraction, tooth extracted, frequency of extraction, and mode of extraction. A total of 990 patients were referred for exodontia and 1050 teeth were extracted from 397 (40.1%) males and 593 (59.9%) females of age 14--89 years. The reasons for extraction include caries and its sequelae (n = 905, 86.2%), periodontal disease (n = 69, 6.6%), trauma (n = 41, 3.9%), orthodontics (n = 24, 2.3%), failed endodontics (n = 5, 0.5%), prosthetics (n = 4, 0.4%), pericoronitis (n = 2, 0.2%). The most frequently extracted teeth were the lower right first molars (n = 109, 10.4%) and the lower left first molars (n = 95, 9.0%), respectively. Molar teeth (n = 830, 79.0%) were more frequently extracted while canines (n = 13, 1.2%) were the least. The lower molars were more commonly extracted (n = 479, 45.6%) followed by upper molars (n = 351, 33.4%). The age range of 21-30 years was more commonly referred for extraction with the most frequently extracted teeth being the lower left first molars (n = 32, 3.0%) in females and (n = 27, 2.7%) in males, respectively. Tooth mortality in Nigerians is significantly associated with dental caries and its sequelae especially in younger patients.

  18. Indications and Risk Factors for Complications of Lower Third Molar Surgery in a Nigerian Teaching Hospital

    Science.gov (United States)

    Osunde, OD; Saheeb, BD; Bassey, GO

    2014-01-01

    Background: The surgical extraction of impacted third molars is a common oral surgical procedure, and it is often associated with complications such as sensory nerve damage, dry socket, pain, swelling, trismus, infection and hemorrhage. Aim: The aim of this study was to determine the surgical indications and risk factors for complications of third molar surgery at a Nigerian teaching hospital. Materials and Methods: Medical records of patients referred to the Oral Surgery Clinic of our institution for surgical extraction of their impacted mandibular third molars from January 2008 to December 2010 were retrospectively examined. Information on patients’ demography, types of impaction, operative parameters and complications were obtained and analyzed using Statistical Package for Social Sciences (SPSS Version 13), Chicago, IL, USA. A P pericoronitis (154/330 [46.7%]) was the most common indication for extraction. The complications were delayed healing (19/330 [5.8%]), alveolar, osteitis (9/330 [2.7%]) and injury to alveolar nerve (2/330 [0.6%]). Cigarette smoking (P < 0.001), Oral contraceptives use (P = 0.01), age of the patient (P = 0.03) and the surgeon's experience (P = 0.04) were found to be significantly associated with the development of alveolar osteitis; nerves injuries were significantly associated with the raising of a lingual flap (P < 0.001) and the technique of surgery (P ≤ 0.001). Conclusion: The age of the patient, cigarette smoking and oral contraceptive use at the time of surgery are some of the factors affecting outcome in third molar surgery. PMID:25506490

  19. Nasal And Hand Carriage Of Bacteria In Different Groups Of Persons In A Teaching Hospital In India

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    P Ganguly

    1997-12-01

    Full Text Available Research Problem: What is the level of bacterial car­riage in different groups of hospital staff?Objective: To study nasal and hand carriage of bacteria in different groups of persons in a teaching hospital.Study Design: Prospective study.Setting: Surgical wards of J.N. Medical College Hospi­tal, A.M.U., Aligarh.Participants: Randomly selected persons from differ­ent groups of hospital staff (doctors, nurses, ward and OT assistants, visitors of patients, patients and medi­cal students.Sample Size: 275 persons.Study Variables: Nasal and hand carriage of S. aureus and gram negative bacilli.Outcome Variables: Percentage of hospital staff show­ing bacterial carriage in their nose or on their hands.Statistical Analysis: By tests of significance.Result: Overall bacterial carriage rate in different cat­egories of hospital staff was found to be 54.5%. Doc­tors and paramedical staff had higher bacterial carriage rate as compared to other groups. Though Staphylo­coccus aureus was the commonest organism isolated from both nose and skin, carriage of Escherichia coli, Pseudomonas and Klebsiella group of gram-negative bacilli was also observed. Nasal carriage was com­moner than dermal carriage.Conclusion: Doctors and paramedical staff in hospital should adopt appropriate preventive measures to avoid transmitting pathogenic bacteria from their nose and skin to their patients.

  20. The Experience of Implementing the Board of Trustees’ Policy in Teaching Hospitals in Iran: An Example of Health System Decentralization

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    Leila Doshmangir

    2015-04-01

    Full Text Available Background In 2004, the health system in Iran initiated an organizational reform aiming to increase the autonomy of teaching hospitals and make them more decentralized. The policy led to the formation of a board of trustees in each hospital and significant modifications in hospitals’ financing. Since the reform aimed to improve its predecessor policy (implementation of hospital autonomy began in 1995, it expected to increase user satisfaction, as well as enhance effectiveness and efficiency of healthcare services in targeted hospitals. However, such expectations were never realized. In this research, we explored the perceptions and views of expert stakeholders as to why the board of trustees’ policy did not achieve its perceived objectives. Methods We conducted 47 semi-structured face-to-face interviews and two focus group discussions (involving 8 and 10 participants, respectively with experts at high, middle, and low levels of Iran’s health system, using purposive and snowball sampling. We also collected a comprehensive set of relevant documents. Interviews were transcribed verbatim and analyzed thematically, following a mixed inductive-deductive approach. Results Three main themes emerged from the analysis. The implementation approach (including the processes, views about the policy and the links between the policy components, using research evidence about the policy (local and global, and policy context (health system structure, health insurers capacity, hospitals’ organization and capacity and actors’ interrelationships affected the policy outcomes. Overall, the implementation of hospital decentralization policies in Iran did not seem to achieve their intended targets as a result of assumed failure to take full consideration of the above factors in policy implementation into account. Conclusion The implementation of the board of trustees’ policy did not achieve its desired goals in teaching hospitals in Iran. Similar

  1. The experience of implementing the board of trustees’ policy in teaching hospitals in Iran: an example of health system decentralization

    Science.gov (United States)

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

    2015-01-01

    Background: In 2004, the health system in Iran initiated an organizational reform aiming to increase the autonomy of teaching hospitals and make them more decentralized. The policy led to the formation of a board of trustees in each hospital and significant modifications in hospitals’ financing. Since the reform aimed to improve its predecessor policy (implementation of hospital autonomy began in 1995), it expected to increase user satisfaction, as well as enhance effectiveness and efficiency of healthcare services in targeted hospitals. However, such expectations were never realized. In this research, we explored the perceptions and views of expert stakeholders as to why the board of trustees’ policy did not achieve its perceived objectives. Methods: We conducted 47 semi-structured face-to-face interviews and two focus group discussions (involving 8 and 10 participants, respectively) with experts at high, middle, and low levels of Iran’s health system, using purposive and snowball sampling. We also collected a comprehensive set of relevant documents. Interviews were transcribed verbatim and analyzed thematically, following a mixed inductive-deductive approach. Results: Three main themes emerged from the analysis. The implementation approach (including the processes, views about the policy and the links between the policy components), using research evidence about the policy (local and global), and policy context (health system structure, health insurers capacity, hospitals’ organization and capacity and actors’ interrelationships) affected the policy outcomes. Overall, the implementation of hospital decentralization policies in Iran did not seem to achieve their intended targets as a result of assumed failure to take full consideration of the above factors in policy implementation into account. Conclusion: The implementation of the board of trustees’ policy did not achieve its desired goals in teaching hospitals in Iran. Similar decentralization

  2. Evaluation of hospital information systems of the teaching hospitals affiliated to Shiraz University of Medical Sciences, based on the American College of Physicians Criteria

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    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

  3. Petri Nets

    Indian Academy of Sciences (India)

    Associate Professor of. Computer Science and. Automation at the Indian. Institute of Science,. Bangalore. His research interests are broadly in the areas of stochastic modeling and scheduling methodologies for future factories; and object oriented modeling. GENERAL I ARTICLE. Petri Nets. 1. Overview and Foundations.

  4. Petri Nets

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 4; Issue 8. Petri Nets - Overview and Foundations. Y Narahari. General Article Volume 4 Issue 8 August 1999 pp ... Author Affiliations. Y Narahari1. Department ot Computer Science and Automation, Indian Institute of Science, Bangalore 560 012, India.

  5. Medical Students' Perception of Educational Environment of Teaching Hospitals of Guilan University of Medical Sciences in 2015

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    Mojtaba Mehrdad

    2016-07-01

    Full Text Available Background and Purpose: The medical educational environment is increasingly becoming the focus of research globally. It is commonly understood that educational environments are an important factor for efficient learning. The present study was done with the aim to evaluation of clinical phase students' perception of learning environment of our teaching hospital and comparing it with the previous study and other similar studies of other medical teaching centers in Iran and other countries.Methods: The Persian version of DREEM questionnaire was submitted to clinical phase medical students consisted of stagers and interns educating in internal medicine and infectious diseases, dermatology and urology wards rotations of Razi teaching hospital.Results: Among 5 domains,the best scored domain by stagers and interns was “students' perception of teachers” (57.75% and the least scored domain was “student perception of learning“ (52.43%. The total mean score of our study (110.42±19.44 and the mean scores of all 5 domains in our study were higher than previous study. The increase of score in 1 domain: student perception of learning was statistically significant.Conclusions: The present study shows that our clinical educational environment has improved as perceived by medical students in comparison to previous study, but we need more effort to improve our clinical educational environment to approach to other excellent education centers around the world. Keywords: Educational environment, DREEM, medical students

  6. Pro asynchronous programming with .NET

    CERN Document Server

    Blewett, Richard; Ltd, Rock Solid Knowledge

    2014-01-01

    Pro Asynchronous Programming with .NET teaches the essential skill of asynchronous programming in .NET. It answers critical questions in .NET application development, such as: how do I keep my program responding at all times to keep my users happy how do I make the most of the available hardware how can I improve performanceIn the modern world, users expect more and more from their applications and devices, and multi-core hardware has the potential to provide it. But it takes carefully crafted code to turn that potential into responsive, scalable applications.With Pro Asynchronous Programming

  7. An assessment of the competence and experience of dentists with the management of medical emergencies in a Nigerian teaching hospital.

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    Adewole, Richard Ayodeji; Sote, Elizabeth Obalowu; Oke, David Adewale; Agbelusi, Adewumi Gbemisola

    2009-01-01

    Previous reports show that medical emergency events have ocurred in Teaching Hospital Dental centres, with attendant mortality and morbidity. (1) To study the pattern of medical emergencies encountered by clinical dental staff of Lagos University Teaching Hospital (2) To evaluate their training, perception of their training and competence as undergraduates and postgraduates to manage such events. All the clinical staff viz: Dental surgeons of different cadres--consultants, registrars, house surgeons and dental nurses of Lagos University Teaching Hospital. A structured questionnaire requesting to know demographic data, respondents attendance of life support training viz: Basic life support (BLS), advanced trauma life support (ATLS), intensive care support (ICS). A self rating in the competence of management of medical emergencies and previous personal encounter with medical emergencies with success/failure in the management with/or without medical colleage assistance were sought. In addition adequacy of their dental clinic/centres for drugs, equipments and their perceived readiness to deal with emergencies were enquired. Among the dental surgeons, 20 (26.6%) were consultants, 40 (53.3%) were registrars and 35 (46.6%) were house-officers. Thirty five (43.7%) had previous knowledge of basic life support (BLS) training, while 45 (56.2%) denied such knowledge. The figures for other trainings such as advanced trauma life Support (ATLS) was 8 (10%) and intensive care support (ICS) 2 (2.5% 73.3% of the respondents felt inadequate in the management of cardiovascular emergencies, while only 15.4% felt adequately prepared. Similar ratings for respiratory emergencies are 63.1% inadequacy, 16.9% adequacy, and only 3.3% felt very adequate. The availability of oxygen extension tubing and ambu bag was nil in all departments. Emergency drugs were claimed to be present by 28.5% oral surgery respondents and, 34.7% Child Dental Health respondents. Most of the respondents felt their

  8. 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

  9. Prevalence of nasal carriage and diversity of Staphylococcus aureus among inpatients and hospital staff at Korle Bu Teaching Hospital, Ghana.

    Science.gov (United States)

    Egyir, Beverly; Guardabassi, Luca; Nielsen, Søren Saxmose; Larsen, Jesper; Addo, Kennedy Kwasi; Newman, Mercy Jemima; Larsen, Anders Rhod

    2013-12-01

    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%) was more common than for other agents (<5%). A higher chance of multidrug-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%). MRSA was detected in six IP with an overall carriage prevalence of ca. 1.3%, but not in HS. All three MRSA isolates from SD belonged to ST88-SCCmec IV, and two of them displayed the same spa type and antibiograms; three MRSA isolates from CHD belonged to distinct lineages (ST88-SCCmec IV, ST8-SCCmec V and ST72-SCCmec V). Altogether, these data indicate a high diversity of S. aureus, low levels of MRSA carriage, and a higher chance of nasal carriage of multidrug-resistant S. aureus among IP compared with HS in this hospital. Copyright © 2013 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  10. The Impact of Hospital Teaching Status on Timing of Intervention, Inpatient Morbidity, and Mortality After Surgery for Vertebral Column Fractures with Spinal Cord Injury.

    Science.gov (United States)

    De la Garza Ramos, Rafael; Nakhla, Jonathan; Nasser, Rani; Jada, Ajit; Sciubba, Daniel M; Kinon, Merritt D; Yassari, Reza

    2017-03-01

    To investigate the impact of hospital teaching status on the timing of intervention and inpatient morbidity and mortality after surgery for acute spinal cord injury (SCI). Data from the Nationwide Inpatient Sample (2002-2011) were reviewed. Patients were included if they had a diagnosis of closed vertebral column fracture with SCI, underwent spine surgery, and were admitted urgently or emergently. Early intervention (the day of or the day after admission), inpatient morbidity and mortality rates were compared between patients admitted to teaching versus nonteaching hospitals. Multivariable regression analyses were performed. A total of 9236 patients were identified (mean age 43 years, 82.6% male gender), with 78.7% admitted to a teaching hospital (n = 7,272) and 21.3% to a nonteaching hospital (n = 1,964). The most common mechanism of injury was a motor vehicle collision (43.9%), while the most common fracture location was between C5 and C7 (35.3%), and 22% of cases were complete SCIs. Following multivariable analysis, teaching hospital status was significantly associated with early intervention (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.01-1.25), but not with complication development (OR, 1.09; 95% CI, 0.98-1.23) or mortality (OR, 1.19; 95% CI, 0.91-1.56). In this nationwide study, patients with vertebral column fractures with SCI who were admitted to teaching hospitals were more likely to receive early intervention compared to patients admitted to nonteaching hospitals. Future studies into the long-term implications of admission to teaching hospitals versus nonteaching hospitals for patients with SCI are encouraged. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. 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

  12. 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.

  13. Burns functional disabilities among burn survivors: a study in Komfo Anokye Teaching Hospital, Ghana.

    Science.gov (United States)

    Agbenorku, Pius

    2013-01-01

    To determine the types of functional disabilities in adult and paediatric burns survivors, with specific emphasis on potential risk and socio-economic factors of burn disabilities present in Ghana. The descriptive study was carried out in Komfo Anokye Teaching Hospital, Kumasi, Ghana from May 2011 to April 2012. Burn survivors who came for follow-up visits after been discharged home and had functional disability were the participants of the study. They were physically examined and interviewed using a pre-tested questionnaire after their informed consent/or that of their parents (in the cases of paediatrics burns survivors) was sought. A total of 70 participants consented for the study. Their ages ranged from 8/12 - 78 years, with a mean age of 12±1.7 years. Majority (60.0%, N=42) of the participants had third degree burns. The nature of disabilities of participants were mostly scar contractures (42.9%, N=30) of which 36.7% (N=11) had impeded arm elevation; 23.3% (N=7) could not fold the palm or move the digits. From the multiple regression analysis risk factors for burn victim to have disability were paediatric age (OR=11.1, P=0.043), third degree of burn (OR=6.2, P=0.001) and anatomical part affected (OR=18.3, P=0.031). Socio-economic factors that affected burn disability victims were nuclear family compensation (OR=4.2, P=0.021), community mockery/stigmatization (OR=0.1, P=0.052) and caretakers time and finance (OR=5.2, P=0.033). The commonest functional disabilities recorded were scar contractions of the axilla region which had impeded the ability of the patients to lift the arm. Risk factors for burns disability included childhood age, third degree of burn incurred and anatomical part affected. Social factors influencing the lives of burn survivors with disability were good family and negative community interactions. Significant economical factors recorded were caretakers' time and financial constrains.

  14. 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

  15. 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

  16. 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

  17. Van der Woude syndrome: A review of 11 cases seen at the Lagos University Teaching Hospital

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    Olutayo James

    2014-01-01

    Full Text Available Background: Van der Woude syndrome (VWS, an autosomal dominant condition associated with clefts of the lip and/or palate and lower lip pits and is caused by mutations in interferon regulatory factor six gene. It is reported to be the most common syndromic cleft world-wide. Non-penetrance for the lip pit phenotype is found in at least 10% of affected individuals and those without the pits are phenocopies for non-syndromic clefting. The aim of this study is to present the phenotypic characteristic of VWS seen at the Lagos University Teaching Hospital (LUTH cleft clinic. Materials and Methods: A review of cases of patients with VWS that attended the cleft lip and palate clinic at the LUTH Idi-Araba, Lagos, from January 2007 to December 2012 was conducted. Data analyses included sex of affected patients, types of cleft, presence of lower lip pits and history of lower lip pits/cleft in the family. Results: A total of 11 cases were seen during the period (male = 4; female = 7. Age at presentation ranged between 1 week and 12 years, with majority (n = 10 less than 2 years of age. Bilateral cleft lip and palate (BCLP was seen in six patients, isolated soft palatal cleft (n = 3 and unilateral cleft lip and alveolus (n = 1 and cleft of hard and soft palate (n = 1. Bilateral lower lips were presented in 10 out of the 11 cases. The mother of the only patient without lip pits presented with bilateral lower lip pits. No family history of cleft/lip pits was elicited in 10 other cases. Conclusion: Most of the cases of VWS presented with BCLP and lower lip pits. Non-penetrance for the lip pits was seen in one out of 11 cases. Our study emphasizes the need to screen family members in all cleft cases, especially clinically diagnosed non-syndromic cases who may be VWS with no lip pits. Future studies are required to investigate the genetic causes of this syndrome in our population.

  18. Assessment of hospital inpatient discharge summaries, written for general practitioners, from a department of medicine for the elderly service in a large teaching hospital.

    Science.gov (United States)

    Mc Larnon, E; Walsh, J B; Ni Shuilleabhain, A

    2016-02-01

    The discharge document summarising an acute inpatient stay in hospital is often the only means of communication between secondary and primary care. This is especially important in the elderly population who have multiple morbidities and are often on many medications. This study aimed to assess if information important to general practitioners is being included in inpatient hospital discharge summaries for patients of the medicine for the elderly service in a large teaching hospital. After a thorough literature review, a "gold standard" letter was defined as having included a discharge diagnosis, medications on discharge and follow-up plans. Forty computerised discharge summaries were retrospectively assessed for inclusion of these parameters. The study group consisted of the first eight sequentially discharged patients under the care of each of the five consultants during a 1-month period (1 September 2011-30 September 2011). A discharge diagnosis was included in 37 of the 40 summaries (92.5 %), medications on discharge were included in 39 summaries (97.5 %) and follow-up was recorded in 35 summaries (87.5 %). This study showed that the information assessed was available in the vast majority of discharge summaries for patients admitted acutely under the care of this medicine for the elderly service. Improvements can be made, including documentation of follow-up plans.

  19. Is an urban legend true in the teaching hospital that "you will get hurt if you go to hospital at the beginning of the fiscal year"?

    Science.gov (United States)

    Inoue, Satoki; Abe, Ryuichi; Tanaka, Yu; Kawaguchi, Masahiko

    2015-02-01

    An urban legend that "you will get hurt if you go to hospital at the beginning of the fiscal year" is in circulation, because people in general suppose that inexperienced newcomers start to work at clinical practice during that time period. We tried to determine whether this urban legend was true or not by using data from our operation management system. We retrospectively conducted a study to investigate whether the number of cannulation failures, which was used as an index of patient disadvantages at clinical practice, could be affected by the volume of residents in clinical participation. The number of insertion trials per case was not prominent in the first month of the fiscal year. However, the number of insertion trials per case increased in proportion to the average number of residents per day. It seems that there was no evidence to support the urban legend that "you will get hurt if you go to hospital at the beginning of the fiscal year." However, our results suggest that rather than an urban legend, we are now confronting the fact that patients may suffer from medical disadvantages in the teaching hospitals.

  20. Pig bite in Brazil: a case series from a teaching hospital

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    Sérgio de Andrade Nishioka

    1994-03-01

    Full Text Available A retrospective survey done from 1987 till 1990 revealed that 23 patients bitten by pigs sought medical help at a teaching hospital in Uberlândia, in southeastern Brazil. Most cases (21 were from Uberlândia. The cases were evenly distributed by month and by year; most of them (14/16; 87.5% occurred between 7. OOa.m. and 7.00 p. m. The male to female ratio was 6.7:1. Age ranged from 6 to 73 (mean 38.95 ± SD 22.06, median 36. The bites were more common on the upper limbs, particularly on the forearms. In 11(47.8% cases the injury was described as deep. In most cases where information was available the injury was related to capture, transport or immobilisation ofthe pigfor slaughter. The following medical procedures were performed: local cleansing in 19(82.6% cases, rabies vaccine (12; 52.2%, antirabies serum (2; 8.7%, suturing (6; 26.1% and tetanus vaccine (12; 52.2%. There was no case of infection at the bite site, neither of rabies or tetanus. By our data, the annual incidence of pig bite in Uberlândia can be estimated to be about 1.5/100.000.Um levantamento retrospectivo revelou que 23 pacientes vítimas de mordida de porco procuraram assistência médica num hospital-escola em Uberlândia, Brasil, de 1987 a 1990. A maioria dos pacientes (21 procedia de Uberlândia. Os casos foram distribuídos uniformemente por mês e ano; a maioria deles (14/16; 87,5% ocorreu entre às 7 e às 19 horas. A razão homem. mulherfoi de 6,7:1. A idade dos pacientes variou de 6 a 73 anos (média: 38,95 ± DP 22,06, mediana 36. As mordidas foram mais comuns nos membros superiores, particularmente nos antebraços. Em 11(47,8% casos o ferimento foi descrito como profundo. Na maioria dos casos em que houve informação disponível, o ferimento foi relacionado com captura, transporte ou imobilização do suíno para abate. Os seguintes procedimentos médicos foram realizados: lavagem local em 19(82,6% casos, vacina anti-rábica (12; 52,2%, soro anti-rábico (2; 8

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

    OpenAIRE

    Bartels, Constantin; AbuHaliga, Abdullah RY; McGee, Hannah; Morgan, Karen; McElvaney, Noel G.; Doyle, Frank

    2012-01-01

    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 ove...

  2. Treatment outcome of tuberculosis patients at Gondar University Teaching Hospital, Northwest Ethiopia. A five--year retrospective study.

    Science.gov (United States)

    Tessema, Belay; Muche, Abebe; Bekele, Assegedech; Reissig, Dieter; Emmrich, Frank; Sack, Ulrich

    2009-10-04

    In Gondar University Teaching Hospital standardized tuberculosis prevention and control programme, incorporating Directly Observed Treatment, Short Course (DOTS) started in 2000. According to the proposal of World Health Organization (WHO), treatment outcome is an important indicator of tuberculosis control programs. This study investigated the outcome of tuberculosis treatment at Gondar University Teaching Hospital in Northwest Ethiopia. We analyzed the records of 4000 tuberculosis patients registered at Gondar University Teaching Hospital from September 2003 to May 2008. Treatment outcome and tuberculosis type were categorized according to the national tuberculosis control program guideline. Multivariate analysis using logistic regression model was used to analyse the association between treatment outcome and potential predictor variables. From the total of 4000 patients, tuberculosis type was categorized as extrapulmonary in 1133 (28.3%), smear negative pulmonary tuberculosis in 2196 (54.9%) and smear positive pulmonary tuberculosis in 671 (16.8%) cases. Of all patients, treatment outcome was classified as successfully treated in 1181(29.5%), defaulted in 730 (18.3%), died in 403 (10.1%), treatment failed in six (0.2%) and transferred out in 1680 (42.0%) patients. Males had the trend to be more likely to experience death or default than females, and the elderly were more likely to die than younger. The proportion of default rate was increased across the years from 97(9.2%) to 228(42.9%). Being female, age group 15-24 years, smear positive pulmonary tuberculosis and being urban resident were associated with higher treatment success rate. The treatment success rate of tuberculosis patients was unsatisfactorily low (29.5%). A high proportion of patients died (10.1%) or defaulted (18.3%), which is a serious public health concern that needs to be addressed urgently.

  3. Treatment outcome of tuberculosis patients at Gondar University Teaching Hospital, Northwest Ethiopia. A five - year retrospective study

    Science.gov (United States)

    Tessema, Belay; Muche, Abebe; Bekele, Assegedech; Reissig, Dieter; Emmrich, Frank; Sack, Ulrich

    2009-01-01

    Background In Gondar University Teaching Hospital standardized tuberculosis prevention and control programme, incorporating Directly Observed Treatment, Short Course (DOTS) started in 2000. According to the proposal of World Health Organization (WHO), treatment outcome is an important indicator of tuberculosis control programs. This study investigated the outcome of tuberculosis treatment at Gondar University Teaching Hospital in Northwest Ethiopia. Methods We analyzed the records of 4000 tuberculosis patients registered at Gondar University Teaching Hospital from September 2003 to May 2008. Treatment outcome and tuberculosis type were categorized according to the national tuberculosis control program guideline. Multivariate analysis using logistic regression model was used to analyse the association between treatment outcome and potential predictor variables. Results From the total of 4000 patients, tuberculosis type was categorized as extrapulmonary in 1133 (28.3%), smear negative pulmonary tuberculosis in 2196 (54.9%) and smear positive pulmonary tuberculosis in 671 (16.8%) cases. Of all patients, treatment outcome was classified as successfully treated in 1181(29.5%), defaulted in 730 (18.3%), died in 403 (10.1%), treatment failed in six (0.2%) and transferred out in 1680 (42.0%) patients. Males had the trend to be more likely to experience death or default than females, and the elderly were more likely to die than younger. The proportion of default rate was increased across the years from 97(9.2%) to 228(42.9%). Being female, age group 15-24 years, smear positive pulmonary tuberculosis and being urban resident were associated with higher treatment success rate. Conclusion The treatment success rate of tuberculosis patients was unsatisfactorily low (29.5%). A high proportion of patients died (10.1%) or defaulted (18.3%), which is a serious public health concern that needs to be addressed urgently. PMID:19799801

  4. 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

  5. Treatment outcome of tuberculosis patients at Gondar University Teaching Hospital, Northwest Ethiopia. A five - year retrospective study

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    Bekele Assegedech

    2009-10-01

    Full Text Available Abstract Background In Gondar University Teaching Hospital standardized tuberculosis prevention and control programme, incorporating Directly Observed Treatment, Short Course (DOTS started in 2000. According to the proposal of World Health Organization (WHO, treatment outcome is an important indicator of tuberculosis control programs. This study investigated the outcome of tuberculosis treatment at Gondar University Teaching Hospital in Northwest Ethiopia. Methods We analyzed the records of 4000 tuberculosis patients registered at Gondar University Teaching Hospital from September 2003 to May 2008. Treatment outcome and tuberculosis type were categorized according to the national tuberculosis control program guideline. Multivariate analysis using logistic regression model was used to analyse the association between treatment outcome and potential predictor variables. Results From the total of 4000 patients, tuberculosis type was categorized as extrapulmonary in 1133 (28.3%, smear negative pulmonary tuberculosis in 2196 (54.9% and smear positive pulmonary tuberculosis in 671 (16.8% cases. Of all patients, treatment outcome was classified as successfully treated in 1181(29.5%, defaulted in 730 (18.3%, died in 403 (10.1%, treatment failed in six (0.2% and transferred out in 1680 (42.0% patients. Males had the trend to be more likely to experience death or default than females, and the elderly were more likely to die than younger. The proportion of default rate was increased across the years from 97(9.2% to 228(42.9%. Being female, age group 15-24 years, smear positive pulmonary tuberculosis and being urban resident were associated with higher treatment success rate. Conclusion The treatment success rate of tuberculosis patients was unsatisfactorily low (29.5%. A high proportion of patients died (10.1% or defaulted (18.3%, which is a serious public health concern that needs to be addressed urgently.

  6. Incidence and diagnosis of Acute kidney injury in hospitalized adult patients: a retrospective observational study in a tertiary teaching Hospital in Southeast China.

    Science.gov (United States)

    Cheng, Xiaoyan; Wu, Buyun; Liu, Yun; Mao, Huijuan; Xing, Changying

    2017-06-24

    Acute kidney injury (AKI) places a heavy burden on the healthcare system in China and is usually misdiagnosed. However, there are limited studies that have described the epidemiology and diagnosis of AKI in China. The aim of this study was to describe the incidence and diagnosis of AKI in hospitalized adult patients in a tertiary teaching hospital in southeast China. All adult patients hospitalized from October 1, 2013 to September 30, 2014 in the First Affiliated Hospital of Nanjing Medical University were screened using the Lab Administration Network. AKI definition and staging were based on the KDIGO AKI criteria. Demographic characteristics, laboratory examination, clinical data, and clinical outcomes of AKI patients were recorded and analyzed. The incidence of AKI was 1.6% (1401/87196). The 30-day mortality was 35.3%. AKI stage 1, 2, 3 and RRT accounted for 38.0% (532/1401), 22.0% (309/1401), 40.0% (560/1401), and 16.3% (228/1401) of patients, respectively. The Renal, other Internal Medicine, Surgery, and ICU Departments accounted for 7.4%, 37.1%, 30.1%, and 25.4% of AKI patients, respectively. The timely diagnosis rate, delayed diagnosis rate, and missed diagnosis rate were 44% (616/1401), 3.3% (46/1401), and 52.7% (739/1401), respectively. Patients hospitalized in the Renal Department had the highest AKI diagnosis rate (89.3%, 88/103), while missed diagnosis rate of the surgical patients was as high as 75.1% (317/422). Multivariable logistic regression analysis indicated that presence of tumors, higher serum albumin, and AKI stage 1 were associated with failure to timely diagnose AKI, whereas presence of chronic kidney disease, oliguria, higher blood urea nitrogen, and greater number of organ failures correlated with earlier diagnosis. AKI was characterized by a high incidence, high short-term mortality, and high missed diagnosis rate in hospitalized adult patients in our hospital. Interventions for improving diagnosis of AKI are urgently needed.

  7. Assessing controlled substance prescribing errors in a pediatric teaching hospital: an analysis of the safety of analgesic prescription practice in the transition from the hospital to home.

    Science.gov (United States)

    Lee, Benjamin H; Lehmann, Christoph U; Jackson, Eric V; Kost-Byerly, Sabine; Rothman, Sharon; Kozlowski, Lori; Miller, Marlene R; Pronovost, Peter J; Yaster, Myron

    2009-02-01

    Iatrogenic errors producing serious and often preventable injury occur frequently in hospitalized patients, particularly in children. Little is known about the epidemiology of analgesic medication errors in patients being discharged from the hospital. The goal of this study was to describe the epidemiology of controlled substance prescription errors by physicians-in-training for children being discharged from the hospital. We conducted a prospective, observational study of the analgesic prescriptions and discharge forms of 241 pediatric patients discharged from a Children's Center of a major urban teaching hospital from November 2003 to April 2004. All patients who were actively followed by the Pediatric Pain Service at the time of their discharge and were discharged with an analgesic prescription were included in the study. Primary outcome variables were the percentage of prescriptions that contained at least 1 medication error or potential adverse drug event. Errors were defined using the Institute for Safe Medication Practices' (ISMP) List of Error-Prone Abbreviations, Symbols, and Dose Designations, literature review, expert panel consensus, and the Johns Hopkins Department of Pharmacy hospital formulary. Two hundred forty-one patients who received 314 prescriptions were included in this study. Prescription errors were common; 257 of 314 (82%) of the prescriptions examined contained 1 or more errors. The most common errors were missing or wrong patient weight (n = 127, 77%), incomplete dispensing information (n = 167, 53%), and no or wrong date on prescription (n = 19, 6%). Nine prescriptions (2.9%) had the potential for significant medical injury and were considered potential adverse drug events. Discharge prescription errors for children requiring potent, opioid analgesic drugs in the management of pain are common, and nearly 3% could cause significant harm. The high rate of prescribing errors highlights the importance of developing, testing and implementing

  8. A study of the problems between basic insurance organizations and teaching hospitals of Shiraz University of Medical Sciences as viewed by the staff of income hospitals and representative of the insurer’s organization in 2013

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    Maryam Najibi

    2015-07-01

    Full Text Available Introduction: In Iran health insurance is a significant tool in healthcare costs, financing health care and equal access to health services for people. Problems between hospitals and insurance organizations impose extra cost to the patient, leading to financial losses they will infringe upon the rights of patients. This study aimed to determine the issues between hospitals and basic insurance organizations and proposed practical solutions to solve problems in Shiraz University of Medical Sciences. Method:This research was a qualitative study (content analysis, which was conducted in 2013. The research population consisted of teaching hospitals of Shiraz University of Medical Sciences; Purposeful sampling was used and continued until data saturation. The representative of the insurers and staff of income hospitals were asked questions using a semi-structured interview. In this study, we used NVIVO for data analysis. Results: The results of this study showed that the most common problems between basic insurance organizations and teaching hospitals include the lack of prompt payment of hospital bills and imposing deduction on the hospitals. Conclusion: Based on the results of this study, it seems that cooperation between hospitals and insurance organizations could be improved by timely payment of hospital bills and codifying appropriate rules and regulations by basic insurance organizations and, on the other hand, with timely completion of bills and training of hospital staff by the hospital authorities.

  9. [Burnout in healthcare workers of a university teaching hospital in Rome, Italy: a cross-sectional study].

    Science.gov (United States)

    Agostinelli, Alessandro; La Torre, Giuseppe; Bevilacqua, Francesca; Chiaradia, Giacomina; Specchia, Maria Lucia; Ricciardi, Walter

    2008-01-01

    A cross-sectional study was performed to assess the frequency of burnout in healthcare workers of a university teaching hospital in Rome (Italy), by means of the Maslach Burnout Inventory. In total 142 healthcare workers participated in the study. Average levels of emotional exhaustion and depersonalization were observed in the study population. Working in emergency care services was found to be correlated with lower levels of personal accomplishment with respect to working in other services. Monitoring burnout in social service and healthcare workers is an effective tool for identifying critical situations in the workplace.

  10. Interpretation and intent: a study of the (mis)understanding of DNAR orders in a teaching hospital.

    Science.gov (United States)

    Fritz, Zoë; Fuld, Jonathan; Haydock, Stephen; Palmer, Chris

    2010-09-01

    Do not attempt resuscitation (DNAR) orders have been shown to be subject to misinterpretation in the 1980s and 1990s. We investigated whether this was still the case, and examined what perceptions doctors and nurses had of what care patients with DNAR orders receive. Using an anonymous written questionnaire, we directly approached 50 doctors and 40 nurses from a range of medical specialities and grades in our teaching hospital. All 50 physicians and 35/40 nurses took part. Using McNemar's test, there were highly significant differences (pcommunication and understanding. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  11. The performance implications of pharmacy information system at the university teaching hospitals of Shiraz, Iran: Cluster approach

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    Saeede Bayati

    2017-01-01

    Full Text Available Pharmacy information system (PIS is becoming vital in assisting pharmacists to do their responsibilities. The aim of this study was to identify the current PIS implications in teaching hospitals affiliated with Shiraz University of Medical Science. This cross-sectional study was conducted in teaching hospitals affiliated with Shiraz University of Medical Science over the year 2016. Data were collected by observing the PIS as well as interviewing its users based on the researcher-made checklist. The checklist was prepared based on reviewing the Persian and English literature and its content validity was approved by the experts. To determine the reliability of the checklist, inter-rater reliability was used. Data were analyzed using SPSS16, and hospitals were clustered using SK-means method. In this study, the least conformity to the standards was shown in smart clinical features (4.54%, pharmaceutical companies' relationship (32.6%, and optimization of drug therapy (34.6%. In contrast, the highest conformity to the standards was shown in reporting capabilities (77.3% and entry information and input (70.4%. Medication stock checking and optimization of drug therapy were effective features that have made a distinction between hospitals and lead to 95% variance between clusters. Based on the results, the current PIS design pays less attention to clinical features. Besides, clinical information for pharmacists and outside organization relationship were not provided by the current system. Thus, emphasis should be placed on the implementation of corrective actions to eliminate the current system's deficiencies.

  12. 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

  13. Survey of Cancer Patient Safety Culture: A Comparison of Chemotherapy and Oncology Departments of Teaching Hospitals of Tehran

    Science.gov (United States)

    Raeissi, Pouran; Sharifi, Marziye; Khosravizadeh, Omid; Heidari, Mohammad

    2017-10-26

    Background: Patient safety culture plays an important role in healthcare systems, especially in chemotherapy and oncology departments (CODs), and its assessment can help to improve quality of services and hospital care. Objective: This study aimed to evaluate and compare items and dimensions of patient safety culture in the CODs of selected teaching hospitals of Iran and Tehran University of Medical Sciences. Materials and Methods: This descriptive-analytical crosssectional survey was conducted during a six-month period on 270 people from chemotherapy and oncology departments selected through a cluster sampling method. All participants answered the standard questionnaire for “Hospital Survey of Patient Safety Culture” (HSOPSC). Statistical analyses were performed using SPSS/18 software. Results: The average score for patient safety culture was three for the majority of the studied CODs. Statistically significant differences were observed for supervisor actions, teamwork within various units, feedback and communications about errors, and the level of hospital management support. (ppatient safety culture were not statistically significant (p>0.05). Conclusion: Our results showed that the overall status of patient safety culture is not good in the studied CODs. In particular, teamwork across different units and organizational learning with continuous improvement were the only two properly operating items among 12 dimensions of patient safety culture. Therefore, systematic interventions are strongly required to promote communication. Creative Commons Attribution License

  14. Cost estimation of patients admitted to the intensive care unit: a case study of the Teaching University Hospital of Thessaly.

    Science.gov (United States)

    Geitona, Mary; Androutsou, Lorena; Theodoratou, Dorina

    2010-01-01

    This study aimed to estimate the cost of patients admitted to the Intensive Care Unit (ICU) of the Teaching University Hospital of Thessaly (TUHT) in 2006 and to demonstrate discrepancies between actual hospitalisation cost and social funds' reimbursement. Cost analysis was performed using a macro-costing approach, which focused on the estimation of nominal and actual cost per ICU patient. Data were derived from the annual records of resources consumed in each hospital unit and from hospital balance sheets. Sensitivity analysis was also performed by inflating nominal costs to present values. There were 312 patients admitted to the ICU. Mean actual cost per ICU patient was estimated at €16,516, whereas actual reimbursement from social funds was only €1,671. This means that reimbursement accounted for just 10% of the actual hospitalisation cost. Once nominal costs were inflated to present values, the reimbursement accounted for 25% of the actual hospitalisation cost. The major cost drivers of ICU hospitalisation were personnel costs followed by infrastructure, hotel services and pharmaceutical expenditure. These results may be limited by a lack of consideration for clinical outcomes along with a high level of aggregation in cost data. Reimbursement should be re-adjusted in order to balance public hospital deficits and make public-private mix viable. This way, intensive care capacity would increase and allow a more equitable distribution of healthcare resources.

  15. 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.

  16. Educational needs assessment of managers working in teaching and private hospitals

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    VAHID KESHTKAR

    2013-07-01

    Full Text Available Introduction: Hospital managers, as one of the most important health care workers, are the subject of continuous education. In some countries around the world, health management education is an important part of health reforms. The aim of present research is to perform evidence-based studies based on assessing hospital managers’ needs. Therefore, it should be considered that educational need assessment regarding hospital managers is essential in today’s health care management. Methods: A total of 26 hospital managers were surveyed using a data gathering form (questionnaire including 59 open questions designed in order to obtain data in 3 different areas. These included managers’ insight towards job duties and the capabilities required to fulfill their duty along with educational needs determined by managers. The next step involved presenting standard description of job duties to hospitals managers and asking them to document their educational needs regarding capabilities required to fulfill their duties. The standard description of job duties originated from ISO 9001 certified hospitals. For each manager, a score ranging from 0 to 19 was attained. For each correct matched statement, a positive point was considered and in the case of unmatched statements, managers received no points. Results: Out of 26 participating managers, only 20 did state the educational needs of hospitals managers. In describing job duties of hospital managers, the mean scores regarding hospital managers of public sector was 10.27 while it was 8 with private hospital managers. Conclusion: The findings of our study indicate that hospital managers as the leaders of the most sophisticated health care facilities delivering expensive complicated services need proper training regarding job competency. Therefore, it seems that continuous need assessment in this area should be carried out.

  17. 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.

  18. Spectrum of Microbial Diseases and Resistance Patterns at a Private Teaching Hospital in Kenya: Implications for Clinical Practice.

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    Daniel Maina

    Full Text Available Accurate local prevalence of microbial diseases and microbial resistance data are vital for optimal treatment of patients. However, there are few reports of these data from developing countries, especially from sub-Saharan Africa. The status of Aga Khan University Hospital Nairobi as an internationally accredited hospital and a laboratory with an electronic medical record system has made it possible to analyze local prevalence and antimicrobial susceptibility data and compare it with other published data.We have analyzed the spectrum of microbial agents and resistance patterns seen at a 300 bed tertiary private teaching hospital in Kenya using microbial identity and susceptibility data captured in hospital and laboratory electronic records between 2010 and 2014.For blood isolates, we used culture collection within the first three days of hospitalization as a surrogate for community onset, and within that group, Escherichia coli was the most common, followed by Staphylococcus aureus. In contrast, Candida spp. and Klebsiella pneumoniae were the most common hospital onset causes of bloodstream infection. Antimicrobial resistance rates for the most commonly isolated Gram negative organisms was higher than many recent reports from Europe and North America. In contrast, Gram positive resistance rates were quite low, with 94% of S. aureus being susceptible to oxacillin and only rare isolates of vancomycin-resistant enterococci.The current report demonstrates high rates of antimicrobial resistance in Gram negative organisms, even in outpatients with urinary tract infections. On the other hand, rates of resistance in Gram positive organisms, notably S. aureus, are remarkably low. A better understanding of the reasons for these trends may contribute to ongoing efforts to combat antimicrobial resistance globally.

  19. Comatose and noncomatose adult diabetic ketoacidosis patients at the University Teaching Hospital, Zambia: Clinical profiles, risk factors, and mortality outcomes

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    Mwanja Kakusa

    2016-01-01

    Full Text Available Background: Diabetic ketoacidosis (DKA is one of the commonly encountered diabetes mellitus emergencies. Aim: This study aimed at describing the clinical profiles and hospitalization outcomes of DKA patients at the University Teaching Hospital (UTH in Lusaka, Zambia and to investigate the role of coma on mortality outcome. Materials and Methods: This was a cross-sectional analytical study of hospitalized DKA patients at UTH. The data collected included clinical presentation, precipitating factors, laboratory profiles, complications, and hospitalization outcomes. Primary outcome measured was all-cause in-hospital mortality. Results: The median age was 40 years. Treatment noncompliance was the single highest identified risk factor for development of DKA, followed by new detection of diabetes, then infections. Comatose patients were significantly younger, had lower baseline blood pressure readings, and higher baseline respiratory rates compared to noncomatose patients. In addition, comatose patients had higher baseline admission random blood glucose readings. Their baseline sodium and chloride levels were also higher. The prevalences of hypokalemia, hypernatremia, and hyperchloremia were also higher among comatose patients compared to noncomatose patients. Development of aspiration during admission with DKA, pneumonia at baseline, development of renal failure, and altered mental status were associated with an increased risk of mortality. Development of renal failure was independently predictive of mortality. Conclusion: The mortality rate from DKA hospitalizations is high at UTH. Treatment noncompliance is the single highest identifiable precipitant of DKA. Aspiration, development of renal failure, altered sensorium, and pneumonia at baseline are associated with an increased risk of mortality. Development of renal failure during admission is predictive of mortality.

  20. Exploring the use of smartphones and tablets by medical House Officers in Korle-Bu Teaching Hospital.

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    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.

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

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    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.

  2. Self-reported practices of hand hygiene among the trainees of a teaching hospital in a resource limited country.

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    Anwar, Muhammad Ali; Rabbi, Sana; Masroor, Muhammad; Majeed, Fouad; Andrades, Marie; Baqi, Shehla

    2009-09-01

    To determine the compliance of hand hygiene among the trainee physicians of a tertiary care teaching hospital; and to identify physicians' opinion regarding various obstacles in adhering to the hand hygiene principles. Cross-sectional survey was conducted among the Interns (House Officers) and Post Graduate trainee physicians of a tertiary care teaching hospital in a resource limited country. Subjects were consented and selected through non probability convenient sampling. A self-administered questionnaire, based on the hand hygiene guidelines laid down by the World Health Organization (WHO) was used. A total of 211 questionnaires were completed. Only 4.7% of the physicians reported to decontaminate their hands before having direct contact with their patients. Only 17% claimed to be aware of the WHO recommendations on hand hygiene. Majority of subjects considered "lack of sinks, soap, water and disposable towel" as a major barrier towards hand hygiene adherence. Overall compliance of hand hygiene was found to be 38.8% but it widely varied as a function of patient care activity. Hand hygiene practices among trainee physicians were not in line with WHO recommendations. To make a difference, interventions taken to improve awareness alone, won't be sufficient; they have to be supported with improving facilities for hand hygiene.

  3. Probiotics in the Prevention of Antibiotic Associated Diarrhoea in a Tertiary Teaching Hospital in Pokhara: A Prospective Study

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    Sahisnuta Basnet

    2017-10-01

    Full Text Available Introduction: Diarrhoea is an undesirable side effect when treating common infections in children with antibiotics. Though studies have shown the effectiveness of probiotics in preventing antibiotic associated diarrhoea, and there is no documented research in Nepal regarding this issue. Aim: The objective of this study was to observe the efficacy of probiotics for the prevention of antibiotic associated diarrhoea when co-administered with an oral antibiotic in children with respiratory tract infections who attended the outpatient department in Manipal Teaching Hospital, Pokhara, Nepal. Materials and Methods: A prospective interventional study was conducted from January 2016 to October 2016 in which 174 children attending the outpatient department in Manipal Teaching Hospital, Pokhara, Nepal and requiring antibiotics for respiratory tract infection were enrolled using convenient sampling method. Eighty-seven of the subjects received standard antibiotic treatment with amoxicillin and clavulanate (control group and another 87 children received the same antibiotic which was prescribed along with probiotics (probiotic group. Result: Out of the 174 eligible children enrolled in the study, diarrhoea occurred in 11/87 (12.6% of the patients in the control group and in 1/87 (1.1% patient in the probiotic group {relative risk, 12.45, 95% CI(1.57,98.67}. The co-administration of probiotic with amoxicillin and clavulanate significantly decreased the incidence of diarrhoea in the probiotic group (p= 0.003. Conclusion: Co-administration of probiotics in children receiving oral amoxicillin and clavulanic acid reduces the risk of diarrhoea.

  4. Comparison of prescribing and adherence patterns of anti-osteoporotic medications post-admission for fragility type fracture in an urban teaching hospital and a rural teaching hospital in Ireland between 2005 and 2008.

    LENUS (Irish Health Repository)

    McGowan, B

    2013-03-13

    INTRODUCTION: Poor adherence reduces the potential benefits of osteoporosis therapy, lowering gains in bone mineral density resulting in increased risk of fractures. AIM: To compare prescribing and adherence patterns of anti-osteoporotic medications in patients admitted to an urban teaching hospital in Ireland with a fragility type fracture to patients admitted to a rural hospital in the North Western region. METHODOLOGY: We identified all patients >55 years admitted to Sligo General Hospital between 2005 and 2008 with a fragility fracture (N = 744) using the hospital in-patient enquiry system (HIPE). The medical card number of those patients eligible for the primary care reimbursement services scheme (PCRS) facilitated the linkage of the HSE-PCRS scheme database to the HIPE database which enabled a study to identify persistence rates of patients prescribed osteoporosis therapy after discharge. The results were compared to the findings of a similar study carried out in St. James\\'s Hospital, Dublin. RESULTS: The 12 months post-fracture prescribing increased from 11.0 % (95 % CI 9.6, 12.4) in 2005 to 47 % (95 % CI 43.6, 50.3) in 2008 in the urban setting and from 25 % (95 % CI 21.5, 28.9) to 39 % (95 % CI 34.5, 42.7) in the rural setting. Adherence levels to osteoporosis medications at 12 months post-initiation of therapy was <50 % in both study groups. Patients on less frequent dosing regimes were better adherers. CONCLUSION: The proportion of patients being discharged on anti-osteoporosis medications post-fragility fracture increased between 2005 and 2008 in both patient groups. Sub-optimal adherence levels to osteoporosis medications continue to be a major concern.

  5. Admission of foreign citizens to the general teaching hospital of bologna, northeastern Italy: An epidemiological and clinical survey

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    Sergio Sabbatani

    Full Text Available BACKGROUND: The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. METHODS: Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy, all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. RESULTS: Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15%, including 2,542 males (34.8% and 4,769 females (65.2%. Males had a mean age of 36.8±14.7 years, while females were aged 30.8±12.2 years. In the assessment of the areas of origin, 34.6% of hospitalizations were attributed to patients coming from Eastern Europe, 15.3% from Northern Africa, 7.3% (comprehensively from Western Europe and United States, 6.9% from the Indian subcontinent, 5.9% from sub-Saharan Africa, 5.7% from Latin America, 4.1% from China, 2.5% from the Philippines, and 1.1% from the Middle East. Among women, most hospitalizations (58.8% were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1%, and pregnancy complications (18.7%, followed by psycho-social disturbances (5.9%, malignancies (5.1%, gastrointestinal diseases (4.7%, and voluntary pregnancy interruption (4.4%. Among men, the most frequent causes of admissions were related to trauma (15.9%, followed by gastroenteric disorders (12%, heart-vascular diseases (8.9%, psycho-social disorders (8.4%, respiratory (7.1%, kidney (6.1%, liver

  6. Outpatients’ experiences of quality service delivery at a teaching hospital in Gauteng

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    Ebin J Arries

    2008-11-01

    Full Text Available Quality service delivery to the consumer of health is a legal reality as it is emphasised in the White Paper on the Transformation of Public Service delivery (South Africa, 1997. The guiding philosophy adopted within this framework is that of Batho Pele, which means placing the consumer at the centre of healthcare service delivery. Increasing attention has been paid to hospital processes from a quality perspective. By analogy, outpatient departments can be viewed as industrial plants where technological know-how is transferred to patients through service delivery, which is a cornerstone of a hospital’s business. Outpatients, as consumers of healthcare, draw conclusions about the quality of service delivery based on their experiences of such services. In this vein, an outpatient’s experience of a particular service is an indicator of his/her level of satisfaction with the quality of that service. No South African study can be found in the literature on out-patients’ experiences of quality service delivery. This study’s purpose is to explore and describe outpatients’ experiences of the quality of service delivery at a teaching hospital in Gauteng. A qualitative, explorative, descriptive study that was contextual in nature was conducted to achieve this aim. Focus group interviews were conducted with outpatients who met the selection criteria. Open coding was used to analyse the contents from the transcripts and field notes typed verbatim. Strategies for trustworthiness, namely co-coding, prolonged engagement, triangulation and adequate referencing, were employed to ensure the credibility of the study and research findings. The results reflect themes that were reduced into two main categories, namely positive and negative experiences. The positive experiences reflect outpatients’ experience of their relationship with medical staff and their satisfaction with the quality of medical care. Negative experiences relate predominantly to a lack

  7. Outpatients’ experiences of quality service delivery at a teaching hospital in Gauteng

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    Odette Newman

    2008-01-01

    Full Text Available Quality service delivery to the consumer of health is a legal reality as it is emphasised in the White Paper on the Transformation of Public Service delivery (South Africa, 1997. The guiding philosophy adopted within this framework is that of Batho Pele, which means placing the consumer at the centre of healthcare service delivery. Increasing attention has been paid to hospital processes from a quality perspective. By analogy, outpatient departments can be viewed as industrial plants where technological know-how is transferred to patients through service delivery, which is a cornerstone of a hospital’s business. Outpatients, as consumers of healthcare, draw conclusions about the quality of service delivery based on their experiences of such services. In this vein, an outpatient’s experience of a particular service is an indicator of his/her level of satisfaction with the quality of that service. No South African study can be found in the literature on out-patients’ experiences of quality service delivery. This study’s purpose is to explore and describe outpatients’ experiences of the quality of service delivery at a teaching hospital in Gauteng. A qualitative, explorative, descriptive study that was contextual in nature was conducted to achieve this aim. Focus group interviews were conducted with outpatients who met the selection criteria. Open coding was used to analyse the contents from the transcripts and field notes typed verbatim. Strategies for trustworthiness, namely co-coding, prolonged engagement, triangulation and adequate referencing, were employed to ensure the credibility of the study and research findings. The results reflect themes that were reduced into two main categories, namely positive and negative experiences. The positive experiences reflect outpatients’ experience of their relationship with medical staff and their satisfaction with the quality of medical care. Negative experiences relate predominantly to a lack

  8. Implementation of an enterprise risk-management program in a community teaching hospital.

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    Behamdouni, Genefer; Millar, Kathy

    2010-01-01

    As the complexity of healthcare and expectations of comprehensive and transparent public accountability heighten, so too must a hospital's approach to assessing and managing risk. Over a period of two years, the area of patient safety and risk at our hospital has moved from a traditional focus on clinical risk management to an enterprise-wide risk management approach. One of the first community hospitals to embrace enterprise risk management (ERM), St. Joseph's Health Centre, in Toronto, Ontario, has seen early benefits in this transformational journey. This article discusses our approach to the development of an ERM program, tools used and lessons learned.

  9. An evaluation of knowledge, attitude, and practice of adverse drug reaction reporting in a tertiary care teaching hospital of Sikkim

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    Supratim Datta

    2015-01-01

    Full Text Available Aim: Spontaneous voluntary adverse drug reaction (ADR reporting is paramount to the success of the Pharmacovigilance Programme of India. There has however been minimal and sporadic voluntary reporting of ADR's at the ADR Monitoring Centre (AMC Gangtok, Sikkim. Knowledge, perception, attitude, and awareness of health professionals are determinants of reporting practices. This questionnaire study aims at evaluating these indicators in the teaching hospital attached to the Medical Institute and find out methods to improve existing reporting practices. Materials and Methods: This is a cross-sectional questionnaire-based observational study carried out in the Medical, Surgical and Pathology Departments of the Teaching Hospital, Gangtok, Sikkim over a period of 2 months. The questionnaires were filled by the respondents and returned back to us within the next 24 h. Data obtained from filled questionnaires were thereby analyzed. Results: The overall correct response rate to the knowledge-based questions was 56.3%. While 97% of respondents were of the view that ADR reporting was necessary, 35% of the respondents felt that the difficulty in deciding the causality of an ADR discouraged them from reporting. 79% of the respondents were not aware of the presence of an AMC affiliated to the hospital, and 87% of the respondents admitted that they were not sending filled ADR forms to the AMC. Conclusions: The study indicates that the respondents have an average knowledge and positive attitude toward ADR reporting and pharmacovigilance. There is however a lack of awareness and poor ADR reporting practices. Efforts are required to enhance awareness and attitude toward pharmacovigilance and ADR reporting.

  10. Safety and effectiveness of outpatient laparoscopic cholecystectomy in a teaching hospital: a prospective study of 110 consecutive patients

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    Polymeneas Georgios

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to evaluate the safety and efficacy of outpatient laparoscopic cholecystectomy (OLC in a day surgery unit in a teaching hospital. OLC was offered to patients with symptomatic cholelithiasis who met the following established inclusion criteria: ASA (American Society of Anesthesiology physical status classification class I and II; age: 18 - 70 years; body mass index (BMI 2; patient acceptance and cooperation (informed consent; presence of a responsible adult to accompany the patient to his residency; patient residency in Athens. The primary study end-point was to evaluate success rates (patient discharge on the day of surgery, postoperative outcome (complications, re-admissions, morbidity and mortality and patient satisfaction. A secondary endpoint was to evaluate its safe performance under appropriate supervision by higher surg