Sample records for teaching hospital enugu

  1. Mother-to-child transmission of HIV: the pre-rapid advice experience of the university of Nigeria teaching hospital Ituku/Ozalla, Enugu, South-east Nigeria

    PubMed Central

    2012-01-01

    Background Mother-to-child transmission of human immune deficiency virus (HIV) is the most common route of HIV transmission in the pediatric age group. A number of risk factors contribute to the rate of this transmission. Such risk factors include advance maternal HIV disease, lack of anti-viral prophylaxis in the mother and child, mixing of maternal and infant blood during delivery and breastfeeding. This study aims to determine the cumulative HIV infection rate by 18?months and the associated risk factors at the University of Nigeria Teaching Hospital, Enugu. Results A retrospective study, involving HIV exposed infants seen at the pediatric HIV clinic of UNTH between March 2006 and September 2008. Relevant data were retrieved from their medical records. The overall rate of mother to child transmission of HIV in this study was 3.9% (95% CI 1.1%- 6.7%). However, in children breastfed for 3?months or less, the rate of transmission was 10% (95% CI ?2.5%-22.5%), compared to 3.5% (95% CI 0.5%-6.5%) in children that had exclusive replacement feeding. Conclusions This retrospective observational study shows a 3.9% cumulative rate of mother-to-child transmission of HIV by 18?months of age in Enugu. Holistic but cost effective preventive interventions help in reducing the rate of mother-to-child transmission of HIV even in economically-developing settings like Nigeria. PMID:22713282

  2. Pattern of respiratory diseases in children presenting to the paediatric emergency unit of the University of Nigeria Teaching Hospital, Enugu: a case series report

    PubMed Central

    2014-01-01

    Background Respiratory diseases are one of the causes of childhood morbidity and mortality as well as hospitalization globally. The patterns of different respiratory illnesses in several parts of the world have been reported but there are few on the combined burden of the diseases. Determination of the burden of respiratory diseases as a group will help ascertain their collective impact on the health systems in order to develop intervention measures. Methods Data from case notes of children with respiratory diseases admitted to the University of Nigeria Teaching Hospital Enugu, Nigeria over a six year period were extracted. Age, gender, admission rates, types of respiratory illness, duration of admission, season of presentation and outcome were analysed. Descriptive and inferential (Chi square) statistics were used to describe the various disease types and ascertain association of the disease outcome, seasonal pattern with the types of diseases. Results Of the total of 8974 children admissions, 2214 (24.7%) were due to respiratory diseases. The mean age of all the children with respiratory diseases was 3.3?years (SD 3.9). Communicable diseases were the common cause of admission cases throughout the seasons, p < 0.001. The highest admission rates were for pneumonia, (34.0%), acute bronchial asthma, (27.7%) and rhinosinusitis (14.6%) p < 0.001. The frequency of respiratory disease decreases with age and children less than five years of age and of low socio-economic status were commonly affected, p?=?0.01. The median duration of hospital stay was two days [range 1 to 8?days], children less than five years old and those of low socio-economic status, spent more than four days (p?=?0.01 and p < 0.001 respectively). The all-cause mortality was 0.5% (11/2214) of which 81.8% (9/11) was due to pneumonia. Conclusions Respiratory diseases constitute a significant burden of childhood illnesses in our centre. Efforts are required to reduce the impact as part of the steps towards the achievement of the Millennium Development Goals. PMID:24916799

  3. Intracranial meningiomas managed at Memfys hospital for neurosurgery in Enugu, Nigeria

    PubMed Central

    Mezue, Wilfred C; Ohaegbulam, Samuel C; Ndubuisi, Chika C; Chikani, Mark C; Achebe, David S

    2012-01-01

    Introduction: The epidemiology and pathology of meningioma in Nigeria are still evolving and little has been published about this tumor in Nigeria, especially in the southeast region. The aim of this paper is to compare the characteristics of intracranial meningioma managed in our center with the pattern reported in the literature worldwide. Materials and Methods: Retrospective analysis of prospectively recorded data of patients managed for intracranial meningioma between January 2002 and December 2010 at a Private neurosurgery Hospital in Enugu, Nigeria. We excluded patients whose histology results were inconclusive. Results: Meningiomas constituted 23.8% of all intracranial tumors seen in the period. The male to female ratio was 1:1.1. The peak age range for males and females were in the fifth and sixth decades, respectively. The most common location is the Olfactory groove in 26.5% of patients followed by convexity in 23.5%. Presentation varied with anatomical location of tumor. Patients with olfactory groove meningioma (OGM) mostly presented late with personality changes and evidence of raised ICP. Tuberculum sellar and sphenoid region tumors presented earlier with visual impairment with or without hormonal abnormalities. Seizures occurred in 30.9% of all patients and in 45% of those with convexity meningiomas. Only 57.4% of the patients were managed surgically and there was no gender difference in this group. WHO grade1 tumors were the most common histological types occurring in 84.6%. One patient had atypical meningioma and two had anaplastic tumors. Conclusion: The pattern of meningioma in our area may have geographical differences in location and histology. Childhood meningioma was rare. PMID:23188985

  4. Childhood intracranial neoplasms Enugu, Nigeria.

    PubMed

    Izuora, G I; Ikerionwu, S; Saddeqi, N; Iloeje, S O

    1989-01-01

    This paper reviews children with intracranial neoplasms seen at the University of Nigeria Teaching Hospital, (UNTH), Enugu, over an 8-year period (1978-1985). There were 21 children, aged 4-14 years, with histologically confirmed intracranial neoplasms. The male to female ratio was 2:1. Of all cases, there was a preponderance of cranio-pharyngiomas (38.1%), followed by the astrocytomas and medulloblastomas with 14.3% each, a result which is at variance with findings elsewhere. The poor prognosis was partly due to late presentation complicated by relatively inadequate diagnostic and therapeutic facilities. A plea is made for the improvement of neurodiagnostic and therapeutic facilities in some regional hospitals in developing countries. PMID:2486793

  5. Reduction Mammoplasty in a Developing Country: A 10-year Review (2001-2010) at the National Orthopaedic Hospital, Enugu

    PubMed Central

    Isiguzo, Chimaobi; Ogbonnaya, Sunday Iheuko; Udezue, Anthonia O

    2015-01-01

    Context: Large breast is a major problem because of associated symptomatology and aesthetic concerns. Reduction mammoplasty (RM) resolves the symptom and at the same time improves the aesthetic appearance of the breast, hence improving self-esteem and social integration. Aims: To describe the pattern of RM in a hospital in the developing world and its impact on postgraduate surgical training. Settings and Design: A retrospective review of all the RMs done in the National Orthopaedic Hospital, Enugu (a major plastic surgery training center in Nigeria) over a ten-year period (2001–2010), in the developing country of Nigeria. Subjects and Methods: All RMs done in the hospital were reviewed after retrieving their records from operation register and medical records department. Fifteen (15) cases were retrieved and analyzed. Data Analysis: Data was analyzed with Microsoft excel 2007. Results: Average age of female patients who had RM was 26.5 years and 83.3% were single. The most common complaint was abnormally large breast (macromastia). Inferior pedicle technique was commonly used. Conclusions: The results of RM are remarkable as it impact positively on the quality of life of the patients. However, the level of awareness about the availability of this service is still low in the region as shown by few cases done over the period of review and this impacts negatively on the training. The need for public awareness cannot be overemphasized.

  6. Intracranial tumors in Enugu, Nigeria.

    PubMed

    Ohaegbulam, S C; Saddeqi, N; Ikerionwu, S

    1980-11-15

    Over a five-year period, there were 48 cases of intracranial tumors at the University of Nigeria Teaching Hospital, Enugu, Nigeria. All the patients were Nigerian Negroes. Glial tumors accounted for 20.8%, pituitary tumors 18.8%, and meningiomas 16.7%. There were five cases of tuberculomas and five cases of metastatic tumors. Miscellaneous tumors contributed 22.9% of the total. There were more males than females, especially in the meningioma and tuberculoma groups. Nearly one-half of the tumors were in people in their first and second decades of life; two-thirds of the tumors were in those under 30 years of age. One-third of the patients have died within the five years under review. The results of this survey are strikingly different from Caucasian series. The relatively low incidence of gliomas and the high incidence of meningiomas and pituitary tumors in this study are interestingly similar to the results of other workers who studied Negro populations and may underscore the importance of genetic factors in the development of some brain tumors. PMID:7427874

  7. Liver biopsy: experience at Enugu, eastern Nigeria.

    PubMed

    Osuafor, T O; Ikerionwu, S E; Ukabam, S O

    1986-01-01

    A retrospective analysis of liver biopsies done at the University of Nigeria Teaching Hospital, Enugu, between January 1980 to December 1985 was done to determine the indications, level of preparation and investigation of the patients, biopsy techniques and failure rate, complications and histopathological results. The register of all biopsies sent to the Morbid Anatomy Department and the clinical records of the patients were used for the analysis. Of the 154 biopsies done, the Menghini technique was used in 128 cases (83.1%), the rest was by exploratory laparotomy. The commonest indication was unexplained hepatomegaly with or without splenomegaly 46 cases (29.8%). Adult cases accounted for 132 cases (85.7%) with male/female distribution of 3:1. Histologically proven cases of hepatocellular carcinoma accounted for 38 cases (14.2%). Pain requiring analgesics occurred in 8 cases (5.2%). The need for adequate clinical documentation of patients is emphasized. PMID:3508625

  8. Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in south-eastern Nigeria: socio-demographic and clinical correlates

    Microsoft Academic Search

    Boniface Ikenna Eze; Chimdi Memnofu Chuka-Okosa; Judith Nkechi Uche

    2009-01-01

    BACKGROUND: This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM) use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria. METHODS: In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between August 2004 - July

  9. Prevalence and Predictors of Episiotomy Among Women at First Birth in Enugu, South-East Nigeria

    PubMed Central

    Izuka, EO; Dim, CC; Chigbu, CO; Obiora-Izuka, CE

    2014-01-01

    Background: Women having their first birth have a higher risk of episiotomies. Therefore, the study of the procedure in this group of at risk women will assist in solving some of its associated controversies. Aim: The aim was to determine the prevalence, predictors, and outcomes of episiotomy among primigravid women in Enugu, Nigeria. Materials and Methods: The study was a retrospective cross-sectional review of labor ward records of women that had their first delivery at the University of Nigeria Teaching Hospital (UNTH) Enugu, over a 5-year of April 204 to March 2009. Only women that had a vaginal delivery were included in the study. Mann–Whitney U-test (continuous data) and Chi-square test (categorical data) were used for data analysis. Results: Prevalence of episiotomy in the study was 62.1% (411/662). The episiotomy rate for booked women (65.6%, 376/573) was significantly higher than that of unbooked women (39.3%, 35/89), (prevalence ratio = 1.67 [95% confidence interval: 1.28, 2.17]). The birth weights of babies delivered in the episiotomy group (median = 3.2 kg [interquartile range (IQR): 2.9-3.5]) was statistically higher than those of women who did not receive episiotomy (median, 3.1 kg [IQR: 2.7-3.4]), (Z = -3.415, P = 0.001). Proportion of newborns with low 1st min Apgar scores in the episiotomy group (21.7%, 89/411) was significantly lower than the no episiotomy group (15.1%, 38/251) (P = 0.04). Conclusion: Prevalence of episiotomy among women that had their first births in the UNTH, Enugu was high, and the predictors included booked status of women, higher gestational age at delivery, and larger neonatal birth weight. More efforts should be made to reduce episiotomy rate in the hospital. PMID:25506488

  10. Hospital outcomes in major teaching, minor teaching, and nonteaching hospitals in New York state

    Microsoft Academic Search

    Car??si A Polanczyk; Michelle Coburn; Edward F Philbin; G. William Dec; Thomas G DiSalvo

    2002-01-01

    PurposeThe possible benefit that hospital teaching status may confer in the care of patients with cardiovascular disease is unknown. Our purpose was to determine the effect of hospital teaching status on in-hospital mortality, use of invasive procedures, length of stay, and charges in patients with myocardial infarction, heart failure, or stroke.

  11. VETERINARY TEACHING HOSPITAL 1620 Campus Delivery

    E-print Network

    Rutledge, Steven

    .297.1269 EQUINE FIELD SERVICE VETERINARIAN Veterinary Teaching Hospital College of Veterinary Medicine an opening for a one-year postdoctoral fellowship as an Equine Field Service Veterinarian. Equine Field

  12. Educational Facilities in the Hospital for Teaching.

    ERIC Educational Resources Information Center

    Green, Alan C.

    1965-01-01

    Planning and design criteria are established for educational facilities in VA hospitals, rendering them more effective for medical education. Rather than developing plans for prototype teaching hospitals, guidelines are presented which may be utilized to meet the needs of a particular situation. Three broad categories of facilities are…

  13. Predicting financial distress in teaching hospitals.

    PubMed

    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. PMID:19175242

  14. University of Illinois Veterinary Teaching Hospital

    E-print Network

    Jain, Kanti

    University of Illinois Veterinary Teaching Hospital at the College of Veterinary Medicine SERVICE EMAIL Director's Office VTHDir@vetmed.illinois.edu Referral Coordinator VTHrDVMcoor@vetmed.illinois.edu Medical Records medrec@vetmed.illinois.edu Anesthesia VTHAnesthesia@vetmed.illinois.edu Cardiology

  15. Medicare and the Financing of Teaching Hospitals

    ERIC Educational Resources Information Center

    Tierney, Thomas M.

    1969-01-01

    Gives reasons why Medicare cannot provide financial support for needs of teaching hospitals over and above payments for those health services specified in the legislation. Speech delivered at the 79th Annual Meeting of the Association of American Medical Colleges, Houston, Texas, November 1, 1968. (WM)

  16. Success factors in merging teaching hospitals.

    PubMed

    Thier, Samuel O; Kelley, William N; Pardes, Herbert; Knight, Amy Wimpey; Wietecha, Mark

    2014-02-01

    Merger has served as a major strategy for the leaders of academic medical centers (i.e., teaching hospitals) who are pursuing health system development for their institutions. Applying hindsight to their personal experience, the authors explore common themes in several mergers that have survived the test of time. Although many elements influence merger outcomes, experience suggests several of unique importance. These include effective leadership in the areas of creating trust, managing uncertainty, ensuring medical staff stability, and bridging cultural divides across the organizations. While a quantitative business case should support any merger, the authors' experiences underscore the importance of successfully assessing and managing organizational and individual dynamics when bringing together major teaching hospitals. PMID:24362373

  17. Urban Problems: Social Security and the Teaching Hospital

    ERIC Educational Resources Information Center

    Pallez, Gabriel

    1973-01-01

    Social security can stifle the teaching hospital's development through increasing expenses and budgetary considerations. These problems are discussed in relation to the hospital organization and university structure in Paris, France. (Author/PG)

  18. Finance versus costs for teaching hospitals in Spain

    Microsoft Academic Search

    Guillem López-casasnovas; Marc Sįez

    1998-01-01

    In this paper we analyse the observed systematic differences in costs for teaching hospitals (THhenceforth) in Spain. Concern has been voiced regarding the existence of a bias in the financing of TH’s has been raised once prospective budgets are in the arena for hospital finance, and claims for adjusting to take into account the ‘legitimate’ extra costs of teaching on

  19. Is Hospital Teaching Status a Key Factor in Hospital Charge for Children with Hip Fractures?

    PubMed Central

    Gao, Yubo; Pugely, Andrew; Karam, Matthew; Phisitkul, Phinit; Mendoza, Sergio; Johnston, Richard C.

    2013-01-01

    OBJECTIVE Proximal femur fractures cause significant pain and economic cost among pediatric patients. The purposes of this study were (a) to evaluate the distribution by hospital type (teaching hospital vs non-teaching hospital) of U.S. pediatric patients aged 1-20 years who were hospitalized with a closed hip fracture and (b) to discern the mean hospital charge and hospital length of stay after employing propensity score to reduce selec-tion bias. METHODS The 2006 Healthcare Cost and Uti-lization Project (HCUP) Kids’ Inpatient Database (KID) was queried for children aged up to 20 years that had principle diagnosis of hip fracture injury. Hip fractures were defined by International Classifi-cation of Diseases, 9th Revision, Clinical Modifica-tion codes 820.0, 820.2 and 820.8 under Section “Injury and Poisoning (800-999)” with principle internal fixation procedure codes 78.55, 79.15 and 79.35. Patient demographics and hospital status were presented and analyzed. Differences in mean hospital charge and hospital length of stay by hospital teaching status were assessed via two propensity score based methods. RESULTS In total, 1,827 patients were nation-ally included for analysis: 1,392 (76.2%) were treated at a teaching hospital and 435 (23.8%) were treated at a non-teaching hospital. The average age of the patients was 12.88 years old in teaching hospitals vs 14.33 years old in nonteaching hospitals. The propensity score based ad-justment method showed mean hospital charge was $34,779 in teaching hospitals and $32,891 in the non-teaching hospitals, but these differences were not significant (p=0.2940). Likewise, mean length of hospital stay was 4.1 days in teaching hospitals and 3.89 days in non-teaching hospitals, but these differences were also not significant (p=0.4220). Conclusions Hospital teaching status did not affect length of stay or total hospital costs in children treated surgically for proximal femur fractures. Future research should be directed at identifying factors associated with variations in hospital charge and length of stay. PMID:24027472

  20. 42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Conditions of payment: Assistants at surgery in teaching hospitals. 415.190 ...Conditions of payment: Assistants at surgery in teaching hospitals. (a) Basis...basis for the services of an assistant at surgery in a teaching hospital. This...

  1. 42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Conditions of payment: Assistants at surgery in teaching hospitals. 415.190 ...Conditions of payment: Assistants at surgery in teaching hospitals. (a) Basis...basis for the services of an assistant at surgery in a teaching hospital. This...

  2. 42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Conditions of payment: Assistants at surgery in teaching hospitals. 415.190 ...Conditions of payment: Assistants at surgery in teaching hospitals. (a) Basis...basis for the services of an assistant at surgery in a teaching hospital. This...

  3. 42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Conditions of payment: Assistants at surgery in teaching hospitals. 415.190 ...Conditions of payment: Assistants at surgery in teaching hospitals. (a) Basis...basis for the services of an assistant at surgery in a teaching hospital. This...

  4. 42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Conditions of payment: Assistants at surgery in teaching hospitals. 415.190 ...Conditions of payment: Assistants at surgery in teaching hospitals. (a) Basis...basis for the services of an assistant at surgery in a teaching hospital. This...

  5. Paracetamol use (and/or misuse) in children in Enugu, South-East, Nigeria

    PubMed Central

    2012-01-01

    Background Paracetamol (also known as acetaminophen) is the commonest available analgesic and anti-pyretic. It is readily accessed from pharmacy, patent medicine and provision shops as over the counter drug making it a potential drug of abuse, especially in children. We sought to find its use and/or misuse in children seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu. Objective To determine the dosage, formulation, and frequency of paracetamol administration to children by caregivers and factors associated with its use and/or misuse. Method An observational prospective study involving 231 children and their caregivers seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital, Ituku - Ozalla, Enugu between June and November 2011 was undertaken. Data on paracetamol use before presentation to the clinic, in addition to demographic and other data were obtained from the caregivers using a structured questionnaire. Ethical consent for the study was obtained from the Hospital Ethics and Research Committee and informed consent was further obtained from the caregivers of the children. Results A total of 231 children aged six weeks to 16?years and their caregivers participated in this study. The mean ages of the children and their caregivers were 3.8 and 33.9?years, respectively. One hundred and thirty three of the children studied were males while 98 were females. Most of the children (75.6%) received paracetamol at home before presenting. Paracetamol tablet alone or in combination with the syrup was mostly used (60%) and this observation was made across all age groups. The commonest reason for using paracetamol tablet instead of the syrup was that it was more effective. Most caregivers relied on past experience (71.2%) rather than on enclosed information leaflet to decide the appropriate dosage. Half of the children also received other medications, mainly anti-malarials and antibiotics. Conclusions Paracetamol was commonly given to children on “self prescription” basis and the tablet formulation was most frequently used, with the possibility of misuse and overdose. Caregivers need to be educated on age-appropriate formulations which are less likely to lead to overdose. PMID:22812400

  6. Hematocrit, Anemia, and Arm Preference for Blood Sample Collection: A Cross-Sectional Study of Pregnant Women in Enugu, South-Eastern, Nigeria

    PubMed Central

    Dim, CC; Ugwu, EO; Dim, NR; Anyaehie, UB

    2015-01-01

    Background: Anemia in pregnancy is a common cause of maternal morbidity and mortality in developing countries. Regular review of hematocrit (HCT) and anemia patterns in pregnancy is necessary in our environment. Aim: The aim was to determine the average HCT, prevalence, and pattern of anemia, as well the arm preferences for blood sample collection among pregnant women in Enugu, South East Nigeria. Subjects and Methods: HCT was determined using venous blood of 200 antenatal women at the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Questionnaires were used to assess participants’ arm preference for blood sample collection for clinical investigations. Data analysis was descriptive and inferential at 95% confidence level. Results: Participants’ mean HCT was 33.3 (3.7%). The average HCT in second trimester 33.3% (3.76%) was significantly lower than that of third trimester (34.6 [3.4%], P = 0.01,). Prevalence of anemia was 28.0% (56/200), and a majority (94.6%, 53/56) of anemic women belong to the mild category. Only parity groups had a significant association with anemia in pregnancy (P = 0.04). None of the participants reported being asked about her arm preference during blood collection for routine antenatal investigations. One hundred and five (52.5%) women expressed preference for either left (34.5%, 69/200) or right arm (18.0%, 36/200) for blood sample collection. Conclusion: The average HCT among pregnant women at the UNTH, Enugu Nigeria was within normal range and the prevalence of anemia was relatively low. The majority of women expressed a preference for either right or left arm for blood sample collection for clinical investigations and would wish their choices sought for and respected.

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

    PubMed

    Vancil, D R; Shroyer, A L

    1998-11-01

    The Colorado Medicaid Program in years past relied on disproportionate share hospital (DSH) payment programs to increase access to hospital care for Colorado citizens, ensure the future financial viability of key safety-net hospitals, and partially offset the state's cost of funding the Medicaid program. The options to finance Medicaid care using DSH payments, however, recently have been severely limited by legislative and regulatory changes. Between 1991 and 1997, a creative Medicaid refinancing strategy called the major teaching hospital (MTH) payment program enabled $131 million in net payments to be distributed to the two major teaching hospitals in Colorado to provide enhanced funding related to their teaching programs and to address the ever-expanding healthcare needs of their low-income patients. This new Medicaid payment mechanism brought the state $69.5 million in Federal funding that otherwise would not have been received. PMID:10187630

  8. 78 FR 32663 - Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ...Notification of Closure of Teaching Hospitals and Opportunity To Apply for Available...announces the closure of two teaching hospitals and the initiation of an application process where hospitals must apply to the Centers for...

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

    PubMed

    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. PMID:22989855

  10. The impact of teaching and research on hospital costs

    Microsoft Academic Search

    C. Huttin; G. de Pouvourville

    2001-01-01

    This study assessed the impact of teaching and research on the average adjusted cost per stay of French public hospitals.\\u000a Stepwise regression analyses were conducted using a 1994 database covering 144 public and private nonprofit hospitals. The\\u000a dependent variable was the average cost per stay adjusted for the casemix. Various cost predictors were used, among which\\u000a variables describing the intensity

  11. Hurricane Katrina's Impact on Tulane's Teaching Hospitals

    PubMed Central

    Taylor, Ian L.

    2007-01-01

    On Monday, August 29, 2005 Hurricane Katrina passed east of New Orleans causing minimal damage to Tulane's Medical Center. Later that day, levees that protected the city failed and several feet of water entered the hospitals and school buildings. Emergency generators provided power for 36 hours before running out of fuel. Temperatures in the hospitals soared into the upper 90's and conditions were made intolerable by 100% humidity and backed-up sewage. For several days, faculty, residents, nurses and hospital personnel performed heroically, caring for patients in appalling conditions, hand-ventilating critically ill patients in shifts. Approximately 200 patients, and 1500 additional personnel would be evacuated on Wednesday and Thursday from a makeshift heliport on Tulane's parking garage. Current disaster plans may be inadequate should facilities be inaccessible for months because of damage or contamination. Contingency plans also need to be made should outside disaster relief be markedly delayed as was the case with Katrina. PMID:18528490

  12. Management of intracranial meningiomas in Enugu, Nigeria

    PubMed Central

    Mezue, Wilfred C; Ohaegbulam, Samuel C; Ndubuisi, Chikandu A; Chikani, Mark C.; Achebe, David S

    2012-01-01

    Background: Meningiomas may range on presentation from incidentally identified small lesions to large symptomatic tumors in eloquent areas of the brain. Management options correspondingly vary and include careful observation, surgical excision, and palliative application of very limited therapeutic maneuvers in select cases. This paper discusses the options and difficulties in the management of meningiomas in a developing country. Methods: This study is a retrospective analysis of prospectively recorded data of patients managed for intracranial meningioma between January 2006 and September 2011 at Memfys Hospital for Neurosurgery, Enugu. Radiographic diagnosis of meningioma was based on computed tomography (CT) and or magnetic resonance imaging (MRI) criteria in all cases, but only patients who had surgery and a histological diagnosis were analyzed. Results: Seventy-four patients were radiographically diagnosed with intracranial meningioma over the period under review. Fifty-five patients were operated upon and 52 (70.3%) with histological diagnosis of meningioma were further analyzed. Histological diagnosis was complete in 42 (56.8%) patients and in 10 (13.5%) patients the subtype of meningioma was not determined. The male to female ratio was 1:1.08. The peak age range for females was in the 6th decade and for males in the 5th decade. The locations were olfactory groove (26.9%), convexity (21.2%), parasagittal/falx (19.2%), sphenoid ridge (15.4%), tuberculum sellae (7.7%), tentorial (3.8%), and posterior fossa (5.8%). The most common clinical presentation was headaches in 67.3% followed by seizures (40.4%) and visual impairment (38.5%). Histology was benign (World Health Organization [WHO] grade 1) in 39 patients. One patient harbored an atypical and two had anaplastic tumors. Gross total resection of the tumor was achieved in 41 patients. Surgical mortality was 3.9%. Conclusion: Effective management of meningioma depends largely on adequate and complete surgical resection and results in good outcomes. Adequate preoperative assessment, including visual assessment, and hormonal assessment in olfactory groove and sphenoid region meningiomas, is necessary. PMID:23087826

  13. Assessing Governance Alternatives for University-Owned Public Teaching Hospitals.

    ERIC Educational Resources Information Center

    Whitley, Evangeline L.

    The governance options matrix is provided to offer a way for state and university policymakers to examine the functioning environments of specific university-owned public teaching hospitals. With it, they can consider the benefits and problems involved with different options for governance. The issues related to the environmental factors affecting…

  14. Innovative Model for Information Assurance Curriculum: A Teaching Hospital

    ERIC Educational Resources Information Center

    Goel, Sanjay; Pon, Damira; Bloniarz, Peter; Bangert-Drowns, Robert; Berg, George; Delio, Vince; Iwan, Laura; Hurbanek, Thomas; Schuman, Sandoor P.; Gangolly, Jagdish; Baykal, Adnan; Hobbs, Jon

    2006-01-01

    A novel idea for information security education created by the New York State Center for Information Forensics and Assurance (CIFA) is presented. This new approach incorporates a teaching hospital model originally developed for medical training. In this model, information security problems from industry and government are solved and abstracted…

  15. Radiologist workloads in teaching hospital departments: Measuring the workload

    Microsoft Academic Search

    AG Pitman; DN Jones

    2006-01-01

    SUMMARY This article proposes a practical method for measuring staff radiologist workloads (clinical productivity) in teaching hospital departments of radiology in Australia. It reviews the Australian background to this, including the Royal Australian and New Zealand College of Radiologists (RANZCR) Education Board accreditation guidelines and the development of the RANZCR practice costing model. It reviews overseas methods of radiologist workload

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

    PubMed Central

    Varallo, Fabiana Rossi; Capucho, Helaine Carneiro; da Silva Planeta, Cleópatra; de Carvalho Mastroianni, Patrķcia

    2014-01-01

    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 Sćo 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. PMID:24626940

  17. Pattern of osteoarthritis in a West African teaching hospital.

    PubMed Central

    Adebajo, A O

    1991-01-01

    The study of the pattern of osteoarthritis in different populations may yield valuable aetiological clues and also allow subtypes to be defined. Over one year 252 osteoarthritic joints from 140 patients seen at a West African teaching hospital were prospectively reviewed. The knee was the joint most often affected. Hip and hand disease, as well as Heberden's nodes, were uncommon. Joint disease was predominantly monoarticular; no patient had three or more sites affected. PMID:1994862

  18. Use of hospital beds: a cohort study of admissions to a provincial teaching hospital.

    PubMed Central

    Anderson, P.; Meara, J.; Brodhurst, S.; Attwood, S.; Timbrell, M.; Gatherer, A.

    1988-01-01

    An instrument was developed to study the use of hospital beds and discharge arrangements of a cohort of 847 admissions to the John Radcliffe Hospital, Oxford, for a three week period during February-March 1986. For only 38% of bed days were patients considered to have medical, nursing, or life support reasons for requiring a provincial teaching hospital bed. The requirements for a bed in the hospital decreased with the patient's age and length of stay in hospital. For only a tenth of patients was the general practitioner concerned in discussions with hospital staff about the patient's discharge and less than one third of patients had been given more than 24 hours' notice of discharge. Several features might increase the proportion of bed days that are occupied by patients with positive reasons for being in hospital. Among these are an increased frequency of ward rounds by consultants, or delegating discharge decisions by consultants to other staff; providing diagnostic related protocols for planning the length of stay in hospital; planned discharges; and providing liaison nurses to help with communication with primary care staff. PMID:3140977

  19. The impact of teaching status on average costs in Spanish hospitals

    Microsoft Academic Search

    Guillem López-Casasnovas; Marc Saez

    1999-01-01

    In this paper, the observed systematic differences in costs for teaching hospitals (TH) in Spain are examined. Concern has been voiced regarding the existence of a bias in the financing of TH once prospective budgets are introduced for hospital finance. Claims for adjustment to take into account the 'legitimate' extra costs of teaching on hospital expenditure may be well grounded.

  20. A comparative analysis of the CVP structure of nonprofit teaching and for-profit non-teaching hospitals.

    PubMed

    Liu, Li-Lin; Forgione, Dana A; Younis, Mustafa Z

    2012-01-01

    Due to the market turbulence facing the hospital industry, the financial viability of teaching hospitals has been severely threatened. Their missions of education, research, and patient care even strengthen this crisis. Therefore, the objective of this study is to conduct a comparative analysis of the cost, volume, and profit (CVP) structure between large nonprofit urban teaching hospitals and small for-profit rural/suburban non-teaching hospitals. The following two hypotheses were developed: (1) large nonprofit urban teaching hospitals tend to have higher fixed cost, lower variable cost, lower total revenue adjusted by case mix index (CMI), and lower return on total assets (ROA); and (2) small for-profit rural/suburban non-teaching hospitals tend to have lower fixed cost, higher variable cost, higher total revenue adjusted by CMI, and higher ROA. Using 117 teaching hospitals and 102 non-teaching hospitals selected from the Medicare Cost Report database in 2005, the results from multiple regression indicated that large nonprofit teaching hospitals located in urban areas are more likely to have higher fixed cost and lower variable cost. While such cost structure doesn't necessarily affect their total revenue adjusted by CMI, it does lead to a lower return on hospitals' total assets. The results support our hypotheses in terms of fixed cost percentage, variable cost percentage, and ROA, but not total revenue adjusted by CMI. The results suggest that cost structure is significantly associated with hospitals' performance. Also, as teaching hospitals' portfolios of services and programs increase (e.g., provision of uncompensated care to Medicare and Medicaid patients and doing research), it becomes strategically necessary and critical to manage the allocation of resources or investments into the fixed capital that supports the business. PMID:23155742

  1. The teaching of clinical skills at a postgraduate hospital.

    PubMed

    Creed, F; Murray, R M

    1981-05-01

    The teaching of 'clinical skills' is generally held to be central to postgraduate training in psychiatry, but the term itself has so far escaped exact definition. In an effort to study some of the component clinical abilities, their inter-relationships, and the factors promoting their transmission, all junior psychiatrists at the Maudsley Hospital were surveyed for their views on the clinical training they had received. Three hundred and seventy three assessement on 43 units were made. Trainees perceived the academic instruction and advice on formulating cases which they had received as being quite unrelated to the quality of help with interview skills and instruction in practical management, but feedback from the consultant to the trainee on the latter's performance was necessary for a high standard of both academic and practical instruction. Encouragement to do research was transmitted independently of other clinical teaching. Over a 3-year period the standard of multi-disciplinary teamwork appeared to improve, but there was a decline in the standard of academic instruction and in encouragement to do research. These overall differences were due to changes in the teaching staff, rather than alterations in teaching methods. Surveys such as this may help to define the goals of postgraduate clinical training, and also monitor the extent to which an institution is achieving these goals. PMID:7267879

  2. Program planning for the community teaching hospital medical library.

    PubMed Central

    McCorkel, J; Cook, V

    1985-01-01

    To respond to the increasing demand for information from medical educators and clinicians and to persuade administrators to purchase the newly available microcomputer library systems, medical librarians in community teaching hospitals may find it useful to engage in intermediate term (for example, five-year) program planning. To increase the probability that the plan which emerges will be implemented, the planning process should fit the organizational nexus. Planning involves needs assessment, prioritized program elements, a written plan, and facilities planning (if applicable), which lead to program implementation. Components of a model program plan are presented. PMID:4027443

  3. Minimally Invasive Hysterectomy at a University Teaching Hospital

    PubMed Central

    Mitri, Michael; Davies, Matthew; Kesterson, Joshua; Ural, Serdar; Kunselman, Allen; Harkins, Gerald

    2014-01-01

    Background and Objectives: To evaluate the feasibility of a minimally invasive approach for hysterectomy for benign disease at a university teaching hospital. Methods: Five hundred thirty-seven consecutive patients underwent hysterectomy for benign disease at Penn State Milton S. Hershey Medical Center in 2010. No cases were excluded. Minimally invasive approaches included total vaginal hysterectomy, laparoscopy-assisted vaginal hysterectomy, total laparoscopic hysterectomy, and laparoscopic supracervical hysterectomy. All surgeries were completed with the resident as the primary surgeon or first assistant. Results: The median age was 45 years, the median body mass index was 30 kg/m2, the median estimated uterine size was 11 cm, and 22% of patients had a prior cesarean section. Of the 537 hysterectomies, 526 (98%) were started with a minimally invasive approach and 517 (96%) were completed in that fashion; thus only 9 conversions (2%) were required. Of the cases in which a minimally invasive approach was used, 16% were vaginal and 84% were laparoscopic. The median operative time was 86 minutes, the median blood loss was 95 mL, the median hospital stay was 1 day, and the median uterine weight was 199 g. For the minimally invasive hysterectomies, there was a 5% major complication rate. Conclusion: Our residency training institution completed 96% of 537 hysterectomies using a minimally invasive approach while maintaining an acceptable operative time, amount of blood loss, hospital stay, and complication rate. Thus our study supports that a minimally invasive approach for hysterectomy for benign disease at an academic resident teaching facility is feasible. PMID:25392620

  4. COMPARISON OF SALMONELLA ENTERICA SEROTYPE INFANTIS ISOLATES FROM A VETERINARY TEACHING HOSPITAL

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: To compare Salmonella enterica serotype Infantis isolates obtained from patients or the environment of a veterinary teaching hospital over a period of 9 years. Design: Retrospective study. Sample Population: 56 S. Infantis isolates obtained from a veterinary teaching hospital from 1996 to...

  5. Assessment of primary health care in a rural health centre in Enugu South east Nigeria

    PubMed Central

    M Chinawa, Josephat; T Chinawa, Awoere

    2015-01-01

    Objective: Primary health care (PHC) is a vital in any community. Any health centre with a well implemented PHC program can stand the test of time in curbing under five mortality and morbidity. This study was therefore aimed at assessing the activities in a health centre located in a rural area in Enugu state and to determine the pattern and presentation of various diseases in the health centre. Methods: This is retrospective study undertaken in a primary health care centre in Abakpa Nike in Enugu east LGA of Enugu State of Nigeria from December 2011 to December 31st 2013. Data retrieved were collected with the aid of a structured study proforma and analyzed using SPSS Version 18. Results: Total number of children that attended immunization program in the health centre over 20 months period was 25,438 (12,348 males and 13090 females), however only 17745 children (7998 males and 9747 females) were actually registered in the hospital records. None of the children was immunized for DPT2 and OPV0 and HBV1 in the course of this study. The dropout rate using DPT1, 2 and 3 (DPT1-DPT2/DPT3) was very high (494%). The mean immunization coverage rate was 8.3%. Family planning activities, integrated management of childhood illnesses program were also carried out in the health centre but at very low level. Conclusions: The major fulcrum of events in the health centre which include immunization coverage, IMCI, and management of common illnesses were simply non operational. However the health centre had a well knitted referral system.

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

    PubMed Central

    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 academic radiology department are involved in teaching undergraduate students at multiple levels. The most valued teaching methodology involves use of images, with one-on-one interaction between the trainer and trainee. The monetary reward for teaching is inbuilt into the salary. The methodology adopted for teaching purposes was significantly different between respondents from private hospitals and those from public teaching hospitals. Because of low satisfaction among the respondents, efforts should be made to provide satisfying teaching rewards. PMID:23745098

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

    PubMed Central

    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. PMID:25540784

  8. Evolution of Hospital-based Pharmacy Teaching Programs from 1989-1998.

    ERIC Educational Resources Information Center

    Raehl, Cynthia; Bond, C. A.

    2000-01-01

    Analyzed databases from four U.S. National Clinical Pharmacy Services Studies and the American Hospital Association for trends in hospital involvement in pharmacy education. Detailed findings indicated that clinical pharmacy services within the nation's teaching hospitals are not standardized and that financial pressures impede a full, consistent…

  9. [Clinical and epidemiological aspects of burned patients hospitalized in a teaching hospital].

    PubMed

    Montes, Samanta Flor; Barbosa, Maria Helena; de Sousa Neto, Adriana Lemos

    2011-04-01

    The objectives of this study were to characterize burned patients according to epidemiological and clinical variables and identify the treatments, invasive procedures and complications. This is a retrospective, descriptive and quantitative study. The sample consisted of 138 burned patients hospitalized in a teaching hospital from January 2003 to December 2007, in Uberaba-MG. Of the 138 hospitalized patients, 98 (71.0%) were male, and the average age was 26.1 years. The average length of stay was 16.2 days; 93 (67.4%) of the burns were caused by accidents and the main cause (68; 49.3%) was an open flame. The average burned body surface was 20.8% and most (122; 88.4%) had second degree burns. The most common topic treatment (93; 67.4%) was silver sulfadiazine. Forty-seven (34.0%) patients had indwelling catheters; 30 (21.7%) underwent tissue transplantation, and 28 (20.3%) underwent debridement; the lesions in 14 (10.1%) patients became infected. PMID:21655786

  10. Organizational factors associated with quality of care in US teaching hospitals.

    PubMed

    Harrison, Jeffrey P; Lambiase, Louis R; Zhao, Mei

    2010-01-01

    This study is unique because it uses multiple regression and data envelopment analysis (DEA) to evaluate teaching hospital quality. The results support the premise that teaching hospital leadership through the effective allocation of resources can improve the quality of care. This study has managerial implications by demonstrating the positive correlation between HMO market penetration and improved clinical quality outcomes. This would suggest that improved efficiency caused by limited HMO reimbursement and tight utilization controls encourage hospitals to cut waste as well as improve their clinical care processes. Additionally, our research found that teaching hospitals with higher levels of long-term debt also had improved quality. This shows that increased investments in facilities and advanced technology at teaching hospitals can lead to enhanced quality. PMID:22329326

  11. Pattern of heart failure in a Nigerian teaching hospital

    PubMed Central

    Onwuchekwa, Arthur C; Asekomeh, Godspower E

    2009-01-01

    Background Congestive cardiac failure (CCF) has emerged as a major public health problem worldwide and imposes an escalating burden on the health care system. Objective To determine the causes and mortality rate of CCF in the University of Port Harcourt Teaching Hospital (UPTH), south Nigeria, over a five-year period from January 2001 to December 2005. Methods A retrospective study of CCF cases were identified from the admission and discharge register of the medical wards of UPTH and the case notes were retrieved from the medical records department and analyzed. Results There were 423 patients: 242 males and 181 females. Their ages ranged from 18 to 100 years with a mean of 54.4 ± 17.3. The commonest causes of CCF were hypertension (56.3%) and cardiomyopathy (12.3%). Chronic renal failure, rheumatic heart disease, and ischemic heart disease accounted for 7.8%, 4.3%, and 0.2% of CCF, respectively. Peripartum heart disease was rare despite being commonly reported in northern Nigerian females. Eighteen patients died from various complications with a mortality rate of 4.3%. Conclusion The burden of CCF in the Niger Delta is mainly attributed to hypertension. Efforts should be geared towards hypertension awareness, detection, treatment, and prevention in the region. PMID:19774215

  12. The impact of teaching status on average costs in Spanish hospitals.

    PubMed

    López-Casasnovas, G; Saez, M

    1999-11-01

    In this paper, the observed systematic differences in costs for teaching hospitals (TH) in Spain are examined. Concern has been voiced regarding the existence of a bias in the financing of TH once prospective budgets are introduced for hospital finance. Claims for adjustment to take into account the 'legitimate' extra costs of teaching on hospital expenditure may be well grounded. Focus is on the estimation of the impact of teaching status on average cost, using a version of a multi-product hospital cost function, taking into account some relevant factors from which to derive the observed differences. It is assumed that the relationship between the explanatory and the dependent variables follows a flexible form for each of the explanatory variables. Also, the underlying covariance structure of the data is modelled. Two qualitatively different sources of variation are assumed: random effects and serial correlation. Random variation refers to both general level variation (through the random intercept) and the variation specifically related to teaching status. It is postulated that the impact of the random effects is dominant over the impact of the serial correlation effects. The model is estimated by restricted maximum likelihood. The results show that costs are 9% higher (15% in the case of median costs) in teaching than in non-teaching hospitals. That is, teaching status legitimately explains no more than half of the observed difference in actual costs. The impact on costs of the teaching factor depends on the number of residents, with an increase of 51.11% per resident for hospitals with fewer than 204 residents (third quartile of the number of residents) and 41.84% for hospitals with more than 204 residents. In addition, the estimated dispersion is higher among teaching hospitals. As a result, due to the considerable observed heterogeneity, results should be interpreted with caution. From a policy making point of view, it is concluded that since a higher relative burden for medical training falls on public hospitals, an explicit adjustment for the extra costs that the teaching factor imposes on hospital finance is needed, before hospital competition for inpatient services takes place. PMID:10544329

  13. Abdominal Injuries in University of Port Harcourt Teaching Hospital

    PubMed Central

    Dodiyi-Manuel, Amabra; Jebbin, Nze Japhet; Igwe, Patrick Okechukwu

    2015-01-01

    Background: Abdominal injury is relatively common in both civilian and military casualties and remains a major source of morbidity and mortality. The mechanism of injury may be blunt or penetrating. Some would require operative intervention, whereas others may be managed conservatively. Objective: The aim was to determine the pattern and outcome of management of abdominal injuries in the University of Port Harcourt Teaching Hospital (UPTH). Patients and Methods: This was a prospective study of all patients with abdominal injuries seen and managed in UPTH over a 4-year period (from January 1, 2009 to December 31, 2012). Relevant data were recorded and analyzed using Statistical Package for Social Sciences version 16. Results: Forty-five patients were seen during the study period. There were 40 males (88.9%) and five females (11.1%) making a male to female ratio of 8:1. Their ages ranged from 15 to 45 years with a mean of 27.8 ± 1.6 years and 21 to 30 years was the most commonly affected age group. The mechanism of injury was penetrating in 33 patients (73.3%) and blunt in 12 patients (26.7%). Thirty-four patients (75.6%) had an exploratory laparotomy after resuscitation, while 11 (24.4%) were managed conservatively. Small bowel was the most commonly injured organ following penetrating injury, seen in 14 patients (42.4%) while spleen was the most common in blunt injuries, seen in five patients (41.7%). The most common postoperative complication was surgical site infection, seen in four patients (8.9%). Two patients died giving a mortality rate of 4.4%. Conclusion: Gunshot to the abdomen is the most common cause of abdominal injury in UPTH. Serious campaign and legislation against militant and criminal activities would help to reduce the incidence.

  14. Unplanned Emergency Department Revisits within 72 Hours to a Secondary Teaching Referral Hospital in Taiwan

    Microsoft Academic Search

    Chiu-Lung Wu; Fa-Tsai Wang; Yao-Chiu Chiang; Yuan-Fa Chiu; Teong-Giap Lin; Lian-Fong Fu; Tsung-Lung Tsai

    2010-01-01

    Background: When patients return to the emergency department (ED) shortly after being seen, it is generally assumed that their initial evaluation or treatment was inadequate. Objectives: The purpose of this study was to determine the rates and causes of revisits to the ED of a 710-bed secondary teaching referral hospital (Kuang Tien General Hospital), to identify areas for improvement, and

  15. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...30,000. Example No: 2. Dr. Smith received $25,000 from Hospital X for...department head in a teaching hospital. Dr. Smith also voluntarily furnished direct medical...maximum amount allowable for all of Dr. Smith's services. Computation:...

  16. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...30,000. Example No: 2. Dr. Smith received $25,000 from Hospital X for...department head in a teaching hospital. Dr. Smith also voluntarily furnished direct medical...maximum amount allowable for all of Dr. Smith's services. Computation:...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...30,000. Example No: 2. Dr. Smith received $25,000 from Hospital X for...department head in a teaching hospital. Dr. Smith also voluntarily furnished direct medical...maximum amount allowable for all of Dr. Smith's services. Computation:...

  18. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...30,000. Example No: 2. Dr. Smith received $25,000 from Hospital X for...department head in a teaching hospital. Dr. Smith also voluntarily furnished direct medical...maximum amount allowable for all of Dr. Smith's services. Computation:...

  19. Hospitable Kinship in Theological Education: Cross-Cultural Perspectives on Teaching and Learning as Gift Exchange

    ERIC Educational Resources Information Center

    Wimberly, Anne E. Streaty

    2004-01-01

    Using an autobiographical approach for pedagogical reflection, the author raises questions about how to include "hospitable kinship" and "gift exchange" in teaching and learning. Her experience with a Zimbabwean community circle of hospitable kinship has prompted her to consider how this method of community formation might be employed in classroom…

  20. PERCEPTIONS ON BIOETHICS AMONG PATIENTS PRESENTING TO FAMILY PHYSICIANS AT A TEACHING HOSPITAL IN KARACHI, PAKISTAN

    Microsoft Academic Search

    Waris Qidwai; Hafeez Qureshi; Syed Sohail Ali; Mahboob Alam; Syed Iqbal Azam

    Objective: To study the perceptions on bioethics among patients presenting to family physicians at a teaching hospital in Karachi, Pakistan Study design: Questionnaire based cross sectional survey Settings: The study was carried out at the family practice center, the Aga Khan University Hospital, Karachi Main outcome measures: Perceptions on the broad principles of bioethics Results: Majority of the respondents were

  1. Relationship of Workplace Factors and Job Involvement of Healthcare Employees with Quality of Patient Care in Teaching and Non-teaching Hospitals

    Microsoft Academic Search

    Manisha Agarwal; Abhishek Sharma

    2010-01-01

    The present study examined the effects of certain hospital workplace factors on job involvement among healthcare employees\\u000a at the paramedical levels and quality of patient care in public hospitals in North India. The sample consisted of paramedical\\u000a healthcare employees (N?=?200), from a medical college affiliated teaching hospital and public hospitals (non-teaching) run by the railway services.\\u000a Data were analyzed statistically

  2. Complementary and alternative medicine use among adults in Enugu, Nigeria

    Microsoft Academic Search

    Jane-lovena E Onyiapat; Ijeoma L Okoronkwo; Ngozi P Ogbonnaya

    2011-01-01

    Background  Attention and interest in the use of Complementary and Alternative Medicine (CAM) has been reawakened globally. Evidence from\\u000a studies carried out in different parts of the world has established that CAM use is very common and varies among populations.\\u000a This study investigated the use of CAM among adults in Enugu urban, irrespective of their health status. It provided information\\u000a on

  3. Current status of Staphylococcus aureus infection in a central teaching hospital in Shanghai, China

    PubMed Central

    2013-01-01

    Background To control the spread of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals, infection control measures such as hand hygiene practices were introduced into the teaching hospitals in Shanghai, China, in 2008. Currently, there is limited information characterizing the latest hospital-acquired S. aureus infections in this area. Therefore, we sought to determine the prevalence, molecular characteristics, and genotype-phenotype correlation of hospital-acquired S. aureus infections in Huashan Hospital, one of the largest teaching hospitals in Shanghai. Results Among 608 hospital-acquired S. aureus clinical isolates obtained from January to December of 2011 in Huashan Hospital, 68.1% were MRSA. The predominant MRSA clones were ST239-SCCmecIII and ST5-SCCmecII. ST239 was mainly recovered from respiratory specimens and sterile body fluids, ST5 was associated with respiratory specimens and blood, and ST1 was most prevalent in urine samples. In this study, 31 dispersed sequence types (STs) of methicillin-susceptible S. aureus (MSSA) were identified, most of which caused skin/soft tissue infection and bacteremia. The frequencies of pvl-, muPA-, and qacA/B-positive isolates were 1.6, 9.9, and 11.8% respectively. MuPA was more frequently identified in ST1 and ST5, and qacA/B was more prevalent in ST239 and ST5. Most of the pvl-positive isolates were MSSA, whereas the majority of muPA- and qacA/B-positive isolates were MRSA. ST239 and ST5 had higher resistance rates to multiple antibiotics. In Huashan Hospital, the infection rate in the intensive care unit (ICU) was 3.9 per 1000 hospitalized days, but only 1.2 per 1000 hospitalized days in the other wards. Each ward harbored its own dominant STs. Pulsed-field gel electrophoresis showed diversity within the same epidemic S. aureus clones originating from the same wards. Conclusion There is still a high prevalence of MRSA infections in the teaching hospital in Shanghai. There were also differences in the major infection types caused by MRSA and MSSA, and hospital-acquired S. aureus infections in the ICU of Huashan Hospital pose a greater threat to patient safety than in other wards. The high proportion of multiple antibiotic and chlorhexidine-based antiseptic-resistant clones in this hospital underscores the need for more effective infection control measures to help curtail dissemination of MRSA to hospitalized patients. PMID:23834674

  4. Clinical Nutrition and Foodservice Personnel in Teaching Hospitals have Different Perceptions of Total Quality Management Performance

    Microsoft Academic Search

    YUKYEONG CHONG; NAN UNKLESBAY; RICHARD DOWDY

    2000-01-01

    Objective To investigate the perceived total quality management (TQM) performance of their department by clinical nutrition managers and dietitians, and foodservice managers and supervisors, in hospital food and nutrition service departments.Design Using a 2-part questionnaire containing items about 3 constructs of TQM performance and demographic characteristics, participants rated their perceptions of TQM performance.Subjects Employees in 7 Council of Teaching Hospitals.

  5. The epidemiology of delays in a teaching hospital. The development and use of a tool that detects unnecessary hospital days.

    PubMed

    Selker, H P; Beshansky, J R; Pauker, S G; Kassirer, J P

    1989-02-01

    This study's purpose was to develop a tool that detects, quantifies, and assigns causes for medically unnecessary hospital delays and use it to describe the epidemiology of delays at a teaching tertiary care hospital. Based on observational data, a taxonomy of delays was constructed that included nine major categories and 166 subcategories. This formed the basis for an instrument for detecting inefficiency in hospital care: the Delay Tool. Initially designed for real-time concurrent assessment, in retrospective use it was also reliable, requiring about 6 minutes per medical record. In using the Delay Tool over a 6-month period on general internal medical and gastrointestinal services, it was discovered that 30% of 960 patients experienced delays, the average length of which was 2.9 days. This represented 17% of all hospital days. The most frequent causes of delays were scheduling of tests (31%), unavailability of post-discharge facilities (18%), physician decision-making (13%), discharge planning (12%), and scheduling of surgery (12%). Because of the longer lengths of the delays involved with awaiting postdischarge facilities (primarily nursing home beds), this was the most important cause of delays and represented 41% of all delay days. The general medicine and gastrointestinal services had significantly different distributions of delay types related to their different kinds of patients and care. The Delay Tool should be helpful in addressing hospital, and hospital-related, inefficiencies in health care delivery. PMID:2918764

  6. Design and Implementation of a New Radiology Consultation Service in a Teaching Hospital Perspective

    Microsoft Academic Search

    Ramin Khorasani; Stuart G. Silverman; Jack E. Meyer; Michael Gibson; Barbara N. Weissman; Steven E. Seltzer

    The steady increase in costs related to testing has been a major factor in the overall growth of health care expenses (1). Concern is substantial about the excessive number of tests ordered by physicians without measurable improvement in patients' outcomes (2). This is of particular concern in teaching hospitals, because in addition to the direct impact on national health care

  7. Assistant Professor, Dentistry and Oral Surgery Department of Clinical Sciences, James L. Voss Veterinary Teaching Hospital

    E-print Network

    Assistant Professor, Dentistry and Oral Surgery Department of Clinical Sciences, James L. Voss Professor. Description Summary The Dentistry and Oral Surgery Service at the James L. Voss Veterinary Teaching Hospital is looking for a veterinary dentist to join the dentistry team consisting of 2 faculty

  8. Dental and Oral Surgery Service Clinician Colorado State University Veterinary Teaching Hospital

    E-print Network

    -call for emergency dental and oral surgery care during assignment weeks. Minimum qualifications for this positionDental and Oral Surgery Service Clinician Colorado State University Veterinary Teaching Hospital% (16 weeks) of the time. When on clinic assignment, this position will be expected to cover the dental

  9. Enterococcal urinary tract infections in a teaching hospital

    Microsoft Academic Search

    L. Lemoine; P. R. Hunter

    1987-01-01

    A six year retrospective survey of enterococcal urinary tract infections in hospital inpatients is reported. During the study period there was an increase in the proportion of significant cultures that yielded enterococci. These organisms were more frequently isolated from catheter specimens than midstream specimens of urine and from surgical than from medical wards.

  10. Workload Impact of Medical Subspecialties in the Teaching Hospital

    ERIC Educational Resources Information Center

    Van Peenen, Hubert J.

    1973-01-01

    This paper documents, using a single test as a model, the significant increase in clinical laboratory workload which occurred in a university hospital when strong sections of nephrology, hematology-oncology, and immunology-rheumatology were added to the department of medicine. (Author)

  11. Seroprevalence of human T-cell lymphoma/leukemia virus type-1 (HTLV-1) antibodies among blood donors at Enugu, Nigeria

    PubMed Central

    Okoye, Augustine Ejike; Ibegbulam, Obike Godswill; Onoh, Robinson Chukwudi; Ugwu, Ngozi Immaculata; Anigbo, Chukwudi Simon; Nonyelu, Charles Emeka

    2015-01-01

    Background Human T-cell lymphotrophic/leukemia virus (HTLV-1) is a retrovirus implicated in transfusion-transmitted infection. Objective The objective of this study was to determine the seroprevalence of HTLV-1 antibodies among blood donors at the University of Nigeria Teaching Hospital, Enugu, Eastern Nigeria. Methods A cross-sectional study was carried out on consented participants over 4 months. A total of 300 blood donors were recruited consecutively from the blood bank. The serum of the collected 5 mL of blood obtained from each participant was stored at ?20°C until required for analysis. The serum samples were then analyzed for antibodies to HTLV-1 using a one-step incubation double-antigen sandwich ELISA (enzyme-linked immunosorbent assay) kit. Participants’ demographic characteristics and degree of exposure to the risk factors associated with HTLV-1 infection were captured using a questionnaire. Statistical analysis of results was done using SPSS version 17. Results Of the 300 blood donors, 288 (96%) were male, while 12 (4%) were female. The average age of the blood donors was 26.85±8.52 years. The age group with the highest representation among the blood donors were those aged between 21 and 25 years. Only 22.3% of the blood donors were above 30 years. None of the 300 screened blood donors tested positive to HTLV-1 antibodies. Hence, the seroprevalence of HTLV-1 infection among blood donors was 0%. Of the blood donors, 5% had history of previous sexually transmitted disease, while 34.7% used condoms during sexual intercourse. Conclusion The seroprevalence obtained in this study cannot statistically support the justification of routine screening of blood donors for HTLV-1 infection. More prospective and multicentered studies are required to determine the infectivity of HTLV-1 in blood donors in Nigeria. PMID:25632240

  12. THE FUTURE OF ACADEMIC MEDICAL CENTERS IN SAUDI ARABIA: DIFFICULTIES ENCOUNTERED IN A TEACHING HOSPITAL

    PubMed Central

    Al-Muhanna, Fahd A.

    1999-01-01

    Objective: The objective of this study was to define and analyze the major difficulties experienced and documented in a university teaching hospital. Methodology: The academic medical center (AMC) reviewed was the King Fahd Hospital of the University (KFHU), Al-Khobar, Eastern Saudi Arabia. Data sources included student registration figures, budget allocation and the hospital annual reports. The retrospective analysis was restricted to difficulties encountered. Results: While numbers of medical students increased, staff positions remained static. There was remarkable budgetary deficiency over 9 years; especially for pharmacy, equipment's and supplies. The number of patients’ visit markedly increased. The difficulties encountered were 237 in 70 sections of KFHU. Other problems included recruitment difficulties and the triple role for the faculty; teaching, researching and service. Conclusion: The role of leadership is emphasized to provide answers for the problems; to manage AMC's more efficiently; to find ways of providing medical care more cost-effectively and to generate more funds. PMID:23008600

  13. Oakwood Main Oakwood Main is a major teaching and research hospital and home to three medical residency

    E-print Network

    Finley Jr., Russell L.

    Oakwood Main Oakwood Main is a major teaching and research hospital and home to three year and sports during our 3rd and 4th year. It is a 145 bed hospital Hospital and Medical Center St John is a busy level 1 trauma center located

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

    PubMed

    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. PMID:23081849

  15. Technical efficiency of teaching hospitals in Iran: the use of Stochastic Frontier Analysis, 1999–2011

    PubMed Central

    Goudarzi, Reza; Pourreza, Abolghasem; Shokoohi, Mostafa; Askari, Roohollah; Mahdavi, Mahdi; Moghri, Javad

    2014-01-01

    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. PMID:25114947

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

    PubMed

    Wray, J L; Sadowski, S M

    1998-04-01

    The authors present an overview of current graduate medical education (GME) issues, particularly the financial challenges to teaching hospitals resulting from the Balanced Budget and Tax Payer Relief Acts of 1997 and other recent market-driven factors. They describe in detail the nature of Medicare GME payments before and after the 1997 legislation, with specific examples, and explain the negative financial impact of the legislation and aspects of the legislation that are designed to alleviate that impact. Other factors influencing GME program size and composition are also discussed, including oversupplies or shortages of physicians, the concern that teaching hospitals are using public funds to train international medical graduates, changing training requirements, etc. The authors also describe a recent consulting assignment during which they assisted a major teaching hospital to develop a GME strategy that was responsive to the organization's mission and patients and that took into account future GME financing challenges. Detailed explanations are given of how the consultants analyzed the hospital's GME programs and finances, developed and ranked key institution-specific program criteria (strategic, organizational and operational, and financial), and, in consultation with all key stakeholders, formulated a GME strategy specific to the institution's needs. The authors conclude by cautioning that each institution's GME strategy will be different, but that it is important for institutions to develop such strategies to better face future challenges. PMID:9580713

  17. The Performance of the Ethics Committees in Teaching Hospitals Affiliated With Mashhad University of Medical Sciences

    PubMed Central

    Meraji, Marziyhe; Sadoughi, Farahnaz; Ramezan Ghorbani, Nahid; Nezami, Azar

    2014-01-01

    Background: During the last three decades, ethics committees have been formed with a growing trend. These committees have a satisfactory and effective impact on the pattern of patient care and its performance. The medical ethics committee is considered one of the most active committees in hospitals, having the aim of providing necessary approaches for the optimal use of the findings in empirical science and diagnostic treatment and observance of Islamic noble values in performing medical affairs. Objectives: The aim of this study is to assess the performance of the ethics committees, in the teaching hospitals affiliated with Mashhad University of Medical Sciences, in Mashhad. Patients and Methods: Subjects of this study include teaching hospitals in Mashhad, affiliated with Mashhad University of Medical Sciences and the tool used in gathering the data was a questionnaire, completed based on the information provided by the proceedings of the meetings held by the ethics committees. Also, for the purpose of gathering the suggestions, specifically on the improvement of the performance, a meeting was held with the representatives from hospitals' ethics committees. During the meeting, work reports were presented and recommendations made, based on those presentations. . Results: Findings of the present study suggest that all hospitals under study, have an ethics committee, of which 85.7% operate in combination with other committees. The composition of the members of the committees, in 57.1% of the hospitals, was based on the guidelines for hospital evaluation. Conclusions: For the performance of the medical ethics committees to improve, it is recommended that the hospital administration and evaluation section, hold regular meetings and oblige members to participate more actively. PMID:24910787

  18. The vulnerability of nursing workers to tuberculosis in a teaching hospital.

    PubMed

    de Souza, Juliana Nery; Bertolozzi, Maria Rita

    2007-01-01

    This study aimed to identify aspects that potentially increase the vulnerability of nursing workers to tuberculosis, through the verification of personal life, work and disease knowledge indexes. The sample is composed of 81 nursing workers involved with assistance in the night and day shifts at USP Teaching Hospital, who answered a questionnaire about life and work habits. The sample aggregated the indexes that increase vulnerability to tuberculosis: long professional experience in hospitals and work load longer than 12 hours. Data show that nursing auxiliaries and workers from the night shift in general have a higher number of vulnerability indexes. PMID:17546358

  19. Imaging of gunshot injuries in a west Dublin teaching hospital--a ten year review.

    PubMed

    Murphy, I; Lavelle, L; Ni Mhurchu, E; McCarthy, R; Heffernan, E

    2014-09-01

    There has been an increase in gun-related crime in Ireland over the last decade to gangland violence, especially in west Dublin. This places a burden on hospital services not previously encountered. The aim of this study was to examine the demographics of gunshot: injuries presenting to a Dublin teaching hospital, and the impact on radiology over a ten year period. A total of 65 gunshot injuries were seen. Mortality for high velocity wounds was much higher (10/23, 43%) than for low-velocity shotgun injuries (2/34, 6%). PMID:25282967

  20. Re-engineering surgical services in a community teaching hospital.

    PubMed

    Cohen, M M; Wreford, M; Barnes, M; Voight, P

    1997-04-01

    The Grace Hospital Surgical Services redesign project began in December 1995 and concluded in November 1996. It was led by the Chief of Surgery, the Surgical/Anesthesia Services Director, and the Associate Director of Critical Care/Trauma. The project was undertaken in order to radically redesign the delivery of surgical services in the Detroit Medical Center (DMC) Northwest Region. It encompassed the Grace Hospital Main Operating Room (10 operating theatres) and Post-Anesthesia Recovery Unit, and a satellite Ambulatory Surgery Center in Southfield, Michigan. The four areas of focus were materials management, case scheduling, patient flow/staffing, and business planning. The guiding objectives of the project were to improve upon the quality of surgical services for patients and physicians, to substantially reduce costs, and to increase case volume. Because the Grace Surgical Services redesign project was conducted in a markedly open communicative, and inclusive fashion and drew participation from a broad range of medical professionals, support staff, and management, it created positive ripple effects across the institution by raising staff cost-consciousness, satisfaction, and morale. Other important accomplishments of the project included: Introduction of block scheduling in the ORs, which improved room utilization and turnaround efficiencies, and greatly smoothed the boarding process for physicians. Centralization of all surgical boarding, upgrading of computer equipment to implement "one call" surgery scheduling, and enlarging the capacity for archiving, managing and retrieving OR data. Installation of a 23-hour, overnight recovery unit and provision of physician assistants at the Ambulatory Surgery Center, opening the doors to an expanded number of surgical procedures, and enabling higher quality care for patients. Reduction of FTE positions by 27 percent at the Ambulatory Surgery Center. This yielded a total cost reduction of +1.5 million per annum in the annual budget of +10.3 million; Recruited 10 new podiatrists and increased the volume of cases brought to Northwest Region facilities by surgical specialists. This added 100 cases in 1996, and is projected to add 500 cases in 1997. A 14.5 percent reduction in the cost of operating the Surgical Services was achieved. This was accompanied by enhanced staff morale, physician satisfaction and a higher quality of patient care. PMID:10172985

  1. Teaching the teacher program to assist nurse managers to educate nursing staff in Ecuadorian hospitals.

    PubMed

    Palmer, Sheri P; Heaston, Sondra

    2009-03-01

    Continuing education for hospital staff nurses is a concern worldwide. Current research shows that continuing education among nurses can positively affect patient outcomes (O'Brien, T., Freemantle, N., Oxman, A, et al., 2002. Interactive continuing education workshops or conferences can improve professional practice and patient outcomes. Journal of Evidence Based Nursing. 26 (5)). Seeing a need for improved patient outcomes among hospitals in Ecuador, we conducted a teaching the teacher program to assist nurse managers to carry-out continuing education in their hospital system. This teaching the teacher program was established through the collaboration between one College of Nursing in Utah, USA and a large healthcare system in Guayaquil, Ecuador. The collaboration has been ongoing for five years, 2003 to present. Initial projects included classes for the nursing staff including technical skills, life-saving techniques, and nursing process and assessment. Collaborators from the US and Ecuador believed that in order to maximize the improvement of nursing care in the hospital system it was necessary to turn attention on the nurse managers and not just the staff nurses. This would allow for meaningful ongoing learning beyond the one-time classroom setting. Continuing education is not common in Ecuadorian hospitals as it is in the United States. The purpose of this paper is to describe the project and provide initial evaluative data on the response to the curriculum; including evidence of managers using the teaching principles they were taught. The underlying aim of the project was to achieve a sustainable impact by teaching the leaders of each unit how to be more effective teachers. In May 2007, a two-day "teaching the teacher" workshop was developed with the needs of the managers in mind. The participants in the course included the chief nursing officer and leaders of various units of the hospital. In May 2008 a follow-up class was taught, along with an evaluation by a verbal and written survey with open ended questions and an observation of an actual class being taught by the participants. PMID:19059007

  2. Variations in surgical rates in Quebec: does access to teaching hospitals make a difference?

    PubMed Central

    Blais, R

    1993-01-01

    OBJECTIVE: To document the geographic variations in the rates of 10 common surgical procedures in Quebec and to examine the relation between surgical rates and level of access to teaching hospitals. DESIGN: Population-based rates standardized for age and sex were calculated from 1985-88 data from MED-ECHO (the provincial hospital discharge database) for each of the 32 community health districts (départements de santé communautaire [DSCs]) in Quebec. Variation across DSCs was analysed with the use of the ratio of the highest to the lowest rate, the coefficient of variation and the systematic component of variation. On the basis of an urbanization index designed by Statistics Canada, DSCs were classified as having a low, medium, high or very high level of access to teaching hospitals. PATIENTS: All Quebec residents except those whose DSC of residence could not be traced (accounting for no more than 1.7% of patients for any study procedure) and aboriginal people from northern Quebec. SURGICAL PROCEDURES STUDIED: Appendectomy, cesarean section, cholecystectomy, coronary artery bypass grafting (CABG), hysterectomy, inguinal hernia repair, prostatectomy, tonsillectomy with or without adenoidectomy, total hip replacement and varicose vein stripping. RESULTS: There was considerable systematic variation in the surgical rates for all 10 procedures. Cesarean section, the rates of which varied the least, still exhibited almost a twofold variation between the highest and lowest rates. The rates of tonsillectomy varied the most, by a factor of more than five. With a few exceptions there was relatively little relation between the rates of the procedures within the DSCs. The rates of appendectomy, cholecystectomy, hysterectomy and tonsillectomy tended to be lower in the DSCs containing teaching hospitals, whereas the reverse was true for CABG. For the other procedures the relation between the rates and the level of access to teaching hospitals was nonsignificant. CONCLUSIONS: The overall consistency of the observed variations with those of previous studies invites a closer look at the practice patterns and the scientific basis of the clinical decisions associated with procedures showing high variations in rates. The lack of a systematic relation between the surgical rates and the level of access to teaching hospitals challenges the belief that remote regions are underserved with respect to the procedures studied. PMID:8485676

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

    Microsoft Academic Search

    Edou R. Heddema; Hannen van E. J; Birgitta Duim; Jongh de B. M; Jan A. Kaan; Rob van Kessel; Johannes T. Lumeij; Caroline E. Visser

    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 performed. Sputum samples from patients, throat-swab samples from exposed students and staff, and faecal specimens

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

    PubMed

    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. PMID:10271804

  5. Prospective Assessment of Inpatient Gastrointestinal Consultation Requests in an Academic Teaching Hospital

    Microsoft Academic Search

    Lukejohn W Day; John P Cello; Erin Madden; Mark Segal

    2010-01-01

    OBJECTIVES:To assess the completeness of gastrointestinal (GI) inpatient consultations at an academic teaching hospital.METHODS:We conducted a prospective, cross-sectional study of 278 inpatient GI consultation requests evaluated from 1 July 2005 to 31 May 2007. A questionnaire assessing multiple aspects of the requesting health-care providers' knowledge and documentation of patient information was completed by first-year GI fellows. Completeness of the consultation

  6. Painful medicine: managed care and the fate of America's major teaching hospitals.

    PubMed

    Levey, S; Anderson, L

    1999-01-01

    Healthcare spending in the United States has risen steadily throughout the post-World War II period as the American healthcare system has been transformed from cottage industry to big business. The increasing rate of social investment in healthcare also transformed America's major teaching hospitals. As a case in point, the University of Iowa Hospitals and Clinics saw annual operating revenues rise from $1 million in 1945 to more than $350 million in 1995, which was accompanied by an extraordinary expansion in its physical facilities and in its multifaceted operations. In the 1970s and even more so in the 1980s, however, the unceasing climb in healthcare spending fueled concern among policy experts, politicians, employers, and insurers alike. In turn, the search for effective cost controls led to the current managed care revolution. While the end of that revolution is not yet in sight, managed care has, it appears, effected significant cost savings, but at no small cost to America's major teaching hospitals and their social missions of teaching, research, and patient care. Whether those missions can survive--and, if so, in what form--in a healthcare system dominated by the managed care ethos is an increasingly important concern. PMID:10539198

  7. Woman Health; Uterus Rupture, Its Complications and Management in Teaching Hospital Bannu, Pakistan

    PubMed Central

    QAZI, Qudsia; AKHTAR, Zubaida; KHAN, Kamran; KHAN, Amer Hayat

    2012-01-01

    ABSTRACT Objectives: To evaluate risk factors, management, maternal and fetal outcomes of ruptured uterus at Women and Children Teaching Hospital Bannu, Pakistan. Study design: The prospective observational study was designed from January 2009 to December 2009. A total 64 patients were found with ruptured uterus evaluated in Women and Children Teaching Hospital Bannu, Pakistan. The aim of the study was to evaluate risk factors, management, maternal and fetal outcomes. Results: Frequency of ruptured uterus in hospital was found in 9/ 1000 deliveries, higher than most other studies. Amongst etiological factors the most important were great multiparity 27 (42.2%), injudicious use of Oxytocin 33 (51.6%), obstructed labour 8 (12.5%) and previous caesarean section 12 (18.8%). Of the total number of patients, 49 (76.6%) underwent abdominal hysterectomy (either subtotal or total), 3.1% of them needed bladder repair and 15.6% underwent repair of uterus. 5 (7.8%) died either due to irreversible shock or disseminated intravascular coagulation, 4% of patients had incontinence of urine, 53 (82.8%) of cases delivered dead babies and 9 (14.1%) had severe birth asphyxia needing neonatal intensive care. Conclusion: Uterine rupture is amongst the preventable obstetric complication that carries severe risks both to the mother as to the baby. Health education of people, training and supervision of health personal may reduce incidence especially in remote areas. PMID:23118819

  8. Hospital clonal dissemination of Enterobacter aerogenes producing carbapenemase KPC-2 in a Chinese teaching hospital.

    PubMed

    Qin, Xiaohua; Yang, Yang; Hu, Fupin; Zhu, Demei

    2014-02-01

    Carbapenems are first-line agents for the treatment of serious nosocomial infections caused by multidrug-resistant Enterobacteriaceae. However, resistance to carbapenems has increased dramatically among Enterobacteriaceae in our hospital. In this study, we report clonal dissemination caused by carbapenem-resistant Enterobacter aerogenes (CREA). In 2011, CREA was identified from 12 patients admitted to the neurosurgical ward. All 12 clinical isolates were non-susceptible to cefotaxime, ceftazidime, cefoxitin, ertapenem, imipenem or meropenem. All isolates carried the gene encoding Klebsiella pneumoniae carbapenemase-2 (KPC-2), except for the isolate E4. However, a remarkably lower expression level of the porin OmpF was detected in the non-KPC-2-producing isolate E4 on SDS-PAGE compared with the carbapenem-susceptible isolate. Epidemiological and molecular investigations showed that a single E. aerogenes strain (PFGE type A), including seven KPC-2-producing clinical isolates, was primarily responsible for the first isolation and subsequent dissemination. In a case-control study, we identified risk factors for infection/colonization with CREA. Mechanical ventilation, the changing of sickbeds and previous use of broad-spectrum antibiotics were identified as potential risk factors. Our findings suggest that further studies should focus on judicious use of available antibiotics, implementation of active antibiotic resistance surveillance and strict implementation of infection-control measures to avoid the rapid spread or clonal dissemination caused by carbapenem-resistant Enterobacteriaceae in healthcare facilities. PMID:24273320

  9. Profile of hospital admissions following acute poisoning from a major teaching hospital in North India.

    PubMed

    Raizada, Alpana; Kalra, Om Prakash; Khaira, Ambar; Yadav, Anil

    2012-04-01

    A retrospective analysis of 584 cases of acute poisoning admitted with a medical emergency to the Department of Medicine, GTB Hospital, Delhi, over a three-year period. The patients were analysed with respect to the age, sex, mode of poisoning, type of poison consumed and mortality. Of these, 42.63% were aged 20-30 years. Poisoning was used as a suicidal agent by 63.8% of the patients. The nature of the poison could not be ascertained in 15.92% of patients. Sedatives were involved in 13.36%. Aluminium phosphide poisoning was found in 11.82%. The overall mortality was estimated to be 13.18% with 53.2% being caused by the consumption of aluminium phosphide. There has been a change in the nature of poisons consumed and the number of cases of aluminium phosphide poisoning is declining. However, aluminium phosphide poisoning still remains a major threat as it carries a high mortality rate. PMID:22431821

  10. Testicular biopsies of azoospermic men at the Lagos State University Teaching Hospital

    Microsoft Academic Search

    S. Odunayo Ikuerowo; M. C. Izegbu; A. S. Benebo; I. O. Fadeyibi; F. O. Omodele

    2010-01-01

    Objectives  This study was conducted to evaluate the histological findings from testicular biopsies in azoospermic men seen at the Lagos\\u000a State University Teaching Hospital, Ikeja — Lagos, Nigeria.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and Methods  A retrospective study of testicular biopsies of azoospermic men who presented to our institution from 2005 to 2006 was performed.\\u000a The patient’s age, type of infertility and histopathological diagnosis were evaluted.

  11. Best practice organizational effectiveness in NHS Trusts. Leeds Teaching Hospitals NHS Trust. Case study.

    PubMed

    Zairi, M; Cooke, M; Whymark, J

    1999-01-01

    Measuring organisational effectiveness in a health-care delivery context is quite a challenging task. Although there are numerous performance assessment models, audit tools and managerial diagnostic tools, they all, however, tend to fall short in their attempts to scrutinize how health-care organizations deploy their capabilities to deliver optimum quality in service provision and what performance levels they achieved as a result of their approach. The project reported here attempted to address these issues, reflecting the experience of Leeds Teaching Hospitals, one of a series of Trusts whose approach to organizational effectiveness was closely examined. PMID:10848174

  12. Contamination of mercurochrome and chlorhexidine-cetrimide in a teaching hospital.

    PubMed

    Danchaivijitr, S; Chokloikaew, S; Trakoolsomboon, S; Tangtrakool, T

    1995-07-01

    A study on the contamination of antiseptics was done in a teaching hospital, during March and April 1989. Ninety-five samples of 9 antiseptics from 23 wards were cultured. Results showed that 2 of 12 and 3 of 5 samples of mercurochrome and chlorhexidine-cetrimide compound were contaminated. This led to a wider scale study on the two products. It was found that over one-half of the samples of mercurochrome and 6 of 54 samples of chlorhexidine-etrimide compound were contaminated. Mercurochrome was contaminated by gram-positive and chlorhexidine-cetrimide compound by gram-negative bacteria. Contamination of mercurochrome was found in samples taken from the pharmacy and wards, and of chlorhexidine-cetrimide compound from wards only. Mercurochrome was removed from the hospital formulary and the use of chlorhexidine-cetrimide compound was more restricted. PMID:7545205

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

    PubMed Central

    2014-01-01

    Background 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. Methods 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. Results 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. Conclusions 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 information for patients. PMID:25189274

  14. Evaluation of pharmacy information system in teaching, private and social services Hospitals in 2011

    PubMed Central

    Saghaeiannejad-Isfahani, Sakineh; Mirzaeian, Razieh; Jannesari, Hasan; Ehteshami, Asghar; Feizi, Awat; Raeisi, Ahmadreza

    2014-01-01

    Objective: Supporting a therapeutic approach and medication therapy management, the pharmacy information system (PIS) acts as one of the pillars of hospital information system. This ensures that medication therapy is being supported with an optimal level of safety and quality similar to other treatments and services. Materials and Methods: The present study is an applied, cross-sectional study conducted on the PIS in use in selected hospitals. The research population included all users of PIS. The research sample is the same as the research population. The data collection instrument was the self-designed checklist developed from the guidelines of the American Society of Health System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and PIS users and pharmacists. Findings: The findings of this study were revealed that regarding the degree of meeting the standards given in the guidelines issued by the Society of Pharmacists, the highest rank in observing input standards belonged to Social Services hospitals with a mean score of 32.75. Although teaching hospitals gained the highest score both in process standards with a mean score of 29.15 and output standards with a mean score of 43.95, the private hospitals had the lowest mean score of 23.32, 17.78, 24.25 in input, process and output standards, respectively. Conclusion: Based on the findings, it can be claimed that the studied hospitals had a minimal compliance with the input, output and processing standards related to the PIS. PMID:25013832

  15. An Individual-Based Model of Transmission of Resistant Bacteria in a Veterinary Teaching Hospital

    PubMed Central

    Suthar, Neeraj; Roy, Sandip; Call, Douglas R.; Besser, Thomas E.; Davis, Margaret A.

    2014-01-01

    Veterinary nosocomial infections caused by antibiotic resistant bacteria cause increased morbidity, higher cost and length of treatment and increased zoonotic risk because of the difficulty in treating them. In this study, an individual-based model was developed to investigate the effects of movements of canine patients among ten areas (transmission points) within a veterinary teaching hospital, and the effects of these movements on transmission of antibiotic susceptible and resistant pathogens. The model simulates contamination of transmission points, healthcare workers, and patients as well as the effects of decontamination of transmission points, disinfection of healthcare workers, and antibiotic treatments of canine patients. The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature. The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery). Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001) and better compliance of healthcare workers with hygiene practices (P<0.0001). More frequent decontamination of heavily trafficked transmission points was especially effective at reducing transmission of the model pathogen. PMID:24893006

  16. Iron Deficiency Among Non-Anemic Under-Five Children in Enugu, South-East, Nigeria

    PubMed Central

    Ekwochi, U; Odetunde, OI; Maduka, IC; Azubuike, JC; Obi, IE

    2013-01-01

    Background: Iron deficiency has been described as the world most common nutritional deficiency and the commonest cause of nutritional anemia in infancy and childhood. The deleterious behavioral and cognitive deficit associated with iron-deficiency anemia could be irreversible. Therefore, the latter should be prevented by early detection of iron deficiency in the non-anemic groups. Aim: To determine the prevalence of iron deficiency in the non-anemic under-five children and to document its variation among the age classes of these children. Subjects and Methods: Under-five children presenting at a tertiary hospital were consecutively enrolled, Serum ferritin levels of the subjects were used to assess the iron status and serum ferrritin level of less than 12 ng/ml was considered as iron deficiency. Data were analyzed using SPSS version 15.0. Chi-square tests were employed as necessary for test of significance in each of the characteristics of the population at P ? 0.05. Results: A total of 178 non anemic under-five children were studied, their mean hematocrit and serum ferrritin values were 35.5 (2.8%) and 54.9 (76.1) ng/ml respectively. Forty-nine (27.5% [49/178]) of the study population was iron deficient and there was no significant difference in the prevalence of iron deficiency among the age classes (P = 0.75). Conclusion: This study has documented a high prevalence of iron deficiency in non-anemic under-five children presenting at the outpatient department and emergency room of a tertiary health facility in Enugu. All the age classes were relatively affected. A further research into the causes of iron deficiency in this age group is recommended. PMID:24116322

  17. Desire for prenatal gender disclosure among primigravidae in Enugu, Nigeria

    PubMed Central

    Okeke, Tochukwu C; Enwereji, Jamike O; Okoro, Onyemaechi S; Iferikigwe, Eric S; Ikeako, Lawrence C; Ezenyeaku, Cyril C; Adiri, Charles O

    2015-01-01

    Background Prenatal gender disclosure is a nonmedical fetal ultrasonography view, which is considered ethically unjustified but has continued to grow in demand due to pregnant women’s requests. Objective The aim of this study was to determine the proportion of primigravidae who want prenatal gender disclosure and the reasons for it. Methods This was a descriptive cross-sectional study of randomly selected primigravidae seen at Enugu Scan Centre. The women were randomly selected using a table of random numbers. Results Ninety percent (225/250) of 250 primigravidae who fulfilled the criteria for inclusion in this study wanted to know the gender of their unborn baby, while 10% (25/250) declined gender disclosure. Furthermore, 62% (155/250) of primigravidae had preference for male children. There was statistically significant desire for male gender (P=0.0001). Statistically significant number of primigravidae who wanted gender disclosure did so to plan for the new baby (P=0.0001), and those that declined gender disclosure “leave it to the will of GOD” (P=0.014). Conclusion Ninety percent of primigravidae wanted gender disclosure because of plans for the new baby, personal curiosity, partner and in-laws’ curiosity; moreover, some women wanted to test the accuracy of the findings at delivery and 62% of primigravidae had preference for male children. In view of these results, gender disclosure could be beneficial in this environment. PMID:25792816

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

    PubMed

    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. While it may still take close to a month for Australian practitioners to receive the hard copy of the journal in the mail, a electronic transfer is instantaneous. The globalization of knowledge and practice is one of the largest impacts of the Internet. With one of the most connected populations in the world, Hong Kong is very active in the sharing of knowledge with international experts. PMID:14660882

  19. A two years retrospective review of episiotomy at Jimma Teaching Hospital, southwestern Ethiopia.

    PubMed

    Marai, Wouhabe

    2002-04-01

    Episiotomy is one of the most commonly performed obstetric interventions. The practice has been on the rise since hospital confinement became the tradition of childbirth. Unlike the rising cesarean section rate the rise in episiotomy rate has not been challenged. There is evidence that episiotomy rate of over 30% is not acceptable and it should be done on selective basis than routinely. A retrospective review of all deliveries that took place at Jimma teaching Hospital from Sept 23, 1998 to Sept 23, 2001 was done to determine the episiotomy rate and factors influencing the practice. The overall incidence of episiotomy among 2861 vaginal deliveries was 25%. The incidence of episiotomy by specific procedure was: 6 out of 21 forceps deliveries (29%), 30 out of 101(30%) vacuum deliveries and 8 out of 71(11%) destructive deliveries. 47% of nulliparas and 5% of multiparas needed episiotomy. The mean ages of patruents delivering by episiotomy and spontaneous vertex delivery were 22 +/- 4 and 26 +/- 6 years respectively. The difference was significant (p < 0.0001). There was not statistically significant difference in mean birth weight, head circumference and gestational age between the two groups. The incidence of episiotomy in this study was low compared to the findings of other studies from both developing and developed countries. Similar studies are warranted in other hospitals of the country to address the practice pattern. Prospective studies should be done to establish indications and outcomes of episiotomy. PMID:12240575

  20. Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital

    PubMed Central

    Segon, Ankur; Ahmad, Shahryar; Segon, Yogita; Kumar, Vivek; Friedman, Harvey; Ali, Muhammad

    2014-01-01

    Background Rapid response teams have been adopted across hospitals to reduce the rate of inpatient cardiopulmonary arrest. Yet, data are not uniform on their effectiveness across university and community settings. Objective The objective of our study was to determine the impact of rapid response teams on patient outcomes in a community teaching hospital with 24/7 resident coverage. Methods Our retrospective chart review of preintervention-postintervention data included all patients admitted between January 2004 and April 2006. Rapid response teams were initiated in March 2005. The outcomes of interest were inpatient mortality, unexpected transfer to the intensive care unit, code blue (cardiac or pulmonary arrest) per 1000 discharges, and length of stay in the intensive care unit. Results Rapid response teams were activated 213 times during the intervention period. There was no statistically significant difference in inpatient mortality (3.13% preintervention versus 2.91% postintervention), code blue calls (3.09 versus 2.89 per 1000 discharges), or unexpected transfers of patients to the intensive care unit (15.8% versus 15.5%). Conclusions The implementation of a rapid response team did not appear to affect overall mortality and code blue calls in a community-based hospital with 24/7 resident coverage. PMID:24701312

  1. Influenza and Pneumococcal Vaccine Coverage Rates among Patients Admitted to a Teaching Hospital in South Korea

    PubMed Central

    Noh, Ji Yun

    2015-01-01

    Background Influenza and pneumococcal vaccinations can reduce morbidity and mortality especially in the elderly and patients with chronic medical disease. The purpose of this study was to estimate vaccination coverage of these populations in a hospital setting. Materials and Methods We conducted a cross-sectional, descriptive study involving adult patients admitted to a 1,000-bed teaching hospital on April 15, 2013. We ascertained the information on whether the patient had received influenza vaccination within a year prior to admission or pneumococcal vaccination by interviewing each patient. Results A total of 491 eligible patients aged ?50 years or with chronic medical illnesses were analyzed. The overall vaccination rate for influenza was 57.2%, and that of pneumococcus was 17.6% among the vaccine-eligible subjects. Influenza/pneumococcal vaccination rates of patients by disease were 62.8%/17.2% for diabetes, 53.3%/15.6% for malignancy, 67.6%/23.5% for chronic pulmonary disease, 66.7%/15.3% for chronic cardiovascular disease, 68.7%/26.9% for chronic renal disease, and 51.2%/18.6% for chronic hepatic disease. Young adult patients with chronic medical conditions were consistently less likely to receive influenza and pneumococcal vaccines irrespective of the underlying disease. Conclusion The influenza and pneumococcal vaccine coverage rates among hospitalized patients were low in South Korea. This was especially the case for young adult patients with chronic medical illnesses.

  2. Study of patient satisfaction in a surgical unit of a tertiary care teaching hospital

    PubMed Central

    Mishra, P.H.; Gupta, Shakti

    2012-01-01

    Background The hospitals have evolved from being an isolated sanatorium to a place with five star facilities. Patients and their relatives coming to the hospital not only expect world-class treatment, but also other facilities to make their stay comfortable in the hospital. This change in expectation has come due to tremendous growth of media and its exposure, as well as commercialization and improvement in facilities. The aim of this study was to evaluate the level of patient/relatives satisfaction at tertiary care teaching hospital and feedback from them for improvement of the same. Methods The study was conducted by 1. Review of available national and international literature on the subject. 2. Carrying out survey amongst 50 patients and their relatives at one of the surgical unit by using structured questionnaire. 3. By analyzing the data using appropriate statistical methods. Results Eighty two percent people were satisfied with the service at admission counter while 81% were satisfied with room preparation at the time of admission. The nursing services satisfied 80% of people while 92% were satisfied with explanation about disease and treatment by doctor. The behavior of nurses, doctors and orderlies satisfied 92, 92 and 83% of people. The cleanliness of toilets satisfied only 49% while diet services satisfied 78% of people. Conclusion The five major satisfiers were behavior of doctors, explanation about disease and treatment, courtesy of staff at admission counter, behavior and cooperation of nurses. The five major dissatisfiers were cleanliness of toilets, quality of food, explanation about rules and regulation, behavior of orderlies and sanitary attendant and room preparedness.

  3. Nurses’ perceptions of evidence-based practice: a quantitative study at a teaching hospital in Iran

    PubMed Central

    Shafiei, Ebrahim; Baratimarnani, Ahmad; Goharinezhad, Salime; Kalhor, Rohollah; Azmal, Mohammad

    2014-01-01

    Background: Evidence-based practice (EBP) provides nurses a method to use critically appraised and scientifically proven evidence for delivering quality health care and the best decision that leads to quality outcomes. The purpose of this study was to measure the practice, attitude and knowledge/skill of evidence-based practice of nurses in a teaching hospital in Iran. Methods: This cross-sectional study was conducted in 2011.The study sample was composed of 195 nurses who were working at the Fatemeh Zahra Hospital affiliated to Bushehr University of Medical Sciences (BPUMS). The survey instrument was a questionnaire based on Upton and Upton study. This tool measures Nurses' perceptions in the three sub-scales of practice, attitude and knowledge/skill of evidence-based practice. Descriptive statistical analysis was used to analyze the data. Pearson correlation coefficients were used to examine the relationship between subscales. Results: The overall mean score of the evidence-based practice in this study was 4.48±1.26 from 7, and the three subscales of practice, attitude and knowledge/skill in evidence-based practice were, 4.58±1.24, 4.57±1.35 and 4.39±1.20, respectively. There was a strong relationship between knowledge and performance subscale (r=0.73,p<0.01). Conclusion: Findings of the study indicate that more training and education are required for evidence-based nursing. Successful implementation of evidence-based nursing depends on organizational plans and empowerment programs in hospitals. Hence, hospital managers should formulate a comprehensive strategy for improving EBP. PMID:25694993

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

    PubMed Central

    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

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

    PubMed Central

    2012-01-01

    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 the quality of care. Inadequate participation of staff in education, reporting and analyzing, underreporting and uselessness of aggregated data, limitation of human and financial resources, punitive directions and management challenges for solutions were the main executive problems which could affect the effectiveness of system. PMID:23497710

  6. Teaching physicians-in-training to address racial disparities in health: a hospital-community partnership.

    PubMed Central

    Jacobs, Elizabeth A.; Kohrman, Claire; Lemon, Maurice; Vickers, Dennis L.

    2003-01-01

    Racial and ethnic disparities in health care continue to be a major impediment to improving the health of many communities in the United States. Efforts must be directed at the multiple social, economic, and historic determinants of health disparities. In addition, health care providers must be aware of these determinants and must have the tools to address them in their individual relationships with patients. This article describes a partnership that arose out of the mutual recognition by a community organization and public hospital of the need to (a) teach physicians how to recognize the root causes of health disparities, (b) improve their cross-cultural understanding and communication, and (c) enhance their awareness of the capacity of community resources to positively impact their patients' lives. PMID:12815083

  7. The knowledge of all for the care of one. OHSU is only teaching hospital and conducts more research

    E-print Network

    Chapman, Michael S.

    is the only place in Oregon to grant doctoral degrees in medicine, dentistry and nursing. It is home3 About OHSU The knowledge of all for the care of one. OHSU is only teaching hospital and conducts; and provide care to those who are underserved. We also work to educate the doctors and nurses who will care

  8. Increased risk of tuberculosis in health care workers: a retrospective survey at a teaching hospital in Istanbul, Turkey

    Microsoft Academic Search

    Caglar Cuhadaroglu; Mustafa Erelel; Levent Tabak; Zeki Kilicaslan

    2002-01-01

    BACKGROUND: Tuberculosis (TB) is an established occupational disease affecting health care workers (HCWs). Determining the risk of TB among HCWs is important to enable authorites to take preventative measures in health care facilities and protect HCWs. This study was designed to assess the incidence of TB in a teaching hospital in Istanbul, Turkey. This study is retrospective study of health

  9. Methicillin-Resistant Staphylococcus aureus Outbreak in a Veterinary Teaching Hospital: Potential Human-to-Animal Transmission

    Microsoft Academic Search

    JENNIFER C. SEGUIN; ROBERT D. WALKER; JOHN P. CARON; WESLEY E. KLOOS; CAROL G. GEORGE; RICHARD J. HOLLIS; RONALD N. JONES; MICHAEL A. PFALLER

    1999-01-01

    During a 13-month period, 11 equine patients visiting a veterinary teaching hospital for various diagnostic and surgical procedures developed postprocedural infections from which methicillin (oxacillin)-resistant Staphylococcus aureus (MRSA) strains were isolated. The S. aureus isolates were identified by conventional methods that included Gram staining, tests for colonial morphology, tests for clumping factor, and tests for coagulase and urease activities and

  10. Outcomes following fractured neck of femur in an Australian metropolitan teaching hospital

    PubMed Central

    Chia, P. H.; Gualano, L.; Seevanayagam, S.; Weinberg, L.

    2013-01-01

    Objectives To determine the morbidity and mortality outcomes of patients presenting with a fractured neck of femur in an Australian context. Peri-operative variables related to unfavourable outcomes were identified to allow planning of intervention strategies for improving peri-operative care. Methods We performed a retrospective observational study of 185 consecutive adult patients admitted to an Australian metropolitan teaching hospital with fractured neck of femur between 2009 and 2010. The main outcome measures were 30-day and one-year mortality rates, major complications and factors influencing mortality. Results The majority of patients were elderly, female and had multiple comorbidities. Multiple peri-operative medical complications were observed, including pre-operative hypoxia (17%), post-operative delirium (25%), anaemia requiring blood transfusion (28%), representation within 30 days of discharge (18%), congestive cardiac failure (14%), acute renal impairment (12%) and myocardial infarction (4%). Mortality rates were 8.1% at 30 days and 21.6% at one year. Factors predictive of one-year mortality were American Society of Anesthesiologists (ASA) score (odds ratio (OR) 4.2 (95% confidence interval (CI) 1.5 to 12.2)), general anaesthesia (OR 3.1 (95% CI 1.1 to 8.5)), age > 90 years (OR 4.5 (95% CI 1.5 to 13.1)) and post-operative oliguria (OR 3.6 (95% CI 1.1 to 11.7)). Conclusions Results from an Australian metropolitan teaching hospital confirm the persistently high morbidity and mortality in patients presenting with a fractured neck of femur. Efforts should be aimed at medically optimising patients pre-operatively and correction of pre-operative hypoxia. This study provides planning data for future interventional studies. Cite this article: Bone Joint Res 2013;2:162–8. PMID:23950158

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

    PubMed Central

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

    2015-01-01

    Background: Quality is one of the most important criteria for the success of an information system, which refers to its desirable features of the processing system itself. The aim of this study was the analysis of system quality of hospital information systems (HIS) in teaching hospitals of Isfahan based on the DeLone and McLean model. Materials and Methods: This research was an applied and analytical-descriptive study. It was performed in teaching hospitals of Isfahan in 2010. The research population consisted of the HIS's users, system designers and hospital information technology (IT) authorities who were selected by random sampling method from users’ group (n = 228), and system designers and IT authorities (n = 52) using census method. The data collection tool was two researcher-designed questionnaires. Questionnaires’ reliability was estimated by using Cronbach's alpha was calculated. It was 97.1% for the system designers and IT authorities’ questionnaire and 92.3% for system users’ questionnaire. Results: Findings showed that the mean of system quality score in a variety of HIS and among different hospitals was significantly different and not the same (P value ? 0.05). In general, Kosar (new version) system and Rahavard Rayaneh system have dedicated the highest and the lowest mean scores to themselves. The system quality criterion overall mean was 59.6% for different HIS and 57.5% among different hospitals respectively. Conclusion: According to the results of the research, it can be stated that based on the applied model, the investigated systems were relatively desirable in terms of quality. Thus, in order to achieve a good optimal condition, it is necessary to pay particular attention to the improving factors of system quality, type of activity, type of specialty and hospital ownership type. PMID:25767816

  12. Parents' and Teachers' Preferred Medium of Instruction in Primary Schools in Enugu, Nigeria

    ERIC Educational Resources Information Center

    Amadi, Eugenia Ada

    2012-01-01

    This study which investigated parents' and teachers' preferred medium of instruction in primary schools was conducted in Enugu, South East, Nigeria. It employed the descriptive survey research method. 500 respondents were used for the study. 250 teachers were selected through simple random sampling technique. Two researcher-designed questionnaires…

  13. Lameness and reproductive performance in small ruminants in Nsukka Area of the Enugu State, Nigeria

    Microsoft Academic Search

    C. A Eze

    2002-01-01

    Four communities in Nsukka Area of Enugu State, known for sheep and goat keeping were purposefully selected for this work. Seventy-one sheep and goat farms were visited between January 1995 and December 1999. During the course of visit no one animal was registered twice in one farm during the study except where the cause of lameness was entirely different from

  14. Hospital procedure volume and teaching status do not influence treatment and outcome measures of rectal cancer surgery in a large general population

    Microsoft Academic Search

    Marko Simunovic; Teresa To; Nancy Baxter; Andrew Balshem; Eric Ross; Zane Cohen; Robin McLeod; Paul Engstrom; Elin Sigurdson

    2000-01-01

    A clear benefit of increased hospital procedure volume or teaching hospital status on outcomes of rectal cancer surgery has\\u000a yet to be shown. Few have examined treatment differences that may lead to varying outcomes. This study assessed the impact\\u000a of hospital procedure volume and teaching status on both treatment and outcome measures of rectal cancer surgery in a large\\u000a general

  15. An Audit of Indications, Complications, and Justification of Hysterectomies at a Teaching Hospital in India

    PubMed Central

    Sehgal, Kriti; Hebbar, Shripad; Nambiar, Jayaram; Bhat, Rajeshwari G.

    2014-01-01

    Objective. Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with final histopathology report of all hysterectomies, performed in a premier teaching hospital. Methods. Present study involved all patients who underwent hysterectomy at a premier university hospital in Southern India, in one year (from 1 January, 2012, to 31 December, 2012). Results. Most common surgical approach was abdominal (74.7%), followed by vaginal (17.8%), and laparoscopic (6.6%) hysterectomy. Most common indication for hysterectomy was symptomatic fibroid uterus (39.9%), followed by uterovaginal prolapse (16.3%). Overall complication rate was 8.5%. Around 84% had the same pathology as suspected preoperatively. Only 6 (5 with preoperative diagnosis of abnormal uterine bleeding and one with high grade premalignant cervical lesion) had no significant pathology in their hysterectomy specimen. Conclusion. Hysterectomy is used commonly to improve the quality of life; however at times it is a lifesaving procedure. As any surgical procedure is associated with a risk of complications, the indication should be carefully evaluated. With the emergence of many conservative approaches to deal with benign gynecological conditions, it is prudent to discuss available options with the patient before taking a direct decision of surgically removing her uterus.

  16. Patient Experience of Nursing Quality in a Teaching Hospital in Saudi Arabia

    PubMed Central

    Al Momani, M; Al Korashy, H

    2012-01-01

    Background: Examining the quality of nursing care from the patient's perspective is an important element in quality evaluation. The extent to which patients’ expectations are met will influence their perceptions and their satisfaction with the quality of care received. Methods: A cross-sectional survey was conducted among admitted patients at King Khalid Teaching Hospital, Riyadh, Saudi Arabia. Data were collected (from January 2011 to March 2011) from a convenience sample of 448 patients using a 42-items questionnaire assessing six dimensions of the nursing care provided to, during hospitalization. Results: On a four–point scale (4-higly agree,3-agree, 2-disagree, and 1-higly disagree). The individual items of nursing care showing the lowest means were the information received from the nurses about self-help (2.81), the information about the laboratory results (2.76) and the way the nurse shared the patient's feeling (2.72). A strong correlation existed between the overall perception level and the variables of gender (P=0.01), and the types of department (0.004). Conclusion: The findings of this study demonstrate negative experiences of patients with nursing care in dimensions of information, caring behavior, and nurse competency and technical care. Awareness of the importance of these dimensions of nursing care and ongoing support to investigate patients’ perception periodically toward quality of nursing care are critical to success the philosophy of patient centered health care. PMID:23113223

  17. Quality of nursing care and satisfaction of patients attended at a teaching hospital1

    PubMed Central

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

    2014-01-01

    Objectives assess the quality of nursing care, the patients' satisfaction and the correlation between both. Method 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. Results 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. Conclusion 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. PMID:25029057

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

    PubMed Central

    Jhaveri, Binit N.; Patel, Tejas K.; Barvaliya, Manish J; Tripathi, Chandrabhanu

    2014-01-01

    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. PMID:25276629

  19. Empathy from the Nurses' Viewpoint in Teaching Hospitals of Tabriz University of Medical Sciences, Iran

    PubMed Central

    Parvan, Kobra; Ebrahimi, Hossein; Zamanzadeh, Vahid; Seyedrasooly, Alehe; Dadkhah, Delavar; Jabarzadeh, Faranak

    2014-01-01

    Introduction: Empathy is the ability to put one in the place of others and to better understand their feelings and experiences. According to researchers, there is a type of challenge in using this concept in nursing field. In most cases, the term empathy substitutes other concepts. Regarding this point, it seems quite necessary to research and discuss different dimensions of this concept in different studies. This study aimed to determine empathy regarding the nurses' point of view. Methods: In this descriptive study sample size was selected according to study population or in the other hand all the nurses in 3 general hospital was selected because they are the most important teaching hospital in Tabriz. LEP (La Monica Empathy Profile) was used as empathy tool. Data were analyzed by SPSS Ver. 13.0. Results: In nonverbal behavior dimension, touching the patient was considered as the most effective methods. On the other hand, nurses could not always be able to control stress and they could not always being with patients to show their empathy. Many people believe that nurses showed very little feelings while raggedly the reflective enclosure and they occasionally had to change their schedules to talk to patients. Conclusion: In most cases the nurses support nonverbal behavior, such as reflective, close and touching encountering in establishing relationship with the patient. However, to improve this situation, planning for nurses to become familiar with the ways through which they can express their interest to show empathy would be effective PMID:25276746

  20. Response to the meningococcal meningitis epidemic (MME) at Aminu Kano Teaching Hospital, Kano (2008-2009).

    PubMed

    Iliyasu, G; Lawal, H; Habib, A G; Hassan-Hanga, F; Abubakar, I S; Bashir, U; Tanko-Yakasai, U; Abubakar, S; Abba, M S; Rano, I S; Abdu, H; Musa, B; Gwarzo, G D

    2009-01-01

    In December 2008 an outbreak of Meningococcal Meningitis swept across sub Saharan Africa with Nigeria, especially its northern states worst affected. The management of Aminu Kano Teaching Hospital constituted an Emergency Preparedness & Response (EPR) committee. Over the course of 18 weeks from 5 January 2009 to 15 May 2009, AKTH managed 222 cases of suspected meningitis with 14 deaths (case fatality rate [CFR] of 6.3%). Twenty three per cent (23%) were microbiologically proven as meningococcal meningitis while 9% were confirmed to be pneumococcal meningitis. Male to female ratio was 1:1 with most patients (81%) aged below 14 years. The epidemic peaked in weeks 10 and 13 with 38 admissions in the respective weeks. Meningococcemia with purpura fulminans, post meningitic immune complex cutaneous vasculitis and polyarthritis were observed. Control measures instituted included provision of free ceftriaxone, chemoprophylaxis to contacts, vaccines to staff/families, and creation of dedicated isolation wards. Clinical management guidelines were developed and hospital staffs were also enlightened. Lessons learnt included the difficulty of discriminating between nosocomial transmission and community clusters; relative increase in pneumococcal meningitis during the epidemic; unreliability of penicillin/chloramphenicol; the utility of internet for communication; and the inadequacy of vaccines to meet staff & public demand. PMID:20120153

  1. Survival characteristics of 771 resin-retained bridges provided at a UK dental teaching hospital.

    PubMed

    King, P A; Foster, L V; Yates, R J; Newcombe, R G; Garrett, M J

    2015-04-10

    Objective To analyse the factors affecting the clinical performance and those influencing the survival of resin-retained bridgework provided at a UK dental teaching hospital between 1994 and 2001.Design A prospective analysis of restorations provided at a single centre using case notes with all patients invited for review to corroborate findings.Setting Department of Restorative Dentistry, University of Bristol Dental Hospital and School, Bristol, United Kingdom.Subjects and methods Between January 1994 and December 2001, data regarding 1,000 consecutive resin-retained bridges provided at Bristol Dental Hospital and School were recorded. Data was available for 805 patients at the time of the study. Following invitation, 621 patients attended for a review appointment. Life table and Kaplan-Meir survival analysis were carried out for all restorations provided.Results The five-year and ten-year survival rates estimated by the life-table method are 80.8% (95% confidence interval 78.0-83.6%) and 80.4% (95% confidence interval 77.6-83.2%) respectively. The median survival cannot be estimated for this study as the survival probability remains above 80% even at the longest follow-up. Analysis of clinical variables influencing survival revealed that design of the restoration and experience of the operator providing the restoration were significant factors. Resin-retained bridges made with minimal tooth preparation are shown to be superior in terms of longevity than those for which other types of tooth preparation is made. Patient satisfaction with their treatment was high. PMID:25858740

  2. A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya

    PubMed Central

    2013-01-01

    Objective To measure the incidence of maternal and early neonatal mortality in women who gave birth at Moi Teaching and Referral Hospital (MTRH) in Kenya and describe clinical and other characteristics and circumstances associated with maternal and neonatal deaths following deliveries at MTRH. Methods A retrospective audit of maternal and neonatal records was conducted with detailed analysis of the most recent 150 maternal deaths and 200 neonatal deaths. Maternal mortality ratios and early neonatal mortality rates were calculated for each year from January 2004 to December 2011. Results Between 2004 and 2011, the overall maternal mortality ratio was 426 per 100,000 live births and the early neonatal mortality rate (<7?days) was 68 per 1000 live births. The Hospital record audit showed that half (51%) of the neonatal mortalities were for young mothers (15–24?years) and 64% of maternal deaths were in women between 25 and 45?years. Most maternal and early neonatal deaths occurred in multiparous women, in referred admissions, when the gestational age was under 37?weeks and in latent stage of labour. Indirect complications accounted for the majority of deaths. Where there were direct obstetric complications associated with the delivery, the leading cause of maternal death was eclampsia and the leading cause of early neonatal death was pre-mature rupture of membranes. Pre-term birth and asphyxia were leading causes of early neonatal deaths. In both sets of records the majority of deliveries were vaginal and performed by midwives. Conclusion This study provides important information about maternal and early neonatal mortality in Kenya’s second largest tertiary hospital. A range of socio demographic, clinical and health system factors are identified as possible contributors to Kenya’s poor progress towards reducing maternal and early neonatal mortality. PMID:23421605

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

    PubMed

    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 correlation with performance indexes of these hospitals. Further research regarding structure is suggested in the future. PMID:21287467

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

    PubMed Central

    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 policies in the past and their outcomes were overlooked, while the context was not prepared appropriately and key stakeholders, particularly the government, did not support the decentralization of Iran’s health system. PMID:25844379

  5. Clinical Setting Influences Off-Label and Unlicensed Prescribing in a Paediatric Teaching Hospital

    PubMed Central

    Czarniak, Petra; Bint, Lewis; Favié, Laurent; Parsons, Richard; Hughes, Jeff; Sunderland, Bruce

    2015-01-01

    Purpose To estimate the prevalence of off-label and unlicensed prescribing during 2008 at a major paediatric teaching hospital in Western Australia. Methods A 12-month retrospective study was conducted at Princess Margaret Hospital using medication chart records randomly selected from 145,550 patient encounters from the Emergency Department, Inpatient Wards and Outpatient Clinics. Patient and prescribing data were collected. Drugs were classified as off-label or unlicensed based on Australian registration data. A hierarchical system of age, indication, route of administration and dosage was used. Drugs were classified according to the Anatomical Therapeutic Chemical Code. Results A total of 1,037 paediatric patients were selected where 2,654 prescriptions for 330 different drugs were prescribed to 699 patients (67.4%). Most off-label drugs (n = 295; 43.3%) were from the nervous system; a majority of unlicensed drugs were systemic hormonal preparations excluding sex hormones (n = 22, 32.4%). Inpatients were prescribed more off-label drugs than outpatients or Emergency Department patients (p < 0.0001). Most off-label prescribing occurred in infants and children (31.7% and 35.9% respectively) and the highest percentage of unlicensed prescribing (7.2%) occurred in infants (p < 0.0001). There were 25.7% of off-label and 2.6% of unlicensed medications prescribed across all three settings. Common reasons for off-label prescribing were dosage (47.4%) and age (43.2%). Conclusion This study confirmed off-label and unlicensed use of drugs remains common. Further, that prevalence of both is influenced by the clinical setting, which has implications in regards to medication misadventure, and the need to have systems in place to minimise medication errors. Further, there remains a need for changes in the regulatory system in Australia to ensure that manufacturers incorporate, as it becomes available, evidence regarding efficacy and safety of their drugs in children in the official product information. PMID:25756896

  6. Bacterial Safety of Commercial and Handmade Enteral Feeds in an Iranian Teaching Hospital

    PubMed Central

    Baniardalan, Mahtash; Sabzghabaee, Ali Mohammad; Jalali, Mohammad; Badri, Shirinsadat

    2014-01-01

    Background: This study aimed to investigate and compare the bacterial safety of handmade and commercial ready-to-use enteral feeding formulas used in an Iranian teaching hospital. Methods: In this experimental study, a total number of 70 samples (21 handmade formulas sampled at two sampling times, i.e. the time of preparation and 18 h after preparation, and 28 commercial ready-to-use formulas) were studied. Total count of viable microorganisms, coliform count and Staphylococcus aureus count for all samples were conducted. Results: Out of 42 handmade samples, 16 samples (76%) had total viable counts greater than 103 CFU/g in the first sampling time and 17 samples (81%) had total viable counts greater than 103 CFU/g in the second sampling time. Also, 11 (52%) had coliform contamination in the first sampling time which reached 76% (16 samples) in the second sampling time. Regarding contamination with S. aureus, 5 samples (24%) were contaminated in the first- and 13 samples (62%) were contaminated in the second-sampling time. Out of 28 commercial formulas, 27 samples (96%) had total viable counts greater than 103 CFU/g. Also, 24 samples (86%) were contaminated with S. aureus and 27 samples (96%) were contaminated with coliforms. In order to compare these two formulas, the results of Mann-Whitney test showed that contamination of ready-to-use formulas in all three microbiological samples was significantly more than that for handmade samples. Conclusions: The results of the present study indicate that the microbial safety of enteral feeding solutions in this hospital is much lower than standard values, demonstrating that the development of protocols for clean techniques in the preparation, handling and storage of both commercial and handmade enteral feeds is necessary. PMID:24932392

  7. Study of Attitudes and Practice of Physicians Regarding Consultation-Liaison Psychiatry in Teaching Hospitals of Mazandaran, Iran

    PubMed Central

    Zarghami, Mehran; Farnia, Samaneh; Khalilian, Ali-Reza; Amirian, Tahereh

    2014-01-01

    Objective: Consultation-liaison (CL) psychiatry interfaces between psychiatry and other medical disciplines to promote integrated care of patients. The purpose of this study is evaluation of attitudes and practice of Mazandaran University of Medical Sciences physicians of teaching hospitals regarding CL psychiatry. Methods:In this descriptive study, all of the general practitioners, specialist and subspecialist physicians and assistants working in teaching hospitals of Mazandaran University of Medical Sciences were requested to fill in a questionnaire which was designed based on previous studies and observations to assess their attitudes and practice. Data were analysed by SPSS-16 software, using chi square. Results: One hundred and forty nine (62.6%) physicians had very positive attitudes and 89 cases (37.4%) had positive attitudes; 234 physicians (98.3%) had acceptable practice, and 4 cases (1.7%) had unacceptable practice. There were no significant differences between physicians with positive and very positive attitudes and between physicians with acceptable and unacceptable practice regarding gender, age, education, specialty and place of work (hospital). The most common reasons of physicians for not requesting psychiatric consultation were lack of time, forgetfulness, lack of access to psychiatrist, and lack of belief in the need for psychiatric consultation respectively. Conclusion: The findings of this study indicate the successful psychiatric educations and psychiatrists practice in formation of positive attitudes and acceptable practice regarding CL Psychiatry in these university hospitals. No significant differences between different specialties and work place hospitals indicate that they are similarly affected. PMID:25053955

  8. Social impact of HIV/AIDS on clients attending a teaching hospital in Southern Nigeria.

    PubMed

    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 stakeholders to reduce stigma and discrimination and ensure adequate integration of PLWHA into the society. PMID:23237039

  9. Outcome of forceps delivery in a teaching hospital: A 2 year experience

    PubMed Central

    John, Lopamudra B.; Nischintha, S.; Ghose, Seetesh

    2014-01-01

    Introduction: The art of forceps delivery though existing for centuries has earned a disreputation due to the possibility of poor maternal and fetal outcome. However, its safe use can reduce the rising cesarean section rates in the present times. This study is to see the outcome of its use in a teaching hospital over a 2 year period. Materials and Methods: In this retrospective observational study, 120 cases of forceps delivery were studied for maternal outcome such as injuries, postpartum hemorrhage, and fetal outcome such as Apgar score at birth, neonatal intensive care unit admissions, injury, and mortality. Results: The most common indication was fetal distress (47.5%). A total of 15 cases (12.5%) of maternal injuries occurred, with 2 uterine ruptures one of which was in a previous lower segment caesarean section case, 4 complete perineal tears and 9 minor cervical and vaginal lacerations. A total of 12 babies (10%) had poor Apgar scores who recovered after resuscitation and one out of them died, which was a case of multiple instrumentation. Conclusion: Forceps is a reasonable option for the obstetrician to reduce the caesarean section rates; however, extreme caution, proper expertise and judicial use of this instrument are required to prevent undue risk to mother and fetus. PMID:24678216

  10. Pharmacovigilance Knowledge among Patients at a Teaching Hospital in Lalitpur District, Nepal

    PubMed Central

    Jha, Nisha; Rathore, Devendra S; Shankar, P Ravi; Gyawali, Sudesh

    2014-01-01

    Background: Consumer’s knowledge and perception towards adverse drug reactions (ADR) can play an important role in ensuring a healthy lifestyle and proper use of medicines. Aims: This study aimed to assess the knowledge and perception towards pharma covigilance in general and consumer pharmacovigilance in particular among out patients in a teaching hospital of Nepal. Settings and Design: A descriptive cross-sectional study using qualitative and quantitative methods was carried out from 1st May to 3 June 2013. Methods: Every fifth patient visiting the outpatient pharmacy was interviewed using a semi-structured questionnaire. Gender, age, educational qualification, profession and ethnicity were noted. Twenty-three patients were interviewed. Results: There were 10 males and 13 females. The age of the respondents ranged from 11 to 50 years with a mean age of 27.8 (SD = 5.61) years. Seven (30.43%) respondents were students studying in different levels. Thirteen (56.52%) participants were from the Newar community. Majority of the patients (86.95%) knew ADRs may be caused by the medicines they consume and 18 (78.26%) were of the opinion that ADRs should be reported to doctors and other health care professionals including pharmacists. Conclusion: Knowledge and perception were low in certain areas. There is a need for educational interventions for improving the awareness of patients and general public for ensuring medicine safety and promoting rational use of medicines. PMID:24783073

  11. How a teaching hospital implemented its termination policies for disruptive residents.

    PubMed

    Tulgan, H; Cohen, S N; Kinne, K M

    2001-11-01

    The development of Policy Standards for Termination that both protect and support residents while safeguarding sponsoring institutions has become increasingly necessary. To date, however, there has been little in the literature that discusses policies that have undergone thorough testing to the highest levels of the U.S. judicial system. Berkshire Medical Center (BMC), an acute-care community teaching hospital affiliated with the University of Massachusetts Medical School, developed a set of specific policies to cope fairly with the resident dismissal process. The authors describe a nine-year legal test of these policies in the case of a resident whose disruptive behavior required their implementation. Also presented is a summary of due process as it applies in such cases. The dismissed resident tested the policies through the Courts of the Commonwealth of Massachusetts all the way to the United States Supreme Court, the Equal Employment Opportunity Commission, and the Massachusetts Department of Industrial Accidents. At every level the termination action was upheld. The resident had previously been in two graduate medical education programs at other institutions, and neither of them had communicated issues of concern that would have forewarned BMC's program about potential problems. A plea for honest and open communication between programs is made. This may help to avoid the lengthy, expensive, and potentially serious consequences of such situations. However, the authors emphasize that when such situations arise, strong policies serve as an ultimate legal protection. PMID:11704510

  12. Drug utilization study in ophthalmology outpatients at a tertiary care teaching hospital.

    PubMed

    Jadhav, Pradeep R; Moghe, Vijay V; Deshmukh, Yeshwant A

    2013-12-22

    In view of the advancement in drug development and availability of new ocular therapeutics in the discipline of ophthalmology, we attempted to study the drug utilization and describe the prescribing practices of ophthalmologists in a tertiary care teaching hospital. Method. A prospective, cross-sectional, observational study was conducted on patients attending Outpatient Department of Ophthalmology for curative complaints. Prescriptions of 600 patients treated were analyzed by the WHO prescribing indicators and additional indices. Results. Analysis showed that the average number of drugs per prescription was 1.49. Percentage of drugs prescribed by generic name was 2.35%. Percentage of encounters with antibiotics was 44.83%. Percentage of drugs prescribed from National Essential drug list (NEDL)/National Formulary of India (NFI) was 19.48%. Patient's knowledge of correct dosage was 93.83%. Antimicrobial agents were the most commonly prescribed drugs followed by antiallergy drugs and ocular lubricants. Fluoroquinolones accounted for 60% of the total antimicrobial drugs, of which gatifloxacin was the most frequently prescribed fluoroquinolone. Conclusion. The study indicated an awareness of polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologists to prescribe by generic name and selection of essential drugs from NEDL/NFI. PMID:24455298

  13. Latent Tuberculosis Infection among a Large Cohort of Medical Students at a Teaching Hospital in Italy

    PubMed Central

    Barberis, Ilaria; Mazzarello, Giovanni; Del Bono, Valerio; Viscoli, Claudio; Copello, Francesco; Sossai, Dimitri; Orengo, Giovanni; Sticchi, Laura; Ansaldi, Filippo

    2015-01-01

    The surveillance of latent tuberculosis infection (LTBI) in both healthcare workers and healthcare students is considered fundamental for tuberculosis (TB) prevention. The aim of the present study was to estimate LTBI prevalence and evaluate potential risk-factors associated with this condition in a large cohort of medical students in Italy. In a cross-sectional study, performed between March and December 2012, 1511 eligible subjects attending the Medical School of the University of Genoa, trained at the IRCCS San Martino-IST Teaching Hospital of Genoa, were actively called to undergo the tuberculin skin test (TST). All the TST positive cases were confirmed with an interferon-gamma release assay (IGRA). A standardized questionnaire was collected for multivariate risk analysis. A total of 1302 (86.2%) students underwent TST testing and completed the questionnaire. Eleven subjects (0.8%) resulted TST positive and LTBI diagnosis was confirmed in 2 (0.1%) cases. Professional exposure to active TB patients (OR 21.7, 95% CI 2.9–160.2; P value 0.003) and previous BCG immunization (OR 28.3, 95% CI 3.0–265.1; P value 0.003) are independently associated with TST positivity. Despite the low prevalence of LTBI among Italian medical students, an occupational risk of TB infection still exists in countries with low circulation of Mycobacterium tuberculosis. PMID:25705685

  14. Potential Drug-drug Interactions in Post-CCU of a Teaching Hospital

    PubMed Central

    Haji Aghajani, Mohammad; Sistanizad, Mohammad; Abbasinazari, Mohammad; Abiar Ghamsari, Mahdieh; Ayazkhoo, Ladan; Safi, Olia; Kazemi, Katayoon; Kouchek, Mehran

    2013-01-01

    Drug-drug interactions (DDIs) can lead to increased toxicity or reduction in therapeutic efficacy. This study was designed to assess the incidence of potential drug interactions (PDI) and rank their clinical value in post coronary care unit (Post-CCU) of a teaching hospital in Tehran, Iran. In this prospective study, three pharmacists with supervision of a clinical pharmacist actively gathered necessary information for detection of DDIs. Data were tabulated according to the combinations of drugs in treatment chart. Verification of potential drug interactions was carried out using the online Lexi-Interact™ 2011. A total of 203 patients (113 males and 90 females) were enrolled in the study. The mean age of patients was 61 ± 12.55 years (range = 26-93). A total of 90 drugs were prescribed to 203 patients and most prescribed drugs were atorvastatin, clopidogrel and metoprolol. Mean of drugs was 11.22 per patient. A total of 3166 potential drug interactions have been identified by Lexi- Interact™, 149 (4.71%) and 55 (1.73%) of which were categorized as D and X, respectively. The most serious interactions were clopidogrel+omeprazole and metoprolol+salbutamol. Drug interactions leading to serious adverse effects are to be cautiously watched for when multiple drugs are used simultaneously. In settings with multiple drug use attendance of a pharmacist or clinical pharmacist, taking the responsibility for monitoring drug interactions and notifying the physician about potential problems could decrease the harm in patient and increase the patient safety. PMID:24250596

  15. Medicare. Concerns with Physicians at Teaching Hospitals (PATH) Audits. Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

    This report evaluates the Department of Health and Human Services PATH (Physicians at Teaching Hospitals) initiative involving audits of Medicare billing processes and procedures. The PATH audits resulted from concerns that medical records did not adequately document the direct involvement of teaching physicians in services provided by resident…

  16. [Evolution of neonatal mortality at the Blida University Teaching Hospital (Algeria) between 1999 and 2006].

    PubMed

    Bezzaoucha, A; El Kebboub, A; Aliche, A

    2010-02-01

    Within the framework of the active information system set up by the department of epidemiology on hospital mortality at the Blida (Algeria) University Teaching Hospital (CHU), a study was carried out to assess the importance and evolution of neonatal mortality recorded at the CHU in the last eight years (1999-2006) as well as the causes of neonatal death. The International Classification of Diseases (ICD-9) was used to encode the nature of the causal disease. Using the software EpiInfo™ in its sixth version performed data entry, monitoring and analysis. On the whole, 2,167 neonatal deaths were recorded at the CHU during the study period, representing a proportional mortality of 25.4%. Early neonatal mortality (0-6 days) accounted for 83.4% of all neonatal mortality. Nearly two thirds of early neonatal deaths occurred in the first three days of life. The monthly evolution of the number of early neonatal deaths revealed a significant rising trend during the study period (P < 0.05) without identification of seasonal effect. The sex ratio was practically the same for early and late neonatal mortality, respectively 1.4 and 1.5. Prematurity accounted for 42.1% of the deaths in early neonatal deaths, followed by respiratory distress syndrome and infection, respectively 17.0 and 14.4%. Infections, with a relative frequency of 36.2%, represented the most common cause for the late neonatal mortality. The rate of early neonatal mortality during the study period, when this one took for denominator the number of newborns admitted in neonatology to express the mortality of service, was 15.6%. Throughout the study period, the rate of early neonatal mortality, without counting the deaths among transferred newborms, could be estimated at 19.2 per 1,000 live births, while the overall neonatal mortality rate could be estimated at 22.3 per 1,000 live births. No significant temporal tendency was pointed out. The CHU of Blida is not characterized by a lower risk of neonatal mortality compared to that recorded at national level. The data of the CHU will contribute to assessing the achievement of objectives set by the National programme on the perinatality. PMID:20084486

  17. Drug utilization in pediatric neurology outpatient department: A prospective study at a tertiary care teaching hospital

    PubMed Central

    Bhatt, Krutika M.; Malhotra, Supriya D.; Patel, Kamlesh P.; Patel, Varsha J.

    2014-01-01

    Background: Neurological disorders are a significant cause of morbidity, mortality and adversely affect quality of life among pediatric patients. In India, more than 30% population is under 20 years of age, many of whom present late during the course of illness. Several drugs prescribed to pediatric population suffering from neurological disorders may be off label or unlicensed. Aims and Objectives: To study drug use pattern, identify off-label/unlicensed drug use and to check potential for drug-drug interactions in patients attending outpatient department of pediatric neurology at a tertiary care teaching hospital. Methodology: Prescriptions of patients attending pediatric neurology outpatient department were collected prospectively for 8 weeks. They were analyzed for prescribing pattern, WHO core prescribing indicators, off-label/unlicensed drug use and potential for drug-drug interactions. Result: A total of 140 prescriptions were collected, male female ratio being 2:1. Epilepsy was the most common diagnosis (73.57%) followed by breath holding spells, migraine and developmental disorders. Partial seizure was the most common type of epilepsy (52.42%). Average number of drugs prescribed per patient was 1.56. Most commonly prescribed drug was sodium valproate (25.11%) followed by phenytoin (11.41%). About 16% of the prescriptions contained newer antiepileptic drugs. More than 60% of the drugs were prescribed from WHO essential drug list. In 8.57% of cases drugs were prescribed in off-label/unlicensed manner. Twenty-six percent prescriptions showed potential for drug interactions. Conclusion: Epilepsy is the most common neurological disease among children and adolescents. Sodium valproate is the most commonly prescribed drug. A few prescriptions contained off-label/unlicensed drugs. PMID:25278669

  18. Evaluation of Potential Drug - Drug Interactions in General Medicine Ward of Teaching Hospital in Southern India

    PubMed Central

    Ahmad, Akram; Khan, Muhammad Umair; Ivan, Rahul; Dasari, Ram; Revanker, Megha; Pravina, A.; Kuriakose, Sheetal

    2015-01-01

    Background: Polypharmacy is considered as one of the major risk factors in precipitation of drug-drug interactions (DDIs). Patient population at high risk include the elderly and patients with co morbidities as they are usually prescribed with more number of drugs. Critical evaluation of such prescriptions by pharmacist could result in identification and reduction of such problems. Objective: The study aims to assess the prevalence, severity and significance of potential DDI (pDDI) in general medicine wards of South Indian tertiary care teaching hospital. Materials and Method: A prospective observational study was conducted in a general medicine ward for a period of six months (September 2012 to February 2013). The socio-demographic, clinical characteristics and medication prescribed was documented in a specially designed form. Analysis was carried out to assess the prevalence, severity and significance of identified pDDIs using Micromedex. Descriptive and Univariate analysis were used to report the findings. Results: A total of 404 case records reviewed, 78 (19.3%) patients had pDDIs. A total of 139 (34.4%) pDDIs were reported during the study period. Majority (53.95%, n=75) of the interactions were moderate in intensity and significant in nature (53.23%, n=74). Positive association between number of pDDIs and age was observed. Conclusion: The prevalence of pDDIs was 19.3% which is lesser then previously reported studies from India. Patient with more co-morbidities and elders were observed with more pDDIs. The study highlighted the need to effectively monitor and patients prevent pDDIs to improve patient safety.

  19. Factors influencing heartworm, flea, and tick preventative use in patients presenting to a veterinary teaching hospital

    PubMed Central

    Gates, Maureen C.; Nolan, Thomas J.

    2009-01-01

    The introduction of modern heartworm, flea, and tick preventatives has provided a safe and effective means of controlling companion animal endoparasites, but achieving good owner compliance remains an ongoing challenge for the veterinary profession. Based on a sample of patients from the veterinary teaching hospital at the University of Pennsylvania, this study retrospectively examined factors associated with preventative use and areas of potential weakness in client communication. Between 1999 and 2006, records of 5,276 canine and 1,226 feline patients were searched for signalment, survey results for heartworm, flea, and tick preventative use, date of visit, presenting complaint, vaccination history, and owner zip code. Data were analyzed using bivariate and multivariate techniques. Overall, only 13 - 23 % of patients were questioned about heartworm, flea, or tick preventative use during routine medical history taking. Patients with a prior history of parasites, younger patients, or those presenting with signs of cardiac disease were no more likely to be questioned about preventative use than healthy animals. Patients presenting to a specialty service were also less likely to be questioned. Approximately 74 - 79% of dogs and 12 – 38 % of cats in the sample were on preventative products at any given time. There was a distinct seasonality to preventative use corresponding to the heartworm transmission season from June through November in the northeastern United States. Only 50% of patients seen for a yearly physical examination in winter were reported to be using preventative products when surveyed later in the year, compared to the roughly 85% on patients in heartworm preventatives when they received their routine physical exam in spring. Month of presentation and neuter status were the only signalment factors significantly (P<0.05) associated with preventative use in the multivariate analysis. Findings from this study emphasize target areas for increasing owner compliance. PMID:19931925

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

    SciTech Connect

    Caujolle, Jean-Pierre, E-mail: ncaujolle@aol.co [Department of Ophthalmology, Saint Roch Hospital, Nice Teaching Hospital, 5 rue Pierre Devoluy, BP 319, 06006 Nice cedex 01 (France); Mammar, Hamid [Department of Radiation Oncology, Protontherapy Center, Centre Antoine Lacassagne, 33 avenue Valombrose, 06189 Nice cedex 02 (France); Chamorey, Emmanuel Phar [Department of Biostatistics and Epidemiology, Centre Antoine Lacassagne, 33 avenue Valombrose, 06189 Nice cedex, 02 (France); Pinon, Fabien [Department of Ophthalmology, Saint Roch Hospital, Nice Teaching Hospital, 5 rue Pierre Devoluy, BP 319, 06006 Nice cedex 01 (France); Herault, Joel [Department of Radiation Oncology, Protontherapy Center, Centre Antoine Lacassagne, 33 avenue Valombrose, 06189 Nice cedex 02 (France); Gastaud, Pierre [Department of Ophthalmology, Saint Roch Hospital, Nice Teaching Hospital, 5 rue Pierre Devoluy, BP 319, 06006 Nice cedex 01 (France)

    2010-09-01

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

  1. Informed consent practices for surgical care at university teaching hospitals: a case in a low resource setting

    PubMed Central

    2014-01-01

    Background Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting. Methods A cross-sectional study conducted at three university teaching hospitals in Uganda. Self-guided questionnaires were left at a central location in each of the surgical departments after verbally communicating to the surgeons of the intention of the study. Filled questionnaires were returned at the same location by the respondents for collection by the research team. In addition, 20 in-depth interviews were held with surgeons and a review of 384 patients’ record files for informed consent documentation was done. Results A total of 132 (62.1%) out of 214 questionnaires were completed and returned. Respondents were intern doctors, residents and specialists from General surgery, Orthopedic surgery, Ear, Nose and Throat, Ophthalmology, Dentistry, Obstetrics and Gynaecology departments. The average working experience of respondents was 4.8 years (SD 4.454, range 0–39 years). 48.8% of the respondents said they obtained consent all the time surgery is done while 51.2% did not obtain consent all the time. Many of the respondents indicated that informed consent was not obtained by the surgeon who operated the patient but was obtained either at admission or by nurses in the surgical units. The consent forms used in the hospitals were found to be inadequate and many times signed at admission before diagnosing the patient’s disease. Conclusions Informed consent administration and documentation for surgical health care is still inadequate at University teaching hospitals in Uganda. PMID:24885609

  2. Hospital Acquired Infections Among Patients Admitted in the Medical and Surgical Wards of a Non-Teaching Secondary Care Hospital in Northern India

    PubMed Central

    Ginawi, I.; Saleem, Mohd; Sigh, Mastan; Vaish, A.K.; Ahmad, I.; Srivastava, V.K.; Abdullah, A. Fahad M.

    2014-01-01

    Objective: To investigate the incidence of Nosocomial Infection (NI) and type of bacteriological isolates among the patients admitted in the medical and surgical wards of a non-teaching secondary care hospital in north India. Materials and Methods: This was a cross-sectional hospital based study conducted in the Wards of General Medicine, General Surgery and Orthopaedic of the hospital. The patient were admitted in the department for various surgical procedures, without evidence of initial infection, were included in the study. Results: A total of 176 patients were included in the study of which 82 were from Medical and 94 from Surgical ward. Overall incidence of NI was found to be 26.1% (Medical ward=28%, Surgical ward=24.5%., p=0.58). The isolation rate of Acinetobacter baumanii was (p=0.15) higher among the patients of medical ward (95.7%) than surgical ward (82.6). Escherichia coli was isolated in 89.1% and no significant difference was observed between medical and surgical wards. Klebsiella pneumoniae was isolated in 50% patients and was almost similar (p=0.37) in medical surgical wards. The isolation rate of Pseudomonos aeruginosa, Enterococcus faecalis, Staphylococcus aureus and Coagulase negative staphylococci were 43.5%, 73.9%, 34.8% and 17.4% respectively. A significant difference was observed in the isolation rate of Enterococcus faecalis (p=0.007) and Coagulase negative staphylococci (p=0.002) between medical and surgical wards. Overall, among the patients who developed NI, 27.2% patient’s bacterial isolates were Gram positive (Surgical=64.1, Medical=80%). Conclusion: The incidence of NI is increasing in the hospitals, so extensive that more care has to be taken in cleaning the wards of the hospitals. PMID:24701489

  3. Evaluating the relevance of disability weights for adjusting disease-cost and comorbidity calculations at the Kigali University Teaching Hospital.

    PubMed

    Frank, Verbeke; Frank, De Pauw; Candide, Tran Ngoc; Gustave, Karara; Emmanuel, Gasakure; Marc, Nyssen

    2010-01-01

    Evaluating the burden of diseases treated in hospitals in terms of (co)morbidity and financial impact is a long standing problem. Proposed solutions often rely on very sophisticated medical registration systems that are less suitable for developing countries. The authors have developed a simple prototype method for calculating financial impact and comorbidity of clinical conditions treated in a Sub-Saharan hospital environment (CALCO method) using disability weights. The developed method has been tested for 4 major clinical entities (tuberculosis, nutritional deficiencies, perinatal complications and malaria) on a dataset of 8.309 electronically registered admissions between February 1st 2009 and September 1st 2009 at the Kigali University Teaching Hospital. Results suggest that the method consists an acceptable instrument for estimating the financial burden of diseases treated in the hospital and that the proposed algorithms provide a useful formal method for quantifying hospital-bound comorbidity. The CALCO method might find its use in future implementations of Performance Based Financing (PBF) programs in Africa. PMID:20841790

  4. The effect of new emergency program on patient length of stay in a teaching hospital emergency department of Tehran

    PubMed Central

    Talleshi, Z.; Hosseininejad, S. M.; Khatir, Goli; Bozorghi, F.; Gorji, A. M. Heidari; Gorji, M. A. Heidari

    2014-01-01

    Background and Aim: Ideally, the period of patients admitting in the Emergency Department (ED) should not exceed 6 hours. Prolonged of the patients admitting time affects the ED overcrowding, quality of patient care and patient satisfaction. To evaluate the efficacy of new programs and suggest new strategies to reduce the overcrowding in a typical overcrowded ED of general teaching hospital in Tehran city. Materials and Methods: In this descriptive case study, charts of patients held over 24 hours, in Imam Hossein Hospital affiliated to the Shaheed Beheshti Medical University, were reviewed from April 21rd on August 23rd, 2008. Results: Of 15,477 patients, 151 (1%) have been held in the ED over 24 hours. Reasons for this long-stay included:lack of available bed in Intensive Care Unit (ICU) (125 patients), lack of available bed in related wards (18 patients), poor final decision — making by physician (eight patient) Conclusion: Long-term stay of patients in ED of teaching hospital is a major problem. The most frequent cause is a limitation of inpatient beds. The long stay time had not been affected by paraclinic procedures, multispecialities involvement or the lack of obvious diagnosis. The following solution is proposed: (1) creation of a holding unit, (2) active inter-facility transfer and (3) governing admittance of patients who need ICU care to related wards. PMID:24791047

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

    PubMed Central

    James, Olutayo; Adeyemo, Wasiu L.; Emeka, Christian I.; Ogunlewe, Mobolanle O.; Ladeinde, Akinola L.; Butali, Azeez

    2014-01-01

    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 worldwide. 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. PMID:24647295

  6. Prevalence of carbapenemase-producing Enterobacteriaceae and its impact on clinical outcomes at a teaching hospital in Taiwan.

    PubMed

    Lai, Chung-Chih; Wu, Un-In; Wang, Jann-Tay; Chang, Shan-Chwen

    2013-08-01

    Among 15,174 non-duplicated Enterobacteriaceae isolates, the prevalence of carbapenem-nonsusceptible Enterobacteriaceae (CNSE) was about 2.5% at a teaching hospital in Taiwan during 2010. Among 117 available isolates of CNSE, 8.6% carried genes encoding carbapenemases. Tigecycline and colistin were the most active agents against carbapenemase-producing and non-producing isolates. Patients infected with CNSE had an all-cause in-hospital mortality of 37.3%, and mortality was similar for infections from carbapenemase producers and non-producers (14-day mortality rates: 22.2% and 21.5%; 30-day mortality rates: 22.2% and 32.3%, respectively). Continuous surveillance of CNSE is recommended in Taiwan. PMID:24016614

  7. Controlling a vancomycin-resistant enterococci outbreak in a Brazilian teaching hospital

    Microsoft Academic Search

    M. L. Moretti; L. G. de Oliveira Cardoso; C. E. Levy; A. Von Nowakosky; L. F. Bachur; O. Bratfich; M. L. Leichsenring; R. Fagnani; S. M. Peres Evangelista Dantas; M. R. Resende; P. Trabasso

    2011-01-01

    The purpose of this article was to describe a 2.5-year interventional program designed to control the dissemination after\\u000a a large hospital outbreak of vancomycin-resistant enterococci (VRE) in a tertiary-care university hospital. A VRE working\\u000a group was designated to work specifically on controlling VRE intrahospital dissemination after the detection of the first\\u000a VRE infection at in our hospital in June 2007.

  8. Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana

    PubMed Central

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

    2014-01-01

    Background Autopsies can provide a good indication of the quality of patient care, in terms of the accuracy of clinical diagnosis and the quality of treatment given. Designs This was a cross-sectional study among clinicians at the Korle-Bu Teaching Hospital (KBTH) in 2012. Data were collected with a 69-item, self-administered, structured questionnaire. A total of 215 questionnaires were sent out and 119 clinicians responded. Data were collected on the benefits and utility of autopsies for medical practice, care of patients, and management of clinical wards. Survey data were analyzed by simple descriptive statistics (i.e. proportions, ratios, and percentages). Data were analyzed using SPSS version 21. Objective This study examined the views of clinicians regarding the utility of autopsies and their influence on clinical practice in a large teaching hospital in Ghana. Results Overall, clinicians in KBTH agreed that autopsy reports are useful in answering clinical questions (55/119; 46.2%), confirming or verifying clinical diagnoses (54/119; 45.4%), providing information on unsuspected diagnoses (40/119; 33.6%), and for medical education (90/119; 75.6%). Overall, 70/119 (58.8%) of clinicians agreed that autopsy findings improve completeness and reliability of death certification and provide information on clinical effectiveness of treatment and patient management. However, only 23/119 (19.3%) of sampled clinicians had personal interactions with a pathologist during autopsy processes and 93/119 (78.2%) had not attended any autopsy demonstrations in the past 6 months. Attendance of pathologists at clinicopathological meetings of clinical departments of KBTH was minimal. Unfortunately, the use of autopsy reports for auditing clinical diagnostic performance was not seen as essential. Conclusion Strengthening the interaction between doctors and pathologists is essential in improving the autopsy process and utilization in the hospital. KBTH should create opportunities for doctors to attend autopsy demonstrations and for pathologists to attend clinicopathological meetings in the hospital. PMID:24499743

  9. Bacteriuria and urinary schistosomiasis in primary school children in rural communities in Enugu State, Nigeria, 2012

    PubMed Central

    Ossai, Okechukwu Paulinus; Dankoli, Raymond; Nwodo, Chimezie; Tukur, Dahiru; Nsubuga, Peter; Ogbuabor, Daniel; Ekwueme, Osaeloka; Abonyi, Godwin; Ezeanolue, Echezona; Nguku, Patrick; Nwagbo, Douglas; Idris, Suleiman; Eze, George

    2014-01-01

    Introduction According to a study conducted in1989, Enugu State has an estimated urinary schistosomiasis prevalence of 79%. Recently, studies have implicated bacteriuria co-infection in bladder cancer. These bacteria accelerate the multi-stage process of bladder carcinogenesis. Knowledge about the prevalence of this co-infection is not available in Enugu and the information provided by the 1989 study is too old to be used for current decision making. Methods We carried out a cross-sectional survey of primary school children aged5-15years, who were randomly selected through a multi stage sampling method using guidelines recommended by WHO for schistosomiasis surveys. An interviewer administered questionnaire was used to collect data on demography, socioeconomic variables and clinical presentations. Urine samples were collected between 10.00am and 2.00pm. Each sample was divided into two: (A) for prevalence and intensity using syringe filtration technique and (B) for culture. Intensity was categorized as heavy (>50ova/10mls urine) and light (<50ova/10mls urine). Significant bacteriuria was bacteria count ? 105 colony forming units/ml of urine. Results Of the 842 pupils, 50.6% were females. The prevalence of urinary schistosomiasis was 34.1%. Infection rate was higher(52.8%) among 13-15 years(Prevalence Ratio = 2.45, 95% Confidence Interval 1.63-3.69). Heavy infections wad 62.7% and egg count/10mls urine ranged from 21-1138. Significant bacteriuria among pupils with urinary schistosomiasis was 53.7% compared to 3.6% in the uninfected(PR = 30.8,95% CI 18.91- 52.09). The commonest implicated organism was Escherchia coli. Conclusion We found high prevalence of bacteriuria co-infection among children with urinary schistosomiasis in Enugu State. This underscores the need for concurrent antibiotics administration and follow-up to avert later complications. PMID:25328634

  10. Anti-malaria prescription in pregnancy among general practitioners in Enugu state, south east Nigeria

    PubMed Central

    Ugwu, Emmanuel Onyebuchi; Iferikigwe, E. S.; Obi, S. N.; Ugwu, A. O.; Agu, P. U.; Okezie, O. A.

    2013-01-01

    Background: The national policy on malaria control recommends use of intermittent preventive treatment with sulfadoxine/pyrimethamine (IPT-SP) for chemoprophylaxis against malaria in pregnancy; and use of quinine and arthemisinin-based combination therapy (ACT) for acute treatment of malaria in the first, and second/third trimesters, respectively. In Nigeria, a large proportion of pregnant women are seen by the general practitioners (GPs). Objective: To determine the pattern of anti-malaria prescription in pregnancy among GPs in Enugu state, and access the level of conformity with the national policy on malaria control. Materials and Methods: Questionnaires were administered to a cross-section of 147 GPs that attended the 2010 Enugu state branch of the Nigeria Medical Association Scientific Conference/Annual General Meeting/Election. Results: The mean age of the GPs was 37 ± 3.6 (range 27-70) years. Quinine was the commonly (45.6% (n = 67)) prescribed anti-malaria drug in the first trimester while in the second/third trimester ACT was commonly (48.3% (n = 71)) prescribed. Seventy-six (51.7%) practitioners prescribed IPT-SP for chemoprophylaxis against malaria while the rest (48.3%) prescribed other drugs. GPs who obtained MBBS qualification less than or equal to 5 years prior to the survey were more likely to comply with the national policy on malaria control in their prescriptions (P < 0.05). Conclusion: The pattern of anti-malaria prescription among GPs in Enugu state is varied, and conformed poorly to the evidence-based national policy on malaria control. There is need for continuing professional development to keep the GPs abreast with current trends in malaria treatment during pregnancy. PMID:23798794

  11. Medication errors in a paediatric teaching hospital in the UK: five years operational experience

    Microsoft Academic Search

    L M Ross; J Wallace; J Y Paton

    2000-01-01

    BACKGROUNDIn the past 10 years, medication errors have come to be recognised as an important cause of iatrogenic disease in hospital patients.AIMSTo determine the incidence and type of medication errors in a large UK paediatric hospital over a five year period, and to ascertain whether any error prevention programmes had influenced error occurrence.METHODSRetrospective review of medication errors documented in standard

  12. Graduate medical education's new focus on resident engagement in quality and safety: will it transform the culture of teaching hospitals?

    PubMed

    Myers, Jennifer S; Nash, David B

    2014-10-01

    The Accreditation Council for Graduate Medical Education recently announced its Clinical Learning Environment Review (CLER) program, which is designed to catalyze and promote the engagement of physician trainees in health care quality and patient safety activities that are essential to the delivery of high-quality patient care in U.S. teaching hospitals. In this Commentary, the authors argue that a strong organizational culture in quality improvement and patient safety is a necessary foundation for resident engagement in these areas. They describe residents' influence via their social networks on the behaviors and attitudes of peers and other health care providers and highlight this as a powerful driver for culture change in teaching hospitals. They also consider some of the potential unintended consequences of the CLER program and offer strategies to avoid them. The authors suggest that the CLER program provides an opportunity for health care and graduate medical education leaders to closely examine organizational quality and safety culture and the degree to which their residents are integrated in these efforts. They highlight the importance of developing collaborative interprofessional strategies to reach common goals to improve patient care. By sharpening the focus on patient safety, supervision, professionalism, patient care transitions, and the overall quality of health care delivery in the clinical learning environment during residents' formative training years, the hope is that the CLER program will inspire a new generation of physicians who possess and value these skills. PMID:25054414

  13. Detailed analyses of self-poisoning episodes presenting to a large regional teaching hospital in the UK

    PubMed Central

    Prescott, Katherine; Stratton, Richard; Freyer, Anette; Hall, Ian; Le Jeune, Ivan

    2009-01-01

    AIMS The primary aim of this paper is to provide comprehensive contemporaneous data on the demographics, patterns of presentation and management of all episodes of deliberate self-poisoning presenting to a large regional teaching hospital over a 12 month period. METHODS We undertook detailed, retrospective analyses using information from electronic patient records and local patient-tracking, pathology and administrative databases. Statistical analyses were performed using Chi-squared tests, anova and two-tailed t-tests (Graphpad Prism). RESULTS One thousand five hundred and ninety-eight episodes of deliberate self-poisoning presented over the year. Demographic data and information on the month, day and time of admission are provided. 70.7% presented to the emergency department (ED) within 4 h of ingestion. 76.3% of patients had only one episode in an extended 29 month follow-up period. A mean of 1.72 drugs were taken per episode with just over half of all episodes involving a single drug only. Paracetamol and ibuprofen were the two most commonly ingested drugs involved in 42.5% and 17.3% of all overdoses respectively. 56.3% of patients taking paracetamol reported ingesting over 8 g (one over the counter packet). Detailed mapping of the patients' pathway through the hospital allowed an estimation of the hospital cost of caring for this patient group at £1.6 million pounds per year. CONCLUSIONS We present comprehensive and contemporary data on presentations to hospital resulting from deliberate self-poisoning. We include demographic information, presentation patterns, drugs used, a detailed analysis of episodes involving paracetamol and an estimate of the financial burden to hospitals of overdose presentations. PMID:19694747

  14. Molecular Diagnostics for Lassa Fever at Irrua Specialist Teaching Hospital, Nigeria: Lessons Learnt from Two Years of Laboratory Operation

    PubMed Central

    Hass, Meike; Gabriel, Martin; Ölschläger, Stephan; Becker-Ziaja, Beate; Folarin, Onikepe; Phelan, Eric; Ehiane, Philomena E.; Ifeh, Veritas E.; Uyigue, Eghosasere A.; Oladapo, Yemisi T.; Muoebonam, Ekene B.; Osunde, Osagie; Dongo, Andrew; Okokhere, Peter O.; Okogbenin, Sylvanus A.; Momoh, Mojeed; Alikah, Sylvester O.; Akhuemokhan, Odigie C.; Imomeh, Peter; Odike, Maxy A. C.; Gire, Stephen; Andersen, Kristian; Sabeti, Pardis C.; Happi, Christian T.; Akpede, George O.; Günther, Stephan

    2012-01-01

    Background Lassa fever is a viral hemorrhagic fever endemic in West Africa. However, none of the hospitals in the endemic areas of Nigeria has the capacity to perform Lassa virus diagnostics. Case identification and management solely relies on non-specific clinical criteria. The Irrua Specialist Teaching Hospital (ISTH) in the central senatorial district of Edo State struggled with this challenge for many years. Methodology/Principal Findings A laboratory for molecular diagnosis of Lassa fever, complying with basic standards of diagnostic PCR facilities, was established at ISTH in 2008. During 2009 through 2010, samples of 1,650 suspected cases were processed, of which 198 (12%) tested positive by Lassa virus RT-PCR. No remarkable demographic differences were observed between PCR-positive and negative patients. The case fatality rate for Lassa fever was 31%. Nearly two thirds of confirmed cases attended the emergency departments of ISTH. The time window for therapeutic intervention was extremely short, as 50% of the fatal cases died within 2 days of hospitalization—often before ribavirin treatment could be commenced. Fatal Lassa fever cases were older (p?=?0.005), had lower body temperature (p<0.0001), and had higher creatinine (p<0.0001) and blood urea levels (p<0.0001) than survivors. Lassa fever incidence in the hospital followed a seasonal pattern with a peak between November and March. Lassa virus sequences obtained from the patients originating from Edo State formed—within lineage II—a separate clade that could be further subdivided into three clusters. Conclusions/Significance Lassa fever case management was improved at a tertiary health institution in Nigeria through establishment of a laboratory for routine diagnostics of Lassa virus. Data collected in two years of operation demonstrate that Lassa fever is a serious public health problem in Edo State and reveal new insights into the disease in hospitalized patients. PMID:23029594

  15. Study of prescription of injectable drugs and intravenous fluids to inpatients in a teaching hospital in Western Nepal

    PubMed Central

    Gyawali, Sudesh; Shankar, P Ravi; Saha, Archana; Mohan, Lalit

    2009-01-01

    Unnecessary, excessive and poor injection practices in the South East Asia region (including Nepal) have been observed previously. The authors aim to study prescription of injectable drugs to inpatients in a teaching hospital in Western Nepal. Prescription of injectable drugs (IDs) and intravenous fluids (IVFs) to inpatients discharged from the wards of the Manipal Teaching Hospital during 1st January to 30th June 2006 was studied. The mean number of drugs, IDs and IVFs administered, median cost of drugs and of IDs/IVFs per prescription calculated. Comparison of ID/IVF use in the four major hospital departments (Medicine, Obstetrics and Gynecology, Pediatrics and Surgery) was done. The administration of IDs/IVFs and injectable antimicrobials were measured in Defined Daily Dose (DDD)/100 bed-days and of Intravenous fluid in Liters (L)/100 bed-days. Of the 1131 patients discharged, 938 (82.94%) patients received one or more IDs/IVFs. The mean number of drugs, IDs and IVFs prescribed were 8.75, 4.72 and 1.42. Median cost of drugs and IDs/IVFs per prescription were 8.26US$ and 5.12US$ respectively. IDs/IVFs accounted for 81.37% of total drug cost. The most commonly used ID, injectable antimicrobial and IVF were Diclofenac (19.3 DDD/100 bed-days), Metronidazole (7.68 DDD/100 bed-days) and Dextrose normal saline (8.56 L/100 bed-days), respectively. The total IVF consumption was 24.25 L/100 bed-days. Significant differences between departments were observed (p<0.05). In conclusion, the use of IDs/IVFs was higher compared to other studies. Interventions to improve IDs/IVFs prescribing practices may be required. PMID:19753281

  16. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...and other scientific research). (i) No personal...respect to equipment or facilities donated to the hospital...and (ii) Outpatient visit days (as defined in... (3) Outpatient visit days are determined by counting only one visit day for each...

  17. Time trends and risk factors for diabetes mellitus in cats presented to veterinary teaching hospitals

    Microsoft Academic Search

    Annalisa Prahl; Lynn Guptill; Nita W. Glickman; Mark Tetrick; Larry T. Glickman

    2007-01-01

    Veterinary Medical Data Base records of cats with diabetes mellitus (DM) from 1970 through 1999 were reviewed to identify trends in hospital prevalence of DM and potential host risk factors. Hospital prevalence increased from eight cases per 10,000 in 1970 to 124 per 10,000 in 1999 (P < 0.001). Case fatality percent at first visit decreased from 40% to 10%

  18. What Teachers Learn From Students: Focusing on the Use of Student Products and Qualitative Methods in the Scholarship of Teaching and Learning in Hospitality and Tourism

    Microsoft Academic Search

    Cynthia S. Deale

    2010-01-01

    The Scholarship of Teaching and Learning (SoTL) is a term that is frequently used for discipline-based studies in higher education, and yet it is not commonly described in hospitality and tourism education. This article presents a case for the use of SoTL in hospitality and tourism education, specifically using student-generated products as sources of evidence or data and via qualitative

  19. Acceptability of artificial donor insemination among infertile couples in Enugu, southeastern Nigeria

    PubMed Central

    Ugwu, Emmanuel O; Odoh, Godwin U; Obi, Samuel N; Ezugwu, Frank O

    2014-01-01

    Background Male factor infertility presents one of the greatest challenges with respect to infertility treatment in Africa. Artificial insemination by donor semen (AID) is a cost-effective option for infertile couples, but its practice may be influenced by sociocultural considerations. The purpose of this study was to determine the awareness and acceptability of AID among infertile couples in Enugu, southeastern Nigeria, and identify the sociocultural factors associated with its practices. Methods Questionnaires were administered to a cross-section of 200 consecutive infertile couples accessing care at the infertility clinics of two tertiary health institutions in Enugu, Nigeria, between April 1, 2012 and January 31, 2013. Results Among the 384 respondents, the level of awareness and acceptability of AID were 46.6% (179/384) and 43% (77/179), respectively. The acceptability rate was significantly higher among female respondents, women with primary infertility, and those whose infertility had lasted for 5 years and beyond (P<0.05). The major reasons for nonacceptance of AID were religious conviction (34.7%, n=33), cultural concern (17.9%, n=17), fear of contracting an infection (17.9%, n=17), and fear of possibility of failure of the procedure (12.6%, n=12). Conclusion Health education and public enlightenment are advocated to increase awareness and dispel the current misconceptions about AID in our environment. PMID:24611022

  20. Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria

    PubMed Central

    2013-01-01

    Background Hypertension is a prevalent cardiovascular disease risk factor among blacks and adolescent hypertension can progress into adulthood. Objective To determine the prevalence of hypertension and prehypertension among secondary school adolescents in Enugu South East Nigeria. Methodology A study of 2694 adolescents aged 10-18 years in Enugu metropolis was carried out. Socio-demographic profile anthropometric and blood pressure readings were obtained. Derived measurements such as Prehypertension, hypertension and BMI were obtained. Results The results showed that the mean systolic blood pressure and diastolic blood pressure for males were 106.66+ 11.80 mmHg and 70.25?+?7.34 mmHg respectively. The mean SBP and DBP for females were 109.83+ 11.66 mmHg and 72.23?+?8.26 mmHg respectively (p?

  1. Poor Availability of Skilled Birth Attendants in Nigeria: A Case Study of Enugu State Primary Health Care System

    PubMed Central

    Nkwo, Peter O; Lawani, Lucky O; Ubesie, Agozie C; Onodugo, Vincent A; Obu, Herbert A; Chinawa, Josephat M

    2015-01-01

    Background: The Government of Enugu State plans to offer free perinatal services at the primary health care (PHC) centers in order to improve perinatal outcomes in the state, but it was not clear whether there are skilled birth attendants (SBAs) at the PHC level to implement the program. Aims: To determine whether there are sufficient numbers of SBAs in the public PHC system in Enugu State of Nigeria. Subjects and Methods: This cross-sectional survey involved enumeration of health workers who worked at each public PHC facility in Enugu State and included verification of the qualifications and trainings of each health worker. Data analysis was performed with the help of Stata statistical package version 13 and results were presented in tables and as simple proportions. Results: There were 55 nurses and no midwife or doctor in the 152 PHC clinics studied. This number represents 0.36 nurses per health facility or about 9% (i.e., 55/608) of a minimum of 608 SBAs required for 24-h perinatal services at the 152 PHC clinics. There were 1233 junior community health extension worker/community health extension workers (JCHEW/CHEWs), averaging 8.1 JCHEW/CHEWs per PHC clinic. Conclusions: Enugu State has an acute shortage of SBAs. We recommend employment of qualified SBAs and in-service training of the JCHEW/CHEW and nurses to upgrade their midwifery skills. Incorporation of competency-based midwifery training into the pre-service training curricula of nurses and JCHEW/CHEW would provide a more sustainable supply of SBAs in Enugu state. PMID:25745571

  2. Drugs use pattern for uncomplicated malaria in medicine retail outlets in Enugu urban, southeast Nigeria: implications for malaria treatment policy

    PubMed Central

    2014-01-01

    Background Malaria treatment policy recommends regular monitoring of drug utilization to generate information for ensuring effective use of anti-malarial drugs in Nigeria. This information is currently limited in the retail sector which constitutes a major source of malaria treatment in Nigeria, but are characterized by significant inappropriate use of drugs. This study analyzed the use pattern of anti-malarial drugs in medicine outlets to assess the current state of compliance to policy on the use of artemisinin-based combination therapy (ACT). Methods A prospective cross-sectional survey of randomly selected medicine outlets in Enugu urban, southeast Nigeria, was conducted between May and August 2013, to determine the types, range, prices, and use pattern of anti-malarial drugs dispensed from pharmacies and patent medicine vendors (PMVs). Data were collected and analyzed for anti-malarial drugs dispensed for self-medication to patients, treatment by retail outlets and prescription from hospitals. Results A total of 1,321 anti-malarial drugs prescriptions were analyzed. ACT accounted for 72.7%, while monotherapy was 27.3%. Affordable Medicines Facility-malaria (AMFm) drugs contributed 33.9% (326/961) of ACT. Artemether-lumefantrine (AL), 668 (50.6%) was the most used anti-malarial drug, followed by monotherapy sulphadoxine-pyrimethamine (SP), 248 (18.8%). Median cost of ACT at $2.91 ($0.65-7.42) per dose, is about three times the median cost of monotherapy, $0.97 ($0.19-13.55). Total cost of medication (including co-medications) with ACT averaged $3.64 (95% CI; $3.53-3.75) per prescription, about twice the mean cost of treatment with monotherapy, $1.83 (95% CI; $1.57-2.1). Highest proportion 46.5% (614), of the anti-malarial drugs was dispensed to patients for self-treatment. Treatment by retail outlets accounted for 35.8% while 17.7% of the drugs were dispensed from hospital prescriptions. Self-medication, 82%, accounted for the highest source of monotherapy and a majority of prescriptions, 85.6%, was adults. Conclusion Findings suggest vastly improved use of ACT in the retail sector after eight years of policy change, with significant contributions from AMFm drugs. However the use of monotherapy, particularly through self-medication remains significant with increasing risk of undermining treatment policy, suggesting additional measures to directly target consumers and providers in the sector for improved use of anti-malarial drugs in Nigeria. PMID:24961280

  3. A review of opioid prescription in a teaching hospital in Colombia

    PubMed Central

    Moyano, Jairo; Figueras, Albert

    2012-01-01

    Introduction: Review of opioid prescriptions in a hospital provides valuable information to health care professionals which may contribute to proper pain management; opioid utilization studies may help uncover factors that can be improved for better prescribing. To evaluate the use of opioid analgesics in a university hospital, a review of opioids prescribed in hospitalized patients was developed. Methods: Information was obtained from the pharmacy database and medical records. The study period was 1 month. Results: Medical records of 1156 patients admitted in July 2009 were analyzed. The most widely prescribed opioid was tramadol; the preferred administration route was intravenous; the main indication was severe pain; and major prescribers were from surgical departments. Discussion: Underutilization of potent opioids for acute and chronic pain seems to occur. Conclusion: Most prescribers prefer weak opioids, given intravenously to treat acute and chronic pain, while some patients may benefit from the prescription of more potent opioids. PMID:23049273

  4. Antimicrobial resistance and prevalence of canine uropathogens at the Western College of Veterinary Medicine Veterinary Teaching Hospital, 2002–2007

    PubMed Central

    Ball, Katherine R.; Rubin, Joseph E.; Chirino-Trejo, M.; Dowling, Patricia M.

    2008-01-01

    Between January 2002 and June 2007, uropathogens were isolated from 473 of 1557 canine urine samples submitted to Prairie Diagnostic Services from the Western College of Veterinary Medicine Veterinary Teaching Hospital. Culture and susceptibility results were analyzed, retrospectively, to estimate the prevalence of common bacterial uropathogens in dogs with urinary tract infections and to identify changes in antimicrobial resistance. The most common pathogens identified were Escherichia coli, Staphylococcus intermedius, Enterococcus spp., and Proteus spp. Antimicrobial resistance increased during the study period, particularly among recurrent E. coli isolates. Using the formula to help select rational antimicrobial therapy (FRAT), bacterial isolates were most likely to be susceptible to gentamicin, fluoroquinolones, amoxicillin-clavulanic acid, and groups 4 and 5 (third generation) cephalosporins. PMID:19119366

  5. Mock Hospital Unit Simulation: A Teaching Strategy to Promote Safe Patient Care

    Microsoft Academic Search

    Teresa Gore; Caralise W. Hunt; Kimberly H. Raines

    2008-01-01

    Patient safety is a priority in nursing care. Nursing educators must prepare future registered nurses with the skills necessary to deliver safe, effective care. The purpose of this article is to report on the use of a mock hospital unit with human patient simulation (HPS). Participants were 24 first-semester baccalaureate nursing students out of a class of 79 juniors, and

  6. The role of the clinical psychologist on a burn unit in a general teaching hospital

    Microsoft Academic Search

    Richard A. Bryant; Stephen W. Touyz

    1996-01-01

    This paper reviews the core skills that a clinical psychologist brings to a burn unit and suggests a model for optimal psychological management of burn patients, families, and staff. Recovery from a burn injury involves three stages that comprise (a) acute treatment of severe medical complications, (b) adjustment to hospitalization, and (c) long-term rehabilitation. Each stage contains numerous issues that

  7. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital

    Microsoft Academic Search

    Robert Maunder; Jonathan Hunter; Leslie Vincent; Jocelyn Bennett; Nathalie Peladeau; Molyn Leszcz; Joel Sadavoy; Lieve M. Verhaeghe; Rosalie Steinberg; Tony Mazzulli

    2003-01-01

    Background: The outbreak of severe acute respiratory syndrome (SARS) in Toronto, which began on Mar. 7, 2003, resulted in extraordinary public health and infection control measures. We aimed to describe the psychological and occupational im- pact of this event within a large hospital in the first 4 weeks of the outbreak and the subsequent administrative and mental health response. Methods:

  8. Cost of elective surgery and utilization of ancillary services in teaching hospitals.

    PubMed Central

    Eastaugh, S R

    1979-01-01

    Measures of surgical utilization studied are the number of elective tests performed preoperatively and the total cost per case. The unit of analysis is a matched pair of patients who underwent the same elective procedure, one a Veterans Administration patient, and the other a municipal or voluntary hospital patient. Federal ownership of the hospital ahd the strongest impact on tests and cost per case. On average, costs for the VA patients were 52 percent more per case. The foreign medical graduate variable had a large positive (inflationary) effect on the number of tests, but a slight downward influence in the cost regressions. The fraction of surgeons with faculty appointments had a strong negative (curtailing) impact on elective testing, but an upward influence on cost per case. Additional variables such as age, average laboratory turnaround time, and fraction of the medical school's students doing their surgical clerkship at the hospital ahd a slight upward influence on utilization. The three policy issues raised in the study involve changing the hospital reimbursement incentives, targeting continuing education programs to categories of staff that need it most, and redistributing faculty and students. PMID:528222

  9. A Ten-year Retrospective Study of Tetanus at a Teaching Hospital in Bangladesh

    Microsoft Academic Search

    AHM Feroz; MH RAHMAN

    2007-01-01

    Summary: Aims: To study the demographic, clinical features, treatment as well as outcomes of tetanus patients in the Bangladeshi population from 1994 to 2003. Design: A retrospective descriptive study. Setting: A large public Medical college hospital with a regional as well as referral service. Materials and Methods: All cases of tetanus in adult patients from January 1994 to December 2003

  10. Characterization of CTX-M ?-lactamases in Enterobacteriaceae from major teaching hospitals 

    E-print Network

    Alqurashi, Maher Sulaiman M.

    2013-11-29

    in Escherichia coli and Klebsiella pneumoniae. CTX-M type has been associated with many outbreaks of infections both in the hospitals and community. CTX-M-15 is now identified as the most predominantly distributed CTX-M enzyme. Clonal outbreaks of CTX-M-15...

  11. Cost Containment Education Efforts in U.S. Teaching Hospitals, 1979.

    ERIC Educational Resources Information Center

    Russe, Henry P.; And Others

    1981-01-01

    The rising cost of medical care is seen in large part due to hospital costs, which many planners feel need to be curbed to bring the health care system under control. An Association of American Medical Colleges' survey of medical schools regarding cost containment educational activities is described. (Author/MLW)

  12. [The nurse as preceptor in personnel development in teaching hospitals in Namibia].

    PubMed

    Jooste, K; Nel, C M

    1993-10-01

    A study undertaken in 1991 focused on the role fulfilment of the preceptor in staff development in training hospitals in Namibia. As in the case in many countries the nursing service climate in Namibia is characterised by constant change in the practice of professional nurses. The preceptor must accompany the professional nurses in their personal and professional development. PMID:8261542

  13. Antibiotics Use Patterns for Surgical Prophylaxis Site Infection in Different Surgical Wards of a Teaching Hospital in Ahvaz, Iran

    PubMed Central

    Alavi, Seyed Mohammad; Roozbeh, Fatemeh; Behmanesh, Farzaneh; Alavi, Leila

    2014-01-01

    Background: Despite the effectiveness of prophylactic antimicrobials to prevent surgical site infection the use of antibiotic prophylaxis is often inappropriate. Objectives: The current study aimed to determine the pattern of prophylactic antibiotic use in a teaching hospital affiliated to Jundishapur University of Medical Sciences, Ahvaz, Iran. Patients and Methods: The current descriptive study included 8586 patients who received prophylactic antibiotics before surgery from April 2011 to March 2012, in Razi Hospital affiliated to Jundishapur University of Medical Sciences. Indications for antibiotic use, proper or inappropriate antibiotics, an antibiotic or combination of antibiotics, dosage and length of treatment for each patient based on the infectious disease textbook (Mandel's Principle and practice of infectious diseases) definitions were administrated. Results: Of the total 8586 patients who took antibiotics for preventive purposes, 4815 (56%) required antimicrobial prophylaxis, and 3771 (44%) patients did not. Of the 4815 patients who received prophylaxis, 86.9% received it appropriately, 13.1% received it inappropriately; 8.2% received inappropriate dosage, and 9.5% received antibiotic longer than 24 hours. Conclusions: The current study revealed that 44% of those who received prophylaxis did not need it. In the patients who received antibiotics, the most common mistakes were antibiotic selection followed by prolonged prophylaxis (> 24 hours) and excess dose. PMID:25774270

  14. The epidemiology of sepsis during rapid response team reviews in a teaching hospital.

    PubMed

    Cross, G; Bilgrami, I; Eastwood, G; Johnson, P; Howden, B P; Bellomo, R; Jones, D

    2015-03-01

    In a three-month retrospective study, we assessed the proportion of rapid response team (RRT) calls associated with systemic inflammatory response syndrome (SIRS) and sepsis. We also documented the site of infection (whether it was community- or hospital-acquired), antibiotic modifications after the call and in-hospital outcomes. Amongst 358 RRT calls, two or more SIRS criteria were present in 277 (77.4%). Amongst the 277 RRT calls with SIRS criteria, 159 (57.4%) fulfilled sepsis criteria in the 24 hours before and 12 hours after the call. There were 118 of 277 (42.6%) calls with SIRS criteria but no evidence of sepsis and 62 of 277 (22.3%) calls associated with both criteria for sepsis as well as an alternative cause for SIRS. Hence, 159 (44.4%) of all 358 RRT calls over the three-month study period fulfilled criteria for sepsis and in 97 (159-62) (27.1%) of the 358 calls, there were criteria for sepsis without other causes for SIRS criteria. The most common sites of infection were respiratory tract (86), abdominal cavity (38), urinary tract (26) and bloodstream (26). Infection was hospital-acquired in 91 (57.2%) and community-acquired in 67 (42.1%) cases, respectively. Patients were on antibiotics in 127 of 159 (79.9%) cases before the RRT call and antibiotics were added or modified in 76 of 159 (47.8%) cases after RRT review. The hospital length-of-stay of patients who received an RRT call associated with sepsis was longer than those who did not (16.0 [8.0 to 28.5] versus 10 days [6.0 to 18.0]; P=0.002). PMID:25735684

  15. A prospective review of the labor analgesia programme in a teaching hospital

    PubMed Central

    Sikdar, Indranil; Singh, Shivinder; Setlur, Rangraj; Mohan, C.V.R.; Datta, Rashmi; Patrikar, S.R.

    2013-01-01

    Background The structured labor analgesia programme in our tertiary care hospital has been in place for the past few years. We undertook this study to analyze the programme and to draw conclusions to further improve the outcomes. Methods A prospective analysis of the data pertaining to 200 patients participating in an ongoing labor analgesia programme in a tertiary care hospital from Nov 2008 to Aug 2009 was performed. Results Mean visual analog score (VAS) before epidural block was 8.34 ± 0.79. Post procedure the average VAS score was 2.20 ± 0.79. One hundred and fifty six (78%) parturients delivered vaginally, 18 (9%) required instrumentation with vacuum including 1 forceps delivery in a multiparous parturient. In 17parturients (8.7%) fetal distress led to a decision to perform LSCS for delivery. Multiparous patients were significantly more satisfied as compared to nulliparous patients (p = 0.010). Conclusion The study demonstrated excellent pain relief and patient satisfaction with minimal complications. The safety and efficacy of epidural bupivacaine in concentrations less than 0.625% combined with 25 mcg of fentanyl demonstrated in our study should be considered are commendation for the widespread adoption of the procedure in tertiary care hospitals. PMID:24600144

  16. Identification and management of adverse effects of antipsychotics in a tertiary care teaching hospital

    PubMed Central

    Lucca, Jisha Myalil; Madhan, Ramesh; Parthasarathi, Gurumurthy; Ram, Dushad

    2014-01-01

    Objective: Antipsychotics have revolutionized psychiatry by allowing significant numbers of patients in long-term hospital settings to be discharged and successfully maintained in the community. However, these medications are also associated with a range of adverse events ranging from mostly annoying to rarely dangerous. This study is carried out to identify the adverse drug reactions (ADRs) to antipsychotics and its management in psychiatric patients. Methods: Prospective interventional study was conducted in the psychiatric unit of a tertiary care hospital. Patients of any age and either sex prescribed with at least one antipsychotic were included and monitored for ADRs. Findings: Among the 517 patients receiving antipsychotics, a total of 289 ADRs were identified from 217 patients at an overall incidence rate of 41.97%. Sixty-seven different kinds of ADRs were observed in the study patients. Central and peripheral nervous system was the most commonly affected system organ class (n = 59) and weight gain (n = 30) was the most commonly observed ADR. Olanzapine was most commonly implicated in reported ADRs (n = 92) followed by risperidone (n = 59). Of the 289 ADRs, 80% required interventions including cessation of drug and/or specific/symptomatic/nonpharmacological treatment. Conclusion: This post marketing surveillance study provides a representative data of the ADR profile of the antipsychotics likely to be encountered in psychiatric patients in an Indian tertiary care hospital. PMID:25114936

  17. Changing Pattern of Bacteriuria among Asymptomatic Secondary School Adolescents within Enugu South East Nigeria

    PubMed Central

    Nwokocha, ARC; Ujunwa, FA; Onukwuli, VO; Okafor, HU; Onyemelukwe, N

    2014-01-01

    Background: Urinary tract infection is one of the infections that could lead to chronic kidney disease. Most of the offending isolates are usually Gram-negative bacteria such as Escherichia coli. Adolescent age groups are a special group of individuals who indulge in some risk behavior that could predispose them to urinary tract infections with possible mixed flora. Aim: The aim was to determine the burden of Gram-positive significant bacteriuria among adolescents in Enugu. Subjects and Methods: A survey of 628 adolescents attending secondary schools in Enugu was studied. Information on sociodemographic profile was obtained using a self-administered questionnaire. Clean-catch urine sample was collected using a sterile boric acid bottle, and this was cultured in both anaerobic and aerobic media. Significant isolates were Gram-stained in order to determine their characteristics. Data were analyzed using SPSS version 15.0.(Chicago Illinois USA). Results: There were 324 females and 304 males. Significant bacteria growth was identified in 61 samples giving a prevalence rate of 9.7% (61/628). Gram-positive bacteria were isolated in 77.1% (47/61) of samples, while Gram-negative bacteria were isolated in 22.9% (14/61) of samples. Staphylococcus saprophyticus was the most common Gram-positive organism isolated this consists 38.3% (18/47) while E. coli was the most common Gram-negative bacteria isolated comprising 64.2% (9/14). Other Gram-positive bacteria isolated were Staphylococcus auerus, Staphylococcus epididimis. All isolated bacteria were more common in females 44/61 (72.1%) than males 17/61 (27.9%). Conclusion: Gram-positive bacteriuria is prevalent among secondary school adolescents, and S. saprophyticus is the most common Gram-positive organism implicated. Further studies should be undertaken to determine the risk factors and possible sensitivity pattern among the age group. PMID:25328783

  18. A prospective study of surgical site infections in a teaching hospital in Goa

    Microsoft Academic Search

    Umesh S. Kamat; A. M. A. Fereirra; M. S. Kulkarni; D. D. Motghare

    2008-01-01

    Introduction  Surgical Site Infections contribute significantly to increased health care costs in terms of prolonged hospital stay and lost\\u000a work days. The problem was largely unexplored in an apex medical institute in Goa.\\u000a \\u000a \\u000a \\u000a Aims and Objectives  To estimate the incidence, and study the bacteriology and the factors associated with SSI in the study setting.\\u000a \\u000a \\u000a \\u000a Settings and Design  Prospective study in the surgical wards

  19. Impact of a hospital-wide multifaceted programme for reducing carbapenem-resistant Enterobacteriaceae infections in a large teaching hospital in northern Italy.

    PubMed

    Viale, P; Tumietto, F; Giannella, M; Bartoletti, M; Tedeschi, S; Ambretti, S; Cristini, F; Gibertoni, C; Venturi, S; Cavalli, M; De Palma, A; Puggioli, M C; Mosci, D; Callea, E; Masina, R; Moro, M L; Lewis, R E

    2015-03-01

    We performed a quasi-experimental study of a multifaceted infection control programme for reducing carbapenem-resistant Enterobacteriaceae (CRE) transmission and bloodstream infections (BSIs) in a 1420-bed university-affiliated teaching hospital during 2010-2014, with 30 months of follow-up. The programme consisted of the following: (a) rectal swab cultures were performed in all patients admitted to high-risk units (intensive-care units, transplantation, and haematology) to screen for CRE carriage, or for any room-mates of CRE-positive patients in other units; (b) cohorting of carriers, managed with strict contact precautions; (c) intensification of education, cleaning and hand-washing programmes; and (d) promotion of an antibiotic stewardship programme carbapenem-sparing regimen. The 30-month incidence rates of CRE-positive rectal cultures and BSIs were analysed with Poisson regression. Following the intervention, the incidence rate of CRE BSI (risk reduction 0.96, 95% CI 0.92-0.99, p 0.03) and CRE colonization (risk reduction 0.96, 95% CI 0.95-0.97, p <0.0001) significantly decreased over a period of 30 months. After accounting for changes in monthly census and percentage of externally acquired cases (positive at ?72 h), the average institutional monthly rate of compliance with CRE screening procedures was the only independent variable associated with a declining monthly incidence of CRE colonization (p 0.002). The monthly incidence of CRE carriage was predictive of BSI (p 0.01). Targeted screening and cohorting of CRE carriers and infections, combined with cleaning, education, and antimicrobial stewardship measures, significantly decreased the institutional incidence of CRE BSI and colonization, despite endemically high CRE carriage rates in the region. PMID:25658534

  20. Donor blood procurement and utilisation at the University of Benin Teaching Hospital, Benin City.

    PubMed

    Enosolease, M E; Imarengiaye, C O; Awodu, O A

    2004-08-01

    Banked blood is a limited resource in Nigeria. We sought to evaluate factors that may further limit the effective utilisation of donor blood in a tertiary hospital in Benin City. The records of the blood transfusion unit of the hospital were studied to identify the methods of blood procurement and utilisation from January 1, 2000 to December 31, 2002. A total of 11,021 units of blood were received in the blood transfusion unit within this period out of which 1491 (13.5%) donor blood samples were found unfit for transfusion and, hence, discarded. Commercial blood donation accounted for 95.3%, compared to 4.7% from replacement and volunteer donors. Commercial blood donation was a major risk factor for likely disposal of donor blood (chi2 = 74.3, p < 0.0001, OR = 21.1. 95% CI = 7.8-56.7). Expired units of blood with low PCV were discarded for lack of infrastructure to fractionate and store them. Over 0.8million naira (US$6000.00) is wasted annually on discarded units of donor blood mainly from commercial donors. A policy on blood procurement to include subgroup selection of donors and improved funding of blood banking services may enhance efficient and effective utilisation of donor blood. PMID:15623119

  1. Clinical profile of carpal tunnel syndrome in a teaching hospital

    PubMed Central

    Malibary, Hussein Mohammed; Al-Najjar, Afnan Tawfeeg; Mohammed Yassen, Dina; Almarzouki Abuhussain, Hamad Abdullah; Radhwi, Osman Omer; Ridha Alfares, Zainab

    2013-01-01

    Objectives: The aim of this study was to review the clinical characteristics and demography of Carpel Tunnel Syndrome (CTS) cases presented to a university hospital. Methodology: A retrospective study was done for 336 consecutive patients (290 females and 46 males), referred with a clinical diagnosis of CTS to the Neuro-diagnostic laboratory at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 2007 and December 2010. All subjects had clinical evaluation and standardized nerve conduction studies (672 hands) performed by the same examiner. Results: Carpal tunnel syndrome was confirmed in 640 hands (95.23%) with female predominance (86.3%). The mean age was 52.4 in females and 54.4 years in males with overall highest occurrence among the age group 45- < 55 years. Bilateral CTS was confirmed in the majority of the patients, i.e., 304(90.5%), and remaining were unilateral. Among unilateral pattern, 22 (68.8%) had right CTS and others had left CTS. Most of the patients were treated conservatively 85.4% while the rest had surgical decompression 14.6%. Conclusion: Overall predominant age group was 45-<55 years with female dominancy. Majority of subjects had bilateral CTS as well as conservative treatment was frequent. PMID:24353521

  2. Knowledge and Awareness of Diabetes and Diabetic Ketoacidosis (DKA) Among Medical Students in a Tertiary Teaching Hospital: An Observational Study

    PubMed Central

    Thangaraju, Pugazhenthan; Kumar, Suresh; Aravindan, U; Balasubramanian, Hariharan; Selvan, Tamil

    2014-01-01

    Background: The management of Diabetes Mellitus and its important complication Diabetic Ketoacidosis is very crucial in today’s world where the prevalence of Diabetes is very high. Medical students are the pillars of our future healthcare system and it is important to evaluate and update their knowledge and awareness regarding these both conditions. Materials and Methods: This study was a cross-sectional; Questionnaire based observational study conducted in a tertiary care hospital. The respondents were final year MBBS students of that college. Study instrument was a self developed, pre-validated, semi-structured questionnaire. Results: A total of 73 questionnaires were considered for analysis, giving a response rate of 90.12% with 43.83% and 56.16% were male and female respondents respectively. About 81.25% and 90.24% of male and female respondents gave correct answer to question related to the best indicator of glycemic control. Lack of knowledge was seen regarding the world Diabetes day. Approximately 37% of the respondent’s parents were diabetic. Only 12 out of 73 respondents were aware about the factors leading to DKA.8 out of 73 were aware about investigations to be done in DKA. Around 43.84% of responders knew regarding the proper screening duration in person with risk of diabetes. Conclusion: From the study it was concluded that most of the students have basic knowledge regarding diabetes mellitus, its clinical features and management etc but only 50 % of the respondent were aware about DKA and further teaching and post teaching evaluation are needed in future direction. PMID:24959462

  3. Cost of providing inpatient burn care in a tertiary, teaching, hospital of North India.

    PubMed

    Ahuja, Rajeev B; Goswami, Prasenjit

    2013-06-01

    There is an extreme paucity of studies examining cost of burn care in the developing world when over 85% of burns take place in low and middle income countries. Modern burn care is perceived as an expensive, resource intensive endeavour, requiring specialized equipment, personnel and facilities to provide optimum care. If 'burn burden' of low and middle income countries (LMICs) is to be tackled deftly then besides prevention and education we need to have burn centres where 'reasonable' burn care can be delivered in face of resource constraints. This manuscript calculates the cost of providing inpatient burn management at a large, high volume, tertiary burn care facility of North India by estimating all cost drivers. In this one year study (1st February to 31st January 2012), in a 50 bedded burn unit, demographic parameters like age, gender, burn aetiology, % TBSA burns, duration of hospital stay and mortality were recorded for all patients. Cost drivers included in estimation were all medications and consumables, dressing material, investigations, blood products, dietary costs, and salaries of all personnel. Capital costs, utility costs and maintenance expenditure were excluded. The burn unit is constrained to provide conservative management, by and large, and is serviced by a large team of doctors and nurses. Entire treatment cost is borne by the hospital for all patients. 797 patients (208 <12 years old) with acute burn were admitted with a mean age of 23.04 years (range 18 days to 83 years). The mean BSA burn was 42.26% (ranging from 2% to 100%). 378/797 patients (47.43%) sustained up to 30% BSA burns, 216 patients (27.1%) had between 31 and 60% BSA and 203 patients (25.47%) had >60% BSA burns. 258/797 patients died (32.37%). Of these deaths 16, 68 and 174 patients were from 0 to 30%, 31 to 60% and >60% BSA groups, respectively. The mean length of hospitalization for all admissions was 7.86 days (ranging from 1 to 62 days) and for survivors it was 8.9 days. There were 299 operations carried out in the dedicated burns theatre. The total expenditure for the study period was Indian Rupees (Rs) 46,488,067 or US$ 845,237. At 1 US$=Rs 55 it makes the cost per patient to be US$ 1060.5. Almost 70% of cost of burn management resulted from salaries, followed by investigations (11.56%) and dressings (8.24%). The mean cost of investigations per patient was Rs 6742.46 (US$ 122.59). Only 147/797 patients received 322 units of blood. Thus, the average cost of blood transfusion for all admissions was Rs 521.17 (US$ 9.47). Our study is evidence to direct costs of providing burn care in a tertiary centre of a low income country, and the large number of patients in our study while averaging the costs also validates the estimates. The 'reasonability' of care being delivered is defined by adequate resuscitation, daily topical dressings, appropriate surgery (escharotomy, debridement, and skin grafting), adequate nutrition and physical therapy. The 'reasonability' of outcomes can be measured by mortality figures. The bottom line of management is strict observation by burn staff. The low mean hospital stay also reflects our admission and discharge policy which is to benefit the maximum number of patients who require resuscitative/intensive care, and who have extensive and deep wounds, or injury of critical nature. We conclude that providing burn care based on our model can be emulated in other LICs as the costing is driven by 'necessity of expense' rather than 'ability to spend'. PMID:23523069

  4. Nurses' autonomy level in teaching hospitals and its relationship with the underlying factors.

    PubMed

    Amini, Kourosh; Negarandeh, Reza; Ramezani-Badr, Farhad; Moosaeifard, Mahdi; Fallah, Ramezan

    2015-02-01

    This study aimed to determine the autonomy level of nurses in hospitals affiliated to Zanjan University of Medical Sciences, Iran. In this descriptive cross-sectional study, 252 subjects were recruited using systematic random sampling method. The data were collected using questionnaire including Dempster Practice Behavior Scale. For data analysis, descriptive statistics and to compare the overall score and its subscales according to the demographic variables, t-test and analysis of variance test were used. The nurses in this study had medium professional autonomy. Statistical tests showed significant differences in the research sample according to age, gender, work experience, working position and place of work. The results of this study revealed that most of the nurses who participated in the study compared with western societies have lower professional autonomy. More studies are needed to determine the factors related to this difference and how we can promote Iranian nurses' autonomy. PMID:24256084

  5. Comparing the perspectives of managers and employees of teaching hospitals about job motivation.

    PubMed

    Mohebbifar, Rafat; Zakaria Kiaei, Mohammad; Khosravizadeh, Omid; Mohseni, Mohammad

    2014-11-01

    Recognition of career motivators and understanding of managers and employees in prioritizing them, in order to plan incentives for this understanding, can play an important role in increasing productivity and creating harmony between the goals of the organization and staff. This study was done to survey the importance of career motivating factors from perspective of employees and managers in educational hospitals of Iran. In this study 269 from a total of 1843 employees of educational hospitals in Qazvin province of Iran were selected through Quota-Random sampling and studied along with all 49 Managers. Lawrence Lindale questionnaire with 10 factors where used in order to determine motivational priorities. The results indicated that among the 10 studied motivational factors, from employees' viewpoint; "Good wages", "Good Working Conditions" and "Job Security" have the greatest roles in motivating employees. In the context of perspective agreement amongst employees and managers, the results showed 20 percent agreement. In this study, results of "Independent T" test showed a significant difference in comparison, between prioritizing employees' view and prediction of managers in the factors of "Job Security" (p = 0/031) and "Interesting Work" (p = 0/001). With respect to increase disagreement in the views of managers and employees as compared to previous studies, Managers need to pay more attention to cognition of motivational factors and make their viewpoints closer to actual motivational need of their employees. Attention to this fact can be a great help to the growth and productivity of the organization, making the organizational and individual goals closer and also keeping managers safe from execution of constant and undue motivational patterns. PMID:25363113

  6. Techniques of rapid sequence induction and intubation at a university teaching hospital

    PubMed Central

    Gebremedhn, Endale G.; Gebeyehu, Kefale D.; Ayana, Hintsawit A.; Oumer, Keder E.; Ayalew, Hulgize N.

    2014-01-01

    BACKGROUND: Rapid sequence induction and intubation (RSII) is a medical procedure involving a prompt induction of general anesthesia by using cricoid pressure that prevents regurgitation of gastric contents. The factors affecting RSII are prophylaxis for aspiration, preoxygenation, drug and equipment preparation for RSII, ventilation after induction till intubation and patient condition. We sometimes saw difficulties with the practice of this technique in our hospital operation theatres. The aim of this study was to assess the techniques of rapid sequence induction and intubation. METHODS: Hospital based observational study was conducted with a standardized checklist. All patients who were operated upon under general anesthesia during the study period were included. The techniques of RSII were observed during the induction of anesthesia by trained anesthetists. RESULTS: Altogether 140 patients were included in this study with a response rate of 95.2%. Prophylaxis was not given to 130 patients (92.2%), and appropriate drugs were not used for RSII in 73 patients (52.1%), equipments for difficult intubation in 21 (15%), suction machines with catheter not connected and turned on in 122 (87.1%), ventilation for patients after induction and before intubation in 41 (29.3%), cricoid pressure released before cuff inflation in 12 (12.1%), and difficult intubation in 8 (5.7%), respectively. RSII with cricoid pressure was applied appropriately in 94 (67.1%) patients, but cricoid pressure was not used in 46 (32.9%) patients. CONCLUSIONS: The techniques of rapid sequence induction and intubation was low. Training should be given for anesthetists about the techniques of RSII. PMID:25215158

  7. Assessment of Prevalence and Mortality Incidences Due to Poisoning in a South Indian Tertiary Care Teaching Hospital

    PubMed Central

    Jesslin, J.; Adepu, R.; Churi, S.

    2010-01-01

    WHO reports estimate poisoning as one of the most common causes of increased morbidity and mortality rate world-wide. Various agents such as pesticides, drugs have been used for intentional and accidental poisoning in different countries. In the Indian scenario, pesticides are the most commonly used poisoning agents. To assess the prevalence and mortality incidence rate due to various poisoning agents a retrospective and prospective study conducted over a period of nine months in a tertiary care teaching hospital. Retrospective data of poisoning cases was collected from the medical records section and the prospective data of poisoning cases was collected from the emergency and causality departments. A total of 1045 poisoning related admissions were identified during the period January 2005 to September 2008. Among them, 68.40% of cases were due to intentional poisoning and 31.60% were due to accidental poisoning. Of the poisoning related admissions, 84.4% of patients recovered, whereas in 7.6% of cases condition did not improve. Mortality rate was observed 4%. Intentional poisoning was observed more in male population (60.2%) in the age group of 18-29 years. Accidental poisoning was seen more in children in the age group of 1-3 years. Incidence of overall poisoning cases were high due to pesticides (39.5%) followed by medicines (26.1%), household products (22.1%), environmental poisoning (12.1%) and heavy metals (0.2%). It was observed that availability of centralised poison information centre and treatment protocols will improvise poison management practices in tertiary care hospitals by the clinicians. PMID:21694990

  8. Clinical, Microbiological, and Genetic Characteristics of Heteroresistant Vancomycin-Intermediate Staphylococcus aureus Bacteremia in a Teaching Hospital.

    PubMed

    Di Gregorio, Sabrina; Perazzi, Beatriz; Ordońez, Andrea Martinez; De Gregorio, Stella; Foccoli, Monica; Lasala, Marķa Beatriz; Garcķa, Susana; Vay, Carlos; Famiglietti, Angela; Mollerach, Marta

    2015-02-01

    The emergence of vancomycin intermediate Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA) is of major concern worldwide. Our objective was to investigate the prevalence, phenotypic and molecular features of hVISA strains isolated from bacteremic patients and to determine the clinical significance of the hVISA phenotype in patients with bacteremia. A total of 104 S. aureus blood isolates were collected from a teaching hospital of Argentina between August 2009 and November 2010. No VISA isolate was recovered, and 3 out of 92 patients (3.3%) were infected with hVISA, 2 of them methicillin-resistant S. aureus (MRSA) (4.5% of MRSA). Macro Etest and prediffusion method detected 3/3 and 2/3 hVISA respectively. Considering the type of bacteremia, the three cases were distributed as follows: two patients had suffered multiple episodes of bacteremia (both hVISA strains recovered in the second episode), while only one patient had suffered a single episode of bacteremia with hVISA infection. MRSA bloodstream isolates exhibiting the hVISA phenotype were related to HA-MRSA Cordobes clone (ST5-SCCmec I-spa t149) and MRSA Argentinean pediatric clone (ST100-SCCmec IVNV-spa t002), but not to CA-MRSA-ST30-SCCmec IV-spa t019 clone that was one of the most frequent in our country. Although still relatively infrequent in our hospital, hVISA strains were significantly associated with multiple episodes of bacteremia (p=0.037) and genetically unrelated. PMID:25535825

  9. Prescribing Practices of Topical Corticosteroids in the Outpatient Dermatology Department of a Rural Tertiary Care Teaching Hospital

    PubMed Central

    Rathod, Suvarna S; Motghare, Vijay M; Deshmukh, Vinod S; Deshpande, Rushikesh P; Bhamare, Chetanraj G; Patil, Jyoti R

    2013-01-01

    Background: Inappropriate or excessive use of topical corticosteroids can lead to cutaneous and systemic adverse effects which occur more commonly with the use of very potent steroids. Monitoring and analysis of the prescription practices of topical steroids can help to achieve rational prescription of these drugs. Aim: The present study was carried out to study and analyze the pattern of prescribing topical corticosteroids among outpatients attending the dermatology clinic in a rural tertiary care and teaching hospital, Ambajogai, Maharashtra. Materials and Methods: A cross-sectional descriptive study was conducted for a duration of two months from August 2011 to September 2011, and 500 prescriptions were randomly collected from the dermatology pharmacy and analyzed. Results: About 66% of the prescriptions contained four to five drugs per prescription. Topical steroids were given in 28.4% of all the prescriptions. In almost all the prescriptions, strength, quantity of the steroid to be used, frequency, site, and duration of application was not mentioned. The chief complaints and diagnoses were not mentioned in about 85% of the prescriptions for topical corticosteroids. About 94.36% of the prescriptions contained very potent steroids. Conclusion: Inadequate prescribing information is a clear characteristic of the dermatological prescriptions containing topical corticosteroids. Doctors should be educated about the importance of giving patients sufficient information regarding the use of steroids. There is a need to revise hospital formulary where low-potency steroids can also be included along with potent ones so that the latter can be avoided in conditions where they are unnecessary. PMID:24082175

  10. Antibiotic sensitivity pattern and cost-effectiveness analysis of antibiotic therapy in an Indian tertiary care teaching hospital

    PubMed Central

    Sriram, Shamungum; Aiswaria, Varghese; Cijo, Annie Eapen; Mohankumar, Thekkinkattil

    2013-01-01

    Objective: The purpose of this study is to analyze the antibiotic sensitivity pattern of microorganisms, to study the antibiotic usage pattern, and to conduct a cost-effectiveness analysis (CEA) for the antibiotics prescribed in a tertiary care teaching hospital in south India. Methods: This prospective study was carried out in the General Medicine and Pulmonology departments of the hospital for a period of 6 months. The study was carried out in three phases: A prospective analysis to check the sensitivity pattern of microorganisms to various antibiotics, data extraction and determining the cost of antibiotics and finally evaluation of the sensitivity pattern of microorganisms and the antibiotic usage. A total of 796 documented records were analyzed. Findings: It was found that Escherichia coli was the major organism identified in 36.4% of the isolated specimens, followed by Klebsiella sp. (18.9%), Streptococcus pneumoniae (15.8%), Staphylococcus aureus (12.4%), and Pseudomonas (9.3%). The sensitivity pattern data of the prospective study revealed that E. coli was highly sensitive to Amikacin (99.3%), Klebsiella to Amikacin (93.8%), Pseudomonas to Meropenem (97.6%), and S. pneumoniae to Ofloxacin (93.8%). In the prescribing pattern study, it was found that the most common disease (21.2%) was found to be lower respiratory tract infection in 51 patients. Cephalosporins (73%), in particular Ceftriaxone (63.5%) was highly prescribed, followed by fluoroquinolones (53.9%). In the CEA, it was revealed that Ceftriaxone was the cost-effective antibiotic with a cost-effectiveness ratio (CER) of 78.27 compared to Levofloxacin, which had a CER of 95.13. Conclusion: Continuous surveillance of susceptibility testing is necessary for cost-effective customization of empiric antibiotic therapy. Furthermore, reliable statistics on antibiotic resistance and policies should be made available. PMID:24991607

  11. A detailed analysis of theatre training activity in a UK teaching hospital.

    PubMed

    McIndoe, A K; Underwood, S M

    2000-05-01

    We examined the placement of anaesthetists in our department over a 2 yr period. Data were collected from an in-theatre system to provide details of caseload and supervision for 34,856 operations. There was wide variation between anaesthetic sub-specialties with overall supervision levels of 35% of cases for senior house officers (SHOs) and 32% for specialist registrars (SpRs). The consultant data showed the size and areas of teaching reserve in the department. We then examined individual logbooks in order to validate our data, and departmental rotas to put these data into perspective with previous attempts to quantify trainee supervision. Supervision data derived from the rota allocations showed that 86% of SHO lists and 62% of SpR lists were scheduled to be supervised. This study has described our training activity and facilitated departmental changes, as well as highlighting the need for great care in interpreting trainee supervision data acquired from different sources, particularly when comparisons are being made. PMID:10844835

  12. Cut throat injuries at a university teaching hospital in northwestern Tanzania: a review of 98 cases

    PubMed Central

    2014-01-01

    Background Cut throat injuries though rarely reported in literature pose a great therapeutic challenge because multiple vital structures are vulnerable to injuries in the small, confined unprotected area. A sudden increase in the number of cut throat patients in our centre in recent years prompted the authors to analyze this problem. This study was conducted in our local setting to describe the etiology, patterns and treatment outcome of these injuries. Methods This was a combined retrospective and prospective study of cut throat injury patients who were managed at Bugando Medical Centre between February 2009 and January 2013. Statistical data analysis was done using SPSS software version 17.0. Results A total of 98 patients with cut throat injuries were studied. Males outnumbered females by a ratio of 2.4: 1. The median age of patients was 26 years (range 8 to 78 years). Majority of patients (79.6%) had no employment and most of them (65.3%) came from rural community. Homicide was the commonest (55.1%) cause, followed by suicidal attempts (34.7%) and accidental (10.2%) injuries. Interpersonal conflict (24.4%) was the most common motivating factor for homicidal injury whereas psychiatric illness (16.2%) and road traffic accidents (9.2%) were the most frequent motivating factors of suicidal attempt and accidental injuries respectively. The majority of injuries were in Zone II accounting for 65.3% of cases and most of them had laryngeal (57.1%) injury. Surgical debridement, laryngeal/hypopharynx repair and tracheostomy were the most common surgical procedures performed in 93.9%, 73.5% and 70.4% of patients respectively. Postoperative complication rate was 57.1%, the commonest being surgical site infections in 28.1% of patients and it was significantly associated with late presentation and anatomical zones (P?hospitalization was 12 days. Patients who had postoperative complications stayed longer in the hospital and this was statistically significant (p?=?0.011). Mortality rate was 11.2% and was significantly associated with co-morbidities, delayed presentation and presence of complications (p?

  13. Pregnancy outcomes among patients with sickle cell disease at Korle-Bu Teaching Hospital, Accra, Ghana: retrospective cohort study.

    PubMed

    Wilson, Nana O; Ceesay, Fatou K; Hibbert, Jacqueline M; Driss, Adel; Obed, Samuel A; Adjei, Andrew A; Gyasi, Richard K; Anderson, Winston A; Stiles, Jonathan K

    2012-06-01

    Pregnancy in sickle cell disease (SCD) patients is associated with increased risk of maternal and fetal mortality. This study determines pregnancy outcomes among women with SCD delivering at Korle-Bu Teaching Hospital, Accra, Ghana. Nine hundred sixty (960) medical records of pregnant women (131 HbSS, 112 HbSC, and 717 comparison group) from 2007 to 2008 were reviewed. The HbSS women were at increased risk of eclampsia (adjusted odds ratio [AOR] = 10.56, 95% confidence interval [CI] = 3.60-30.96, P < 0.001), intrauterine growth restriction (AOR = 4.00, 95% CI = 1.38-11.64, P = 0.011), and placenta previa (AOR = 22.03, 95% CI = 9.87-49.14, P < 0.001) compared with the comparison group. The HbSC women had increased risk for intrauterine fetal death (AOR = 3.38, 95% CI = 1.15-9.96, P = 0.027) and decreased risk of delivering low birth weight babies (AOR = 0.21, 95% CI = 0.06-0.73, P = 0.014). Women with SCD in Ghana are at a greater risk of morbidity and mortality in pregnancy compared with women without hemoglobinopathies. Improved maternal and fetal outcomes in Ghanaian women with SCD can be achieved through effective intervention by health care providers with thorough knowledge about predisposing factors toward adverse outcomes. PMID:22665597

  14. Pregnancy Outcomes among Patients with Sickle Cell Disease at Korle-Bu Teaching Hospital, Accra, Ghana: Retrospective Cohort Study

    PubMed Central

    Wilson, Nana O.; Ceesay, Fatou K.; Hibbert, Jacqueline M.; Driss, Adel; Obed, Samuel A.; Adjei, Andrew A.; Gyasi, Richard K.; Anderson, Winston A.; Stiles, Jonathan K.

    2012-01-01

    Pregnancy in sickle cell disease (SCD) patients is associated with increased risk of maternal and fetal mortality. This study determines pregnancy outcomes among women with SCD delivering at Korle-Bu Teaching Hospital, Accra, Ghana. Nine hundred sixty (960) medical records of pregnant women (131 HbSS, 112 HbSC, and 717 comparison group) from 2007 to 2008 were reviewed. The HbSS women were at increased risk of eclampsia (adjusted odds ratio [AOR] = 10.56, 95% confidence interval [CI] = 3.60–30.96, P < 0.001), intrauterine growth restriction (AOR = 4.00, 95% CI = 1.38–11.64, P = 0.011), and placenta previa (AOR = 22.03, 95% CI = 9.87–49.14, P < 0.001) compared with the comparison group. The HbSC women had increased risk for intrauterine fetal death (AOR = 3.38, 95% CI = 1.15–9.96, P = 0.027) and decreased risk of delivering low birth weight babies (AOR = 0.21, 95% CI = 0.06–0.73, P = 0.014). Women with SCD in Ghana are at a greater risk of morbidity and mortality in pregnancy compared with women without hemoglobinopathies. Improved maternal and fetal outcomes in Ghanaian women with SCD can be achieved through effective intervention by health care providers with thorough knowledge about predisposing factors toward adverse outcomes. PMID:22665597

  15. An Audit of Operating Room Time Utilization in a Teaching Hospital: Is There a Place for Improvement?

    PubMed Central

    Stavrou, George; Tsouskas, John; Tsaousi, Georgia; Kotzampassi, Katerina

    2014-01-01

    Aim. To perform a thorough and step-by-step assessment of operating room (OR) time utilization, with a view to assess the efficacy of our practice and to identify areas of further improvement. Materials and Methods. We retrospectively analyzed the most ordinary general surgery procedures, in terms of five intervals of OR time utilization: anaesthesia induction, surgery preparation, duration of operation, recovery from anaesthesia, and transfer to postanaesthesia care unit (PACU) or intensive care unit (ICU). According to their surgical impact, the procedures were defined as minor, moderate, and major. Results. A total of 548 operations were analyzed. The mean (SD) time in minutes for anaesthesia induction was 19 (9), for surgery preparation 13 (8), for surgery 115 (64), for recovery from anaesthesia 12 (8), and for transfer to PACU/ICU 12 (9). The time spent in each step presented an ascending escalation pattern proportional to the surgical impact (P = 0.000), which was less pronounced in the transfer to PACU/ICU (P = 0.006). Conclusions. Albeit, our study was conducted in a teaching hospital, the recorded time estimates ranged within acceptable limits. Efficient OR time usage and outliers elimination could be accomplished by a better organized transfer personnel service, greater availability of anaesthesia providers, and interdisciplinary collaboration. PMID:25006514

  16. Prevalence of Anaemia among Pregnant Women at Booking in the University of Uyo Teaching Hospital, Uyo, Nigeria

    PubMed Central

    Olatunbosun, Olujimi A.; Abasiattai, Aniekan M.; Bassey, Emem A.; James, Robert S.; Morgan, Anyiekere

    2014-01-01

    Background. Anaemia with an estimated prevalence of 35–75% among pregnant women is a major cause of maternal deaths in Nigeria. Objective. To determine the prevalence of anaemia, associated sociodemographic factors and red cell morphological pattern among pregnant women during booking at the University Teaching Hospital, Uyo. Material and Methods. A cross-sectional analytical study of 400 women at the booking clinic over a 16-week period. The packed cell volume and red cell morphology of each pregnant woman were determined. Their biodata, obstetric and medical histories, and results of other routine investigations were obtained with questionnaires and analyzed with SPSS Package version 17.0. Results. The mean packed cell volume was 31.8% ±3.2 and 54.5% of the women were anaemic. The commonest blood picture was microcytic hypochromia and normocytic hypochromia suggesting iron deficiency anaemia. Anaemia was significantly and independently related to a history of fever in the index pregnancy (OR = 0.4; P = 0.00; 95% CI = 0.3–0.7), HIV positive status (OR = 0.2; P = 0.01; 95% CI = 0.1–0.6), and low social class (OR = 0.3; P = 0.00; 95% CI = 0.2–0.7). Conclusion. Women need to be economically empowered and every pregnant woman should be encouraged to obtain antenatal care, where haematinics supplementation can be given and appropriate investigations and treatment of causes of fever and management of HIV can be instituted. PMID:24982910

  17. Ventilator-associated pneumonia in a teaching hospital in Tehran and use of the Iranian Nosocomial Infections Surveillance Software.

    PubMed

    Afhami, Sh; Hadadi, A; Khorami, E; Seifi, A; Bazaz, N Esmailpour

    2013-10-01

    Ventilator-associated pneumonia is the most common health-care-associated infection in the intensive care unit (ICU) and computer-assisted diagnosis and surveillance is called for. The frequency of ventilator-associated pneumonia was assessed prospectively during a 6-month period in the ICUs of a teaching hospital in Tehran, Islamic Republic of Iran. To determine the accuracy of the Iranian Nosocomial Infections Surveillance (INIS) system, patient data were input to the software and compared with physicians' judgement. The frequency of ventilator-associated pneumonia was 21.6%, or 9.96 episodes per 1000 ventilator days. The duration of admission to the ICU, duration of mechanical ventilator and number of re-intubations were significantly higher in patients who developed pneumonia. The INIS system identified 100% of cases, with no false-positive or false-negative results. Compared with developed countries, the frequency of ventilator-associated pneumonia was high in our ICUs, and INIS software was accurate in diagnosing nosocomial infection. PMID:24313153

  18. Sensitivity profile of Staphylococcus spp. and Streptococcus spp. isolated from toys used in a teaching hospital playroom?

    PubMed Central

    Boretti, Vanessa Stolf; Corrźa, Renata Nunes; dos Santos, Silvana Soléo Ferreira; Lećo, Mariella Vieira Pereira; Silva, Célia Regina Gonēalves e

    2014-01-01

    Objective: To evaluate the presence of microorganisms of the genus Staphylococcus and Streptococcus on toys in the playroom of a teaching hospital, as well to as analyze the antimicrobial resistance from isolated strains. Methods: Samples were collected from 60 toys, using wet swabs, soon after being used by the children. The samples were inoculated in enriched and selective agar for isolation and later identification of the microorganisms. Antibiogram testing was performed by agar diffusion technique. Results: The genus Staphylococcus was present in 87.0% (52/60) of the toys. Seventy-three strains were isolated, with 29.0% (21/73) coagulase-positive and 71.0% (52/73) coagulasenegative. Among the coagulase-negative strains, 90.4% were resistant to penicillin, 65.4% to oxacillin, 28.8% to clarithromycin, 61.5% to clindamycin, and none to vancomycin. Among the coagulase-positive strains, 76.2% were resistant to penicillin, 23.8% to oxacillin, 23.8% to clarithromycin, 47.6% to clindamycin, and none to vancomycin. The genus Streptococcus was not detected in any of the evaluated toys. Conclusions: Toys can be contaminated with potentially pathogenic bacteria with antimicrobial resistance, representing a possible source of nosocomial infection for patients who are already debilitated. PMID:25479842

  19. Uterine Fibroid Embolization for Symptomatic Fibroids: Study at a Teaching Hospital in Kenya

    PubMed Central

    Mutai, John Kiprop; Vinayak, Sudhir; Stones, William; Hacking, Nigel; Mariara, Charles

    2015-01-01

    Objective: Characterization of magnetic (MRI) features in women undergoing uterine fibroid embolization (UFE) and identification of clinical correlates in an African population. Materials and Methods: Patients with symptomatic fibroids who are selected to undergo UFE at the hospital formed the study population. The baseline MRI features, baseline symptom score, short-term imaging outcome, and mid-term symptom scores were analyzed for interval changes. Assessment of potential associations between short-term imaging features and mid-term symptom scores was also done. Results: UFE resulted in statistically significant reduction (P < 0.001) of dominant fibroid, uterine volumes, and reduction of symptom severity scores, which were 43.7%, 40.1%, and 37.8%, respectively. Also, 59% of respondents had more than 10 fibroids. The predominant location of the dominant fibroid was intramural. No statistically significant association was found between clinical and radiological outcome. Conclusion: The response of uterine fibroids to embolization in the African population is not different from the findings reported in other studies from the west. The presence of multiple and large fibroids in this study is consistent with the case mix described in other studies of African-American populations. Patient counseling should emphasize the independence of volume reduction and symptom improvement. Though volume changes are of relevance for the radiologist in understanding the evolution of the condition and identifying potential technical treatment failures, it should not be the main basis of evaluation of treatment success.

  20. Assessment of sleep quality in post-graduate residents in a tertiary hospital and teaching institute

    PubMed Central

    Murthy, Vasantmeghna Srinivasa; Nayak, Ajita Sunil

    2014-01-01

    Objectives: To evaluate subjective sleep quality, day-time sleepiness, prevalence of substance use, satisfaction with life among residents at our institute. To evaluate association of sleep qualitywith satisfaction with life and day-time sleepiness. To compare the findings between residents in clinical and para-clinical departments. Materials and Methods: Eighty-four residents filled questionnaires to obtain socio-demographic information and use of substance (s). Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Satisfaction With Life scale (SWLS) were also used. Association between sleep quality and sleepiness and satisfaction with life was evaluated. From the data collected, comparisons were made between the clinical and para-clinical department residents. Results: A significant number of residents belonging to the clinical faculty were poorsleepers; reported high levels of abnormal day-time sleepiness and less satisfaction with life compared to residents in para-clinical faculties. The differences in correlation between sleepiness and satisfaction with life with sleep quality among the two groups were not found to be significant. A larger percentage of clinical residents reported use of at least one substance during the residency period compared to the para-clinical residents. Conclusions: Poor sleep quality is perceived greatly by the resident doctors in our public hospital, especially among clinical faculties. Interventions are thus necessary in order to ensure adequate sleep among them. PMID:25535441

  1. EXPLANATORY MODELS OF HYPERTENSION AMONG NIGERIAN PATIENTS AT A UNIVERSITY TEACHING HOSPITAL

    PubMed Central

    Taylor, Kelly D.; Adedokun, Ayoade; Awobusuyi, Olugbenga; Adeniran, Peju; Onyia, Elochukwu; Ogedegbe, Gbenga

    2013-01-01

    Objective To elicit the explanatory models (EM) of hypertension among patients in a hospital-based primary care practice in Nigeria. Design Semi-structured in-depth individual interviews and focus groups were conducted with 62 hypertensive patients. Interviews and focus groups were audio-taped and transcribed verbatim. Data analysis was guided by phenomenology and content analysis using qualitative research software ATLAS.ti 5.0. Results Patients expressed four categories of EM of hypertension: 1) perceptions of hypertension, 2) consequences, 3) effect on daily life, and 4) perception of treatment. Focus group discussions and key informant interviews yielded a wide range of insights into the social and cultural factors influencing patients’ beliefs and health behavior. Participants were aware of the risks of hypertension. There was disagreement between participants’ own understanding of the serious nature of hypertension, the need for long-term treatment, and the desire to take medication long-term. Participants acknowledged the use of traditional medicine (e.g. teas and herbs) and healers. Different themes emerged for men versus women such that women often focused on family issues while men tended to discuss external stressors stemming from work as a cause of hypertension. Men were concerned with frequent urination, decreased libido and erectile dysfunction. Conclusion Knowledge gained will inform development of patient-centered treatment plans and targeted behavioral and educational interventions. PMID:23534506

  2. Use of identification wristbands among patients receiving inpatient treatment in a teaching hospital

    PubMed Central

    Hoffmeister, Louķse Viecili; de Moura, Gisela Maria Schebella Souto

    2015-01-01

    OBJECTIVE: to evaluate the use of identification wristbands among patients hospitalized in inpatient units. METHOD: quantitative, descriptive and transversal research, with a sample of 385 patients. Data collection occurred through the observational method through the filling out of a structured questionnaire which aimed to check the presence of the identification wristband and the identifiers used. Descriptive statistics with absolute and relative frequencies was used for analysis. RESULTS: it was obtained that 83.9% of the patients were found to have the correctly identified wristband, 11.9% had a wristband with errors, and 4.2% of the patients were without a wristband. The main nonconformities found on the identification wristbands were incomplete name, different registration numbers, illegibility of the data and problems with the physical integrity of the wristbands. CONCLUSION: the study demonstrated the professionals' engagement in the process of patient identification, evidencing a high rate of conformity of the wristbands. Furthermore, it contributed to identify elements in the use of wristbands which may be improved for a safe identification process. PMID:25806629

  3. Quality Control in Linen and Laundry Service at A Tertiary Care Teaching Hospital in India

    PubMed Central

    Singh, Dara; Qadri, GJ; Kotwal, Monica; Syed, AT; Jan, Farooq

    2009-01-01

    Introduction: The clean bedding and clean clothes installs psychological confidence in the patients and the public and enhances their faith in the services rendered by the hospital. Being an important Component in the management of the patients, a study was carried out to find out the current quality status and its conformity with the known standards and identify the areas of intervention in order to further increase the patient and staff satisfaction regarding the services provided by linen and laundry department Methods: Quality control practised in the Linen and Laundry Service was studied by conducting a prospective study on the concept of Donabedian model of structure, process and outcome. Study was done by pre-designed Proforma along with observation / Interviews / Questionnaire and study of records. The input studied included physical facilities, manpower, materials, equipments and environmental factors. The various elements of manpower studied consisted of number of staff working, their qualification, training, promotion avenues, motivation and job satisfaction. Process was studied by carrying out observations in linen and laundry service through a predesigned flow chart which was supplemented by interviews with different category of staff. Patient satisfaction, staff satisfaction and microbial count of laundered linen (quality dimensions) were studied in the outcome. Results: The current study found that in spite of certain deficiencies in the equipment, manpower and process, the linen and laundry service is providing a satisfactory service to its users. However the services can be further improved by removing the present deficiencies both at structure and process level. PMID:21475509

  4. Fear of blood/injection in healthy and unhealthy adults admitted to a teaching hospital.

    PubMed

    Kose, S; Mandiracioglu, A

    2007-03-01

    Blood/injury phobia is one of the specific phobias. The aim of this study was to determine the fear of injection and blood in patients and healthy people. This study was carried out at Tepecik Hospital, Clinical Biochemistry Laboratory and Blood Center. Data were collected from 1500 adults who agreed to participate in the study (237 patients with chronic diseases and 1263 healthy people) during the period from January 2003 to February 2005. All participants completed two self-administered questionnaires (17-item Symptom Questionnaire and 20-item Blood/Injection Fear Scale) after giving blood samples by blood donation. 30.1% of the patients and 19.5% of the healthy adults reported that they had fear of blood/injection. Symptoms related to having blood drawn or injection were more frequently reported among women than men. Patients' educational level was also associated with the Symptom Questionnaire and fear of blood/injection scores. Fear of blood/injection was significantly higher in patients with chronic diseases. Fear of blood/injection should be considered by healthcare professionals as it is important for assessing the treatment-seeking individuals. PMID:17313613

  5. Adverse drug reaction profile of anti-snake venom in a rural tertiary care teaching hospital

    PubMed Central

    Deshpande, Rushikesh Prabhakar; Motghare, Vijay Motiram; Padwal, Sudhir Laxman; Pore, Rakesh Ramkrishna; Bhamare, Chetanraj Ghanshyam; Deshmukh, Vinod Shivaji; Pise, Harshal Nutan

    2013-01-01

    Objectives The study was carried out with the aim of evaluation of the adverse drug reaction profile of anti-snake venom serum (ASV) in a rural tertiary care hospital. Methods An observational study was conducted in SRTR Medical College, Ambajogai, Maharashtra, India. A total number of 296 indoor case papers of snake bite from February to September 2011 and June to August 2012 were retrieved from the record section and the antivenom reactions were assessed. In addition, basic epidemiological data and prescribing practices of ASV were also analyzed. Results Vasculotoxic snake bites were more common (50.61%) than neuroparalytic ones (22.56%). Mild envenomation was the commonest presentation. A total of 92 (56.10%) patients who received ASV suffered from antivenom reactions. The most common nature of reaction was chills, rigors (69.56%) followed by nausea and vomiting (34.8%). 10-15% patients suffered from moderate to severe reactions like hypotension and sudden respiratory arrest. We did not find any dose response relationship of ASV to risk of reactions (odds ratio 0.37). Intradermal sensitivity test was performed in about 72% cases. Conclusion Our study showed a higher incidence of reactions to ASV at our institute. PMID:24396245

  6. Phenotypic and Molecular Characterization of Multidrug Resistant Klebsiella pneumoniae Isolated from a University Teaching Hospital, China

    PubMed Central

    Liu, Helu; Lü, Dongyue; Liang, Hong; Dou, Yuhong

    2014-01-01

    The multidrug-resistant rate of Klebsiella pneumoniae has risen rapidly worldwide. To better understand the multidrug resistance situation and molecular characterization of Klebsiella pneumoniae, a total of 153 Klebsiella pneumoniae isolates were collected, and drug susceptibility test was performed to detect its susceptibility patterns to 13 kinds of antibiotics. Phenotypic tests for carbapenemases ESBLs and AmpC enzyme-producing strains were performed to detect the resistance phenotype of the isolates. Then PCR amplification and sequencing analysis were performed for the drug resistance determinants. The results showed that 63 strains harbored blaCTX-M gene, and 14 strains harbored blaDHA gene. Moreover, there were 5 strains carrying blaKPC gene, among which 4 strains carried blaCTX-M, blaDHA and blaKPC genes, and these 4 strains were also resistant to imipenem. Our data indicated that drug-resistant Klebsiella pneumoniae were highly prevalent in the hospital. Thus it is warranted that surveillance of epidemiology of those resistant isolates should be a cause for concern, and appropriate drugs should be chosen. PMID:24740167

  7. Phenotypic and molecular characterization of multidrug resistant Klebsiella pneumoniae isolated from a university teaching hospital, China.

    PubMed

    Du, Jikun; Li, Peipei; Liu, Helu; Lü, Dongyue; Liang, Hong; Dou, Yuhong

    2014-01-01

    The multidrug-resistant rate of Klebsiella pneumoniae has risen rapidly worldwide. To better understand the multidrug resistance situation and molecular characterization of Klebsiella pneumoniae, a total of 153 Klebsiella pneumoniae isolates were collected, and drug susceptibility test was performed to detect its susceptibility patterns to 13 kinds of antibiotics. Phenotypic tests for carbapenemases ESBLs and AmpC enzyme-producing strains were performed to detect the resistance phenotype of the isolates. Then PCR amplification and sequencing analysis were performed for the drug resistance determinants. The results showed that 63 strains harbored bla CTX-M gene, and 14 strains harbored bla DHA gene. Moreover, there were 5 strains carrying bla KPC gene, among which 4 strains carried bla CTX-M, bla DHA and bla KPC genes, and these 4 strains were also resistant to imipenem. Our data indicated that drug-resistant Klebsiella pneumoniae were highly prevalent in the hospital. Thus it is warranted that surveillance of epidemiology of those resistant isolates should be a cause for concern, and appropriate drugs should be chosen. PMID:24740167

  8. Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: A cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban

    PubMed Central

    2011-01-01

    Background Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008. Methods Questionnaire-based cross-sectional study, including all eligible staff. Sample: 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes. Results Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p < 0.001); 43.2% in auxiliaries, 26.1% in nurses, 18.9% among physicians, and 34.7% among other non-health professionals (p = 0.024). The findings showed a very high level of agreement with smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes. Conclusions Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking behaviour had greater influence in TC attitudes than health professionals' education. Our study is the first in Portugal to identify potential predictors of non-compliance with the partial smoking ban, further emphasising the need for a 100% smoke-free policy, effective enforcement and public health education to ensure compliance and promote social norm change. PMID:21943400

  9. A Survey on the Users’ Satisfaction with the Hospital Information Systems (HISs) based on DeLone and McLean’s Model in the Medical-Teaching Hospitals in Isfahan City

    PubMed Central

    Saghaeiannejad-Isfahani, Sakineh; Jahanbakhsh, Maryam; Habibi, Mahboobeh; Mirzaeian, Razieh; Nasirian, Mansoreh; Rad, Javad Sharifi

    2014-01-01

    Background and purpose: The user’s satisfaction with information system in fact denotes the extent the user is satisfied with the system’s achievement in fulfilling his/her information requirements. This study tries to explore the users’ satisfaction with hospital information systems (HISs) based on DeLone and McLean’s model focusing on the medical-teaching hospitals of Isfahan city. Methodology: This study which was applied and descriptive-analytical in nature was carried out in the medical-teaching hospitals of Isfahan city in 2009. Research population consisted of the system users from which a sample was selected using random sampling method. The size of the sample was 228. Data collection instrument was a self-developed questionnaire produced based on the satisfaction criterion in the DeLone and McLean’s model. Its content validity was assessed based on the opinions given by the computer sciences professionals with its estimated Cronbach’s alpha found to be 92.2%. The data were analyzed using SPSS software. Findings: As the findings of the study showed, the differences among the mean scores obtained for the satisfaction with different kinds of HISs in use in the hospitals were statistically significant (p value?0.05). Generally, Kowsar System (old version) and Pouya Samaneh Diva system gained the highest and lowest mean scores for the criterion in question, respectively. The overall mean score for the satisfaction was 54.6% for different types of systems and 55.6% among the hospitals. Conclusion: Given the findings of the study, it can be argued that based on the used model, the level of users’ satisfaction with the systems in question was relatively good. However, to achieve the total optimum condition, when designing the system, the factors affecting the enhancement of the users’ satisfaction and the type of hospital activity and specialty must be given special consideration. PMID:25132711

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

    PubMed Central

    Vazin, Afsaneh; Zamani, Zahra; Hatam, Nahid

    2014-01-01

    This study was conducted with the purpose of determining the frequency of medication errors (MEs) occurring in tertiary care emergency department (ED) of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5%) MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2%) and antimicrobial (23.6%) medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6%) and wrong time error (4.4%) were the most frequent administration errors. The less-experienced nurses (P=0.04), higher patient-to-nurse ratio (P=0.017), and the morning shifts (P=0.035) were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction of MEs in EDs. PMID:25525391

  11. Adverse Drug Reactions amongst Adult Patients Admitted in Lagos State University Teaching Hospital Lagos, Nigeria.

    PubMed

    Aderemi-Williams, R I; Awodele, O; Boyle, C A

    2014-06-01

    Background: Adverse drug reaction (ADR) is a global drug therapy problem. It has been rated as one of the top leading causes of morbidity and mortality. In Nigeria, not much is known about ADRs especially with the existing weak post marketing surveillance for monitoring drug use, and its effect on the population. Objectives: The study is aimed to determining the incidence of ADRs, presentations of ADRs, classes of drugs that frequently cause ADRs and predictors of ADRs in adult medical in-patients in LASUTH. Method: A retrospective study of six hundred and twenty four (624) case notes of all patients admitted to the medical wards in LASUTH between January 1, 2009 and December 31, 2009 was carried out. Information obtained includes age, gender, and adverse drug reaction and drug details. The results obtained were analyzed using SPSS version 16 statistical software. Level of significance was set at p ? 0.05. Results: A total of 624 case notes consisting of 358 males and 266 females were assessed. The number of patients who experienced adverse drug reactions was 67 (n = 624, 10.7%). The incidence rate of ADRs in LASUTH from the study was 10.7 per 100 patients' population. Most of the ADRs observed were type A reactions (97.8%). Mostly implicated classes of drugs are antidiabetics (26.7%) and NSAIDs (29.3%). Conclusion: The incidence rate of ADRs was 10.7%. ADRs which are predictable and preventable occur in hospitalized patients, such may be prevented or minimized by implementing measures to target specific drugs that are commonly suspected. PMID:24909574

  12. Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from a university teaching hospital in Japan.

    PubMed

    Kuwata, Y; Tanimoto, S; Sawabe, E; Shima, M; Takahashi, Y; Ushizawa, H; Fujie, T; Koike, R; Tojo, N; Kubota, T; Saito, R

    2015-04-01

    Clostridium difficile infection control strategies require an understanding of its epidemiology. In this study, we analysed the toxin genotypes of 130 non-duplicate clinical isolates of C. difficile from a university hospital in Tokyo, Japan. Multilocus sequence typing (MLST) and eBURST analysis were performed for these isolates and nine strains previously analysed by polymerase chain reaction (PCR) ribotyping. Minimum inhibitory concentrations (MICs) were determined for six antibiotics, and the bacterial resistance mechanisms were investigated. Ninety-five toxigenic strains (73 %), including seven tcdA-negative, tcdB-positive and cdtA/cdtB-negative strains (A(-)B(+)CDT(-)) and three A(+)B(+)CDT(+) strains, and 35 (27 %) non-toxigenic strains, were classified into 23 and 12 sequence types, respectively. Of these, sequence type (ST)17 (21.8 %) was the most predominant. MLST and eBURST analysis showed that 139 strains belonged to seven groups and singletons, and most A(+)B(+)CDT(-) strains (98 %, 89/91) were classified into group 1. All isolates were susceptible to metronidazole, vancomycin and meropenem; the ceftriaxone, clindamycin and ciprofloxacin resistance rates were 49, 59 and 99 %, respectively. Resistance rates to ceftriaxone and clindamycin were higher in toxigenic strains than in non-toxigenic strains (P?

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

    PubMed

    Vazin, Afsaneh; Zamani, Zahra; Hatam, Nahid

    2014-01-01

    This study was conducted with the purpose of determining the frequency of medication errors (MEs) occurring in tertiary care emergency department (ED) of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5%) MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2%) and antimicrobial (23.6%) medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6%) and wrong time error (4.4%) were the most frequent administration errors. The less-experienced nurses (P=0.04), higher patient-to-nurse ratio (P=0.017), and the morning shifts (P=0.035) were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction of MEs in EDs. PMID:25525391

  14. Marjolin's ulcers at a university teaching hospital in Northwestern Tanzania: a retrospective review of 56 cases

    PubMed Central

    2012-01-01

    Background Marjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Although many individual case reports exist, no comprehensive evaluation of Marjolin's ulcer patients has been conducted in our setting. This study was conducted to describe the clinicopathological presentation and treatment outcome of this condition in our local setting and to identify predictors of outcome. Methods This was a retrospective study of histologically confirmed cases of Marjolin's ulcer seen at Bugando Medical Centre over a period of 10-years between January 2001 and December 2010. Data were retrieved from patients' files and analyzed using SPSS computer software version 15.0 Results A total of 56 patients were studied. Male to female ratio was 2.1:1. Burn scars (89.3%) were the most common causative lesions of Marjolin's ulcer. The mean latent period between original injury and diagnosis of Marjolin's ulcer was 11.34 ± 6.14 years. Only 12.0% of the reported cases were grafted at the time of injury (P < 0.00). Most patients (48.2%) presented between one and five years of onset of illness. The lower limb (42.9%) was the most frequent site for Marjolin's ulcers. The median tumor size at presentation was 8 cm and the vast majority of patients (85.7%) presented with large tumors of ? 5 cm in diameter. Lymph node metastasis at the time of diagnosis was recorded in 32.1% of cases and distant metastasis accounted for 26.9% of cases. Squamous cell carcinoma (91.1%) was the most common histopathological type. Wide local excision was the most common surgical procedure performed in 80.8% of cases. Post-operative complication rate was 32.1% of which surgical site infection was the most common complication in 38.9% of patients. Local recurrence was noted in 33.3% of cases who were treated surgically. The mean length of hospital stay for in-patients was 7.9 ± 2.3 days. Mortality rate was 7.1%. According to multivariate logistic regression analysis, stage and grade of the tumor and presence of local recurrence were the main predictors of death (P < 0.001). Conclusion Marjolin's ulcers are not rare in our environment and commonly occur in burn scars that were not skin grafted and were left to heal secondarily. A high index of suspicion is required in the management of chronic non-healing ulcers and all suspected lesions should be biopsed. Early recognition and aggressive treatment of Marjolin's ulcers and close follow-up are urgently needed to improve outcomes in our environment. PMID:22336561

  15. Oral Health Status of a Sample of Prisoners in Enugu: A Disadvantaged Population

    PubMed Central

    Akaji, EA; Ashiwaju, MO

    2014-01-01

    Background: The aim of this study is to determine the oral health status of a sample of prisoners at the Federal Prison in Enugu. The health status of inmates in the prison system needs to be incorporated into data and reports that summarize the state of the nation's health; this will encourage the provision of health care to prisoners and foster development of the nation's health. Subjects and Methods: The study involved 230 inmates of the Federal Prison in Enugu. An interviewer-administered questionnaire was used to gather data on the demographic characteristics of the participants, social habits, methods and frequency of cleaning the mouth. Intraoral examination was carried out to determine caries and periodontal statuses employing decayed missing and filled teeth (DMFT) index and community periodontal index of treatment needs respectively. The proportions of participants with other soft and hard tissue conditions were also recorded. Frequency distribution tables with mean values were generated for categorical variables and non-parametric test was used to relate DMFT values with frequency of cleaning the mouth. Results: Among the participants, 67.0% (154/230) had decayed teeth or tooth missing due to caries. None of the decayed teeth was restored yielding a 0.0% (0/230) index of restorative provision. Spearman correlation (rho) between ranks of DMFT and frequency of cleaning the mouth was -0.32 (95%CI=-0.43 to -0.19). 5.2% (12/230) participants had community periodontal index (CPI) score of 0 and 94.8% (218/230) had CPI of 1, 2, 3 or 4. Also, 56.1% (129/230) had extrinsic stains on their teeth and 17.3% (40/230) presented with fractured teeth. Conclusion: More than half of the participants were affected by dental caries and periodontal health was compromised in the majority of them. Measures to improve their oral health and the establishment of dental health-care facility in the institution are strongly encouraged. PMID:25221723

  16. Susceptibility of bacterial etiological agents to commonly-used antimicrobial agents in children with sepsis at the Tamale Teaching Hospital

    PubMed Central

    2013-01-01

    Background Bloodstream infections in neonates and infants are life-threatening emergencies. Identification of the common bacteria causing such infections and their susceptibility patterns will provide necessary information for timely intervention. This study is aimed at determining the susceptibilities of bacterial etiological agents to commonly-used antimicrobial agents for empirical treatment of suspected bacterial septicaemia in children. Methods This is a hospital based retrospective analysis of blood cultures from infants to children up to 14 years of age with preliminary diagnosis of sepsis and admitted to the Neonatal Intensive Care Unit (NICU) and Paediatric Wards of the Teaching Hospital Tamale from July 2011 to January 2012. Results Out of 331 blood specimens cultured, the prevalence of confirmed bacterial sepsis was 25.9% (86/331). Point prevalence for confirmed cases from NICU was 44.4% (28/63) and 21.6% (58/268) from the Paediatric ward. Gram positive cocci (GPC) were the predominant isolates with Coagulase positive (32.2%) and Coagulase-negative (28.7%) Staphylococci accounting for 60.9% of the total isolates. Gram negative rods (GNR) comprised 39.1% of all isolates with Klebsiella, E.coli and Salmonella being the most common organisms isolated. Klebsiella was the most frequent GNR from the NICU and Salmonella typhi was predominantly isolated from the paediatric ward. Acinetobacter showed 100.0% susceptibility to Ceftriaxone and Cefotaxime but was resistant (100.0%) to Ampicillin, Tetracycline and Cotrimoxazole. Escherichia coli and Klebsiella were 80.0% and 91.0% susceptible to Ceftriaxone and Cefotaxime respectively. Klebsiella species showed 8.3% susceptibility to Tetracycline but was resistant to Ampicillin and Cotrimoxazole. Escherichia coli showed 40.0% susceptibility to Ampicillin, Chloramphenicol and Cotrimoxazole; 20.0% susceptibility to Tetracycline and 80.0% susceptible to Gentamicin and Cefuroxime. Coagulase negative Staphylococci was susceptible to Gentamicin (72.0%) but Coagulase positive Staphylococci showed intermediate sensitivity to Gentamicin (42.9%). Conclusion Coagulase Negative, Coagulase Positive Staphylococci, Salmonella and Klebsiella were the aetiological agents of bloodstream infection among children at TTH. While gram-positive and gram-negative bacteria showed low susceptibility to Ampicillin, Tetracycline and Cotrimoxazole, the GNR were susceptible to Gentamicin and third-generation cephalosporins. PMID:23419199

  17. American Hospital Association

    MedlinePLUS

    ... Integration Eliminating Racial and Ethnic Disparities Health Information Technology Health Reform Moving Forward Teaching Hospitals - Medical Education Quality and Patient Safety Tools & Resources Action Center ...

  18. Prevalence and Predictors of Tuberculosis Coinfection among HIV-Seropositive Patients Attending the Aminu Kano Teaching Hospital, Northern Nigeria

    PubMed Central

    Iliyasu, Zubairu; Babashani, Musa

    2009-01-01

    Background The HIV/AIDS epidemic has been accompanied by a severe epidemic of tuberculosis (TB), although the prevalence of coinfection is largely unknown, especially in developing countries, including Nigeria. The aim of this study was to determine the prevalence and predictors of TB coinfection among HIV-seropositive Nigerians. Methods The case files of HIV/AIDS patients attending Aminu Kano Teaching Hospital, Nigeria from January to December 2006 were reviewed. Results A total of 1320 HIV/AIDS patients had complete records and were reviewed, among which 138 (10.5%) were coinfected with TB (95% CI, 8.9% to 12.2%). Pulmonary TB was diagnosed in 103 (74.6%) patients, among whom only 18 (17.5%) were sputum-positive. Fifty (36.2%) coinfected patients had some type of extrapulmonary TB (EPTB); 15 had both pulmonary TB and EPTB. Among the 35 patients with EPTB only, 20 (57.1%) had abdominal TB, 5 (14.3%) had TB adenitis, 5 (14.3%) had spinal TB, 3 (8.6%) were being monitored for tuberculous meningitis, and 1 (2.9%) each had renal TB and tuberculous adrenalitis. The highest prevalence of TB, 13.7% (n = 28), was seen among patients aged 41–50 years. TB coinfection was significantly associated with marital status, WHO clinical stage, and CD4 count. Marital status (OR, 2.1; 95% CI, 1.28–3.59; P = 0.04), WHO clinical stage at presentation (4.81; 1.42–8.34; P = 0.001), and baseline CD4 count (2.71; 1.51–6.21; P = 0.02) remained significant predictors after adjustment for confounding. Conclusions The moderately high prevalence of TB among HIV-seropositive patients underscores the urgent need for strategies that lead to rapid identification and treatment of coinfection with active or latent TB. PMID:19265273

  19. Knowledge, attitudes, and practice of doctors to adverse drug reaction reporting in a teaching hospital in India: An observational study

    PubMed Central

    Khan, Sarfaraz Alam; Goyal, Chhaya; Chandel, Nitibhushansingh; Rafi, Mohammed

    2013-01-01

    Background: Underreporting of spontaneous adverse drug reaction (ADR) is a threat to pharmacovigilance. Various factors related with the knowledge and attitudes are responsible for underreporting of ADRs. Aims: The study was aimed at investigating the knowledge and attitudes of doctors to ADR reporting. Materials and Methods: It was a questionnaire-based cross-sectional study. One hundred and eight questionnaires were administered to doctors working in a teaching hospital with an ADR monitoring center. Statistical Analysis Used: The descriptive statistics were used for responses to evaluate the knowledge and attitudes toward ADR reporting. Pearson's Chi-square test was used to observe the association of knowledge and attitude with experience and position. Results: The response rate was 62.9%. Spontaneous reporting rate was found to be 19.1%. The major factors found to be responsible for underreporting of ADR include inadequate risk perception about newly marketed drugs (77.9%), fear factor (73.5%), diffidence (67.7%), lack of clarity of information on ADR form about reporting (52.9%), lethargy (42.7%), insufficient training to identify ADRs (41.2%), lack of awareness about existence of pharmacovigilance program (30.9%) and ADR monitoring center in the institute (19.1%), and inadequate risk perception of over-the-counter (OTC) product (20.6%) and herbal medicines (13.2%). Experience and position did not influence the knowledge and attitudes of doctors. Conclusion: The deficiencies in knowledge and attitudes require urgent attention not only to improve the rate of spontaneous reporting, but also for enhanced safety of the patients and society at large. PMID:23633861

  20. Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria

    PubMed Central

    Lawan, Umar M.; Amole, Gboluwaga T.; Jahum, Mahmud G.; Sani, Abdullahi

    2014-01-01

    Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ?12 months) and caregivers was systematically selected and studied. The data were analyzed using the MINITAB® 12.21 (USA) statistical software. Results: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9) and attachment (78.7%) during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2%) of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7%) had “fair” to “good” infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers’ practices and age of the infants emerged as significant predictors of wasting in the infants. Conclusion and Recommendations: Barely 3 years to the 2015 target of the millennium development goals (MDGs), infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to improve the knowledge and practices of mothers on infant feeding. PMID:24696628

  1. Diathermy versus Scalpel Incision in a Heterogeneous Cohort of General Surgery Patients in a Nigerian Teaching Hospital

    PubMed Central

    Ayandipo, Omobolaji O; Afuwape, Oludolapo O; Irabor, David; Oluwatosin, Odunayo M; Odigie, Vincent

    2015-01-01

    Background: The anecdotal fear of using cautery for surgical incisions is still common in surgical practice despite recent evidences. The aim of this study is to compare the results of electrocautery and the scalpel in skin incisions. Materials and Methods: This is a prospective randomized double blind study conducted in the Department of Surgery, of a teaching hospital in Ibadan. Patients were randomized to have either scalpel or electrocautery incisions. The duration used in making the skin incision; the incisional blood loss and the ensuing length and depth of the wound were noted. Postoperative pain; duration of wound healing and the occurrence of surgical site infection were also noted. Results: There were 197 patients consisting of the scalpel group (n = 98) and the electrocautery group (n = 99). The ages ranged from 16 to 73 years. The demography, case distribution and body mass index were similar in both groups. The mode of presentation was predominantly elective. The incision time was shorter in the electrocautery group (P < 0.001). The blood loss was less with the diathermy compared to the scalpel (6.53 ± 3.84 ml vs. 18.16 ± 7.36 ml, P < 0.001). The cumulative numerical rating scale score for pain was 12.65 (standard deviation [SD] 8.06) and 17.12 (SD 9.49) in the diathermy and scalpel groups respectively (P < 0.001). There was no statistically significant difference in wound infection and wound closure (epithelialization time) (P = 0.206). Conclusion: The use of electrocautery in making skin incision is associated with reduced incision time, incisional blood loss, and postoperative pain.

  2. Perceptions of burden of caregiving by informal caregivers of cancer patients attending University of Calabar Teaching Hospital, Calabar, Nigeria

    PubMed Central

    Akpan-Idiok, Paulina Ackley; Anarado, Agnes Nonye

    2014-01-01

    Introduction Cancer care is devastating to families. This research studied the informal caregivers’ perceptions of burden of caregiving to cancer patients attending University of Calabar Teaching Hospital, Calabar. Methods The research adopted a cross-sectioned descriptive design and 210 caregivers providing care to advanced cancer patients were purposively selected. Data were collected using a researcher developed questionnaire and standardized Zarit Burden Interview scale (ZBIS). Data collected were analysed using descriptive and chi-square statistics with the help of SPSS 18.0 and PAS 19.0 softwares. Results The results indicated that the caregivers were in their youthful and active economic age, dominated by females, Christians, spouses, partners and parents. The burden levels experienced by the caregivers were as follows: severe (46.2%), moderate (36.2%) and trivial of no burden (17.6%). The forms of burden experienced were physical (43.4%), psychological (43.3%), financial (41.1%) and social (46.7%), quite frequently and nearly always. Psychological and social forms of burden had the highest weighted score of 228 in terms of magnitude of burden. The result further showed that there was a significant (P = 0.001) and inverse association between caregivers’ burden and the care receivers’ functional ability. The level of burden also increased significantly (P = 0.000) with the duration of care, while there was also a significant (P = 0.01) relationship between caregivers’ experience of burden and their desire to continue caregiving. Conclusion Caregiving role can be enhanced by provision of interventions such as formal education programme on cancer caregiving, oncology, home services along side with transmural care. PMID:25419297

  3. Drug utilization evaluation of meropenem and correlation of side effects with renal status of patients in a teaching based hospital.

    PubMed

    Khan, Muhammad Umair; Yousuf, Rabia Ismail; Shoaib, Muhammad Harris

    2014-09-01

    Meropenem is a restricted, broad spectrum and expensive antibiotic. The major consequences of irrational use of restricted antibiotics are increase drug resistance and drug expenditure. The use of antibiotics, specifically restricted antibiotics, must be monitored continuously to increase its adherence to the standard guidelines to avoid such problems. The objective of this study was to evaluate the appropriateness of meropenem use with respect to renal status of patients in a teaching based hospital. A retrospective study was carried out from 1st January 2013 to 30th June 2013 to determine the evaluation of meropenem use in accordance to the criteria developed through national (Infectious disease society of Pakistan) and international guidelines (Health care infection control practices advisory committee). The data was recorded on data collection form by thorough reviewing of patients' medical records. Main outcomes measured were indication, dose, interval, duration, creatinine clearance, complete blood count and culture sensitivity test. Correlation of different variable (side effects and generalized health) was also observed with reference to renal status of patients. Statistical analyses were performed using descriptive statistics. A total of 201 cases of meropenem prescription were identified during the study period. The variable, which was most consistent with the criteria was 'indication', in which 97.52% of meropenem prescription was indicated in diseases encouraged by guidelines. However, the use of meropenem as an empirical therapy was the major problem reported in this study as it adhered to in only 43% of the cases. It was also noted that prevalence of side effects increased when meropenem was prescribed in renal compromised patients, and also observed that generalized health of patients decreased with meronem use in renal unstable patients. Thrombocytopenia was the major problem associated with the meropenem use (37.81%). The study detected various areas where use of meropenem was not according to the standards. Strict policies and procedures need to be implemented to use meropenem in line with the standard guidelines. PMID:25176244

  4. Carbapenem Restriction and its Effect on Bacterial Resistance in an Intensive Care unit of a Teaching Hospital

    PubMed Central

    Sistanizad, Mohammad; Kouchek, Mehran; Miri, Mohammad; Goharani, Reza; Solouki, Mehrdad; Ayazkhoo, Ladan; Foroumand, Masoumeh; Mokhtari, Majid

    2013-01-01

    Development of antibiotic resistance in Intensive Care Units (ICUs) is a worldwide problem. The purpose of this study was to evaluate the effect of an antibiotic stewardship program (ASP) by carbapenems restriction on gram-negative antimicrobial resistance in ICU. The study was designed in a 21 bedded general ICU of a teaching hospital with two wings (one and two) in Tehran, Iran. Carbapenem prescription in ICU1 was restricted to only the culture proven multi-drug-resistant bacteria with the absence of sensitivity to other antimicrobial agents. Carbapenem had to be prescribed by a trained ICU physician with close consultation with infectious disease specialist and the clinical pharmacist posted in ICU. Post-prescription reviews and de-escalations were carried out by the same team on regular basis. Restriction policy was commenced in January 2011 in ICU1. All documented infections and resistance patterns of isolated pathogens were recorded in both ICUs during two periods of 6 months before and 9 months after restriction policy implementation. During this study bacterial growth was detected in 51.5% of 1601 samples. Carbapenem administration was decreased from 6.86 to 2.75 DDD/100 patients day (60% decreases) pre-restriction and post-restriction respectively. Significant increase in sensitivity of pseudomonas to imipenem was observed in ICU1 comparing with pre-restriction period six months post restriction (p = 0.000). Sensitivity of Klebsiella and Acinetobacter to imipenem did not change significantly during the study period. Conclusion: Our study demonstrated that restriction of carbapenems can increase sensitivity of P. aeroginosa to imipenem. PMID:24250656

  5. High prevalence of metallo-?-lactamase among carbapenem-resistant Klebsiella pneumoniae in a teaching hospital in China.

    PubMed

    Li, Bin; Xu, Xiao-hong; Zhao, Zhi-chang; Wang, Mei-hua; Cao, Ying-ping

    2014-10-01

    The aim of this study was to characterize the carbapenemases in carbapenem-resistant Klebsiella pneumoniae (CR-KP) from a Chinese teaching hospital. A total of 40 CR-KPs were screened for the presence of carbapenemases. Minimum inhibitory concentrations were determined by agar dilution. The modified Hodge test was used for the detection of carbapenemase production. Carbapenemase, extended-spectrum ?-lactamase, and AmpC genes were detected using polymerase chain reaction (PCR) and sequencing. A conjugation test was performed using a broth culture mating method, transferred plasmids were typed by PCR-based replicon typing, and clonal relatedness was investigated by enterobacterial repetitive intergenic consensus sequences PCR (ERIC-PCR) and multilocus sequence typing (MLST). The results revealed that modified Hodge test was positive for 28 CR-KPs, and CR-KPs exhibited high resistance rates against various antibiotics, except colistin (5.0%) and tigecycline (22.5%). ERIC and MLST profiles showed no clonal outbreak. PCR demonstrated a high prevalence rate (55.0%, 22/40) of metallo-?-lactamases (MBLs) in CR-KPs. IMP-4, IMP-8, NDM-1, and KPC-2 were identified in 14 (35.0%), 7 (17.5%), 2 (5.0%), and 7 (17.5%) isolates, respectively. Notably, 2 CR-KPs coproduced 2 carbapenemases simultaneously (IMP-8/NDM-1 and IMP-4/KPC-2). In vitro transfer of carbapenem resistance was successful for 11 MBL-producing CR-KPs. The extended spectrum ?-lactamase genes were detected in 30 (75.0%) of these CR-KPs. To the best of our knowledge, this is the first report focusing on carbapenem resistance in K. pneumoniae due to metalloenzymes in China. Screening and surveillance of MBLs in Enterobacteriaceae is urgently needed in this region to control and prevent the spread of these resistance determinants. PMID:25285938

  6. Evaluation of the impact of asbestos wastes on soils in Emene-Enugu, Southeastern Nigeria.

    PubMed

    Igwe, O; Omonona, O V; Onwuka, O S; Nnebedum, O D

    2014-12-01

    This study investigated the impacts of asbestos wastes on soils in Emene-Enugu, southeastern Nigeria, generated by the activities of a major asbestos products manufacturing company in southeastern Nigeria. The methods of investigation included vertical electrical sounding (VES), 2-D horizontal resistivity profiling (HRP), induced polarization (IP) survey, chemical analysis of plant tissues and standard penetration tests of soil samples. The 2-D HRP and IP identified six closed waste pits alongside the two active pits. The VES revealed four geoelectrical layers in the area: from bottom to top; the inferred lithologies included dark shale, clay, gravel and recent sands. The geochemical data results revealed that Cd concentration of the soils of the waste pits is above the contaminated land exposure assessment soil guideline value for residential and allotment land uses. The geochemical pollution indices classified the soils as "unpolluted" to "extremely polluted". Bioconcentration factor of Pb in plant tissues was found to be above recommended limits of 0.045. The geotechnical parameters indices revealed that the soils varied from "very soft" to "stiff" and "very loose" to "medium". Soils of the active pits have very low strength and bearing capacity while closed pits have high strength and bearing capacity. It may be safe, therefore, to conclude that as the wastes are completely turned into soils, they will assume geotechnical properties similar to those of natural soils. PMID:25098901

  7. A cross sectional study of somatic complaints of Nigerian females using the Enugu Somatization Scale.

    PubMed

    Ebigbo, P O

    1986-06-01

    Among Nigerian mentally ill a constant male-female ratio of 2:1, over-representation of single males and married females and the tendency for the females who seek psychiatric aid to be psychotic with schizoaffective disturbances have been observed. The question arose as to why this is so. To answer this, the Enugu Somatization Scale, developed in an effort to avoid the difficulty encountered in using Western diagnostic illness categories and scales for assessing mental illness in Nigeria was administered to 51 mentally ill females, 60 adolescent secondary school girls, 67 post secondary school females, 149 pregnant females, and 60 women who were once able to bear children but now no longer can. It was found that somatization is used by Nigerian females to contain their stress. The pregnant females scored lowest while those women who can no longer deliver scored highest. Pregnancy is seen as a state of rest from societal stress for the females, who otherwise are not allowed by the society to be so mentally ill as to seek a psychiatrist and who have to be psychotic to be able to do so. Various tentative, dynamic explanations of the items in the scale answered in the affirmative by a wide cross section of the women, based on the clinical experience of the author, are offered. PMID:3487415

  8. Organizational and human behavioral factors on performance of a hospital information system : a case study from a large teaching hospital in the Boston area

    E-print Network

    Hozumi, Dairiku

    2007-01-01

    Improvement in efficiency of healthcare in the United States is an urgent issue. Information technology is seen as one of key solutions to improve efficiency. As such, hospitals in the United States are rapidly adopting ...

  9. PrimaryChildrensHospital

    Cancer.gov

    Located in the foothills of the Wasatch Mountains, Primary Children's Hospital is the children's hospital for Utah, Idaho, Wyoming, Nevada, and Montana. Our 289-bed hospital is equipped and staffed to care for children with complex illness and injury. Primary Children's is owned by Intermountain Healthcare and is the pediatric specialty teaching hospital for the University Of Utah School of Medicine.

  10. Six year audit of cardiac arrests and medical emergency team calls in an Australian outer metropolitan teaching hospital

    Microsoft Academic Search

    Michael Buist; Julia Harrison; Ellie Abaloz; Susan Van Dyke

    2007-01-01

    Problem In-hospital cardiac arrest often represents failure of optimal clinical care. The use of medical emergency teams to prevent such events is controversial. In-hospital cardiac arrests have been reduced in several single centre historical control studies, but the only randomised prospective study showed no such benefit. In our hospital an important problem was failure to call the medical emergency team

  11. A questionnaire-based survey to ascertain the views of clinicians regarding rational use of antibiotics in teaching hospitals of Kolkata

    PubMed Central

    Chatterjee, Dattatreyo; Sen, Sukanta; Begum, Sabnam Ara; Adhikari, Anjan; Hazra, Avijit; Das, Anup Kumar

    2015-01-01

    Objectives: The objective was to assess the views of clinicians in teaching hospitals of Kolkata regarding the use of antibiotics in their own hospitals, focusing on perceived misuse, reasons behind such misuse and feasible remedial measures. Materials and Methods: A total of 200 clinicians from core clinical disciplines was approached in six teaching hospitals of Kolkata through purposive sampling. A structured, validated questionnaire adopted from published studies and modified to suit the responding population was completed by consenting respondents through face-to-face interaction with a single interviewer. Respondents were free to leave out questions they did not wish to answer. Results: Among 130 participating clinicians (65% of approached), all felt that antibiotic misuse occurs in various hospital settings; 72 (55.4% of the respondents) felt it was a frequent occurrence and needed major rectification. Cough and cold (78.5%), fever (65.4%), and diarrhea (62.3%) were perceived to be the commonest conditions of antibiotic misuse. About half (50.76%) felt that oral preparations were more misused compared to injectable or topical ones. Among oral antibiotics, co-amoxiclav (66.9%) and cefpodoxime (63.07%) whereas among parenteral ones, ceftriaxone and other third generation cephalosporins (74.6%) followed by piperacillin-tazobactam (61.5%) were selected as the most misused ones. Deficient training in rational use of medicines (70.7%) and absence of institutional antibiotic policy (67.7%) were listed as the two most important predisposing factors. Training of medical students and interns in rational antibiotic use (78.5%), implementation of antibiotic policy (76.9%), improvement in microbiology support (70.7%), and regular surveillance on this issue (64.6%) were cited as the principal remedial measures. Conclusions: Clinicians acknowledge that the misuse of antibiotics is an important problem in their hospitals. A system of clinical audit of antibiotic usage, improved microbiology support and implementation of antibiotic policy can help to promote rational use of antimicrobial agents.

  12. Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Internal Medicine ward of a teaching hospital in Western Nepal: a prospective study

    PubMed Central

    Shankar, Ravi Pathiyil; Partha, Praveen; Shenoy, Nagesh Kumar; Easow, Joshy Maducolil; Brahmadathan, Kottallur Narayanan

    2003-01-01

    Background Information about antibiotic use and resistance patterns of common microorganisms are lacking in hospitals in Western Nepal. Excessive and inappropriate use of antibiotics contributes to the development of bacterial resistance. The parameter: Defined daily dose/100 bed-days, provides an estimate of consumption of drugs among hospital in-patients. This study was carried out to collect relevant demographic information, antibiotic prescribing patterns and the common organisms isolated including their antibiotic sensitivity patterns. Methods The study was carried out over a 3-month period (01.04.2002 to 30.06.2002) at the Manipal Teaching Hospital, Western Nepal. The median number of days of hospitalization and mean ± SD cost of antibiotics prescribed during hospital stay were calculated. The use of antibiotics was classified for prophylaxis, bacteriologically proven infection or non-bacteriologically proven infection. Sensitivity patterns of the common organisms were determined. Defined daily dose/100 bed-days of the ten most commonly prescribed antibiotics were calculated. Results 203 patients were prescribed antibiotics; 112 were male. Median duration of hospitalization was 5 days. 347 antibiotics were prescribed. The most common were ampicillin, amoxicillin, metronidazole, ciprofloxacin and benzylpenicillin. Mean ± SD cost of antibiotics was 16.5 ± 13.4 US$. Culture and sensitivity testing was carried out in 141 patients. The common organisms isolated were H. influenzae, E. coli, K. pneumoniae and S. aureus. Conclusions Antibiotic resistance is becoming a problem in the Internal Medicine ward. Formulation of a policy for hospital antibiotic use and an educational programme especially for junior doctors is required. PMID:12904265

  13. Experiences of leaders in the implementation of Lean in a teaching hospital—barriers and facilitators in clinical practices: a qualitative study

    PubMed Central

    Aij, Kjeld Harald; Simons, Frederique Elisabeth; Widdershoven, Guy A M; Visse, Merel

    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 considered the experiences of leaders themselves. This study aims to bridge this gap. Design Semistructured, indepth interviews. Setting One of largest teaching hospitals in the Netherlands. Participants 31 medical, surgical and nursing professionals with an average of 19.2?years of supervisory experience. All professionals were appointed to a Lean Training Programme and were directly involved in the implementation of Lean. Results The evidence obtained in this study shows that, from the perspectives of participants, leadership management support, a continuous learning environment and cross-departmental cooperation play a significant role in successful Lean implementation. The results suggest that a Lean Training Programme contributed to positive outcomes in personal and professional skills that were evident during the first 4?months after programme completion. Conclusions Implementing Lean in a teaching hospital setting is a challenge because of the ambiguous and complex environment of a highly professionalised organisation. The study found that leadership management support and a continuous learning environment are important facilitators of Lean implementation. To increase the successful outcomes of leadership actions, training should be supplemented with actions to remove perceived barriers. This requires the involvement of all professionals, the crossing of departmental boundaries and a focus on meaning-making processes rather than simply ‘implementing’ facts. Therefore, this research suggests that programme participants, such as staff members and leaders, can mutually explore the meanings of Lean thinking and working for their own contexts. By entering this shared learning process (eg, learning on the job) the ownership of Lean implementation could also increase. PMID:24171938

  14. Glucose-6-phosphate dehydrogenase deficiency among children attending the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

    PubMed

    Isaac, Iz; Mainasara, As; Erhabor, Osaro; Omojuyigbe, St; Dallatu, Mk; Bilbis, Ls; Adias, Tc

    2013-01-01

    Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common human enzyme deficiencies in the world. It is particularly common in populations living in malaria-endemic areas, affecting more than 400 million people worldwide. This present study was conducted with the aim of determining the prevalence of G6PD deficiency among children visiting the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital for pediatric-related care. The study included 118 children, made up of 77 (65.3%) males and 41 (34.7%) females aged ?5 years with mean age of 3.26 ± 1.90 years. Randox G6PD quantitative in vitro test screening was used for the diagnosis of G6PD deficiency. Of the 118 children tested, 17 (14.4%) were G6PD-deficient. Prevalence of G6PD deficiency was concentrated predominantly among male children (22.1%). Male sex was significantly correlated with G6PD deficiency among the children studied (r = 7.85, P = 0.01). The highest prevalence occurred among children in the 2- to 5-year age-group. Of the 17 G6PD-deficient children, twelve (70.2%) were moderately deficient, while five (29.4%) were severely deficient. Blood film from G6PD-deficient children indicated the following morphological changes; Heinz bodies, schistocytes, target cells, nucleated red cells, spherocytes, and polychromasia. This present study has shown a high prevalence of G6PD deficiency among children residing in Sokoto in the northwestern geopolitical zone of Nigeria. The study indicated a male sex bias in the prevalence of G6PD deficiency among the children studied. There is a need for the routine screening of children for G6PD deficiency in our environment, to allow for evidence-based management of these children and to ensure the avoidance of food, drugs, and infective agents that can potentially predispose these children to oxidative stress as well as diseases that deplete micronutrients that protect against oxidative stress. There is need to build capacity in our setting among pediatricians to ensure the effective management of children with G6PD deficiency. PMID:23874116

  15. Glucose-6-phosphate dehydrogenase deficiency among children attending the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

    PubMed Central

    Isaac, IZ; Mainasara, AS; Erhabor, Osaro; Omojuyigbe, ST; Dallatu, MK; Bilbis, LS; Adias, TC

    2013-01-01

    Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common human enzyme deficiencies in the world. It is particularly common in populations living in malaria-endemic areas, affecting more than 400 million people worldwide. This present study was conducted with the aim of determining the prevalence of G6PD deficiency among children visiting the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital for pediatric-related care. The study included 118 children, made up of 77 (65.3%) males and 41 (34.7%) females aged ?5 years with mean age of 3.26 ± 1.90 years. Randox G6PD quantitative in vitro test screening was used for the diagnosis of G6PD deficiency. Of the 118 children tested, 17 (14.4%) were G6PD-deficient. Prevalence of G6PD deficiency was concentrated predominantly among male children (22.1%). Male sex was significantly correlated with G6PD deficiency among the children studied (r = 7.85, P = 0.01). The highest prevalence occurred among children in the 2- to 5-year age-group. Of the 17 G6PD-deficient children, twelve (70.2%) were moderately deficient, while five (29.4%) were severely deficient. Blood film from G6PD-deficient children indicated the following morphological changes; Heinz bodies, schistocytes, target cells, nucleated red cells, spherocytes, and polychromasia. This present study has shown a high prevalence of G6PD deficiency among children residing in Sokoto in the northwestern geopolitical zone of Nigeria. The study indicated a male sex bias in the prevalence of G6PD deficiency among the children studied. There is a need for the routine screening of children for G6PD deficiency in our environment, to allow for evidence-based management of these children and to ensure the avoidance of food, drugs, and infective agents that can potentially predispose these children to oxidative stress as well as diseases that deplete micronutrients that protect against oxidative stress. There is need to build capacity in our setting among pediatricians to ensure the effective management of children with G6PD deficiency. PMID:23874116

  16. OPPORTUNITIES IN HOTELS-HOSPITALITY, SUMMER CAMP, TEACHING, AU PAIR, CHILDCARE, HOMECARE & MORE 1. CHILDCARE POSITION IN MISSISSAUGA, ON

    E-print Network

    .scotia-personnel-ltd.com ------------------------------------------------------------------------------ 6. Teaching in South Korea Job Location: Seoul and across South Korea Job Description: Teaching-6840. Email: info@scotia-personnel-ltd.com Visit website at: www.scotia-personnel-ltd.com #12;3. Child Care, Boston, etc. Caring for children, working with private families. 1 year terms. Benefits include Salary

  17. Frequency of bacterial agents isolated from patients with nosocomial infection in teaching hospitals of Mazandaran University of Medical Sciences in 2012

    PubMed Central

    Davoudi, Ali Reza; Najafi, Narges; Hoseini Shirazi, Mohsen; Ahangarkani, Fatemeh

    2014-01-01

    Background: The antibiotic resistance of nosocomial organisms is rapidly increasing. The purpose of this study was to determine the frequency of bacterial agents isolated from patients with nosocomial infection. Methods: This study was performed in the different wards of teaching hospitals of Mazandaran University of Medical Sciences (northern Iran). The study population consists of the patients with the symptoms of nosocomial infection admitted in these hospitals in 2012. The patient data (including age, sex, type of infection, type of isolated organisms and their antibiotic susceptibility) were collected and analyzed. Results: The total number of hospitalizations was 57122 and the number of nosocomial infection was 592. The overall prevalence of nosocomial infection was 1.03% that was mostly in Burn unit and intensive care unit. The most common nosocomial infection was wound infection (44.6%) and the most common organisms were Pseudomonas aeruginosa and Acinetobacter. Conclusion: Given the increasing numbers of nosocomial infection in this region, especially infection with Pseudomonas aeruginosa, it is necessary to make a precise reporting and improve the procedures of infection control in hospitals. PMID:25489435

  18. A nursing care classification system for assessing workload and determining optimal nurse staffing in a teaching hospital in China: A pre-post intervention study.

    PubMed

    Yu, Dongmei; Ma, Yuqin; Sun, Qingwen; Lu, Gendi; Xu, Ping

    2014-04-22

    We aimed to evaluate the effectiveness of a nursing care classification system for re-assessing nurse workload and determining staffing needs. Adequate bed-nurse ratios help manage hospital cost-efficiency, quality of care and patient safety. A prospective pre-post intervention study was conducted from January 2010 to December 2012 in 16 medical-surgical units of a tertiary teaching hospital. Nursing tasks were classified into four grades of care reflecting actual workload. Units were re-staffed accordingly and bed-nurse ratios compared with government-authorized bed-nurse ratios. Patient satisfaction, hospital stays and mortality were evaluated pre- and poststaffing changes. Average bed-nurse ratio (1:0.41) exceeded the national standard (1:0.40) in 16 units, but was inadequate in five units. Re-staffing increased average bed-nurse ratio from 1:0.41 to 1:0.48. Patients' satisfaction increased from 96.9% to 97.6%, and hospital stays decreased significantly. Nursing care classification effectively distributes nurse staffing to match patients' care levels, improving patient outcomes. PMID:24754507

  19. Optimal allocation of public water supply to the urban sectors of Enugu, Nigeria: a linear programming approach

    NASA Astrophysics Data System (ADS)

    Ezenwaji, Emma E.; Anyadike, Raymond N. C.; Igu, Nnaemeka I.

    2014-03-01

    Recent studies in water supply in Enugu urban area have observed that there is a persistent water supply shortage relative to demand. One of the strategies for achieving a good water supply under the circumstance is through efficient water allocation to consumers. The existing allocation system by the Enugu State Water Corporation is not achieving the desired goal, because it is not based on any scientific criteria. In this study, we have employed the linear programming modelling technique to optimise the allocation of 35,000,000 L of water produced daily by the State Water Corporation and supplied to the four sectors of the town. The result shows that the model allocated 27,470,000 L to the residential sector, 3,360,000 L to commercial, 3,120,000 L to industrial and 882,000 L to public institutions sectors leaving a balance of 168,000 L to be utilised in emergency situations. This allocation pattern departs sharply from the present management technique adopted by the corporation. It is then suggested that for urban water supply to be sustainable in the town, the corporation should rely on this technique for water supply.

  20. Prevalence of antimicrobial residues in raw table eggs from farms and retail outlets in Enugu State, Nigeria.

    PubMed

    Ezenduka, Ekene V; Oboegbulem, Steve I; Nwanta, John A; Onunkwo, Joseph I

    2011-03-01

    The use of antimicrobial agents in poultry production results in their accumulation in the body tissues and products such as milk and egg. The subsequent accumulation of these drugs and their metabolites in body cells is known as drug residue. This study was designed to determine the prevalence of antimicrobial residues in eggs from poultry farms and retail outlets in Enugu State, Nigeria. Eggs from 25 selected commercial farms and ten retail outlets were screened for the prevalence of antimicrobial residue. Also, structured questionnaires were administered to 25 commercial farms in the state to determine the management practices and the most widely used antimicrobial drugs in farms and possible association between the management practices and the occurrence of antimicrobial residues in eggs from these farms. All the 25 farms surveyed use oxytetracycline. Eggs from nine of the surveyed farms tested positive for antimicrobial residue and three of the ten surveyed farms also tested positive for antimicrobial residue. No association was observed (p?0.05; Fisher's exact test) between the occurrence of antibiotic residues in eggs and farm size, feed source and housing systems. This study was able to demonstrate the presence of antimicrobial residues in eggs destined for human consumption. Drugs like nitrofurans which has been banned for use in food animals are still very much in use in Enugu State, Nigeria. Antibiotics given as feed additives may give rise to drug residues in food animals. PMID:21104128

  1. Strategic planning and designing of a hospital disaster manual in a tertiary care, teaching, research and referral institute in India

    PubMed Central

    Talati, Shweta; Bhatia, Prateek; Kumar, Ashok; Gupta, A. K.; Ojha, Col. D

    2014-01-01

    BACKGROUND: As per the “Disaster Management Act, 2005” of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1 900 bed tertiary care hospital, in consultation and involvement of all concerned stakeholders. METHODS: A committee of members from hospital administration, clinical, diagnostic and supportive departments worked on an initial document prepared according to the Act and gave their inputs to frame a final disaster manual. RESULTS: The prepared departmental standard operating procedures involved 116 people (doctors and paramedical staff), and were then synchronized, in 12 committee meetings, to produce the final hospital disaster manual. CONCLUSIONS: The present disaster manual is one of the few comprehensive plans prepared by the stakeholders of a government hospital in India, who themselves form a part of the disaster response team. It also helped in co-ordinated conduction of mock drills. PMID:25215145

  2. A Study of Utilization of Antimicrobial Agents in Patients on Ventilator in Intensive Care Unit (ICU) at Tertiary Care Teaching Hospital, India

    PubMed Central

    Gandhi, Anuradha M; Patel, Prakruti P

    2014-01-01

    Objective: To study the use of antimicrobial agents in patients on ventilator in ICU. Materials and Methods: Study was conducted at tertiary care teaching hospital Ahmedabad, India. Total 300 patients admitted in ICU and prescribed antimicrobial agents were included in the study. The data were recorded in preformed Case Record Form (CRF) and were analysed by Z and x2 Test. Results: Patients were divided into group A (patients on ventilator support) and group B (patients without ventilator support). In all the patients antimicrobial agents were prescribed empirically and more than two antimicrobial agents were prescribed in both groups. It was observed that above 60% antimicrobial agents were prescribed according to WHO, National and State Essential Medicine List (EML). Restricted antimicrobial agents (according to antimicrobial policy of tertiary care teaching hospital) were prescribed significantly (p<0.05) higher in group A as compared to group B. Resistance to antimicrobial agents by Pseudomonas aeruginosa and Kleibsella shown significantly (p<0.05) higher in group A as compared to group B. Change of antimicrobial therapy after Culture Sensitivity Test (CST) was significantly (p<0.05) higher in group A as compared to group B. Conclusion: Number of antimicrobial agents, antimicrobial resistance and change of antimicrobial therapy after CST were higher in patients on ventilator support. PMID:25584243

  3. Incidence of Road Traffic Injury and Associated Factors among Patients Visiting the Emergency Department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia.

    PubMed

    Tiruneh, Bewket Tadesse; Dachew, Berihun Assefa; Bifftu, Berhanu Boru

    2014-01-01

    Background. Road traffic injuries are a major public health issue. The problem is increasing in Africa. Objective. To assess the incidence of road traffic injury and associated factors among patients visiting the emergency department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Methods. Institutional based cross-sectional study design was conducted. A total of 356 systematically selected study subjects were included in the study. Bivariate and multivariate logistic regressions were performed to identify associated factors with road traffic injury. Odds ratios with 95% confidence interval were computed to determine the level of significance. Results. The incidence of road traffic injury in the emergency department of Tikur Anbessa Specialized Teaching Hospital was 36.8%. Being a farmer (AOR = 3.3; 95% CI = 1.06-10.13), conflict with family members (AOR = 7.7; 95% CI = 3.49-8.84), financial problem (AOR = 9.91; 95% CI = 4.79-6.48), psychological problem (AOR = 17.58; 95% CI = 7.70-12.14), and alcohol use (AOR = 2.98; 95% CI = 1.61-5.27) were independently associated with road traffic injury. Conclusion and Recommendation. In this study the incidence of road traffic injury was high. Alcohol is one of the most significant factors associated with Road Traffic Injury. Thus urgent education on the effect of alcohol is recommended. PMID:25165583

  4. Prevalence and characterization of Staphylococcus aureus and Staphylococcus pseudintermedius isolated from companion animals and environment in the veterinary teaching hospital in Zambia, Africa.

    PubMed

    Youn, Jung-Ho; Park, Yong Ho; Hang'ombe, Bernard; Sugimoto, Chihiro

    2014-03-01

    The Republic of Zambia consists of only one veterinary teaching school at the University of Zambia (UNZA) where students and veterinarians are exposed to many bacterial pathogens including Staphylococcus aureus (SA) and Staphylococcus pseudintermedius (SP). The aim of this study was the characterization and antimicrobial susceptibility profile of eleven SA and 48 SP isolates from the veterinary hospitals' in- and outpatients and the environment. No isolate was resistant to cefoxitin by disk diffusion test and the corresponding resistance gene mecA was not found. In contrast, the resistance rates of SA to penicillin (63.6%) and trimethoprim-sulfamethoxazole (36.4%) and SP to penicillin (52.1%) and tetracycline (25.0%) were the highest. A variety of sequence types (STs) without a predominant type including numerous novel types were determined, especially for SP (39.6%). The spa typing provided a clonal assignment for all SAs (100%) and 24 SPs (50%) with three and two novel types, respectively. This study has provided an overview of SA and SP in the veterinary teaching hospital at UNZA. However, for a better understanding of these species regarding pathogenesis and transmission, further studies on the prevalence and characterization of SA and SP from veterinary staff, pet owners, and farm animals in Zambia is needed. PMID:24480623

  5. Factors associated with success of vaginal birth after one caesarean section (VBAC) at three teaching hospitals in Addis Ababa, Ethiopia: a case control study

    PubMed Central

    2013-01-01

    Background Vaginal delivery after previous one cesarean section for a non recurring indication has been described by several authors as safe and having a success rate of 60–80%. Hence many centers are offering VBAC for candidates leaving the century old dictum of once cesarean always cesarean. But predicting success of VBAC after trial of labor (TOL) is still a difficult task due to the lack of a validated prediction tool. Studies on predictors of success are few and most of them conducted in developed countries and difficult to generalize. Therefore assessing factors associated with successful VBAC is very important to for counseling mothers while offering VBAC. The aim of this study was to assess factors associated with successful VBAC in three teaching Hospitals in Addis Ababa Ethiopia. Methods A case control study was conducted to compare the factors associated with successful VBAC in teaching hospitals in Addis Ababa in one year period. The cases were those successfully delivered vaginally and the controls were those with failed VBAC and delivered by caesarean section. The sample size of the cases was 101vaginal deliveries and the controls were 103 failed VBAC patients which made the case to control ratio of 1:1. Result In this study independent factors determining successful VBAC were, history of successful VBAC in the past, rupture of membrane at admission, and cervical dilatation of more than 3cm at admission. Presence of meconium, malposition and history of stillbirth were associated with failed VBAC. Factors like maternal age, past caesarean indications, inter delivery interval, and birth weight were not found to be significant determinants of success. The most common reason for repeat cesarean section for after trial of labor was labour dysfunction because of absence of a policy for augmentation on a scarred uterus in these hospitals. Conclusion It is possible to prepare a decision tool on the success of VBAC by taking important past and present obstetric and reproductive performance history as predictor. PMID:23374116

  6. Epidemiology of Multi-Drug Resistant Organisms in a Teaching Hospital in Oman: A One-Year Hospital-Based Study

    PubMed Central

    Balkhair, Abdullah; Al-Farsi, Yahya M.; Al-Muharrmi, Zakariya; Al-Rashdi, Raiya; Al-Jabri, Mansoor; Neilson, Fatma; Al-Adawi, Sara S.; El-Beeli, Marah

    2014-01-01

    Background. Antimicrobial resistance is increasingly recognized as a global challenge. A few studies have emerged on epidemiology of multidrug resistant organisms in tertiary care settings in the Arabian Gulf. Aim. To describe the epidemiology of multi-drug resistant organisms (MDRO) at Sultan Qaboos University Hospital, a tertiary hospital in Oman. Methods. A retrospective review of MDRO records has been conducted throughout the period from January 2012 till December 2012. Organisms were identified and tested by an automated identification and susceptibility system, and the antibiotic susceptibility testing was confirmed by the disk diffusion method. Results. Out of the total of 29,245 admissions, there have been 315 patients registered as MDRO patients giving an overall prevalence rate of 10.8 (95% CI 9.3, 12.4) MDRO cases per 1000 admissions. In addition, the prevalence rate of MDRO isolates was 11.2 (95% CI 9.7, 12.9) per 1000 admissions. Overall, increasing trends in prevalence rates of MDRO patients and MDRO isolates were observed throughout the study period. Conclusion. Antimicrobial resistance is an emerging challenge in Oman. Continuous monitoring of antimicrobial susceptibility and strict adherence to infection prevention guidelines are essential to prevent proliferation of MDRO. Along such quest, stringent antibiotic prescription guidelines are needed in the country. PMID:24526881

  7. Prospects of using community directed intervention strategy in delivering health services among Fulani Nomads in Enugu State, Nigeria

    PubMed Central

    2013-01-01

    Background The Community Directed Interventions (CDI) strategy has proven effective in increasing access to health services in sedentary populations. It remains to be seen if CDI strategy is feasible among nomads given the dearth of demographic and medical data on the nomads. This study thus characterized the nomadic populations in Enugu State, Nigeria and outlined the potentials of implementing CDI among nomads. Study design and methods This exploratory study adopted qualitative methods. Forty focus group discussions (FGD) were held with members of 10 nomadic camps in 2 LGAs in Enugu State, as well as their host communities. Thirty in-depth interviews (IDIs) were held with leaders of nomadic camps and sedentary populations. Ten IDIs with traditional healers in the nomadic camps and 14 key informant interviews with health workers and programme officers were also conducted. Documents and maps were reviewed to ascertain the grazing routes of the nomads as well as existing health interventions in the area. Results Like sedentary populations, nomads have definable community structures with leaders and followers, which is amenable to implementation of CDI. Nomads move their cattle, in a definite pattern, in search of grass and water. In this movement, the old and vulnerable are left in the camps. The nomads suffer from immunization preventable health problems as their host communities. The priority health problems in relation to CDI include malaria, measles, anemia, and other vaccine preventable infections. However, unlike the sedentary populations, the nomads lack access to health interventions, due to the mutual avoidance between the nomads and the sedentary populations in terms of health services. The later consider the services as mainly theirs. The nomads, however, are desirous of the modern health services and often task themselves to access these modern health services in private for profit health facilities when the need arises. Conclusion Given the definable organizational structure of the nomads in Enugu State and their desire for modern health intervention, it is feasible to test the CDI strategy for equitable healthcare delivery among nomads. They are willing and capable to participate actively in their own health programmes with minimal support from professional health workers. PMID:23566078

  8. Patient safety culture in a large teaching hospital in Riyadh: baseline assessment, comparative analysis and opportunities for improvement

    PubMed Central

    2014-01-01

    Background In light of the immense attention given to patient safety, this paper details the findings of a baseline assessment of the patient safety culture in a large hospital in Riyadh and compares results with regional and international studies that utilized the Hospital Survey on Patient Safety Culture. This study also aims to explore the association between patient safety culture predictors and outcomes, considering respondent characteristics and facility size. Methods This cross sectional study adopted a customized version of the HSOPSC and targeted hospital staff fitting sampling criteria (physicians, nurses, clinical and non-clinical staff, pharmacy and laboratory staff, dietary and radiology staff, supervisors, and hospital managers). Results 3000 questionnaires were sent and 2572 were returned (response rate of 85.7%). Areas of strength were Organizational Learning and Continuous Improvement and Teamwork within units whereas areas requiring improvement were hospital non-punitive response to error, staffing, and Communication Openness. The comparative analysis noted several areas requiring improvement when results on survey composites were compared with results from Lebanon, and the United States. Regression analysis showed associations between higher patient safety aggregate score and greater age (46 years and above), longer work experience, having a Baccalaureate degree, and being a physician or other health professional. Conclusions Patient safety practices are crucial toward improving overall performance and quality of services in healthcare organizations. Much can be done in the sampled organizations and in the context of KSA in general to improve areas of weakness and further enhance areas of strength. PMID:24621339

  9. The relationship between the managerial skills and results of "performance evaluation "tool among nursing managers in teaching hospitals of iran university of medical science.

    PubMed

    Isfahani, Haleh Mousavi; Aryankhesal, Aidin; Haghani, Hamid

    2015-01-01

    Performance of different organizations, such as hospitals is mainly influenced by their managers' performance. Nursing managers have an important role in hospital performance and their managerial skills can improve the quality of the services. Hence, the present study was conducted in order to assess the relationship between the managerial skills and the results of their performance evaluation in Teaching Hospitals of Iran University of Medical Science in 2013. The research used the cross sectional method in 2013. It was done by distributing a managerial skills assessment questionnaire, with close-ended questions in 5 choice Likert scale, among 181 managers and head nurses of hospitals of Iran university of Medical Sciences; among which 131 answered the questions. Another data collection tools was a forms to record evaluation marks from the personnel records. We used Pearson and Spearman correlation tests and SPSS for analysis and description (frequency, mean and standard deviation). Results showed that the managerial skills of the nursing mangers were fair (2.57 out of 5) and the results of the performance evaluation were in a good condition (98.44). The mangers' evaluation results and the managerial skills scores were not in a meaningful correlation (r=0.047 np=0.856). The research showed no correlation between different domains of managerial skills and the performance evaluation marks: decision making skills (r=0.074 and p=0.399), leadership (correlation coefficient 0.028 and p=0.654), motivation (correlation coefficient 0.118 and p=0.163), communication  (correlation coefficient 0.116 and p=0.122), systematic thinking  (correlation coefficient 0.028 and p=0.828), time management (correlation coefficient 0.077 and p=0.401) and strategic thinking  (correlation coefficient 0.041 and p=0.756). Lack of any correlation and relation between managers' managerial skills and their performance evaluation results shows need to a fundamental revision at managers' performance evaluation form. PMID:25716403

  10. Updates on the epidemiology and pattern of traumatic maxillofacial injuries in a nigerian university teaching hospital: a 12-month prospective cohort in-hospital outcome study.

    PubMed

    Olusanya, Adeola Adenike; Adeleye, Amos Olufemi; Aladelusi, Timothy Olukunle; Fasola, Abiodun Olubayo

    2015-03-01

    Many studies have been undertaken in Nigeria on maxillofacial trauma. However, only a few have considered both the skeletal and soft tissue injuries (in general) involving all the aspects of the maxillofacial region or considered other etiological sources of trauma apart from road traffic crashes. Fewer still have reviewed the outcome of management of facial injuries in our low-resource environment. This study sets out to examine the recent trends in both the clinical and epidemiological patterns of all facial injuries from all causes seen in a low-resource practice of a developing country. It also assessed the in-hospital treatment outcomes, and the levels of the patients' satisfaction with treatment received in this setting. Over a 12-month period, the clinical records of consecutive patients who were evaluated and treated for maxillofacial injuries in our unit were prospectively acquired, entered into predesigned forms and subsequently analyzed. There were 259 patients (79.5% males) during the study period. The mean age was 32.21(?±?16.588) years. Overall, motor bike crashes, 42.1%, were the commonest source of these traumas; and armed robbery was the commonest form (69.0%) of assault. Mandibular fractures were the commonest maxillofacial fractures (37.8%) whereas head injury had the highest frequency among the associated injuries (71.4%). Closed reduction and immobilization was deployed in 88.0% of those who had treatment and majority was satisfied with the esthetic outcome of the treatment received. Mean length of hospital stay was 12.6 (?±?4.423) days. Maxillofacial trauma poses a significant socioeconomic burden on affected individuals in this study population. This is made worse by the presence of associated injuries in the other body systems. More local studies on the outcome of management of maxillofacial trauma will improve the available literature in this region. PMID:25709753

  11. Differences in medical error risk among nurses working two- and three-shift systems at teaching hospitals: a six-month prospective study.

    PubMed

    Tanaka, Katsutoshi; Takahashi, Masaya; Hiro, Hisanori; Kakinuma, Mitsuru; Tanaka, Mika; Kamata, Naoki; Miyaoka, Hitoshi

    2010-01-01

    Shift work, including night work, has been regarded as a risk factor for medical safety. However, few studies have investigated the difference in medical error risk between two- and three-shift systems. A total of 1,506 registered nurses working shifts at teaching hospitals participated in this study to evaluate the difference in medical error risk between two- and three-shift systems. After adjustment for potential confounding factors using a log Poisson generalized estimating equation model, the results showed significantly higher frequencies of perceived adverse events over 6 months in the three-shift than in the two-shift system, with estimated mean numbers of adverse events of 1.05 and 0.74, respectively. Shorter intervals after night shifts and greater frequency of night shifts in three-shift systems, which reduce the recovery time from night shift work, may be linked to increased medical errors by nurses. PMID:20562512

  12. Implementing an Online Reporting System in the Anatomical Pathology Department of a Tertiary Care Teaching Hospital in India: A Case Study

    PubMed Central

    Radhakrishna, Kedar; Correa, Marjorie; Thounaojam, Deepak; Raj, Tony D. S.

    2013-01-01

    This article presents a case study in designing, developing, and implementing a web-enabled reporting application for the anatomical pathology (histopathology) department of a tertiary care teaching hospital in India. The article describes workflows, requirements assessment, and implementation methods that the investigators adopted for deploying the solution. The primary focus of the study was to demonstrate the requirements assessment performed, the strategies adopted, and the challenges encountered during the development and implementation. The study demonstrates a successful deployment as well as successful adoption of healthcare information technology by the end users. Factors that played a crucial role in adoption included the combination of people, processes, and technology. The lessons learned from this study would help application developers design efficient systems that suit the requirements of the end users while keeping in mind the ever-changing need for workflows and scalability in a developing country. PMID:23861673

  13. Advanced abdominal pregnancy: a study of 13 consecutive cases seen in 1993 and 1994 at Komfo Anokye Teaching Hospital, Kumasi, Ghana.

    PubMed

    Opare-Addo, H S; Deganus, S

    2000-04-01

    Thirteen cases of advanced abdominal pregnancy (AAP) managed at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana, over a two-year period (1993-1994) are presented. An incidence ratio of one advanced abdominal pregnancy to 1,320 deliveries occurred during this period. The ratio of advanced abdominal pregnancy to ectopic pregnancy was 1:43.7. The perinatal mortality rate and maternal case fatality rates were 69.6% and 15.3% respectively. Recurrent abdominal pains in the gravid patient with abnormal fetal lie and prior history of tubal pregnancy and/or previous abdominal surgery were significant findings in the cases reviewed. These findings should, therefore, always prompt lucid and elaborate ultrasound examination of a pregnancy to exclude abdominal pregnancy. PMID:11000706

  14. Teaching Hospital and Other Issues Related to Graduate Medical Education. Hearing before the Subcommittee on Health of the Committee on Ways and Means. House of Representatives, One Hundred Fourth Congress, Second Session (June 11, 1196).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Ways and Means.

    This document reports testimony presented on Medicare financing of graduate medical education, as proposed by the Balanced Budget Act of 1995. Witnesses included: (1) Timothy M. Golddfarb, Director, Healthcare Systems (Oregon), who noted the importance of graduate medical education funding to teaching hospitals; (2) Leo P. Brideau of Strong…

  15. Secondary Prevention Measures after Acute Myocardial Infarction: Comparison between Diabetics and Non-Diabetics at a Saudi Teaching Hospital

    Microsoft Academic Search

    Daad H. Akbar

    2000-01-01

    Objective: To compare between the use of secondary prevention measures after acute myocardial infarction in diabetic and non-diabetic patients who were admitted to the King Abdulaziz University Hospital. Method: All patients admitted with a definitive diagnosis of acute myocardial infarction between January 1995 and December 1999 were studied. Patients’ age, sex, body mass index, development of heart failure, peak serum

  16. Antimicrobial therapy and control of multidrug-resistant Pseudomonas aeruginosa bacteremia in a teaching hospital in Taiwan

    Microsoft Academic Search

    Ching-Hsiang Leung; Nai-Yu Wang; Chang-Pan Liu; Li-Chuan Weng; Feng-Chih Hsieh; Chun-Ming Lee

    Background and Purpose: The emergence of multidrug-resistant (MDR) Pseudomonas aeruginosa is a challeng- ing clinical problem. This study investigated the source of an outbreak of MDR P. aeruginosa infections and the role of combination therapy in its management. Methods: MDR P. aeruginosa isolates were collected at the MacKay Memorial Hospital, Taipei, Taiwan, and anti- biotic synergy was investigated based on

  17. Caregivers's knowledge, attitude and practice on childhood malaria and treatment in urban and rural communities in Enugu, south-east Nigeria

    Microsoft Academic Search

    T. Oguonu; H. U. Okafor; H. A. Obu

    2005-01-01

    Objective: To ascertain caregivers's knowledge, attitude and practice regarding malaria and treatment of children in rural and urban communities in Enugu, Nigeria.Study design: This was a cross-sectional study, and caregivers were selected by convenience sampling.Method: In total, 224 and 184 respondents were interviewed in paediatric outpatient clinics in rural and urban areas, respectively, using structured questionnaires.Results: Most respondents in rural

  18. Antibiotic prescribing in women during and after delivery in a non-teaching, tertiary care hospital in Ujjain, India: a prospective cross-sectional study

    PubMed Central

    2013-01-01

    Objectives Antibacterial drugs (hereafter referred to as antibiotics) are crucial to treat infections during delivery and postpartum period to reduce maternal mortality. Institutional deliveries have the potential to save lives of many women but extensive use of antibiotics, add to the development and spread of antibiotic resistance. The aim of this study was to present antibiotic prescribing among inpatients during and after delivery in a non-teaching, tertiary care hospital in the city of Ujjain, Madhya Pradesh, India. Methods A prospective cross-sectional study was conducted including women having had either a vaginal delivery or a cesarean section in the hospital. Trained nursing staff collected the data on daily bases, using a specific form attached to each patient file. Statistical analysis, including bivariate and multivariable logistic regression was conducted. Results Of the total 1077 women, 566 (53%) had a vaginal delivery and 511 (47%) had a cesarean section. Eighty-seven percent of the women that had a vaginal delivery and 98% of the women having a cesarean section were prescribed antibiotics. The mean number of days on antibiotics in hospital for the women with a vaginal delivery was 3.1 (±1.7) and for the women with cesarean section was 6.0 (±2.5). Twenty-eight percent of both the women with vaginal deliveries and the women with cesarean sections were prescribed antibiotics at discharge. The most commonly prescribed antibiotic group in the hospital for both the women that had a vaginal delivery and the women that had a cesarean section were third-generation cephalosporins (J01DD). The total number of defined daily doses (DDD) per100 bed days for women that had a vaginal delivery was 101, and 127 for women that had a cesarean section. Conclusions The high percentage of women having had a vaginal delivery that received antibiotics and the deviation from recommendation for cesarean section in the hospital is a cause of concern. Improved maternal health and rational use of antibiotics are intertwined. Specific policy and guidelines on how to prescribe antibiotics during delivery at health care facilities are needed. Additionally, monitoring system of antibiotic prescribing and resistance needs to be developed and implemented.

  19. Trends and correlation of antibacterial usage and bacterial resistance: time series analysis for antibacterial stewardship in a Chinese teaching hospital (2009-2013).

    PubMed

    Zou, Y M; Ma, Y; Liu, J H; Shi, J; Fan, T; Shan, Y Y; Yao, H P; Dong, Y L

    2015-04-01

    The purpose of this investigation was to describe the effect of antibacterial stewardship and evaluate the trends and correlation of antibacterial resistance and usage from 2009 to 2013 in a tertiary-care teaching hospital in northwest China. Antibacterial usage was expressed as defined daily doses per 100 patients per day (DDDs/100 PDs). Hospital-wide population-level data and time series analysis were used to evaluate the trends and determine associations between antibacterial exposure and acquisition of resistance. Yearly consumption of overall antibacterials significantly decreased from 66.54 to 28.08 DDDs/100 PDs (??=?-10.504, p?hospital level. PMID:25487131

  20. Left in the dark: Seven years after Katrina, Sandy is teaching hospitals more lessons on how to survive nature's fury.

    PubMed

    Evans, Melanie; Carlson, Joe; Barr, Paul; Kutscher, Beth; Zigmond, Jessica

    2012-11-01

    In the wake of the devastation Sandy wreaked along the Atlantic Coast, some hospitals were forced to close. But others took on new roles, whether as makeshift phone-charging stations or dealing with healthcare needs patients usually turned to outpatient centers for. "The biggest challenge is making up for the other services that are not available in the community," says Steven Littleson, of Jersey Shore University Medical Center. PMID:23198308

  1. Imperfect Implementation of an Early Warning Scoring System in a Danish Teaching Hospital: A Cross-Sectional Study

    PubMed Central

    Niegsch, Mark; Fabritius, Maria Louise; Anhųj, Jacob

    2013-01-01

    Background In 2007, the initiation of a patient safety campaign led to the introduction of Ward Observational Charts (WOC) and Medical Early Warning Score (MEWS) at Naestved Regional Hospital. This included systematic measuring of vital signs of all patients in order to prevent patient deterioration and assure timely and correct initiation of treatment. The aim of this study was to assess to what degree WOC guidelines being followed by ward staff. Design and Setting A 7-day prospective, observational, randomised, cross-sectional, point prevalence study of WOC guideline compliance in hospitalised patients on twelve wards at Naestved Hospital. Results The study included 132 patients. Of these, 58% had been observed and managed correctly according to WOC guidelines. 77% had all MEWS elements recorded by staff. One patient had no MEWS elements recorded. Only 38% of patients with abnormal MEWS were correctly escalated by nursing staff. Staff was aware of the abnormal MEWS observed by investigator in 60% of the patients. Each element of WOC was on average recorded by staff in 90% of the patients. Conclusion At the time of our study, the long-term implementation of WOC guidelines has not been completed satisfactorily. The lacking component in the implementation of MEWS and WOC is the documentation of action taken upon finding an abnormal value. Unsuccessful implementation could result in incorrect results from evaluation of an early warning system. We suggest a redesign of the training programme to educate staff in recognising and caring for critically ill patients at Naestved Hospital. PMID:23922906

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

    PubMed Central

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

    2014-01-01

    Objective To determine the prevalence, clinical significance and the associated risk factors of potential drug-drug interactions (DDIs) at internal medicine ward of University of Gondar (UOG) hospital. Method A prospective cross-sectional study was conducted on patients treated in internal medicine ward of UOG hospital from April 29, 2013 to June 2, 2013. Data was collected from medical records and by interviewing the patients face to face. Descriptive analysis was conducted for back ground characteristics and logistic regression was used to determine the associated risk factors. Result In our study, we have identified a total number of 413 potential DDIs and 184 types of interacting combinations with 4.13 potential DDIs per patient. Among 413 potential DDIs most were of moderate interactions 61.2% (n=253) followed by 26% (n=107) of minor interactions and 12.8% (n=53) of major interactions. There was significant association of occurrence of potential DDIs only with taking three or more medications. Conclusion We have recorded a high rate of prevalence of potential DDI in the internal medicine ward of UOG hospital and a high number of clinically significant DDIs which the most prevalent DDI were of moderate severity. Careful selection of drugs and active pharmaceutical care is encouraged in order to avoid negative consequences of these interactions. PMID:25183081

  3. Hospitality Management Hospitality Management

    E-print Network

    McConnell, Terry

    Hospitality Management Hospitality Management Norm Faiola, Chair, 315-443-1710 Lyman Hall Faculty PROGRAM The Department of Hospitality Management requires a diversity of skills from many disciplines of the global hospitality industry. Academic Offerings HOSPITALITY AND FOOD SERVICE MANAGEMENT MINOR HOSPITALITY

  4. High prevalence of plasmid-mediated 16S rRNA methylase gene rmtB among Escherichia coli clinical isolates from a Chinese teaching hospital

    PubMed Central

    2010-01-01

    Background Recently, production of 16S rRNA methylases by Gram-negative bacilli has emerged as a novel mechanism for high-level resistance to aminoglycosides by these organisms in a variety of geographic locations. Therefore, the spread of high-level aminoglycoside resistance determinants has become a great concern. Methods Between January 2006 and July 2008, 680 distinct Escherichia coli clinical isolates were collected from a teaching hospital in Wenzhou, China. PCR and DNA sequencing were used to identify 16S rRNA methylase and extended-spectrum ?-lactamase (ESBL) genes, including armA and rmtB, and in situ hybridization was performed to determine the location of 16S rRNA methylase genes. Conjugation experiments were subsequently performed to determine whether aminoglycoside resistance was transferable from the E. coli isolates via 16S rRNA methylase-bearing plasmids. Homology of the isolates harboring 16S rRNA methylase genes was determined using pulse-field gel electrophoresis (PFGE). Results Among the 680 E. coli isolates, 357 (52.5%), 346 (50.9%) and 44 (6.5%) isolates were resistant to gentamicin, tobramycin and amikacin, respectively. Thirty-seven of 44 amikacin-resistant isolates harbored 16S rRNA methylase genes, with 36 of 37 harboring the rmtB gene and only one harboring armA. The positive rates of 16S rRNA methylase genes among all isolates and amikacin-resistant isolates were 5.4% (37/680) and 84.1% (37/44), respectively. Thirty-one isolates harboring 16S rRNA methylase genes also produced ESBLs. In addition, high-level aminoglycoside resistance could be transferred by conjugation from four rmtB-positive donors. The plasmids of incompatibility groups IncF, IncK and IncN were detected in 34, 3 and 3 isolates, respectively. Upstream regions of the armA gene contained ISCR1 and tnpU, the latter a putative transposase gene,. Another putative transposase gene, tnpD, was located within a region downstream of armA. Moreover, a transposon, Tn3, was located upstream of the rmtB. Nineteen clonal patterns were obtained by PFGE, with type H representing the prevailing pattern. Conclusion A high prevalence of plasmid-mediated rmtB gene was found among clinical E. coli isolates from a Chinese teaching hospital. Both horizontal gene transfer and clonal spread were responsible for the dissemination of the rmtB gene. PMID:20573216

  5. Colorectal cancer in patients seen at the teaching hospitals of Guadeloupe and Martinique: discrepancies, similarities in clinicopathological features, and p53 status

    PubMed Central

    2014-01-01

    Background In Guadeloupe and Martinique, two French Overseas Departments, colorectal cancer (CRC) has become an essential public health issue. However, little is known about CRC characteristics and the p53 status in these populations, particularly in Guadeloupe, whereas certification of a cancer registry has been recently validated. Methods This was a descriptive retrospective study of 201 patients who, between 1995 and 2000, underwent surgery for CRC in the Guadeloupe Teaching Hospital (GlpeTH; 83 patients) and in the Martinique Teaching Hospital (MqueTH; 118 patients). The clinicopathological features and the p53 expression, evaluated with immunohistochemistry, were compared at the time of diagnosis. A relationship between these parameters and the p53 expression was also studied. Data were analysed, using the SPSS computer software version 17.0. Results No statistical difference was found between the two groups of patients regarding age (p?=?0.60), percentage of young patients (?50 years; p?=?0.94)), sex (p?=?0.47), histological type (p?=?0.073) and tumour sites (p?=?0.65), although the GlpeTH patients were diagnosed with more distal colon cancers (54.2%) than the Mque TH patients (47.4%). By contrast, a significant difference was found regarding the tumour grade (p?

  6. Birth and emergency planning: a cross sectional survey of postnatal women at Korle Bu Teaching Hospital, Accra, Ghana.

    PubMed

    Udofia, Emilia A; Obed, Samuel A; Calys-Tagoe, Benedict N L; Nimo, Kwasi Poku

    2013-03-01

    Birth and emergency planning encourages early decision making, helps overcome barriers to skilled maternity care and reduces preventable maternal and newborn deaths. A facility based postnatal survey of 483 childbearing women in Accra, Ghana determined birth and emergency planning steps, awareness of obstetric danger signs, reported maternal and newborn complications and birth outcome based on length of hospital stay. Supervised antenatal care and delivery were nearly universal. Overall, 62% had a birth plan, 74% had adequate knowledge of danger signs, while 64% and 37% reported maternal and newborn complications respectively. Accompaniment by a birth companion and saving money were considered the most useful planning steps. Knowledge of danger signs was associated with birth and emergency planning, and birth and emergency planning was associated with reported birth outcome. Birth and emergency planning as a critical component of antenatal care can influence birth outcomes and should be extended to all pregnant women. PMID:24069732

  7. Sutureless large incision cataract extraction: Indications and results from two teaching hospital eye departments in the United Kingdom

    PubMed Central

    Khan, Mohammad I.; Syed, Shamsuzzoha; Subash, Mala; Mearza, Ali; Muhtaseb, Mohammed

    2012-01-01

    Objective: To highlight the role of Sutureless Large Incision Cataract Extraction (SLICE) in the United Kingdom for the treatment of cataracts at high risk for intra- or postoperative complications. Setting: Two University Hospitals in the United Kingdom Materials and Methods: Retrospective case note review of planned SLICE performed over a 12-month period. Results: SLICE was performed on 11 eyes of 11 patients (mean age, 79 years) having preoperative vision of hand motions (10 eyes) with very dense or mobile cataracts and high risk for phacoemulsification. Mean follow up was 12 weeks, with no operative or postoperative complications. Nine patients (without ocular or systemic comorbidity) achieved best corrected vision of 0.3 LogMAR (20/40) or better. Conclusions: SLICE is safe and effective for dense or mobile cataracts and can play a role in patients where conventional phacoemulsification carries higher risks of complications. PMID:23439745

  8. Construct an optimal triage prediction model: a case study of the emergency department of a teaching hospital in Taiwan.

    PubMed

    Wang, Shen-Tsu

    2013-10-01

    The purpose of triage is to prevent the delay of treatment for patients in real emergencies due to excessive numbers of patients in the hospital. This study uses the data of patients of consistent triage to develop the triage prediction model. By integrating Principal Component Analysis (PCA) and Support Vector Machine (SVM), the anomaly detection (overestimate and underestimate) prediction accuracy rate can be 100%, which is better than the accuracy rate of SVM (about 89.2%) or Back- propagation Neural Networks (BPNN) (96.71%); afterwards, this study uses Support Vector Regression (SVR) to adopt Genetic Algorithm (GA) to determine three SVR parameters to predict triage. After using the scroll data predictive values, we calculate the Absolute Percentage Error (APE) of each scroll data. The resulting SVR's Mean Absolute Percentage Error (MAPE) is 3.78%, and BPNN's MAPE is 5.99%; therefore, the proposed triage prediction model of this study can effectively predict anomaly detection and triage. PMID:23990379

  9. Assessment of clinico-immunological profile of newly diagnosed HIV patients presenting to a teaching hospital of eastern India

    PubMed Central

    Bishnu, Saptarshi; Bandyopadhyay, Dipanjan; Samui, Samiran; Das, Indrani; Mondal, Pradip; Ghosh, Pramit; Roy, Deeptarka; Manna, Sukanta

    2014-01-01

    Background & objectives: Newly diagnosed HIV patients may be asymptomatic or present with a wide range of symptoms related to opportunistic infections, acute seroconversion illness or other medical illnesses. This study was designed to evaluate the socio-demographic parameters, spectrum of the presenting clinical conditions and concurrent immunological status of newly diagnosed HIV patients and document the WHO clinical stages at the time of HIV diagnosis. Methods: This cross-sectional, observational study was undertaken over a 12 month period at a tertiary referral hospital in eastern India. Three hundred sixty consecutive newly diagnosed HIV patients were selected for the study from the HIV clinic and medicine wards of this hospital. Demographic and clinical data and relevant laboratory investigations of the patients were recorded and analyzed. Results: Mean age of patients was 36.38 ± 10.62 yr, while 63.89 per cent were males. The main mode of transmission of HIV for males and females were unprotected exposure to commercial sex (139, 60.44%) and intercourse with HIV seropositive spouses (89, 68.46%), respectively. Fever (104, 28.89%), weight loss (103, 28.61%) and generalized weakness (80, 22.22%) were the predominant symptoms. Overall mean CD4 count was 176.04 ± 163.49 cells/?l (males 142.19 ± 139.33 cells/?l; females 235.92 ± 185.11 cells/?l). Overall, 224 opportunistic infections were documented in 160 patients, opportunistic diarrhoea (44, 12.22%) and pulmonary tuberculosis (39, 10.83%) being the commonest. There were 83 and 133 patients in WHO clinical stages 3 and 4, respectively; 291 (80.83%) patients were eligible for initiation of first-line antiretrovirals at presentation. Interpretation & conclusions: Advanced immunodeficiency and burden of opportunistic infections characterize newly diagnosed HIV patients in eastern India. The physicians should keep in mind that these patients may have more than one clinical condition at presentation. PMID:25109725

  10. The Pattern of Pediatric Respiratory Illnesses Admitted in Ebonyi State University Teaching Hospital South-East Nigeria

    PubMed Central

    Ezeonu, CT; Uneke, CJ; Ojukwu, JO; Anyanwu, OU; Okike, CO; Ezeanosike, OB; Agumadu, HU

    2015-01-01

    Background: Reports from the developed nations reveal respiratory tract infections as the leading cause of childhood hospital admissions. Children may be admitted for a variety of respiratory illnesses. Data on the spectrum of pediatric respiratory illnesses admitted in the hospital is scarce. Aim: To determine the pattern of pediatrics respiratory illness admissions, seasonal frequency, underlying risk factors and outcome. Subjects and Methods: A retrospective assessment of respiratory cases admitted in the pediatric ward from 2005 to 2010 was conducted using case notes. Parameters considered included month of presentation, age, sex, immunization and nutritional status, tools of diagnosis and patient outcome. Results were analyzed using the Statistical Package for the Social Sciences with the level of significance P ? 0.05. Results: Of the 239 cases admitted, there were more males than females (1.4:1). The commonest case was Bronchopneumonia, 71.6% (171/239 out of which 161 were uncomplicated, 5 had effusions and 6 were associated with measles). Other cases were Pulmonary Tuberculosis, 10.9% (26/239), Lobar pneumonia 8.8% (21/239), Bronchiolitis, 5% (12/239), Aspiration pneumonitis 2.1% (5/239) and Bronchial asthma, 0.8% (2/239). Mortality was 7.5% (18/239) mostly from Bronchopneumonia amongst the 1–5 years old. Mortality was significantly associated with malnutrition (P < 0.001) and poor immunization status (P < 0.01). Conclusion: Bronchopneumonia was found to be the commonest illness with significant mortality and peak occurrence in the rainy season. More emphasis must be laid on anticipatory guidance and prevention by encouraging the immunization, good nutrition and increased attention on children even after 1 year of age.

  11. Hospital diversification strategy.

    PubMed

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger. PMID:25223156

  12. A cost-benefit analysis of twice-daily consultant ward rounds and clinical input on investigation and pharmacy costs in a major teaching hospital in the UK

    PubMed Central

    Ahmad, Aftab; Weston, Philip J; Ahmad, Mahin; Sharma, Dushyant; Purewal, Tejpal

    2015-01-01

    Objectives Misuse of investigations, medications and hospital beds is costing the National Health Service (NHS) billions of pounds with little evidence that approaches centred on reducing overuse are sustainable. Our previous study demonstrated that twice-daily consultant ward rounds reduce inpatient length of stay and suggested a reduction in overuse of investigations and medications. This study aims to assess the impact of daily consultant ward rounds on the use of investigations and medications and estimate the potential cost benefit. Settings The study was performed on two medical wards in a major city university teaching hospital in Liverpool, UK, receiving acute admissions from medical assessment and emergency departments. Participants and intervention The total number of patients admitted, investigations performed and pharmacy costs incurred were collected for 2?years before and following a change in the working practice of consultants from twice-weekly to twice-daily consultant ward rounds on the two medical wards. Outcome measures We performed a cost-benefit analysis to assess the net amount of money saved by reducing inappropriate investigations and pharmacy drug use following the intervention. Results Despite a 70% increase in patient throughput (p<0.01) the investigations and pharmacy, costs per patient reduced by 50% over a 12-month period (p<0.01) and were sustained for the next 12?months. The reduction in investigations and medication use did not have any effect on the readmission or mortality rate (p=NS), whereas, the length of stay was almost halved (p<0.01). Daily senior clinician input resulted in a net cost saving of £336?528 per year following the intervention. Conclusions Daily consultant input has a significant impact on reducing the inappropriate use of investigations and pharmacy costs saving the NHS more than £650K on the two wards over a 2-year period. PMID:25854972

  13. Prevalence of nontyphoidal Salmonella serogroups and their antimicrobial resistance patterns in a university teaching hospital in Eastern Province of Saudi Arabia

    PubMed Central

    Elhadi, Nasreldin; Aljindan, Reem; Aljeldah, Mohammed

    2013-01-01

    Background Nontyphoidal Salmonella (NTS) species are important food-borne pathogens that cause gastroenteritis and bacteremia, and are responsible for a huge global burden of morbidity and mortality. The aim of this study was to investigate the prevalent serogroups and antibiotic resistance of NTS in our region. Methods We reviewed the serogroup distribution and antimicrobial susceptibility patterns of NTS strains obtained from 158 stool specimens of patients with acute diarrheal infection attending the outpatient and inpatient department at a university hospital in the Eastern Province of Saudi Arabia in the period from September, 2008 to April, 2011. A retrospective analysis of the 158 patients with NTS infection was conducted to determine the most prevalent NTS serogroups causing acute gastroenteritis and their antimicrobial susceptibility patterns. Results At this teaching hospital, a total of 17,436 fecal samples were analyzed during the 2008–2011 study period. Of these specimens, 158 tested positive for NTS, giving an overall prevalence of 9.06 per 1,000. Of 158 NTS cases, serogroup D1 (25.3%) was the most prevalent, followed by serogroup B (19.6%), and serogroup C1 (18.9). One third of all NTS serogroup strains tested were resistant to tetracycline. The NTS strains showed resistance to ampicillin (31.3%), amoxicillin/clavulanic acid (29.9%), trimethoprim/sulfamethoxazole (20.9%), and cefotaxime (14.93%). Conclusion The findings of this study support the concern that use of antibiotics in animal feeds may contribute to acquisition of resistance in food-borne bacteria, such as Salmonella. Our study also concludes that the prevalence of NTS in the Eastern Province of Saudi Arabia is very low compared with other studies worldwide. PMID:24285925

  14. A questionnaire study on the knowledge, attitude, and the practice of pharmacovigilance among the healthcare professionals in a teaching hospital in South India

    PubMed Central

    Gupta, Sandeep Kumar; Nayak, Roopa P.; Shivaranjani, R.; Vidyarthi, Surendra Kumar

    2015-01-01

    Objective: The primary objective of this study was to evaluate the knowledge, attitude, and practices (KAP) of the healthcare professionals about pharmacovigilance in Dhanalakshmi Srinivasan Medical College and Hospital (DSMCH), Perambalur (Tamil Nadu), a tertiary care teaching hospital. The second primary objective was to assess the causation of underreporting of adverse drug reactions (ADRs) as it needs to be well-assessed in India. The secondary objective was to compare the findings of this study with the results of the published studies from India on evaluation of the KAP of pharmacovigilance among healthcare professional. Materials and Methods: A cross-sectional study was carried out using a pretested questionnaire. The questionnaire was designed to assess the KAP regarding pharmacovigilance. The healthcare professionals (doctors, nurses, and pharmacists) working in the DSMCH, Perambalur (Tamil Nadu) during the study period were included. Only those who gave their consent to participate were included in the study. The data was analyzed by using the Statistical Package for Social Sciences (SPSS) statistical software, version 16. Results: One hundred and fifty pretested questionnaires were distributed among the healthcare professionals and 101 responded. 62.4% healthcare workers gave correct response regarding the definition of pharmacovigilance. 75.2% of healthcare workers were aware regarding the existence of a National Pharmacovigilance Program of India. 69.3% healthcare professional agreed that ADR reporting is a professional obligation for them. Among the participants, 64.4% have experienced ADRs in patients, but only 22.8% have ever reported ADR to pharmacovigilance center. Unfortunately only 53.5% healthcare workers have been trained for reporting adverse reactions. But, 97% healthcare professionals agreed that reporting of ADR is necessary and 92.1% were of the view that pharmacovigilance should be taught in detail to healthcare professional. Conclusion: This study demonstrated that knowledge and attitude towards pharmacovigilance is gradually improving among healthcare professionals, but unfortunately the actual practice of ADR reporting is still deficient among them. PMID:25657902

  15. Knowledge, perception and practice of injection safety and healthcare waste management among teaching hospital staff in south east Nigeria: an intervention study

    PubMed Central

    Enwere, Oguamanam Okezie; Diwe, Kevin Chiekulie

    2014-01-01

    Introduction Health care workers are exposed to the risk of blood-borne diseases such as HIV, Hepatitis B and C in their daily encounter with infected patients and materials through unsafe injections. This study determined the baseline and post-intervention knowledge and practice of modern injection safety standards among health care workers. Methods The study population was the healthcare workers in a teaching hospital in southeastern Nigeria. Data was collected using a self-administered 37-item structured questionnaire assessing their knowledge and practice on injection safety. Collected data was analyzed using SPSS. Results Nurses comprised 62.8% (98/156) of the population. While most had heard of injection safety only 67.2% (84/125) had previously had any form of training on it. Only 54% (81/150) had heard or seen color coded bins. The standard needle and syringe is still widely used and 45% (65/145) still recap needles on syringes after use irrespective of type of personnel. Half (50.6% =78/154) of our respondents had had a previous needle prick injury. Only 25.6% (20/78) with previous needle prick injury had post-exposure prophylaxis. All doctors and laboratory scientists always use gloves compared to 94.8% (91/96) nurses while handling patients or materials. Following the intervention, a significantly high number became aware of post-exposure prophylaxis and color coded bins and liners. Conclusion There is a need for healthcare workers to be regularly updated on changing safety standards in their practice. Also hospitals must be encouraged to acquire and use internationally accepted standard materials in collection and disposal patient's samples. PMID:25237415

  16. Hospitality Services. Curriculum Guide.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  17. The mission of the hospitality management division is to educate students for management and leadership in the hospitality industry and to lead the profession through excellence in teaching, research and service.

    E-print Network

    Mohanty, Saraju P.

    The mission of the hospitality management division is to educate students for management and service. The Hospitality Management program at UNT features a unique laboratory environment. Students put of Merchandising, Hospitality and Tourism B.S. Hospitality Management 2013-2014 Texas Common Course Numbering

  18. Substantial Variation in Hospital Rankings after Adjusting for Hospital-Level Predictors of Publicly-Reported Hospital-Associated Clostridium difficile Infection Rates.

    PubMed

    Datta, Rupak; Kazerouni, N Neely; Rosenberg, Jon; Nguyen, Vinh Q; Phelan, Michael; Billimek, John; Cao, Chenghua; McLendon, Patricia; Cummings, Kate; Huang, Susan S

    2015-04-01

    Across 366 California hospitals, we identified hospital-level characteristics predicting increased hospital-associated Clostridium difficile infection (HA-CDI) rates including more licensed beds, teaching and long-term acute care (LTAC) hospitals, and polymerase chain reaction testing. Adjustment for these characteristics impacted rankings in 24% of teaching hospitals, 13% of community hospitals, and 11% of LTAC hospitals. Infect Control Hosp Epidemiol 2015;00(0): 1-3. PMID:25782902

  19. Hirschsprung’s disease in children: a five year experience at a University teaching hospital in northwestern Tanzania

    PubMed Central

    2014-01-01

    Background Hirschsprung’s disease (HD) is the commonest cause of functional intestinal obstruction in children and poses challenges to pediatricians and pediatric surgeons practicing in resource-limited countries. This study describes the clinical characteristics and outcome of management of this disease in our setting and highlights challenges associated with the care of these patients and proffer solutions for improved outcome. Methods This was a descriptive prospective study of children aged ? 10 years who were histologically diagnosed and treated for HD at our centre between July 2008 and June 2013. Results A total of 110 patients (M: F ratio= 3.6:1) with a median age of 24 months were studied. Six (5.5%) patients were in the neonatal period. Sixty-four (58.2%) patients had complete intestinal obstruction whereas 42 (38.2%) and 4 (3.6%) patients had chronic intestinal obstruction and intestinal perforation respectively. No patient had enterocolitis. Constipation (94.5%) was the most common complaints. 109 (99.1%) patients had colostomy prior to the definitive pull-through. The median duration of colostomy before definitive pull-through was 4 months. The majority of patients (67.3%) had short segment of aganglionosis localized to the recto-sigmoid region. The definitive pull-through was performed in 94 (85.5%) patients (Swenson’s pull-through 76 (80.9%), Duhamel’s pull-through (12.8%) and Soave’s pull-through 4 (4.3%) patients). Postoperative complication rate was 47.3%. The median length of hospital stay was 26 days. Patients who developed complications stayed longer in the hospital and this was statistically significant (p <0.001). Mortality rate was 21.8%. The age < 4 weeks, delayed presentation and surgical site infection were the main predictors of mortality (p < 0.001). During the follow-up period, the results of Swenson’s and Duhamel’s pull through procedures were generally good in 87.8% and 42.9% of patients respectively. The result of Soave’s procedures was generally poor in this study. Conclusion HD remains the commonest cause of functional intestinal obstruction in children and contributes significantly to high morbidity and mortality in our setting. The majority of patients present late when the disease becomes complicated. Early diagnosis and timely definitive pull through procedure are essential in order to decrease the morbidity and mortality associated with this disease. PMID:24973940

  20. An assessment of the disease burden of foot ulcers in patients with diabetes mellitus attending a teaching hospital in Lagos, Nigeria.

    PubMed

    Ogbera, A O; Fasanmade, O; Ohwovoriole, A E; Adediran, O

    2006-12-01

    The major part of the burden of people with diabetes mellitus (DM) is their impaired quantity and quality of life. This is due to acute and chronic complications of which diabetic foot ulceration (DFU) takes the greatest toll. Most studies on the disease burden of DFU were carried out in developed countries, and to date, no indigenous study has addressed the burden of foot ulceration in Nigerians with DM. This study attempted to determine the disease burden of this important DM complication. The study was carried out at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. The working definition of disease burden encompassed prevalence, morbidity, mortality, and the direct economic costs of diabetes mellitus foot syndrome (DMFS). For determination of the estimates of prevalence, the "capture-recapture" and intensive case-counting methods were used, mortality and morbidity were determined from records of admissions, and associated deaths over a 3-year period (1998-2000). The direct economic costs of foot ulceration were derived from the costs incurred from in-patient days, tests, drugs/medications, surgery, and other miscellaneous units of services. The total number of people with DM seen in LUTH from 1998 to 2000 was 1500, the hospital prevalence of DFU using the capture-recapture method being 9.5%. A total of 7253 medical admissions were made in this 3-year period, and of this number 827 (11.4%) were DM related. DFU-related admissions were 97 in number, and this made up 1.3% and 11.7% of the total medical and diabetes admissions, respectively. During this period, a total of 61 lower limb amputations were carried out and 26 (42.6%) of these were DM related. The proportion of medical deaths due to DMFS deaths was greater than the proportion of medical admissions due to DFU (P = .007). The case fatality of individuals with DFU was approximately 53%. A total number of 20 patients with DM foot ulcers were hospitalized during a 1-year period of the study (2003-2004). The majority had type 2 DM. A large majority (65%) of these patients had some form of surgery in addition to medical management of their condition. Mean costs for successfully treating a patient with DMFS was Nigerian Naira (NGN) 180,581.60. The total costs incurred ranged from NGN 20,400.00 to NGN 278,029.00. Drugs or medications accounted for the majority of the total costs incurred by the patients (46.9%). PMID:17088600

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

    PubMed Central

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

    2014-01-01

    Introduction The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 – January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Methods Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Results Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR?=?6.2; CI95% 2.3–17.0, P?=?0.0003), antimicrobial treatment (OR?=?3.8, CI95% 1.0–13.9, P?=?0.0442), cumulative number of days in the intensive care unit (OR?=?1.3, CI95% 1.1–1.6, P?=?0.0007) or in the surgery ward (OR?=?1.1, CI95% 1.0–1.3, P?=?0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Conclusion Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring MRSP. Rigorous control measures were needed to control the outbreak. We recommend the implementation of a search-and-isolate policy to reduce the burden of MRSP. PMID:25333798

  2. Abnormal blood glucose as a prognostic factor for adverse clinical outcome in children admitted to the paediatric emergency unit at komfo anokye teaching hospital, kumasi, ghana.

    PubMed

    Ameyaw, Emmanuel; Amponsah-Achiano, Kwame; Yamoah, Peter; Chanoine, Jean-Pierre

    2014-01-01

    Dysglycaemia (hyper- or hypoglycaemia) in critically ill children has been associated with poor outcome. We compared the clinical outcomes in children admitted to Pediatric Emergency Unit (PEU) at Komfo Anokye Teaching Hospital (KATH) for acute medical conditions and presenting with euglycaemia or dysglycaemia. This is a prospective case matching cohort study. Eight hundred subjects aged between 3 and 144 months were screened out of whom 430 (215 with euglycaemia and 215 with dysglycaemia) were enrolled. The median age was 24 months (range: 3-144 months). In the dysglycaemia group, 28 (13%) subjects had hypoglycemia and 187 (87%) had hyperglycemia. Overall, there were 128 complications in 116 subjects. The number of subjects with complications was significantly higher in dysglycaemia group (n = 99, 46%) compared to euglycaemia group (n = 17, 8%) (P < 0.001). Forty subjects died out of whom 30 had dysglycaemia (P = 0.001). Subjects with dysglycaemia were 3 times (95% CI: 1.5-6.0) more likely to die and 4.8 times (95% CI: 3.1-7.5) more likely to develop complications (P = 0.001). Dysglycaemia is associated with increased morbidity and mortality in children with acute medical conditions and should lead to intensive management of the underlying condition. PMID:25614747

  3. Abnormal Blood Glucose as a Prognostic Factor for Adverse Clinical Outcome in Children Admitted to the Paediatric Emergency Unit at Komfo Anokye Teaching Hospital, Kumasi, Ghana

    PubMed Central

    Amponsah-Achiano, Kwame; Chanoine, Jean-Pierre

    2014-01-01

    Dysglycaemia (hyper- or hypoglycaemia) in critically ill children has been associated with poor outcome. We compared the clinical outcomes in children admitted to Pediatric Emergency Unit (PEU) at Komfo Anokye Teaching Hospital (KATH) for acute medical conditions and presenting with euglycaemia or dysglycaemia. This is a prospective case matching cohort study. Eight hundred subjects aged between 3 and 144 months were screened out of whom 430 (215 with euglycaemia and 215 with dysglycaemia) were enrolled. The median age was 24 months (range: 3–144 months). In the dysglycaemia group, 28 (13%) subjects had hypoglycemia and 187 (87%) had hyperglycemia. Overall, there were 128 complications in 116 subjects. The number of subjects with complications was significantly higher in dysglycaemia group (n = 99, 46%) compared to euglycaemia group (n = 17, 8%) (P < 0.001). Forty subjects died out of whom 30 had dysglycaemia (P = 0.001). Subjects with dysglycaemia were 3 times (95% CI: 1.5–6.0) more likely to die and 4.8 times (95% CI: 3.1–7.5) more likely to develop complications (P = 0.001). Dysglycaemia is associated with increased morbidity and mortality in children with acute medical conditions and should lead to intensive management of the underlying condition. PMID:25614747

  4. Changes in gram negative microorganisms’ resistance pattern during 4?years period in a referral teaching hospital; a surveillance study

    PubMed Central

    2012-01-01

    Background and purpose Surveillance studies evaluating antimicrobial susceptibilities are of great value in preventing the spread of resistant pathogens by elucidating the trend of resistance in commonly used antibiotics and as a consequence providing information for prescribing the most appropriate agent. This study is a longitudinal antimicrobial resistance surveillance study designed to evaluate the trend in antimicrobial resistance to gram negative microorganisms from 2007 to 2010. Method During a four-year period (2007–2010) isolates derived from all patients admitted to infectious diseases ward of Imam Khomeini Hospital, the major referral center for infectious disease in Iran with the highest admission rates, were evaluated. Based on disk diffusion method and zone of inhibition size, the microorganism was regarded as to be sensitive, resistant or has intermediate susceptibility to the antimicrobial agents. Results The widest spread Gram-negative microorganism in all of isolates taken together in our study was E.coli (30%) followed by Stenotrophomonas maltophilia in 28.6% and Enterobacter spp. in 11.9%, respectively. The susceptibility to amikacin, imipenem, piperacillin/tazobactam, and nitrofurantoin was equal or above 50% for all microorganisms over four years. However, the susceptibility to ampicillin, ampicillin/sulbactam, cefotaxim, and ceftriaxone was less than 50% in derived isolates during the study period. Conclusion In conclusion, the finding of the present study revealed that resistance rate to common antimicrobial agents in Iran is growing and isolates were susceptible mostly to broad-spectrum antibiotics including imipenem and piperacillin/tazobactam. PMID:23351308

  5. Social barriers to diagnosis and treatment of breast cancer in patients presenting at a teaching hospital in Ibadan, Nigeria.

    PubMed

    Pruitt, Liese; Mumuni, Tolulope; Raikhel, Eugene; Ademola, Adeyinka; Ogundiran, Temidayo; Adenipekun, Adeniyi; Morhason-Bello, Imran; Ojengbede, Oladosu A; Olopade, Olufunmilayo I

    2015-03-01

    Globally, breast cancer is the most frequent malignancy in women, and stage at diagnosis is a key determinant of outcome. In low- to middle-income countries, including Nigeria, advanced stage diagnosis and delayed treatment represent a significant problem. That social barriers contribute to delay has been noted in previous research; however, few specific factors have been studied. Using semi-structured interviews, this study identifies social barriers to diagnosis and treatment for patients who presented at University College Hospital Ibadan, Nigeria. Transcripts from the interviews were coded and analysed thematically. Thirty-one patients and five physicians were interviewed. The median age of patients was 51 (range: 28 to above 80), 83% were Christian and 17% were Muslim. Preliminary analysis showed that delays in diagnosis reflected a lack of education as well as the utilisation of non-physician medical services such as pharmacists. Delays in treatment were often due to fear of unanticipated surgery and cost. The majority of women did not know the cause of their breast cancer, but some believed it was caused by a spiritual affliction. This study suggests that further education and awareness of breast cancer for both patients and providers is needed in order to increase early stage diagnosis. PMID:25443995

  6. An evaluation of prenatal ultrasound screening for CTEV: accuracy data from a single NHS University Teaching Hospital.

    PubMed

    Pullinger, M; Southorn, T; Easton, V; Hutchinson, R; Smith, R P; Sanghrajka, A P

    2014-07-01

    Congenital Talipes Equinovarus (CTEV) is one of the most common congenital limb deformities. We reviewed the records of infants who had received treatment for structural CTEV between 1 January 2007 and 30 November 2012. This was cross-referenced with the prenatal scans of mothers over a corresponding period of time. We investigated the sensitivity, specificity, and positive and negative predictive values of the fetal anomaly scan for the detection of CTEV and explored whether the publication of Fetal Anomaly Screening Programme guidelines in 2010 affected the rate of detection. During the study period there were 95 532 prenatal scans and 34 373 live births at our hospital. A total of 37 fetuses with findings suggestive of CTEV were included in the study, of whom 30 were found to have structural CTEV at birth. The sensitivity of screening for CTEV was 71.4% and the positive predictive value was 81.1%. The negative predictive value and specificity were more than 99.5%. There was no significant difference between the rates of detection before and after publication of the guidelines (p = 0.5). We conclude that a prenatal fetal anomaly ultrasound screening diagnosis of CTEV has a good positive predictive value enabling prenatal counselling. The change in screening guidance has not affected the proportion of missed cases. This information will aid counselling parents about the effectiveness and accuracy of prenatal ultrasound in diagnosing CTEV. PMID:24986955

  7. Occupational exposure to blood and body fluids among healthcare workers in a teaching hospital: an experience from northern Thailand.

    PubMed

    Chaiwarith, Romanee; Ngamsrikam, Teewin; Fupinwong, Sawalak; Sirisanthana, Thira

    2013-01-01

    This retrospective study was conducted among healthcare workers (HCWs) in a tertiary care hospital to (i) determine the incidence of exposure to blood and/or body fluids, (ii) describe the characteristics of such exposures, and (iii) describe management after exposure. There were 1,611 episodes of occupational exposure between January 1, 2005 and December 31, 2010. Of those affected, 1,086 (67.4%) were women. The mean age was 27.6 ± 7.2 years. Nurses (483, 29.9%) were the HCWs most frequently exposed to blood and/or body fluids. The incidence was highest among physicians (11%/year). Percutaneous injury by hollow needles was the most common type of injury (576, 35.8%). Of the 1,611 episodes, 142 (8.8%) comprised HCWs being exposed to human immunodeficiency virus-positive sources. One hundred fifty-one HCWs (9.4%) were exposed to hepatitis B surface (HBs) antigen-positive sources. Sixty-one HCWs had indications for both hepatitis B virus (HBV) vaccine and hepatitis B immunoglobulin; 43 (70.5%) received both. Among the 266 HCWs who had no protective antibody against HBV and were exposed to HBs antigen-negative sources, only 1 (0.4%) received HBV vaccine. These findings suggest that guidelines for post-exposure management among HCWs exposed to HBs antigen-positive sources are not regularly followed. HBV immunization is necessary for all HCWs. PMID:23514908

  8. HIV/AIDS Knowledge, Attitude and Risk Perception among Pregnant Women in a Teaching Hospital, Southwestern Nigeria

    PubMed Central

    Ojieabu, Winifred Aitalegbe; Femi-Oyewo, M. N.; Eze, Uchenna I.

    2011-01-01

    Aim: The rising HIV infection rates among women especially of child bearing age particularly in Sub-Saharan Africa expose children to increased HIV risk even before they are born. Without effective measures or awareness campaigns to deal with mother-to-child transmission, 390 000 out of the global 430 000 children newly infected with HIV during 2008 were from sub-Saharan Africa This study was undertaken to assess HIV/AIDS related knowledge, attitude and risk perception among pregnant women in Tertiary hospital, Southwestern Nigeria Method: The study was carried out using a 43- item self administered questionnaire, pretestd and administered to 403 pregnant women during ante-natal clinic sessions Results: High HIV/AIDS awareness level (97%) was recorded, 77.7% had correct knowledge of the cause of the disease but knowledge on the modes of vertical transmission during pregnancy (57.5%) and prevention during breast-feeding (62.3%) was not encouraging A lot of misconceptions about the cause of the HIV/AIDS, modes of contact, transmission, prevention and anti-retroviral therapy were recorded Conclusion: The survey revealed that a lot needed to be done to improve the knowledge, attitude, perception and behavioral changes among the populace especially in this particular group. This calls for urgent and proper response in order to stem the tide of HIV/AIDS. PMID:24826022

  9. Patterns of Complementary and Alternative Medicine Use, Perceived Benefits, and Adverse Effects among Adult Users in Enugu Urban, Southeast Nigeria

    PubMed Central

    Okoronkwo, Ijeoma; Onyia-pat, Jane-lovena; Okpala, Pat; Agbo, Mary-Ann; Ndu, Afam

    2014-01-01

    The use of complementary and alternative medicine (CAM) is now on the increase. Evidence from studies carried out globally has established that CAM use is very common and varies among populations. This study investigated patterns of CAM use, perceived benefits, and associated harm with CAM use among adults. A cross-sectional study was conducted in three local government areas of Enugu urban, Southeast Nigeria. An interviewer-administered questionnaire was used to collect data from all consenting adult participants aged between 18 and 65 years. Of the 732 participants interviewed, 62.8% were females while 37.2% were males. Majority (84.7%) of the participants had used CAM at one time or another. The most commonly used CAM product was the biological products, followed by spiritual therapy. The major route of administration for CAM products was oral and about 40% of the participants combined CAM with conventional medicine. Majority (78.6%) of CAM users benefited from CAM products after using them while a few complained of adverse reactions. As CAM is gaining widespread acceptance and use, there is need for clinical trial on the benefits and adverse effects associated with the use of CAM to facilitate proof of efficacy and safety of the products. PMID:24803945

  10. Investigation of the Relationship Between Organizational Learning and Organizational Citizen Behavior Among the Staff of Teaching Hospital

    PubMed Central

    Kiaei, Mohammad Zakaria; Hasanpoor, Edris; Sokhanvar, Mobin; Mohseni, Mohammad; Ziaiifar, Hajarbibi; Moradi, Mahin

    2014-01-01

    Background: Today, the concept of organizational learning has attracted the attention of many managers and researchers in scientific and research circles as well as those in the organization-related studies. Taking the organizational learning into account might offer a means of organizational effectiveness that has gone unnoticed. Thus the present study aimed at investigating the relationship between the organizational learning in each of its four aspects as independent variables and organizational citizen behavior of the staff as constituting the dependent variable of the study. Methods: This was a descriptive-analytical study with a practical approach conducted in 2010. The sample included 167 staff members working in educational health centers affiliated with Qazvin University of Medical Sciences. The data were collected via both the organizational learning questionnaire and organizational citizen behavior questionnaire and analyzed by using SPSS software and Spearman test. Results: The results indicated that the mean of organizational learning indicator was 2.9±0.648 and that of organizational citizen behavior 3.78±0.413. In addition, the spearman correlation coefficient ranging from 0.058 to 0.129 between the elements of the organizational learning and the organizational citizen behavior was not statistically significant (p>0.05). The findings also indicated that the correlation between them was average among the staff of Shahid Raja’ee Educational health center (0.319), thus the relationship between the two sets of variables proved significant (p=0.031). However, the same was not true in other centers. Conclusion: It was concluded that management commitment, open space, transfer of knowledge, and systemic vision could all enhance the level of organizational learning in hospitals which calls for focus on the elements of organizational citizen behavior. PMID:25568629

  11. Risperidone use in a teaching hospital during its first year after market approval: economic and clinical implications.

    PubMed

    Carter, C S; Mulsant, B H; Sweet, R A; Maxwell, R A; Coley, K; Ganguli, R; Branch, R

    1995-01-01

    Risperidone, a new antipsychotic drug, was recently approved by the Food and Drug Administration (FDA) on the basis of its having comparable efficacy and less toxicity than haloperidol. In a preliminary study to evaluate the therapeutic efficiency of this drug, we conducted a survey of resperidone utilization, cost, and safety during its first year of availability at an academic psychiatric hospital. Data were obtained from a computerized, centralized medical record system, from an adverse drug reaction monitoring system, and from pharmacy purchasing records. In its first year of availability, risperidone became the second most widely used antipsychotic agent at our institution. Most of this use extended beyond the adult schizophrenia population, for whom pre-marketing safety and efficacy data are available. The direct institutional cost of risperidone treatment exceeded the entire budget for antipsychotic drugs during the year before its release. Results from the adverse drug reaction reporting system did not indicate a strong advantage of risperidone over more established antipsychotic agents with respect to extrapyramidal side effects. Furthermore, the mean dose of risperidone associated with extrapyramidal symptoms was 3.5 mg/day, considerably lower than that suggested by pre-marketing studies in a more select patient group. These results confirm that new pharmacological agents are generally used in much broader patient populations than those for which efficacy and safety have been established prior to FDA approval. This study also raises questions about the therapeutic efficiency of risperidone compared with other antipsychotic drugs. We conclude that systematic studies of outcome, safety, and cost of new pharmaceuticals in naturalistic settings are needed to provide the data necessary to establish local standards of cost-effective care. PMID:8851645

  12. In vitro antibacterial activity of ceftobiprole against clinical isolates from French teaching hospitals: proposition of zone diameter breakpoints.

    PubMed

    Lascols, C; Legrand, P; Mérens, A; Leclercq, R; Muller-Serieys, C; Drugeon, H B; Kitzis, M D; Reverdy, M E; Roussel-Delvallez, M; Moubareck, C; Brémont, S; Miara, A; Gjoklaj, M; Soussy, C-J

    2011-03-01

    The aims of this study were to determine the in vitro activity profile of ceftobiprole, a pyrrolidinone cephalosporin, against a large number of bacterial pathogens and to propose zone diameter breakpoints for clinical categorisation according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) minimum inhibitory concentration (MIC) breakpoints. MICs of ceftobiprole were determined by broth microdilution against 1548 clinical isolates collected in eight French hospitals. Disk diffusion testing was performed using 30 ?g disks according to the method of the Comité de l'Antibiogramme de la Société Franēaise de Microbiologie (CA-SFM). The in vitro activity of ceftobiprole, expressed by MIC(50/90) (MICs for 50% and 90% of the organisms, respectively) (mg/L), was as follows: meticillin-susceptible Staphylococcus aureus, 0.25/0.5; meticillin-resistant S. aureus (MRSA), 1/2; meticillin-susceptible coagulase-negative staphylococci (CoNS), 0.12/0.5; meticillin-resistant CoNS, 1/2; penicillin-susceptible Streptococcus pneumoniae, ? 0.008/0.03; penicillin-resistant S. pneumoniae, 0.12/0.5; viridans group streptococci, 0.03/0.12; ?-haemolytic streptococci, ? 0.008/0.016; Enterococcus faecalis, 0.25/1; Enterococcus faecium, 64/128; Enterobacteriaceae, 0.06/32; Pseudomonas aeruginosa, 4/16; Acinetobacter baumannii, 0.5/64; Haemophilus influenzae, 0.03/0.12; and Moraxella catarrhalis, 0.25/0.5. According to the regression curve, zone diameter breakpoints could be 28, 26, 24 and 22 mm for MICs of 0.5, 1, 2 and 4 mg/L respectively. In conclusion, this study confirms the potent in vitro activity of ceftobiprole against many Gram-positive bacteria, including MRSA but not E. faecium, whilst maintaining a Gram-negative spectrum similar to the advanced-generation cephalosporins such as cefepime. Thus ceftobiprole appears to be well suited for the empirical treatment of a variety of healthcare-associated infections. PMID:21295447

  13. Detection of OXA-type carbapenemases and integrons among carbapenem-resistant Acinetobactor baumannii in a teaching hospital in China.

    PubMed

    Hu, Qiaojuan; Hu, Zhidong; Li, Jing; Tian, Bin; Xu, Hairu; Li, Jin

    2011-10-01

    The increasing trend of carbapenem-resistance (CR) and multi-drug resistance (MDR) in A. baumannii worldwide has limited the therapeutic effectiveness of antibiotic therapy. The study was conducted to determine the prevalence of carbapenemases and integrons among the isolates of imipenem-resistant A. baumannii (IRAB). A total of 71 non-repetitive imipenem- resistant A. baumannii isolates were collected and tested for susceptibility to 17 antimicrobials. The modified Hodge test and EDTA-disc synergy test were performed for the screening of carbapenemases and metallo-? -lactamases (MBLs) production, respectively. Isolates were then subjected to multiplex-PCR targeting genes encoding for OXA-type carbapenemase, MBLs and integrases. Random amplified polymorphic DNA (RAPD) genotyping was performed to assess genetic relatedness. All isolates exhibited multi-drug resistant phenotype. Colistin was the most active antimicrobial agent tested. Seventy-one isolates (100%) demonstrated positive in the modified Hodge test. Thirty-nine isolates showed positive in the EDTA-disc synergy test, however, no MBL genes were detected. All strains possessed a bla(OXA-51) -like gene. The co-exis-tence of bla(OXA-51) -like/bla(OXA-23) -like/intI1, bla(OXA-51) -like/bla(OXA-23) -like, bla(OXA-51) -like/bla(OXA-24) -like was detected in 91.6% (n = 65), 5.6% (n = 4), 2.8% (n = 2), respectively. Analysis of the genetic con-text of bla(OXA-23) showed the presence of ISAba1 upstream of bla(OXA-23) . No ISAba1 was detected upstream of bla(OXA-51) . Two different gene cassettes were found in these strains, and a high prevalence of aacA4, aadA1 and catB8 genes was observed. RAPD of 71 isolates showed 7 genotypes. The strains were mainly recovered from patients in intensive care unit, neurosurgery and department of respiratory disease. These ?ndings show that multi-drug resistance in A. baumannii is a common problem. This study also shows a high distribution of bla(OXA-23) -like and intI1 genes in imipenem-resistant A. baumannii isolates. The clonal spread played an important role in the increase of OXA-23 producing IRABs in the hospital environment. PMID:21656808

  14. Virtual Hospital

    NSDL National Science Digital Library

    Provided and maintained by the University of Iowa Health Care, the Virtual Hospital is designed as a "medical reference and health promotion tool for health care providers and patients." To that end, the site offers current and authoritative medical information for patients and professional and pedagogical information for health care providers. The former includes patient educational briefs browseable by organ system or by a topical list, a collection of peer-reviewed and annotated Web resources, an internal search engine, and archives of a column offering medical advice to middle-aged users. Resources in the health care provider section include several digital libraries aimed at certain specialties (Pediatrics, Pediatric Radiology, Family Medicine, and Medical Student); multimedia textbooks and teaching files grouped by organ system; lectures and publications; and clinical practice guidelines. Additional resources at the site include links to the Virtual Children's and Virtual Naval Hospitals, an internal search engine, and online continuing education courses.

  15. The association between work ethics and attitudes towards organizational changes among the administrative, financial and support employees of general teaching hospitals

    PubMed Central

    Ravangard, Ramin; Sajjadnia, Zahra; Jafari, Abdosaleh; Shahsavan, Najme; Bahmaie, Jamshid; Bahadori, Mohammadkarim

    2014-01-01

    In order to achieve success in today’s competitive world, organizations should adapt to environmental changes. On the other hand, managers should have a set of values and ethical guidelines for their administrative and organizational functions. This study aimed to investigate the association between work ethics and attitudes towards organizational changes among the administrative, financial and support employees of general teaching hospitals affiliated to Shiraz University of Medical Sciences. This was an applied, cross-sectional and descriptive-analytic study conducted in 2013. A sample of 124 employees was selected using stratified sampling proportional to size and simple random sampling methods. Data were collected using 2 questionnaires measuring the dimensions of employees' work ethics (four dimensions) and attitudes towards organizational changes (three dimensions). The collected data were analyzed using SPSS 18.0 and statistical tests, including ANOVA, independent samples t-test, and Pearson’s correlation coefficient. A P < 0.05 was considered statistically significant. The maximum and minimum score of work ethic dimensions were related to being cooperative (4.60 ± 0.38) and dependable (4.29 ± 0.39) respectively. On the other hand, the maximum and minimum score of attitudes towards the various dimensions of organizational changes were related to the behavioral (3.83 ± 0.70) and the affective (3.55 ± 0.88) dimensions respectively. Furthermore, there was a significant relationship between the work ethics and education levels of the employees in this study (P = 0.003). Also, among work s dimensions, only being considerate had a significant association with attitudes towards organizational changes (P = 0.014) and their cognitive dimension (P = 0.005). To improve employees' work ethics and attitudes towards organizational changes, the following suggestions can be offered: training hospitals managers in participative management style and its application, as well as the importance of meeting the employees' needs and expectations based on their characteristics; familiarizing employees with the Islamic work ethic; educating employees on the importance of being considerate towards their colleagues and subordinates in the workplace, and reinforcing this desirable quality; and finally, clarifying the need for changes in the organization for all employees. PMID:25512831

  16. A study of snake bite among children presenting to a paediatric ward in the main Teaching Hospital of North Central Province of Sri Lanka

    PubMed Central

    2014-01-01

    Background Snake bite is a common problem in the North Central province of Sri Lanka. Common krait (Bungarus careuleus), Ceylon krait (Bungarus ceylonicus), Cobra (Naja naja), Russell’s viper (Daboia russelii), Saw-scaled viper (Echis carinatus) and Hump-nosed pit viper (Hypnale hypnale) are the six species of venomous land snakes in Sri Lanka. A significant number of adults and children are bitten by snakes every year. However, the majority of research studies done in Sri Lanka and other countries show adults bitten by snakes and studies describing children bitten by snakes are very sparse. Methods A descriptive cross sectional study was performed in the Teaching Hospital Anuradhapura in the North Central Province of Sri Lanka from May 2010 to 2011 May to describe the characteristics associated with cases of snake bite. Results There were 24 males and 20 females. The highest numbers of bites (48%) were in the range of ages 6-12 years. The majority of the bites occurred between 6 pm to 6 am (59%).The foot was the most common bitten site (48%). Out of all the venomous bites, the Hump-nosed pit viper (Hypnale hypnale) accounted for the highest number (44%) and Russell’s viper (Daboia ruselii) accounted for the second highest number (27%). A significant number of venomous bites occurred indoors while sleeping (22%). Antivenom serum was given to (39%) of venomous bites. Deaths occurred in (11%) of the venomous bites. Conclusions Hump-nosed pit viper (Hypnale hypnale) accounted for the highest number of venomous bites. Majority of the bites occurred between 6 pm and 6 am. Foot was the most common bitten site. A significant number of venomous bites occurred indoor while sleeping. Antivenom serum was given to a significant number of venomous bites. Educating the public on making their houses snake proof and using a torch when going out during night time will help in the prevention of getting bitten by snakes. PMID:25073710

  17. A Study on the Usage Pattern of Antimicrobial Agents for the Prevention of Surgical Site Infections (SSIs) in a Tertiary Care Teaching Hospital

    PubMed Central

    Khan A.K, Afzal; P.V, Mirshad; Rashed, Mohammed Rafiuddin; Banu, Gausia

    2013-01-01

    Context: Inappropriate antimicrobial use increases the incidence of drug resistance, drug toxicity and superinfections, thereby increasing the healthcare costs. Various approaches for rationalizing the antimicrobial therapy, have been suggested. Collection of baseline data on the pattern of the antimicrobial use is usually suggested as the first step in this direction, which will help in identifying the problem areas, which demand our attention. Aims: To study the usage pattern of prophylactic antimicrobials in surgical patients, in order to detect any inappropriateness concerning the selection, timing, redosing and the duration of antimicrobial administration. Settings and Design: A retrospective review of the randomly selected medical records of general surgical cases over an 8 month period in a tertiary care teaching hospital. Methods and Material: The medical records of 258 patients who had undergone surgical procedures were verified for the appropriateness of the antimicrobial prophylaxis, with respect to the choice of the antimicrobial agent, the time of its administration, the intraoperative dosing, and the duration of the postoperative use. The obtained data was analyzed and conclusions were drawn with the help of descriptive statistics. Results: Third generation cephalosporins were used preoperatively in all the 258(100%) patients through the intravenous route. In addition, 77(30%) patients received metronidazole or amikacin. The antimicrobials were administered half an hour to one hour before the surgery. No intraoperative redosing was given. The duration of the postoperative prophylaxis was extended to 36 hours or more in 248(96%) of the cases. Conclusions: The timing of administration of the preoperative dose was appropriate and well delegated to the operating room nurse. The intra operative dose was appropriately omitted. The main concern was the increasing use of the third generation cephalosporins and the unnecessary prolonged duration of the postoperative prophylaxis, which needed to be addressed. PMID:23730643

  18. Profile of atherosclerotic risk factors and management in patients of peripheral arterial disease at a tertiary care teaching hospital of north India.

    PubMed

    Aiman, U; Haseen, M A; Beg, M H; Khan, R A; Siddiqui, F A; Alam, I

    2014-01-01

    Peripheral arterial disease, being a manifestation of systemic atherosclerosis, carries a high risk of adverse cardiovascular events. Secondary medical prevention therapies of same magnitude as that for coronary artery disease are recommended for peripheral arterial disease patients also. Available evidence indicates that this condition commonly remains underdiagnosed and undertreated. There is lack of any report about management of these patients in India. The objectives of the present study were to characterize the atherosclerotic risk factor profile and pattern of drug prescription for patients of peripheral arterial disease at a tertiary care teaching hospital and to compare this management with standard guidelines. Data were collected from prescriptions of patients attending cardiothoracic and vascular surgery outpatient department with diagnosis of atherosclerotic peripheral arterial disease from July 2012 to Jun 2013. One hundred twenty prescriptions were analysed. The mean age (±SD) of patients was 53±7.18 years and 23.3% were females. History of smoking, either past or present, was present in 91.6% patients. History of ischemic heart disease was present in 25%, while 26.7% patients were diabetic. Mean number of cardiovascular risk factors was 2.6. The percentage of eligible patients who were receiving a particular drug was 100% for aspirin and statins, 48.3% for angiotensin converting enzyme inhibitors, 46.7% for beta blockers and 66.7% for cilostazol. The vascular surgeons of this centre are using antiplatelet agents and statins adequately for peripheral arterial disease. The prescription of angiotensin converting enzyme inhibitors, beta blockers and cilostazol is low. Exercise therapy and smoking cessation need more attention. PMID:25593383

  19. Selected micronutrient levels and response to highly active antiretroviral therapy (HAART) among HIV/AIDS patients attending a teaching Hospital in Addis Ababa, Ethiopia.

    PubMed

    Eshetu, Amare; Tsegaye, Aster; Petros, Beyene

    2014-12-01

    Poor micronutrient levels are associated with an increased risk of progression to AIDS and are also suggested to influence outcome of highly active antiretroviral therapy (HAART), though existing data are inconclusive to support the latter. Few published data are available on micronutrient levels in Ethiopian HIV/AIDS patients taking HAART. The objective of the study was to determine the association of micronutrient levels and response to HAART (CD4(+) T cell count) among adult HIV/AIDS patients attending a teaching Hospital in Addis Ababa. CD4(+) T cell counts and micronutrient (retinol, zinc, and iron) levels for 171 subjects were determined using standard procedures. Some proportions of the study participants were found deficient for retinol (14.03 %), zinc (47.3 %), and iron (2.8 %). Patients who were deficient in retinol had a significantly lower median CD4(+) T cell counts (P?=?0.002) compared to non-deficient subjects. Association of micronutrient quartiles with CD4+ T cell count was assessed using adjusted multivariate regression by taking quartile 4 as a reference category. Accordingly, patients who had retinol levels in quartile 4 had a significantly lower mean CD4(+) T cell count compared to quartile 3 (P?=?0.02). The significantly higher CD4(+) T cell counts in patients who were non-deficient in retinol imply the role of retinol in improving the production of CD4(+) T cells. However, both lower and higher retinol levels were associated with suppressed immunity (CD4?

  20. A comparison of enoxaparin with unfractionated heparins in patients with coronary heart disease in an emergency department in rural South Indian tertiary care teaching hospital

    PubMed Central

    Ahmad, Akram; Patel, Isha; Asani, Himani; Jagadeesan, M.; Parimalakrishnan, S.; Selvamuthukumaran, S.

    2015-01-01

    Aim: Antithrombotic therapy with heparin plus antiplatelets reduces the rate of ischemic events in patients with coronary heart disease. Low molecular weight heparin has a more predictable anticoagulant effect than standard unfractionated heparin, is easier to administer, does not require monitoring and is associated with less ADRs. The purpose of the present study was to evaluate and compare the clinical and cost outcomes of Enoxaparin with a standard unfractionated heparin in patients with coronary heart disease. Materials and Methods: This was a noninvasive prospective observational descriptive study carried out at a multi-specialty tertiary care teaching hospital situated in rural Tamil Nadu, India. Male and female coronary heart disease (CHD) patients aged 35–75 years newly diagnosed or those having a history of CHD were included. The intervention group received enoxaparin for 5 days. A series of resting the electrocardiogram, prothrombin time and ADRs were measured in all patients during days 1 and 21 respectively. Results: Compared to unfractionated heparin group of patients, the average prothrombin time was significantly higher (P < 0.0001) whereas hypokalemia was significantly lower (P < 0.02) in enoxaparin group of patients. Even though recurrence of angina and ADRs such as bleeding, nausea, headache and sudden cough occurred less frequently in the enoxaparin group of patients compared to unfractionated heparin group of patients, the differences were not significant. Conclusions: Antithrombotic therapy with enoxaparin plus aspirin was safer and more effective than unfractionated heparin plus aspirin, in reducing the incidence of ischemic events in patients with unstable angina or myocardial infarction in the early phase.

  1. Factors associated with antiretroviral treatment interruption in human immunodeficiency virus (HIV)-1-infected children attending the Jos University Teaching Hospital, Jos, Nigeria

    PubMed Central

    Ebonyi, Augustine O.; Ejeliogu, Emeka U.; Okpe, Sylvanus E.; Shwe, David D.; Yiltok, Esther S.; Ochoga, Martha O.; Oguche, Stephen

    2015-01-01

    Background: Interrupting anti-retroviral therapy (ART) for any number of reasons is an indication of a compromised adherence to ART. Several factors, including the pill burden from other drugs used in treating co-infections in children with human immunodeficiency virus (HIV), may influence ART adherence. The aim of this study was to identify the factors associated with ART interruption in HIV-1-infected children. Materials and Methods: A retrospective cohort study analysing data on 580 children consecutively enrolled on ART between February 2006 and December 2010 at the paediatric HIV clinic of Jos University Teaching Hospital (JUTH), Jos. Subjects were children aged 2 months — 15 years diagnosed with HIV-1 infection and on first-line ART. Cotrimoxazole prophylaxis was usually commenced at diagnosis while awaiting ART commencement. Children diagnosed with tuberculosis (TB) were also placed on multiple individual anti-TB drugs. Statistical analysis used: A comparison of the data on children with and without ART interruption was made. Variables associated with ART interruption in a univariate analysis were fit in a multivariate logistic model to determine the factors that were associated with ART interruption. Results: Children on anti-TB drugs were twice more likely to interrupt ART compared to those who were not, (adjusted odds ratio, AOR = 1.84 (1.03-3.28); P = 0.04). But children on cotrimoxazole prophylaxis had a 57% reduction in the odds of interrupting ART compared to those who were not, (AOR = 0.43 (0.20-0.93); P = 0.03). Conclusion: Children on ART and also taking multiple individual anti-TB drugs should be monitored closely for ART adherence. Cotrimoxazole prophylaxis should be encouraged in children diagnosed with HIV while awaiting ART commencement as this may prime them for a better ART adherence. PMID:25657493

  2. Profile of Atherosclerotic Risk Factors and Management in Patients of Peripheral Arterial Disease at a Tertiary Care Teaching Hospital of North India

    PubMed Central

    Aiman, U.; Haseen, M. A.; Beg, M. H.; Khan, R. A.; Siddiqui, F. A.; Alam, I.

    2014-01-01

    Peripheral arterial disease, being a manifestation of systemic atherosclerosis, carries a high risk of adverse cardiovascular events. Secondary medical prevention therapies of same magnitude as that for coronary artery disease are recommended for peripheral arterial disease patients also. Available evidence indicates that this condition commonly remains underdiagnosed and undertreated. There is lack of any report about management of these patients in India. The objectives of the present study were to characterize the atherosclerotic risk factor profile and pattern of drug prescription for patients of peripheral arterial disease at a tertiary care teaching hospital and to compare this management with standard guidelines. Data were collected from prescriptions of patients attending cardiothoracic and vascular surgery outpatient department with diagnosis of atherosclerotic peripheral arterial disease from July 2012 to Jun 2013. One hundred twenty prescriptions were analysed. The mean age (±SD) of patients was 53±7.18 years and 23.3% were females. History of smoking, either past or present, was present in 91.6% patients. History of ischemic heart disease was present in 25%, while 26.7% patients were diabetic. Mean number of cardiovascular risk factors was 2.6. The percentage of eligible patients who were receiving a particular drug was 100% for aspirin and statins, 48.3% for angiotensin converting enzyme inhibitors, 46.7% for beta blockers and 66.7% for cilostazol. The vascular surgeons of this centre are using antiplatelet agents and statins adequately for peripheral arterial disease. The prescription of angiotensin converting enzyme inhibitors, beta blockers and cilostazol is low. Exercise therapy and smoking cessation need more attention. PMID:25593383

  3. Socio-economic status of patients with type 2 diabetes and hypertension attending the Ahmadu Bello University Teaching Hospital, Zaria, North-West Nigeria.

    PubMed

    Okoduwa, Stanley Irobekhian Reuben; Umar, Ismaila Alhaji; Ibrahim, Sani; Bello, Fatima; Ndidi, Uche Samuel

    2015-01-01

    Hypertension (HTN) and Type 2 diabetes (T2D) are lifestyle interrelated diseases of global significance. Interestingly, the prevalence of these diseases in Africa and indeed Nigeria seems to be on the increase. This study, therefore, investigated the socioeconomic status (based on income, education and occupational activity) of 400 subjects (52% female and 48% male) aged 20 years and above who were sampled randomly among the newly diagnosed HTN and/or T2D cases at the Ahmadu Bello University Teaching Hospital, Zaria, North-West Nigeria. A semi-structured questionnaire was used to collect information from the subjects. From the result obtained, most of the respondents who live in towns or city suffer from either HTN or T2D while more town dwellers (28%) suffer from a combination of both diseases. It was also discovered that most respondents who suffer from HTN and from a combination of HTN and T2D belong to the old generation (60-79 years). There is higher prevalence rate of diabetes among the respondents who had no formal education or attended only basic Arabic schools. Most respondents who earn good income (NGN50,000-NGN100,000 and above NGN100,000) suffer HTN, T2D and a combination of both diseases. Those engaged in heavy occupational activities had the lowest prevalence of the disease compared with those of light or moderate occupational activities. These data will be found useful in planning intervention healthcare preventive programs especially on public enlightenment workshops and seminars to educate the populace on the importance of lifestyle modification, healthy diet and regular exercises. PMID:25560354

  4. Seroprevalence of human papillomavirus immunoglobulin G antibodies among women presenting at the reproductive health clinic of a university teaching hospital in Nigeria

    PubMed Central

    Aminu, M; Gwafan, JZ; Inabo, HI; Oguntayo, AO; Ella, EE; Koledade, AK

    2014-01-01

    Background Human papillomavirus (HPV) is the cause of 90%–95% of squamous cell cancers. Persistent infection with high-risk HPV can lead to development of precancerous lesions of the cervix in 5%–10% of infected women, and can progress to invasive cervical cancer 15–20 years later. This study was conducted to determine the seroprevalence of HPV immunoglobulin G (IgG) antibodies among women of reproductive age attending a reproductive health clinic at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methods The study was descriptive, cross-sectional, and experimental, combining the use of a structured questionnaire and analysis of serum samples obtained from 350 consecutive consenting women. The serum samples were analyzed for IgG antibodies to HPV by enzyme-linked immunosorbent assay. Results We found a seroprevalence of 42.9% (150/350) for IgG antibodies to HPV in these women. Women aged 45–49 years and those who had their sexual debut aged 20–23 years had the highest HPV seroprevalence, ie, 50% (57/114) and 51.1% (46/90), respectively. Presence of antibodies varied according to sociodemographic factors, but was significantly associated with educational status, tribe, and religion (P<0.05). Human papillomavirus infection was not significantly associated with the reproductive characteristics and sexual behavior of the women. Antibodies to HPV were detected in 50.0% (9/18) of women with a family history of cervical cancer and in 30.8% (4/13) of those with a history or signs of WHIM (warts, hypogammaglobulinemia, immunodeficiency, myelokathexis) syndrome as a genetic disorder (P>0.05). Conclusion Further studies are needed to determine the HPV serotypes and evaluate the risk of natural development of HPV-related malignancies among women in the study area. PMID:24868172

  5. Intraoperative and Anesthesia-Related Cardiac Arrest and Its Mortality in Older Patients: A 15-Year Survey in a Tertiary Teaching Hospital

    PubMed Central

    Nunes, Juscimar C.; Braz, Jose R. C.; Oliveira, Thais S.; de Carvalho, Lidia R.; Castiglia, Yara M. M.; Braz, Leandro G.

    2014-01-01

    Background Little information is known about factors that influence perioperative and anesthesia-related cardiac arrest (CA) in older patients. This study evaluated the incidence, causes and outcome of intraoperative and anesthesia-related CA in older patients in a Brazilian teaching hospital between 1996 and 2010. Methods During the study, older patients received 18,367 anesthetics. Data collected included patient characteristics, surgical procedures, American Society of Anesthesiologists (ASA) physical status, anesthesia type, medical specialty team and outcome. All CAs were categorized by cause into one of four groups: patient's disease/condition-related, surgery-related, totally anesthesia-related or partially anesthesia-related. Results All intraoperative CAs and deaths rates are shown per 10,000 anesthetics. There were 100 CAs (54.44; 95% confidence intervals [CI]: 44.68–64.20) and 68 deaths (37.02; 95% CI: 27.56–46.48). The majority of CAs were patient's disease-/condition-related (43.5; 95% CI: 13.44–73.68). There were six anesthesia-related CAs (3.26; 95% CI: 0.65–5.87) - 1 totally and 5 partially anesthesia-related, and three deaths, all partially anesthesia-related (1.63; 95% CI: 0.0–3.47). ASA I-II physical status patients presented no anesthesia-related CA. Anesthesia-related CA, absent in the last five years of the study, was due to medication-/airway-related causes. ASA physical status was the most important predictor of CA (odds ratio: 14.52; 95% CI: 4.48–47.08; P<0.001) followed by emergency surgery (odds ratio: 8.07; 95% CI: 5.14–12.68; P<0.001). Conclusions The study identified high incidence of intraoperative CAs with high mortality in older patients. The large majority of CAs were caused by factors not anesthesia-related. Anesthesia-related CA and mortality rates were 3.26 and 1.63 per 10,000 anesthetics, with no anesthesia-related CA in the last five years of the study. Major predictors of intraoperative CAs were poorer ASA physical status and emergency surgery. All anesthesia-related CAs were medication-related or airway-related, which is important for prevention strategies. PMID:25117481

  6. Performance of modified WHO presumptive criteria for diagnosis of HIV infection in children <18 months admitted to University Teaching Hospital in Lusaka

    PubMed Central

    Mutesu-Kapembwa, Kunda; Andrews, Ben; Kapembwa, Kenneth; Chi, Benjamin H.; Banda, Yolan; Mulenga, Veronica; Kankasa, Chipepo

    2012-01-01

    Background Making a diagnosis of HIV infection in children aged less than 18 months remains a challenge in low resource settings like Zambia due to the limited availability of gold standard testing with HIV DNA PCR. Clinicians in rural areas have to depend on clinical diagnosis to start HAART as they wait for the dry blood spot (DBS) for DNA PCR results sent from the urban centers. Methods This descriptive cross-sectional study was performed at the University Teaching Hospital, Lusaka, Zambia. 299 HIV-exposed children aged less than 18 months were enrolled following a consent procedure. Patients were evaluated for HIV infection based on the World Health Organization’s presumptive diagnostic criteria (WHO-PDC), integrated management of childhood illnesses (IMCI) criteria, select physical exam abnormalities, and CD4% and findings were compared with HIV-DNA PCR results. Results Of the 299 exposed patients analyzed, 111(37%) were found to be HIV-positive by DNA PCR. The median CD4% in the infected children was 18%. WHO-PDC used on its own had 23% sensitivity (95% CI 17–32%) and 93% specificity (88–96%), respectively, whereas IMCI criterion had 10% sensitivity (6–17%) and 97% specificity (94–99%), respectively. Multivariate analysis was used to identify the most sensitive predictors when combined with the WHO-PDC and IMCI criterion. WHO-PDC with CD4% improved the sensitivity to 77% (68–83%) with a specificity of 83% (77–88%), positive predictive value (PPV) of 73% (64–80%) and negative predictive value (NPV) of 86% (80–90%). IMCI with CD4% improved sensitivity to 80% (71–87%) with a specificity of 88% (82–92%), PPV 78% (69–85%) and NPV 89% (84–93%). The addition of individual physical exam findings without CD4% improved the sensitivity of WHO-PDC only modestly. When the WHO-PDC, weight<3rd percentile, hepatomegaly, splenomegaly, lymphadenopathy and CD4% were combined, the sensitivity improved to 85% (77–90%), specificity 63% (56–70%), PPV 58% (50–65%) and NPV of 88% (81–92%). Conclusion The WHO-PDC clinical algorithm can be improved when combined with a CD4% <25% in children less than 12 months of age and CD4% <20% in those between 12 and 18 months. PMID:23170039

  7. Characterization of carbapenemases, extended spectrum ?-lactamases, quinolone resistance and aminoglycoside resistance determinants in carbapenem-non-susceptible Escherichia coli from a teaching hospital in Chongqing, Southwest China.

    PubMed

    Zhang, Chuanming; Xu, Xiuyu; Pu, Shuli; Huang, Shifeng; Sun, Jide; Yang, Shuangshuang; Zhang, Liping

    2014-10-01

    Carbapenem-resistant Escherichiacoli isolates harboring carbapenemases or combining an extended-spectrum ?-lactamase (ESBL) enzyme with loss of porins present an increasingly urgent clinical danger. Combined resistance to aminoglycosides and fluoroquinolones in carbapeneme non-susceptible (CNS) isolates will inevitably create problems. In the current study, we characterized the carbapenemases and ESBLs, and the prevalence of quinolone resistance determinants and aminoglycoside resistance determinants in carbapenem-non-susceptible (CNS) E.coli isolates from a teaching hospital in Chongqing, Southwest China in 2012. Thirty non-duplicated CNS E.coli isolates were screened via antimicrobial susceptibility testing, and the drug resistance profiles of the 30 strains were analyzed. Carbapenemase genes blaKPC-2, ESBL genes including blaCTX-M-3, blaCTX-M-14, blaCTX-M-55 and blaTEM, ARD genes including aac(6')-Ib, armA and rmtB, and QRD genes including qnrA, qnrB, qnrC, qnrD, qnrS and aac(6')-Ib-cr were identified and clonal relatedness was investigated by pulsed-field gel electrophoresis. Of the 30 isolates, 2 (6.7%) harbored carbapenemase gene blaKPC-2; 29 (96.7%) carried ESBLs; 20 (66.7%) were QRD positive; and 11 (36.7%) were ARD positive. Between the two blaKPC-2 positive strains, one contained ESBL, QRD and ARD genes, while the other expressed ESBL genes but was negative for both QRD and ARD genes. Of the 29 ESBLs positive isolates, 2 (6.9%) were carbapenemase positive, 19 (65.5%) were QRD positive, and 11 (37.9%) were ARD positive. PFGE revealed genetic diversity among the 30 isolates, indicating that the high prevalence of CNS E. coli isolates was not caused by clonal dissemination. Production of ESBLs was associated with the carbapenem resistance and QRD genes were highly prevalent among the CNS E. coli isolates. Multiple resistant genes were co-expressed in the same isolates. This is the first report of a multidrug resistant carbapenem-non-susceptible E.coli co-harboring resistant determinants blaKPC-2, blaCTX-M-14, blaCTX-M-55, blaTEM, aac(6')-Ib-cr, qnrB, aac(6')-Ib and rmtB from Chongqing, mainland China. PMID:25107431

  8. Hyperkalemia in hospitalized patients

    Microsoft Academic Search

    Robert W. Dunlay; Marc S. Stevens

    2000-01-01

    Objective: Evaluate the prevalence of hyperkalemia(potassium < 5.5 mmol\\/l) in hospitalized patientsnot on dialysis, as well as the association\\u000a ofmedications, impaired renal function and comorbidconditions with hyperkalemia.Design: A retrospective case-control method.Setting: A tertiary care teaching hospital.Patients: Hyperkalemic adults not on dialysis withage and sex matched controls.Interventions: None.Main outcome measures: The use of medicationsassociated with hyperkalemia and renal function usinga calculated

  9. Peer-driven contraceptive choices and preferences for contraceptive methods among students of tertiary educational institutions in Enugu, Nigeria

    PubMed Central

    Iyoke, CA; Ezugwu, FO; Lawani, OL; Ugwu, GO; Ajah, LO; Mba, SG

    2014-01-01

    Purpose To describe the methods preferred for contraception, evaluate preferences and adherence to modern contraceptive methods, and determine the factors associated with contraceptive choices among tertiary students in South East Nigeria. Methods A questionnaire-based cross-sectional study of sexual habits, knowledge of contraceptive methods, and patterns of contraceptive choices among a pooled sample of unmarried students from the three largest tertiary educational institutions in Enugu city, Nigeria was done. Statistical analysis involved descriptive and inferential statistics at the 95% level of confidence. Results A total of 313 unmarried students were studied (194 males; 119 females). Their mean age was 22.5±5.1 years. Over 98% of males and 85% of females made their contraceptive choices based on information from peers. Preferences for contraceptive methods among female students were 49.2% for traditional methods of contraception, 28% for modern methods, 10% for nonpharmacological agents, and 8% for off-label drugs. Adherence to modern contraceptives among female students was 35%. Among male students, the preference for the male condom was 45.2% and the adherence to condom use was 21.7%. Multivariate analysis showed that receiving information from health personnel/media/workshops (odds ratio 9.54, 95% confidence interval 3.5–26.3), health science-related course of study (odds ratio 3.5, 95% confidence interval 1.3–9.6), and previous sexual exposure prior to university admission (odds ratio 3.48, 95% confidence interval 1.5–8.0) all increased the likelihood of adherence to modern contraceptive methods. Conclusion An overwhelming reliance on peers for contraceptive information in the context of poor knowledge of modern methods of contraception among young people could have contributed to the low preferences and adherence to modern contraceptive methods among students in tertiary educational institutions. Programs to reduce risky sexual behavior among these students may need to focus on increasing the content and adequacy of contraceptive information held by people through regular health worker-led, on-campus workshops. PMID:25114515

  10. Incidence, Pattern and Management of Ovarian Cancer at a Tertiary Medical Center in Enugu, South East Nigeria

    PubMed Central

    Iyoke, CA; Ugwu, GO; Ezugwu, EC; Onah, N; Ugwu, O; Okafor, O

    2013-01-01

    Background: The incidence of ovarian cancer is thought to be increasing in developing countries and little is known about the pattern and incidence of this disease in South-East Nigeria. Aims: The objectives of the study were to determine the incidence, describe the pattern and management of ovarian cancer at a tertiary medical center in Enugu South East Nigeria. Materials and Methods: This was a retrospective review of cases of histologically diagnosed primary ovarian cancer at the study center over 11 years. Cases of histologically diagnosed primary ovarian cancer were identified through the records of the study center cancer registry and confirmed from the records of the histopathology department. Case notes, admission and theatre records were used to obtain data relating to clinical management, mortality and incidence of primary ovarian cancer. Statistical analysis was dose using SPSS statistical software version 17.0 for windows. Descriptive and inferential statistics were applied to obtain rates, proportions and 95% confidence intervals for these estimates. Results: There were 20,227 gynecological admissions during the study period (from January 2000 to December 2010) and 206 gynecological cancers. There were 54 cases of primary ovarian cancer giving an incidence rate of 1/405 gynecological admissions per year or 0.3% (95% confidential interval [CI] 0.23%, 0.38%) or 2.4% (54/206) per gynecological cancer per year. Epithelial ovarian cancer constituted 68% of cases of ovarian cancer (95% CI 54%, 82%): Sex cord and germ cell tumors constituted 16% each (95% CI 6%, 26%). Approximately 60% of women who had epithelial ovarian cancer were aged 50 years or below (95% CI 47%, 74%) and 72% of epithelial ovarian cancer occurred in multiparous women (95% CI 72.1%, 91.9%). Over 84% of ovarian cancer presented in stages 3 and 4 of the disease (95% CI 94%, 72%). The mainstay of management was surgery: Compliance with cis-platinum based adjuvant chemotherapy was poor. Case-specific mortality rate within 1 year of diagnosis was, at least, 70% (95% CI 64%, 84%). Conclusions: Primary ovarian cancer was uncommon and consisted mainly of epithelial cancer. Epithelial ovarian cancer occurred more in multiparous women and in women under 50 years in our center contrary to the known pattern of the disease. PMID:24116325

  11. The Economic Burden of Malaria on Households and the Health System in Enugu State Southeast Nigeria

    PubMed Central

    Onwujekwe, Obinna; Uguru, Nkoli; Etiaba, Enyi; Chikezie, Ifeanyi; Uzochukwu, Benjamin; Adjagba, Alex

    2013-01-01

    Background Malaria is the number one public health problem in Nigeria, responsible for about 30% of deaths in under-fives and 25% of deaths in infants and 11% maternal mortality. This study estimated the economic burden of malaria in Nigeria using the cost of illness approach. Methods A cross-sectional study was undertaken in two malaria holo-endemic communities in Nigeria, involving both community and hospital based surveys. A random sample of 500 households was interviewed using interviewer administered questionnaire. In addition, 125 exit interviews for inpatient department stays (IPD) and outpatient department visits (OPD) were conducted and these were complemented with data abstraction from 125 patient records. Results From the household survey, over half of the households (57.6%) had an episode of malaria within one month to the date of the interview. The average household expenditure per case was 12.57US$ and 23.20US$ for OPD and IPD respectively. Indirect consumer costs of treatment were higher than direct consumer medical costs. From a health system perspective, the recurrent provider costs per case was 30.42 US$ and 48.02 US$ for OPD and IPD while non recurrent provider costs were 133.07US$ and 1857.15US$ for OPD and IPD. The mode of payment was mainly through out-of-pocket spending (OOPS). Conclusion Private expenditure on treatment of malaria constitutes a high economic burden to households and to the health system. Removal of user fees and interventions that will decrease the use of OOPS for treatment of malaria will significantly decrease the economic burden of malaria to both households and the health system. PMID:24223796

  12. The long walk to universal health coverage: patterns of inequities in the use of primary healthcare services in Enugu, Southeast Nigeria

    PubMed Central

    2014-01-01

    Background Knowledge and understanding of health service usage are necessary for health resource allocation, planning and monitoring the achievement of universal coverage (UHC). There is limited information on patterns of utilization among adult users of primary health care (PHC) services. Lack of understanding of current and past utilization patterns of health services often hinders the improvement of future Primary Health Care (PHC) delivery in the remote areas of developing countries. This paper presents new knowledge on the patterns of utilization of PHC services among adults in Enugu metropolis southeast Nigeria. Methods A cross-sectional study was conducted in 15 PHC facilities of Enugu North Local Government Area (LGA) from June to July 2012. A total of 360 consenting adult users aged 18 years and above were consecutively recruited as they attended the health facilities. An interviewer-administered questionnaire was used to collect data from the respondents. A modified Likert scale questionnaire was used to analyze data on patterns of utilization. Utilization of PHC services was compared by gender, socio-economic status (SES) and level of education. Results Out of the 360 respondents, (46.9%) utilized PHC services regularly. The components of PHC mostly utilized by respondents were immunization with a mean score of 3.05, treatment of common ailments (2.99) and maternal and child health (2.64). The least poor SES group utilized PHC services the most while the very poor and poor SES groups used PHC services least. There were statistically significant relationships between utilization of PHC services and gender (p?=?0.0084), level of education (p?=?0.0366) and income (p?=?0.0001). Conclusions Most adult users in this study did not utilize the health facilities regularly and there were gender, educational and SES inequities in the use of PHC services. These inequities will negate the achievement of universal health coverage with PHC services and should be remedied using appropriate interventions. PMID:24655898

  13. RFID solution benefits Cambridge hospital.

    PubMed

    James, Andrew

    2013-10-01

    Keeping track of thousands of pieces of equipment in a busy hospital environment is a considerable challenge, but, according to RFID tagging and asset tracking specialist, Harland Simon, RFID technology can make the task considerably simpler. Here Andrew James, the company's RFID sales manager, describes the positive benefits the technology has brought the Medical Equipment Library (MEL) at Addenbrooke's Hospital, one of the world's most famous teaching hospitals. PMID:24341115

  14. Use of linked electronic health records to assess mortality and length of stay associated with pandemic influenza A(H1N1)pdm09 at a UK teaching hospital.

    PubMed

    Smith, C; Curran, M D; Roddick, I; Reacher, M

    2015-04-01

    Effective use of data linkage is becoming an increasingly important focus in the new healthcare system in England. We linked data from the results of a multiplex PCR assay for respiratory viruses for a population of 230 inpatients at a UK teaching hospital with their patient administrative system records in order to compare the mortality and length of stay of patients who tested positive for influenza A(H1N1)pdm09 with those positive for another influenza A virus. The results indicated a reduced risk of death among influenza A(H1N1)pdm09 patients compared to other influenza A strains, with an adjusted risk ratio of 0·25 (95% confidence interval 0·08-0·75, P = 0·01), while no significant differences were found between the lengths of stay in the hospital for these two groups. Further development of such methods to link hospital data in a routine fashion could provide a rapid means of gaining epidemiological insights into emerging infectious diseases. PMID:25119499

  15. Presence, Distribution, and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Small Animal Teaching Hospital: A Year-Long Active Surveillance Targeting Dogs and Their Environment

    PubMed Central

    van Balen, Joany; Kelley, Christina; Nava-Hoet, Rocio C.; Bateman, Shane; Hillier, Andrew; Dyce, Jonathan; Wittum, Thomas E.

    2013-01-01

    Abstract Methicillin-resistant Staphylococcus aureus (MRSA) is known to be present in small animal veterinary clinical environments. However, a better understanding of the ecology and dynamics of MRSA in these environments is necessary for the development of effective infectious disease prevention and control programs. To achieve this goal, a yearlong active MRSA surveillance program was established at The Ohio State University (OSU) Veterinary Medical Center to describe the spatial and molecular epidemiology of this bacterium in the small animal hospital. Antimicrobial susceptibility testing, staphylococcal chromosomal cassette mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE) typing, and dendrogram analysis were used to characterize and analyze the 81 environmental and 37 canine-origin MRSA isolates obtained during monthly sampling events. Overall, 13.5% of surfaces were contaminated with MRSA at 1 or more sampling times throughout the year. The majority of the environmental and canine isolates were SCCmec type II (93.8% and 86.5%, respectively) and USA100 (90.1% and 86.5%, respectively). By PFGE analysis, these isolates were found to be closely related, which reflects a low diversity of MRSA strains circulating in the hospital. For 5 consecutive months, 1 unique pulsotype was the most prevalent across the medical services and was recovered from a variety of surfaces and hospital locations. Carts/gurneys, doors, and examination tables/floors were the most frequently contaminated surfaces. Some surfaces maintained the same pulsotypes for 3 consecutive months. Molecular analysis found that incoming MRSA-positive dogs were capable of introducing a new pulsotype into the hospital environment during the surveillance period. Our results suggest that once a MRSA strain is introduced into the hospital environment, it can be maintained and spread for extended periods of time. These findings can aid in the development of biosecurity and biocontainment protocols aimed at reducing environmental contamination and potential exposures to MRSA in veterinary hospital staff, clients, and patients. PMID:23473216

  16. Students Completing a Pediatric Clinical Clerkship in a Regional Center Perform as Well as Their Peers Training at a University Teaching Hospital … And They Liked It Better?

    Microsoft Academic Search

    Robert Stein; Ian Johnston; Susan Bannister

    2009-01-01

    Background: Medical school size in Ontario is increasing. As some institutions cannot accommodate all medical students in the university-affiliated hospital, some students are completing the majority of their clinical rotations in a regional setting. Purpose: To determine whether the regional experience is equivalent to the more traditional tertiary care experience. Methods: Students' examination results and rotation evaluation forms were collected

  17. Compare Hospitals

    MedlinePLUS

    2014 Leapfrog Hospital Survey Results Now Available Thank you for visiting the Leapfrog Hospital Survey Results Website. These results are based on surveys submitted by hospitals across the country that have demonstrated a commitment ...

  18. Special Issue of Teaching Ideas.

    ERIC Educational Resources Information Center

    Health Education (Washington D.C.), 1986

    1986-01-01

    This special issue contains teaching strategies and suggestions for health-related activities at all educational levels. A few of the topics addressed by the 21 articles are heart disease, testicular cancer, hospital stress, family life, and sexual responsibility. (MT)

  19. Medical student teaching in the UK: how well are newly qualified doctors prepared for their role caring for patients with cancer in hospital?

    Microsoft Academic Search

    J Cave; K Woolf; J Dacre; H W W Potts; A Jones

    2007-01-01

    A number of studies have identified problems with undergraduate oncology teaching. We have investigated how well prepared newly qualified doctors (first foundation year, or FY1 doctors) are for treating patients with cancer. Twenty-five FY1 doctors and 15 senior doctors participated in interviews. We turned the emergent themes into a questionnaire for all 5143 UK FY1 doctors in 2005. The response

  20. TeachingTeaching Interactive

    E-print Network

    Jones, Michelle

    of these departments include: The College of Nursing, The College of Education, The College of Food, Agriculture educational goals otherwise out of reach due to their location. Teaching a multi-site class can facilitateTeachingTeaching with Interactive Video: A Faculty Orientation Presented by OSU Extension and OSU

  1. Complexity and Diversity of Klebsiella pneumoniae Strains with Extended-Spectrum  -Lactamases Isolated in 1994 and 1996 at a Teaching Hospital in Durban, South Africa

    Microsoft Academic Search

    SABIHA Y. ESSACK; LUCINDA M. C. HALL; DEVADAS G. PILLAY; MARGARET LYNN MCFADYEN; DAVID M. LIVERMORE

    2001-01-01

    b-Lactamase production was investigated in cultures of 25 Klebsiella pneumoniae isolates isolated at a hospital in Durban, South Africa, in 1994 and 1996. Twenty of these isolates gave ceftazidime MIC\\/ceftazidime plus clavulanate MIC ratios of >8, implying production of extended-spectrum b-lactamases (ESBLs), and DNA sequencing identified an ESBL gene (blaTEM-53) in a further two isolates. Pulsed-field gel electrophoresis (PFGE) defined

  2. Neuromuscular monitoring, muscle relaxant use, and reversal at a tertiary teaching hospital 2.5 years after introduction of sugammadex: changes in opinions and clinical practice.

    PubMed

    Ledowski, Thomas; Ong, Jing Shen; Flett, Tom

    2015-01-01

    Sugammadex was introduced to Royal Perth Hospital in early 2011 without access restriction. Two departmental audits (26-page online survey and 1-week in-theatre snapshot audit) were undertaken to investigate the change of beliefs and clinical practice related to the use of neuromuscular blocking agents at the Royal Perth Hospital since this introduction. Results were compared with data from 2011. We found that, in the 2.5 years since introduction of Sugammadex, more anesthetists (69.5 versus 38%) utilized neuromuscular monitoring, and aminosteroidal neuromuscular blocking agents were used in 94.3% of cases (versus 77% in 2011). Furthermore, 53% of anesthetists identified with a practice of "deeper and longer" intraoperative paralysis of patients. All 71 patients observed during the 5-day in-theatre audit were reversed with Sugammadex. Since the introduction of Sugammadex, 69% (n = 20) of respondents felt it provided "faster turnover," less postoperative residual neuromuscular blockade (n = 23; 79%), and higher anesthetist satisfaction (n = 17; 59%). 45% (n = 13) of colleagues reported that they would feel professionally impaired without the unrestricted availability of Sugammadex, and 1 colleague would refuse to work in a hospital without this drug being freely available. In clinical practice Sugammadex was frequently (57%) mildly overdosed, with 200?mg being the most commonly administered dose. PMID:25667592

  3. Neuromuscular Monitoring, Muscle Relaxant Use, and Reversal at a Tertiary Teaching Hospital 2.5 Years after Introduction of Sugammadex: Changes in Opinions and Clinical Practice

    PubMed Central

    Ledowski, Thomas; Ong, Jing Shen; Flett, Tom

    2015-01-01

    Sugammadex was introduced to Royal Perth Hospital in early 2011 without access restriction. Two departmental audits (26-page online survey and 1-week in-theatre snapshot audit) were undertaken to investigate the change of beliefs and clinical practice related to the use of neuromuscular blocking agents at the Royal Perth Hospital since this introduction. Results were compared with data from 2011. We found that, in the 2.5 years since introduction of Sugammadex, more anesthetists (69.5 versus 38%) utilized neuromuscular monitoring, and aminosteroidal neuromuscular blocking agents were used in 94.3% of cases (versus 77% in 2011). Furthermore, 53% of anesthetists identified with a practice of “deeper and longer” intraoperative paralysis of patients. All 71 patients observed during the 5-day in-theatre audit were reversed with Sugammadex. Since the introduction of Sugammadex, 69% (n = 20) of respondents felt it provided “faster turnover,” less postoperative residual neuromuscular blockade (n = 23; 79%), and higher anesthetist satisfaction (n = 17; 59%). 45% (n = 13) of colleagues reported that they would feel professionally impaired without the unrestricted availability of Sugammadex, and 1 colleague would refuse to work in a hospital without this drug being freely available. In clinical practice Sugammadex was frequently (57%) mildly overdosed, with 200?mg being the most commonly administered dose. PMID:25667592

  4. Computers in Hospital Clinical Nursing: Implications for Nursing Education.

    ERIC Educational Resources Information Center

    St. Thomas, Sister

    The use of computers in hospital clinical nursing and implications for the education of nurses were studied with a sample of 130 hospitals. Of concern was how computers were used, which hospital personnel used computers in health care, costs to educate staff nurses, and who teaches nurses about computers. Questionnaires completed by hospital data…

  5. First description of NDM-1-, KPC-2-, VIM-2- and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital.

    PubMed

    Liu, Y; Wan, L-G; Deng, Q; Cao, X-W; Yu, Y; Xu, Q-F

    2015-01-01

    A total of 180 non-duplicate carbapenem-resistant Klebsiella pneumoniae isolates were recovered from patients hospitalized between December 2010 and January 2012 at a Chinese hospital. Eight KPC-2, four NDM-1, one VIM-2, and five KPC-2 plus IMP-4 producers were identified and all were multidrug resistant due to the presence of other resistance determinants, including extended-spectrum ?-lactamases (CTX-M-15, SHV-12), 16S rRNA methylases (armA, rmtB) and plasmid-mediated quinolone-resistance determinants (qnrA, B, S, aac(6')-Ib-cr). Nine K. pneumoniae clones (Kpn-A1/ST395, Kpn-A3/ST11, Kpn-A2/ST134, Kpn-B/ST263, Kpn-C/ST37, Kpn-D/ST39, Kpn-E/ST1151, Kpn-F/ST890, Kpn-G/ST1153) were identified. bla KPC-2 was located on transferable ~65 kb IncL/M (ST395, ST11, ST134, ST39) and ~100 kb IncA/C (ST37, ST1153, ST890) plasmids, respectively. On the other hand, bla NDM-1 was associated with a ~70 kb IncA/C plasmid (ST263). However, non-typable plasmids of ~40 kb containing bla VIM-2 were detected in the ST1151 clone. This work reports the first co-occurrence of four diverse types of carbapenemase of K. pneumoniae clones from a single hospital in China. IncA/C, IncL/M, and other successful plasmids may be important for the dissemination of carbapenemases, producing a complex epidemiological picture. PMID:24762211

  6. A survey of hospital toilet facilities

    Microsoft Academic Search

    A. F. Travers; E. Burns; N. D. Penn; S. C. Mitchell; G. P. Mulley

    1992-01-01

    OBJECTIVE--To assess the quality of toilet facilities available for disabled people in a large provincial teaching hospital. DESIGN--Survey of toilet facilities for patients on the wards and in the outpatient department. SETTING--Teaching hospital in Leeds. RESULTS--Although the quality of toilet facilities varied, none met the standards recommended by the British Standards Institution. The worst facilities were found on a ward

  7. Characterisation of acute respiratory infections at a United Kingdom paediatric teaching hospital: observational study assessing the impact of influenza A (2009 pdmH1N1) on predominant viral pathogens

    PubMed Central

    2014-01-01

    Background According to the World Health Organisation, influenza A (2009 pdmH1N1) has moved into the post-pandemic phase, but there were still high numbers of infections occurring in the United Kingdom in 2010-11. It is therefore important to examine the burden of acute respiratory infections at a large children’s hospital to determine pathogen prevalence, occurrence of co-infection, prevalence of co-morbidities and diagnostic yield of sampling methods. Methods This was a retrospective study of respiratory virus aetiology in acute admissions to a paediatric teaching hospital in the North West of England between 1st April 2010 and 31st March 2011. Respiratory samples were analysed either with a rapid RSV test if the patient had symptoms suggestive of bronchiolitis, followed by multiplex PCR testing for ten respiratory viruses, or with multiplex PCR testing alone if the patient had suspected other ARI. Patient demographics and data regarding severity of illness, presence of co-morbidities and respiratory virus sampling method were retrieved from case notes. Results 645 patients were admitted during the study period. 82/645 (12.7%) patients were positive for 2009 pdmH1N1, of whom 24 (29.2%) required PICU admission, with 7.3% mortality rate. Viral co-infection occurred in 48/645 (7.4%) patients and was not associated with more severe disease. Co-morbidities were present more frequently in older children, but there was no significant difference in prevalence of co-morbidity between 2009 pdmH1N1 patients and those with other ARI. NPA samples had the highest diagnostic yield with 192/210 (91.4%) samples yielding an organism. Conclusions Influenza A (2009 pdmH1N1) is an ongoing cause of occasionally severe disease affecting both healthy children and those with co-morbidities. Surveillance of viral pathogens provides valuable information on patterns of disease. PMID:24948099

  8. Hospital Hints

    MedlinePLUS

    ... hospital. You will need: Bathrobe and slippers (put your name on each item); most hospitals provide special bed ... medicines , including prescription and over-the-counter drugs Your allergies Names and telephone numbers (home and business) to contact ...

  9. Norovirus - hospital

    MedlinePLUS

    ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ... to understand an outbreak, such as in a hospital setting. This test is done by collecting a ...

  10. Improvement in medication adherence and self-management of diabetes with a clinical pharmacy program: a randomized controlled trial in patients with type 2 diabetes undergoing insulin therapy at a teaching hospital

    PubMed Central

    Cani, Catarina Gomes; da Silva Girćo Lopes, Laura; Queiroz, Mįrcia; Nery, Mįrcia

    2015-01-01

    OBJECTIVE: To evaluate the impact of a clinical pharmacy program on health outcomes in patients with type 2 diabetes undergoing insulin therapy at a teaching hospital in Brazil. METHOD: A randomized controlled trial with a 6-month follow-up period was performed in 70 adults, aged 45 years or older, with type 2 diabetes who were taking insulin and who had an HbA1c level ?8%. Patients in the control group (CG) (n?=?36) received standard care, patients in the intervention group (IG) (n?=?34) received an individualized pharmacotherapeutic care plan and diabetes education. The primary outcome measure was change in HbA1c. Secondary outcomes included diabetes and medication knowledge, adherence to medication, insulin injection and home blood glucose monitoring techniques and diabetes-related quality of life. Outcomes were evaluated at baseline and 6 months using questionnaires. RESULTS: Diabetes knowledge, medication knowledge, adherence to medication and correct insulin injection and home blood glucose monitoring techniques significantly improved in the intervention group but remained unchanged in the control group. At the end of the study, mean HbA1c values in the control group remained unchanged but were significantly reduced in the intervention group. Diabetes-related quality of life significantly improved in the intervention group but worsened significantly in the control group. CONCLUSION: The program improved health outcomes and resulted in better glycemic control in patients with type 2 diabetes undergoing insulin therapy. PMID:25789518

  11. Types and Frequency of Errors during Different Phases of Testing At a Clinical Medical Laboratory of a Teaching Hospital in Tehran, Iran

    PubMed Central

    Abdollahi, Alireza; Saffar, Hiva; Saffar, Hana

    2014-01-01

    Background: According to official data, 60–70% of clinical decisions about hospitalization and discharge are based on laboratory results. Aims: The objective of this study is to examine the frequency of errors before, during, and after analysis in a major medical laboratory. Materials and Methods: This descriptive, cross-sectional study was conducted throughout 2012 (January–December 2012). Errors are recorded by the Quality Control Committee in a specially designed record. Results: A total of 303,866 samples, 2,430,928 tests were received for analysis. The total number of errors was 153,148 (6.3%) (116,392 for inpatients and 36,756 for outpatients). Analysis of the results revealed that about 65.09% of the errors occur across preanalytical phase, whereas 23.2% and 11.68% are related to analytical and postanalytical phase, respectively. Conclusion: More than half of the laboratory errors are related to preanalytical phase; therefore, proper training and knowledge of intervening factors are essential for reducing errors and optimizing the quality. PMID:24926448

  12. Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People's Republic of China.

    PubMed

    Zhu, Ling-Ling; Li, Wei; Song, Ping; Zhou, Quan

    2014-01-01

    The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People's Republic of China. Injection device-related near misses and adverse events comprised the following: 1) improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2) complications associated with vascular access; 3) incidents induced by absence of efficient electronic pump management and infusion tube management; and 4) liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan-do-check-act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety. PMID:24669192

  13. Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People’s Republic of China

    PubMed Central

    Zhu, Ling-ling; Li, Wei; Song, Ping; Zhou, Quan

    2014-01-01

    The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People’s Republic of China. Injection device-related near misses and adverse events comprised the following: 1) improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2) complications associated with vascular access; 3) incidents induced by absence of efficient electronic pump management and infusion tube management; and 4) liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan–do–check–act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety. PMID:24669192

  14. National survey of hospital patients.

    PubMed Central

    Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

    1994-01-01

    OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened rather than how satisfied they were with treatment can elucidate the problems that exist and so enable them to be solved. PMID:7819893

  15. Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: A surgical experience of 104 cases in a resource-limited setting

    PubMed Central

    2012-01-01

    Background Typhoid intestinal perforation is still prevalent in many developing countries. Despite the advances in the management, the outcome in these patients in resource limited countries is still very poor. This study was to review our experiences on the surgical management of typhoid intestinal perforation and to determine the prognostic factors for mortality in our local setting. Methods This was a combined retrospective and prospective study of patients who were operated for typhoid intestinal perforation at Bugando Medical Centre between August 2006 and September 2011. Data collected were analyzed using SPSS computer software version 15. Results A total of 104 patients were studied representing 8.7% of typhoid fever cases. Males were affected twice more than the females (2.6:1). Their ages ranged from 8 to 76 years with a median age of 18.5 years. The peak age incidence was in the 11-20 years age group. Fever and abdominal pain were the most common presenting symptoms and majority of the patients (80.8%) perforated between within 14 days of illness. Chest and abdominal radiographs revealed pneumoperitonium in 74.7% of cases. Ultrasound showed free peritoneal collection in 85.7% of cases. Nine (10.2%) patients were HIV positive with a median CD4+ count of 261 cells/?l. The perforation-surgery interval was more than 72 hours in 90(86.5%) patients. The majority of patients (84.6%) had single perforations and ileum was the most common part of the bowel affected occurring in 86.2% of cases. Simple closure of the perforations was the most commonly performed procedure accounting for 78.8% of cases. Postoperative complication rate was 39.4% and surgical site infection was the most frequent complication in 55.5% of cases. Mortality rate was 23.1% and it was statistically significantly associated with delayed presentation, inadequate antibiotic treatment prior to admission, shock on admission, HIV positivity, low CD4 count (< 200 cells/?l), high ASA classes (III-V), delayed operation, multiple perforations, severe peritoneal contamination and presence of postoperative complications (P < 0.001). The median overall length of hospital stay was 28 days. Conclusion Typhoid intestinal perforation is still endemic in our setting and carries high morbidity and mortality. This study has attempted to determine the factors that statistically influence mortality in typhoid perforation in our environment. Appropriate measures focusing at these factors are vital in order to deliver optimal care for these patients in this region. PMID:22401289

  16. [The army nurse, from hospital to overseas operations].

    PubMed

    Guérot, Franēoise; Saliou, Henri; Lefort, Hugues; De Rudnickl, Stéphane

    2014-09-01

    Assigned to French army teaching hospitals, the army nurse can be deployed on overseas operations in support of the armed forces. Experience in the treatment of casualties in life-threatening emergencies is essential, as is the ability to adapt and react. Designated on a voluntary basis, after some two years of working in an army teaching hospital, the hospital nurse receives training in the specificities of the theatre of deployment. PMID:25464633

  17. Greek hospitals: how well their resources are used

    Microsoft Academic Search

    Dimitris I. Giokas

    2001-01-01

    The paper concerns the use of different estimation methods (parametric and non-parametric), jointly or individually, as means of ascertaining relative efficiency, as well as specific estimates of the efficient marginal costs of hospital services (inpatient days in medical care, inpatient days in surgical area, etc.) of public, general and teaching hospitals in Greece. In addition, the efficient cost of hospitals

  18. Hospitality Management Media Resources

    NSDL National Science Digital Library

    HospitalityNet is an industry website that collects articles, news, job opportunities, and educational resources focused on tourism and related subjects. The subjects covered on this website for training and informational purposes varies widely, from financial information to tours of successful hotels and even ideas for advertising and other business implementations. This would be very helpful to a teacher who seeks media with which to teach in class, or for students seeking ideas for projects. This is especially ideal for students who are unsure of what career path to choose, as it provides school appraisals and videos of the requirements involved with hotel management, highlighting the more exciting aspects of the position. The resources here would also be very helpful in designing new businesses or developing Hospitality business models.

  19. Teaching Geriatrics Away from the Medical Model.

    ERIC Educational Resources Information Center

    Stotts, Michael L.

    1986-01-01

    Suggests alternatives to the medical education model for teaching geriatrics. Proposes geriatric learning that shows interdisciplinary care, stresses wellness over illness, and demonstrates examples of care, support, independence, and limited maintenance away from nursing homes and hospitals. (Author/ABB)

  20. American Hospital Directory

    MedlinePLUS

    ... Outpatient Welcome Understanding and using Free Hospital Profiles Free Hospital Profiles How to look up a hospital ... more than 50 hospitals.) How to see the Free Hospital Profile The Free Hospital Profile is displayed ...

  1. Teaching Shakespeare.

    ERIC Educational Resources Information Center

    Davis, James E., Ed.

    1976-01-01

    This issue of "Focus: Teaching English in Southeastern Ohio" contains articles about teaching Shakespeare, student summaries of a Shakespeare conference held at Ohio University-Zanesville in April 1976, and suggested projects for teaching poetry writing. It also contains lists of materials and articles related to the teaching of Shakespeare, and…

  2. Teaching Pronunciation

    ERIC Educational Resources Information Center

    Knight, Michael

    1975-01-01

    Gives practical hints for teaching pronunciation with special attention to accent: 1. Teaching of pronunciation should take place in a "meaningful context." 2. Mimicry drills form the basis for teaching pronunciation. 3. Discrimination drills are a prerequisite for successful teaching of pronunciation. 4. Speaking in chorus is a useful method for…

  3. Hospital fundamentals.

    PubMed

    Althausen, Peter L; Hill, Austin D; Mead, Lisa

    2014-07-01

    Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID:24918827

  4. Unit Cost of Medical Services at Different Hospitals in India

    PubMed Central

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

    Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1?=?INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates under government-sponsored insurance schemes. PMID:23936088

  5. Determining the quality of educational climate across multiple undergraduate teaching sites using the DREEM inventory

    Microsoft Academic Search

    Rajesh Varma; Ekta Tiyagi; Janesh K Gupta

    2005-01-01

    BACKGROUND: Our obstetrics and gynaecology undergraduate teaching module allocates 40–50 final year medical students to eight teaching hospital sites in the West Midlands region. Based on student feedback and concerns relating to the impact of new curriculum changes, we wished to objectively assess whether the educational environment perceived by students varied at different teaching hospital centres, and whether the environment

  6. Using a Computer to Teach Nursing.

    ERIC Educational Resources Information Center

    Bitzer, Maryann D.; Boudreaux, Martha C.

    1969-01-01

    A computer-based education system, PLATO (Programed Logic for Automatic Teaching Operations), has been used to teach nursing students at Mercy Hospital School of Nursing in Urbana, Illinois since 1963. PLATO III, the model now being used in a maternity nursing course, has 70 student terminals (20 of which can be used at any one time) connected to…

  7. WWW - an effective way of teaching radiology

    Microsoft Academic Search

    M. Wangel; L. Niemitukia; T. Katila; S. Soimakallio

    2001-01-01

    The Internet and especially the World Wide Web (WWW) have given new opportunities and challenges in teaching radiology. In Kuopio University and Kuopio University Hospital, we started to develop a new WWW-based radiology teaching file in 1996. Our file was made as a result of weaknesses in other files and as an answer to our local needs. The file consists

  8. A Course on Teaching for House Officers.

    ERIC Educational Resources Information Center

    Camp, Martha G.; And Others

    1985-01-01

    A Bowman Gray School of Medicine of Wake Forest University course on teaching is described that was developed specifically for hospital house officers so that they could become familiar with instructional principles and resources necessary to carry out their teaching responsibilities. (MLW)

  9. Costs of surgical procedures in Indian hospitals

    PubMed Central

    Chatterjee, Susmita; Laxminarayan, Ramanan

    2013-01-01

    Objective Despite a growing volume of surgical procedures in low-income and middle-income countries, the costs of these procedures are not well understood. We estimated the costs of 12 surgical procedures commonly conducted in five different types of hospitals in India from the provider perspective, using a microcosting method. Design Cost and utilisation data were collected retrospectively from April 2010 to March 2011 to avoid seasonal variability. Setting For this study, we chose five hospitals of different types: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed district hospital, a 655-bed private teaching hospital and a 778-bed tertiary care teaching hospital based on their willingness to cooperate and data accessibility. The hospitals were from four states in India. The private, charitable and tertiary care hospitals serve urban populations, the district hospital serves a semiurban area and the private teaching hospital serves a rural population. Results Costs of conducting lower section caesarean section ranged from rupees 2469 to 41?087; hysterectomy rupees 4124 to 57?622 and appendectomy rupees 2421 to 3616 (US$1=rupees 52). We computed the costs of conducting lap and open cholecystectomy (rupees 27?732 and 44?142, respectively); hernia repair (rupees 13?204); external fixation (rupees 8406); intestinal obstruction (rupees 6406); amputation (rupees 5158); coronary artery bypass graft (rupees 177?141); craniotomy (rupees 75?982) and functional endoscopic sinus surgery (rupees 53?398). Conclusions Estimated costs are roughly comparable with rates of reimbursement provided by the Rashtriya Swasthya Bima Yojana (RSBY)—India's government-financed health insurance scheme that covers 32.4 million poor families. Results from this type of study can be used to set and revise the reimbursement rates. PMID:23794591

  10. The Teaching Nursing Home: Past Accomplishments and Future Directions.

    ERIC Educational Resources Information Center

    Lipsitz, Lewis A.

    1996-01-01

    Discusses the past, present, and future of the use of nursing homes as teaching sites. Suggests that teaching nursing homes must provide state-of-the-art care while avoiding the pitfalls that threaten academic hospitals; balance must be maintained between the benefits of teaching and the burdens placed on patients and staff. (JOW)

  11. VETERINARY TEACHING HOSPITAL 1602 Campus Delivery

    E-print Network

    Birner, Thomas

    treadmill, electrical stimulation, laser, therapeutic ultrasound, shockwave, and manual therapies for rehabilitation therapies. This person performs exams, develops plan of care, directly provides rehabilitation of rehabilitation modalities including underwater treadmill, land treadmill, shockwave, NMES, TENS, LASER

  12. VETERINARY TEACHING HOSPITAL 1602 Campus Delivery

    E-print Network

    to fill a senior level Veterinary Nursing Coordinator position. This position is an integral part Classified regulations to include onboarding initiatives; career development; succession planning through his/her professional qualifications and leadership skills as well as project the highest levels

  13. Survey of 3765 cardiopulmonary resuscitations in British hospitals (the BRESUS Study): methods and overall results

    Microsoft Academic Search

    H. Tunstall-Pedoe; L. Bailey; D. A. Chamberlain; A. K. Marsden; M. E. Ward; D. A. Zideman

    1992-01-01

    OBJECTIVE--To determine the circumstances, incidence, and outcome of cardiopulmonary resuscitation in British hospitals. DESIGN--Hospitals registered all cardiopulmonary resuscitation attempts for 12 months or longer and followed survival to one year. SETTING--12 metropolitan, provincial, teaching, and non-teaching hospitals across Britain. SUBJECTS--3765 patients in whom a resuscitation attempt was performed, including 927 in whom the onset of arrest was outside the hospital.

  14. WORKING PAPER N 2011 42 Innovative procedures: the key factor for hospital performance

    E-print Network

    Boyer, Edmond

    -teaching public and for-profit hospitals is investigated using a French exhaustive administrative dataset controlling for case-mix. For-profit hospitals treat the at-risk oldest patients more often with innovative hospitals (Sloan, 2000). European countries usually have a mix of for-profit hospitals which select

  15. Hospital capacity management decisions: Emphasis on cost control and quality enhancement

    Microsoft Academic Search

    Ling Li; W. C. Benton

    2003-01-01

    This paper empirically examines the effects of several key hospital demographic factors (hospital size, location, teaching involvement) and service characteristics on hospital capacity management decisions, and the effects of hospital capacity resource management choices on cost control and quality enhancement. In this research structural equation modeling (SEM) was used as the research vehicle. SEM modeling measures multiple relationships among independent

  16. Massachusetts General Hospital - Psychiatry Program

    NSDL National Science Digital Library

    The Massachusetts General Hospital has organized a School of Psychiatry web site with a wealth of resources. The site is divided into three sections; Parents, Educators and Clinicians. The Educator section provides many useful resources from basic health information and disorder background to helping educators cope with teaching students with mental health issues in the classroom. This site will be a valuable resource for both educators and students in the field of Mental Health.

  17. Teaching Heritage

    NSDL National Science Digital Library

    Subtitled "a professional development Website for teachers," Teaching Heritage is an impressive collection of information and resources for teaching Australian history and culture. There are eight main sections to the site: four offer teaching resources and four provide teaching units. The resource sections include an examination of different ways of defining heritage, an Australian heritage timeline, discussions of different approaches to teaching heritage through media, and outcomes-based approaches in teaching and assessing heritage coursework. The teaching units deal in depth with issues of citizenship, nationalism, Australian identities, and new cultural values. A Heritage Gallery features images of various culturally significant or representative places in Australia, such as New Italy, the Dundullimal Homestead, Australian Hall, Kelly's Bush, and many more. Obviously, teachers of Civics on the southern continent will find this site extremely useful, but the teaching units -- rich with texts and images -- also offer fascinating introductions for anyone interested in the issues of Australian nation-making.

  18. The Teaching Nursing Home Program.

    ERIC Educational Resources Information Center

    Mezey, Mathy D; And Others

    1984-01-01

    Describes the Teaching Nursing Home Program that links nursing schools with nursing homes, pooling personnel and resources for the benefit of the institutions and society. The program seeks to extend to nursing homes the benefits that have been enjoyed by hospitals because of educational and service linkages with schools of medicine and nursing.…

  19. Teaching Writing

    ERIC Educational Resources Information Center

    Tomas, Z.; Kostka, I.; Mott-Smith, J. A.

    2013-01-01

    The authors of "Teaching Writing" draw on their years of teaching and their knowledge of theory and research to present major concepts in teaching L2 writing. These concepts encompass how cultural differences affect the writing class, planning instruction, text-based writing, writing strategies, modeling, and responding to student…

  20. The internal organization of hospitals: a descriptive study.

    PubMed Central

    Sloan, F A

    1980-01-01

    This study presents descriptive information on several dimensions of the internal organization of hospitals, with particular emphasis on medical staff, using data from two unique national surveys. Three alternative theories of hospital behavior by economists are described and evaluated with these data. The study also shows how standard bed size, teaching, and ownership categories relate to important features of hospital organization. In this way, understanding of these standard "control" variables is enhanced. For example, systematic organizational differences between proprietary and other hospitals are reported, holding bed size and teaching status constant. No single theory of hospital behavior emerges as dominant. The tables demonstrate the diversity of hospitals and the likelihood that no single model can adequately describe the behavior of all hospitals. PMID:7204062

  1. Assessing and Managing Caregiver Stress: Development of a Teaching Tool for Medical Residents

    ERIC Educational Resources Information Center

    Famakinwa, Abisola; Fabiny, Anne

    2008-01-01

    Forty medical residents from major teaching hospitals in Boston, Massachusetts, participated in small group teaching sessions about caregiver stress. A teaching tool was developed that included a teaching handout, interactive cases, standard instruments for assessing caregiver stress, peer-reviewed articles about caregiving, and a list of…

  2. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  3. Teaching to Teach in Toronto

    ERIC Educational Resources Information Center

    Dang, Kien; Waddell, Andrea E.; Lofchy, Jodi

    2010-01-01

    Objective: The training objectives for postgraduate education in the United States and Canada both state that teaching skills should be formally developed during training. This article reviews the development of the Teaching-to-Teach program at the University of Toronto Department of Psychiatry, the current curriculum, evaluation, and future…

  4. Evaluating Teaching through Teaching Awards.

    ERIC Educational Resources Information Center

    Carusetta, Ellen

    2001-01-01

    Reviews the literature on teaching awards and then examines a specific case, the Alan P. Stuart Award for Excellence in Teaching at the University of New Brunswick, using Menges's three tests of effective awards. Suggests that examining the strengths and weaknesses of institutional teaching awards can help illuminate the processes involved in…

  5. Teaching Chemical Engineers about Teaching

    ERIC Educational Resources Information Center

    Heath, Daniel E.; Hoy, Mary; Rathman, James F.; Rohdieck, Stephanie

    2013-01-01

    The Chemical and Biomolecular Engineering Department at The Ohio State University in collaboration with the University Center for the Advancement of Teaching developed the Chemical Engineering Mentored Teaching Experience. The Mentored Teaching Experience is an elective for Ph.D. students interested in pursuing faculty careers. Participants are…

  6. Teaching Morally and Teaching Morality

    ERIC Educational Resources Information Center

    Fenstermacher, Gary D.; Osguthorpe, Richard D.; Sanger, Matthew N.

    2009-01-01

    In this article, the authors introduce what they believe is an important distinction between teaching morality and teaching morally. In P-12 schools, the moral education debate often focuses on character education programs or other moral curricula. Such programs and curricula are championed as a means of teaching morality and transmitting moral…

  7. For-Profit Hospital Status and Rehospitalizations to Different Hospitals: An Analysis of Medicare Data

    PubMed Central

    Kind, Amy JH; Bartels, Christie; Mell, Matthew W; Mullahy, John; Smith, Maureen

    2010-01-01

    BACKGROUND About one-quarter of rehospitalized Medicare patients are admitted to hospitals different from their original. The extent to which this practice is related to for-profit hospital status, and impacts payments and mortality, is unknown. OBJECTIVE To describe and examine predictors of and payments for rehospitalization to a different hospital within 30 days among Medicare beneficiaries in for-profit and in not-for-profit/public hospitals. DESIGN Retrospective cohort study. SETTING Medicare fee-for-service hospitals throughout the United States. PARTICIPANTS Random 5% national sample of Medicare beneficiaries with acute-care rehospitalizations within 30-days of discharge, 2005–2006 (N=74,564). MEASUREMENTS 30-day rehospitalizations to different hospitals; total payments/mortality over subsequent 30-days. Multivariate logistic and quantile regression models included index hospital for-profit status, discharge counts, geographic region, rural-urban commuting area, and teaching status; and patient sociodemographics, disabled status, comorbidities, and a measure of risk-adjustment. RESULTS 22% (16,622) of the sample was rehospitalized to a different hospital. Factors associated with increased risk for rehospitalization to a different hospital included being hospitalized within a for-profit, major medical school-affiliated, or low volume index hospital, and having a Medicare-defined disability. When compared to those rehospitalized to the same hospital, patients rehospitalized to different hospitals had significantly higher adjusted 30-day total payments (median additional $1,308/patient, p-value<0.001), but no significant differences in 30-day mortality, regardless of index hospital for-profit status. LIMITATIONS The analysis lacked detailed clinical data, and did not assess specific provider practice motivations or the role of patient choice. CONCLUSIONS Rehospitalizations to different hospitals are common among Medicare beneficiaries, more likely among those initially hospitalized at a for-profit hospital, and related to increased overall payments without improved mortality. PMID:21135295

  8. Hospital Greenspace Lawson Memorial Hospital,

    E-print Network

    in the surrounding local community. This reduced the number to 15 facilities. Each of these was visited to ground in the Highlands where the greening of hospital space should be piloted. The clear ambition of the local community support Clinical credibility Community buy in Environmental expertise Project management support Funding

  9. Quality Communication in Hospitality: Language Skills or Culture Transfer?

    ERIC Educational Resources Information Center

    Leung, Peggy; Lo, Terence

    This paper focuses on English language teaching for the hospitality industry in Hong Kong, presenting a brief statement on the concept of transfer and its relevance to teaching English as a Foreign Language (EFL) for the world of work. The observable changes in the nature of language in the world of work in a service-oriented economy are…

  10. Hospitality Management Education: Here Today, Gone Tomorrow?

    Microsoft Academic Search

    Robert C. Lewis

    1993-01-01

    Hospitality management education hasn't changed with the times, and 10 years from now, many current North American programs will cease to exist. To survive, programs must pay greater attention to quality teaching and quality, real-world research that addresses the way companies are really run.

  11. Hospital outreach service: Helping to prevent nursing home placement

    Microsoft Academic Search

    Phillip Bairstow; Sarah Ashe; Mary Bairstow

    1998-01-01

    An outreach service from a post-acute metropolitan teaching hospital delivered an intensive, multidisciplinary and coordinated allied health service, and achieved both early hospital discharge and the prevention or delay of nursing home placement. This article reports on three types of cases which illustrate how the service assisted ward teams, families and patients to determine whether nursing home placement was essential.

  12. Gender and Hospital Resource UseUnexpected Differences

    Microsoft Academic Search

    Annette M. Bernard; Rodney A. Hayward; Judith S. Rosevear; Laurence F. McMahon

    1993-01-01

    Several recent studies have explored gender differences in medical care that are not attributable to clinical characteristics. At an 880bed teaching hospital between July 1987 and June 1990, we studied the importance of gender on two measures of hospital care: length of stay and ancillary service use. The latter was measured on a relative value unit (RVU) scale, based on

  13. Predictors of Medication Errors Among Elderly Hospitalized Patients

    Microsoft Academic Search

    Debra Matsen Picone; Marita G. Titler; Joanne Dochterman; Leah Shever; Taikyoung Kim; Paul Abramowitz; Mary Kanak; Rui Qin

    2008-01-01

    Medication errors are a serious safety concern and most errors are preventable. A retrospective study design was employed to describe medication errors experienced during 10187 hospitalizations of elderly patients admitted to a Midwest teaching hospital between July 1, 1998 and December 31, 2001 and to determine the factors predictive of medication errors. The model considered patient characteristics, clinical conditions, interventions,

  14. Going to the Hospital

    MedlinePLUS

    ... or music player with earphones Before a Planned Hospital Stay Keep in mind that hospitals are not ... a short time in the hospital. During the Hospital Stay While the person with Alzheimer’s is in ...

  15. Hospitals, nursing homes turn to 3rd-party financing

    Microsoft Academic Search

    Slaff

    1982-01-01

    Experience is teaching the administrators of hospitals and nursing homes how to make better arrangements for third-party financing of energy-management systems. Accustomed to health-insurance reimbursement for health-care costs, hospitals have lacked incentives for conservation. Plans now used most by hospitals and health-care facilities involve third-party arrangements where: (1) an equipment vendor installs equipment and takes a share of the energy-cost

  16. Effect of reactive pharmacy intervention on quality of hospital prescribing

    Microsoft Academic Search

    C J Hawkey; S Hodgson; A Norman; T K Daneshmend; S T Garner

    1990-01-01

    OBJECTIVE--To evaluate the medical impact of reactive pharmacy intervention. DESIGN--Analysis of all interventions during 28 days by all 35 pharmacists in hospitals in Nottingham. SETTING--All (six) hospitals in the Nottingham health authority (a teaching district), representing 2530 mainly acute beds, 781 mental illness beds, and 633 mainly health care of the elderly beds. PATIENTS--Hospital inpatients and outpatients. INTERVENTIONS--Recording of every

  17. Pattern of ophthalmological accidents and emergencies presenting to hospitals

    Microsoft Academic Search

    R S Bhopal; D W Parkin; R F Gillie; K H Han

    1993-01-01

    STUDY OBJECTIVE--To investigate the numbers and characteristics of patients with ophthalmological accidents and emergencies presenting to hospitals. DESIGN--Prospective survey over eight weeks. SETTING--Two general and one ophthalmic accident and emergency departments, two general outpatient departments, and an eye hospital ward consulting room (all in two teaching hospitals) in Newcastle upon Tyne. MEASUREMENTS AND MAIN RESULTS--Consultation numbers by age, sex, health

  18. Team Teaching.

    ERIC Educational Resources Information Center

    Cunningham, David C.

    1963-01-01

    A study was designed to evaluate the effectiveness of principals in structuring teaching teams; to assess background and personality characteristics appearing essential to successful individual and team performance; and to select personality factor scores which would predict individual and team success. Subjects were 31 teaching teams (99…

  19. Teaching Ideas.

    ERIC Educational Resources Information Center

    Middleton, Kathleen, Ed.

    1979-01-01

    Ideas to aid the classroom teacher include integration of emphasis on reading into health education; definitions pertinent to contemporary health education; teaching students to read food labels; identification of implications of scientific advances such as test tube reproduction; and a card game to teach food groups to middle school children.…

  20. Teaching Grammar

    ERIC Educational Resources Information Center

    Crawford, William J.

    2013-01-01

    Grammar is a component in all language skills: reading, writing, speaking, and listening. Teachers need to know rules of grammar (teacher knowledge) as well as techniques that help students use grammar effectively and effortlessly (teaching knowledge). Using reflective practice to help teachers become comfortable with teaching grammar, this…

  1. Multidimensional Teaching

    ERIC Educational Resources Information Center

    Berry, Robert Q., III; Ellis, Mark W.

    2013-01-01

    Multidimensional mathematics teaching, as discussed in this article encourages the use of context in mathematics teaching and learning to help teachers better recognize and build upon the cultural and social resources students bring to the classroom. Such efforts can impact students' performance and can help students make sense of decisions…

  2. Teaching Vocabulary

    ERIC Educational Resources Information Center

    Lessard-Clouston, M.

    2013-01-01

    Vocabulary is central to English language teaching. Without sufficient vocabulary, students cannot understand others or express their own ideas. Teachers who find the task of teaching English vocabulary a little daunting are not alone! This book presents important issues from recent vocabulary research and theory so that teachers may approach…

  3. The Mercer Clinic Holiday Pet Basket program was started in 1995 by Veterinary Medical Teaching Hospital staff members of the "VOICE" staff newsletter. It has grown due to need over the years from only 25 baskets to 130

    E-print Network

    Schladow, S. Geoffrey

    The Mercer Clinic Holiday Pet Basket program was started in 1995 by Veterinary Medical Teaching that every year we rely on the kindness of others to help these very special pets who are more than a pet this wonderful tradition alive by contributing any time of year to the Mercer Veterinary Clinic Holiday Pet

  4. Hospitals for sale.

    PubMed

    Costello, Michael M; West, Daniel J; Ramirez, Bernardo

    2011-01-01

    The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve. PMID:21864058

  5. An Epidemiologic Study on Aging and Dysphagia in the Acute Care Hospitalized Population: 2000–2007

    Microsoft Academic Search

    Steven B. Leder; Debra M. Suiter

    2009-01-01

    Objectives: To describe total and yearly demographic trends relative to aging, dysphagia referral rates and oral feeding status in hospitalized patients from 2000 through 2007. Methods: We evaluated a prospective, consecutive, referred sample of 4,038 hospitalized patients in an urban, tertiary, acute care teaching hospital. Dysphagia referral rates are described according to year, age (decade), sex, admitting diagnostic category, results

  6. Teaching Metacognition

    NSDL National Science Digital Library

    Marsha Lovett

    This webpage features resources associated with the 2008 Educause Learning Initiative annual meeting session on Teaching Metacognition. It includes links to Marsha Lovett's powerpoint slides and a video of her presentation. The presentation describes effective methods of teaching students: (1) that their ability to learn is mutable, (2) how to plan and set goals for their learning, and (3) how to self-monitor their learning and make adjustments when necessary. The presentation also describes gains in student learning resulting from teaching these metacognitive skills in first-year science courses.

  7. How much time do nurses spend teaching cancer patients.

    PubMed

    Agre, P; Bookbinder, M; Cirrincione, C; Keating, E

    1990-08-01

    As patients live longer and hospital stays grow shorter the demand for nurses to teach effectively and efficiently increases. Given the current nursing shortage, nurses have less time available to do teaching. As a result, hospitals will have to be creative in providing quality education in a cost-effective manner. A descriptive study was undertaken to establish a baseline on how much time nurses actually spend teaching. Seven to ten consecutive admissions on each inpatient unit for a total of one hundred twenty-one patients were enrolled into the study during a seven-day period. All patient/family teaching was documented until the patient was discharged or transferred. Data were collected on a total of 825 days of patient hospitalization. The average teaching time per patient per day (pppd) was 16.6 min. This teaching time amounts to 128 h a day and costs the center $2355 in nurses hourly wages each day or $859,657 per year. This study has established that nurses spend a significant amount of time teaching and has estimated its cost. It provides a baseline for making comparisons in teaching methodologies. Patient Education closed circuit television (CCTV) may be an alternative to one-on-one teaching and decrease the amount of time the nurse spends in repetitive teaching. PMID:2290757

  8. Incidental tuberculous endometritis in premenstrual curettings from infertile women in eastern Nigeria.

    PubMed

    Gini, P C; Ikerionwu, S E

    1990-02-01

    A total of 4700 specimens of premenstrual endometrial curettings from infertile women were reviewed at the University of Nigeria Teaching Hospital, Enugu. Ten cases of tuberculous endometritis were found, giving a prevalence of 0.2%. The significance of this low prevalence is discussed. It is suggested that more deliberate efforts should be made to search for genital tuberculosis in infertile women in developing countries. PMID:1968860

  9. [Forensic medicine in the hospital].

    PubMed

    Roche, L

    1993-05-01

    The reform of teaching hospitals which integrates all the hospital disciplines has been responsible for the creation of forensic medicine units in hospitals. Several solutions have been proposed; in Lyon this organisation has been set up within the framework of medical emergency units as that is effectively where there are the most forensic problems to solve. This integration is beneficial for our discipline: it is thus possible to set up a permanent service 24 hours a day, 7 days a week, at the disposal of the justice department and the police, and it opens the possibility of doing extra examinations like X-rays or getting the opinion of a specialist such as an ophthalmologist. But the forensic pathologist in hospital can help his colleagues to draw up a difficult certificate or give advice concerning medical law: it must be remembered that forensic medicine is not only a link between medicine and law in matters of experts' reports or certificates, it also establishes the same link between the legal world and medicine. This integration has allowed the development of clinical forensic medicine and a better understanding of the needs of the general practitioner in this area. This national experience has been broadcast in periodicals such as Journal de médecine légale et Droit médical (Journal of forensic medicine and Medical Law) and books published by Editions A. Lacassagne of which I am in charge. PMID:8221170

  10. A Model of Determining a Fair Market Value for Teaching Residents: Who Profits?

    Microsoft Academic Search

    Edward J. Cullen; Stephen T. Lawless; James H. Hertzog; Scott Penfil; Kathleen K. Bradford; Vinay M. Nadkarni; David H. Corddry; Andrew T. Costarino

    2010-01-01

    Context. Centers for Medicare & Medic- aid Services (CMS) Health Resources and Services Ad- ministration Children's Hospitals Graduate Medical Ed- ucation (GME) Payment Program now supports freestanding children's teaching hospitals. Objective. To analyze the fair market value impact of GME payment on resident teaching efforts in our pedi- atric intensive care unit (PICU). Design. Cost-accounting model, developed from a 1-year

  11. Implementing a Teaching Nursing Home: Lessons for Research and Practice.

    ERIC Educational Resources Information Center

    Aronson, Miriam K.

    1984-01-01

    Describes the National Institute on Aging Teaching Nursing Home (TNH) Program, devised to bring to long-term care research and training activities similar to those in teaching hospitals and thus develop an interface between research and practice. Conflicting goals, orientations, organizations, value systems, and practices are discussed. (JAC)

  12. The effects of hospital-physician integration strategies on hospital financial performance.

    PubMed Central

    Goes, J B; Zhan, C

    1995-01-01

    STUDY QUESTION. This study investigated the longitudinal relations between hospital financial performance outcomes and three hospital-physician integration strategies: physician involvement in hospital governance, hospital ownership by physicians, and the integration of hospital-physician financial relationships. DATA SOURCES AND STUDY SETTING. Using secondary data from the State of California, integration strategies in approximately 300 California short-term acute care hospitals were tracked over a ten-year period (1981-1990). STUDY DESIGN. The study used an archival design. Hospital performance was measured on three dimensions: operational profitability, occupancy, and costs. Thirteen control variables were used in the analyses: market competition, affluence, and rurality; hospital ownership; teaching costs and intensity; multihospital system membership; hospital size; outpatient service mix; patient volume case mix; Medicare and Medicaid intensity; and managed care intensity. DATA COLLECTION/EXTRACTION. Financial and utilization data were obtained from the State of California, which requires annual hospital reports. A series of longitudinal regressions tested the hypotheses. PRINCIPAL FINDINGS. Considerable variation was found in the popularity of the three strategies and their ability to predict hospital performance outcomes. Physician involvement in hospital governance increased modestly from 1981-1990, while ownership and financial integration declined significantly. Physician governance was associated with greater occupancy and higher operating margins, while financial integration was related to lower hospital operating costs. Direct physician ownership, particularly in small hospitals, was associated with lower operating margins and higher costs. Subsample analyses indicate that implementation of the Medicare prospective payment system in 1983 had a major impact on these relationships, especially on the benefits of financial integration. CONCLUSIONS. The findings support the validity of hospital-physician financial integration efforts, and to a lesser extent the involvement of physicians in hospital governance. The results lend considerably less support for strategies built around direct physician ownership in hospitals, particularly since PPS implementation. RELEVANCE/IMPACT. These findings challenge prior studies that found few financial benefits to hospital-physician integration prior to PPS implementation in 1983. The results imply that financial benefits of integration may take several years after implementation to emerge, are most salient in a managed care or managed competition environment, and vary by hospital size and multihospital system membership. PMID:7591779

  13. Nosocomial Infections at Kenyatta National Hospital Intensive-Care Unit in Nairobi, Kenya

    Microsoft Academic Search

    Z. W. W. Ngumi

    2006-01-01

    The objective of this study was to identify the common bacteria isolated from patients, antibiotics used, sensitivity patterns, therapeutic procedures and cleaning protocols practised in Kenyatta National Hospital Intensive-Care Unit (ICU). Kenyatta National Hospital is a 1,800-bed referral and tertiary-care hospital which is also the Teaching University Hospital. The ICU has 20 beds. Two members of staff, a consultant and

  14. Hospital Quality, Efficiency, and Input Slack Differentials

    PubMed Central

    Valdmanis, Vivian G; Rosko, Michael D; Mutter, Ryan L

    2008-01-01

    Objective To use an advance in data envelopment analysis (DEA) called congestion analysis to assess the trade-offs between quality and efficiency in U.S. hospitals. Study Setting Urban U.S. hospitals in 34 states operating in 2004. Study Design and Data Collection Input and output data from 1,377 urban hospitals were taken from the American Hospital Association Annual Survey and the Medicare Cost Reports. Nurse-sensitive measures of quality came from the application of the Patient Safety Indicator (PSI) module of the Agency for Healthcare Research and Quality (AHRQ) Quality Indicator software to State Inpatient Databases (SID) provided by the Healthcare Cost and Utilization Project (HCUP). Data Analysis In the first step of the study, hospitals’ relative output-based efficiency was determined in order to obtain a measure of congestion (i.e., the productivity loss due to the occurrence of patient safety events). The outputs were adjusted to account for this productivity loss, and a second DEA was performed to obtain input slack values. Differences in slack values between unadjusted and adjusted outputs were used to measure either relative inefficiency or a need for quality improvement. Principal Findings Overall, the hospitals in our sample could increase the total amount of outputs produced by an average of 26 percent by eliminating inefficiency. About 3 percent of this inefficiency can be attributed to congestion. Analysis of subsamples showed that teaching hospitals experienced no congestion loss. We found that quality of care could be improved by increasing the number of labor inputs in low-quality hospitals, whereas high-quality hospitals tended to have slack on personnel. Conclusions Results suggest that reallocation of resources could increase the relative quality among hospitals in our sample. Further, higher quality in some dimensions of care need not be achieved as a result of higher costs or through reduced access to health care. PMID:18783457

  15. Teaching Excellence, Teaching Expertise, and the Scholarship of Teaching

    Microsoft Academic Search

    Carolin Kreber

    2002-01-01

    The previous decade witnessed significant advancements in the scholarship of teaching at the levels of both theory building and program development. Notwithstanding these achievements, there remains considerable ambiguity regarding the meaning of the concept. This ambiguity has implications for faculty evaluation. Excellence in teaching, expertise in teaching, and the scholarship of teaching are analyzed according to the nature and sources

  16. A Practicum for Oral Cancer Teaching.

    ERIC Educational Resources Information Center

    Barr, Charles E.; Goldberg, Marshal D.

    1983-01-01

    A hospital-based method for teaching general practice dental residents, involving patients for whom the residents are responsible, is described. Residents present prepared cases of dental patients according to a predetermined protocol: a talk, complete documentation of clinical history and laboratory findings, and discussion of therapy and…

  17. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

    Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

    2004-01-01

    Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

  18. Hospital marketing revisited.

    PubMed

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature. PMID:10283019

  19. National Hospital Discharge Survey

    Cancer.gov

    The National Hospital Discharge Survey (NHDS), which has been conducted annually since 1965, collects data from a sample of approximately 270,000 inpatient records acquired from a national sample of about 500 hospitals. Only hospitals with an average length of stay of fewer than 30 days for all patients, general hospitals, or children's general hospitals are included in the survey. Information collected includes diagnoses, surgical and nonsurgical procedures, prescription and over-the-counter drugs, immunizations, allergy shots, anesthetics, and dietary supplements.

  20. Teaching Tips.

    ERIC Educational Resources Information Center

    Journalism Educator, 1981

    1981-01-01

    Four journalism teachers provide information on the use of tape recordings and written transcripts to illustrate the importance of factual accuracy, voluntary participation in a special advertising class, a method of teaching the history of public relations, and the importance of drill work to improve journalists' spelling abilities. (RL)

  1. Teaching Tennis

    ERIC Educational Resources Information Center

    Breag, Daniel

    2005-01-01

    This article describes an approach to teaching the basic skills of tennis to students in grades 4 and 5. It relates a five-lesson unit suitable to a near-weekly class schedule. The author found it effective when seeing his students as infrequently as once every four days for fifty minutes.

  2. Teaching Green

    ERIC Educational Resources Information Center

    Waters, John K.

    2011-01-01

    It has been 41 years since the late Wisconsin Senator Gaylord Nelson launched the first nationwide grassroots demonstration on behalf of the environment, known as Earth Day. The event was a national "teach-in" about environmental causes, and it is widely considered the spark that ignited the modern environmental education movement. Within months,…

  3. Teaching Tips.

    ERIC Educational Resources Information Center

    Journalism Educator, 1985

    1985-01-01

    Presents a variety of journalism classroom techniques, including an editing scavenger hunt, a discovery method for compiling news sources, intense instruction in news technology, criteria for evaluating ad copy, a course combining print and broadcast journalism, use of the Teletext, and teaching ad forms for the new media. (HTH)

  4. Teaching Typography.

    ERIC Educational Resources Information Center

    Communication: Journalism Education Today, 1998

    1998-01-01

    Outlines nine objectives students should be able to accomplish after completing the activities in the unit on typography presented in the previous articles in this journal. Offers eight tips for teaching typography. Includes a short list of books about typography and a list of seven organizations. (SR)

  5. On Teaching.

    ERIC Educational Resources Information Center

    Shea, Mary Ann, Ed.

    This collection of lectures includes the following contributions from faculty at the University of Colorado at Boulder: (1) "Aloof Professors and Shy Students" (Patricia Nelson Limerick); (2) "Teaching the Thundering Herd: Surviving in a Large Classroom" (Charles R. Middleton); (3) "The Scientist as a Story Teller" (R. Igor Gamow); (4) "Active…

  6. Reflective Teaching

    ERIC Educational Resources Information Center

    Farrell, Thomas S. C.

    2013-01-01

    Thomas Farrell's "Reflective Teaching" outlines four principles that take teachers from just doing reflection to making it a way of being. Using the four principles, Reflective Practice Is Evidence Based, Reflective Practice Involves Dialogue, Reflective Practice Links Beliefs and Practices, and Reflective Practice Is a Way of Life,…

  7. Teaching Pronunciation

    ERIC Educational Resources Information Center

    Murphy, John

    2013-01-01

    Murphy provides a comprehensive overview of teaching pronunciation with a focus on thought groups and prominence. Understanding thought groups, or how speakers use clusters of words to best fit the communicative situation, is essential for clearer understanding of most components of English pronunciation that are teachable in ESL/EFL classrooms.…

  8. Teaching Otherwise

    Microsoft Academic Search

    Carl Anders Säfström; Graham Greene

    2003-01-01

    In this paper I discuss some conditions forunderstanding teaching as an act ofresponsibility towards an other, rather than asan instrumental act identified throughepistemology. I first put the latter intocontext through a critical reading of teachingas it is inscribed in humanistic discourses oneducation. Within these discourses, I explorehow students are treated as objects ofknowledge that reinforce the teacher's ego. Icontend that

  9. Teaching War Literature, Teaching Peace

    ERIC Educational Resources Information Center

    Powers, Janet M.

    2007-01-01

    This article explores literature taught in three different courses and the peace education approaches used for each, including epics in literature courses, Vietnam War literature, and literature of anger and hope. The author recommends the teaching of war literature as an essential part of a peace education curriculum. Devastating events such as…

  10. Teaching Writing/Teaching Literature.

    ERIC Educational Resources Information Center

    Moran, Charles

    Believing that a course in the novel ought to include the making of prose as well as its analysis, a college English instructor altered his teaching strategy by treating both the novel author and his students as writers. Prior to studying a particular novel, the instructor gave students an assignment that would involve a particular literary…

  11. Does delirium contribute to poor hospital outcomes?

    Microsoft Academic Search

    Sharon K. Inouye; Julia T. Rushing; Marquis D. Foreman; Robert M. Palmer; Peter Pompei

    1998-01-01

    OBJECTIVE: To determine the independent contribution of admission delirium to hospital outcomes including mortality, institutionalization,\\u000a and functional decline.\\u000a \\u000a \\u000a DESIGN: Three prospective cohort studies.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Three university-affiliated teaching hospitals.\\u000a \\u000a \\u000a \\u000a \\u000a PATIENTS: Consecutive samples of 727 patients, aged 65 years and older.\\u000a \\u000a \\u000a \\u000a \\u000a MEASUREMENTS AND MAIN RESULTS: Delirum was present at admission in 88 (12%) of 727 patients. The main outcome measures at hospital

  12. Hospital demand for physicians.

    PubMed

    Morrisey, M A; Jensen, G A

    1990-01-01

    This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

  13. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    ERIC Educational Resources Information Center

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  14. MAPUniversity Hospital Directions from University Hospital to

    E-print Network

    Feschotte, Cedric

    Physical Therapy (Level 6) Patient Rooms 2000Ā­2999 (Level 2) 3000Ā­3999 (Level 3) 4000Ā­4999 (Level 4) 5000version 1 MAPUniversity Hospital version 7 Directions from University Hospital to: Huntsman Cancer provides non-clinical services such as photocopying, faxing, phone access and hotel accommodations for out

  15. Teaching Channel

    NSDL National Science Digital Library

    2013-01-01

    The tagline of Teaching Channel is "Great Teaching. Inspiring Classrooms." Educators from kindergarten to college will find hundreds of resources here, including fact sheets, lesson plans, videos, and blogs to help them in the classroom. First-time visitors will need to fill out a short free registration to get started. After this, users can click on left-hand side of the page to browse through Topics that include planning, class culture, behavior, engagement, and assessment. The materials are also arranged by subject and grade level. The Featured Videos area is a delight as well, as it contains dozens of offerings, such as "Carbon Cycling: Create Your Own Biology Lab" and "Reading Like a Historian." Finally, the high-quality blog posts are thoughtful and erudite, including offerings like "Setting Goals for 2012: Where Do You Start?" and "10 Common Core 'Ah-Ha' Moments."

  16. Machines That Teach.

    ERIC Educational Resources Information Center

    Sniecinski, Jozef

    This paper reviews efforts which have been made to improve the effectiveness of teaching through the development of principles of programed teaching and the construction of teaching machines, concluding that a combination of computer technology and programed teaching principles offers an efficient approach to improving teaching. Three different…

  17. The application of hospitality elements in hospitals.

    PubMed

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority. PMID:23424818

  18. Central line infections - hospitals

    MedlinePLUS

    ... and increase how long you are in the hospital. Your central line needs special care to prevent ... The hospital staff will use aseptic technique when a central line is put in your chest or arm. Aseptic ...

  19. Help prevent hospital errors

    MedlinePLUS

    A hospital error is when there is a mistake in your medical care. Errors can be made in your: ... Surgery Diagnosis Equipment Lab and other test reports Hospital errors are a leading cause of death. Doctors ...

  20. The Transition from Excess Capacity to Strained Capacity in U.S. Hospitals

    PubMed Central

    Bazzoli, Gloria J; Brewster, Linda R; May, Jessica H; Kuo, Sylvia

    2006-01-01

    After many years of concern about excess hospital capacity, a growing perception exists that the capacity of some hospitals now seems constrained. This article explores the reasons behind this changing perception, looking at the longitudinal data and in-depth interviews for hospitals in four study sites monitored by the Community Tracking Study of the Center for Studying Health System Change. Notwithstanding the differences for individual hospitals, we observed that adjustments to the supply of hospital services tend to be slow and out of sync with changes in the demand for hospital services. Those hospitals reporting capacity problems are often teaching hospitals, located near previously closed facilities or in population growth areas. These findings suggest therefore that approaches to dealing with capacity problems might best focus on better matching individual hospitals' supply and demand adjustments. PMID:16771819

  1. [Medical informatics in research, teaching and patient management].

    PubMed

    Adlassnig, K P

    1995-01-01

    The field of medical informatics in its current understanding is defined and criteria distinguishing this field from similar areas are provided. Special consideration is given to its position at a School of Medicine - in particular to the University of Vienna Medical School with the Vienna General Hospital as its teaching hospital. Demands for medical informatics and electronic data processing (EDP) in this extended field of activity come from four different sources: (1) research in medical informatics, (2) teaching of medical informatics as well as EDP training, (3) EDP service for research and teaching, and (4) EDP hospital operations to assist patient care. (Purely administrative EDP demands are not considered here.) It is shown that the different demands can be fulfilled by the usually available institutions involved in medical informatics and EDP at a School of Medicine. At many places these institutions are as follows: (1) a department or division of medical informatics with a possibly attached computer center dedicated to provide assistance in the area of research and teaching, (2) the computer center of the respective university the School of Medicine belongs to, (3) the computer center of the hospital-owned institution responsible for all EDP activities connected to patient care, and (4) external software companies and EDP training centers. To succeed in the development of an exhaustive, school-wide system of medical informatics and EDP that considers the different demands in research, teaching, and EDP hospital operations equally, close and well-suited coordination between the institutions involved is necessary. PMID:7871786

  2. Welcoming and Restoring, Dwelling and Sending: Creating a Space for Hospitality in Faculty Development

    ERIC Educational Resources Information Center

    Larson, Marion H.

    2009-01-01

    Parker Palmer's (1983) often-quoted definition of teaching--"To teach is to create a space in which obedience to truth is practiced"--can be applied productively to work in faculty development. Exploring this notion is enhanced by the theological literature in hospitality, which can be viewed through Amy Oden's (2001) discussion of four movements…

  3. Children's Hospital Medical Center

    E-print Network

    Papautsky, Ian

    UNIVERSITY COMMONS Children's Hospital Medical Center Children's Hospital Medical Research Center Complex Radiation Safety HealthProfessions Building WherryHall Veterans Affairs Medical Center VAMC VAMC ShrinersHospital forChildren Shriners Garage Cincinnati Dept of Health LoganHall Medical Sciences Building

  4. Children's Hospital Medical Center

    E-print Network

    Papautsky, Ian

    UNIVERSITY COMMONS Children's Hospital Medical Center Children's Hospital Medical Research Center WherryHall Veterans Affairs Medical Center VAMC VAMC VAMC VAMC VAMC Holmes CHMC CHMC Children's Hospital Vontz Center Hamilton Co. Coroner Kettering Lab Complex Radiation Safety HealthProfessions Building

  5. Children's Hospital Medical Center

    E-print Network

    Papautsky, Ian

    UNIVERSITY COMMONS Children's Hospital Medical Center Children's Hospital Medical Research Center Affairs Medical Center VAMC VAMC VAMC VAMC VAMC Holmes CHMC CHMC Children's Hospital Garage CHMC Kingsgate Co. Coroner Kettering Lab Complex Radiation Safety HealthProfessions Building WherryHall Veterans

  6. Modeling a Hospital Organization

    Microsoft Academic Search

    William V. Gudaitis; Robert A. Brown

    1975-01-01

    A multidimensional input-output model of a hospital's components is developed which, because it tracks the flows of people, materials, and services, can be used for long-range planning and resource allocation, and dynamic simulation of the hospital. The model also allows the determination of shadow prices, and hence, the profitability of the various hospital components.

  7. 2. View northwest of main hospital building complex, hospital building ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. View northwest of main hospital building complex, hospital building (Building 90), administration and clinical hospital building (Building 88), and hospital building (Building 91) - National Home for Disabled Volunteer Soldiers Western Branch, 4101 South Fourth Street, Leavenworth, Leavenworth County, KS

  8. THE UNIVERSITY OF CONNECTICUT HEALTH CENTER JOHN DEMPSEY HOSPITAL

    E-print Network

    Oliver, Douglas L.

    /diagnosis, and specific topics will be addressed with each teaching opportunity. The education will be provided-food interaction will be identified and counseled of such possible interactions prior to discharge. Nursing of medication in the hospital, if any f) safe and effective use of medication to take at home, if any g) pain

  9. THE PRINCE HENRY HOSPITAL DEMENTIA CAREGIVERS’ TRAINING PROGRAMME

    Microsoft Academic Search

    HENRY BRODATY; MEREDITH GRESHAM; GEORGINA LUSCOMBE

    1997-01-01

    Objective. To describe the theory, elements and practice of a successful caregiver training programme; and report the 8-year outcome. Design. Prospective, randomized control trial and longitudinal follow-up over approximately 8 years. Setting. Psychiatry unit, general teaching hospital, Sydney, Australia. Participants. 96 persons less than 80 years old with mild to moderate dementia and their cohabiting caregivers. Interventions. All patients received

  10. UNIVERSITY OF CONNECTICUT HEALTH CENTER JOHN DEMPSEY HOSPITAL

    E-print Network

    Oliver, Douglas L.

    in the hospital as serious risk for drug-nutrient, the nurse will counsel the patient on the potential interaction: PATIENT CARE NUMBER: 08-038 SUBJECT: PATIENT COUNSELING ON PAGE: 1 of 2 DRUG-NUTRIENT INTERACTIONS To assure that patients receive adequate teaching on potential drug-food interactions PROCEDURE: 1

  11. Department of Hospitality and Tourism Management ANNUAL REPORT

    E-print Network

    Tomkins, Andrew

    1 of 7 Department of Hospitality and Tourism Management ANNUAL REPORT May 16, 2005 Ā­ May 15, 2006 TEACHING 1. Total HTM Students: 236 a. HTM Majors: 165 b. Business Administration Majors with HTM Forecasted c. In addition, HTM majors are required to complete a 400 hour practicum work requirements prior

  12. A Study of Hospital Admission Rules During Pediatric Residency Training.

    ERIC Educational Resources Information Center

    Ferguson, Jane; Alpert, Joel J.

    1980-01-01

    A survey of U.S. pediatric training programs to determine the role of rules in the hospital admission of pediatric patients is reported. The results support the hypothesis that rules are a widely used teaching tool. The rules relate to such factors as fevers, age, specific diseases, administrative concerns, head traumas, and poisonings. (JMD)

  13. Vocational education: challenges for hospitality management in the new millennium

    Microsoft Academic Search

    Mike Rimmington

    1999-01-01

    Puts forward the author’s view of key issues affecting hospitality education into the new millennium. Issues identified as particularly impacting on UK centres are graduate standards, quality and quality assessment, research assessment, key skills and learning and teaching including the impact of information technology. Amongst these issues, information technology is identified as having the greatest potential impact to bring about

  14. Teaching Fractions

    NSDL National Science Digital Library

    Lisa Fazio

    2012-01-01

    This research guide provides suggestions for specialists and teachers looking to improve fraction instruction in their classrooms or schools. The guide starts with ideas for introducing fraction concepts in kindergarten and early elementary school and continues with activities and teaching strategies designed to help older students understand fraction magnitudes and computational procedures involving fractions. It then examines ways of helping students use fractions to solve rate, ratio, and proportion problems. Each recommendation includes a brief summary of supporting research and descriptions of classroom activities that can be used to implement the recommendation.

  15. Hotel General Managers’ Perceptions of Business Ethics Education: Implications for Hospitality Educators, Professionals, and Students

    Microsoft Academic Search

    Ronnie Yeh

    2012-01-01

    Ethics is a growing concern in American society; consequently, business ethics is also becoming a concern in the hospitality industry. This article investigated the perceptions and preparations of hotel general managers toward teaching business ethics in their hotels and ethics education in college hospitality programs and within the hotel industry. For hotel professionals, business ethics is normally discussed or taught

  16. Community Strain of Methicillin-Resistant Staphylococcus aureus Involved in a Hospital Outbreak

    Microsoft Academic Search

    F. G. O'BRIEN; J. W. PEARMAN; M. GRACEY; T. V. RILEY; W. B. GRUBB

    1999-01-01

    Western Australia (WA) has been able to prevent methicillin-resistant Staphylococcus aureus (MRSA) strains from outside of the state from becoming established in its hospitals. Recently, a single-strain outbreak of MRSA occurred in a WA metropolitan teaching hospital following admission of an infected patient from a remote community. The strain responsible for the outbreak was unrelated to any imported strains and

  17. Clinical assessment of dehydration in older people admitted to hospital What are the strongest indicators?

    Microsoft Academic Search

    Angela Vivanti; Keren Harvey; Susan Ash; Diana Battistutta

    Due to an absence of published primary data, this study explores dehydration prevalence and the change in physiological parameters frequently used to assess dehydration (fluid deficit) in older hospitalized people, as no standard measurement method exists. This observational long- itudinal cohort study recruited 43 people aged 60 years or over, voluntarily admitted to a tertiary teaching hospital's Geriatric and Rehabilitation

  18. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada

    Microsoft Academic Search

    G. Ross Baker; Peter G. Norton; Virginia Flintoft; Régis Blais; Adalsteinn Brown; Jafna Cox; Ed Etchells; William A. Ghali; Philip Hébert; Sumit R. Majumdar; Maeve O'Beirne; Luz Palacios-Derflingher; Robert J. Reid; Sam Sheps; Robyn Tamblyn

    2004-01-01

    Background: Research into adverse events (AEs) has highlighted the need to improve patient safety. AEs are unintended injuries or complications resulting in death, disability or prolonged hospital stay that arise from health care management. We esti- mated the incidence of AEs among patients in Canadian acute care hospitals. Methods: We randomly selected 1 teaching, 1 large community and 2 small

  19. Reliability of Birth Certificate Data: A Multi-Hospital Comparison to Medical Records Information

    Microsoft Academic Search

    David L. DiGiuseppe; David C. Aron; Lorin Ranbom; Dwain L. Harper; Gary E. Rosenthal

    2002-01-01

    Objective: To examine the reliability of birth certificate data and determine if reliability differs between teaching and nonteaching hospitals. Methods: We compared information from birth certificates and medical records in 33,616 women admitted for labor and delivery in 1993–95 to 20 hospitals in Northeast Ohio. Analyses determined the agreement for 36 common data elements, and the sensitivity, specificity, and positive

  20. Information Needs and Seeking Behaviours of Nurses: A Survey of Two Hospitals in Bayelsa State, Nigeria

    ERIC Educational Resources Information Center

    Baro, Emmanuel E.; Ebhomeya, Loveth

    2013-01-01

    Purpose: The purpose of this paper is to identify the information needs of nurses in two hospitals in Nigeria and the ways in which they went about attempting to meet those needs. Design/methodology/approach: The study is a descriptive survey of nurses at the Federal Medical Center (FMC), Yenagoa, and Niger Delta University Teaching Hospital

  1. A Cost Analysis Study of the Radiography Program at Middlesex Hospital Using Shock's Analysis Model.

    ERIC Educational Resources Information Center

    Spence, Weymouth

    Federal and state governments want to decrease payments for medical education, and other payers are trying to restrict payouts to direct and necessary patient care services. Teaching hospitals are increasing tuition and fees, reducing education budgets and, in many instances, closing education programs. Hospital administrators are examining the…

  2. Pediatric Vancomycin Use in 421 Hospitals in the United States, 2008

    PubMed Central

    Lasky, Tamar; Greenspan, Jay; Ernst, Frank R.; Gonzalez, Liliana

    2012-01-01

    Background Recommendations to prevent the spread of vancomycin resistance have been in place since 1995 and include guidelines for inpatient pediatric use of vancomycin. The emergence of large databases allows us to describe variation in pediatric vancomycin across hospitals. We analyzed a database with hospitalizations for children under 18 at 421 hospitals in 2008. Methodology/Principal Findings The Premier hospital 2008 database, consisting of records for 877,201 pediatric hospitalizations in 421 hospitals, was analyzed. Stratified analyses and logistic mixed effects models were used to calculate the probability of vancomycin use while considering random effects of hospital variation, hospital fixed effects and patient effects, and the hierarchical structure of the data. Most hospitals (221) had fewer than 10 hospitalizations with vancomycin use in the study period, and 47 hospitals reported no vancomycin use in 17,271 pediatric hospitalizations. At the other end of the continuum, 21 hospitals (5.6% of hospitals) each had over 200 hospitalizations with vancomycin use, and together, accounted for more than 50% of the pediatric hospitalizations with vancomycin use. The mixed effects modeling showed hospital variation in the probability of vancomycin use that was statistically significant after controlling for teaching status, urban or rural location, size, region of the country, patient ethnic group, payor status, and APR-mortality and severity codes. Conclusions/Significance The number and percentage of pediatric hospitalizations with vancomycin use varied greatly across hospitals and was not explained by hospital or patient characteristics in our logistic models. Public health efforts to reduce vancomycin use should be intensified at hospitals with highest use. PMID:22916234

  3. Use of Social Media Across US Hospitals: Descriptive Analysis of Adoption and Utilization

    PubMed Central

    Griffis, Heather M; Kilaru, Austin S; Werner, Rachel M; Asch, David A; Hershey, John C; Hill, Shawndra; Ha, Yoonhee P; Sellers, Allison; Mahoney, Kevin

    2014-01-01

    Background Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health. Objective The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics. Methods We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews. Results Adoption of social media varied across hospitals with 94.41% (3351/3371) having a Facebook page and 50.82% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts. Conclusions Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes, including links between social media use and the quality of hospital care and services. PMID:25431831

  4. Teaching Teachers to Play and Teach Games

    ERIC Educational Resources Information Center

    Wright, Steven; McNeill, Michael; Fry, Joan; Wang, John

    2005-01-01

    This study was designed to determine the extent to which a technical and a tactical approach to teaching a basketball unit to physical education teacher education (PETE) students would each affect their games playing abilities, perceived ability to teach, and approach preference for teaching the game. Pre- and post-unit data were collected through…

  5. Teaching teachers to play and teach games

    Microsoft Academic Search

    Steven Wright; Michael McNeill; Joan Fry; John Wang

    2005-01-01

    This study was designed to determine the extent to which a technical and a tactical approach to teaching a basketball unit to physical education teacher education (PETE) students would each affect their games playing abilities, perceived ability to teach, and approach preference for teaching the game. Pre- and post-unit data were collected through videotape of half-court games play, questionnaire and

  6. Comparison of burnout pattern between hospital physicians and family physicians working in Suez Canal University Hospitals

    PubMed Central

    Kotb, Amany Ali; Mohamed, Khalid Abd-Elmoez; Kamel, Mohammed Hbany; Ismail, Mosleh Abdul Rahman; Abdulmajeed, Abdulmajeed Ahmed

    2014-01-01

    Introduction The burnout syndrome is characterized by emotional exhaustion, depersonalization, and low personal accomplishment. It is associated with impaired job performance. Methods This descriptive study examined 171 physicians for the presence of burnout and its related risk factors. The evaluation of burnout was through Maslach Burnout Inventory (MBI). The participant was considered to meet the study criteria for burnout if he or she got a “high“ score on at least 2 of the three dimensions of MBI. Results In the current study, the prevalence of burnout in hospital physicians (53.9%) was significantly higher than family physicians (41.94%) with (p=0.001). Participants who work in the internal medicine department scored the highest prevalence (69.64%) followed by Surgeons (56.50%) and Emergency doctors (39.39%). On the other hand, Pediatricians got the lowest prevalence (18.75%). Working in the teaching hospital and being married are strong predictors for occurrence of burnout. Conclusion There is a significant difference of burnout between hospital physicians and family physicians among the study subjects. Working in the teaching hospital and being married are strong predictors for occurrence of burnout. PMID:25422682

  7. Implementation of Patient Safety and Patient-Centeredness Strategies in Iranian Hospitals

    PubMed Central

    Aghaei Hashjin, Asgar; Kringos, Dionne S.; Manoochehri, Jila; Ravaghi, Hamid; Klazinga, Niek S.

    2014-01-01

    Objective To examine the extent of implementation for patient safety (PS) and patient-centeredness (PC) strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade) in Iran. Methods A cross-sectional study through an adapted version of the MARQuIS questionnaire, eliciting information from hospital and nursing managers in 84 Iranian hospitals on the implementation of PS and PC strategies in 2009–2010. Results The majority of hospitals reported to have implemented 84% of the PS and 72% of the PC strategies. In general, implementation of PS strategies was unrelated to the type of hospital, with the exception of health promotion reports, which were more common in the Social Security Organization (SSO), and MRSA testing, which was reported more often in nonprofit hospitals. MRSA testing was also more common among teaching hospitals compared to non-teaching hospitals. The higher grade hospitals reported PS strategies significantly more frequently than lower grade hospitals. Overall, there was no significant difference in the reported implementation of PC strategies across general and specialized hospitals; except for the provision of information in different languages and recording of patient’s diet which were reported significantly more often by general than specialized hospitals. Moreover, patient hotel services were more common in private compared to public hospitals. Conclusions Despite substantial reporting of PS and PC strategies, there is still room for strengthening standard setting on safety, patient services and patient-centered information strategies in Iranian hospitals. To assure effective implementation of PS and PC strategies, enforcing standards, creating a PS and PC culture, increasing organizational responsiveness, and partnering with patients and their families need more attention. PMID:25268797

  8. 42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...exception for services furnished in hospital outpatient and certain other ambulatory settings), 415.176 (concerning renal dialysis services), and 415.184 (concerning psychiatric services), the medical records must document the teaching...

  9. 42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...exception for services furnished in hospital outpatient and certain other ambulatory settings), 415.176 (concerning renal dialysis services), and 415.184 (concerning psychiatric services), the medical records must document the teaching...

  10. 42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...exception for services furnished in hospital outpatient and certain other ambulatory settings), 415.176 (concerning renal dialysis services), and 415.184 (concerning psychiatric services), the medical records must document the teaching...

  11. Teaching Geology

    NSDL National Science Digital Library

    The study of geology at the University of Colorado has a long and distinguished history, and in recent years they have also become increasingly interested in providing online teaching resources in the field. Educators will be glad to learn about this site's existence, as they can scroll through a list of interactive demonstrations that can be utilized in the classroom. Specifically, these demonstrations include a shaded interactive topographical map of the western United States, a magnetic field of the Earth, and several animated maps of various National Park sites. The site comes to a compelling conclusion with the inclusion of the geology department's slide library, which can be used without a password or registration.

  12. Focus: Teaching by Genre.

    ERIC Educational Resources Information Center

    Wimer, Frances N., Ed.

    1974-01-01

    The focus of this bulletin is teaching the various literary genres in the secondary English class. Contents include "The Song Within: An Approach to Teaching Poetry,""Teaching Folk-Rock,""Approaches to Teaching Poetry,""Focus on an Elective Program: Twentieth Century Lyrical Poetry,""Hoffman and Poe: Masters of the Grotesque,""Plays: Shared and…

  13. ENGLISH LANGUAGE TEACHING CENTRE

    E-print Network

    Edinburgh, University of

    ENGLISH LANGUAGE TEACHING CENTRE www.ed.ac.uk/english-language-teaching Student Information About the University from a variety of backgrounds and from 120 different countries. The English Language Teaching Centre We are one of the largest university centres for English language teaching and intensive language

  14. Teaching Dissent and Persuasion

    Microsoft Academic Search

    Kathleen M. Carson; Brian Hodgen; Rainer E. Glaser

    2006-01-01

    Teaching philosophy should be based on the desired outcome of the teaching. In the case of science education, the guiding principle for a teaching philosophy should start with the desire to help students understand and use science, regardless of their major or profession. To effectively teach students how to understand science, one must include both the content and the process.

  15. Teaching or Learning?

    ERIC Educational Resources Information Center

    Milton, Ohmer

    This article, the 6th in a series of AAHE research reports, summarizes research on teaching and learning. Most studies on teaching methods conclude that there are no significant differences between the various teaching methods and student achievement. The problem with these studies is that they have concentrated on teaching and have ignored…

  16. A Passion for Teaching.

    ERIC Educational Resources Information Center

    Levine, Sarah L., Ed.; McVay, Scott, Ed.

    This book, celebrating teachers and teaching, contains the artistry and wisdom of 42 teachers who have remained passionate about classroom teaching for many years. Chapter 1, "Beginnings," includes "The First Day of School" (Richard A. Lawson), "Sustaining the Wonder of Teaching" and "Harvest Home," (Bettye T. Spinner), "The Call to Teach,"…

  17. American Hospital Association

    NSDL National Science Digital Library

    2005-01-01

    Founded in 1898, the American Hospital Association (AHA) is the national umbrella organization that represents a wide range of hospitals and health care networks. While some of the siteā??s contents are designed for health care professionals and executives, the general public and some scholars will find some of the features, such as their quarterly reports on the latest in hospital trends, quite valuable. A good place to start is the Resource Center section of the site, which contains helpful guides to locating the information on the site itself. There are a number of free resources available here, such as a fact sheet about Americaā??s hospitals and studies, including ā??The State of Americaā??s Hospitals: Taking the Pulseā?¯ and ā??Costs of Caring: Sources of Growth in Spending for Hospital Careā?¯.

  18. The July Effect: Is Emergency Department Length of Stay Greater at the Beginning of the Hospital Academic Year?

    PubMed Central

    Riguzzi, Christine; Hern, H. Gene; Vahidnia, Farnaz; Herring, Andrew; Alter, Harrison

    2014-01-01

    Introduction There has been concern of increased emergency department (ED) length of stay (LOS) during the months when new residents are orienting to their roles. This so-called “July Effect” has long been thought to increase LOS, and potentially contribute to hospital overcrowding and increased waiting time for patients. The objective of this study is to determine if the average ED LOS at the beginning of the hospital academic year differs for teaching hospitals with residents in the ED, when compared to other months of the year, and as compared to non-teaching hospitals without residents. Methods We performed a retrospective analysis of a nationally representative sample of 283,621 ED visits from the National Hospital Ambulatory Medical Care Survey (NHAMCS), from 2001 to 2008. We stratified the sample by proportion of visits seen by a resident, and compared July to the rest of the year, July to June, and July and August to the remainder of the year. We compared LOS for teaching hospitals to non-teaching hospitals. We used bivariate statistics, and multivariable regression modeling to adjust for covariates. Results Our findings show that at teaching hospitals with residents, there is no significant difference in mean LOS for the month of July (275 minutes) versus the rest of the year (259 min), July and August versus the rest of the year, or July versus June. Non-teaching hospital control samples yielded similar results with no significant difference in LOS for the same time periods. There was a significant difference found in mean LOS at teaching hospitals (260 minutes) as compared to non-teaching hospitals (185 minutes) throughout the year (p<0.0001). Conclusion Teaching hospitals with residents in the ED have slower throughput of patients, no matter what time of year. Thus, the “July Effect” does not appear to a factor in ED LOS. This has implications as overcrowding and patient boarding become more of a concern in our increasingly busy EDs. These results question the need for additional staffing early in the academic year. Teaching hospitals may already institute more robust staffing during this time, preventing any significant increase in LOS. Multiple factors contribute to long stays in the ED. While patients seen by residents stay longer in the ED, there is little variability throughout the academic year. PMID:24578770

  19. Competition Among Hospitals

    Microsoft Academic Search

    Martin S. Gaynor; William B. Vogt

    2003-01-01

    Our objective is to determine the effect of ownership type (for-profit, not-for-profit, government) on firm conduct in hospital markets. Secondary objectives include estimating hospital demand systems useful for market definition and merger simulation. To this end, we estimate a structural model of demand and pricing in the short term hospital industry in California, and then use the estimates to simulate

  20. Competition Among Hospitals

    Microsoft Academic Search

    Martin Gaynor; William Vogt

    2002-01-01

    Our objective is to determine the effect of ownership type (for-profit, not-for-profit, government) on firm conduct in hospital markets. Secondary objectives include estimating hospital demand systems useful for market definition and merger simulation. To this end, we estimate a structural model of demand and pricing in the short term hospital industry in California, and then use the estimates to simulate

  1. Quantifying physician teaching productivity using clinical relative value units

    Microsoft Academic Search

    Michael M. Yeh; Daniel F. Cahill

    1999-01-01

    OBJECTIVE: To design and test a customizable system for calculating physician teaching productivity based on clinical relative value\\u000a units (RVUs).\\u000a \\u000a \\u000a SETTING\\/PARTICIPANTS: A 550-bed community teaching hospital with 11 part-time faculty general internists.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN: Academic year 1997–98 educational activities were analyzed with an RVU-based system using teaching value multipliers (TVMs).\\u000a The TVM is the ratio of the value of a unit

  2. Use of OsiriX in developing a digital radiology teaching library.

    PubMed

    Shamshuddin, S; Matthews, H R

    2014-10-01

    Widespread adoption of digital imaging in clinical practice and for the image-based examinations of the Royal College of Radiologists has created a desire to provide a digital radiology teaching library in many hospital departments around the UK. This article describes our experience of using OsiriX software in developing digital radiology teaching libraries. PMID:24880758

  3. PHILOSOPHY OF EDUCATION AND CARE TEACHING GERIATRICS AWAY FROM THE MEDICAL MODEL

    Microsoft Academic Search

    Michael L. Stotts

    1986-01-01

    The nursing home as well as other health and social service agencies are vastly underdeveloped as teaching resources. Several historical reasons account for the gaps in geriatric health and medical education. To mimic the teaching hospital as a model for transmitting knowledge about aging to students is to direct learning into negative and unproductive pathways. Alternative curriculum designs are suggested.

  4. Estimating the Effects of Teaching on the Costs of Inpatient Care: The Case of Radiology Treatments.

    ERIC Educational Resources Information Center

    Massell, Adele P.; Hosek, James R.

    The report investigates production and the cost effects of teaching within hospital departments. Models of primary production show that the cost effects of teaching are determined by the salaries paid to students (including residents, interns, medical students, and technical trainees) and physicians, by the levels of student inputs used in…

  5. Student Housing & Hospitality Services

    E-print Network

    Handy, Todd C.

    Welcome e-Packet 2012 /13 Winter Session Student Housing & Hospitality Services #12;Welcome Welcome of the Student Housing and Hospitality Services Department at the University of British Columbia's Okanagan in their personal transition. The Residence Advisors, Nurse and Counselor in Residence program and peer mentors

  6. Mental hospitals in India.

    PubMed

    Krishnamurthy, K; Venugopal, D; Alimchandani, A K

    2000-04-01

    This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present statusThe earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals.Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and grovernmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses. PMID:21407925

  7. Library Services in Hospitals.

    ERIC Educational Resources Information Center

    Department of Health and Social Security, London (England).

    The memorandum gives guidance to the provision and organization of library services at hospitals both for staff and for patients. It also draws attention to the assistance available from outside sources towards the development and maintenance of these services so hospital authorities may make the most effective use of the available facilities.…

  8. Handbook on Hospital Television.

    ERIC Educational Resources Information Center

    Prynne, T. A.

    Designed for both hospital personnel interested in television and audiovisual personnel entering the medical field, this handbook is a verbal and pictorial survey of what is being done with TV within the medical profession. After an introduction which answers technical questions about medical TV posed during the American Hospital Association's…

  9. Hospitality, Tourism, and Recreation.

    ERIC Educational Resources Information Center

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  10. Hospitality Services Reference Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  11. Children's Hospital Los Angeles

    Cancer.gov

    The Pediatric Psychology Program at Children's Hospital Los Angeles (CHLA) consists of outpatient and inpatient hospital-based services that provide therapeutic support and intervention to children and families. The pediatric psychology postdoctoral fellows will participate in varied clinical activities with child and adolescent patients and their families.

  12. Hospitality Occupations. Curriculum Guide.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

    This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

  13. Hospital Ethics Committees: The hospital attorney's role

    Microsoft Academic Search

    David A. Buehler; Richard M. Divita; Jackson Joe Yium

    1989-01-01

    In light of the foregoing, we conclude that hospital attorneys, risk managers, and other advocates despite the immense contribution which they may make to the process and deliberations of ethics committees—have a unique role in the bioethical decision-making process, but one that neither requires nor precludes membership on such committees. This is not to deny in any way appropriate access

  14. Teach Engineering

    NSDL National Science Digital Library

    TeachEngineering is a resource for K-12 educators wanting to introduce students to engineering, even if they have no background knowledge of engineering. The project is a collaboration between four engineering colleges and is funded by the National Science Foundation. The resources provided here are intended to help teachers "enhance learning, excite students and stimulate interest in science and math through the use of hands-on engineering." The lessons connect real-world experiences with curricular content already taught in K-12 classrooms and link the content to educational standards. The collection of materials are included in a database that can be searched by keyword, grade level, educational standard or other criteria, or browsed by subject area, curricular units, lessons or activities. Educators are encouraged to submit reviews and create their own area on the website to easily access personal favorites. Only a few sample lessons were posted at the time of this report, but the database is expected to be available sometime in January 2005. Other sections of the website provide information and links to learn more about the field of engineering.

  15. Hospital efficiency and debt.

    PubMed

    Bernet, Patrick Michael; Rosko, Michael D; Valdmanis, Vivian G

    2008-01-01

    U.S. Hospitals rely heavily on debt financing to fund major capital investments. Hospital efficiency is at least partly determined by the amount and quality of plant and equipment it uses. As such, a hospital's access to debt and credit rating may be related to its efficiency. This study explores this relationship using a broad sample of hospitals and associated bond issuance histories. Employing stochastic frontier analysis (SFA), we measure cost inefficiency to gauge the impact of debt issuance and debt rating. We find that hospitals with recent bond issues were less inefficient. Although we do not find a perfectly linear relationship between debt rating and inefficiency, we have evidence that hints at such a relation. Finally, we find an increase in inefficiency in the years following bond issues, consistent with the possibility of a debt death spiral. PMID:21110482

  16. Hospitality as an Environmental Metaphor.

    ERIC Educational Resources Information Center

    Horwood, Bert

    1991-01-01

    Compares stewardship and hospitality as they relate to the biosphere. Traces the origin of the word "hospitality," discusses cultural traditions of hospitality, and applies the concept of hospitality to the natural world. Considers forms of symbiosis in nature: commensals, mutualism, and parasitism. Hospitality promotes respect, humility, and…

  17. Bedside teaching in medical education: a literature review.

    PubMed

    Peters, Max; Ten Cate, Olle

    2014-04-01

    Bedside teaching is seen as one of the most important modalities in teaching a variety of skills important for the medical profession, but its use is declining. A literature review was conducted to reveal its strengths, the causes of its decline and future perspectives, the evidence with regard to learning clinical skills and patient/student/teacher satisfaction. PubMed, Embase and the Cochrane library were systematically searched with regard to terms related to bedside teaching. Articles regarding the above-mentioned subjects were included. Bedside teaching has shown to improve certain clinical diagnostic skills in medical students and residents. Patients, students/residents and teachers all seem to favour bedside teaching, for varying reasons. Despite this, the practice of bedside teaching is declining. Reasons to explain this decline include the increased patient turnover in hospitals, the assumed violation of patients' privacy and an increased reliance on technology in the diagnostic process. Solutions vary from increasingly using residents and interns as bedside teachers to actively educating staff members regarding the importance of bedside teaching and providing them with practical essentials. Impediments to bedside teaching need to be overcome if this teaching modality is to remain a valuable educational method for durable clinical skills. PMID:24049043

  18. MANUAL OF ADMINISTRATIVE POLICIES and PROCEDURES POLICY #7.12 POLICY FOR THE USE OF ANIMALS IN RESEARCH, TESTING AND TEACHING

    E-print Network

    Sinnamon, Gordon J.

    OF ANIMALS IN RESEARCH, TESTING AND TEACHING Policy Category: Research Subject: Use of Animals in Research of Animals in Research, Testing & Teaching Related University Policies: [MAPP 7.10] Effective Date: November and teaching involving animals performed at Western, its affiliated hospitals, affiliated university colleges

  19. [Hospital clinical experience: meanings for Family Health resident nurses].

    PubMed

    Landim, Simone Alves; Batista, Nildo Alves; da Silva, Gilberto Tadeu Reis

    2010-01-01

    This qualitative research in phenomenological design aimed at understanding the meaning of hospital clinical experience in the nurse's training in a Multiprofessional Family Health Residency. The study was developed in a teaching institution. Data collection was based on interviews and had as study population eight resident nurses. I investigated the residents' experience according to their speeches, by making the following guiding question: "Talk about your hospital experience, how does it show itself in your training as a resident"? One open category emerged from the subject' description: Causing to approach the hospital experience and the Primary Health Care. Among the meanings attributed to the hospital experience, there is the need and relevance as an integrant part of the curriculum vitae of the Multiprofessional Family Health Residency for the nurses. PMID:21308222

  20. Variations in hospital billing for total joint arthroplasty.

    PubMed

    Stryker, Louis S; Odum, Susan M; Fehring, Thomas K

    2014-09-01

    Although regional variations in Medicare spending are known, it is not clear whether regional variations exist in hospital charges for total joint arthroplasty. Data from Centers for Medicare and Medicaid Services (CMS) on Diagnosis Related Groups 469 and 470 (Major Joint with and without Major Complicating or Comorbid Condition) from 2011 were analyzed for variation by region. Drastic variations in charges between institutions were apparent with significant differences between regions for hospital charges and payments. The median hospital charge nationwide was $71,601 and $46,219 for Diagnosis Related Groups 469 and 470, respectively, with corresponding median payments of $21,231 and $13,743. Weak to no correlation was found between hospital charges and payments despite adjustments for wage index, cost of living, low-income care and teaching institution status. PMID:24973930

  1. Factors influencing hospital high length of stay outliers

    PubMed Central

    2012-01-01

    Background The study of length of stay (LOS) outliers is important for the management and financing of hospitals. Our aim was to study variables associated with high LOS outliers and their evolution over time. Methods We used hospital administrative data from inpatient episodes in public acute care hospitals in the Portuguese National Health Service (NHS), with discharges between years 2000 and 2009, together with some hospital characteristics. The dependent variable, LOS outliers, was calculated for each diagnosis related group (DRG) using a trim point defined for each year by the geometric mean plus two standard deviations. Hospitals were classified on the basis of administrative, economic and teaching characteristics. We also studied the influence of comorbidities and readmissions. Logistic regression models, including a multivariable logistic regression, were used in the analysis. All the logistic regressions were fitted using generalized estimating equations (GEE). Results In near nine million inpatient episodes analysed we found a proportion of 3.9% high LOS outliers, accounting for 19.2% of total inpatient days. The number of hospital patient discharges increased between years 2000 and 2005 and slightly decreased after that. The proportion of outliers ranged between the lowest value of 3.6% (in years 2001 and 2002) and the highest value of 4.3% in 2009. Teaching hospitals with over 1,000 beds have significantly more outliers than other hospitals, even after adjustment to readmissions and several patient characteristics. Conclusions In the last years both average LOS and high LOS outliers are increasing in Portuguese NHS hospitals. As high LOS outliers represent an important proportion in the total inpatient days, this should be seen as an important alert for the management of hospitals and for national health policies. As expected, age, type of admission, and hospital type were significantly associated with high LOS outliers. The proportion of high outliers does not seem to be related to their financial coverage; they should be studied in order to highlight areas for further investigation. The increasing complexity of both hospitals and patients may be the single most important determinant of high LOS outliers and must therefore be taken into account by health managers when considering hospital costs. PMID:22906386

  2. Understanding differences between high- and low-price hospitals: implications for efforts to rein in costs.

    PubMed

    White, Chapin; Reschovsky, James D; Bond, Amelia M

    2014-02-01

    Private insurers pay widely varying prices for inpatient care across hospitals. Previous research indicates that certain hospitals use market clout to obtain higher payment rates, but there have been few in-depth examinations of the relationship between hospital characteristics and pricing power. This study used private insurance claims data to identify hospitals receiving inpatient prices significantly higher or lower than the median in their market. High-price hospitals, compared to other hospitals, tend to be larger; be major teaching hospitals; belong to systems with large market shares; and provide specialized services, such as heart transplants and Level I trauma care. High-price hospitals also receive significant revenues from nonpatient sources, such as state Medicaid disproportionate-share hospital funds, and they enjoy healthy total financial margins. Quality indicators for high-price hospitals were mixed: High-price hospitals fared much better than low-price hospitals did in U.S. News & World Report rankings, which are largely based on reputation, while generally scoring worse on objective measures of quality, such as postsurgical mortality rates. Thus, insurers may face resistance if they attempt to steer patients away from high-price hospitals because these facilities have good reputations and offer specialized services that may be unique in their markets. PMID:24476706

  3. What motivates senior clinicians to teach medical students?

    PubMed Central

    Dahlstrom, Jane; Dorai-Raj, Anna; McGill, Darryl; Owen, Cathy; Tymms, Kathleen; Watson, D Ashley R

    2005-01-01

    Background This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. Methods The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia). Their motivations to teach medical students were assessed applying Q methodology. Results Of the 75 participants, 18 (24%) were female and 57 (76%) were male. The age distribution was as follows: 30–40 years = 16 participants (21.3%), 41–55 years = 46 participants (61.3%) and >55 years = 13 participants (17.3%). Most participants (n = 48, 64%) were staff specialists and 27 (36%) were visiting medical officers. Half of the participants were internists (n = 39, 52%), 12 (16%) were surgeons, and 24 (32%) were other sub-specialists. Of the 26 senior clinicians that did not participate, two were women; 15 were visiting medical officers and 11 were staff specialists; 16 were internists, 9 were surgeons and there was one other sub-specialist. The majority of these non-participating clinicians fell in the 41–55 year age group. The participating clinicians were moderately homogenous in their responses. Factor analysis produced 4 factors: one summarising positive motivations for teaching and three capturing impediments for teaching. The main factors influencing motivation to teach medical students were intrinsic issues such as altruism, intellectual satisfaction, personal skills and truth seeking. The reasons for not teaching included no strong involvement in course design, a heavy clinical load or feeling it was a waste of time. Conclusion This study provides some insights into factors that may be utilised in the design of teaching programs that meet teacher motivations and ultimately enhance the effectiveness of the medical teaching workforce. PMID:16022738

  4. Teaching tolerance

    PubMed Central

    Cousens, Leslie P.; Mingozzi, Federico; van der Marel, Sander; Su, Yan; Garman, Richard; Ferreira, Valerie; Martin, William; Scott, David W.; De Groot, Anne S.

    2012-01-01

    Babies born with Pompe disease require life-long treatment with enzyme-replacement therapy (ERT). Despite the human origin of the therapy, recombinant human lysosomal acid ? glucosidase (GAA, rhGAA), ERT unfortunately leads to the development of high titers of anti-rhGAA antibody, decreased effectiveness of ERT, and a fatal outcome for a significant number of children who have Pompe disease. The severity of disease, anti-drug antibody (ADA) development, and the consequences thereof are directly related to the degree of the enzyme deficiency. Babies born with a complete deficiency GAA are said to have cross-reactive immunologic material (CRIM)–negative Pompe disease and are highly likely to develop GAA ADA. Less frequently, GAA ADA develop in CRIM-positive individuals. Currently, GAA-ADA sero-positive babies are treated with a combination of immunosuppressive drugs to induce immunological tolerance to ERT, but the long-term effect of these regimens is unknown. Alternative approaches that might redirect the immune response toward antigen-specific tolerance without immunosuppressive agents are needed. Methods leading to the induction of antigen-specific regulatory T cells (Tregs), using peptides such as Tregitopes (T regulatory cell epitopes) are under consideration for the future treatment of CRIM-negative Pompe disease. Tregitopes are natural T cell epitopes derived from immunoglobulin G (IgG) that cause the expansion and activation of regulatory T cells (Treg). Teaching the immune system to tolerate GAA by co-delivering GAA with Tregitope peptides might dramatically improve the lives of CRIM-negative babies and could be applied to other enzyme replacement therapies to which ADA have been induced. PMID:23095864

  5. Commercialism in nonprofit hospitals.

    PubMed

    Sloan, F A

    1998-01-01

    The private nonprofit hospital is the dominant organizational form in the U.S. hospital industry. Various reasons have been advanced for its high market share. As hospitals undergo massive changes due in large part to changes in payment practices, there is widespread concern that nonprofit hospitals may become less committed to noncommercial activities. This may even be more likely when such hospitals convert to for-profit status. The empirical evidence indicates that, on average, hospitals of nonprofit and for-profit ownership are similar in the provision of uncompensated care, the quality of care, and the adoption of technology. Conversion of a nonprofit to for-profit status does not adversely affect the provision of uncompensated care on average. However, for-profits are more likely to be located in areas where consumers have the ability to pay for care. As hospital markets become more competitive and the opportunity for cross-subsidizing more unprofitable, collective-good activities will become increasingly difficult. Support for such activities, if they are to exist, will have to come from explicit public subsidies. PMID:10182439

  6. Imaging the heart: cardiac scintigraphy and echocardiography in US hospitals (1983)

    SciTech Connect

    McPhee, S.J.; Garnick, D.W.

    1986-10-01

    The rapid growth of cardiac catheterization has raised questions about the availability of less costly, noninvasive tests such as cardiac scintigraphy and echocardiography. To assess their availability and rates of use, we surveyed 3778 non-federal short-term US hospitals in June, 1983. Overall, 2605 hospitals (69%) offered /sup 201/Tl myocardial perfusion scans, 2580 (68%) 99mTc equilibrium gated blood pool scans, and 2483 (67%) cardiac shunt scans; 1679 hospitals (44%) offered M-mode and/or 2-dimensional echocardiography, and 768 (20%) pulsed Doppler echocardiography. Volumes of procedures varied enormously among hospitals capable of performing them. High volumes of both scintigraphy and echocardiography were performed in a small number of hospitals. Larger, voluntary, and teaching hospitals performed higher volumes of both procedures. Despite widespread availability of these noninvasive technologies, high volumes of both cardiac scintigraphy and echocardiography procedures are concentrated in a small number of US hospitals.

  7. A transition strategy for becoming a baby-friendly hospital: exploring the costs, benefits, and challenges.

    PubMed

    DelliFraine, Jami; Langabeer, James; Delgado, Rigoberto; Williams, Janet F; Gong, Alice

    2013-04-01

    The objectives of this study were to provide an economic assessment as well as a calculated projection of the costs that typical U.S. tertiary-care hospitals would incur through policy reconfiguration and implementation to achieve the UNICEF/World Health Organization Baby-Friendly® Hospital designation and to examine the associated challenges and benefits of becoming a Baby-Friendly Hospital. We analyzed hospital resource utilization, focusing on formula use and staffing profiles at one U.S. urban tertiary-care teaching hospital, as well as conducted an online survey and telephone interviews with a selection of Baby-Friendly Hospitals to obtain their perspective on costs, challenges, and benefits. Findings indicate that added costs for a new Baby-Friendly Hospital will approximate $148 per birth, but these costs sharply decrease over time as breastfeeding rates increase in a Baby-Friendly environment. PMID:23249129

  8. Out of the frying pan: New York City hospitals in an age of deregulation.

    PubMed

    Salit, Sharon; Fass, Steven; Nowak, Mark

    2002-01-01

    For several decades New York City hospitals had been distinguished by their tightly regulated environment, chronically weak finances, high occupancy rates, teaching intensity, dependency on public payers, low managed care penetration, and minimal merger activity. Then in the late 1990s a rapid convergence of forces--the Balanced Budget Act, managed care growth, state deregulation of commercial rates, escalating costs, and plunging hospital occupancy rates--threw the city's hospital industry into turmoil. In this paper we describe this period of turbulent change that has left most of the city's safety-net and small community hospitals near bankruptcy. PMID:11900065

  9. Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India

    PubMed Central

    Manar, Manish Kumar; Sahu, Krishna Kumar; Singh, Shivendra Kumar

    2014-01-01

    Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW) management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices. PMID:25657950

  10. Teaching Physics in Cameroon.

    ERIC Educational Resources Information Center

    Bryant, Daniel

    1983-01-01

    Discusses experiences in teaching high school physics in the Cameroon. Comments on the educational system, the school, instructional strategies, materials/equipment, and the author's personal experiences teaching in this developing country. (JN)

  11. Effective College Teaching.

    ERIC Educational Resources Information Center

    Caraway, James E.

    1978-01-01

    The author discusses other writings on effective college teaching and then presents his list of necessary characteristics for the effective teacher, stressing the interpersonal dimension of the teaching-learning situation. (MF)

  12. Responsive Teaching through Conversation

    ERIC Educational Resources Information Center

    Dozier, Cheryl; Garnett, Susan; Tabatabai, Simeen

    2011-01-01

    Conversations are the heart of responsive teaching. By talking with struggling learners, teachers can find out about their interests in order to design effective, personalized instruction; build relationships; work through complexities in teaching and learning; and celebrate successes.

  13. Teaching Normal Birth, Normally

    PubMed Central

    Hotelling, Barbara A

    2009-01-01

    Teaching normal-birth Lamaze classes normally involves considering the qualities that make birth normal and structuring classes to embrace those qualities. In this column, teaching strategies are suggested for classes that unfold naturally, free from unnecessary interventions. PMID:19436595

  14. President's Teaching Scholars Program

    NSDL National Science Digital Library

    University of Colorado

    This program from the University of Colorado is designed to honor and reward faculty who have excelled in teaching, scholarship, and research and to endorse teaching excellence throughout the university.

  15. Sharing Teaching Ideas.

    ERIC Educational Resources Information Center

    Mathematics Teacher, 1979

    1979-01-01

    This article suggests: ways to teach algebraic properties; a way to prove the Pythagorean Theorem using transformational geometry; a method of packaging and carrying AC-powered calculators; and a method for teaching standard formulas. (MK)

  16. Estimating the Number of Residents Needed in Community Teaching Hospitals.

    ERIC Educational Resources Information Center

    Penchansky, Roy

    1984-01-01

    A method of estimating resident staffing needs is evaluated, including discussion of (1) methodological changes needed to estimate needs for service care and assisting attending physicians with private cases; (2) data collection; (3) representative findings; (4) using cost, ease of use, understandability, communicability, and validity as…

  17. Head, Department of Medicine Queen's University and Affiliated Teaching Hospitals

    E-print Network

    Ellis, Randy

    , and Rheumatology. The Department works collaboratively to provide a broad range of medical services for the greater/oncology, nephrology, neurology, respirology, rheumatology, palliative care, and critical care, the Department also

  18. A Division of Substance Abuse Medicine in a Teaching Hospital.

    ERIC Educational Resources Information Center

    Lerner, William D.; And Others

    1986-01-01

    Physicians are likely to encounter a wide gamut of disorders related to drug and alcohol abuse and will need specialized knowledge and skills to treat the affected population effectively. The development and implementation of a program to meet these needs at the Medical College of Virginia is described. (MLW)

  19. Histopathological Audit of 373 Nononcological Hysterectomies in a Teaching Hospital

    PubMed Central

    Tiwana, Kanwardeep Kaur; Nibhoria, Sarita; Monga, Tanvi; Phutela, Richa

    2014-01-01

    Hysterectomy, the most common gynecological surgery, provides a definitive cure to various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. However, with advent of effective medical and conservative treatment modalities for nononcological causes it is now posing question mark on justification of hysterectomy. Therefore, an audit is required to assess the correlation between preoperative diagnosis and histopathological examination of specimen for justification of the procedure. In this study over period of one year (April 2013 to March 2014) 373 hysterectomies specimens were received in the department of pathology for nononcological causes. The age of patients ranged from 22 to 85 years with mean 45 ± 9.2 years. All cases were divided into five categories on the basis of age and audit was done. In this study the most common finding was leiomyoma (43.7%) followed by adenomyosis (19.3%). Almost 50% of hysterectomies causes were justified as preoperative diagnosis matched with histopathology. Cohen kappa statistics were used to measure agreement between preoperative and postoperative histopathological diagnosis which was found to be fair with ? value being 0.36. This study highlights that regular audit of surgeries can help improve quality of health care services and provide safe conservative option to patients. PMID:25295217

  20. Physical restraint usage at a teaching hospital: a pilot study.

    PubMed

    Barton-Gooden, Antoinette; Dawkins, Pauline E; Bennett, Joanna

    2015-02-01

    This mixed method study examines the prevalence of restraint usage; perception of nurses and doctors about the practice and whether they were trained to apply physical restraints. The physical restraint prevalence tools were used to observe 172 adult patients and conduct 47 chart audits in the medical-surgical wards and a psychiatric unit in November 2011. Focus group discussions with nurses and doctors were conducted. Quantitative data were analyzed using the SPSS and focus group discussions thematically analyzed. The prevalence of physical restraints between the medical-surgical wards was 75%. Nurses and medical doctors were not formally trained to apply restraint, and had learnt from peer observation. They expressed sadness, guilt, and fear when restraints are used and identified that inadequate institutional support existed. Restraint usage was high, and nurses and doctors experienced moral dilemma when they perceived that lack of formal training and inadequate institutional support may contribute to patient injury. PMID:23814174