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Sample records for akdeniz university hospital

  1. University Hospitals for Sale.

    ERIC Educational Resources Information Center

    Culliton, Barbara J.

    1984-01-01

    Although faculty opposition stopped the sale of Harvard's McLean Hospital to the Hospital Corporation of America (HCA), a partnership remains a possibility. Issues related to the proposed sale as well as those affecting hospital economics are considered. Proposed terms of the sale are included. (JN)

  2. Daylight exposure and the other predictors of burnout among nurses in a University Hospital.

    PubMed

    Alimoglu, Mustafa Kemal; Donmez, Levent

    2005-07-01

    The purpose of the study was to investigate if daylight exposure in work setting could be placed among the predictors of job burnout. The sample was composed of 141 nurses who work in Akdeniz University Hospital in Antalya, Turkey. All participants were asked to complete a personal data collection form, the Maslach Burnout Inventory, the Work Related Strain Inventory and the Work Satisfaction Questionnaire to collect data about their burnout, work-related stress (WRS) and job satisfaction (JS) levels in addition to personal characteristics. Descriptive statistics, parametric and non-parametric tests and correlation analysis were used in statistical analyses. Daylight exposure showed no direct effect on burnout but it was indirectly effective via WRS and JS. Exposure to daylight at least 3h a day was found to cause less stress and higher satisfaction at work. Suffering from sleep disorders, younger age, job-related health problems and educational level were found to have total or partial direct effects on burnout. Night shifts may lead to burnout via work related strain and working in inpatient services and dissatisfaction with annual income may be effective via job dissatisfaction. This study confirmed some established predictors of burnout and provided data on an unexplored area. Daylight exposure may be effective on job burnout.

  3. In-hospital Cardiac Arrest at Cork University Hospital.

    PubMed

    O'Sullivan, E; Deasy, C

    2016-01-01

    We describe the incidence and outcomes of in-hospital cardiac arrest (IHCA) at Cork University Hospital over a one year time period (2011), prior to the implementation of national early warning scoring (NEWS) systems. There were 43 217 coded CUH admissions, in 2011, to 518 in-patient beds. The Hospital In-Patient Enquiry Database was used to identify adults (>/= 18 years) who sustained IHCA. Available Utstein variables were collected. Fifty-two patients were found to be incorrectly coded IHCA. 17 of 63 (27.0%) IHCA survived to discharge. IHCA with shockable rhythm had significantly higher survival. IHCA survival was significantly lower on wards versus any other hospital location. Median days of stay prior to arrest were significantly different between survivors and non-survivors. All survivors (n = 17) had intact neurological outcome post-event. Our outcomes from IHCA are poorest on hospital wards when compared to other areas of the hospital. Those that survive have excellent function and one-year survival.

  4. Hospital-integrated PACS at the University Hospital of Geneva

    NASA Astrophysics Data System (ADS)

    Ratib, Osman M.; Ligier, Yves; Hochstrasser, Denis; Scherrer, Jean-Raoul

    1991-07-01

    The PACS under development at the University Hospital of Geneva is a hospital-wide image management system for radiological as well as non-radiological medical images which is part of one of the widest hospital information systems (HIS) in Switzerland (Diogene system). It is based on a multi-vendor open architecture and a set of widely available industry standards, namely: Unix as the operating system, TCP-IP as network protocol and an SQL-based distributed database (INGRES) that handles both the PACS and the HIS. The PACS is based on a distributed architecture of servers of two types: the archive servers connected to the sources of images and equipped with large optical disk libraries (jukeboxes) and display servers distributed over the hospital. A standard image storage format was developed based on the ACR-NEMA standard. This file format (the PAPYRUS format) allows storage of sets of images as a sequence of ACR-NEMA messages in an 'encapsulated' file structure. In order to provide a more uniform user interface on a variety of different workstations, a common platform for image display and manipulation called OSIRIS is developed based on X-11 windowing system and OSF/Motif extension. Such a platform is designed to be portable to any computer running Unix and equipped with a graphic display system running X-11. Because this software is written in the object-oriented language C++, it is easily expandable and easily adaptable to different needs and requirements.

  5. Disaster drill at a university hospital.

    PubMed

    Rehmani, Rifat

    2005-01-01

    The course of a disaster drill held on 23 October 2001 at Aga Khan University, Karachi is reported. The Hospital Emergency Plan was put to trial on that day. Volunteers were invited to become simulated casualties in the drill. Briefing seminars had been conducted with the key players of the hospital. The scenario was a man-made type disaster. A 747 jumbo jet with 200 passengers had crashed at the end of the runway at Quaid-e-Azam International Airport while taking off in a thunderstorm. Fifty casualties were sent to Emergency Room by ambulance. The Plan was activated and relevant units were mobilized according to the Plan. It took 2 hours to complete the disaster drill. Major difficulties were identified in the operations, communications, staff deployment, and emergency control center. Debriefing sessions reviewed difficulties encountered throughout the drill and the possible remedies. PMID:15816693

  6. Rediscovering university teaching hospitals for Australia.

    PubMed

    Penington, David G

    2008-09-15

    Partnership between research and health services has a long history in other countries, but has been relatively recent in Australia, with several models arising in the 1960s and 1970s as research-based specialties developed. Since the implementation of Medibank, which became Medicare, Australian Health Care Agreements have been primarily crafted on the basis of transactional numbers, ignoring the need for links with teaching and research and the need to implement new developments. Education and research have been seen as the responsibility of the federal government, and hospitals are progressively less recognised or funded for these functions by the states. Australia's teaching hospitals are in danger of falling seriously behind those in other countries and losing their capacity to monitor quality, to innovate and to branch into new strategies in partnership with primary care services. We should look at initiatives in other countries such as the United Kingdom and Canada, which are making big strides in tackling similar issues. University hospitals hold the key, if appropriately linked with other services. The current Australian Health Care Agreements are on hold. A new agency is needed to support clinical and service-related research, with a new structure and track for federal government funding, and providing oversight of research and development, of clinical governance and quality of outcomes in health care, linked with new strategies for prevention and treatment. A component of the foreshadowed additional federal government funding for health should be sequestered to set up such an agency. PMID:18803539

  7. Clinical career ladders: Thomas Jefferson University Hospital.

    PubMed

    Smith, J E; Sheaffer, S L; Frey, B M

    1989-11-01

    The clinical career ladder program developed for pharmacists at Thomas Jefferson University Hospital, a 700-bed teaching hospital, is described. A task force was assembled to develop a clinical career ladder that would parallel the managerial advancement track in terms of rewards and recognition. The task force created separate lists of competencies for staff and clinical pharmacists and ranked the competencies according to their complexity and the number of years most pharmacists would need to achieve them. Separate pathways were established for staff and clinical pharmacists: staff pharmacist I, II, and III and clinical pharmacist I, II, and III. A salary scale designed to provide meaningful salary increases between levels was established. Nearly all pharmacists who are hired begin at level I and are allowed to apply for promotion to level II within six months. Opportunities for promotion occur twice annually. Pharmacists who have received an overall rating of effective or outstanding at the most recent performance appraisal may submit documented evidence that they have gained the knowledge and skills required at the higher level. A promotions review board evaluates each application and informs the director of pharmacy as to whether the applicant meets the criteria for promotion. Response to the program has been favorable, as indicated by the number of pharmacists who have applied for promotion and the quality of their applications. A carefully planned clinical career ladder program was well received by pharmacists, who responded by acquiring the knowledge and skills necessary for promotion.

  8. Hospitality Major Vocational High School Students' Expectations on University Education

    ERIC Educational Resources Information Center

    Chung, Ya-Ting; Yang, Cheng-Cheng

    2013-01-01

    Hospitality is not a new industry in Asia, but high quality hospitality industry has become more and more important in the trend of questing service-based economy and the increasing number of tourists in Asia. Thus there are more universities opened hospitality degree programs in Asia, Taiwan is no exception. In this context, why high school…

  9. Financial Analysis of National University Hospitals in Korea

    PubMed Central

    Lee, Munjae

    2015-01-01

    Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry. PMID:26730356

  10. [University clinics in the competitive hospital market].

    PubMed

    Schmidt, C E; Möller, J; Hesslau, U; Bauer, M; Gabbert, T; Kremer, B

    2005-07-01

    In recent years Germany has faced a growing economization and competition among hospitals. To protect their interests hospitals have to operate similarly to other commercial businesses. Academic hospitals face difficult circumstances in this competition. They have to facilitate research and education activities which require additional financial and personnel resources but also provide maximum acute care treatment at all times. This causes additional disadvantages in terms of financial resources, compared to private hospital chains. Such examples of financial shortcomings have led to the privatization of academic research centres in Germany. An alternative strategy to privatization of academic acute care hospitals is the change of their legal status into a capital company or into a foundation, according to US experiences. Public private partnerships (PPPs) may also represent a potential alternative, as they have already produced a growing number of successful examples in the public sector in Germany. Academic acute care hospitals can also choose a strategic reorganization of their targets, similar to their privately held competitors in the market. Potential economies in scale may be achieved in areas such as medical treatment, research and personnel planning.However, it is vital that academic acute care hospitals start to act productively and also individually. This article provides a number of managerial pathways and options to maintain and strengthen operational competitiveness. PMID:15942750

  11. Smart Information System for Gachon University Gil Hospital

    PubMed Central

    Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

    2012-01-01

    Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. Results The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Conclusions Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future. PMID:22509476

  12. 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…

  13. [110 years--University Obstetrics and Gynecology Hospital "Maichin dom"].

    PubMed

    Zlatkov, V

    2014-01-01

    The first specialized Obstetrics and Gynecology Hospital in Bulgaria was founded based on the idea of Queen Maria Luisa (1883). Construction began in 1896 and the official opening of the hospital took place on November 19, 1903. What is unique about the University Obstetrics and Gynecology Hospital "Maichin dom" is above all the fact that the Bulgarian school of obstetrics and gynecology was founded within its institution. Currently, the hospital has nearly 400 beds and 600 employees who work at nine clinics and six laboratories, covering the entire spectrum of obstetric and gynecological activities. Its leading specialists still continue to embody the highest level of professionalism and dedication. The future development of the hospital is chiefly associated with the renovation of facilities, resources and equipment and with the enhancement of the professional competence of the staff and of the quality of hospital products to improve the health and satisfaction of the patients.

  14. Seoul National University Bundang Hospital's Electronic System for Total Care

    PubMed Central

    Yoo, Sooyoung; Lee, Kee Hyuck; Lee, Hak Jong; Ha, Kyooseob; Lim, Cheong; Chin, Ho Jun; Yun, Jonghoar; Cho, Eun-Young; Chung, Eunja; Baek, Rong-Min; Chung, Chin Youb; Wee, Won Ryang; Lee, Chul Hee; Lee, Hai-Seok; Byeon, Nam-Soo

    2012-01-01

    Objectives Seoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS). Methods SNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status. Results The BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail. Conclusions Beyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value. PMID:22844650

  15. Building for change: university hospital design for future clinical learning.

    PubMed

    Nordenström, Jörgen; Kiessling, Anna; Nordquist, Jonas

    2013-09-01

    Recent developments in the way health care is organized and delivered have rendered many old hospital structures obsolete. The creation of an entire new university hospital for tertiary health care, clinical research and education has made it necessary to discuss and define what pedagogical strategies should be used in this new setting and how physical structures can support learning. Contemporary health care is per se interprofessionally team-based, but most health care education is still performed in silos, separated for each profession. When building a new hospital new possibilities arise to create an interprofessional and learner-centered environment with an adjusted physical infrastructure and spaces for learning. The old hospital conserved highly discipline-based (and professionally isolated) curriculas and didactically oriented; all manifested in the physical environments. However, the New Karolinska University Hospital presents a shift towards a pedagogy characterized by learning centeredness, interprofessionalism clearly expressed in the architecture, design and allocation of spaces within the new buildings. The aim of this article is to highlight the considerations that have been made during the process to design and plan for the new university hospital. PMID:23713805

  16. Building Capacity through University Hospital and University School of Nursing Partnerships. UHC/AACN White Paper.

    ERIC Educational Resources Information Center

    American Association of Colleges of Nursing, Washington, DC.

    This paper represents the work of a task force sponsored by the University Health System Consortium and the American Association of Colleges of Nursing. These two organizations share a common concern for preparing and retaining a well-educated nursing workforce for complex university hospital settings. The charge to the task force was to develop…

  17. Journey to the Beacon Award: the Georgetown University Hospital perspective.

    PubMed

    Jaworski Miller, Lisa; Corbett, Gina; Herold, Mary; Tavares, Doris; Kirchner, Lisa; Heath, Janie

    2005-06-01

    The medical intensive care unit (MICU) at Georgetown University Hospital in Washington, D.C., was among the first four hospitals to be awarded the Beacon Award from the American Association of Critical- Care Nurses. The Beacon Award is given to those units that prove, through a 42-question application, how they excel and serve as a guiding light to other intensive care units. The MICU's "journey" to the award prompted an introspective look into the unit, its policies, and its methods of providing the highest quality patient care, in an environment that is supportive to the nursing staff.

  18. Outpatient admissions and hospital costs of Syrian refugees in a Turkish university hospital

    PubMed Central

    Tahirbegolli, Bernard; Çavdar, Sabanur; Sümer, Esin Çetinkaya; Akdeniz, Sıdıka I.; Vehid, Suphi

    2016-01-01

    Objectives: To examine the most frequent admitted polyclinics, diagnoses, and the costs of Syrian refugee patient in a Turkish university hospital in the metropolitan city of Istanbul, Western part of Turkey. Methods: Research methodology consist of analyzing outpatient admissions to the Hospital Polyclinics of Faculty of Medicine, Istanbul University, Cerrahpasa, Istanbul, Turkey from January-June 2014. We carried out diagnosis groups as classified in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification, and analyzed the hospital cost of first admission through records based in the hospital information system. Results: Median age of 251 Syrian refugee patients is 19 years, inter quartile rate 7-34 years. Patients aged 65 and older compared with those until 18 years and 19 to 64 years aged groups have made statistically significant (p<0.001) less hospital admissions. The Most frequented clinic was the emergency clinic. On June there have been significantly (p<0.001) more admissions compared with other months. The most common diagnoses were diseases of the respiratory system. The costs of per admission was estimated nearly 48 US Dollar/per patient and the total amount of hospital admissions was 12,031.93 US Dollar. Conclusion: On the specified dates, the clinics were mostly frequented from Syrian refugees until 18 years group. The most common presenting symptoms are respiratory diseases and most frequented clinic is emergency. PMID:27381545

  19. Focus on: Thomas Jefferson University Hospital, Department of Biomedical Instrumentation.

    PubMed

    Tackel, I S; Bell, D; Edelson, R C

    1993-01-01

    Technology management services at Thomas Jefferson University Hospital are provided by two distinct cost centers: The Department of Biomedical Instrumentation and Jefferson Biomedical Shared Services. The in-house division of the Department of Biomedical Instrumentation (BMI) provides clinical engineering services to the hospital, a 717-bed, tertiary care facility. BMI supports traditional patient care instrumentation, as well as dialysis machines, anesthesia machines, lasers, and the neonatal extracorporeal membrane oxygenation (ECMO) systems. In addition, the department supports over 3,000 personal computers and associated peripherals, and provides research, design, database support, device evaluation, incident investigation, and product problem investigation services. Jefferson Biomedical Shared Services, an integral component of the Department of Biomedical Instrumentation, offers a shared services program to local area hospitals. It has a current client list of 11 major healthcare institutions with annual revenues approaching $3,000,000 per year.

  20. [The Tissue Bank of the University Hospital Erasme].

    PubMed

    Hinsenkamp, M; Anastasescu, M; Fourrez, S; Collard, J F

    2011-01-01

    The evolution of the Tissue Bank belonging to the University Hospital Erasme is summarized during its 13 years of experience. In parallel with this evolution, the important modifications of the legislation, the selection criteria and the bone graft processing are reported. The significant improvement of the safety of the allograft related to the risk of infection is also mentioned. In constant progression, the ongoing research within the BTE studies the osteogenic activity of the graft, mostly of bone demineralized matrix. PMID:22458057

  1. A palliative care initiative in Dokuz Eylul University Hospital.

    PubMed

    Mutafoglu, Kamer

    2011-04-01

    Turkey is among the countries with only "capacity building activity" in terms of palliative care development according to the mapping levels reported by the International Observatory on End of Life Care (http://www.eolc-observatory.net/global/pdf/world_map.pdf). Palliative care units are lacking even in major hospitals. Although some medical oncologists and pain specialists have been providing pain control and symptom relief to some extend, all these interventions remain a fragmented approach to care since there are no palliative care programs. Establishing palliative care services should be a priority in the development of comprehensive cancer care, particularly in a country where more than 60% of the cancer patients present with advanced stage disease. Like all the other university hospitals in the country, palliative care services have not been established so far in Dokuz Eylul University Hospital for several reasons although almost all the modern cancer treatment modalities have been provided to cancer patients. A group of health professionals have recently started a palliative care initiative in the hospital with an aim to raise awareness and to implement basic palliative care interventions to the current cancer care. This paper aims to tell the story of how this initiative get started and which step were taken so far.

  2. Decentralization and Hospital Pharmacy Services: The Case of Iranian University Affilliated Hospitals

    PubMed Central

    Ashna Delkhosh, Reza; Ardama, Ali; Salamzadeh, Jamshid

    2013-01-01

    The aim of this study was to evaluate the satisfaction rate of hospital managerial/clinical teams (HMCTs) including principles (chief executives), managers, supervisor pharmacists and head nurses from services presented by private sectors directing 10 pharmacy departments in hospitals affiliated to Shahid Beheshti University of Medical Sciences. This study is an observational and descriptive study in which a questionnaire containing 16 questions evaluating the satisfaction of the HMCTs from private sectors, and questions about demography of the responders was used for data collection. Collected data was applied to assign a satisfaction score (maximum 64) for each respondent. SPSS 17.0 and Microsoft Office Excel 2007 were used for statistical description and analysis of these information (where applicable). Overall, 97 people in charge of the hospitals (HMCTs) entered the study. The average satisfaction score was 26.38 ± 6.81 with the lowest satisfaction rate observed in Mofid children specialty hospital (19.5%) and the highest rate obtained for Imam Hussein (p.b.u.h) general hospital (65.3%). Generally, 59% of the HMCTs believed that the function of the private sector in the pharmacy of hospitals is satisfactory. Assuming that the satisfaction scores under 75% of the total obtainable score (i.e. 48 out of 64) could not be considered as an indicator of desired pharmacy services, our results revealed that the status of the services offered by private sectors are far behind the desired satisfactory level. PMID:24250687

  3. How to make a hospital-based wound center financially viable: the Georgetown University Hospital model.

    PubMed

    Attinger, Christopher E; Hoang, Han; Steinberg, John; Couch, Kara; Hubley, Katherine; Winger, Linda; Kugler, Margaret

    2008-11-01

    As the medical need and expenditure for chronic wound care have increased markedly over the past decade, wound centers have grown exponentially throughout the country. They can be community-based or hospital-based, and in either case, can be run by the facility or by a national chain. The wound center's viability is dependent on generated revenue, and its clinical effectiveness is based on a multidisciplinary approach to wound care. By incorporating the wound center into an existing hospital system, one can take advantage of the hospital's resources to effectively treat the more complex patients. Additionally, by focusing on limb salvage, the hospital attracts the critical limb ischemia and other complex patients that often require inpatient admission. We examined the Georgetown University Hospital Center for Wound Healing performance over the first 6 years of operation. Since opening the wound center in 1999, the number of outpatient visits has doubled, the wound care inpatient census has doubled, and the operative cases have increased 3-fold. Because the outpatient segment of the wound center can at best cover its direct cost, it cannot financially justify its existence. Hyperbaric oxygen (HBO) can increase the revenue to the point where the indirect costs are covered as well and the wound center can be revenue neutral. Due to the medical complexity of limb salvage patients, the inpatient collections are much higher than those of the outpatient wound center and therefore can serve as justification for the latter's financial viability. More importantly, with the wound center in place, the hospital can provide the local/regional community with a comprehensive service that can effectively treat the most challenging wounds. The success is built on a multidisciplinary team approach, use of evidence-based treatment protocols, efficient clinical structure, and a supportive hospital system. The beneficiaries include the patient with a healed wound, the physician with a

  4. Assessment of nurses' work climate at Alexandria Main University Hospital.

    PubMed

    Emam, Sanaa Abdel-aziz; Nabawy, Zeinab Mohamed; Mohamed, Azzaa Hassan; Sbeira, Walaa Hashem

    2005-01-01

    Work climate is indicative of how well the organization is realizing its full potential. An accurate assessment of work climate can identify the unnecessary obstacles to nurses interfering with their best performance. The present study aims to assess nurses' work climate at Alexandria Main University Hospital. The study sample included all nurses (N=400) who were working in inpatient medical and surgical units at the Alexandria Main University Hospital who were available at the time of data collection. A structured questionnaire was developed to assess nurses' perceptions regarding the dimensions of work climate. Data was collected by individual interview using the structured questionnaire. Results indicated that the highest percentages of nurses in medical and surgical units perceived that their work climate is characterized by good way of performance management, feeling of responsibility, warmth and supportive relationships, quality of communication, morale, organizational clarity and feeling of identity and belongness to the hospital. Nurses perceived that they are lacking work climate conducive to conflict resolution, participation in decision making, opportunity for training and development, fair rewards and recognition, calculated risks, sufficient resources, effective leadership and teamwork. There were no significant difference between nurses perceptions in medical and surgical units regarding all dimensions of work climate. The highest percentage of nurses in all units were satisfied only with the feeling of responsibility, way of performance management, and quality of communication. Conflict and identity were perceived as the most important areas that need improvement in the hospital. Based on the results recommendations were given to enhance work climate through designing compensation and recognition systems, and negotiate their requirements and accomplishment based on established standards and outcomes measures. Also, encouragement of and planning for

  5. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

    PubMed

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

  6. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital

    PubMed Central

    Yoo, Sooyoung; Hwang, Hee

    2016-01-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience. PMID:27651940

  7. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

    PubMed

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience. PMID:27651940

  8. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital

    PubMed Central

    Yoo, Sooyoung; Hwang, Hee

    2016-01-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

  9. Cost accounting by diagnosis in a Japanese university hospital.

    PubMed

    Tanaka, Koji; Sato, Junzo; Guo, Jinqiu; Takada, Akira; Yoshihara, Hiroyuki

    2004-10-01

    Cost accounting according to diagnoses covering approximately 600 inpatients with 64 diseases in 20 departments of Kumamoto University was carried out. The reports of these results were automatically generated and used for individual departmental meetings with participating delegates. The administration of each department as well as the management of diseases was discussed at the meetings, and all departments were requested to provide a report of their discussions. We are planning to increase the number of patients in the sample group and to perform more comprehensive and accurate hospital cost accounting.

  10. Primary biliary cirrhosis--experience in University Hospital, Kuala Lumpur.

    PubMed

    Mohammed, R; Goh, K L; Wong, N W

    1996-03-01

    Primary biliary cirrhosis is an uncommon disease amongst Malaysians. Over a 12-year period, between 1979 and 1991, only seven patients with clinical, biochemical and histologic evidence of primary biliary cirrhosis were identified in University Hospital Kuala Lumpur. All were Chinese females between the ages of 30 to 55 years. The presenting complaint was pruritus in 5 patients. All except one patient was jaundiced when the diagnosis was made. These patients were followed up from 1 to 11 years. Three deaths were reported, one from massive hemetemesis and two from liver failure.

  11. Strategic directions for university hospitals in Saudi Arabia.

    PubMed

    Bin Abdulrahman, Khalid A; Tawfik, Bassel

    2016-01-01

    The kingdom of Saudi Arabia is currently witnessing a massive support for its healthcare services. This year's fiscal budget for health care is by far the largest in the history of the kingdom. While pursuing the conventional goals of healthcare delivery systems, such as equity, affordability and availability of services, the ministry of education (MOE), formerly called ministry of higher education (MOHE), is also seeking to achieve certain excellence standards, which are expected to set the bar for other countries in the region to follow suit. Almost all, under construction, university hospitals were adopting a paradigm shift in the standard of health care and training provided. This report summarizes these standards.

  12. Do university hospitals perform better than general hospitals? A comparative analysis among Italian regions

    PubMed Central

    Grillo Ruggieri, Tommaso; Podetti, Silvia

    2016-01-01

    Objective The aim of this research was to investigate how university hospitals (UHs) perform compared with general hospitals (GHs) in the Italian healthcare system. Design and setting 27 indicators of overall performance were selected and analysed for UHs and GHs in 10 Italian regions. The data refer to 2012 and 2013 and were selected from two performance evaluation systems based on hospital discharge administrative data: the Inter-Regional Performance Evaluation System developed by the Management and Health Laboratory of the Scuola Superiore Sant'Anna of Pisa and the Italian National Outcome Evaluation Programme developed by the National Agency for Healthcare Services. The study was conducted in 2 stages and by combining 2 statistical techniques. In stage 1, a non-parametric Mann-Whitney U test was carried out to compare the performance of UHs and GHs on the selected set of indicators. In stage 2, a robust equal variance test between the 2 groups of hospitals was carried out to investigate differences in the amount of variability between them. Results The overall analysis gave heterogeneous results. In general, performance was not affected by being in the UH rather than the GH group. It is thus not possible to directly associate Italian UHs with better results in terms of appropriateness, efficiency, patient satisfaction and outcomes. Conclusions Policymakers and managers should further encourage hospital performance evaluations in order to stimulate wider competition aimed at assigning teaching status to those hospitals that are able to meet performance requirements. In addition, UH facilities could be integrated with other providers that are responsible for community, primary and outpatient services, thereby creating a joint accountability for more patient-centred and integrated care. PMID:27507233

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

    PubMed

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

    2013-01-01

    We present the case of a 12-year-old girl referred to Kigali University Teaching Hospital (KUTH) for persistent cough, fever and haemoptysis. Respiratory symptoms started acutely with a stridor at age 4. Thereafter she developed a chronic cough with intermittent fever. She was treated ambulatory in the health care centre with oral antibiotics and finally referred to the district hospital at age 7. The chest X-ray then suggested tuberculosis for which a 6 month treatment was given with no improvement. The cough persisted and haemoptysis appeared so the patient was referred to the reference hospital (KUTH). Chest X-ray showed diffuse lesions of the left lung with bronchiectasis. Bronchoscopy revealed the presence of a foreign body in the left intermediary bronchus and a piece of plastic was extracted. Symptoms rapidly disappeared with antibiotic treatment. This case illustrates how important it is to include foreign body inhalation in the differential diagnosis of respiratory disease in children. Bronchoscopy plays a key role in diagnosis and treatment. The authors point out the advantages of the joint efforts of the Belgian Development Aid Agency (BTC) and the Université libre de Bruxelles (ULB) in the development of this activity in the Rwandese context. PMID:24303659

  14. Clostridium difficile infection in a French university hospital

    PubMed Central

    Khanafer, Nagham; Oltra, Luc; Hulin, Monique; Dauwalder, Olivier; Vandenesch, Francois; Vanhems, Philippe

    2016-01-01

    Abstract The epidemiology of Clostridium difficile infection (CDI) has changed with an increase in incidence and severity. Prospective surveillance was therefore implemented in a French university hospital to monitor the characteristics of patients at risk and to recognize local trends. Between 2007 and 2014, all hospitalized patients (≥18 years) with CDI were included. During the survey, the mean incidence rate of CDI was 2.9 per 10,000 hospital-days. In all, 590 patients were included. Most of the episodes were healthcare-associated (76.1%). The remaining cases were community-acquired (18.1%) and unknown (5.9%). The comparison with healthcare-associated cases showed that the community-acquired group had a lower rate of antimicrobial exposure (P < 0.001), proton pump inhibitor (P < 0.001), and immunosuppressive drugs (P = 0.02). Over the study period, death occurred in 61 patients (10.3%), with 18 (29.5%) being related to CDI according to the physician in charge of the patient. Active surveillance of CDI is required to obtain an accurate picture of the real dimensions of CDI. PMID:27281101

  15. New Integrated Information System for Pusan National University Hospital

    PubMed Central

    Kim, Hyung Hoi; Cho, Kyung-Won; Kim, Hye Sook; Kim, Ju-Sim; Kim, Jung Hyun; Han, Sang Pil; Park, Chun Bok; Kim, Seok

    2011-01-01

    Objectives This study presents the information system for Pusan National University Hospital (PNUH), evaluates its performance qualitatively, and conducts economic analysis. Methods Information system for PNUH was designed by component-based development and developed by internet technologies. Order Communication System, Electronic Medical Record, and Clinical Decision Support System were newly developed. The performance of the hospital information system was qualitatively evaluated based on the performance reference model in order to identify problem areas for the old system. The Information Economics approach was used to analyze the economic feasibility of hospital information system in order to account for the intangible benefits. Results Average performance scores were 3.16 for input layer, 3.35 for process layer, and 3.57 for business layer. In addition, the cumulative benefit to cost ratio was 0.50 in 2011, 1.73 in 2012, 1.76 in 2013, 1.71 in 2014, and 1.71 in 2015. The B/C ratios steadily increase as value items are added. Conclusions While overall performance scores were reasonably high, doctors were less satisfied with the system, perhaps due to the weak clinical function in the systems. The information economics analysis demonstrated the economic profitability of the information systems if all intangible benefits were included. The second qualitative evaluation survey and economic analysis were proposed to evaluate the changes in performance of the new system. PMID:21818459

  16. [Pediatric colonoscopy at the University Hospital of Cocody (Ivory Coast)].

    PubMed

    Okon, J B; Assi, C; Diakité, M; Siaka, K; Ouattara, A; Soro, D; Coulibaly, A; Lohouès, M J; Camara, B M

    2012-01-01

    No published data are available on pediatric colonoscopy in Ivory Coast (and only one report on pediatric gastroscopy). We conducted a retrospective study of all colonoscopy reports of procedures performed from 1 September, 1991, to December 31, 2010, at the University Hospital of Cocody in Abidjan (Ivory Coast) and examined the epidemiological aspects, conditions of performance, indications, and results of colonoscopy in patients younger than 18 years. Eleven of the total of 1 159 colonoscopies were performed in in this age group (0.94%). The mean age of these 8 girls and 3 boys was 15 years (range: 10 to 17 years). All patients had been referred by a gastroenterologist. Bowel preparation was performed in all with a water enema. Premedication was performed exclusively with midazolam. A pediatric colonoscope was used. The colonoscopy was incomplete in 36% of cases (n=4). Rectal bleeding was the main indication. Results were abnormal in 72% of cases (n=8) and the lesions found were juvenile polyps, ulcerative colitis, sigmoid varices, rectocolitis due to a caustic product, and adenomatous polyps. The results of the examination were normal in 3 children. No complications were reported. In conclusion, although the pediatric colonoscopy practice at the University Hospital of Cocody in Abidjan is extremely small, its therapeutic and diagnostic yields are high, particularly in cases of rectal bleeding. Physicians (general practitioners and pediatricians) managing children should not hesitate to ask for a colonoscopy when appropriate.

  17. Stress factors affecting academic physicians at a university hospital.

    PubMed

    Lindfors, Sara; Eintrei, Christina; Alexanderson, Kristina

    2009-01-01

    Research is limited regarding occupational stress in academic physicians; professionals whose work situation includes the three areas of clinical practice, research, and teaching. The aim of this study was to gain knowledge of factors experienced as stressful by academic physicians employed by a university hospital. A questionnaire assessing the frequency and intensity of 36 potentially stressful factors was sent to all 157 academic physicians who were employed at the Linköping University Hospital, Sweden. The response rate was 77%. Both a high frequency and intensity of stress was experienced by 66% of the academic physicians in relation to "time pressure" and by almost 50% in connection with both "find time for research" and having "conflict of interest between different work assignments". Moreover, physicians in the higher age group and those who had attained a higher academic position experienced less stress. The female participants experienced more stress than the males due to gender-related problems and to variables associated with relationships at work. More knowledge is needed to determine the consequences of this finding and to identify coping strategies used for handling such stress.

  18. Air quality in Ain Shams University Surgery Hospital.

    PubMed

    El Awady, M Y; El Rahman, A T Abd; Al Bagoury, L S; Mossad, I M

    2014-12-01

    Through air sampling, it was possible to evaluate microbial contamination in environments at high risk of infection, and to check the efficiency of ventilation system and the medical team's hygiene procedures. This study measured the concentration of particulate matter (PM) 2.5 or less microns and microbiological organisms in operating rooms (OR), intensive care units (ICU) and emergency rooms (ER) in Ain Shams University Surgery Hospital, and to assess ventilation characteristics in operating rooms in the hospital. The passive air sampling was done from ICUs, ORs, and ERs in Ain Shams University Surgery Hospital. Also for each operating room, an observational checklist was done to record other factors that may affect air quality in the room. The evaluated air quality indices were: suspended (PM) 2.5 micrometer or less, culture media and microbial identification of bacteria and fungi, and temperature and relative humidity. The results showed that the highest mean found for bacterial (105.70±30.49) and fungi concentration (7.50±5.30) was in ER. The three settings did not differ statistically as regard levels of PM 2.5, temperature, and relative humidity. A positive correlation exits between bacteria and fungi concentration on one hand and relative humidity on the other. Diphteroid, CONS, MRSA, S. aureus, and Anthracoid were the most frequent isolated bacterial types, while Penicillium and Asperigillus fumigatus were the most frequent isolated fungi. In operating rooms, the percent of unmasked persons present and the temperature positively influence the bacterial count, while ventilation condition is negatively influencing fungi count, and the number of persons present in the operating room positively affects the PM level.

  19. Air quality in Ain Shams University Surgery Hospital.

    PubMed

    El Awady, M Y; El Rahman, A T Abd; Al Bagoury, L S; Mossad, I M

    2014-12-01

    Through air sampling, it was possible to evaluate microbial contamination in environments at high risk of infection, and to check the efficiency of ventilation system and the medical team's hygiene procedures. This study measured the concentration of particulate matter (PM) 2.5 or less microns and microbiological organisms in operating rooms (OR), intensive care units (ICU) and emergency rooms (ER) in Ain Shams University Surgery Hospital, and to assess ventilation characteristics in operating rooms in the hospital. The passive air sampling was done from ICUs, ORs, and ERs in Ain Shams University Surgery Hospital. Also for each operating room, an observational checklist was done to record other factors that may affect air quality in the room. The evaluated air quality indices were: suspended (PM) 2.5 micrometer or less, culture media and microbial identification of bacteria and fungi, and temperature and relative humidity. The results showed that the highest mean found for bacterial (105.70±30.49) and fungi concentration (7.50±5.30) was in ER. The three settings did not differ statistically as regard levels of PM 2.5, temperature, and relative humidity. A positive correlation exits between bacteria and fungi concentration on one hand and relative humidity on the other. Diphteroid, CONS, MRSA, S. aureus, and Anthracoid were the most frequent isolated bacterial types, while Penicillium and Asperigillus fumigatus were the most frequent isolated fungi. In operating rooms, the percent of unmasked persons present and the temperature positively influence the bacterial count, while ventilation condition is negatively influencing fungi count, and the number of persons present in the operating room positively affects the PM level. PMID:25643516

  20. Unit cost analysis in a university hospital: an example from Srinagarind Hospital, Khon Kaen.

    PubMed

    Vatanasapt, V; Kosuwon, W; Pengsaa, P

    1993-12-01

    This is the first analytic study to identify the unit cost in the University Hospital using the standard method of analysis in health economics. The unit costs in the report can be used to calculate the cost of each service for any disease. The costs of the hospital administration cost center and the supportive cost center were both allocated to the patient care service center by the simultaneous allocation method. The cost of teaching personnel was excluded from the analysis because it is quite difficult to estimate and differentiate the ratio of teaching costs to service costs. The hotel cost of the inpatient ward varied from 77.81 baht to 604.7 baht per day. The unit cost per service per day is different from the charge which is presently used at Srinagarind Hospital. Some services, such as in-house transportation are not included in the charge. This study was conducted to identify the unit cost of each service. The decision to establish charges can depend partly on this data and partly on the administrator's judgement. Other factors, such as patient poverty can dictate the final decision. In any case, the hospital and health service center should identify their own unit costs to be able to plan for effective budget management.

  1. Unit cost analysis in a university hospital: an example from Srinagarind Hospital, Khon Kaen.

    PubMed

    Vatanasapt, V; Kosuwon, W; Pengsaa, P

    1993-12-01

    This is the first analytic study to identify the unit cost in the University Hospital using the standard method of analysis in health economics. The unit costs in the report can be used to calculate the cost of each service for any disease. The costs of the hospital administration cost center and the supportive cost center were both allocated to the patient care service center by the simultaneous allocation method. The cost of teaching personnel was excluded from the analysis because it is quite difficult to estimate and differentiate the ratio of teaching costs to service costs. The hotel cost of the inpatient ward varied from 77.81 baht to 604.7 baht per day. The unit cost per service per day is different from the charge which is presently used at Srinagarind Hospital. Some services, such as in-house transportation are not included in the charge. This study was conducted to identify the unit cost of each service. The decision to establish charges can depend partly on this data and partly on the administrator's judgement. Other factors, such as patient poverty can dictate the final decision. In any case, the hospital and health service center should identify their own unit costs to be able to plan for effective budget management. PMID:7798815

  2. [Chronobiological aspects of sleep of nurses in a university hospital].

    PubMed

    Xavier, Karine Gracinda da Silva; Vaghetti, Helena Heidtmann

    2012-01-01

    This study was aimed at identifying the chronotype of nurses in the morning and evening shifts of a university hospital, how these workshifts influence their sleep and correlate chronotypes with influences of sleep on and off the workplace. Fifteen nurses participated in the study by answering to the questionnaire of Horne&Ostberg and semi-structured interviews between March and July 2010. Data from questionnaires were organized into spreadsheets and the interviews were analyzed by thematic analysis. Nurses worked as follows: five in moderately morning shift, four in indifferent shift, two in moderately evening shift, three in evening shift and one in morning shift. Shift work was found to develop peculiar eating and sleep habits. The chronobiological profile did not translate subjectivities regarding sleep and work shifts. Night nurses demonstrated higher dysfunction in sleep-wake cycle, which had an impact on the daily lives of all nurses.

  3. Myelodysplastic syndrome: a review from University Hospital, Kuala Lumpur.

    PubMed

    Ng, S C; Kuperan, P; Bosco, J; Menaka, N

    1990-04-01

    Twenty patients with Myelodysplastic Syndrome (MDS) were diagnosed in University Hospital, Kuala Lumpur over a 5 year period. They were subclassified using the French American British (FAB) criteria. 90% of the patients were above 40 years old and the sex ratio was about equal. The predominant presenting symptom was anaemia and there was paucity of physical signs at presentation. Patients with 'aggressive' subtypes of MDS i.e. refractory anaemia with excess blasts (RAEB), refractory anaemia with excess blasts in transformation (RAEB(-)+) and chronic myelomonocytic leukaemia (CMML) had more frequent thrombocytopenia and neutropenia and their marrow pictures frequently had dysmegakaryopoiesis and dysgranulopoiesis as compared to more the "benign" subtypes i.e. refractory anaemia (RA) and refractory leukaemic anaemia with ringed sideroblasts (RARS). Four patients had leukaemic transformation and all of them came from the 'aggressive' subtypes. The current views on treatment of MDS are discussed.

  4. Parasuicide in Pakistan: experience at a university hospital.

    PubMed

    Khan, M M; Islam, S; Kundi, A K

    1996-04-01

    There have been few reports of parasuicide from Pakistan, where the act is considered to be a criminal offence and the Islamic religion strongly disapproves of it. In order to address the problem, a retrospective case report analysis of all index cases of parasuicide presenting over a period of 3.5 years to a university hospital in Karachi, Pakistan, was undertaken. Our results showed that most of the subjects were young adults, with married women representing the single largest group. Self-poisoning with medication was the most common method, and benzodiazepines the most frequently used drug. Interpersonal conflict with the opposite sex was the most common precipitating cause. In Pakistani culture, marriage appears to be a significant source of stress for women. Reports based on official police records do not reflect the true picture of the problem in Pakistan. PMID:8712026

  5. [Drug supply chain safety in hospitals: current data and experience of the Grenoble university hospital].

    PubMed

    Bedouch, P; Baudrant, M; Detavernier, M; Rey, C; Brudieu, E; Foroni, L; Allenet, B; Calop, J

    2009-01-01

    Drug supply chain safety has become a priority for public health which implies a collective process. This process associates all health professionals including the pharmacist who plays a major role. The objective of this present paper is to describe the several approaches proven effective in the reduction of drug-related problem in hospital, illustrated by the Grenoble University Hospital experience. The pharmacist gets involved first in the general strategy of hospital drug supply chain, second by his direct implication in clinical activities. The general strategy of drug supply chain combines risk management, coordination of the Pharmacy and Therapeutics Committee, selection and purchase of drugs and organisation of drug supply chain. Computer management of drug supply chain is a major evolution. Nominative drug delivering has to be a prior objective and its implementation modalities have to be defined: centralized or decentralized in wards, manual or automated. Also, new technologies allow the automation of overall drug distribution from central pharmacy and the implementation of automated drug dispensing systems into wards. The development of centralised drug preparation allows a safe compounding of high risk drugs, like cytotoxic drugs. The pharmacist should develop his clinical activities with patients and other health care professionals in order to optimise clinical decisions (medication review, drug order analysis) and patients follow-up (therapeutic monitoring, patient education, discharge consultation).

  6. Leprosy in a University Hospital in Southern Brazil*

    PubMed Central

    de Lima, Adma Silva; Pinto, Karin Cristine; Bona, Míryan Priscilla Santos; de Mattos, Suelen Mayara Lopes; Hoffmann, Marina Portiolli; Mulinari-Brenner, Fabiane Andrade; Ottoboni, Vanessa Cristhine Dallolmo

    2015-01-01

    BACKGROUND Leprosy is an infectious disease that may lead to irreversible nerve damage, compromising patient's quality of life and leading to loss of working years. OBJECTIVES To evaluate the epidemiological profile of patients followed at a University Hospital. MATERIALS AND METHODS This is a retrospective observational study, based on a review of medical records. We studied the clinical and epidemiological features of patients with leprosy monitored at the Hospital de Clínicas of the Federal University of Paraná between January 2005 and January 2010. RESULTS The mean age was 47.51, while 35.94% of patients were aged 41-60. The male:female rate was 1.8:1. The most prevalent occupations were: retired, students or rural workers. Patients came mainly from Curitiba or nearby areas, but there were also patients from the countryside. The mean diagnostic delay was 24.57 months. Multibacillary forms prevailed, with the lepromatous variety being the most common, closely followed by the borderline type. Neural enlargement was found in more than 50% of the patients and 48.44% of them developed reactional states. Hemolysis was the most commonly detected drug side effect. Initial functional evaluation was possible in 70% of patients, 55% of whom had disabilities upon diagnosis. The most prevalent associated disease was hypertension. CONCLUSIONS This study showed an important diagnostic delay and a high rate of sequelae in this specific population. Brazil is one of the few remaining countries that has not yet eradicated leprosy and it is important to improve health policies in order to prevent sequelae and achieve eradication. PMID:26560210

  7. Foreign Body Endoscopy Experience of a University Based Hospital

    PubMed Central

    Nassar, Eiad; Yacoub, Rabi; Raad, Dany; Hallman, Jason; Novak, Jan

    2013-01-01

    Background Guidelines support endoscopic removal of certain gastric FB and all FB lodged in the esophagus. We aim to report our experience on endoscopic foreign bodies (FB) removal in order to aid in the formation of future guidelines regarding this subject. Methods Retrospective analysis of one hundred forty-four cases of FB removal involving 43 patients who underwent esophagogastroduodenoscopy (EGD) for FB removal from January 2005 through December 2010 in a university-based hospital. To evaluate to outcome of endoscopic FB removal, cost of procedures and complications. Results Of all FB removal cases, 23 (53%) were males, with total mean age of 26.4 ± 11.3 years. Only 20% were performed on an outpatient bases. Abdominal x-ray was obtained to confirm ingestion of FB in 83%, and computed tomography scan was performed in 13%. Most procedures were performed in operation room (59%) while only 21% of the cases were performed in endoscopy lab. General anesthesia was used in 58%, while monitored anesthesia care in 28%. Average time to EGD was 17.14 hours. No major complications due to procedure were reported. Minor trauma and erosions due to FB were reported in 14%. FB extraction was unsuccessful in only three cases, and one case required surgical intervention. Cost of all procedures was over 430, 000 dollars with mean of 2,990 dollars for procedure. Conclusion Endoscopic retrieval is effective and safe procedure, but utilizes significant hospital resources.

  8. Hospital Universiti Sains Malaysia (HUSM): 25 Years Of Excellent Service

    PubMed Central

    Kamari, Zaidun

    2009-01-01

    Our Hospital University Sains Malaysia (HUSM) was given the Cabinet approval to exist under the Ministry of Education on 23 November 1982. The Deputy Prime Minister during that period, Yang Berhormat Tun Musa Hitam announced this after the cabinet meeting was held together with the presence of the Yang Berhormat Ministers of Health; and Education, Director of the Public Works Department and the Implementation and Coordinating Unit, Prime Minister’s Department. The first patients moved in on 14 March 1983 and the inauguration of HUSM was done on 26 August 1984 by the Duli Yang Maha Mulia Tuanku Ismail Petra Ibni Al-Marhum Sultan Yahya Petra, the Sultan of Kelantan Darul Naim. HUSM celebrated it’s 25th anniversary at the Dewan Utama, USM Health Campus on the 15th December 2008 which was inaugurated by Yang Berhormat, Minister of Higher Education Dato’ Seri Mohamed Khaled Nordin. USM’s Vice Chancellor Professor Tan Sri Dato’ Dzulkifli Abdul Razak, Chairman of the USM Board of Directors Tan Sri Dato’ Haji Dr. Ani bin Arope, Health Campus Director Professor Dato’ Dr. Mafauzy Mohamed, former Campus Director, Dato’ Prof Mohd Roslani Abdul Majid, the current and previous Hospital Directors and Deputy Directors since 1983 were present. The achievements of HUSM since its establishment and its vision to fulfil the University’s Accelerated Programme for Excellence (APEX) are elaborated. PMID:22589644

  9. Microbial Keratitis Profile at a University Hospital in Hong Kong

    PubMed Central

    Lai, Tracy H. T.; Young, Alvin L.

    2014-01-01

    Purpose. To evaluate the recent trends in demographics, risk factors, and microbiological profiles of microbial keratitis at a university hospital in Hong Kong. Design. Retrospective review. Methods. The medical records of 51 patients admitted to the Prince of Wales Hospital for microbial keratitis from January 2010 to June 2012 were reviewed. Demographics, risk factors, clinical features, microbiological results, and treatment were recorded. Data was analyzed and compared to our historical sampled data collected 11 years ago. Results. The mean age of patients was 41.6 ± 20.3 years. Contact lens use was the major risk factor (45%), followed by injury (12%). The culture positive rate was 59%, of which 37% were Gram-positive organisms and 53% were Gram-negative organisms. Pseudomonas aeruginosa (50%) and coagulase-negative Staphylococcus (13%) were the most commonly isolated pathogens. No resistance to fluoroquinolones was identified. Conclusions. Our study showed that contact lens wear remained the major risk factor for microbial keratitis in Hong Kong and Pseudomonas aeruginosa remained the commonest bacterium isolated. This is comparable to our historical data and other studies conducted in East Asia. PMID:27433502

  10. Epidemiology of in-hospital trauma deaths in a Brazilian university hospital

    PubMed Central

    2014-01-01

    Background The analysis of patterns of trauma deaths may improve the evaluation of a trauma system and identify areas that may benefit from more resources. The objective of this study was to analyze the epidemiology of trauma deaths in a Brazilian university hospital in order to assess the profile of these fatalities over a 16-year period. Method Retrospective study of time series using database records. The research subjects were in-hospital deaths from external causes during the years 1995, 2000, 2005 and 2010. The following variables were analyzed: cause of injury, trauma scores, time and cause of death. Results 467 cases were studied, being 325 patients (69.6%) admitted with signs of life and 142 (30.4%) considered dead on arrival. The mean age was 35.35 ± 18.03 years. 85.4% were males. Blunt trauma occurred in 73.0% of cases and penetrating mechanism in 27.0%. There was a significant increase (p < 0.001) in deaths from motorcycle crashes over the years, which went from 7.3% in 1995 to 31.5% in 2010. In contrast, there was a significant decrease (p = 0.030) in firearm-injury victims; from 21.0% in 1995 to 9.6% in 2010. About 60% of deaths occurred less than 24 hours after admission. The main causes of death were lesions of the central nervous system (56.3% of the total), followed by hemorrhagic shock (18.1%) and sepsis/multiple organ dysfunction syndrome (17.1%). The mean Injury Severity Score (ISS) of patients with signs of life was 26.41 ± 9.00, 71.3% of whom had ISS >25. The mean Revised Trauma Score (RTS) was 5.24 ± 2.05. Only 25.8% of the deaths had TRISS <0.50. Conclusion There was a shift in the profile of causes of death from trauma in this university teaching hospital, with a large decrease in penetrating injuries and a higher incidence of deaths of motorcycle riders. PMID:25361609

  11. Hospital Coding Practice, Data Quality, and DRG-Based Reimbursement under the Thai Universal Coverage Scheme

    ERIC Educational Resources Information Center

    Pongpirul, Krit

    2011-01-01

    In the Thai Universal Coverage scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group (DRG) reimbursement. Questionable quality of the submitted DRG codes has been of concern whereas knowledge about hospital coding practice has been lacking. The objectives of this thesis are (1) To explore hospital coding…

  12. Ambulance Services at Hospital Universiti Sains Malaysia and Hospital Kota Bharu: A Retrospective Study of Calls

    PubMed Central

    Shah Che Hamzah, Mohd Shaharudin; Ahmad, Rashidi; Nik Abdul Rahman, Nik Hisamuddin; Pardi, Kasmah Wati; Jaafar, Naimah; Wan Adnan, Wan Aasim; Jaalam, Kamaruddin; Sahil Jamalullail, Syed Mohsin

    2005-01-01

    This retrospective study attempted to identify the pattern of ambulance calls for the past two years at the Hospital Universiti Sains Malaysia (HUSM) and Hospital Kota Bharu (HKB). This study will provide a simple method of acquiring information related to ambulance response time (ART) and to test whether it met the international standards and needs of the client. Additionally, this paper takes into account the management of emergency calls. This included ambulance response time, which was part of Emergency Medical Services (EMS) episode: onset of ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint had been noted. ART ended when the emergency team arrived at the scene of incident. Information regarding ambulance calls from the record offices of HUSM and HKB was recorded for the year 2001 and 2002, tabulated and analyzed. There was a significant difference in the total number of calls managed by HUSM and HKB in the year 2001. It was noted that 645 calls were managed by HUSM while 1069 calls were recorded at HKB. In the year 2002, however, HUSM led with 613 extra numbers of calls as compare to HKB with 1193 numbers of calls. The pattern of ambulance calls observed is thought to possibly be influenced by social activities like local festivities, school holidays and the seasons. Further, it is observed that no studies were previously undertaken to compare the ART at both the HUSM and HKB to that of the international standards. In fact, a literature review undertaken so far showed no similar studies have been done for the whole Malaysia. PMID:22605956

  13. The HOSPITAL score as a predictor of 30 day readmission in a retrospective study at a university affiliated community hospital

    PubMed Central

    2016-01-01

    Introduction Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP) program. Risk assessment tools have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. One such tool is the HOSPITAL score that uses seven readily available clinical variables to predict the risk of readmission within 30 days of discharge. The HOSPITAL score has been internationally validated in large academic medical centers. This study aims to determine if the HOSPITAL score is similarly useful in a moderate sized university affiliated hospital in the midwestern United States. Materials and Methods All adult medical patients discharged from the SIU-SOM Hospitalist service from Memorial Medical Center (MMC) from October 15, 2015 to March 16, 2016, were studied retrospectively to determine if the HOSPITAL score was a significant predictor of hospital readmission within 30 days. Results During the study period, 998 discharges were recorded for the hospitalist service. The analysis includes data for the 931 discharges. Patients who died during the hospital stay, were transferred to another hospital, or left against medical advice were excluded. Of these patients, 109 (12%) were readmitted to the same hospital within 30 days. The patients who were readmitted were more likely to have a length of stay greater than or equal to 5 days (55% vs. 41%, p = 0.005) and were more likely to have been admitted more than once to the hospital within the last year (100% vs. 49%, p < 0.001). A receiver operating characteristic evaluation of the HOSPITAL score for this patient population shows a C statistic of 0.77 (95% CI [0.73–0.81]), indicating good discrimination for hospital readmission. The Brier score for the HOSPITAL score in this setting was 0.10, indicating good overall performance. The Hosmer–Lemeshow goodness of fit test shows a χ2 value of 1

  14. The HOSPITAL score as a predictor of 30 day readmission in a retrospective study at a university affiliated community hospital

    PubMed Central

    2016-01-01

    Introduction Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP) program. Risk assessment tools have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. One such tool is the HOSPITAL score that uses seven readily available clinical variables to predict the risk of readmission within 30 days of discharge. The HOSPITAL score has been internationally validated in large academic medical centers. This study aims to determine if the HOSPITAL score is similarly useful in a moderate sized university affiliated hospital in the midwestern United States. Materials and Methods All adult medical patients discharged from the SIU-SOM Hospitalist service from Memorial Medical Center (MMC) from October 15, 2015 to March 16, 2016, were studied retrospectively to determine if the HOSPITAL score was a significant predictor of hospital readmission within 30 days. Results During the study period, 998 discharges were recorded for the hospitalist service. The analysis includes data for the 931 discharges. Patients who died during the hospital stay, were transferred to another hospital, or left against medical advice were excluded. Of these patients, 109 (12%) were readmitted to the same hospital within 30 days. The patients who were readmitted were more likely to have a length of stay greater than or equal to 5 days (55% vs. 41%, p = 0.005) and were more likely to have been admitted more than once to the hospital within the last year (100% vs. 49%, p < 0.001). A receiver operating characteristic evaluation of the HOSPITAL score for this patient population shows a C statistic of 0.77 (95% CI [0.73–0.81]), indicating good discrimination for hospital readmission. The Brier score for the HOSPITAL score in this setting was 0.10, indicating good overall performance. The Hosmer–Lemeshow goodness of fit test shows a χ2 value of 1

  15. Going all digital in a university hospital: a unified large-scale PACS for multiple departments and hospitals

    NASA Astrophysics Data System (ADS)

    Vogl, Raimund

    2001-08-01

    In 1997, a large PACS was first introduced at Innsbruck University Hospital in the context of a new traumatology centre. In the subsequent years, this initial PACS setting covering only one department was expanded to most of the hospital campus, with currently some 250 viewing stations attached. Constantly connecting new modalities and viewing stations created the demand for several redesigns from the original PACS configuration to cope with the increasing data load. We give an account of these changes necessary to develop a multi hospital PACS and the considerations that lead us there. Issues of personnel for running a large scale PACS are discussed and we give an outlook to the new information systems currently under development for archiving and communication of general medical imaging data and for simple telemedicine networking between several large university hospitals.

  16. INTESTINAL PARASITES IN DIABETIC PATIENTS IN SOHAG UNIVERSITY HOSPITALS, EGYPT.

    PubMed

    Elnadi, Nada A; Hassanien, Hassan A; Ahmad, Amal M; Abd Ellah, Asmaa K

    2015-08-01

    Intestinal parasites usually create benign diseases, though they may induce complications with high morbidity and mortality to the immunocompromised, including diabetic patients. The study detected the prevalence of intestinal parasitic infections in diabetic patients, comparing to non-diabetic controls and other parameters. A total of 100 fecal samples were collected from diabetic patients at the outpatient clinic of Sohag University Hospitals and another 100 from cross matched controls. The samples were examined macroscopically and microscopically by direct smear and different concentration methods then stained by Modified Ziehl-Neelsen Acid fast stain. Glycated hemoglobin (Hb Alc) was measured to detect DM controlled patients. The data were organized, tabulated, and statistically analyzed. Intestinal parasites were found in 25 (25%) cases out of 100 patients in diabetic group and 7(7%) cases out of 100 controls with high significance (P<0.001)). In the diabetic group, Giardia lamblia was detected in 22 cases (22%) and 5 (5%) among controls, Entamoeba histolytica in 7 cases (7%) and 3 (3%) among controls, Hymenolypis nana in 5 cases (5%) and 3 (3%) among controls, Entamoeba coli in 8 patients (8%), Entamoeba hartmanni in 3 cases (3%), Dientamoeba fragilis in a case (1%), Cryptosporidium parvum in 5 cases (5%) and microsporidia in 3 cases (3%). But, E. coli, E. hartmanni, D. fragilis and C. parvum nor microsporidia were detected in controls. The rate of G. lamblia in DM patients compared to controls was high significant (P<0.001). Hymenolepis nana was 5% (5 cases) in diabetic patients compared to 3% (3 cases) in controls. Residence and sex differences were not significant, while age, >10 years showed the highest prevalence (P< 0.003), type I infection rate was significantly higher than type II (P<0.001). DM control was also significantly affected the infection rates (P<0.007 in type I and P< 0.01 in type II). PMID:26485865

  17. Dynamic network data envelopment analysis for university hospitals evaluation

    PubMed Central

    Lobo, Maria Stella de Castro; Rodrigues, Henrique de Castro; André, Edgard Caires Gazzola; de Azeredo, Jônatas Almeida; Lins, Marcos Pereira Estellita

    2016-01-01

    ABSTRACT OBJECTIVE To develop an assessment tool to evaluate the efficiency of federal university general hospitals. METHODS Data envelopment analysis, a linear programming technique, creates a best practice frontier by comparing observed production given the amount of resources used. The model is output-oriented and considers variable returns to scale. Network data envelopment analysis considers link variables belonging to more than one dimension (in the model, medical residents, adjusted admissions, and research projects). Dynamic network data envelopment analysis uses carry-over variables (in the model, financing budget) to analyze frontier shift in subsequent years. Data were gathered from the information system of the Brazilian Ministry of Education (MEC), 2010-2013. RESULTS The mean scores for health care, teaching and research over the period were 58.0%, 86.0%, and 61.0%, respectively. In 2012, the best performance year, for all units to reach the frontier it would be necessary to have a mean increase of 65.0% in outpatient visits; 34.0% in admissions; 12.0% in undergraduate students; 13.0% in multi-professional residents; 48.0% in graduate students; 7.0% in research projects; besides a decrease of 9.0% in medical residents. In the same year, an increase of 0.9% in financing budget would be necessary to improve the care output frontier. In the dynamic evaluation, there was progress in teaching efficiency, oscillation in medical care and no variation in research. CONCLUSIONS The proposed model generates public health planning and programming parameters by estimating efficiency scores and making projections to reach the best practice frontier. PMID:27191158

  18. Computed Tomography Utilization in a Tertiary Care University Hospital

    PubMed Central

    Boone, John M.; Brunberg, James A.

    2009-01-01

    Purpose Improvements in computed tomography (CT) technology, with shorter scan times and better image quality, have contributed to an increase in the use of CT in the United States in recent years. This increased use has implications both for health policy and radiation risk assessment. The purpose of this study was to evaluate trends in CT utilization. Methods The CT performance records at a university-based, tertiary care, level 1 trauma center hospital were evaluated from 1998 through 2005. The hospital’s decision support infrastructure was used to track overall patient visits and stays. From these data sets, the age and sex dependency of CT utilization rates were evaluated for out-patients, in-patients, and emergency room patients. Results Out-patient utilization rates averaged over the age groups of 21–30 years old, 41–50 years, and 61–70 years were 20, 59, and 87 CT scans per 1000 out-patient visits, respectively. In-patient use for these same age group were 88, 148, and 162 CT scans per 1000 in-patient-days. CT utilization rates for emergency room (ER) patients were 705, 687, and 394 CT scans per 1000 ER patient visits, for the same 3 age groups. Male patients outnumbered female patients for both emergency room and in-patient CT utilization from the early teens through the mid-40s. Conclusions Overall use of computed tomography increased 27% from 2000 to 2004 for out-patient visits, and 48% over the same period for in-patients. CT utilization in our very high volume emergency room (ER), from 2000 to 2004, increased 131%. Part of the ER increased CT utilization may be due to the installation of two CT scanners near the ER. PMID:18242530

  19. Enterococcal urinary tract infections in a university hospital: clinical studies.

    PubMed

    Barros, Milton; Martinelli, Reinaldo; Rocha, Heonir

    2009-08-01

    Although urinary tract infections (UTI) represent the most common infection caused by enterococci, some aspects remain to be fully clarified. The aim of this study was to determine the clinical characteristics present in UTI caused by Enterococcus spp. in patients followed up at the Prof. Edgard Santos Teaching Hospital of the Federal University of Bahia. All patients consecutively examined between 1997 and 2005, who received a diagnosis of UTI caused by Enterococcus spp. were included in the study. UTI was defined as the presence of > or = 10(5) colony-forming units per mL of urine. Standard microbiological techniques were used. During the study period, 6.2% of the urine cultures were positive for Enterococcus spp. The mean age of the patients was 48.9 years and 57% were male. At initial evaluation, 13% of the patients had complaints suggestive of UTI. Nineteen patients had a history consistent with obstructive uropathy and 26 with neurogenic bladder. At final evaluation, UTI was the diagnosis in 48 patients. In 36 patients (29%), the primary diagnosis was related to urogenital diseases, consisting of obstructive uropathy in 23 of these cases, while in 32 patients (25.8%) primary diagnosis was related to neurologic diseases, frequently neurogenic bladder. UTI caused by Enterococcus spp. is not infrequent, is usually associated with few or no symptoms and occurs in sick patients who have anatomical or functional obstructive uropathy associated or not with urinary tract catheterization or instrumentation. The diagnosis of enterococcal UTI may indicate a urinary tract abnormality yet to be diagnosed. PMID:20231994

  20. Community-, Healthcare- and Hospital-Acquired Severe Sepsis Hospitalizations in the University HealthSystem Consortium

    PubMed Central

    Page, David B.; Donnelly, John P.; Wang, Henry E.

    2015-01-01

    Objectives Severe sepsis poses a major burden on the U.S. healthcare system. Previous epidemiologic studies have not differentiated community-acquired severe sepsis from healthcare-associated severe sepsis or hospital-acquired severe sepsis hospitalizations. We sought to compare and contrast community-acquired severe sepsis, healthcare-associated severe sepsis, and hospital-acquired severe sepsis hospitalizations in a national hospital sample. Setting United States Interventions None Measurements & Main Results Prevalence of community-acquired severe sepsis, healthcare-associated severe sepsis, and hospital-acquired severe sepsis, adjusted hospital mortality, length of hospitalization, length of stay in an ICU, and hospital costs. Among 3,355,753 hospital discharges, there were 307,491 with severe sepsis, including 193,081 (62.8%) community-acquired severe sepsis, 79,581 (25.9%) healthcare-associated severe sepsis, and 34,829 (11.3%) hospital-acquired severe sepsis. Hospital-acquired severe sepsis and healthcare-associated severe sepsis exhibited higher in-hospital mortality than community-acquired severe sepsis (hospital-acquired [19.2%] vs healthcare-associated [12.8%] vs community-acquired [8.6%]). Hospital-acquired severe sepsis had greater resource utilization than both healthcare-associated severe sepsis and community-acquired severe sepsis, with higher median length of hospital stay (hospital acquired [17 d] vs healthcare associated [7 d] vs community-acquired [6 d]), median length of ICU stay (hospital-acquired [8 d] vs healthcare-associated [3 d] vs community-acquired [3 d]), and median hospital costs (hospital-acquired [$38,369] vs healthcare-associated [$8,796] vs community-acquired [$7,024]). Conclusions In this series, severe sepsis hospitalizations included CA-SS (62.8%), HCA-SS (25.9%) and HA-SS (11.3%) cases. HA-SS was associated with both higher mortality and resource utilization than CA-SS and HCA-SS. PMID:26110490

  1. Activity-based costing and its application in a Turkish university hospital.

    PubMed

    Yereli, Ayşe Necef

    2009-03-01

    Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey. PMID:19269382

  2. Activity-based costing and its application in a Turkish university hospital.

    PubMed

    Yereli, Ayşe Necef

    2009-03-01

    Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey.

  3. The Day Reagan Was Shot: How a University Hospital PR Staff Handled the Crisis.

    ERIC Educational Resources Information Center

    Turk, Emily R.; And Others

    1981-01-01

    The experiences of George Washington University Hospital's public relations staff when it handled the crisis of the shooting of President Reagan is described. Security, choice of a spokesperson, relations with the news media, dealing with VIPs, etc., are discussed. (MLW)

  4. University Hospital Struck Deaf and Silent by Lightning: Lessons to Learn.

    PubMed

    Dami, Fabrice; Carron, Pierre-Nicolas; Yersin, Bertrand; Hugli, Olivier

    2015-08-01

    We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident. PMID:25912779

  5. University Hospital Struck Deaf and Silent by Lightning: Lessons to Learn.

    PubMed

    Dami, Fabrice; Carron, Pierre-Nicolas; Yersin, Bertrand; Hugli, Olivier

    2015-08-01

    We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident.

  6. Hospitable Gestures in the University Lecture: Analysing Derrida's Pedagogy

    ERIC Educational Resources Information Center

    Ruitenberg, Claudia

    2014-01-01

    Based on archival research, this article analyses the pedagogical gestures in Derrida's (largely unpublished) lectures on hospitality (1995/96), with particular attention to the enactment of hospitality in these gestures. The motivation for this analysis is twofold. First, since the large-group university lecture has been widely critiqued as…

  7. Charges by Residents and Faculty Physicians in a University Hospital Pediatric Practice.

    ERIC Educational Resources Information Center

    Berkelhamer, Jay E.

    1986-01-01

    The impact of pediatric residents on total patient charges generated in the outpatient pediatric practice of a university hospital was evaluated. Average charges for visits to residents were greater than for visits to faculty pediatricians. The difference was attributable to the higher number of hospital laboratory tests ordered by residents.…

  8. Refreshing campaign aims to revive rehab referrals. Staten Island University Hospital reinforces rehab credentials.

    PubMed

    Botvin, Judith D

    2002-01-01

    Staten Island University Hospital, Staten Island, N.Y., runs a campaign to REinforce its REcognition as an excellent Rehabilitiation center. Radio and print ads reach a large community, while a direct mail campaign targets hospital social workers and discharge personnel with fun-loving, RElated gifts. PMID:11833237

  9. Chicago blizzard found University of Chicago Hospitals prepared for weather crisis.

    PubMed

    1999-01-01

    The University of Chicago Hospitals has planned for every kind of crisis, including last January's snow-storm of the decade. Executives only used internal communication and situation updates to ensure the hospital was ready to cope with adequate staffing and supply demands. PMID:10387295

  10. Universal neonatal audiological screening: experience of the University Hospital of Pisa.

    PubMed

    Ghirri, Paolo; Liumbruno, Annalisa; Lunardi, Sara; Forli, Francesca; Boldrini, Antonio; Baggiani, Angelo; Berrettini, Stefano

    2011-04-11

    The early identification of pre-lingual deafness is necessary to minimize the consequences of hearing impairment on the future communication skills of a baby. According to the most recent international guidelines the deafness diagnosis must occur before the age of three months and the prosthetic-rehabilitative treatment with a traditional hearing aid should start within the first six months. When a Cochlear implant becomes necessary, the treatment should start between the age of 12 months and 18 months. The only way to diagnose the problem early is the implementation of universal neonatal audiological screening programs. Transient evoked otoacoustic emissions (TEOAE) is the most adequate test because it's accurate, economic and of simple execution. Automatic auditory brainstem response (AABR) is necessary to identify patients with auditory neuropathy but it is also important to reduce the number of false-positives.The 20-30% of infant hearing impairment is represented by progressive or late-onset hearing loss (HL) so it's also necessary to establish an audiological follow up program, especially in infants at risk.From November 2005 all neonates born in the University hospital of Pisa undergo newborn hearing screening. From 2008 the screening program follows the guidelines for the execution of the audiological screening in Tuscany which have been formulated by our group according to the 2007 JCIH Position Statement and adaptated to our regional reality by a multidisciplinary effort. From November 2005 to April 2009 8113 neonates born in the Neonatal Unit of Santa Chiara Hospital (Pisa) have undergone newborn hearing screening. 7621 neonates (93.9%) without risk factors executed only the TEOAE test. 492 (6.1%) neonates had audiological risk factors and thus underwent TEOAE and AABR. 84 patients (1,04%) failed both TEOAE and AABR tests. 78 of them underwent further investigations. 44 patients resulted false positives (the 0,54% of the screened newborns). 34 neonates

  11. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    PubMed

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods. PMID:27601396

  12. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    PubMed

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods.

  13. PAHO'S Strategy for Universal Access to Health and Universal Health Coverage: implications for health services and hospitals in LAC.

    PubMed

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

    Moving towards Universal Access to Health and Universal Health Coverage (UAH/UHC) is an imperative task on the health agenda for the Americas. The Directing Council of the Pan American Health Organization (PAHO) recently approved resolution CD53.R14, titled Strategy for Universal Access to Health and Universal Health Coverage. From the perspective of the Region of the Americas, UAH/UHC "imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, affordable, effective, quality medicines, while ensuring that the use of these services does not expose users to financial hardship, especially groups in conditions of vulnerability". PAHO's strategic approach to UAH/UHC sets out four specific lines of action toward effective universal health systems. The first strategic line proposes: a) implementation of integrated health services delivery networks (IHDSNs) based on primary health care as the key strategy for reorganizing, redefining and improving healthcare services in general and the role of hospitals in particular; and b) increasing the response capacity of the first level of care. An important debate initiated in 2011 among hospital and healthcare managers in the region tried to redefine the role of hospitals in the context of IHSDNs and the emerging UAH/UHC movement. The debates resulted in agreements around three main propositions: 1) IHSDNs cannot be envisioned without hospitals; 2) The status-quo and current hospital organizational culture makes IHSDNs inviable; and 3) Without IHSDNs, hospitals will not be sustainable. This process, that predates the approval of PAHO's UAH/UHC resolution, now becomes more relevant with the recognition that UAH/UHC cannot be attained without a profound change in healthcare service and particularly in hospitals. In this context, a set of challenges both for

  14. Wide-area network connecting a hospital drug informatics center with a university.

    PubMed

    Malone, P M; Young, W W; Malesker, M A

    1998-06-01

    A wide-area network (WAN) connecting a new drug informatics center in a university-affiliated hospital with the university's campus-based computer network is described. In 1994 a pharmacy school developed a drug informatics center in an affiliated hospital. The center was originally designed around a local-area network (LAN) to be located at the hospital and planned to provide clients with easy access to typical productivity software and various electronic information resources. Only occasional modem connections to the university network were envisioned. However, large price increases in information retrieval systems and decreases in the cost of a frame relay connection (T1 line) to the campus network led to the installation of a WAN when the drug informatics center was established. Technical, political, and legal problems were overcome, and the connection was made. The WAN gave faculty and students at the hospital access to many of the university's computing and Internet resources. In addition, the faculty and students have access to various files and programs available only on the drug informatics center's file server at the affiliated hospital. It cost about $6500 to install all WAN equipment and maintain the frame relay for the first year, or a third of what would have been necessary for information retrieval software had a separate LAN been established at the hospital. A WAN connecting a drug informatics center and a university's computer network gave the center access to more electronic information resources at lower cost than would have been possible with a separate LAN.

  15. [Hospital staff use of generic essential drugs: the case of Yalgado Ouedraogo University Hospital Centre (Burkina Faso)].

    PubMed

    Savadogo, Léon G B; Sondo, Blaise; Guissou, Innocent Pierre; Kouanda, Seni; Dujardin, Bruno

    2002-01-01

    With the institution of the primary health care strategy in 1978 and the devaluation of the CFA franc in 1994 the French-speaking countries of Africa are striving to encourage the prescription of generic essential drugs. However, their prescription rates continue to remain low in these countries, especially in the major hospitals. The aim of this study was thus to determine how prescribers at the national hospital in Ouagadougou were informed about genetric drugs and to analyse their attitudes and practices with a view to elucidating the barriers to a more widespread use of generic essential drugs in hospital practice. The study consisted of a survey of all of the qualified prescribers (n=194) at Yalgado Ouedraogo University Hospital Centre in 1998. Thirty refused to participate and 35 questionnaires were discarded because they were poorly filled out. So, the responses of 129 (66.5%) prescribers in all were analysed. More than 80% (106/129) of the prescribers were aware of the existence of generic drugs in the hospital, but only 24.8% of them considered generics to have the same efficacy as their corresponding proprietary drugs. However, 64.3% of the prescribers felt that there was a place for generic drugs in a last-resort echelon of medical care, such as the national hospital in Ouagadougou, and 85.3 % were willing to prescribe them for their patients because of their low cost. The analysis of the data and the responses to the open questions show that the main conditions that would boost the prescription of generic essential drugs by hospital staff are as follows: generic essential drugs available in appropriate dosage forms and of guaranteed quality; appropriate basic training starting in medical and nursing schools; providing the prescribers with information and further education about generic drugs; and better dispensing of these drugs by the hospital's central pharmacy.

  16. The universal newborn hearing screening program at the University Hospital of Ferrara: focus on costs and software solutions.

    PubMed

    Ciorba, Andrea; Hatzopoulos, Stavros; Busi, Micol; Guerrini, Piero; Petruccelli, Joseph; Martini, Alessandro

    2008-06-01

    In the present paper, the authors report the results of the Universal Newborn Hearing Screening (UNHS) project at the University Hospital of Ferrara. A total of 6,759 full-term newborns and a total of 1,016 NICU babies were tested at the University Hospital of Ferrara, from January 2000 to December 2006. The paper presents information from clinically acceptable screening procedures developed and tested during the 6 years of the program and addresses two questions pertinent to hearing screening: (i) the cost-estimate of a UNHS program based on European economical and administration premises and (ii) the development of a database-structure for the evaluation of the UNHS/NHS performance and the individual patient tracking.

  17. Body Mass Index and Hospital Mortality in Patients with Acute Coronary Syndrome Receiving Care in a University Hospital

    PubMed Central

    Camprubi, Mercedes; Cabrera, Sandra; Sans, Jordi; Vidal, Georgina; Salvadó, Teresa; Bardají, Alfredo

    2012-01-01

    Although obesity is a well-established cardiovascular risk factor, some controversy has arisen with regard to its effect on hospital mortality in patients admitted for acute coronary syndrome. Methods. Clinical and anthropometric variables were analyzed in patients consecutively admitted for acute coronary syndrome to a university hospital between 2009 and 2010, and the correlation of those variables with hospital mortality was examined. Results. A total of 824 patients with a diagnosis of myocardial infarction or unstable angina were analyzed. Body mass index was an independent factor in hospital mortality (odds ratio 0.739 (IC 95%: 0.597 − 0.916), P = 0.006). Mortality in normal weight (n = 218), overweight (n = 399), and obese (n = 172) subjects was 6.1%, 3.1%, and 4.1%, respectively, with no statistically significant differences between the groups. Conclusions. There is something of a paradox in the relationship between body mass index and hospital mortality in patients with acute coronary syndrome in that the mortality rate decreases as body mass index increases. However, no statistically significant differences have been found in normal weight, overweight, or obese subjects. PMID:22900151

  18. Do Spanish Hospital Professionals Educate Their Patients About Advance Directives? : A Descriptive Study in a University Hospital in Madrid, Spain.

    PubMed

    Pérez, María; Herreros, Benjamín; Martín, M Dolores; Molina, Julia; Kanouzi, Jack; Velasco, María

    2016-06-01

    It is unknown whether hospital-based medical professionals in Spain educate patients about advance directives (ADs). The objective of this research was to determine the frequency of hospital-based physicians' and nurses' engagement in AD discussions in the hospital and which patient populations merit such efforts. A short question-and-answer-based survey of physicians and nurses taking care of inpatients was conducted at a university hospital in Madrid, Spain. In total, 283 surveys were collected from medical professionals, of whom 71 per cent were female, with an average age of thirty-four years. Eighty-four per cent had never educated patients about ADs because of lack of perceived responsibility, time, or general knowledge of ADs. Patient populations that warranted AD discussions included those with terminal illnesses (77 per cent), chronic diseases (61 per cent), and elderly patients (43 per cent). Regarding degree of AD understanding in medical professionals: 57 per cent of medical professionals claimed sufficient general knowledge of ADs, 19 per cent understood particulars regarding AD document creation, and 16 per cent were aware of AD regulatory policies. Engagement in AD discussions was considered important by 83 per cent of medical professionals, with 79 per cent interested in participating in such discussions themselves. The majority of hospital physicians and nurses do not educate their patients about ADs, despite acknowledging their importance. Patient populations of highest priority included those with terminal diseases or chronic illness or who are of advanced age. PMID:26797513

  19. 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

  20. Hospital costs fell as numbers of LVADs were increasing: experiences from Oslo University Hospital

    PubMed Central

    2012-01-01

    Background The current study was undertaken to examine total hospital costs per patient of a consecutive implantation series of two 3rd generation Left Ventricle Assist Devices (LVAD). Further we analyzed if increased clinical experience would reduce total hospital costs and the gap between costs and the diagnosis related grouped (DRG)-reimbursement. Method Cost data of 20 LVAD implantations (VentrAssist™) from 2005-2009 (period 1) were analyzed together with costs from nine patients using another LVAD (HeartWare™) from 2009-June 2011 (period 2). For each patient, total costs were calculated for three phases - the pre-LVAD implantation phase, the LVAD implantation phase and the post LVAD implant phase. Patient specific costs were obtained prospectively from patient records and included personnel resources, medication, blood products, blood chemistry and microbiology, imaging and procedure costs including operating room costs. Overhead costs were registered retrospectively and allocated to the specific patient by predefined allocation keys. Finally, patient specific costs and overhead costs were aggregated into total hospital costs for each patient. All costs were calculated in 2011-prices. We used regression analyses to analyze cost variations over time and between the different devices. Results The average total hospital cost per patient for the pre-LVAD, LVAD and post-LVAD for period 1 was $ 585, 513 (range 132, 640- 1 247, 299), and the corresponding DRG- reimbursement (2009) was $ 143, 192 . The mean LOS was 54 days (range 12- 127). For period 2 the total hospital cost per patient was $ 413, 185 (range 314, 540- 622, 664) and the corresponding DRG- reimbursement (2010) was $ 136, 963. The mean LOS was 49 days (range 31- 93). The estimates from the regression analysis showed that the total hospital costs, excluding device costs, per patient were falling as the number of treated patients increased. The estimate from the trend variable was -14, 096 US$ (CI -3

  1. From HIS to IAIMS: expanding the scope of information processing applications in a German university hospital.

    PubMed Central

    Prokosch, H. U.; Puhle, B.; Müller, M.; Wagner, R.; Junghans, G.; Marquardt, K.; Dudeck, J.

    1994-01-01

    Since the mid eighties the department of medical informatics at the University Hospital of Giessen (Germany) has been engaged in the development of a comprehensive hospital information system. The installation of a campus wide network has set the basis to provide not only clinical patient-oriented information, but also general information resources for research, medical education and administrative purposes, thus creating an environment which in the U.S. became known as an integrated academic information management system (IAIMS). The underlying concept of the whole approach is to provide one-stop information shopping capabilities at the clinicians and administrators desktop in order to meet the increasing information needs of health professionals with the emerging reality of the potential benefits of computer and communication technologies. This paper describes the various steps performed to realize this concept at Giessen University Hospital and the evaluation results derived from analysis of the acceptance of these new technologies among our hospital staff. PMID:7949903

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

    PubMed

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

    2016-07-01

    Although organ transplantation is well established for end-stage organ failure, many patients die on waiting lists due to insufficient donor numbers. Recently, there has been renewed interest in donation after circulatory death (DCD). In a retrospective observational study we reviewed the screening of patients considered for DCD between March 2007 and December 2012 in our hospital. Overall, 148 patients were screened, 17 of whom were transferred from other hospitals. Ninety-three patients were excluded (53 immediately and 40 after review by donation staff). The 55 DCD patients were younger than those excluded (P=0.007) and they died from hypoxic brain injury (43.6%), intraparenchymal haemorrhage (21.8%) and subarachnoid haemorrhage (14.5%). Antemortem heparin administration and bronchoscopy occurred in 50/53 (94.3%) and 22/55 (40%) of cases, respectively. Forty-eight patients died within 90 minutes and proceeded to donation surgery. Associations with not dying in 90 minutes included spontaneous ventilation mode (P=0.022), absence of noradrenaline infusion (P=0.051) and higher PaO2:FiO2 ratio (P=0.052). The number of brain dead donors did not decrease over the study period. The time interval between admission and death was longer for DCD than for the 45 brain dead donors (5 [3-11] versus 2 [2-3] days; P<0.001), and 95 additional patients received organ transplants due to DCD. Introducing a DCD program can increase potential organ donors without reducing brain dead donors. Antemortem investigations appear to be acceptable to relatives when included in the consent process.

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

    PubMed

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

    2016-07-01

    Although organ transplantation is well established for end-stage organ failure, many patients die on waiting lists due to insufficient donor numbers. Recently, there has been renewed interest in donation after circulatory death (DCD). In a retrospective observational study we reviewed the screening of patients considered for DCD between March 2007 and December 2012 in our hospital. Overall, 148 patients were screened, 17 of whom were transferred from other hospitals. Ninety-three patients were excluded (53 immediately and 40 after review by donation staff). The 55 DCD patients were younger than those excluded (P=0.007) and they died from hypoxic brain injury (43.6%), intraparenchymal haemorrhage (21.8%) and subarachnoid haemorrhage (14.5%). Antemortem heparin administration and bronchoscopy occurred in 50/53 (94.3%) and 22/55 (40%) of cases, respectively. Forty-eight patients died within 90 minutes and proceeded to donation surgery. Associations with not dying in 90 minutes included spontaneous ventilation mode (P=0.022), absence of noradrenaline infusion (P=0.051) and higher PaO2:FiO2 ratio (P=0.052). The number of brain dead donors did not decrease over the study period. The time interval between admission and death was longer for DCD than for the 45 brain dead donors (5 [3-11] versus 2 [2-3] days; P<0.001), and 95 additional patients received organ transplants due to DCD. Introducing a DCD program can increase potential organ donors without reducing brain dead donors. Antemortem investigations appear to be acceptable to relatives when included in the consent process. PMID:27456178

  4. A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage Scheme

    PubMed Central

    2011-01-01

    Background In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Methods Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large), location (urban/rural), and type (public/private). Results Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1) Discharge Summarization, 2) Completeness Checking, 3) Diagnosis and Procedure Coding, 4) Code Checking, 5) Relative Weight Challenging, 6) Coding Report, and 7) Internal Audit. The hospital coding practice can be affected by at least five main factors: 1) Internal Dynamics, 2) Management Context, 3) Financial Dependency, 4) Resource and Capacity, and 5) External Factors. Conclusions Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors. PMID:21477310

  5. [Efforts to achieve and effects of acquiring ISO 15189 in Tokushima University Hospital].

    PubMed

    Shono, Kazuko; Kishi, Misako; Satou, Mituyo; Nagamine, Yasunori; Doi, Tosio

    2009-12-01

    The medical laboratory of Tokushima University Hospital acquired ISO 15189, an international standard for medical laboratories, on July 6th, 2007, resulting in it achieving the 24th place in Japan and 5th place among national university hospitals. The first surveillance was just performed on October 6th, 2008. Tokushima University Hospital, in which our medical laboratory is included as one section, already succeeded in acquiring ISO 9001, PrivacyMark System, and Quality Health Care ver. 5 before accomplishing ISO 15189. To achieve ISO 15189, we prepared documents based on ISO 9001 without any consultation, resulting in a review of the difference between ISO 9001 and ISO 15189 after the preliminary survey. Although achieving ISO 15189 resulted in an improvement in the reliability of laboratory results and accuracy, leading to the development of our technical skills and awareness, and sharing of knowledge, we consider that the considerable investment of time to prepare the requirements remains to be overcome.

  6. APACHE II: preliminary report on 100 intensive care unit cases in University Hospital, Kuala Lumpur.

    PubMed

    Teoh, G S; Mah, K K; abd Majid, S; Streram; Yee, M K

    1991-03-01

    A good overall assessment of the severity of illnesses of patients admitted to a general intensive care unit (ICU) is not without problems. The APACHE (acute physiology and chronic health evaluation) prognostic scoring system enables us to stratify acutely ill patients and compare efficiency of ICU therapy in different hospitals. This preliminary study carried out on 100 consecutive admissions to the ICU in University Hospital, Kuala Lumpur showed the spectrum of ICU admissions and the direct relationship between APACHE II score and mortality.

  7. Quality of care in university hospitals in Saudi Arabia: a systematic review

    PubMed Central

    Aljuaid, Mohammed; Mannan, Fahmida; Chaudhry, Zain; Rawaf, Salman; Majeed, Azeem

    2016-01-01

    Objectives To identify the key issues, problems, barriers and challenges particularly in relation to the quality of care in university hospitals in the Kingdom of Saudi Arabia (KSA), and to provide recommendations for improvement. Methods A systematic search was carried out using five electronic databases, for articles published between January 2004 and January 2015. We included studies conducted in university hospitals in KSA that focused on the quality of healthcare. Three independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their relevant characteristics. All studies were assessed using the Institute of Medicine indicators of quality of care. Results Of the 1430 references identified in the initial search, eight studies were identified that met the inclusion criteria. The included studies clearly highlight a need to improve the quality of healthcare delivery, specifically in areas of patient safety, clinical effectiveness and patient-centredness, at university hospitals in KSA. Problems with quality of care could be due to failures of leadership, a requirement for better management and a need to establish a culture of safety alongside leadership reform in university hospitals. Lack of instructions given to patients and language communication were key factors impeding optimum delivery of patient-centred care. Decision-makers in KSA university hospitals should consider programmes and assessment tools to reveal problems and issues related to language as a barrier to quality of care. Conclusions This review exemplifies the need for further improvement in the quality of healthcare in university hospitals in KSA. Many of the problems identified in this review could be addressed by establishing an independent body in KSA, which could monitor healthcare services and push for improvements in efficiency and quality of care. PMID:26916686

  8. [Coronary angioplasty: experience at the University Hospital of Madrid].

    PubMed

    Iñiguez, A; Macaya, C; Bañuelos, C; Rodrigo, J L; García-Espinosa, A; Gil Aguado, M; Miquel, J; Herrero, C; Ferrero, J; Pérez Casar, F

    1990-10-01

    The results of 963 consecutive coronary angioplasties, with 1.135 lesions attempted in 816 patients, were prospectively analyzed. Initial angiographic success (residual stenosis less than 50%) was achieved in 1.017 lesions (89.6%), and final success was obtained in 838/963 procedures (87%). Major complications included: emergency surgery in 4 cases (0.4%), acute myocardial infarction in 28 (2.9%), and death during hospitalization in nine (0.9%). Surgical stand-by was required only for cases with vital risk should the attempted vessel occlude. This criteria was present in 230 (23.8%) angioplasties. Coronary angioplasty was performed during the diagnostic procedure in 300 (31.1%) case, with final success in 264 (88%) of them. A exercise test was achieved before the procedure in 419 (50%) successful angioplasties and in 246 (58.7%) of them it was abnormal because of angina (with or without ST depression). After procedure, exercise could be performed in 780 cases (93%), and the result remained unchanged in only 44 (5.6%) (p less than 0.01). At discharge 780 (93%) patients with final success considered themselves clinically improved. In our experience, coronary angioplasty is a good myocardial revascularization technique, with high success, low rate of major complications, and that provides a good clinical outcome. Surgical stand-by may be unnecessary in prost of angioplasty procedures if patients selection is carefully done, also, this approach makes it possible to perform angioplasty at time of diagnostic catheterization.

  9. Microbiota associated with tramp ants in a Brazilian University Hospital.

    PubMed

    Teixeira, Maxelle M; Pelli, Afonso; Santos, Vitorino M Dos; Reis, Maria das G

    2009-01-01

    Our aim was to study the fauna of ants in the Hospital Universitário of the Universidade Federal do Triângulo Mineiro, municipality of Uberaba, Minas Gerais State, Brazil, as well as to identify the microorganisms the ants carry and their patterns of resistance to antibiotics. Sterile tubes (traps) containing honey were used to attract the ants. Traps were exposed for 3h, and those which attracted ants were considered the test group, while the ones that did not attract the insects constituted the control group. Only the ant species Tapinoma melanocephalum (Fabricius) was sampled. Sixty microorganisms were isolated from the sampled ants, including seven Gram-positive bacilli, 14 Gram-negative bacilli, 22 Gram-positive cocci and 17 filamentous fungi. Pseudomonas, Staphylococcus and Group D Streptococcus were the microorganisms with the highest resistance to the tested antibiotics. The ants should be considered an important vector of infections as they carry several pathogenic microorganisms, spreading them on the surface of sterile materials, equipment and uncontaminated food. It is impossible to define the exact role of ants in nosocomial infections at this moment; however, this issue must be better studied and special attention must be given by the commissions of Nosocomial Infection Control.

  10. Risk factors for recurrent hospital-acquired Clostridium difficile infection in a Japanese university hospital

    PubMed Central

    Hikone, Mayu; Ainoda, Yusuke; Tago, Sayaka; Fujita, Takahiro; Hirai, Yuji; Takeuchi, Kaori; Totsuka, Kyoichi

    2015-01-01

    Background Clostridium difficile infection (CDI) is a highly prevalent hospital-associated infection. Although most patients respond well to discontinuation of antibiotics, 20%–30% of patients relapse. To initiate early therapeutic measures, the risk factors for recurrent CDI must be identified, although very few Japanese studies have used standard surveillance definitions to identify these risk factors. Methods We retrospectively reviewed the medical records of patients with health care facility-onset CDI between August 2011 and September 2013. Patients with diarrhea who were positive for Clostridium difficile (via an enzyme immunoassay) were defined as having CDI. Clinical data (eg, demographics, comorbidities, medication, laboratory results, and clinical outcomes) were evaluated, and multivariate analysis was used to identify risk factors that were associated with recurrent CDI. Results Seventy-six health care facility-onset CDI cases were identified, with an incidence rate of 0.8 cases per 10,000 patient-days. Fourteen cases (18.4%) were recurrent, with 13 patients having experienced a single recurrent episode and one patient having experienced three recurrent episodes. The 30-day and 90-day mortality rates were 7.9% and 14.5%, respectively. Multivariate analysis revealed that recurrent patients were more likely to have underlying malignant disease (odds ratio: 7.98; 95% confidence interval: 1.22–52.2; P=0.03) and a history of intensive care unit hospitalization (odds ratio: 49.9; 95% confidence interval: 1.01–2,470; P=0.049). Conclusion Intensive care unit hospitalization and malignancy are risk factors for recurrent CDI. Patients with these factors should be carefully monitored for recurrence and provided with appropriate antimicrobial stewardship. PMID:26203270

  11. Parents' experiences of their premature infants' transportation from a university hospital NICU to the NICU at two local hospitals.

    PubMed

    Granrud, Marie Dahlen; Ludvigsen, Elin; Andershed, Birgitta

    2014-01-01

    The aim of this study was to describe how the parents of premature infants experience the transportation of their baby from the neonatal intensive care unit at a university hospital (NICU-U) to such a unit at a local hospital (NICU-L). This descriptive qualitative study comprises interviews with nine sets of parents and two mothers. The qualitative content analysis resulted in one theme: living in uncertainty about whether the baby will survive, and three categories: being distanced from the baby; fearing that something would happen to the baby during transportation; and experiencing closeness to the baby. The results also revealed that the parents experienced developmental, situational and health-illness transitions.

  12. Conflict management in public university hospitals in Turkey: a pilot study.

    PubMed

    Tengilimoglu, Dilaver; Kisa, Adnan

    2005-01-01

    By nature, hospitals are extremely complex organizations, combining many different professional groups within an intricate administrative structure. Conflicts therefore expectedly arise between individuals, groups, and departments. It is in the interest of health care administrators to periodically assess the major factors giving rise to these conflicts. In this study, a questionnaire designed to measure sources of conflict in the workplace was completed by 204 staff members at Gazi University Hospital. Of the participants, 30.9% were physicians, and 12.5% were administrators at various levels; 61.5% were female, and 38.5% were male. In terms of work experience, 52.6% of participants had worked less than 5 years at the hospital. The results of the study show that educational differences among the hospital staff were a major barrier to good communication and information flow between groups. Professionals in the same specialties experienced fewer conflicts. Another source of conflict was that resource allocation was considered unfair across departments. Although the hospital management provided an ombudsman for staff concerns, staff rarely resorted to the ombudsman because of the stigma associated with complaining. A lack of opportunity for career advancement was mentioned by 52% of the participants as a source of conflict. At present, job performance and rewards are not closely related in public university hospitals in Turkey because promotions and pay raises are strictly limited by law. Bureaucracy was also perceived to be a source of conflict, with 48.4% of participants saying that their performance was less than optimal because of the presence of multiple supervisors. This pilot study suggests that in Turkey, legislative reform is needed to give public university hospitals more flexibility regarding work incentives, open-door policies at the administrative level, and social interactions to improve teamwork among hospital staff.

  13. Conflict management in public university hospitals in Turkey: a pilot study.

    PubMed

    Tengilimoglu, Dilaver; Kisa, Adnan

    2005-01-01

    By nature, hospitals are extremely complex organizations, combining many different professional groups within an intricate administrative structure. Conflicts therefore expectedly arise between individuals, groups, and departments. It is in the interest of health care administrators to periodically assess the major factors giving rise to these conflicts. In this study, a questionnaire designed to measure sources of conflict in the workplace was completed by 204 staff members at Gazi University Hospital. Of the participants, 30.9% were physicians, and 12.5% were administrators at various levels; 61.5% were female, and 38.5% were male. In terms of work experience, 52.6% of participants had worked less than 5 years at the hospital. The results of the study show that educational differences among the hospital staff were a major barrier to good communication and information flow between groups. Professionals in the same specialties experienced fewer conflicts. Another source of conflict was that resource allocation was considered unfair across departments. Although the hospital management provided an ombudsman for staff concerns, staff rarely resorted to the ombudsman because of the stigma associated with complaining. A lack of opportunity for career advancement was mentioned by 52% of the participants as a source of conflict. At present, job performance and rewards are not closely related in public university hospitals in Turkey because promotions and pay raises are strictly limited by law. Bureaucracy was also perceived to be a source of conflict, with 48.4% of participants saying that their performance was less than optimal because of the presence of multiple supervisors. This pilot study suggests that in Turkey, legislative reform is needed to give public university hospitals more flexibility regarding work incentives, open-door policies at the administrative level, and social interactions to improve teamwork among hospital staff. PMID:15825820

  14. Characteristics of Blastocystis hominis infection in a Turkish university hospital.

    PubMed

    Ozçakir, Olcay; Güreser, Semra; Ergüven, Sibel; Yilmaz, Yakut Akyön; Topaloğlu, Rezzan; Hasçelik, Gülşen

    2007-01-01

    In order to determine characteristics of Blastocystis (B.) hominis infection; 770 individuals' stool specimens were examined both by simple and concentration techniques and stained with iodine solution and trichrome in the Parasitology Laboratory of Hacettepe University Faculty of Medicine, Turkey. Among the examined 770 specimens, B. hominis was detected in 94 (12.2%). B. hominis was the most common intestinal parasite among the study group. It was mostly detected with Dientamoeba fragilis. Among the groups the incidence of B. hominis in allergic patients was higher than controls. Among the immunosuppressed patients, B. hominis was detected significantly higher in patients who had solid tumours. Of the 48 individuals who had only B. hominis in their stool the most common symptom was abdominal pain. Concentration technique with trichrome stain was more sensitive than simple smear with lugol solution for the detection of B. hominis. Studies with more patients must be planed to understand the B. hominis infection in solid tumour patients and coexistence of B. hominis and D. fragilis. PMID:18224616

  15. Candida dubliniensis at a University Hospital in Saudi Arabia

    PubMed Central

    Fotedar, R.; Al Hedaithy, S. S. A.

    2003-01-01

    Candida dubliniensis is a newly described yeast species that is a close phylogenetic relative of C. albicans. Although it has been reported from different parts of the world, no detailed investigation of this species has been done in Saudi Arabia. The purpose of the present study was to identify C. dubliniensis isolates recovered from clinical specimens at a tertiary-care hospital in Riyadh, Saudi Arabia, and to determine the drug susceptibility profiles of those isolates. Over a period of 8 months, 823 germ tube- and chlamydospore-positive yeasts identified as C. albicans and recovered from different clinical specimens were screened for their ability to grow at 45°C on Sabouraud dextrose agar. Isolates which failed to grow at 45°C were presumptively identified as C. dubliniensis. The species identities were further confirmed by the production of pseudohyphae and chlamydospores on Staib agar and their inability to assimilate d-xylose and α-methyl-d-glucoside by using the API 20C AUX system. A total of 27 (3.3%) isolates were identified as C. dubliniensis. They were all recovered from 23 human immunodeficiency virus-negative patients. The prevalence of C. dublinensis in bronchoalveolar lavage (33.3%), oral (16.7%), and blood (16.7%) specimens was high. In addition, 33 isolates previously identified as C. albicans and preserved among our stock blood culture isolates were also recruited for the study. Of these, 5 isolates were found to be C. dubliniensis, thus making the total number of isolates identified as this species 32. Antifungal susceptibility testing of the C. dubliniensis isolates showed 100% sensitivity to amphotericin B, 97% sensitivity to each of fluconazole and ketoconazole, and 87.5% sensitivity to itraconazole. However, in contrast to other studies, the majority of the isolates (65.6%) showed high levels of resistance to flucytosine (MIC > 64 μg/ml). Further studies are warranted to investigate the cause of this unusually high rate of resistance to

  16. Organizing integrated care in a university hospital: application of a conceptual framework

    PubMed Central

    Axelsson, Runo; Axelsson, Susanna Bihari; Gustafsson, Jeppe; Seemann, Janne

    2014-01-01

    Background and aim As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals. Theory and methods The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews. Results The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location. Conclusions It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care. PMID:24966806

  17. Education Program Cost Reimbursement in University Hospitals. Is There a Coherent National Policy?

    ERIC Educational Resources Information Center

    Jeddeloh, Norman P.

    1981-01-01

    Medicare reimbursement for educational program costs is a quagmire of conflicting rules, regulations, laws, procedures, and precedents. The reimbursement principles in force fail to recognize the special value to patient care provided by the integration of the university hospital with an academic health sciences center and are illogical and…

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

    ERIC Educational Resources Information Center

    Young, Philip E.

    1976-01-01

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

  19. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals.

    PubMed

    Edward, G M; Biervliet, J D; Hollmann, M W; Schlack, W S; Preckel, B

    2008-01-01

    The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables: number of patients visiting the PAC, staffing of the PAC, opening hours, scheduling, and additional preoperative diagnostic testing. The number of patients seen yearly varies from 7.000 to 13.500. In all clinics, the preoperative assessment was performed by anaesthetists and residents. In five PACs, preoperative assessment was also performed by physician assistants or nurse practitioners. Opening hours varied. Consultations are by appointment, 'walk-in', or a combination of these two. In four clinics additional testing is performed at the PAC itself. This study shows that the organisational structure of the PAC at similar university hospitals varies greatly; this can have important implications when designing a benchmarking process.

  20. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    PubMed

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers. PMID:26922733

  1. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    PubMed

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

  2. Sporadic Medullary Thyroid Carcinoma: Clinical Data From A University Hospital

    PubMed Central

    Correia-Deur, Joya Emilie M.; Toledo, Rodrigo A.; Imazawa, Alice T.; Lourenço, Delmar M.; Ezabella, Marilza C. L.; Tavares, Marcos R.; Toledo, Sergio P. A.

    2009-01-01

    INTRODUCTION: Medullary thyroid carcinoma may occur in a sporadic (s-medullary thyroid carcinoma, 75%) or in a multiple endocrine neoplasia type 2 form (MEN2, 25%). These clinical forms differ in many ways, as s-medullary thyroid carcinoma cases are RET-negative in the germline and are typically diagnosed later than medullary thyroid carcinoma in MEN2 patients. In this study, a set of cases with s-medullary thyroid carcinoma are documented and explored. PURPOSE: To document the phenotypes observed in s-medullary thyroid carcinoma cases from a university group and to attempt to improve earlier diagnosis of s-medullary thyroid carcinoma. Some procedures for diagnostics are also recommended. METHOD: Patients (n=26) with apparent s-medullary thyroid carcinoma were studied. Their clinical data were reviewed and peripheral blood was collected and screened for RET germline mutations. RESULTS: The average age at diagnosis was 43.9 years (± 10.82 SD) and did not differ between males and females. Calcitonin levels were increased in all cases. Three patients presented values that were 100-fold greater than the normal upper limit. Most (61.54%) had values that were 20-fold below this limit. Carcinoembryonic antigen levels were high in 70.6% of cases. There was no significant association between age at diagnosis, basal calcitonin levels or time of disease onset with thyroid tumor size (0.6–15 cm). Routine thyroid cytology yielded disappointing diagnostic accuracy (46.7%) in this set of cases. After total thyroidectomy associated with extensive cervical lymph node resection, calcitonin values remained lower than 5 pg/mL for at least 12 months in eight of the cases (30.8%). Immunocyto- and histochemistry for calcitonin were positive in all analyzed cases. None of the 26 cases presented germline mutations in the classical hotspots of the RET proto-oncogene. CONCLUSION: Our cases were identified late. The basal calcitonin measurements and immunostaining for calcitonin were

  3. Weighing the views of a university hospital and medical school regarding an HMO.

    PubMed

    Herrmann, T J; Matthews, C W; Segadelli, L J

    1983-09-01

    After 14 years of study, the University of Michigan decided to terminate development of a health maintenance organization (HMO). The process was long and difficult because of the university's need to consider the HMO from the university's perspective of both an employer and a provider. As an employer, the university's early view was favorable and then declined when employee interest was found to be weak and the HMO's impact on the rapidly rising cost of the university's health insurance benefit was determined to be modest. As a provider, the university's view was mixed. In regard to its hospitals, the university's judgment was positive largely because it hoped that HMO incentives might help the hospitals remain viable in the health care delivery environment that was becoming increasingly competitive. From the Medical School's point of view, an HMO was felt not to be desirable because it could put in jeopardy the professional fee revenue used by the school to help underwrite its academic programs, which are the primary source of faculty pride and recognition.

  4. Weighing the views of a university hospital and medical school regarding an HMO.

    PubMed

    Herrmann, T J; Matthews, C W; Segadelli, L J

    1983-09-01

    After 14 years of study, the University of Michigan decided to terminate development of a health maintenance organization (HMO). The process was long and difficult because of the university's need to consider the HMO from the university's perspective of both an employer and a provider. As an employer, the university's early view was favorable and then declined when employee interest was found to be weak and the HMO's impact on the rapidly rising cost of the university's health insurance benefit was determined to be modest. As a provider, the university's view was mixed. In regard to its hospitals, the university's judgment was positive largely because it hoped that HMO incentives might help the hospitals remain viable in the health care delivery environment that was becoming increasingly competitive. From the Medical School's point of view, an HMO was felt not to be desirable because it could put in jeopardy the professional fee revenue used by the school to help underwrite its academic programs, which are the primary source of faculty pride and recognition. PMID:6887212

  5. Understanding the acceptance factors of an Hospital Information System: evidence from a French University Hospital

    PubMed Central

    Ologeanu-Taddei, R.; Morquin, D.; Domingo, H.; Bourret, R.

    2015-01-01

    The goal of this study was to examine the perceived usefulness, the perceived ease of use and the perceived behavioral control of a Hospital Information System (HIS) for the care staff. We administrated a questionnaire composed of open-end and closed questions, based on the main concepts of Technology Acceptance Model. As results, the perceived usefulness, ease of use and behavioral control (self-efficacy and organizational support) are correlated with medical occupations. As an example, we found that a half of the medical secretaries consider the HIS is ease of use, at the opposite to the anesthesiologists, surgeons and physicians. Medical secretaries reported also the highest rate of PBC and a high rate of PU. Pharmacists reported the highest rate of PU but a low rate of PBC, which is similar to the rate of the surgeons and physicians. Content analysis of open questions highlights factors influencing these constructs: ergonomics, errors in the documenting process, insufficient compatibility with the medical department or the occupational group. Consequently, we suggest that the gap between the perceptions of the different occupational groups may be explained by the use of different modules and by interdependency of the care stare staff. PMID:26958237

  6. [Past and present issues of the pulmonary circulation in the General University Hospital in Prague].

    PubMed

    Jansa, Pavel; Ambrož, David; Lindner, Jaroslav

    2014-12-01

    The development of right heart catheterization is closely connected not only with its pioneer Werner Forssmann but also with the University Hospital in Prague. Shortly after Forssmann´s pioneering performance of catheterization, Dr. Otto Klein measured cardiac output using the Fick´s principle in 11 patients in University Hospital. In the 60s and 70s of last century, there was established an research group represented by Severin Daum, Frantisek Boudik, Vlastimil Jezek, Alois Ourednik and Zdenek Suso at 2nd Internal Clinic of General Cardiopulmonary Hospital. After 1999, the issue of pulmonary hypertension has been re-emerged by Professor Michal Aschermann and this had significant clinical implications. The highly specialized centre for pulmonary arterial hypertension (PAH) was found at the clinic and in Cardio Centre of General University Hospital it has been initiated a successful program of pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH) since 2004. Surgical treatment is also provided to patients from Slovakia. The number of patients, wide range of therapy and its results, including the excellent results of surgical treatment situates the centre among the most important centres in Europe dealing with pulmonary hypertension.

  7. The art of improvisation: the working process of administrators at a Federal University Hospital.

    PubMed

    Littike, Denilda; Sodré, Francis

    2015-10-01

    The scope of this article is to analyze the working process of administrators at a Federal University Hospital (HUF). It includes research with a qualitative approach conducted through interviews with twelve administrators. The work process, the work tools and the human activity per se are understood to be under scrutiny. Work is acknowledged as a category that analyzes the management methods used by professional health workers. The HUFs are responsible for two social policies, namely education and health. The aim of the administrators' work is an organizational issue, and the administration tools used are bureaucratic and out-of-date for the current political context of hospital management. The most significant feature of this hospital administration is improvisation, which reduces the potential of the administrators in such a way that, instead of introducing innovative changes into their work process, they prefer to leave their jobs. Improvisation is caused by the production of sequential obstacles in management decision-making at this teaching hospital. In short, the transfer of administration at the HUF, from direct government administration by the University to the Brazilian Company of Hospital Services (EBSERH), was analyzed on the grounds that this would establish a "new" management model.

  8. Patient satisfaction with nursing care in a regional university hospital in southern Spain.

    PubMed

    González-Valentín, Araceli; Padín-López, Susana; de Ramón-Garrido, Enrique

    2005-01-01

    Patient satisfaction is a valid indicator for measurement of service quality. Patients' opinions are important because dissatisfaction suggests opportunities for improvement. We evaluated the satisfaction of patients with nursing care in a regional university hospital in southern Spain and determined the relevant sociodemographic and attendance characteristics. A cross-sectional descriptive study was undertaken using the SERVQUAL questionnaire. Reliability and validity of the SERVQUAL instrument were established. The only interaction considered was gender and education level. Analysis of covariance showed that the only factors significantly associated with lower patient satisfaction were female gender, higher educational level, lower overall satisfaction with the hospital, and not knowing the name of the nurse.

  9. Microscopically diagnosed head and neck cancers in the University Hospital, Kuala Lumpur.

    PubMed

    Jayalakshmi, P; Pathmanathan, R; Raman, R; Prasad, U

    1989-03-01

    A retrospective study of 1000 cases of microscopically diagnosed head and neck cancers in the University Hospital, Kuala Lumpur was done. Head and neck neoplasms comprise 7.1% of all tumours diagnosed in this Hospital and the commonest sites of involvement are the nasopharynx (29.1%), cervical lymph nodes (22.6%), oral cavity (10.2%), thyroid (8.2%) and skin (6.5%). Histologically, 87% of tumours are epithelial in nature. The results of this study show that nasopharyngeal carcinoma is commonest in Chinese males, while oral and laryngeal malignancies occur more frequently in Indians.

  10. Geropsychiatric consultation in a university hospital: a report on 67 referrals.

    PubMed

    Ruskin, P E

    1985-03-01

    The author describes the evaluation and treatment of 67 patients 60 years old or older who were referred to a consultation-liaison service in a university hospital. Age, sex, referring service, reasons for referral, psychiatric diagnosis, and interventions or recommendations were determined. Primary psychiatric diagnoses included depression (24%), dementia (19%), delirium (18%), schizophrenia (16%), and personality disorders (12%). Recommendations or interventions included advice in the use of psychotropic medications (61%), assistance with competency issues (25%), recommendation for further medical evaluation or treatment (36%), individual psychotherapy (28%), family therapy (25%), disposition planning (24%), and transfer to a geropsychiatry unit (12%). Hospitalized elderly patients with emotional problems represent a unique diagnostic and therapeutic challenge.

  11. Developing an emergency department based Special Operations Team: Robert Wood Johnson University Hospital's experience.

    PubMed

    Zavotsky, Kathleen Evanovich; Valendo, Michael; Torres, Peter

    2004-01-01

    Robert Wood Johnson University Hospital initiated an emergency department based Special Operations Team as a way to help prepare staff for the care of hazardous material incidents (HAZMAT) victims and the unexpected consequences of a mass casualty incident. The team evolved over a period of 5 years and is now able to provide significant educational offerings, policy and procedure review and participation in extensive planning efforts in the hospital and community. This article will review the process and present future goals of the team.

  12. Patient satisfaction with nursing care in a regional university hospital in southern Spain.

    PubMed

    González-Valentín, Araceli; Padín-López, Susana; de Ramón-Garrido, Enrique

    2005-01-01

    Patient satisfaction is a valid indicator for measurement of service quality. Patients' opinions are important because dissatisfaction suggests opportunities for improvement. We evaluated the satisfaction of patients with nursing care in a regional university hospital in southern Spain and determined the relevant sociodemographic and attendance characteristics. A cross-sectional descriptive study was undertaken using the SERVQUAL questionnaire. Reliability and validity of the SERVQUAL instrument were established. The only interaction considered was gender and education level. Analysis of covariance showed that the only factors significantly associated with lower patient satisfaction were female gender, higher educational level, lower overall satisfaction with the hospital, and not knowing the name of the nurse. PMID:15686078

  13. Developing an emergency department based Special Operations Team: Robert Wood Johnson University Hospital's experience.

    PubMed

    Zavotsky, Kathleen Evanovich; Valendo, Michael; Torres, Peter

    2004-01-01

    Robert Wood Johnson University Hospital initiated an emergency department based Special Operations Team as a way to help prepare staff for the care of hazardous material incidents (HAZMAT) victims and the unexpected consequences of a mass casualty incident. The team evolved over a period of 5 years and is now able to provide significant educational offerings, policy and procedure review and participation in extensive planning efforts in the hospital and community. This article will review the process and present future goals of the team. PMID:15133453

  14. The Rockefeller University Hospital (1910-2010): creating the science of medicine.

    PubMed

    Hirsch, Jules

    2011-01-01

    The year 2010 marked the centennial of the Rockefeller University Hospital, one of the great philanthropic achievements of 20th-century science. For 100 years, the Hospital played a central role in the development and growth of medical science by enabling physician-scientists to make intensive study of human biology and disease. With ingenuity and devotion, they greatly enriched clinical medicine as well as basic biological science. This account emphasizes the founding and first half-century of the Hospital as it became a germinal center for clinical investigation. The second half of the century saw rapid change in medicine and health care with vexing problems, many yet unsolved. This history should serve as a call to arms for maintaining the linkage of science and medicine, supporting patient-oriented research as a basic discipline of medicine.

  15. [Outcomes of Infection Control Team Inspections at the Dental Hospital, Tokyo Medical and Dental University].

    PubMed

    Mitsuhiro, Sunakawa; Hiroyuki, Matsumoto; Rie, Okihata; Hiromi, Tsuruoka; Yuichi, Yamada; Toshiko, Adachi; Yuichi, Izumi

    2015-07-01

    In the Dental Hospital, Tokyo Medical and Dental University, an infection control team (ICT) has been formed to inspect each diagnosis department of clinics and wards in order to identify problems regarding nosocomial infection control. In this study, we analyzed the inspection reports and highlighted the following serious problems: 1) inadequate hygienic hand-washing for out- and in-patient treatment, 2) incomplete wearing of personal protective equipment (PPE) by dental health care workers, 3) necessity of environmental improvement in the clinics, and 4) cross-infection risk induced by. the continuous use of treatment devices without appropriate disinfection. The ICT provided feedback to the inspected departments, suggesting solutions to problems regarding nosocomial infection control. In order to enhance infection control in our hospital, dental healthcare practitioners must make further efforts on nosocomial infection control and prevention, and act according to their position by continuously educating students and enlightening hospital staff about the importance of infection control. PMID:26502663

  16. Analysis of Time-of-Day Energy Demand and Supply in University and Hospital

    NASA Astrophysics Data System (ADS)

    Shimazaki, Yoichi

    The aim of this study was to estimate the time-of-day energy demand in University of Yamanashi. Our University consisted of Kofu campus (Faculty of Education & Human Sciences and Faculty of Engineering) and Faculty of Medicine campus (Faculty of Medicine and University Hospital). The energy data of 4 facilities were classified into hot water, heating, cooling and electric power demands based on electric power consumptions, city gas and heavy oil from 1996 to 2005. For 10 years, primary energy increased 1.2 times in the whole of the university. The amount of electric power consumption was 63% in the fuel classification. The amount of electric power consumption of faculty reacted to the change in temperature greatly. In 2005, it was found that thermoelectric-ratios for 4 facilities, i.e. Education, Engineering, Medicine and Hospital were 2.3, 1.5, 2.0 and 2.7 respectively. These data are very useful for the energy saving and energy management of university.

  17. Evaluation of well-being at work among nursing professionals at a University Hospital.

    PubMed

    Alves, Priscila Castro; Neves, Vanessa Faria; Coleta, Marilia Ferreira Dela; Oliveira, Áurea de Fátima

    2012-01-01

    Well-being at work is based on Positive Psychology, and is defined as a psychological state with positive affective links towards work and also towards the organisation. The purpose of this study was to look at the degree of well-being at work among nursing professionals who work at a University hospital and also identify differences between occupational categories and types of work contracts. The sample was made up of 340 professionals who answered valid scales of the following constructs: Work Satisfaction, Involvement with Work and Affective Organisational Commitment. For the analysis of the data we used SPSS, version 12, for descriptive statistics, and also for testing differences between means. The results showed an average level of well-being in the workplace and also differences between professional categories and work regime, when it comes to satisfaction with salaries and promotions, which can have a reflection in the quality of service provided to the patients of this University hospital.

  18. Assessment of nurses' knowledge about magnetic resonance imaging in a university hospital in Sao Paulo.

    PubMed

    Lima, Marcos Souza; Shigueoka, David Carlos; Salvador, Maria Elisabete; da Silva Canteras, Lígia Mara; Carmagnani, Maria Isabel Sampaio; Ajzen, Sérgio Aron

    2012-12-01

    The aims of this descriptive study were to determine the academic profile of nurses in a university hospital, assess their level of knowledge about magnetic resonance imaging (MRI) and verify whether this knowledge was acquired during their undergraduate or graduate education. Ninety randomly selected nurses working in inpatient wards and outpatient units of a university hospital participated in the study. Data were collected through a questionnaire completed by the participants between August and October 2009. Most nurses were females who have received specialized education. The participants had a limited knowledge about MRI, which was restricted to the procedures to prepare patients for MRI examination and MRI contraindications. Most of the nurses acquired information about MRI during the professional practice. The majority of nurses showed interest to know more about the MRI examination, especially regarding the exam environment, conditions and contraindications, in order to prevent accidents. PMID:23181959

  19. Patient dosimetry in interventional cardiology at the University Hospital of Osijek.

    PubMed

    Faj, Dario; Steiner, Robert; Trifunovic, Dejan; Faj, Zlatan; Kasabasic, Mladen; Kubelka, Dragan; Brnic, Zoran

    2008-01-01

    The interventional cardiology was recently implemented at the University Hospital of Osijek. Patients' absorbed doses during coronary angiography (CA) and the percutaneous transluminal coronary angioplasty (PTCA) procedures were measured and compared with published data and international standards. All patients undergoing CA or PTCA procedures during a 1-month period were included in the study. Patients' doses are expressed in terms of dose area product (DAP) per procedure. The patients' DAPs ranged from 2.6 to 210 Gy cm2 (average of 59 Gy cm2) during CAs, and from 61 to 220 Gy cm2 (average of 120 Gy cm2) during PTCAs. Patients' doses during CAs and PTCAs at the University Hospital of Osijek are in good agreement with the published ones. In complex cases, the radiochromic dosimetry films were used to show possible dose distributions across patient's skin. The film dosimetry showed a limitation of using only DAP values for the estimation of skin injuries risk.

  20. Positioning matrix of economic efficiency and complexity: a case study in a university hospital.

    PubMed

    Ippolito, Adelaide; Viggiani, Vincenzo

    2014-01-01

    At the end of 2010, the Federico II University Hospital in Naples, Italy, initiated a series of discussions aimed at designing and applying a positioning matrix to its departments. This analysis was developed to create a tool able to extract meaningful information both to increase knowledge about individual departments and to inform the choices of general management during strategic planning. The name given to this tool was the positioning matrix of economic efficiency and complexity. In the matrix, the x-axis measures the ratio between revenues and costs, whereas the y-axis measures the index of complexity, thus showing "profitability" while bearing in mind the complexity of activities. By using the positioning matrix, it was possible to conduct a critical analysis of the characteristics of the Federico II University Hospital and to extract useful information for general management to use during strategic planning at the end of 2010 when defining medium-term objectives.

  1. The Day-Hospital of the University Hospital, Bobo Dioulasso: An Example of Optimized HIV Management in Southern Burkina Faso

    PubMed Central

    Chas, Julie; Hema, Arsène; Slama, Laurence; Kabore, Nongondo Firmin; Lescure, François-Xavier; Fontaine, Camille; Pialoux, Gilles; Sawadogo, Adrien

    2015-01-01

    Objectives To evaluate the epidemiological evolution of patients with HIV (PtHIV), between 2002 and 2012, in a day-hospital that became an HIV reference centre for south-west Burkina Faso. Materials and Methods This was a retrospective study of PtHIV followed in the Bobo Dioulasso university hospital since 2002. The study was based on clinical data recorded using ESOPE software and analysed using Excel and SAS. Results A total of 7320 patients have been treated at the centre since 2002; the active file of patients increased from 147 in 2002 to 3684 patients in 2012. Mean age was stable at 38.4 years and the majority were female (71%). The delay to initiation of antiretroviral (ARV) treatment after HIV diagnosis decreased from 12.9 months in 2002 to 7.2 months in 2012. The percentage of PtHIV lost to follow-up, untreated for HIV and deaths all decreased after 2005. Voluntary anonymous screening and/or an evocative clinical picture were the main reasons for HIV diagnosis, usually at a late stage (41.1% at WHO stage 3). Virological success increased due to a decrease in time to initiation of ARV treatment and an increase in percentage of patients treated (90.5% in 2012, mainly with 1st line drugs). However, there was also a slight increase in the rate of therapeutic failures and the percentage of patients who progressed to 2nd or 3rd line-ARVs. Conclusion Our day-hospital is a good example of the implementation of a specialist centre for the management of PtHIV in a resource-limited country (Burkina Faso). PMID:25970181

  2. Chemotherapy in nasopharyngeal carcinoma: review of results at University Hospital, Kuala Lumpur.

    PubMed

    Khanijow, V K; Prasad, U; Chang, C M

    1989-12-01

    Nasopharyngeal carcinoma (NPC) is one of the commonest presentation of head and neck cancers in Malaysia, especially in the Chinese. The standard treatment is radical radiotherapy to the post-nasal space and the neck. Chemotherapy is given to patients with primary advanced disease and to patients with recurrence. The study reviews results of chemotherapy given to 33 patients at the University Hospital, Kuala Lumpur, over the last four years.

  3. Juvenile myoclonic epilepsy--a report of 11 patients at the University Hospital, Kuala Lumpur.

    PubMed

    Manonmani, V; Tan, C T

    1993-10-01

    This is a report on 11 cases of Juvenile Myoclonic Epilepsy (JME) from the University Hospital, Kuala Lumpur, all of whom were diagnosed in the last one and a half years. This genetic syndrome is seen in all the three main racial groups: Chinese, Malays and Indians. It accounts for 2% of the epilepsy patients seen at the neurology clinic. Lack of awareness is the main hindrance to diagnosis.

  4. Consumption of benzodiazepines in a French university hospital between 1980 and 1991.

    PubMed

    Alran, C; Damase-Michel, C; Celotto, N; Durand, M C; Montastruc, J L

    1993-01-01

    The consumption of benzodiazepines in the Toulouse university hospital from 1980 to 1991 was investigated. During this period, total annual consumption of benzodiazepines as anxiolytics remained stable, whereas their prescription as hypnotics fell (-70%). Moreover, short half-life benzodiazepines as hypnotics were preferred to long half-life ones. In parallel, there was an enhancement in new (zopiclone, zolpidem, buspirone) and old (alimemazine, hydroxyzine) drugs' consumption, the ratio benefits/risks of which have not yet been well defined. PMID:8104854

  5. [Analysis of the antibiotics resistance in the patients treated in the Ternopyl university hospital].

    PubMed

    Olĭnyk, O V; Krasiĭ, N I

    2013-10-01

    The results of monitoring of the microorganisms resistance to antibiotics in departments of anesthesiology and abdominal surgery of the Ternopyl University Hospital are adduced. The data obtained permit to estimate possibilities for application of antimicrobic preparations in empiric therapy. Taking into account a large quantity of multiresistant isolates in a certain stationary, administration of empiric therapy in the treatment of intrahospital infection must be conducted, basing on the local data, concerning the microflora sensitivity to antibiotics.

  6. Hand injuries in foreign labour workers in an Irish university hospital.

    PubMed

    Sattler, Thorsten; Tobbia, Dalia; O'Shaughnessy, Michael

    2009-01-01

    The present study reports on a new, rapidly growing patient subpopulation presenting with hand injuries to the Department of Plastic Surgery in Cork University Hospital (Ireland). The impact of the 10 new European Union accession states on the trauma workload is examined. The associated growth in expenditure on interpreter services is also examined. Potential risk factors in the foreign workers' new working environment is explored. PMID:20190909

  7. Patient satisfaction with nursing care at a university hospital in Turkey.

    PubMed

    Uzun, O

    2001-10-01

    Patient satisfaction is an important measure of service quality (SQ) in health care organizations. Patients' satisfaction and their expectations of care are valid indicators of quality nursing care. This article reports the results of a survey patient satisfaction with nursing care, administered by interview to 422 adults discharged from a university hospital in Turkey. The direct measurement of patient satisfaction with nursing care is a new phenomenon for this university hospital, and this was the first time that such an evaluation had been done in this particular hospital. In this study, SERVQUAL scale was used for determining patient satisfaction with nursing care. Weighted scores in dimensions of SERVQUAL were generally low, and there were statistically significant differences in means paired t-tests (p < .01). Sociodemographic characteristics of the patients (age, gender, education level) with regard to patient satisfaction were determined. Several statistically significant differences were found between the sociodemographic characteristics and weighted scores for dimensions of SERVQUAL (p < 0.5). According to results, the SQ gap scores for five dimensions were negative to meet expectations. The negative scores for tangibles, reliability, responsiveness, assurance, and empathy indicate areas needing improvement. In this hospital, results of this study support the need for nurses to take steps to improve patient satisfaction with nursing care.

  8. Patient satisfaction with nursing care at a university hospital in Turkey.

    PubMed

    Uzun, O

    2001-10-01

    Patient satisfaction is an important measure of service quality (SQ) in health care organizations. Patients' satisfaction and their expectations of care are valid indicators of quality nursing care. This article reports the results of a survey patient satisfaction with nursing care, administered by interview to 422 adults discharged from a university hospital in Turkey. The direct measurement of patient satisfaction with nursing care is a new phenomenon for this university hospital, and this was the first time that such an evaluation had been done in this particular hospital. In this study, SERVQUAL scale was used for determining patient satisfaction with nursing care. Weighted scores in dimensions of SERVQUAL were generally low, and there were statistically significant differences in means paired t-tests (p < .01). Sociodemographic characteristics of the patients (age, gender, education level) with regard to patient satisfaction were determined. Several statistically significant differences were found between the sociodemographic characteristics and weighted scores for dimensions of SERVQUAL (p < 0.5). According to results, the SQ gap scores for five dimensions were negative to meet expectations. The negative scores for tangibles, reliability, responsiveness, assurance, and empathy indicate areas needing improvement. In this hospital, results of this study support the need for nurses to take steps to improve patient satisfaction with nursing care. PMID:11668854

  9. Development of a research dedicated archival system (TARAS) in a university hospital.

    PubMed

    Rajala, Tiina; Savio, Sami; Penttinen, Jarkko; Dastidar, Prasun; Kähönen, Mika; Eskola, Hannu; Miettunen, Risto; Turjanmaa, Väinö; Järvenpää, Ritva

    2011-10-01

    Recent healthcare policies have influenced the manner in which patient data is handled in research projects, and the regulations concerning protected health information have become significantly tighter. Thus, new procedures are needed to facilitate research while protecting the confidentiality of patient data and ensuring the integrity of clinical work in the expanding environment of electronic files and databases. We have addressed this problem in a university hospital setting by developing the Tampere Research Archival System (TARAS), an extensive data warehouse for research purposes. This dynamic system includes numerous integrated and pseudonymized imaging studies and clinical data. In a pilot study on asthma patients, we tested and improved the functionality of the data archival system. TARAS is feasible to use in retrieving, analyzing, and processing both image and non-image data. In this paper, we present a detailed workflow of the implementation process of the data warehouse, paying special attention to administrative, ethical, practical, and data security concerns. The establishment of TARAS will enhance and accelerate research practice at Tampere University Hospital, while also improving the safety of patient information as well as the prospects for national and international research collaboration. We hope that much can be learned from our experience of planning, designing, and implementing a research data warehouse combining imaging studies and medical records in a university hospital.

  10. [Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

    PubMed

    Yokota, Hiromitsu; Yatomi, Yutaka

    2013-08-01

    Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised.

  11. [Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

    PubMed

    Yokota, Hiromitsu; Yatomi, Yutaka

    2013-08-01

    Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised. PMID:24218765

  12. [Perceived quality assessment in the University Hospital Authority in Sassary, Italy].

    PubMed

    Virdis, A; Licheri, N; Cagnina, N; Sassu, A; Tanda, E; Soddu, M D

    2010-01-01

    In line with the health legislation that introduced a system to monitor and review the quality, the Hospital Authority of University of Sassari has placed among its main objectives the satisfaction of patients/clients and has made an initial assessment of customer satisfaction for users hospitalized in their facilities with the methodology of the questionnaire. It was drawn up a questionnaire to closed questions, with default value scales, divided into 4 areas: 1) Hospitality, 2) Hotel treatment, 3) Professionalism of staff-information related pathology, informed consent, 4) personal opinion of the patient upon discharge. The questionnaire was administered the day of discharge, to users hospitalized of six UO of Hospital Authority in the months of September and October 2009, and patients discharged within 2 months were given a total of 514, of them have completed the testing 290 (54% of discharged patients). The questionnaires were analyzed in the results of both the individual UO involved in both the overall result, persons responsible for each facility was sent a report with the results of its own. The survey results are satisfactory with regard to both positive aspects, that is the overall grade average of 86.23% which to criticism, to which they are planning initiatives for their solution. PMID:20677672

  13. Hospitals Pharmacy Quality Assurance System Assessment in Tehran University of Medical Sciences, Iran

    PubMed Central

    Dargahi, H; Khosravi, SH

    2010-01-01

    Background: Health system pharmacies, like other health care professional, practice under a number of mandated standards. Basic concepts of quality assurance (QA) standards should be applied to hospital pharmacy practice. The survey reported here is to assess QA system implementation and its standard indicators observation in Tehran University of Medical Sciences (TUMS) hospitals’ pharmacies in 2007 – 2008. Methods: A cross – sectional, descriptive analytical survey was accomplished. First, a checklist within the framework of QA standard indicators was made to assess TUMS hospitals pharmacies practice. Collected data was saved by Excel software for recording and analyzed by SPSS version-15. Observation rate of QA standard indicators was classified by inappropriate, relatively appropriate, and appropriate. Results: Characteristics of TUMS hospitals pharmacists organizational structure, size, equipment, safety facility and drug requirement were studied by QA standard indicators. Conclusion: Many of QA standard indicators are observed and implemented in TUMS hospitals pharmacies, but several of these standards are not observed too. It is appropriate that all TUMS hospitals pharmacies are required to advance the profession, often with the same goal of increasing involvement in direct patient care. PMID:23113043

  14. Translational science and the hidden research system in universities and academic hospitals: a case study.

    PubMed

    Lander, Bryn; Atkinson-Grosjean, Janet

    2011-02-01

    Innovation systems (IS) and science policy scholarship predominantly focus on linkages between universities and industry, and the commercial translation of academic discoveries. Overlooked in such analyses are important connections between universities and academic hospitals, and the non-commercial aspects of translational science. The two types of institutions tend to be collapsed into a single entity-'the university'-and relational flows are lost. Yet the distinctions and flows between the two are crucial elements of translational science and the biomedical innovation system. This paper explores what has been called the 'hidden research system' that connects hospitals, universities, and their resources, with the clinical and scientific actors who make the linkages possible. Then, using a novel conceptual model of translational science, we examine the individual interactions and dynamics involved in a particular example of the biomedical innovation system at work: the diagnosis of IRAK-4 deficiency, a rare immunological disorder, and the translational flows that result. Contra to conventional IS analyses, we are able to point to the strong role of public-sector institutions, and the weak role of the private-sector, in the translational processes described here. Our research was conducted within a Canadian network of scientists and clinician-scientists studying the pathogenomics of immunological disorders and innate immunity.

  15. Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt.

    PubMed

    Kishk, Rania Mohammed; Mandour, Mohamed Fouad; Farghaly, Rasha Mohamed; Ibrahim, Ahmed; Nemr, Nader Attia

    2014-01-01

    Introduction. Blood stream infection (BSI) is a common problem of newborn in neonatal intensive care units (NICUs). Monitoring neonatal infections is increasingly regarded as an important contributor to safe and high-quality healthcare. It results in high mortality rate and serious complications. So, our aim was to determine the incidence and the pattern of BSIs in the NICU of Suez Canal University Hospital, Egypt, and to determine its impact on hospitalization, mortality, and morbidity. Methods. This study was a prospective one in which all neonates admitted to the NICUs in Suez Canal University hospital between January, 2013 and June 2013 were enrolled. Blood stream infections were monitored prospectively. The health care associated infection rate, mortality rate, causative organism, and risk factors were studied. Results. A total of 317 neonates were admitted to the NICU with a mortality rate of 36.0%. During this study period, 115/317 (36.3%) developed clinical signs of sepsis and were confirmed as BSIs by blood culture in only 90 neonates with 97 isolates. The total mean length of stay was significantly longer among infected than noninfected neonates (34.5 ± 18.3 and 10.8 ± 9.9 days, resp., P value < 0.001). The overall mortality rates among infected and noninfected neonates were 38.9% and 34.8%, respectively, with a significant difference. Klebsiella spp. were the most common pathogen (27.8%) followed by Pseudomonas (21.6%) and Staphylococcus aureus (15.4%). Conclusion. The rate of BSIs in NICU at Suez Canal University Hospital was relatively high with high mortality rate (36.0%). PMID:25389439

  16. Acute adult poisoning cases admitted to a university hospital in Tabriz, Iran.

    PubMed

    Islambulchilar, M; Islambulchilar, Z; Kargar-Maher, M H

    2009-04-01

    The aim of our study was to investigate the etiological and demographical characteristics of acute adult poisoning cases admitted to a university hospital in Tabriz, Iran. This retrospective study was performed on 1342 poisoning admissions to a university hospital from 2003 to 2005, by data collection from the medical records of patients. Poisonings were 5.40% of the total admissions. There was a predominance of female patients (55.7%) compared to male patients (44.3%) with a female-to-male ratio of 1.2:1. Most poisonings occurred in the age range of 11-20 years (38.9%). Drugs were the most common cause of poisonings (60.8%). Among the drug poisonings, benzodiazepines (40.31%) were the most frequent agents, followed by antidepressants (31.98%). The seasonal distribution in poisoning patients suggested a peak in spring (28%) and summer (27.5%). In 9.8% of cases accidental and in 90.2% intentional poisonings were evident. Most suicide attempts were made by women (58.51%) and unmarried people (51.4%).The mean duration of hospitalization was 3.02 +/- 2.8 days. There were 28 (2.3%) deaths; the majority (13 cases) was due to pesticides. This was a university hospital-based study, so these results may not be representative of the general population. Despite this drawback, these data still provide important information on the characteristics of the poisoning in this part of Iran. To prevent such poisonings, the community education about the danger of central nervous system-acting drugs and reducing the exposure period of people to pesticides are recommended. PMID:19734268

  17. Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt

    PubMed Central

    Kishk, Rania Mohammed; Mandour, Mohamed Fouad; Farghaly, Rasha Mohamed; Ibrahim, Ahmed; Nemr, Nader Attia

    2014-01-01

    Introduction. Blood stream infection (BSI) is a common problem of newborn in neonatal intensive care units (NICUs). Monitoring neonatal infections is increasingly regarded as an important contributor to safe and high-quality healthcare. It results in high mortality rate and serious complications. So, our aim was to determine the incidence and the pattern of BSIs in the NICU of Suez Canal University Hospital, Egypt, and to determine its impact on hospitalization, mortality, and morbidity. Methods. This study was a prospective one in which all neonates admitted to the NICUs in Suez Canal University hospital between January, 2013 and June 2013 were enrolled. Blood stream infections were monitored prospectively. The health care associated infection rate, mortality rate, causative organism, and risk factors were studied. Results. A total of 317 neonates were admitted to the NICU with a mortality rate of 36.0%. During this study period, 115/317 (36.3%) developed clinical signs of sepsis and were confirmed as BSIs by blood culture in only 90 neonates with 97 isolates. The total mean length of stay was significantly longer among infected than noninfected neonates (34.5 ± 18.3 and 10.8 ± 9.9 days, resp., P value < 0.001). The overall mortality rates among infected and noninfected neonates were 38.9% and 34.8%, respectively, with a significant difference. Klebsiella spp. were the most common pathogen (27.8%) followed by Pseudomonas (21.6%) and Staphylococcus aureus (15.4%). Conclusion. The rate of BSIs in NICU at Suez Canal University Hospital was relatively high with high mortality rate (36.0%). PMID:25389439

  18. Indoor air quality levels in a University Hospital in the Eastern Province of Saudi Arabia

    PubMed Central

    El-Sharkawy, Mahmoud F.; Noweir, Mohamed E. H.

    2014-01-01

    Aim of the Study: The complex hospital environment requires special attention to ensure a healthy indoor air quality (IAQ) to protect patients and healthcare workers against hospital-acquired infections and occupational diseases. Poor hospital IAQ may cause outbreaks of building-related illness such as headaches, fatigue, eye, and skin irritations, and other symptoms. The general objective for this study was to assess IAQ inside a large University hospital at Al-Khobar City in the Eastern Province of Saudi Arabia. Materials and Methods: Different locations representing areas where most activities and tasks are performed were selected as sampling points for air pollutants in the selected hospital. In addition, several factors were studied to determine those that were most likely to affect the IAQ levels. The temperature and relative percent humidity of different air pollutants were measured simultaneously at each location. Results: The outdoor levels of all air pollutant levels, except volatile organic compounds (VOCs), were higher than the indoor levels which meant that the IAQ inside healthcare facilities (HCFs) were greatly affected by outdoor sources, particularly traffic. The highest levels of total suspended particulates (TSPs) and those less than 10 microns (PM10) inside the selected hospital were found at locations that are characterized with m4ore human activity. Conclusions: Levels of particulate matter (both PM10 and TSP) were higher than the Air Quality Guidelines (AQGs). The highest concentrations of the fungal species recorded were Cladosporium and Penicillium. Education of occupants of HCF on IAQ is critical. They must be informed about the sources and effects of contaminants and the proper operation of the ventilation system. PMID:24696632

  19. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    PubMed Central

    Pasquini, T.A.S.; Neder, H.D.; Araújo-Junqueira, L.; De-Souza, D.A.

    2012-01-01

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant. PMID:23250013

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

    PubMed Central

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

    2015-01-01

    Background: Pseudomonas aeruginosa is an opportunistic pathogen that is commonly responsible for nosocomial infections. The aim of this study was to perform a genotyping analysis of the Pseudomonas aeruginosa-resistant isolates by the multilocus sequence typing (MLST) method at the university teaching hospital in Iran. Materials and Methods: Antimicrobial susceptibility was analyzed for P. aeruginosa isolates. Ceftazidime-resistant (CAZres) isolates with a positive double-disc synergy test were screened for the presence of extended-spectrum β-lactamase-encoding genes. Phenotypic tests to detect the metallo-β-lactamase strains of P. aeruginosa were performed on imipenem-resistant (IMPres) isolates. Selected strains were characterized by MLST. Results: Of 35 P. aeruginosa isolates, 71%, 45% and 45% of isolates were CAZres, IMPres and multidrug resistant (MDR), respectively. Fifty-seven percent of the isolates carried the blaOXAgroup-1. All the five typed isolates were ST235. Isolates of ST235 that were MDR showed a unique resistance pattern. Conclusion: This study shows a high rate of MDR P. aeruginosa isolates at the university teaching hospital in Iran. It seems MDR isolates of P. aeruginosa ST235 with unique resistance pattern disseminated in this hospital. PMID:26380241

  1. [The implementation of a quality management tool at a university hospital].

    PubMed

    Pertence, Poliana Prioste; Melleiro, Marta Maria

    2010-12-01

    The objective of this study was to understand the perception of a multidisciplinary health team regarding the implementation of a quality management took at a teaching hospital. The setting of this qualitative study was the University Hospital at University of São Paulo (HU-USP). Participants were seven workers from the Committee for the Implementation of the 5S Program. Data collection was performed through semi-structured interviews and the statements were analyzed according to Janesick. Two categories emerged from the statements: The perception of the multidisciplinary team participating in the implementation of the 5S Program and Factors that affect the implementation of the 5S Program. The categories were interpreted following the Donabedian framework. This study permitted to understand the perception of the multidisciplinary team regarding the implementation of a quality management tool. It is believed that the present findings will contribute with evaluating the 5S Program at the HU-USP, and provide the necessary support for reorganizing activities at that hospital. PMID:21337786

  2. Subsequent Oophorectomy and Ovarian Cancer after Hysterectomy for Benign Gynecologic Conditions at Chiang Mai University Hospital.

    PubMed

    Jitkunnatumkul, Aurapin; Tantipalakorn, Charuwan; Charoenkwan, Kittipat; Srisomboon, Jatupol

    2016-01-01

    This study was undertaken to determine the incidence of subsequent oophorectomy due to ovarian pathology or ovarian cancer in women with prior hysterectomy for benign gynecologic conditions at Chiang Mai University Hospital. Medical records of women who underwent hysterectomy for benign gynecologic diseases and pre-cancerous lesions between January 1, 2004 and December 31, 2013 at Chiang Mai University Hospital were retrospectively reviewed. The incidence and indications of oophorectomy following hysterectomy were analyzed. During the study period, 1,035 women had hysterectomy for benign gynecologic conditions. Of these, 590 women underwent hysterectomy with bilateral salpingo-oophorectomy and 445 hysterectomy with bilateral ovarian preservation or unilateral salpingo-oophorectomy. The median age was 47 years (range, 11-75 years). Ten women (2.45 %) had subsequent oophorectomy for benign ovarian cysts. No case of ovarian cancer was found. The mean time interval between hysterectomy and subsequent oophorectomy was 43.1 months (range, 2-97 months) and the mean follow-up time for this patient cohort was 51 months (range, 1.3-124.9 months). According to our hospital-based data, the incidence of subsequent oophorectomy in women with prior hysterectomy for benign gynecologic conditions is low and all present with benign conditions. PMID:27644627

  3. Pain treatment in a palliative unit or team of a university hospital.

    PubMed

    Scott, J F

    1982-01-01

    A Palliative Care Unit and Team provides a model for delivering care, in which narcotic analgesics can be optimally effective in the treatment of cancer pain. Our rapidly expanding knowledge of pain physiology and narcotic pharmacokinetics will not benefit patients unless we design more appropriate organizational structures to implement therapy and to teach symptom control. The Palliative Care Service model, as developed at several university hospitals in Canada, is designed to assist and complement oncology departments. Its primary role is to provide a consultation service to cancer patients wherever they may be in the health care system (home, O.P.D., hospital). A multi-specialty and interdisciplinary team offers assessment and therapy of pain and other symptoms. The McGill Pain Questionnaire is one useful tool in evaluating pain treatment. The Service also provides the university with a Palliative Care Unit designed for patients with advanced cancer who have complex symptomatology. Hospital organization must reflect the fact that environmental and psychosocial factors alter pain perception and response. Oral morphine is more effective when administered in a Palliative Care Unit than when it is given to patients in other settings. The Unit provides personnel skilled in analgesic titration and a supportive environment in which psychological, social and spiritual components of the pain experience can be evaluated and treated. PMID:6953724

  4. Analysis of maxillofacial prosthetics at university dental hospitals in the capital region of Korea

    PubMed Central

    Lee, Jong-Ho

    2016-01-01

    PURPOSE The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required. PMID:27350859

  5. Does medicine still show an unresolved discrimination against women? Experience in two European university hospitals.

    PubMed

    Santamaría, A; Merino, A; Viñas, O; Arrizabalaga, P

    2009-02-01

    Have invisible barriers for women been broken in 2007, or do we still have to break through medicine's glass ceiling? Data from two of the most prestigious university hospitals in Barcelona with 700-800 beds, Hospital Clínic (HC) and Hospital de la Santa Creu i Sant Pau (HSCSP) address this issue. In the HSCSP, 87% of the department chairs are men and 85% of the department unit chiefs are also men. With respect to women, only 5 (13%) are in the top position (department chair) and 4 (15%) are department unit chiefs. Similar statistics are also found at the HC: 87% of the department chairs and 89% of the department unit chiefs are men. Currently, only 6 women (13%) are in the top position and 6 (11%) are department unit chiefs. Analysis of the 2002 data of internal promotions in HC showed that for the first level (senior specialist) sex distribution was similar. Nevertheless, for the second level (consultant) only 25% were women, and for the top level (senior consultant) only 8% were women. These proportions have not changed in 2007 in spite of a 10% increase in leadership positions during this period. Similar proportions were found in HSCSP where 68% of the top promotions were held by men. The data obtained from these two different medical institutions in Barcelona are probably representative of other hospitals in Spain. It would be ethically desirable to have males and females in leadership positions in the medical profession.

  6. Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay

    PubMed Central

    Bentancor, Ana; Hernández, Ana Laura; Godoy, Yamile; Dapueto, Juan J

    2016-01-01

    ABSTRACT OBJECTIVE To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team. METHODS In this case study, the following aspects were analyzed: 1) historical background; 2) implementation of Law 18,897 of October 22, 2012; and 3) functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay), taking into account three dimensions: structure, process, and results. RESULTS Between December 2012 and November 2013, a total of 6,676 voluntary interruptions of pregnancy were reported in Uruguay; out of these, 80 were conducted at the Hospital de Clínicas. The patients’ demographic data agreed with those reported at the national level: Of the total patients, 81.0% were aged over 19 years; 6.2% decided to continue with the pregnancy; and only 70.0% attended the subsequent control and received advice on contraception. CONCLUSIONS In its implementation year in Uruguay, we can assess the experience as positive from the point of view of women’s health. Our experience as a mental health team at the Hospital de Clínicas, inserted into the multidisciplinary voluntary interruption of pregnancy team, is in the process of assessment and reformulation of practices. PMID:27384969

  7. The use of sedative-hypnotic drugs in a university teaching hospital.

    PubMed Central

    O'Reilly, R; Rusnak, C

    1990-01-01

    We reviewed the charts of 476 patients admitted to a university teaching hospital to determine whether sedative-hypnotic drugs (SHDs) were being used excessively and to examine the use of SHDs as hypnotics. The frequency of medical and surgical indications for barbiturates and benzodiazepines or other minor tranquillizers as well as the use of such drugs were compared among different groups of patients and specialty wards. Of the patients 29% had a regular order and 40% had a PRN order; only 77% of the PRN orders were administered. A total of 215 patients (45%) received an SHD during their hospital stay, and 160 (34%) received the drug as a hypnotic. Medical indications accounted for 49% of the regular orders but only 2% of the PRN orders; moreover, 89% of all the PRN orders were for insomnia. On average, patients receiving SHDs as hypnotics were older (p less than 0.05) and stayed longer in hospital (p less than 0.01) than those who did not; however, no patient on the geriatric or pediatric ward received an SHD as a hypnotic during the hospital stay. The differences in use between patient groups may have been influenced by orientation of ward staff. Physicians should review their rationale for prescribing hypnotics and avoid routine orders on admission. PMID:2369436

  8. Maternal mortality from septic abortions in University Hospital, Kuala Lumpur from March 1968 to February 1974.

    PubMed

    Ng, K H; Sinnathuray, T A

    1975-09-01

    4 maternal deaths from abortion that took place during the 6-year period from March 1968 to February 1974 in the University Hospital, Kuala Lumpur are reviewed with focus on the avoidable causes and preventive aspects. The total maternal deaths from all causes for the 1699 admission was 13. The mortality rate from abortion during this period was 0.241/1000 pregnancies. The number of abortion cases admitted into the hospital during the 6-year period increased steadily. Of the 4 abortion deaths, 3 patients admitted to attempts at inducing abortion. 1 patient denied having induced abortion, although her husband felt that it could have occurred. All 4 cases of abortion deaths occurred in patients with septic abortions and were, theoretically, avoidable deaths. It is most important to prevent sepsis in a case of abortion. Patients with endotoxic shock are often given intravenous steroids in pharmacological doses every 4-6 hours.

  9. To see or not to see. Perceptions of equality in a Swedish university hospital.

    PubMed

    Oresland, S; Jakobsson, A; Segesten, K

    1999-01-01

    In order to examine the perceptions of sex equality among medical doctors (MDs) and registered nurses (RNs), a survey was conducted in a Swedish University Hospital in May 1995. A questionnaire was sent to 475 MDs and RNs of three different age groups. The results showed that women tend to have similar opinions irrespective of occupation and age, which differed significantly from those of men. Men believed that equality in general exists in the hospital, while women think the values and conditions in the workplace mainly benefit men. No evidence was found to indicate a change in the sex hierarchy within the health care system. Rather, the status quo will be maintained and gender stereotypes reinforced from one generation to the next. PMID:12032919

  10. Quality assessment of the wound dressing procedure in patients at a university hospital.

    PubMed

    Nonino, Eleine Aparecida Penha Martins; Anselmi, Maria Luiza; Dalmas, José Carlos

    2008-01-01

    This observational and sectional study analyzed the quality of the wound dressing procedure performed on hospitalized patients at a medical surgical unit of a University Hospital, based on their classification according to the degree of care dependency and activity performance phases. Using a check list, 168 wound dressings were observed between October and December 2005. Procedure quality was analyzed based on the Positivity Index (IP) and values >70% were considered satisfactory. For the preparation, the IP was 68%, 63%, 73% and 75% for patients with degrees I, II, III and IV, respectively; for execution, 70%, 69%, 71% and 75% and, for unit organization, it was >70% for all degrees. However, the items: validity time frame checking, respect for aseptic principles and maintenance of logical sequence of procedures were compromised. Rigorous execution of procedures allows for risk decrease and assures beneficial results for patients, conferring quality to nursing actions.

  11. To see or not to see. Perceptions of equality in a Swedish university hospital.

    PubMed

    Oresland, S; Jakobsson, A; Segesten, K

    1999-01-01

    In order to examine the perceptions of sex equality among medical doctors (MDs) and registered nurses (RNs), a survey was conducted in a Swedish University Hospital in May 1995. A questionnaire was sent to 475 MDs and RNs of three different age groups. The results showed that women tend to have similar opinions irrespective of occupation and age, which differed significantly from those of men. Men believed that equality in general exists in the hospital, while women think the values and conditions in the workplace mainly benefit men. No evidence was found to indicate a change in the sex hierarchy within the health care system. Rather, the status quo will be maintained and gender stereotypes reinforced from one generation to the next.

  12. Deep venous thrombosis of the upper extremity five years experience at a university hospital.

    PubMed

    Painter, T D; Karpf, M

    1984-11-01

    All patients with deep vein thrombosis of the arm seen at one University Hospital over a 5 year period were reviewed. The 17 cases could be divided into distinct patient groups. The first group (primary thrombosis) consisted of 7 patients primarily healthy young males (mean age 23) who had vocations or avocations which involved vigorous physical activity of the arms. The 10 patients with secondary thrombosis tended to be older (mean age 47.3) and to be ill or hospitalized at the time of onset of their illness. Followup information could be obtained in 9 of the cases and 7 of these patients had persistence in their symptoms consisting of residual discomfort and edema of the involved arm especially after exercise. None of the patients treated with anticoagulation were asymptomatic. The only patients who were symptomatic were one patient who received streptokinase and another who underwent thrombectomy. Three illustrative case studies are included.

  13. Distinctiveness of management in a university psychiatric hospital as a public health institution.

    PubMed

    Koncina, Miroslav

    2008-06-01

    The distinctiveness of management of a university psychiatric hospital which has the status of a public health institution is manifested in the following ways: * Distinctive features and characteristics of managing service provider organizations compared to those whose operational results involve tangible products; * Distinctive features of management which originate from its role as a regional hospital and a tertiary research and educational institution in the field of psychiatry, with special importance for the Republic of Slovenia as a whole; * Distinctive features of management that are defined by the social and legal framework of operation of public health institutions and their special social mission. This paper therefore discusses the specific theoretical and practical findings regarding management of service provider organizations from the viewpoint of their social mission and significance, as well as their legal organization, internal structure and values.

  14. Distinctiveness of management in a university psychiatric hospital as a public health institution.

    PubMed

    Koncina, Miroslav

    2008-06-01

    The distinctiveness of management of a university psychiatric hospital which has the status of a public health institution is manifested in the following ways: * Distinctive features and characteristics of managing service provider organizations compared to those whose operational results involve tangible products; * Distinctive features of management which originate from its role as a regional hospital and a tertiary research and educational institution in the field of psychiatry, with special importance for the Republic of Slovenia as a whole; * Distinctive features of management that are defined by the social and legal framework of operation of public health institutions and their special social mission. This paper therefore discusses the specific theoretical and practical findings regarding management of service provider organizations from the viewpoint of their social mission and significance, as well as their legal organization, internal structure and values. PMID:18587280

  15. Antimicrobial susceptibility patterns of Streptococcus pneumoniae over 6 years at Gondar University Hospital, Northwest Ethiopia

    PubMed Central

    Anagaw, Belay; Gezachew, Mucheye; Biadgelgene, Fantahun; Anagaw, Berhanu; Geleshe, Tariku; Taddese, Birke; Getie, Birhanu; Endris, Mengistu; Mulu, Andargachew; Unakal, Chandrashekhar

    2013-01-01

    Objective To assess the magnitude and antimicrobial susceptibility patterns of Streptococcus pneumoniae isolates from various clinical specimens. Methods A record based on retrospective study was conducted at Gondar University Teaching Hospital from September 2007 to January 2012. All patients who visited Gondar University Hospital and provided clinical specimens (body fluids, discharge, swab and blood) for routine bacteriological culturing and antimicrobial susceptibility testing were taken for analysis. Clinical specimens were processed for bacterial culture according to the standard procedures. Antimicrobial susceptibility test for isolated organisms was done using agar disk diffusion method. The data were entered and analyzed using SPSS software version 16 package. Results One hundred and fifty three Streptococcus pneumoniae were isolated from patients who visited Gondar University Teaching Hospital bacteriology laboratory for culture. Majority of the pneumococcal isolates were from inpatients [111(72.5%)], and 74(48.4%) were from body fluids. Out of the total isolates, 93(61%) were found to be resistant to at least one antibiotic used for susceptibility testing. Forty eight (43.2%) of the isolates were multi-drug resistant (resistant to two or more drugs). The resistance rate noted for both ciprofloxacin 17(11.1%) and ceftriaxone 15(9.8%) were alarming. Conclusions High proportions of the isolates tend to be increasingly resistant to the commonly prescribed drugs. The recommended drug of choice like ciprofloxacin and ceftriaxone were found to be less susceptible in the study area. Based on the findings, we therefore recommend that antimicrobial agents should be inspected for acceptable activity before they are prescribed and administered empirically. Further study with a better design and survey of antimicrobial susceptibility at large scale shoule be performed to draw advanced information. PMID:23836097

  16. Translational research in thoracic surgery—the National Taiwan University Hospital experience

    PubMed Central

    Lin, Mong-Wei; Yang, Pei-Wen

    2016-01-01

    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan.

  17. Cryptococcosis in the University Hospital, Kuala Lumpur and review of published cases.

    PubMed

    Pathmanathan, R; Soo-Hoo Tuck Soon

    1982-01-01

    Between January 1974 and June 1980, 85 cases of cryptococcosis were diagnosed in the University Hospital, Kuala Lumpur, Malaysia. The diagnosis was based on positive culture of the organism in 81 cases; the remaining four were diagnosed on histopathological findings. Cerebral cryptococcosis was the most common presentation and Chinese are particularly susceptible (72% of cases). The incidence of the disease is shown to be far greater than previously suspected. Association with compromised host status is uncommon (14%). The local literature is briefly reviewed and the findings discussed.

  18. Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur.

    PubMed

    Jalaludin, M A

    1993-10-01

    Fourteen patients who presented to the University Hospital of Kuala Lumpur between June 1981 and June 1991 were reviewed retrospectively. Nasal septal abscesses are uncommon and therefore there are limited reports in the medical literature. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection. Two out of the fourteen patients developed saddle nose deformity and septal perforation because of delay in treatment, the cases were misdiagnosed by non-otolaryngologist as turbinates swelling. The leading cause of nasal septal abscess was non-surgical trauma which accounted for about 85.7%. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.

  19. Mortality according to age and burned body surface in the Virgen del Rocio University Hospital.

    PubMed

    Gómez-Cía, T; Mallén, J; Márquez, T; Portela, C; Lopez, I

    1999-06-01

    The application of updated clinical protocols for the treatment of burned patients is showing very good results. The mortality curves according to age and the percentage of burned body surface could be of great use for the comparison of clinical results between different burns units. The probability of survival in 1000 consecutive patients admitted to the Burns Unit of the Virgen del Rocio University Hospital between July, 1993 and August, 1997, is compared, by graphic analysis, with the mortality curves of other centers, obtaining similar results. We conclude that the results of medical attendance in our unit are in line with those considered as a reference.

  20. [Hurricane Ike and the University of Texas Medical Branch Hospital's evacuation].

    PubMed

    Maybauer, D M; Megna, M; Kafka, G; Maybauer, M O

    2009-12-01

    In September 2008 the University of Texas Medical Branch at Galveston was threatened by Hurricane Ike. The incident commander decided to evacuate the hospital. This is a report on how this was accomplished and the lessons learned. An adequate disaster preparedness plan, sufficient logistics, a comprehensive incident command center and the use of complex communication systems were crucial for success. Within 11 h a total of 469 patients had been evacuated using 143 ambulances, 23 helicopters, 2 fixed wing aircraft, buses and numerous passenger vans. The authors encourage physicians, as responsible members of the health care team, to be prepared to respond to disasters.

  1. Ameloblastoma: A Survey of 199 Cases in the University College Hospital, Ibadan, Nigeria

    PubMed Central

    Ajagbe, H. A.; Daramola, J. O.

    1987-01-01

    In a study of occurrence of tumors of the jaw seen in the University College Hospital over a 24-year period, 199 cases of histologically diagnosed ameloblastoma were found. Notable features of these lesions were extreme size at presentation and high frequency of recurrence. Ameloblastoma ranks next in frequency to fibroosseous lesions and salivary gland tumors in this community. The incidence in men exceeds that of women. The mandible was the location in over 85 percent of the cases. Six cases were suspected to have turned malignant following multiple surgical operations. ImagesFigure 1Figure 2Figure 3 PMID:3573061

  2. Translational research in thoracic surgery—the National Taiwan University Hospital experience

    PubMed Central

    Lin, Mong-Wei; Yang, Pei-Wen

    2016-01-01

    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan. PMID:27651941

  3. Candidiasis in pediatric patients with cancer interned in a university hospital

    PubMed Central

    De Carvalho Parahym, Ana Maria Rabelo; De Melo, Luciana Resende Bandeira; De Morais, Vera Lúcia Lins; Neves, Rejane Pereira

    2009-01-01

    Fungi are common causes of infection in immunocompromised patients. Candida species are frequently involved in these cases. In order to investigate candidiasis in pediatric patients with cancer, clinical samples were collected from one hundred and twenty two patients interned in the Oswaldo Cruz University Hospital in Recife, Brazil. Yeasts were isolated from thirty-four clinical samples. The species isolated were: Candida albicans (fourteen isolates), C. parapsilosis (nine isolates), C. guilliermondii (two isolates) and C. tropicalis (two isolates). We found that candidemia was most frequent in patients with malignant hematology and that C. parapsilosis infections caused the highest mortality. PMID:24031365

  4. Translational research in thoracic surgery-the National Taiwan University Hospital experience.

    PubMed

    Lin, Mong-Wei; Yang, Pei-Wen; Lee, Jang-Ming

    2016-08-01

    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan.

  5. Translational research in thoracic surgery-the National Taiwan University Hospital experience.

    PubMed

    Lin, Mong-Wei; Yang, Pei-Wen; Lee, Jang-Ming

    2016-08-01

    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan. PMID:27651941

  6. Rate of Medical Errors in Affiliated Hospitals of Mazandaran University of Medical Sciences

    PubMed Central

    Saravi, Benyamin Mohseni; Mardanshahi, Alireza; Ranjbar, Mansour; Siamian, Hasan; Azar, Masoud Shayeste; Asghari, Zolikah; Motamed, Nima

    2015-01-01

    Introduction: Health care organizations are highly specialized and complex. Thus we may expect the adverse events will inevitably occur. Building a medical error reporting system to analyze the reported preventable adverse events and learn from their results can help to prevent the repeat of these events. The medical errors which were reported to the Clinical Governance’s office of Mazandaran University of Medical Sciences (MazUMS) in years 2011-2012 were analyzed. Methods and Materials: This is a descriptive retrospective study in which 18 public hospitals were participated. The instrument of data collection was checklist that was designed by the Ministry of Health of Iran. Variables were type of hospital, unit of hospital, season, severity of event and type of error. The data were analyzed with SPSS software. Results: Of 317966 admissions 182 cases, about 0.06%, medical error reported of which most of the reports (%51.6) were from non- teaching hospitals. Among various units of hospital, the highest frequency of medical error was related to surgical unit (%42.3). The frequency of medical error according to the type of error was also evaluated of which the highest frequency was related to inappropriate and no care (totally 37%) and medication error 28%. We also analyzed the data with respect to the effect of the error on a patient of which the highest frequency was related to minor effect (44.5%). Conclusion: The results showed that a wide variety of errors. Encourage and revision of the reporting process will be result to know more data for prevention of them. PMID:25870528

  7. INPATIENTS SATISFACTION WITH NURSING SERVICES AT KING KHALID UNIVERSITY HOSPITAL, RIYADH, SAUDI ARABIA

    PubMed Central

    Al-Doghaither, Abdulla H.

    2000-01-01

    Abstract: Recent development and changes in health care services in Saudi Arabia have encouraged a search a search for comprehensive and established measurements of the quality of care. Patient satisfaction with nursing care in particular has ferquently been used as a sensitive and objective measure of quality of hosiptal services. Objectives: The objectives of this study are: (1) to assess the level of inpatient satisfaction with nursing care (PSWC) in the various wards of the hospital; (2) to assess the socio-demographic determinants of PSWC in addition to the effects of duration of hospital stay and type of wards on the level of satisfaction. Methods: The sample consisted of randomly selected 450 inpatients with probability proportion to the size of the wards. The data was collected by personal interviews using a 21-item structured questionnaire pertaining to nursing services. Results: The results revealed that the instrument of measurement was valid and reliable. The overall mean satisfaction score was 2.4 (77%) and the highest mean satisfaction was for items on skillfulness and the lowest score was for communication items. Multiple regression analysis indicated that sex, age, marital status and duration of stay are the most imortant predictors of PSWC; female, young, married and short duration of hospital stay have the highest satisfaction score. Conclusion: In conclusion, this study has highlighted the aspects of nursing care at King Khalid University Hospital (KKUH) which need re-examination by the management. The most importance findings have been that there is: (1) a shortage of nurses at the hospital; (2) limited communication between nurses and patients: most probably due to cultural and language barriers; (3) no proper oversight of patients personal hygiene; (4) dissatisfaction of male patients with most of the nursing care rendered. These results offer the hospial management the opportunity to work out stategies to connect the deficiencies highlighted

  8. PACS in the Utrecht University Hospital: final conclusions of the clinical evaluation

    NASA Astrophysics Data System (ADS)

    Wilmink, J. B.; ter Haar Romeny, Bart M.; Barneveld Binkhuysen, Frits H.; Achterberg, A. J.; Zuiderveld, Karel J.; Calkoen, P.; Kouwenberg, Jef M.

    1990-08-01

    In the past three years, a clinical evaluation of a PACS has been performed in the Utrecht University Hospital as part of the Dutch PACS project. The clinical evaluation focussed on the following aspects: technical evaluation of the prototype PACS equipment coupled to the HIS; diagnostic accuracy studies; studies concerning the impact on the organization of the radiology-department and the referring wards; and cost-savings analysis. Some of the results of these subprojects have already been presented at previous SPIE conferences. In this paper the general condusions are presented about the usefulness of the evaluated PAC-System in the daily routine of radiology department and clinic. By making available the images of radiological examinations fast, complete, reliable and continously on the ward, concrete improvements with regard to the current process could be realized. The possibilities of PACS caused an increasing enthousiasm among the clinicians. By the easier access to all images of their patients during 24 hours/day, they saw more images on the day of the examination and images could be more easily used at consultations of other specialists. The overall conclusion is positive, but a lot of work has to be done to transform PACS from an experimental setup into a routine production system on which a flimless hospital can be based. A complete PACS needs an inteffigent Image Management System, which indudes prefetching algorithms based on data from the Hospital Information System and automated procedures for removing obsolete images from the local buffers in the workstations. As yet PACS is very expensive, and the direct savings in the hospital cannot compensate for the high costs of investment. Possibly PACS can contribute to a shorter stay of patients in the hospital. This will lead to savings for government and health insurance companies and they can be expected to contribute to PAS implementation studies.

  9. Knowledge of periconceptional folic acid use among pregnant women at Ain Shams University Hospital, Cairo, Egypt.

    PubMed

    Al-Darzi, W; Al-Mudares, F; Farah, A; Ali, A; Marzouk, D

    2014-10-12

    Egypt has a high incidence of neural tube defects. Folic acid supplementation in the periconceptional period is known to lower the risk of such defects. This cross-sectional study aimed to measure the level of knowledge about periconceptional folic acid use among pregnant women attending for antenatal care at Ain Shams University Hospital, Cairo, Egypt in 2012. Questionnaires were filled through personal interviews with 660 pregnant women. Of the respondents, 62.4% had heard of folic acid and 39.2% knew about the role of folic acid supplementation in prevention of congenital anomalies. Knowledge about using folic acid before and in the first trimester of pregnancy was highest among university-educated women and those working in professional occupations. Only 18.8% of women reported taking folic acid, and 8.8% had used it before conception. Awareness campaigns are suggested to improve knowledge about folic acid among women in the childbearing period in Egypt.

  10. National Bloodstream Infection Surveillance in Switzerland 2008-2014: Different Patterns and Trends for University and Community Hospitals.

    PubMed

    Buetti, Niccolò; Marschall, Jonas; Atkinson, Andrew; Kronenberg, Andreas

    2016-09-01

    OBJECTIVE To characterize the epidemiology of bloodstream infections in Switzerland, comparing selected pathogens in community and university hospitals. DESIGN Observational, retrospective, multicenter laboratory surveillance study. METHODS Data on bloodstream infections from 2008 through 2014 were obtained from the Swiss infection surveillance system, which is part of the Swiss Centre for Antibiotic Resistance (ANRESIS). We compared pathogen prevalences across 26 acute care hospitals. A subanalysis for community-acquired and hospital-acquired bloodstream infections in community and university hospitals was performed. RESULTS A total of 42,802 bloodstream infection episodes were analyzed. The most common etiologies were Escherichia coli (28.3%), Staphylococcus aureus (12.4%), and polymicrobial bloodstream infections (11.4%). The proportion of E. coli increased from 27.5% in 2008 to 29.6% in 2014 (P = .04). E. coli and S. aureus were more commonly reported in community than university hospitals (34.3% vs 22.7%, P<.001 and 13.9% vs 11.1%, P<.001, respectively). Fifty percent of episodes were community-acquired, with E. coli again being more common in community hospitals (41.0% vs 32.4%, P<.001). The proportion of E. coli in community-acquired bloodstream infections increased in community hospitals only. Community-acquired polymicrobial infections (9.9% vs 5.6%, P<.001) and community-acquired coagulase-negative staphylococci (6.7% vs 3.4%, P<0.001) were more prevalent in university hospitals. CONCLUSIONS The role of E. coli as predominant pathogen in bloodstream infections has become more pronounced. There are distinct patterns in community and university hospitals, potentially influencing empirical antibiotic treatment. Infect Control Hosp Epidemiol 2016;37:1060-1067.

  11. Preparing an Academic Medical Center to Manage Patients Infected With Ebola: Experiences of a University Hospital.

    PubMed

    Schultz, Carl H; Koenig, Kristi L; Alassaf, Wajdan

    2015-10-01

    As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered to become an Ebola Treatment Center as part of the US effort to manage the threat. We developed detailed policies and procedures for Ebola patient management at our university hospital. Both the EMS system and county public health made significant contributions during the development process. This article shares information about this process and the outcomes to inform other institutions facing similar challenges of preparing for an emerging threat with limited resources. The discussion includes information about management of (1) patients who arrive by ambulance with prior notification, (2) spontaneous walk-in patients, and (3) patients with confirmed Ebola who are interfacility transfers. Hospital management includes information about Ebola screening procedures, personal protective equipment selection and personnel training, erection of a tent outside the main facility, establishing an Ebola treatment unit inside the facility, and infectious waste and equipment management. Finally, several health policy considerations are presented. PMID:26403515

  12. The use of primary total hip arthroplasty in university hospitals of the European Union.

    PubMed

    Scheerlinck, Thierry; Druyts, Pieter; Casteleyn, Pierre-Paul

    2004-06-01

    Current practice in primary total hip replacement was investigated by postal survey in 125 university hospitals of the European Union (EU). Most hospitals (78.4%) use a hip register and implant cemented as well as uncemented stems (72.0%) and cups (68.8%). In Scandinavian & Anglo-Saxon countries, 42.9% of the departments implant cemented stems in all their patients, and 16.7% implant cemented cups in all their patients. In these countries, modern cementing techniques are commonly used and therapeutic choices are strongly influenced by hip registers. In Southern Europe, cemented cups have been abandoned in 31.1% and modern cementing techniques are less common. Benelux & Germanic countries have a practice in between. Three cemented (Exeter, Charnley, Lubinus) and three uncemented stems (Zweymüller, ABG, Bi-contact) represent 41.9% and 25.3% of stem types in use. Most departments (70.4%) have adopted alternative bearings. Ceramic-ceramic and metal-metal are both used in almost half of the hospitals. Metal-polyethylene has been abandoned in 15.2%. These trends are taught to new generations of surgeons in the EU and could become common practice in a near future. PMID:15287402

  13. Preparing an Academic Medical Center to Manage Patients Infected With Ebola: Experiences of a University Hospital.

    PubMed

    Schultz, Carl H; Koenig, Kristi L; Alassaf, Wajdan

    2015-10-01

    As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered to become an Ebola Treatment Center as part of the US effort to manage the threat. We developed detailed policies and procedures for Ebola patient management at our university hospital. Both the EMS system and county public health made significant contributions during the development process. This article shares information about this process and the outcomes to inform other institutions facing similar challenges of preparing for an emerging threat with limited resources. The discussion includes information about management of (1) patients who arrive by ambulance with prior notification, (2) spontaneous walk-in patients, and (3) patients with confirmed Ebola who are interfacility transfers. Hospital management includes information about Ebola screening procedures, personal protective equipment selection and personnel training, erection of a tent outside the main facility, establishing an Ebola treatment unit inside the facility, and infectious waste and equipment management. Finally, several health policy considerations are presented.

  14. The effectiveness of the installation of a mobile voice communication system in a university hospital.

    PubMed

    Hanada, Eisuke; Fujiki, Tadayoshi; Nakakuni, Hideaki; Sullivan, Corbet Vernon

    2006-04-01

    In large hospitals, collaborative clinical practice is currently emphasized, with members of various departments expected to work as a team. The importance of accurate communication among the team members is of utmost importance. To improve such communication, the introduction of mobile voice communication systems has received much attention in Japan. Shimane University Hospital also introduced a Personal Handy-phone System (PHS) for doctors. In the traditional setting, much time was wasted searching for doctors through multiple calls on fixed-line telephones. In order to measure the effectiveness of our system, the change in the number of calls made on fixed-line telephones before and after PHS installation was compared. The total number of calls was reduced by more than 35%, and the number of calls to the wards on weekdays was reduced by half. Mobile telecommunication systems with small output power, such as PHS, are known to cause little interference with medical devices which makes it possible to use mobile voice communication safely in hospitals. The improvement in communication by this systems resulted in an improvement in labor efficiency.

  15. Transfusion Consent in Oman: Physicians’ Perception at a Tertiary Care University Hospital

    PubMed Central

    Al-Riyami, Arwa Z.; Al-Marshoodi, Ibrahim; Zia, Fehmida; Al-Huneini, Mohammed; Al-Rawas, Abdul Hakim; Jose, Sachin; Daar, Shahina; Al-Khabori, Murtadha; Al-Sabti, Hilal

    2016-01-01

    Objectives Transfusion is a common intervention that mandates the discussion of benefits, risks, and alternatives to planned transfusions. In Oman, transfusion consent was first introduced at the Sultan Qaboos University Hospital in March 2014. We sought to evaluate our physicians’ opinions, attitudes, and perception of the transfusion consent process. Methods Attending physicians of different specialties were invited to complete an anonymous survey on transfusion consent. Results A total of 114 physicians responded to the survey. Transfusion benefits and risks were explained regularly by 91% and 87% of the surveyed physicians, respectively. On the other hand, alternatives were declared by only 38%. Discomfort with the consent process was admitted by 10% of the physicians. There was no statistically significant association between discomfort in obtaining the consent and the physician seniority (p = 0.801), nor their specialties (p = 0.623). The importance of the consent process was acknowledged by 80% of surveyed physicians, who supported its implementation in other hospitals. Conclusion This survey reflects positive attitudes of the surveyed physicians on the importance of transfusion consent. However, actions are required to achieve physicians’ full ease with the process and to ensure that transfusion alternatives are discussed. We advocate implementation of transfusion consent in other hospitals in Oman. PMID:27403236

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

    PubMed Central

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

    2015-01-01

    Background: Patient education is widely recognized as a core component of nursing. Patient education can lead to quality outcomes including adherence, quality of life, patients' knowledge of their illness and self-management. This study aimed to clarify patient education process in teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS) in Iran. Methods: This cross-sectional study was conducted in 2013. In this descriptive quantitative study, the sample covered 187 head nurses selected from ten teaching hospitals through convenience sampling. Data were collected with a questionnaire developed specifically for this study. The questionnaire measured patient education process in four dimensions: need assessment, planning, implementing and evaluating. Results: The overall mean score of patient education was 3.326±0.0524. Among the four dimensions of the patient education process, planning was in the highest level (3.570±0.0591) and the lowest score belonged to the evaluation of patient education (2.840 ±0.0628). Conclusion: Clarifying patient education steps, developing standardized framework and providing easily understandable tool-kit of the patient education program will improve the ability of nurses in delivering effective patient education in general and specialized hospitals. PMID:26478878

  17. University Hospitals: creating the infrastructure for quality and value through accountable care.

    PubMed

    Zenty, Thomas F; Bieber, Eric J; Hammack, Elizabeth R

    2014-01-01

    University Hospitals Health System Inc. (UH), in Cleveland, Ohio, like many hospitals and healthcare systems, sought to anticipate the dramatic changes of healthcare reform, including its increased focus on quality and outcomes. UH evaluated incentives to keep patients out of hospital and to ease mounting pressures on reimbursement and costs. During UH's strategic planning sessions in 2009 and 2010, we identified value--the combination of quality and efficiency--to be a key driver of our future success. Ahead of the enactment of the Affordable Care Act, in early 2010 we chose to proceed with the formation of an accountable care organization (ACO). We believed the ACO was a novel vehicle by which to improve the efficient delivery of our high-quality healthcare to maximize the value of the services we provide. We also believed that the most successful strategy, if it can be achieved, is to build on success. A major success, or a series of smaller successes, will go a long way toward achieving operational buy-in, enhancing respect for strategic initiatives, and convincing physicians of the need for change. Through thoughtful governance, effective plan design, customized data analytics, physician networks and incentives, innovative patient engagement, and supplemental coordination resources, our ACOs have succeeded in improving population health and delivering value.

  18. [Implementing a “Health Promoting Workplace”: compatible organizational practices in university hospital].

    PubMed

    Bilterys, Robert; Dedobbeleer, Nicole

    2016-01-01

    In 2006, a University Hospital in Quebec decided to implement the Health Promoting Hospital project (HPH). A study was conducted on the internal context of the HPH Project implementation, and more particularly on one of its dimensions, the “health promoting workplace”. Compatibility is an important factor of the internal context, but has been rarely studied. The objective of this paper is to examine whether there are any organizational practices compatible with those of a health promoting workplace for nurses. A questionnaire was administered, interviews were conducted with strategic actors and a document analysis was performed.The results show various levels of compatibility with the criteria of a health promoting workplace. Thus, compatibility was very high for criteria related to the development of a learning and efficient organization, the strategies to ensure a healthy and safe workplace, and healthy lifestyles. However, poor compatibility was observed for criteria related to the adoption of a health promotion policy and no compatibility was observed for nurses’ participation in the decision-making process.The study identified strengths and weaknesses in the “Health Promoting Workplace” Subproject implementation process. It also emphasized the importance of the adaptation of tools to local conditions. In this case, it is the WHO assessment tool for hospitals wishing to assess their health promotion practices and to stimulate their development. PMID:27391884

  19. Retrorectal tumours: literature review and Vilnius University Hospital "Santariskiu klinikos" experience of 14 cases

    PubMed Central

    2011-01-01

    Objective Retrorectal tumours are rare lesions in adults. The diagnosis of retrorectal lesion is often difficult and misdiagnosis is common. We present significant number of cases in view of scarce information available on this matter. Methods 14 patients were treated at Vilnius university hospital "Santariskiu klinikos" Centre of abdominal surgery from 1997 to 2010. The case notes of patients who underwent surgery for a retrorectal tumour were reviewed retrospectively. Surgical histories, operations, histological tumour type, surgical time, weight of the specimen, blood loss, length of stay were analysed. Results 13 patients underwent laparotomy, 1 patient had combined perineal approach and laparotomy. The most common types of the tumour were fibroma (3 cases), leiomyosarcoma (2 cases). 5 tumours (35,7%) were found to be malignant. 57% of the patients had undergone at least one operation prior to definitive treatment. 5 female patients were initially admitted under gynaecologists. Hospital stay varied from 14 days to 22 days (mean 16,2 days). A report of a representative case is presented. Conclusions Retrorectal lesions in female patients can mimic gynaecological pathology. Patients with this rare pathology are to be treated in a major tertiary hospital by surgeons, who are able to operate safely in the retrorectal space. PMID:21719397

  20. Adult allogeneic bone marrow transplantation: initial experience in the University Hospital, Kuala Lumpur.

    PubMed

    Teh, A; Bosco, J J; Leong, K W; Saw, M H; Menaka, N; Devashanti, P

    1997-03-01

    Prior to 1993, bone marrow transplantation for adult patients was not available in Malaysia. Adult allogeneic bone marrow transplantation commenced in Malaysia when the first transplant was conducted at the University Hospital, Kuala Lumpur on 2 November 1993. Up till July 1995, 10 adult bone marrow transplants had been conducted at the University Hospital. Five patients had acute myeloid leukaemia in first remission, 4 had chronic myeloid leukaemia and 1 had acute lymphoblastic leukaemia in first partial remission. The age range of patients at the time of transplant is 16-40 years (mean 25.5 years). All patients engrafted successfully and the survival for the first 100 days post-transplant is 90%. One patient demonstrated haematological relapse post-transplant but achieved remission with donor buffy-coat infusion. The mean drug cost incurred was RM28,269 for the first 100 days. Locally available adult allogeneic bone marrow transplantation is safe, affordable and has comparable results with reputable overseas transplant centres.

  1. Hydatidiform molar pregnancy in Malaysian women: a histopathological study from the University Hospital, Kuala Lumpur.

    PubMed

    Cheah, P L; Looi, L M; Sivanesaratnam, V

    1993-06-01

    A review of gestational trophoblastic disease diagnosed at the Department of Pathology, University Hospital, Kuala Lumpur from January 1989 to December 1990 using established histological criteria showed 25 complete hydatidiform moles (CHM), 11 partial hydatidiform moles (PHM), 1 invasive mole and 2 choriocarcinoma. The ages of the patients with CHM ranged from 21 to 43 years (mean = 28.5 years) and PHM 20 to 33 years (mean = 27.5 years). The invasive mole occurred in a 42-year-old Malay woman. The two patients with choriocarcinoma were both Chinese and 41 and 46-years old respectively. During the same period, 1,062 non-molar abortions and 13,115 births, inclusive of livebirths and stillbirths were recorded at the University Hospital. The incidence rate of hydatidiform moles was thus estimated to be 1:384 pregnancies. PHM constituted 30% of all molar pregnancies. Hydatidiform moles occurred among the Malays, Chinese and Indians at the rate of 2.43, 2.66 and 3.29 per 1,000 pregnancies respectively. It appears that hydatidiform molar pregnancy has the highest prevalence among the Indians, a finding similar to an earlier Singapore study.

  2. The nursing staff opinion about the continuous quality improvement program of a university hospital

    PubMed Central

    da Costa, Fernanda Mazzoni; Greco, Rosangela Maria; Bohomol, Elena; Arreguy-Sena, Cristina; Andrade, Vitor Luiz

    2014-01-01

    ABSTRACT Objective To analyze the nursing staff opinion about the continuous quality improvement program at a University Hospital. Methods A descriptive study designed as a case study, analyzing the quality program at a University Hospital, with the opinion of a sample stratified by nursing team category through a self-administered questionnaire, from May to July 2012. The answers were submitted to factor analysis, having the dialectical and historical materialism as the theoretical-methodological reference. Results The factor analysis grouped the variables in six factors: working conditions, approval, belongingness, tranquility, interpersonal relations, and private life. With the exception of the factor interpersonal relations, the answers revealed that workers do not have opinion about the proposed questions. Four of the six factors had a predominance of positive answers. Conclusion A high percentage of respondents was not aware of the implications of a quality program. The majority believed that the program influenced positively in their working conditions and in the interpersonal relationships at work and agree with the program; however, they did not feel part of the program, and were not at ease to develop these activities. They did not acknowledge the program interfering in their personal life. PMID:25003928

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

    PubMed Central

    Tiong, William H.C.; O'Shaughnessy, Michael; O'Sullivan, Sean T.

    2011-01-01

    Previous studies in USA and Canada have found that physicians and physicians in training have a limited understanding of medical care costs. In this study, we set out to survey all grades of doctors in the surgical department, emergency department, and anaesthetic department in a university-affiliated, Irish teaching hospital. Open-ended questionnaires on cost of 25 routinely used items in the hospital were sent to each department. The aims of the study were to assess the present knowledge of cost among the various grades of doctors, and to evaluate the level of professional experience on cost awareness and their confidence in their estimates. We had an overall response rate of 56.8% with 68.5% of doctors admitted to have estimated more than 90% of their responses. Ninety three percent of doctors have no confidence in their estimates on cost of listed items. We found that the lack of cost awareness was universal among doctors of all grades (P = 0.236). The doctors in our study population showed a high level of inaccuracy on their estimates of cost of routinely used items with 84% of the items overestimated. Our results were discouraging and demonstrated that considerable educational activity will be necessary if doctors are to be more cost effective in meeting the national health care budget. PMID:24765391

  4. Factors of importance for work satisfaction among nurses in a university hospital in Sweden.

    PubMed

    Gardulf, Ann; Orton, Marie-Louise; Eriksson, Lars E; Undén, Maria; Arnetz, Bengt; Kajermo, Kerstin Nilsson; Nordström, Gun

    2008-06-01

    The shortage of registered nurses in the healthcare sector is a problem in most countries. Swedish nurses tend to leave or seek new positions. However, few Swedish studies have addressed questions regarding what factors are of importance for nurses to perceive work satisfaction although satisfied nurses are linked to many positive organizational outcomes, e.g. improved quality of patient care. The aim of this study was to investigate what factors are of importance for nurses at a university hospital to perceive work satisfaction. Eight hundred and thirty-three nurses responded to the mailed Quality Work Competence questionnaire and the Huddinge University Hospital Model Questionnaire. Regression analyses identifies five factors linked to the head nurses leadership contributing to the nurses' feelings of work satisfaction: 'professional competence is made good use of', 'feeling of satisfaction with immediate superior regarding support for nursing research and development', 'opportunities for developing one's own competence for the current job', 'career opportunities in one's own profession' and 'yearly dialogue for performance appraisal with immediate superior'. The nurses also reported work-related exhaustion. Few saw opportunities for making a career as a nurse. In conclusion, the study identified specific amenable factors linked to the head nurses leadership that are of importance in creating attractive workplaces for nurses. PMID:18489684

  5. Identification of child maltreatment while caring for them in a university hospital.

    PubMed

    Paavilainen, Eija; Merikanto, Juhani; Astedt-Kurki, Päivi; Laippala, Pekka; Tammentie, Tarja; Paunonen-Ilmonen, Marita

    2002-03-01

    The purpose of the study was to look at how nurses and physicians of a university hospital rated their ability to identify child maltreatment while caring for those children. In this study, child maltreatment was defined as physical, psychological or sexual abuse or neglect of a child under the age of 18 by parents or caregivers. The total population of staff caring for children (N=513) in a university hospital were surveyed. Data were collected with a questionnaire developed for this study with reference to the literature. Altogether 317 questionnaires were returned, which yielded a response rate of 62%. The data were analysed using statistical methods and quantitative content analysis. Forty per cent of the respondents estimated that they had never cared for a maltreated child. Two-thirds of the respondents believed that they would be able to identify a child maltreatment case. The most distinct signs by which maltreatment could be identified were fractures, multiple bruises and the fact that the child had frequent injuries. The child's or parent's behaviour often aroused suspicion of maltreatment. Seventy-one per cent of the respondents rated the identification of maltreatment as rather difficult or difficult. Awkwardness of the phenomenon, the staff's pressure of work and relative unfamiliarity with the phenomenon were assessed as things that make the identification difficult. The fact that no jointly agreed guidelines were available for handling the matter was seen as a particular weakness. The respondents had fairly much theoretical knowledge about child maltreatment. However, child maltreatment is a multi-dimensional phenomenon that calls forth emotions. The development and improvement of practical nursing and medical care and of staff collaboration require that education be provided to different occupational groups and parties caring for children and that jointly agreed hospital-specific and regional models for operation be developed.

  6. Congenital lobar emphysema: 30-year case series in two university hospitals*

    PubMed Central

    Cataneo, Daniele Cristina; Rodrigues, Olavo Ribeiro; Hasimoto, Erica Nishida; Schmidt, Aurelino Fernandes; Cataneo, Antonio José Maria

    2013-01-01

    OBJECTIVE: To review the cases of patients with congenital lobar emphysema (CLE) submitted to surgical treatment at two university hospitals over a 30-year period. METHODS: We reviewed the medical records of children with CLE undergoing surgical treatment between 1979 and 2009 at the Botucatu School of Medicine Hospital das Clínicas or the Mogi das Cruzes University Hospital. We analyzed data regarding symptoms, physical examination, radiographic findings, diagnosis, surgical treatment, and postoperative follow-up. RESULTS: During the period studied, 20 children with CLE underwent surgery. The mean age at the time of surgery was 6.9 months (range, 9 days to 4 years). All of the cases presented with symptoms at birth or during the first months of life. In all cases, chest X-rays were useful in defining the diagnosis. In cases of moderate respiratory distress, chest CT facilitated the diagnosis. One patient with severe respiratory distress was misdiagnosed with hypertensive pneumothorax and underwent chest tube drainage. Only patients with moderate respiratory distress were submitted to bronchoscopy, which revealed no tracheobronchial abnormalities. The surgical approach was lateral muscle-sparing thoracotomy. The left upper and middle lobes were the most often affected, followed by the right upper lobe. Lobectomy was performed in 18 cases, whereas bilobectomy was performed in 2 (together with bronchogenic cyst resection in 1 of those). No postoperative complications were observed. Postoperative follow-up time was at least 24 months (mean, 60 months), and no late complications were observed. CONCLUSIONS: Although CLE is an uncommon, still neglected disease of uncertain etiology, the radiological diagnosis is easily made and surgical treatment is effective. PMID:24068262

  7. Level of radiation dose in university hospital non-insured private health screening programs in Korea

    PubMed Central

    2016-01-01

    Objectives The aim of this study is to evaluate radiation exposure resulting from the comprehensive health examinations of selected university hospital programs and to present basic data for research and management strategies on the health effects of medical radiation exposure. Methods Radiation-based diagnostic studies of the comprehensive health examination programs of ten university hospitals in Seoul, Korea, as introduced in their websites, were analyzed. The medical radiation studies of the programs were reviewed by radiologists. Only the effective doses of the basic studies were included in the analysis. The optional studies of the programs were excluded. Results Among the 190 comprehensive health examination programs, 132 programs (69.5%) included computed tomography studies, with an average of 1.4 scans. The average effective dose of radiation by program was 3.62 mSv for an intensive program for specific diseases; 11.12 mSv for an intensive program for cancer; 18.14 mSv for a premium program; and 24.08 mSv for an overnight program. A higher cost of a programs was linked to a higher effective dose (r=0.812). The effective doses of the examination programs for the same purposes differed by as much as 2.1 times by hospital. Inclusion of positron emission tomography–computed tomography was the most critical factor in determining the level of effective dose. Conclusions It was found that radiation exposure dose from comprehensive health exam programs targeted for an asymptomatic, healthy public reached between 3.6 and 24 times the annual dose limit for the general public. Relevant management policies at the national level should be provided to minimize medical radiation exposure. PMID:27032387

  8. A Review of Clostridium difficile Infection at the University Hospital of the West Indies, Jamaica

    PubMed Central

    Clare-Pascoe, N; Lee, MG; Murphy, T; Nicholson, A; Ferguson, TS

    2015-01-01

    ABSTRACT Objectives: This study examined the frequency of Clostridium difficile infection (CDI) among hospital admission and diarrhoeal stool samples over a six-year period. Methods: A review of all suspected cases of C difficile positive patients from 2007 to 2012 at the University Hospital of the West Indies (UHWI), Jamaica, was performed. Clostridium difficile infection was confirmed by clinical features and a positive enzyme-linked immunosorbent assay (ELISA) stool test for Clostridium Toxins A and B. The demographics, clinical features, risk factors, treatment and outcomes were also collated. Results: There were 56 patients reviewed. The most commonly affected age group was 40–59 years of age. The proportion of CDI cases per total stool samples increased from 0.5% in 2007 to 5.9% in 2010 then fell to 2.2% in 2011 but increased again to 4.3% in 2012. The proportion of cases per total UHWI admissions also increased from 0.12 cases per 1000 admissions in 2007 to 1.16 in 2010 and 1.36 in 2012 (p < 0.001). Most CDI cases were nosocomial (76% males, 48.6% females). Co-morbidities included hypertension and end-stage renal disease. Ceftazidime was the most common antibiotic associated with the development of CDI. Resolution occurred in 62.5% of patients. Duration of hospital stay was longer in males than females (≥ 21 versus < 7 days) and males had more adverse outcomes, with death in 23.8% versus 11.4%. Conclusion: There has been an increase in the frequency of CDI at UHWI with a greater than expected frequency of community acquired CDI. Increased awareness is needed of the increasing risk for CDI and measures must be taken to prevent the disease, especially in hospitalized patients. PMID:26624597

  9. [Measures taken by a university hospital for the prevention and control of the 2009 H1N1 influenza].

    PubMed

    Hayashi, Jun; Murata, Masayuki; Furusyo, Norihiro; Hoshina, Takayuki; Shimono, Nobuyuki

    2010-09-01

    After extensive discussion with the Fukuoka City government of measures for the prevention and control of the 2009 H1N1 influenza pandemic, Kyushu University Hospital organized the infection control teams of 39 hospitals in the Fukuoka City area in preparation for a possible outbreak. A facility was set up at Kyushu University Hospital for the screening of outpatients with fever, and those with influenza and an underlying disease or severe symptoms were admitted to the hospital. 37 (22%) of the 171 outpatients with fever were infected with the new strain of influenza, confirmed by rapid influenza antigen test and PCR: Of these 37 patients, 17 (45.9%) were negative by influenza antigen test. Other 37 patients (5 adults, 32 children) were admitted, all of whom were successfully treated with neuraminidase inhibitors and discharged with no aftereffects.

  10. Anaesthetic contribution to deaths in the operating theatre at the University Hospital Kuala Lumpur--a retrospective survey.

    PubMed

    Tan, I; Delilkan, A E

    1993-12-01

    From January 1980 to August 1992, there were 125 deaths occurring in the operating theatre at the University Hospital Kuala Lumpur. Out of these 125, six were judged to have been mainly 'due to anaesthesia.' In the same time period, there were a total of 155,000 anaesthetics given in the hospital. This gives an anaesthetic death rate (in the operating theatre) of six out of 155,000 or 0.39:10,000.

  11. Nursing competency and organizational climate as perceived by staff nurses in a Chinese university hospital.

    PubMed

    Ying, Liu; Kunaviktikul, Wipada; Tonmukayakal, Ouyporn

    2007-09-01

    Nursing competency is important to ensure patient safety and improve the quality of nursing care. Based on competency-based human resource management strategies, the organizational climate can positively influence nursing competency. However, a review of the literature indicated that there were no studies about the relationship between nursing competency and organizational climate in the People's Republic of China. This descriptive, correlational study examined the relationship between nursing competency and the organizational climate. The sample consisted of 243 staff nurses who completed the questionnaire worked at one university hospital in Liao Ning Province. The findings showed that there was a significantly moderate positive relationship between nursing competency and organizational climate. The study results suggested that Chinese nurse managers should maintain and provide a positive organizational climate to improve nursing competency.

  12. A retrospective study on malaria cases admitted to the University Hospital, Kuala Lumpur, 1984-1988.

    PubMed

    Sidhu, P S; Ng, S C

    1991-06-01

    A review of malaria cases over a five year period from 1984-1988 at the University Hospital, Kuala Lumpur, Malaysia is presented. A total of 64 cases were recorded; 50% of which were due to Plasmodium falciparum, 40.6% were due to Plasmodium vivax, 6.2% due to Plasmodium malariae and 3.1% due to a mixed infection of Plasmodium falciparum and Plasmodium vivax. The breakdown of species type compared similarly with other studies conducted in the region. Of this total, sixteen cases were imported from Pakistan, India, Thailand, Indonesia, Sri Lanka, Vietnam, Madagascar and Mali. The presenting symptoms and the clinical findings were typical of a malaria infection. The main problem in the future will be the increase in imported cases of malaria.

  13. First year's experience with an acute pain service--University Hospital Kuala Lumpur.

    PubMed

    Vijayan, R; Delilkan, A E

    1994-12-01

    An Acute Pain Service (APS) was started in University Hospital, Kuala Lumpur by the Department of Anaesthesiology in October 1992 for more effective control of postoperative pain. The main modalities of treatment included patient controlled analgesia (PCA) using morphine or pethidine with PCA devises, epidural opiate analgesia (EOA) using tramadol or fentanyl/bupivacaine mixture and subcutaneous administration of morphine or pethidine. Five hundred and fifty-one patients were managed in the first year, with an overall patient satisfaction score of 83%. The majority (98.5%) of them were after abdominal or major orthopaedic surgery. Eighty per cent of patients scored < 3 on the verbal numeric pain scale, where 0 is no pain and 10 is the worst imaginable pain, on the first postoperative day. Nausea and vomiting was an unpleasant side effect in 20% of patients.

  14. Temperature drop in normal term newborn infants born at the University Hospital, Kuala Lumpur.

    PubMed

    Raman, S; Shahla, A

    1992-05-01

    A prospective study of temperature drop in 141 normal term newborn infants delivered vaginally at the labour ward, University Hospital, Kuala Lumpur were studied. The effect of various manoeuvres on the temperature drop were also studied. They were randomized into 3 study groups, 63 cases where the babies were wiped with dry cloth alone, 37 cases where the babies were put into a plastic bag immediately after birth and lastly 41 cases where the babies were wiped with dry cloth and then inserted into a plastic bag. There was significant temperature drop in all the 3 groups maximum in the first 15 minutes and the fall continued for 1 hour after delivery (p less than 0.001). This shows that in an air-conditioned labour ward in a tropical country the temperature fall in newborn infants can be significant. This study also showed that plastic is a poor insulator against significant temperature drop.

  15. Retrospective review of serologic rubella activity in University Hospital Kuala Lumpur.

    PubMed

    Chua, K B; Lam, S K; Hooi, P S; Chua, B H; Lim, C T

    2000-09-01

    A retrospective review of rubella serological results carried out in the Virus Diagnostic Unit, University Hospital Kuala Lumpur (UHKL) from January 1993 to September 1999 showed the presence of rubella infection annually which appeared to increase periodically every two to three years. There was no statistical significant difference in the rubella positive rate between male and female population aged 14 to 48 years. Congenital rubella infections (CRI) occurred in babies delivered in UHKL yearly from 1993 to 1998 with an average incidence rate of 48 per 100,000 deliveries. Peaks of rubella cases appeared to be followed by an increase in incidence of CRI cases 6 to 9 months later. The study showed that only 50.8% clinically diagnosed rubella was confirmed by laboratory finding. This study also showed an increase of rubella activity for the months of July, August and September 1999 and this may herald an increase of CRI cases in the coming millennium.

  16. A review of patients with deep vein thrombosis diagnosed at University Hospital, Kuala Lumpur.

    PubMed

    Liam, C K; Ng, S C

    1990-11-01

    In this retrospective study, 81 patients were diagnosed to have deep vein thrombosis (DVT) at the University Hospital, Kuala Lumpur over a ten year period from 1977 to 1986. Fifty-six patients had their DVT confirmed by venograms. The left side was affected in 79.5% of venographically proven cases of DVT of the lower limbs above the popliteal vein. The incidence of clinically apparent DVT following surgery was 0.21 per 1,000 operations. The incidence of pregnancy-related DVT was 0.039%. DVT was 3 times more frequent in the puerperium than in the antenatal period. The overall incidence of symptomatic pulmonary embolism was 13.6% of the cases of DVT.

  17. Imported malaria: a retrospective study in University Hospital, Kuala Lumpur, a ten-year experience.

    PubMed

    Jamaiah, I; Anuar, A K; Najib, N A; Zurainee, M N

    1998-03-01

    Over a period of ten years (1983-1992), 134 malaria cases admitted to University Hospital, Kuala Lumpur (UHKL) were analysed. Malays constituted 27.6%, Chinese 29.8%, Indians 9.7%, Indonesians 16.4% and other foreigners 16.4%. Therefore, of the total number of cases, foreigners constituted 32.8% (44) of all the malaria cases admitted to UHKL. Fifteen of these foreigners had chloroquine-resistant strains of malarial parasites. Three species of malaria were reported of which Plasmodium falciparum constituted the most (46.3%) (80% of these developed resistance to chloroquine). Plasmodium vivax was confirmed in 44.8% (10% of these developed resistance to chloroquine) and there was only one case of Plasmodium malarie infection.

  18. [Aging and work ability of workers of a university hospital's cleaning and hygiene service].

    PubMed

    Andrade, Cristiane Batista; Monteiro, Maria Inês

    2007-06-01

    This study was conducted with the cleaning personnel of a university hospital in the city of Campinas, State of São Paulo. These are public employees whose work is mainly physical: cleaning is a job that requires heavy physical work; in addition, workers are also exposed to chemical products. The objective of this survey was to evaluate the work ability of cleaners from different age groups, for which was used the Work Ability Index, an instrument developed by Finnish researchers. The sample was comprised of 69 workers who answered the questionnaire: 21.7% have excellent work ability; 31.9% good; 31.9% moderate; and 14.5% poor. The most frequently reported diseases with medical diagnosis were: lesion due to accidents, musculoskeletal disorders, and cardiovascular diseases. The members of the older group ranked lower in the Work Ability Index and reported a larger number of diseases, which therefore affected their work ability.

  19. High frequency of low serum levels of vitamin 12 among patients attending Jordan University Hospital.

    PubMed

    Barghouti, F F; Younes, N A; Halaseh, L J; Said, T T; Ghraiz, S M

    2009-01-01

    This study aimed to estimate the status of serum vitamin B12 level in patients attending Jordan University Hospital in Amman, and to examine the relationship with demographic data, chronic illness, dietary habits, haematological parameters and symptoms related to vitamin B12 levels. A total of 838 patients completed a questionnaire and gave blood samples; 44.6% were vitamin B12 deficient (< 180 pg/mL) and 34.2% had hypovitaminosis (180-300 pg/mL). Vitamin B12 deficiency was associated with memory impairment, low meat intake and strict vegetarian (vegan) diets. The high frequency of low vitamin B12 warrants the development of a strategy to correct this problem in Jordan.

  20. Rotavirus - A Retrospective Study of Incidence at the Hospital Universiti Sains Malaysia (HUSM)

    PubMed Central

    Ludin, C.M. Mat; Radzi, J. Md.; Maimunah, A.

    2003-01-01

    The present study, analyzes data from 1991 to 2000 for rotavirus infection among children with diarrhoea and acute gastroenteritis admitted to the Hospital Universiti Sains Malaysia (HUSM). The Latex Slide Agglutination Test was used for the detection of rotavirus antigens. Out of 1097 stool samples tested, 207 samples or 18.8 % were found to be positive for rotavirus. The infection occurred most frequently in infants and young children from 6 months to 2 years of age. The infection was recorded highest in the year of 2000 – 48 cases (34.1%) and the lowest in 1999 – 5 cases (6.6%). Stool examination and cultures from the rotavirus positive samples revealed no parasites and enteropathogenic bacteria. These observations suggested that rotavirus could still remain as an important agent causing diarrhoea and gastroenteritis in young children admitted to HUSM. PMID:23386803

  1. Rotavirus - A Retrospective Study of Incidence at the Hospital Universiti Sains Malaysia (HUSM).

    PubMed

    Ludin, C M Mat; Radzi, J Md; Maimunah, A

    2003-07-01

    The present study, analyzes data from 1991 to 2000 for rotavirus infection among children with diarrhoea and acute gastroenteritis admitted to the Hospital Universiti Sains Malaysia (HUSM). The Latex Slide Agglutination Test was used for the detection of rotavirus antigens. Out of 1097 stool samples tested, 207 samples or 18.8 % were found to be positive for rotavirus. The infection occurred most frequently in infants and young children from 6 months to 2 years of age. The infection was recorded highest in the year of 2000 - 48 cases (34.1%) and the lowest in 1999 - 5 cases (6.6%). Stool examination and cultures from the rotavirus positive samples revealed no parasites and enteropathogenic bacteria. These observations suggested that rotavirus could still remain as an important agent causing diarrhoea and gastroenteritis in young children admitted to HUSM. PMID:23386803

  2. [Aging and work ability of workers of a university hospital's cleaning and hygiene service].

    PubMed

    Andrade, Cristiane Batista; Monteiro, Maria Inês

    2007-06-01

    This study was conducted with the cleaning personnel of a university hospital in the city of Campinas, State of São Paulo. These are public employees whose work is mainly physical: cleaning is a job that requires heavy physical work; in addition, workers are also exposed to chemical products. The objective of this survey was to evaluate the work ability of cleaners from different age groups, for which was used the Work Ability Index, an instrument developed by Finnish researchers. The sample was comprised of 69 workers who answered the questionnaire: 21.7% have excellent work ability; 31.9% good; 31.9% moderate; and 14.5% poor. The most frequently reported diseases with medical diagnosis were: lesion due to accidents, musculoskeletal disorders, and cardiovascular diseases. The members of the older group ranked lower in the Work Ability Index and reported a larger number of diseases, which therefore affected their work ability. PMID:17722389

  3. Burnout among physicians and nursing staff working in the emergency hospital of Tanta University, Egypt.

    PubMed

    Abdo, S A M; El-Sallamy, R M; El-Sherbiny, A A M; Kabbash, I A

    2016-12-01

    Little is known about professional burnout among health-care workers in Egypt. The current study aimed to reveal the extent of burnout among physicians and nursing staff working in the emergency hospital of Tanta University and to identify some of its determinants. A cross-sectional study was carried out on all physicians (n = 266) and a systematic random sample of nurses (n = 284). Burnout was assessed using the Maslach Burnout Inventory and its subscales. Most of the participants (66.0%)had a moderate level of burnout and 24.9% of them had high burnout. Multivariate analysis of variables affecting burnout showed that age, sex, frequency of exposure to work-related violence, years of experience, work burden, supervision and work activities were significant predictors of burnout among the respondents. The authors recommend health education interventions during pre-employment training programmes for prevention of burnout syndrome and periodic screening for early detection and management of burnout. PMID:26996364

  4. A five-year analysis of the incidence of glomerulonephritis at Cairo University Hospital-Egypt.

    PubMed

    Ibrahim, Salwa; Fayed, Ahmed; Fadda, Sawsan; Belal, Dawlet

    2012-07-01

    Our study aimed to obtain a comprehensive review of the incidence of biopsy-proven glomerulonephritis (GN) at the Cairo University Hospitals, Egypt, over the last five years. We analyzed the clinical and pathological data of all renal biopsy samples that were performed during the period from July 2003 to July 2008. Renal biopsy samples of 924 patients were referred for pathological assessment during the period of the study [437 male and 487 female patients; their mean age was 26.5 ± 14.6 years (range: 2.5-71 years)]. Focal segmental glomerulo-nephritis was the most frequent cause of primary GN (21.21%), followed by mesangial proliferative GN (18.93%), diffuse proliferative GN (13.96%), focal proliferative GN (12.77%) and membranous GN (10.93%). The results could be explained by the high incidence of lupus nephritis among the study subjects as well as the relatively young age of the study group.

  5. Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality.

    PubMed

    Backman, Chantal; Vanderloo, Saskia; Forster, Alan John

    2016-09-01

    Measuring and monitoring overall health system performance is complex and challenging but is crucial to improving quality of care. Today's health care organizations are increasingly being held accountable to develop and implement actions aimed at improving the quality of care, reducing costs, and achieving better patient-centered care. This paper describes the development of the Collaborative for Excellence in Healthcare Quality (CEHQ), a 5-year initiative to achieve higher quality of patient care in university hospitals across Canada. This bottom-up initiative took place between 2010 and 2015, and was successful in engaging health care leaders in the development of a common framework and set of performance measures for reporting and benchmarking, as well as working on initiatives to improve performance. Despite its successes, future efforts are needed to provide clear national leadership on standards for measuring performance. PMID:27460940

  6. Temperature drop in normal term newborn infants born at the University Hospital, Kuala Lumpur.

    PubMed

    Raman, S; Shahla, A

    1992-05-01

    A prospective study of temperature drop in 141 normal term newborn infants delivered vaginally at the labour ward, University Hospital, Kuala Lumpur were studied. The effect of various manoeuvres on the temperature drop were also studied. They were randomized into 3 study groups, 63 cases where the babies were wiped with dry cloth alone, 37 cases where the babies were put into a plastic bag immediately after birth and lastly 41 cases where the babies were wiped with dry cloth and then inserted into a plastic bag. There was significant temperature drop in all the 3 groups maximum in the first 15 minutes and the fall continued for 1 hour after delivery (p less than 0.001). This shows that in an air-conditioned labour ward in a tropical country the temperature fall in newborn infants can be significant. This study also showed that plastic is a poor insulator against significant temperature drop. PMID:1520194

  7. Burnout among physicians and nursing staff working in the emergency hospital of Tanta University, Egypt.

    PubMed

    Abdo, S A M; El-Sallamy, R M; El-Sherbiny, A A M; Kabbash, I A

    2016-03-15

    Little is known about professional burnout among health-care workers in Egypt. The current study aimed to reveal the extent of burnout among physicians and nursing staff working in the emergency hospital of Tanta University and to identify some of its determinants. A cross-sectional study was carried out on all physicians (n = 266) and a systematic random sample of nurses (n = 284). Burnout was assessed using the Maslach Burnout Inventory and its subscales. Most of the participants (66.0%)had a moderate level of burnout and 24.9% of them had high burnout. Multivariate analysis of variables affecting burnout showed that age, sex, frequency of exposure to work-related violence, years of experience, work burden, supervision and work activities were significant predictors of burnout among the respondents. The authors recommend health education interventions during pre-employment training programmes for prevention of burnout syndrome and periodic screening for early detection and management of burnout.

  8. Nursing competency and organizational climate as perceived by staff nurses in a Chinese university hospital.

    PubMed

    Ying, Liu; Kunaviktikul, Wipada; Tonmukayakal, Ouyporn

    2007-09-01

    Nursing competency is important to ensure patient safety and improve the quality of nursing care. Based on competency-based human resource management strategies, the organizational climate can positively influence nursing competency. However, a review of the literature indicated that there were no studies about the relationship between nursing competency and organizational climate in the People's Republic of China. This descriptive, correlational study examined the relationship between nursing competency and the organizational climate. The sample consisted of 243 staff nurses who completed the questionnaire worked at one university hospital in Liao Ning Province. The findings showed that there was a significantly moderate positive relationship between nursing competency and organizational climate. The study results suggested that Chinese nurse managers should maintain and provide a positive organizational climate to improve nursing competency. PMID:17688481

  9. Amniotic band syndrom at Bobo Dioulasso university teaching hospital (Burkina-Faso): about two cases

    PubMed Central

    Zaré, Cyprien; Traoré, Ibrahim Alain; Dakouré, Patrick Wendpuoiré Hamed; Gandéma, Salif; Sano, Bakary Gustave; Bénao, Lazard Bouma; Belemlilga, Hermann; Yabré, Nassirou

    2015-01-01

    Amniotic band syndrome is a rare congenital disorder. The authors report the first cases documented at Souro Sanou University Hospital in Bobo-Dioulasso (CHUSS) in 2 male new borns. The malformations found at birth, were worn only on limbs and were in the form of skin furrow necking with a major lymphedema downstream. In both cases, the constriction furrow at member pelvic was associated with a club foot and a pseudosyndactyly in one case. Surgical treatment consisted of a section of the constrictor ring and a Z-plasty. The functional outcome was satisfactory with the acquisition of a plantar support for both children. Through these two observations, epidemiological, diagnostic, and particularities of the management of this condition are discussed in the Burkina-Faso. PMID:26918082

  10. SNAKE BITE: CASE SERIES OF PATIENTS PRESENTED TO GONDAR UNIVERSITY HOSPITAL, NORTH WEST ETHIOPIA.

    PubMed

    Mekonnen, Desalew; Mitiku, Tadesse; Tamir, Yenesew; Azazh, Aklilu

    2016-04-01

    Snakebite is an important public health challenge. Venomous snake bites cause significant morbidity and mortality if treatment measures, especially antivenom therapy, are delayed. We did a case series of 27 adult patients admitted after snakebite to the medical wards of Gondar University Hospital (GUH) from September 2013 to August 2014. The age range was from 15 to 74 years. The male to female ratio was 8:1. The majority (25) of patients presented after 12 hours of being bitten. Most of the bites occurred on the legs. Hematologic complications, including prolonged bedside whole blood clotting test, bleeding complications and Disseminated Intravascular Coagulation, were the common complications detected. The case fatality rate was 4/27 (14.8%). Availability of affordable snake specific antivenom is recommended. A large population study is needed to address the burden in Ethiopia. PMID:27476228

  11. Salivary gland neoplasms: a 21year review of cases seen at University College Hospital, Ibadan.

    PubMed

    Kolude, B; Lawoyin, J O; Akang, E E

    2001-01-01

    The present study updates the experience of salivary gland tumours in Ibadan. All cases of benign and malignant salivary gland neoplasms histologically diagnosed between 1975 and 1995 in the Oral Pathology Department and Cancer Registry of the University College Hospital, Ibadan were reviewed. Salivary gland neoplasms accounted for 3.5% of head and neck neoplasms, the majority (46.5%) occurring in the parotid, followed by the submandibular (18.1%) and palatal glands (10.7%). The ratio of benign to malignant neoplasms was 1.1 to 1. Mucoepidermoid carcinoma and adenoid cystic carcinoma were the most common malignant neoplasms. There was a predilection of adenoid cystic carcinoma for the submandibular gland.

  12. [Perceived quality of care among health professionals at the University Hospital of Oran (EHUO)].

    PubMed

    Chougrani, Saada; Ali, Abdessamed Dali

    2011-01-01

    Created in 2003 as a profit organization, the University Hospital of Oran (Etablissement Hospitalier Universitaire d'Oran-EHUO) is currently in the process of developing a 'Quality' project aimed at assessing staff perception of quality. 20% of staff members representing the various professional categories working at EHUO (medical, nursing and administrative staff) were selected using quota sampling. Face-to-face interviews were conducted in March 2009 with 117 staff members from 25 medical and 5 non-medical units. The average length of service among medical and administrative staff was higher than the average length of service of nursing staff (8.3 vs 5.8 years; p = 0.9 Kruskal-Wallis H test). In discussing the question of quality, it was found that all categories of staff emphasized their specific professional experiences, standards and frames of reference. All staff members showed a greater preference for the various dimensions of the "are process" (mostly physicians and nurses rather than administrative staff (p=0.01)) than for the "structure" or "organization" components of the quality plan. In this sense, there appears to be a greater focus on technical rather than management aspects, as shown by the fact that two thirds of staff members were ill-informed about the hospital's quality assurance program (quality management, blood safety, complaints management...). While they appeared to be fully supportive of audit and certification procedures, 50% of health staff members were reluctant to support patient involvement in the management of the 'Quality' project. Finally, there appears to be a lack of awareness of quality concepts, standards and methodologies among hospital staff. This study suggests that there is a need for greater awareness, further training, and greater monitoring of practices based on concrete actions. PMID:22365045

  13. Drug-related problems among medical ward patients in Jimma university specialized hospital, Southwest Ethiopia

    PubMed Central

    Tigabu, Bereket Molla; Daba, Daniel; Habte, Belete

    2014-01-01

    Objective: The increasing number of available drugs and drug users, as well as more complex drug regimens led to more side effects and drug interactions and complicates follow-up. The objective of this study was to assess drug-related problems (DRPs) and associated factors in hospitalized patients. Methods: A hospital-based cross-sectional study design was employed. The study was conducted in Jimma University Specialized Hospital, Jimma, located in the south west of Addis Ababa. All patients who were admitted to the medical ward from February 2011 to March 2011 were included in the study. Data on sociodemographic variables, past medical history, drug history, current diagnosis, current medications, vital signs, and relevant laboratory data were collected using semi-structured questionnaire and data collection forms which were filling through patient interview and card review. Data were analyzed using SPSS version 16 for windows. Descriptive statistics, cross-tabs, Chi-square, and logistic regression were utilized. Findings: Out of 257 study participants, 189 (73.5%) had DRPs and a total of 316 DRPs were identified. From the six classes of DRPs studied, 103 (32.6%) cases related to untreated indication or need additional drug therapy, and 49 (15.5%) cases related to high medication dosage. Unnecessary drug therapy in 49 (15.5%) cases, low medication dosage in 44 (13.9%) cases, and ineffective drug therapy in 42 (13.3%) cases were the other classes of problems identified. Noncompliance in 31 (9.8%) cases was the least prevalent DRP. Independent factors which predicted the occurrence of DRPs in the study population were sex, age, polypharmacy, and clinically significant potential drug-drug interactions. The prevalence of DRPs was substantially high (73.5%). Conclusion: Drug-related problems are common among medical ward patients. Indication-related problems, untreated indication and unnecessary drug therapy were the most common types of DRPs among patients of our

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

    PubMed Central

    Aqil, M.; Bhadana, V.; Alam, M.S.; Pillai, K. K.; Kapur, P.

    2012-01-01

    Objective: A prospective medicine usage evaluation based on prescription monitoring was conducted in the medicine OPD of our university teaching hospital to know prescribing trends of different categories of medicines. Materials and Methods: A total of 600 patients were included in the study comprising of 339 (56.5%) males and 261 (43.5%) females. The data were recorded within the OPD by a registered pharmacist on a medicine usage evaluation form, approved by The University Institutional Review Board (IRB). Results: A total of 2365 medicines were prescribed to 600 patients during the 3 months study period. The mean number of medicines per prescription were found to be 3.94. Medicines were most frequently prescribed as solid dosage forms (85.62%), especially tablets (70.82%), and liquid formulations (14.12%). Oral route (96.17%) was the most preferred mode of administration, followed by topical (2.11%) and parenteral (1.60%) routes. Combination therapy (94.33%) was more prevalent than monotherapy (5.66%). An overwhelming tendency for prescribing medicines by brand names (99%) was observed by the physicians. The most frequently prescribed class of medicines were antimicrobials > analgesics > cardiovascular > gastrointestinal agents. The most prescribed individual medicines among various therapeutic classes included isoniazid (antimicrobial), amlodipine (cardiovascular), metformin (hypoglycemic), cetirizine (antiallergic), rabeprazole (GI medicine), atorvastatin (hypolipidemic), dextromethorphan (respiratory medicine), alprazolam (sedative-hypnotic), paracetamol (analgesic). Conclusions: There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be developed for the purpose. The number of medicines to be included per prescription should be judged rationally and polypharmacy ought to be curbed. Use of antimicrobial also needs to be rationalized as

  15. A multicentre analysis of epidemiology of the nosocomial bloodstream infections in Japanese university hospitals.

    PubMed

    Nagao, M

    2013-09-01

    Nosocomial bloodstream infections (BSIs) are an important cause of morbidity and mortality. The current study analysed data from a concurrent surveillance programme to examine the current epidemiological trends for nosocomial BSIs at 22 Japanese university hospitals from 1 April 2008 to 31 March 2012. The number of blood culture sets taken, the rate of multiple blood culture sets and the rates of antibiotic-resistant isolates among six major nosocomial BSI pathogens (Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Candida spp.) not including coagulase-negative staphylococci, were evaluated. The clinical characteristics of nosocomial BSIs caused by these pathogens were also collected for 2941 patients. The number of blood culture sets taken per bed increased during the 4-year study period (from 4.07 in 2008 to 5.37 in 2011), and the rates of multiple blood culture sets also increased (from 29.9% in 2008 to 50.0% in 2011). Methicillin resistance was detected in 50.2% of S. aureus isolates. The prevalence rates of extended-spectrum beta-lactamase-producing E. coli and Klebsiella spp. isolates increased annually during the study period, and the average prevalence rates were 12.3% and 5.8%, respectively. The overall crude mortality of nosocomial BSIs due to the six pathogens evaluated was 24.5% (43.2% in ICU settings and 20.5% in non-ICU settings). Thus, our multicentre study evaluated the current epidemiological trends for nosocomial BSIs, and we found that further efforts are needed to increase the use of multiple blood culture sets and improve the prognosis of nosocomial BSIs in Japanese university hospitals.

  16. Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

    PubMed Central

    Birhanu, Anteneh Messele; Alemu, Fekadu Mazengia; Ashenafie, Tesfaye Demeke; Balcha, Shitaye Alemu; Dachew, Berihun Assefa

    2016-01-01

    Background Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI): 11.7–19.2). Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0) and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92) were the factors associated with depression among diabetic patients. Conclusion The prevalence of depression was low as compared to other similar studies elsewhere. Disease (diabetes) duration of 10 years and above and being a Muslim religion follower (as compared to Christian) were the factors significantly associated with depression. Early screening of depression and treating depression as a routine component of diabetes care are recommended. Further research with a large sample size, wider geographical coverage, and segregation of type of diabetes mellitus is recommended. PMID:27274296

  17. Salivary gland tumours: a 15-year review at the Dental Centre Lagos University Teaching Hospital.

    PubMed

    Ladeinde, A L; Adeyemo, W L; Ogunlewe, M O; Ajayi, O F; Omitola, O G

    2007-12-01

    The aim of this study was to determine the relative frequency of tumours of the salivary gland seen at the Dental Centre, Lagos University Teaching Hospital, Nigeria over a period of 15 years. All cases that were histologically diagnosed as salivary gland tumours from January 1990 to December 2004 were retrieved from the histopathology records of the Department of Oral Pathology and Biology and Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital, Lagos, Nigeria. All the cases were subjected to analysis of age, sex, site of occurrence and histologic diagnosis based on 1991 World Health Organisation (WHO) classification. Salivary gland constituted 6.3% of all oro-facial tumours and tumour-like lesions. The frequency of malignant tumours was 60.8% (n = 73) and benign tumours 39.2% (n = 47). Minor salivary glands (63.3%) were mostly affected. The male-to-female ratio was 1.1:1, and most (72.5%) of the tumours occurred in the age group of 21-60 years. Pleomorphic adenoma was the most commonly occurring tumour (29.2%) followed by adenoid cystic carcinoma (19.2%). The predominant benign and malignant tumours were pleomorphic adenoma and adenoid cystic carcinoma respectively. Palate (45.8%) was the most frequently affected site. The mean.age (+/-SD) of patients with benign tumours was significantly lower than those with malignant tumours (P = 0.003). The incidence of salivary gland tumours in this study is higher than in most previous reports. Malignant tumours which occurred in older age group were the most commonly seen.

  18. [Blastocystis hominis in patients at the Ruiz y Paez University Hospital from Bolivar City, Venezuela].

    PubMed

    Devera, R; Azacon, B; Jiménez, M

    1998-01-01

    Blastocystis hominis is a polymorphic protozoan of discussed taxonomic position, which is currently associated with human intestinal disease. In order to determine the prevalence of the microorganism in a sample of hospitalized patients, a study was carried out from november 1996 to april 1997 on 100 adult patients of both sexes aged 20 to 79 years at the "Ruíz y Páez" University Hospital of Bolivar city, Venezuela. A coproparasitological study was carried out using direct examination and Faust method. Infection by parasites and/or commensals was demonstrated in 48 patients. The most frequent agent was B. hominis with a prevalence of 42.0%. We did not find a statistically association between sex (P > 0.05) or age (X2 = 3.52; d.f; = 3) and B. hominis infection. B. hominis was most frequently identified as the single parasite (88.1%), and with a number of less than 5 cells per 400X microscopic field (73.8%). The infection was more common in patients with base chronic-immunosuppressive diseases, the major one being cancer. Diarrhea was observed in 27.0% of cases. Due to its high prevalence, especially as a single agent, together with the particular immunological characteristics of the patients studied, a potential pathogenic role of the opportunistic type is suggested for B. hominis. PMID:10413881

  19. Efficiency of blood usage for elective surgery in the University Hospital Kuala Lumpur.

    PubMed

    Lim, E J; Lopez, C G; Veera, S N; Menaka, N; Aminah, A

    1996-12-01

    Provision of quality care, service and blood products to patients while containing costs and the amount of blood used should be the aim of every blood bank. Therefore a prospective audit was carried out over three months to determine how efficiently blood was being used in elective surgery in the University Hospital, Kuala Lumpur. Every case with blood crossmatched was monitored to determine the amount transfused and the posttransfusion haemoglobin level. Overcrossmatching of varying degrees was noted in almost all surgical procedures and overtransfusion in 45.5% of patients transfused. The rate of case postponement was 18.1%. These indicate inefficient utilization of blood and other resources. The transfusion index (TI) and range of units transfused were calculated for each procedure. They can be used as indicators of blood requirement and potential severity of hemorrhage. Suggestions to improve efficiency of blood utilization include the introduction and ongoing monitoring of guidelines on crossmatching and transfusion based on the data obtained here, by the hospital blood transfusion committee; the "group, screen and hold" practice for surgical procedures with high crossmatch transfusion ratios, low transfusion indices and a small range of units transfused could also be adopted.

  20. Amoebiasis: a 10 year retrospective study at the University Hospital, Kuala Lumpur.

    PubMed

    Jamaiah, I; Shekhar, K C

    1999-09-01

    A hospital based retrospective study of amoebiasis was carried out for a ten-year period at the University Hospital, Kuala Lumpur. Of the 51 cases traced, 30 (59%) had amoebic dysentery, 20 (39%) were amoebic liver abscess (ALA) and one patient had both conditions. Entameoba histolytica trophozoites were identified in 13 (43%) of the amoebic dysenteric stools and 9 (30%) from biopsy. Of the 20 (39%) ALA cases, only one showed parasites in the stool and biopsy. Majority of the patients with dysentery were Malays while Chinese comprised 40% with ALA. Males predominated overall with a male female ratio of 3:1, while for ALA it was 9:1. Most of ALA were single (71.4%) and were localised in the right lobe. The majority of the patients were unemployed. Eighty three percent (83%) of the patients presented with diarrhoea or dysentery followed by abdominal pain while those with ALA had fever, chills, rigors and pain in the right hypochondrium. Eighty percent of the ALA cases showed hepatomegaly. All patients responded to treatment with metronidazole.

  1. Broken paediatric appointments at the University of Benin Teaching Hospital, Benin City.

    PubMed

    Obi, J O

    1979-06-01

    Appointment system was introduced to the University of Benin Teaching Hospital at the initial stage of the Hospital development. This is a new experience to the local community which is largely illiterate. The appointment breaking was low contrary to expectation. Indifference or negligence accounted for a high percentage of defaulting. The system was deemed to be good by 66.4 per cent of the defaulters interviewed only 1.2 per cent felt that it was bad. Efforts by the health visiting Sister to visit the defaulters at home and persuade them to attend the clinic reduced the number of broken appointments. The habit of breaking appointments by parents/guardians of children who showed indifference or negligence were more difficult to remedy. For a referral system to be effective in a largely illiterate community where referral system is new, knowledge of the reasons for breaking appointments in the community should be known and remedied. Promotion of personalized attention and intensive health education are essential.

  2. Health centres' view of the services provided by a university hospital laboratory: use of satisfaction surveys.

    PubMed

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-03-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions.

  3. The Direct Cost of Parkinson Disease at Juntendo Medical University Hospital, Japan.

    PubMed

    Yoritaka, Asako; Fukae, Jiro; Hatano, Taku; Oda, Eisei; Hattori, Nobutaka

    2016-01-01

    Objective Many studies on the cost of Parkinson disease (PD) have been published; however, there are limited studies pertaining to this issue in Asia. This study looks to assess the direct medical costs of patients with PD at a university hospital in Japan by calculating the average monthly direct medical costs of PD patients from July to December 2008. Methods We enrolled 724 consecutive patients (411 women and 313 men) with PD who were registered in Japan's "Specified Disease Treatment Research Program" and obtained data on the total direct medical costs of all patients. Results Values are reported as the mean (standard deviation). The major finding of the direct medical cost analysis was that the outpatient clinic cost per subject (n=715) was USD 485.74 (376.31) per month. A multivariate analysis revealed that a younger age, the presence of wearing-off, hallucination, and longer disease duration increased the direct medical cost significantly. Disease severity had no influence on the direct medical costs. A longer disease duration was significantly correlated with higher hospitalization costs. Conclusion The direct medical cost of PD in Japan was found to be similar to that in Western countries. Costs due to productivity loss exceeded the direct costs, and they may be reduced through the better integration of PD patients in the work environment. PMID:26781008

  4. T cell subset profile in healthy Zambian adults at the University Teaching Hospital

    PubMed Central

    Chisenga, Caroline Cleopatra; Kelly, Paul

    2016-01-01

    Introduction Symptom-free human immunodeficiency virus antibody-negative Zambian adults (51 subjects, aged 20 to 62 years, 33.3% women and 66.7% men) were studied to establish T cell subset reference ranges. Methods We carried out across sectional study at the University Teaching Hospital, Lusaka. Blood samples were collected from healthy donor volunteers from hospital health care staff, between February and March 2015. Immunopheno typing was undertaken to characterize Tcell subsets using the markers CD3, CD4, CD8, α4β7, Ki67, CD25, CCR7, CD54RA, CD57, CD28, CD27 and HLA-DR. Results Among 51 volunteers, Women had significantly higher absolute CD4 count (median 1042; IQR 864, 1270) than in men (671; 545, 899) (p=0.003). Women also had more CD4 cells expressing homing, naïve, effector and effector memory T cell subsets compared to men. However, in the CD8 population, only the effector cells were significantly different with women expressing more than the males. Conclusion We provide early reference range for T cell subsets in Zambian adults and conclude that among the African women some T cell subsets are higher than men. PMID:27231509

  5. Advertised sustainability practices among suppliers to a university hospital operating room.

    PubMed

    Schieble, Thomas M

    2008-01-01

    The present study aimed to identify firms supplying products to our university operating room (OR) that promote sustainable manufacturing methods. Results show that 72% of our suppliers, or 152 of 211 companies, do not promote sustainability practices in a salient manner. Multi-national firms document sustainability methods significantly more than U.S. divisions of multi-nationals or U.S. firms with chi-square = 157.93 (p < 0.001). Although the current study did not evaluate real manufacturing methods, sustainability promotion is an important marketing tool through which purchasers may begin the process of due diligence for product selection. Lack of sustainability information among suppliers in this study suggests that hospital procurement departments likely focus solely on issues like price or quality when making purchase decisions. These results also suggest an opportunity for healthcare administrators to evaluate more fully the products involved in the healthcare supply chain; the intrinsic, intangible value added to hospital products through sustainable manufacturing is consistent with responsible patient care and has the potential to create marketing and public relations value.

  6. Health centres' view of the services provided by a university hospital laboratory: Use of satisfaction surveys

    PubMed Central

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-01-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions. PMID:20205616

  7. Health centres' view of the services provided by a university hospital laboratory: use of satisfaction surveys.

    PubMed

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-03-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions. PMID:20205616

  8. A 5-Year Retrospective Review of Fungal Keratitis at Hospital Universiti Sains Malaysia

    PubMed Central

    Mohd-Tahir, Fadzillah; Norhayati, A.; Siti-Raihan, Ishak; Ibrahim, M.

    2012-01-01

    Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospital Universiti Sains Malaysia from January 2007 until December 2011. Results. Forty-seven patients (47/186, 25.27%) were treated for fungal keratitis during the study period. This demonstrated that the incidence of fungal keratitis has increased each year from 2007 to 2011 by 12.50%, 17.65%, 21.21%, 26.83%, and 28.57%, respectively. The most common predisposing factors were injury to the eye followed by use of topical steroid, and preexisting ocular surface disease. Fusarium species were the most common fungal isolated, followed by Candida species. Clinical diagnosis of fungal keratitis was made in 26 of the 41 (63.41%) cases of positive isolates. Of these, in eleven cases (23.40%) patients required surgical intervention. Clinical outcome of healed scar was achieved in 34 (72.34%) cases. Conclusions. The percentage of positive fungal isolated has steadily increased and the trend of common fungal isolated has changed. The latest review regarding fungal keratitis is important for us to improve patients' outcome in the future. PMID:23304138

  9. Postoperative pain management at Tirana university hospital center -Mother Teresa-, Tirana, Albania.

    PubMed

    Dibra, A; Kellici, S; Akshija, I

    2012-01-01

    There is no or little evidence on postoperative pain assessment and treatment in Albanian hospitals. This study is based on our every day work and aims to highlight our experience. We conducted a descriptive drug utilization study which implied data collection over 6 months. Evidence of the enrolled patients was kept by maintaining records and the completed structured questionnaires. Postoperative pain was assessed through a five-category verbal rating scale (VRS). Metamizole was the most prescribed and administered analgesic drug as single therapy and in combination therapy, and acetaminophen was the least prescribed drug. The compliance between the prescribed dosages and those administered was higher in patients treated with a single analgesic compared to multiple therapies. A few patients reported adverse events (4.2 percent). There is much variability in postoperative pain management methods used by medical staff within the Tirana University Hospital. In Albania to date there is no standard protocol for postoperative pain treatment. This study shows that there are no essential differences in patient outcomes in terms of efficacy of analgesic treatment. This leads to the conclusion that a postoperative protocol/guideline for pain management should be prepared, based on our local study findings and also on international experience. Moreover, the guidelines should consider use of balanced analgesia.

  10. [A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

    PubMed

    Maisch, Bernhard

    2005-03-01

    1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state

  11. [A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

    PubMed

    Maisch, Bernhard

    2005-03-01

    1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state

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

    PubMed Central

    Abda, Edris; Hamza, Leja; Tessema, Fasil; Cheneke, Waqtola

    2016-01-01

    Background Developing countries are now experiencing the epidemiologic transition, whereby the burden of chronic diseases, like metabolic syndrome, is increasing. However, no study had previously been conducted to show the status of metabolic syndrome among outpatients of Jimma University Teaching Hospital. Therefore, this study was designed to determine the prevalence of metabolic syndrome and associated factors among adult (≥20 years) patients. Methods A cross-sectional hospital-based study was conducted in July 2014 among adult (≥20 years) patients attending Jimma University Teaching Hospital, outpatient department. All patients attending the outpatient department and were willing to participate in the study were included. Anthropometric and biochemical measurements were undertaken for all the study subjects to know the status of metabolic syndrome. Metabolic syndrome was identified using the National Cholesterol Education Program’s Adult Treatment Panel III criteria. Results A total of 225 participants were included in the study, of whom 106 (47.1%) were males and 119 (52.9%) were females. A total of 59 (26%) adults were found to have metabolic syndrome, which was seen more than twice as much in females, 42 (35%), as compared with males, 17 (16%), (P<0.01). The most frequent metabolic syndrome parameters were hypertension (45%), hyperglycemia (39%), decreased high-density lipoprotein (HDL) (31%), central obesity (26%), and elevated triglycerides (18%). Elevated blood pressure is more common in females (44.5%) than in males (34.9%). Decreased HDL-cholesterol was observed among 37% of females versus 24% males (P<0.001) and 6% of males versus 45% females had central obesity (P<0.001). Hypertension and body mass index were significantly lower among males (35% and 14%) than females (45% and 41%) (P<0.01 and P<0.001), respectively. Conclusion It is demonstrated that metabolic syndrome is prevalent in adult outpatients in Jimma and increases as age increases; it

  13. Predictors of hospital stay and mortality in dengue virus infection-experience from Aga Khan University Hospital Pakistan

    PubMed Central

    2014-01-01

    Background Dengue virus infection (DVI) is very common infection. There is scarcity of data on factor associated with increased hospital stay and mortality in dengue virus infection (DVI). This study was done to know about factors associated with increased hospital stay and mortality in patients admitted with DVI. Results Out of 532 patients, two third (72.6%) had stay ≤3 days while one third (27.4%) had stay greater than 3 days. The mean length of hospital stay was 3.46 ± 3.45 days. Factors associated with increased hospital stay (>3 days) included AKI (acute kidney injury) (Odd ratio 2.98; 95% CI 1.66-5.34), prolonged prothrombin time (Odd ratio 2.03; 95% CI 1.07-3.84), prolonged activated partial thromboplastin time (aPTT) (Odd ratio 1.80; CI 95% 1.15-2.83) and increased age of > 41.10 years (Odd ratio 1.03; CI 95% 1.01-1.04).Mortality was 1.5%. High mortality was found in those with AKI (P <0.01), dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) (P <0.001), respiratory failure (P0.01), prolong PT (P 0.001), prolong aPTT (P0.01) and increased hospital stay (P0.04). Conclusion Increasing age, coagulopathy and acute kidney injury in patients with DVI is associated with increased hospital stay. Morality was more in patients with AKI, DHF and DSS, respiratory failure, coagulopathy and these patients had more prolonged hospitalization. PMID:25064632

  14. [Trial of a small image network system in a radiology department of an university hospital].

    PubMed

    Kasuga, T; Sone, S; Izuno, I; Oguchi, K; Aoki, J; Sakai, F; Takizawa, M; Hosoba, M; Yamaguchi, K

    1995-04-01

    This paper describes the construction of an image network system in Shinshu University Hospital, and some of its current issues and advantages. Our discussion is based on our experience with a PACS system. SAIPACS, which was installed in 1990 for use in clinical conferencing and pre- and post-graduate education, and with a new CT and MRI network, which was subsequently introduced in 1993. The SAIPACS interconnects eight digital imaging modalities, including CT, MRI, XTV-DR (including digital tomosynthesis), FCR, nuclear medicine (RI), DSA, US, and a film digitizer (FD), with a workstation. Transmission time from the magnetic disk of each imaging modality to the SAIPACS image disk is not rapid enough. Therefore, we need to select images for transfer that are pertinent to our specific purpose, to complete image transmission within a practically acceptable period of time. The new CT/MRI network is composed of two CT units, two MRI systems, an image processing unit and a Universal Gateway. It provides faster image transmission than the SAIPACS system, because there is no need to reform image data to send them in a reversible compressed form. A versatile network system connected to the SAIPACS and CT/MRI network enables digital image data to be processed and edited and images to be transferred back to SAIPACS for clinical or educational use. PMID:7784154

  15. Suicide Attempts Among Patients Admited to Hospital of Kermanshah University of Medical Sciences

    PubMed Central

    Sadeghi, Shokouh; Heydarheydari, Sahel; Darabi, Fatemeh; Golchinnia, Abdollah

    2015-01-01

    Background: Suicide is a modern-age human challenge considered as a social and mental health problem acquiring enormous attention on primary and secondary heath care plans. Objectives: The current study aimed to investigate frequency of suicide attempts and related social factors among patients admitted in Hospital of Kermanshah University of Medical Sciences Patients and Methods: This cross-sectional study was descriptive-analytical type carried out on 251 patients admitted at medical centers of Kermanshah University of Medical Sciences after failed suicide attempts. Data collection was done through filling forms. Results: Average age of the population was 29 ± 11.6 years. Female were more prone to commit suicide whereas the patients had a variety of social lifestyles and crisis such as divorce, drug abuse, and domestic problems. The most frequent method of committing suicide was the use of burning materials. Conclusions: In reference to the young age of the statistical population of attempters and frequent personal-life crisis among them, educational, welfare and consultation facilities are suggested. PMID:26082910

  16. Geographic variations in avoidable hospitalizations in the elderly, in a health system with universal coverage

    PubMed Central

    Magan, Purificacion; Otero, Angel; Alberquilla, Angel; Ribera, Jose Manuel

    2008-01-01

    Background The study of Hospitalizations for ambulatory care sensitive conditions (ACSH) has been proposed as an indirect measure of access to and receipt of care by older persons at the entryway to the Spanish public health system. The aim of this work is to identify the rates of ACSH in persons 65 years or older living in different small-areas of the Community of Madrid (CM) and to detect possible differences in ACSH. Methods Cross-sectional, ecologic study, which covered all 34 health districts of the CM. The study population consisted of all individuals aged 65 years or older residing in the CM between 2001 and 2003, inclusive. Using hospital discharge data, avoidable ACSH were selected from the list of conditions validated for Spain. Age- and sex-adjusted ACSH rates were calculated for the population of each health district and the statistics describing the data variability. Point graphs and maps were designed to represent the ACSH rates in the different health districts. Results Of all the hospitalizations, 16.5% (64,409) were ACSH. Globally, the rate was higher among men: 33.15 per 1,000 populations vs. 22.10 in women and these differences were statistically significant (p < 0.05) in each district. For men the range was 70.82 and the coefficient of variation (CV) was 0.47, while for women the range was 43.69 and the CV was 0.48. In 93.1% of cases, the ACSH were caused by hypertensive cardiovascular disease, heart failure or pneumonia. A centripetal pattern can be observed, with lower rates in the districts in the center of the CM. This geographic distribution is maintained after grouping by sex. Conclusion A significant variation is demonstrated in "preventable" hospitalizations between the different districts. In all the districts the men present rates significantly higher than women. Important variations in the access are observed the Primary Attention in spite of existing a universal sanitary cover. PMID:18282282

  17. Misuse of antibiotics reserved for hospital settings in outpatients: a prospective clinical audit in a university hospital in Southern France.

    PubMed

    Roche, Manon; Bornet, Charléric; Monges, Philippe; Stein, Andreas; Gensollen, Sophie; Seng, Piseth

    2016-07-01

    Some antibiotics are reserved essentially for hospital settings owing to cost effectiveness and in order to fight the emerging antibiotic resistance crisis. In some cases, antibiotics reserved exclusively for use in hospitals may be prescribed in outpatients for serious infections or in the absence of a therapeutic alternative. A 30-day prospective audit of outpatient prescriptions of antibiotics reserved exclusively for use in hospitals was performed. The objective of this study was to evaluate the relevance of outpatient antibiotic prescriptions by measuring appropriateness according to guidelines. During the study period, 53 prescriptions were included, only 40% of which were appropriate. Among the 32 inappropriate prescriptions, 4 cases lacked microbial arguments, 1 case was not adequate for the infection type, 1 case involved an incorrect antibiotic dosage, 1 case involved an incorrect interval of dose administration, 3 cases had a therapeutic alternative and 22 cases were not recommended. Of the 53 prescriptions, 66% were started in hospital and 34% in outpatients. Only 25% of cases were prescribed with infectious diseases specialist (IDS) advice, 64% were based on microbiological documentation and 13% had a negative bacterial culture. Inappropriate prescriptions were usually observed in antibiotic lock therapy, skin infections, Clostridium difficile colitis, intra-abdominal infections and intravascular catheter-related infections. Outpatient prescriptions of antimicrobial drugs reserved exclusively for use in hospitals are frequently inappropriate. We recommend a real-time analysis algorithm with the involvement of an IDS for monitoring prescriptions to improve the quality of these prescriptions and possibly to prevent antibiotic resistance. PMID:27234677

  18. Managing the University/Training Hospital Interface: The Case of the Rheinisch-Westfalische Technishce Hochschule (RWTH) Aachen.

    ERIC Educational Resources Information Center

    von Bernuth, Gotz

    1991-01-01

    The Faculty of Medicine of the Rheinisch-Westfalische Technische Hochschule Aachen (Germany), founded in 1966, has been housed in one building since 1984. The faculty and university hospital are managed by three institutions: the dean (responsible for teaching and research); the clinical directorate (responsible for patient care); and the…

  19. Screening and Brief Intervention for Alcohol Problems among College Students Treated in a University Hospital Emergency Department

    ERIC Educational Resources Information Center

    Helmkamp, James C.; Hungerford, Daniel W.; Williams, Janet M.; Manley, William G.; Furbee, Paul M.; Horn, Kimberly A.; Pollock, Daniel A.

    2003-01-01

    The authors evaluated a protocol to screen and provide brief interventions for alcohol problems to college students treated at a university hospital emergency department (ED). Of 2,372 drinkers they approached, 87% gave informed consent. Of those, 54% screened positive for alcohol problems (Alcohol Use Disorders Identification Test score [less…

  20. The Heart and Mind Coming Together: A Case Study of the Implementation of a University-Children's Hospital Partnership

    ERIC Educational Resources Information Center

    O'Connor, C. Richele

    2008-01-01

    The purpose of this qualitative study was to investigate the perceptions of university students serving as volunteers in an oncology ward at a local children's hospital. The implementation of this project was guided by the body of literature regarding service learning. Data were collected from the five students using a structured interview and was…

  1. Clonal composition of Staphylococcus aureus isolates at a Brazilian university hospital: identification of international circulating lineages.

    PubMed

    Vivoni, Adriana Marcos; Diep, Binh An; de Gouveia Magalhães, Ana Cristina; Santos, Kátia Regina N; Riley, Lee W; Sensabaugh, George F; Moreira, Beatriz M

    2006-05-01

    In only a few instances has the clonal composition of Staphylococcus aureus collections that include methicillin-susceptible S. aureus (MSSA) been extensively characterized. In order to investigate the clonal composition of MSSA and methicillin-resistant S. aureus (MRSA) and examine whether the infections diagnosed at our hospital were related to internationally distributed S. aureus lineages, we collected 89 clinical S. aureus isolates from patients at a public university hospital in Rio de Janeiro, Brazil, from September 1999 to June 2000. All S. aureus isolates were genotyped by pulsed-field gel electrophoresis and multilocus restriction fragment typing (MLRFT), and a subset (n = 17) was further characterized by multilocus sequence typing (MLST). The 34 MRSA isolates were additionally characterized by SCCmec typing. The MSSA population (n = 55) was grouped into 18 restriction fragment types (RFTs); of these, five RFTs accounted for 67% (37) of the MSSA isolates. MRSA isolates were clustered into only three RFTs (P = 0.02). The majority of MSSA RFTs were related to sequence type 30 (ST30) (12 isolates, 22%), ST1, ST188, and ST432 (6 isolates, 11% each). The predominant MRSA RFT comprised 31 (91%) of 34 isolates; four randomly selected isolates of this RFT were ST239, the previously described widely disseminated Brazilian clone. However, a fifth isolate belonging to this RFT was the ST644, a new single locus variant of ST239. By applying MLRFT and MLST, we found evidence for a clonal structure in MSSA isolates and detected the dissemination of MSSA clonal complexes 1, 5, 8, 30, and 45.

  2. Synopsis of congenital cardiac disease among children attending University of Nigeria Teaching Hospital Ituku Ozalla, Enugu

    PubMed Central

    2013-01-01

    Background The objective of this study was to determine the pattern of congenital cardiac disease among children attending UNTH, Enugu, Nigeria. The nature of these abnormalities and the outcome were also considered. The exact etiology is unknown but genetic and environmental factors tend to be implicated. The difference in the pattern obtained worldwide and few studies in Nigeria could be due to genetic, environmental, socioeconomic, or ethnic origin. Methods A retrospective analysis of discharged cases in which a review of the cases of all children attending children outpatient clinics including cardiology clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu over a five year period (January 2007-June 2012) was undertaken. All the children presenting with cardiac anomalies were included in the study and the cases were investigated using ECG, X-ray and echocardiography studies. Results A total of 31,795 children attended the children outpatient clinics of the hospital over the study period. Of these, seventy one (71) had cardiac diseases. The overall prevalence of cardiac disease is 0.22%. The commonest symptoms were breathlessness, failure to thrive and cyanosis. Almost all types of congenital detects were represented, the commonest being isolated ventricular septal detect (VSD), followed by tetralogy of Fallot. One of these cardiac anomalies presented with Downs’s syndrome and another with VACTERAL association. Conclusions The results of this study show that 0.22% per cent of children who attended UNTH in Enugu State had congenital cardiac abnormalities and the commonest forms seen were those with VSD. PMID:24252233

  3. Registration of surgical adverse outcomes: a reliability study in a university hospital

    PubMed Central

    Visser, Annelies; Gouma, Dirk J; Goslings, J Carel

    2012-01-01

    Objective Accurate registration of adverse surgical outcomes is essential to detect areas for improvement of surgical care quality. One reason for inaccurate adverse outcome registration may be the method to collect these outcomes. The authors compared the completeness of the national complication registry database (LHCR) as used in our hospital with relevant information from other available resources. Design Retrospective reliability analysis. Setting University hospital. Participants From the 3252 patients admitted to the surgical wards in 2010, the authors randomly selected a cohort of 180 cases, oversampling those with adverse outcomes. The LHCR contains adverse outcomes as reported during morning hand-offs or in discharge letters. The authors checked if the number and severity of adverse outcomes recorded in the LHCR agreed with those reported in morning hand-offs, discharge letters and medical and nursing files. Results In 135 of 180 patients, all resources could be retrieved completely. Fourteen per cent of the patients with adverse outcomes were not recorded in the LHCR. Missing adverse outcomes were all reversible without the need for (re)operation, for example, postoperative pain, delirium or urinary tract complications. Only 38% of these adverse outcomes were reported in the morning hand-offs and discharge letters but were best reported in the medical and nursing files. Conclusions Registration of surgical adverse outcomes appears largely depending on the reliability of the underlying sources. For a more complete adverse outcome registration, the authors advocate a better hand-off and additional consultation of the patient's dossier. This extra effort allows for improvement actions to eventually avoid ‘mild’ adverse outcomes patients perceive as important and undesirable. PMID:22637372

  4. Irritable bowel syndrome among nurses working in King Abdulaziz University Hospital, Jeddah, Saudi Arabia

    PubMed Central

    Ibrahim, Nahla Khamis; Al-Bloushy, Randa Ibrahim; Sait, Salma Hani; Al-Azhary, Hatoon Wahid; Al Bar, Nusaybah Hussain; Mirdad, Ghazal A.

    2016-01-01

    Background Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder that can cause disability and economic burden. Nurses are a vital part of the medical team and their well-being is an important issue. Yet, few studies have been done concerning IBS among nurses. Objectives To determine the prevalence, severity, and predictors of IBS among nurses working at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Materials and methods A cross-sectional study was conducted among 229 nurses who fulfilled the eligibility criteria. They were selected by stratified random sampling during 2014–2015. A validated, confidential, self-administered data collection sheet was used for collection of personal and sociodemographic data. Rome III Criteria, IBS Severity Scoring System (IBS-SSS), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were included. Both descriptive and inferential statistics were done. A multiple logistic regression analysis was done to determine the predictors of IBS. Results The prevalence of IBS among nurses was 14.4%, and IBS-Mixed type was the commonest variety (54.5%). Positive family history of IBS, working in outpatient clinics, having day shift, poor sleep quality, and high anxiety and depression scale scores were significantly associated with IBS. After controlling for confounding factors in regression analysis, the predictors of IBS were food hypersensitivity (aOR=4.52; 95% CI: 1.80−11.33), morbid anxiety (aOR=4.34; 95% CI: 1.49–12.67), and positive family history of IBS (aOR=3.38; 95% CI: 1.12–13.23). Conclusion The prevalence of IBS was 14.4%. Food hypersensitivity, morbid anxiety, and family history were the predictors of IBS. Screening and management of IBS, food hypersensitivity, and psychological problems among nurses are recommended. PMID:27032964

  5. Occurrence of classes I and II integrons in Enterobacteriaceae collected from Zagazig University Hospitals, Egypt

    PubMed Central

    Malek, Mai M.; Amer, Fatma A.; Allam, Ayman A.; El-Sokkary, Rehab H.; Gheith, Tarek; Arafa, Mohamed A.

    2015-01-01

    Integrons are genetic units characterized by the ability to capture and incorporate gene cassettes, thus can contribute to the emergence and transfer of antibiotic resistance. The objectives of this study were: (1) to investigate the presence and distribution of class I and class II integrons and the characteristics of the gene cassettes they carry in Enterobacteriaceae isolated from nosocomial infections at Zagzig University Hospital in Egypt, (2) to determine their impact on resistance, and (3) to identify risk factors for the existence of integrons. Relevant samples and full clinical history were collected from 118 inpatients. Samples were processed; isolated microbes were identified and tested for antibiotic susceptibilities. Integrons were detected by polymerase chain reaction (PCR) and were characterized into class I or II by restriction fragment length polymorphism (RFLP). Integron-positive isolates were subjected to another PCR to detect gene cassette, followed by gene cassette sequencing. Risk factors were analyzed by logistic regression analysis. Seventy-six Enterobacteriaceae isolates were recognized, 41 of them (53.9%) were integron-positive; 39 strains carried class I and 2 strains carried class II integrons. Integrons had gene cassettes encoding different combinations and types of resistance determinants. Interestingly, blaOXA129 gene was found and ereA gene was carried on class I integrons. The same determinants were carried within isolates of the same species as well as isolates of different species. The presence of integrons was significantly associated with multidrug resistance (MDR). No risk factors were associated for integron carriage. We conclude that integrons carrying gene cassettes encoding antibiotic resistance are significantly present among Enterobacteriaceae causing nosocomial infection in our hospital. Risk factors for acquisition remain to be identified. PMID:26157425

  6. Diabetes insipidus following neurosurgery at a university hospital in Western Saudi Arabia

    PubMed Central

    Qari, Faiza A.; AbuDaood, Elaff A.; Nasser, Tariq A.

    2016-01-01

    Objectives: To review the incidence, spectrum of clinical manifestation, course, risk factors, as well as treatment of diabetes insipidus (DI) following neurosurgery of the pituitary gland. Methods: The files of 24 patients that underwent neurosurgery for sellar lesions, or tumor near the hypothalamus or pituitary gland at the Department of Neurosurgery, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia were retrospectively reviewed between January 2011 to December 2014. A total of 24 patients were studied, and were divided into 2 groups namely; DI and non-DI. Patient characteristics were studied using descriptive statistics. The differences in proportion between the 2 groups were found out using Z-test for proportion in 2 populations. The mean differences in the hormonal abnormalities for the 2 groups were assessed using independent t-test. All statistics are considered statistically significant when p<0.05. Results: During hospitalization, 13 (54.2%) out of 24 patient that underwent neurosurgery had manifestations of DI, which was transient in 5 (38.8%) and permanent in 8 (61.2%). The DI subgroup contained higher prevalence of prolactinoma, craniopharyngioma, pre-operative panhypopituitarism, and macroadenoma in MRI imaging and transphenoidal surgery. Furthermore, urine osmolality was significantly lower in the DI group post-operatively with a significant p=0.023. It was recognized that the permanent DI documented more significant numbers than other studies. Conclusion: In our study group, it was recognized that permanent DI meant that our patients needed desmopressin for more than 3 months, which documented a more significant number than other studies. PMID:26837398

  7. Pancreatic cancer in Universiti Sains Malaysia Hospital: a retrospective review of years 2001-2008.

    PubMed

    Norsa' adah, Bachok; Nur-Zafira, Azemi; Knight, Aishah

    2012-01-01

    Pancreatic cancer is usually detected late and has a high mortality rate. Since little is known about this cancer in Malaysia, a review of all cases admitted to Universiti Sains Malaysia Hospital was conducted to identify the epidemiological distribution and assess survival. A list of pancreatic cancer patients in 2001-2008 was obtained from the Hospital Record Department. Only cases confirmed by radio-imaging or histo-pathology examination were included. We excluded those with incomplete medical records. Kaplan-Meier and Cox proportional hazard approaches were used for data analysis. Only 56 cases were included with a mean (SD) age of 49.6 (16.0) years, with 60.7% males and 82.1% of Malay ethnicity. Previous history included cholelithiasis in 23.2%, diabetes mellitus in 16.1%, previous laparotomy in 10.7%, chronic pancreatitis in 7.1%, alcohol drinking in 5.4% and positive family history in 3.6%. The common presenting history included 67.9% loss of appetite, 66.1% loss of weight, 58.9% jaundice and 46.4% abdominal pain. Tumour staging was: 21.5% stage l, 17.8% stage ll, 3.6% stage lll and 57.1% stage lV. The median (95% CI) survival time was 3.4 (0.5, 6.3) months and significant prognostic factors were duration of symptoms (HR 0.97; 95% CI: 0.95, 0.99; p value 0.013), ascites (HR 2.64; 95% CI: 1.28, 5.44; p value 0.008) and Whipple surgery (HR 4.20; 95% CI: 2.27, 7.76; p value <0.001). The history of presenting complaints was short and the majority presented at late stages of the disease, thus the median survival time was very poor.

  8. A survey on antibiotic therapy knowledge among physicians of a tertiary care and university hospital.

    PubMed

    Gentile, Ivan; Landolfo, Danilo; Buonomo, Antonio Riccardo; Crispo, Manuel; Iula, Vita Dora; Minei, Giuseppina; Catania, Maria Rosaria; Borgia, Guglielmo

    2015-03-01

    Antibiotic therapy has resulted in major progress in the fight against infectious diseases and is associated with an improved quality of life and increased survival. However, the emergence of resistant bacterial strains represents an inevitable consequence of antibiotic treatment and yields a loss of beneficial effects. Due to the scarce availability of new molecules in the near future, physicians have to learn how to best use currently available molecules. The aim of the present study was to evaluate the criteria that physicians use in choosing targeted antibiotic therapy. To achieve this goal, we used a questionnaire comprising seven questions. The questionnaire was administered, with the guarantee of anonymity, to a pool of physicians at the Federico II University Hospital of Naples who could prescribe antibiotics. Of the physicians interviewed, 68% chose antibiotic therapy autonomously or in cooperation with other doctors of the same structure, whereas 30% of interviewees referred to the infectious diseases consultant (8% after the first bacterial isolation and 22% after antibiotic therapy failure). The definition and meaning of minimum inhibitory concentration (MIC) were known to the vast majority of physicians (82% and 83%, respectively). In contrast, few of the interviewees knew the definition or meaning of breakpoint (16% and 17%, respectively). The key question of the questionnaire focused on the main criterion for antibiotic choice: 68% of interviewees gave an incorrect answer, most interviewees considering only the lowest MIC value for the isolated bacterium as the fundamental parameter in antibiotic choice. Our study shows that antibiotic therapy in a teaching hospital is often chosen using inappropriate criteria. Due to the well-known effects of the wrong antibiotic choice on therapeutic failure rate and on healthcare cost, information and training programmes for physicians who prescribe antibiotics are urgently needed.

  9. Inpatient Management Of Diabetes Mellitus Among Noncritically Ill Patients At The University Hospital Of Puerto Rico

    PubMed Central

    Allende-Vigo, Myriam Zaydee; González-Rosario, Rafael A.; González, Loida; Sánchez, Viviana; Vega, Mónica A.; Alvarado, Milliette; Ramón, Raul O.

    2014-01-01

    OBJECTIVE To describe the state of glycemic control in non-critically ill diabetic patients admitted to the PR University Hospital, and the adherence to current standard of care guidelines for the treatment of diabetes. METHODS This was a retrospective study of patients admitted to a General Medicine ward with Diabetes Mellitus as a secondary diagnosis. Clinical data was analyzed for the first 5 days and the last 24 hours of admission. RESULTS One hundred and forty-seven (147) non-critically ill diabetic patients were evaluated. The rate of hyperglycemia and hypoglycemia was 56.7% and 2.8%, respectively. Nearly 60% of patients were hyperglycemic during the first 24 hrs of admission and 54.2% during the last 24 hrs. Mean last glucose value before discharge was 189.6 ± 73 mg/dL. Most patients were treated with subcutaneous insulin with basal insulin alone used as the most common regimen. The proportion of patients classified as uncontrolled receiving basal-bolus therapy increased from 54.3% on day 1 to 60.0% on day 5, with still 40.0% receiving only basal insulin. Most of the uncontrolled patients had their insulin dose increased (70.1%), however, a substantial portion had no change (23.7%) or even had a decrease (6.2%) in their insulin dose. CONCLUSIONS Even though there are areas of improvement in the management of hospitalized diabetic patients, it is still suboptimal, probably due to clinical inertia. A comprehensive educational diabetes management program, along with standardized insulin orders should be implemented to improve the care of these patients. PMID:24325996

  10. Invasive fungal disease in university hospital: a PCR-based study of autopsy cases.

    PubMed

    Ruangritchankul, Komkrit; Chindamporn, Ariya; Worasilchai, Navaporn; Poumsuk, Ubon; Keelawat, Somboon; Bychkov, Andrey

    2015-01-01

    Invasive fungal disease (IFD) has high mortality rate, especially in the growing population of immunocompromised patients. In spite of introduction of novel diagnostic approaches, the intravital recognition of IFD is challenging. Autopsy studies remain a key tool for assessment of epidemiology of visceral mycoses. We aimed to determine species distribution and trends of IFD over the last 10 years in unselected autopsy series from a large university hospital. Forty-five cases of visceral mycoses, confirmed by histopathology and panfungal PCR, were found in 587 consecutive autopsies. Major underlying diseases were diabetes mellitus (20%), hematologic malignancies (15.6%) and systemic lupus erythematosus (15.6%). There was a high risk for disseminated IFD in immunocompromised patients stayed in the hospital over 1 month with a fever longer than 3 weeks. The most common fungi were Aspergillus spp. (58%), Candida spp. (16%), Mucorales (14%) and Fusarium spp. (10%). We found significant increase in Aspergillus flavus (P = 0.04) and Mucorales (P < 0.01) infections over the last 5 years. Concordance rate between histopathology and panfungal PCR was 89.5% to the genus level. All 6 cases of fusariomycosis were misinterpreted as aspergillosis by histology alone. The precise species identification, necessary for targeted antifungal treatment, was rendered only by the molecular technique. Panfungal PCR showed high performance on formalin-fixed paraffin-embedded specimens, providing important epidemiological data in retrospective autopsy series. Rapid detection of fungi by panfungal PCR assay has high potential for intravital diagnostics of IFD in surgical and biopsy specimens. PMID:26823814

  11. Motorcycle-related injuries at a university teaching hospital in north central Nigeria

    PubMed Central

    Elachi, Itodo C.; Okunola, Benjamin B.; Yongu, Williams T.; Onyemaechi, Ndubuisi OC; Odatuwa-Omagbemi, Odoyoh D.; Ahachi, Chukwukadibia N.; Mue, Daniel D.

    2014-01-01

    Background: Motorcycle-related injuries lead to considerable morbidity and mortality. The aim of this study is to determine the pattern and outcome of motorcycle-related injuries at Benue State University Teaching Hospital, Makurdi, Nigeria. Patients and Methods: Case records of all patients who presented to the accident and emergency department with motorcycle-related injuries between July 2012 and June 2013 were analysed for age, gender, injury host status (i.e. rider, pillion or pedestrian), nature of collision (motorcycle versus other vehicles, motorcycle versus motorcycle, motorcycle versus pedestrian or lone riders), body region injured, injury severity score (ISS) at arrival, length of hospital stay (LOS) and mortality. Results: Seventy - nine patients with motorcycle-related injuries were included in the study. They consisted of 63 males (61.8%) and 16 females (15.7%). The age range was 5-65 years with a mean of 32.4 ± 14.0. Motorcycle versus vehicle collisions were the most common mechanism of injury (n = 46, 58.2%). Musculoskeletal injuries constituted the most common injuries sustained (n = 50, 47.6%) and the tibia was the most frequently fractured bone (n = 14, 35.9%). The majority of patients (57.0%) sustained mild/moderate injuries (ISS ≤ 15). There was no statistically significant difference between the sexes for sustaining mild/moderate injuries or severe/profound injuries (P > 0.05). Mortality rate was 6.3% with head injuries being involved in all cases. Conclusion: Young males were mostly injured in motorcycle-related trauma. Musculoskeletal injuries were the most common injuries sustained and head injuries were involved in all the deaths. Enforcement of motorcycle crash bars and helmet usage is recommended. PMID:25538360

  12. Uppsala University Hospital 300 years—a survey of the surgical development

    PubMed Central

    2009-01-01

    Professor Lars Roberg, the initiator of the Nosocomium Academicum (1708), our first university hospital in Sweden, claimed that ‘no-one who does not understand surgery is a completely trained doctor’. However, it was not until the end of 19th century that modern surgery was born. The Academic Hospital was opened in 1867, and at the turn of that century Uppsala had a flourishing period under the influence of Karl Gustav Lennander, professor of surgery. In 1889 he performed the first appendectomy in Scandinavia. At the end of the 19th century the surgical tree began to branch out. In Uppsala gynaecology and obstetrics was the first to be an independent speciality (1891). It was followed by ophthalmology (1894) with Allvar Gullstrand as professor and head of the department. Gullstrand received the Nobel Prize in medicine in 1911. A separate department for diseases of the ear, nose, and throat was founded in 1916 with the Nobel laureate Robert Bárány as head. Thoracic surgery began in Uppsala in the 1940s with lung surgery and was separated from general surgery in 1958 with Viking Olov Björk as head of the department. Björk introduced open heart surgery in Uppsala. In 1951 reconstructive plastic surgery was organized by Tord Skoog, who devoted special interest to operations for cleft lip and palate surgery. Neurosurgery was established in 1962, and Uppsala has held a prominent position in the development of modern neurointensive care. During the 1970s general surgery became subspecialized into gastrointestinal, endocrine, and vascular surgery. At the same time fracture surgery was transferred to the orthopaedists, and urological surgery became an independent speciality. Transplantation surgery was introduced in Uppsala in 1967, when Professor Lars Thorén performed the first kidney transplantation. Today Uppsala has a leading position in transplantation of pancreatic islets cells. PMID:19242867

  13. Invasive fungal disease in university hospital: a PCR-based study of autopsy cases

    PubMed Central

    Ruangritchankul, Komkrit; Chindamporn, Ariya; Worasilchai, Navaporn; Poumsuk, Ubon; Keelawat, Somboon; Bychkov, Andrey

    2015-01-01

    Invasive fungal disease (IFD) has high mortality rate, especially in the growing population of immunocompromised patients. In spite of introduction of novel diagnostic approaches, the intravital recognition of IFD is challenging. Autopsy studies remain a key tool for assessment of epidemiology of visceral mycoses. We aimed to determine species distribution and trends of IFD over the last 10 years in unselected autopsy series from a large university hospital. Forty-five cases of visceral mycoses, confirmed by histopathology and panfungal PCR, were found in 587 consecutive autopsies. Major underlying diseases were diabetes mellitus (20%), hematologic malignancies (15.6%) and systemic lupus erythematosus (15.6%). There was a high risk for disseminated IFD in immunocompromised patients stayed in the hospital over 1 month with a fever longer than 3 weeks. The most common fungi were Aspergillus spp. (58%), Candida spp. (16%), Mucorales (14%) and Fusarium spp. (10%). We found significant increase in Aspergillus flavus (P = 0.04) and Mucorales (P < 0.01) infections over the last 5 years. Concordance rate between histopathology and panfungal PCR was 89.5% to the genus level. All 6 cases of fusariomycosis were misinterpreted as aspergillosis by histology alone. The precise species identification, necessary for targeted antifungal treatment, was rendered only by the molecular technique. Panfungal PCR showed high performance on formalin-fixed paraffin-embedded specimens, providing important epidemiological data in retrospective autopsy series. Rapid detection of fungi by panfungal PCR assay has high potential for intravital diagnostics of IFD in surgical and biopsy specimens. PMID:26823814

  14. Levels of organic compounds in interiors (school, home, university and hospital) of Ouargla city, Algeria

    NASA Astrophysics Data System (ADS)

    Boudehane, A.; Lounas, A.; Moussaoui, Y.; Balducci, C.; Cecinato, A.

    2016-11-01

    Indoor environments are affected by a number of organic contaminants, whose concentrations can exceed by orders of magnitude those found outdoors in external air. At this regard, polycyclic aromatic hydrocarbons (PAHs) deserve a special concern. PAHs occur in the air both in the gaseous and particulate forms; they are associated to fine aerosols and soil dust, and deposit on surfaces. Nonetheless, scarce information exists about the PAH pollution of indoor locations in Northern Africa. PAHs were first investigated in dust of interiors in Ouargla (Saharan Algeria), concurrently with n-alkanes and polar organics. Settled dust was collected from pre-cleaned surfaces (0.5 m2 each) at 7 internal locations in total from a school, the city hospital and university, and a home. Three sample series were collected 15, 30 days and random after the preliminary cleaning of surfaces. Contemporarily, organic compounds were collected at 15 locations of the target sites by deploying diffusive samplers over the whole study period to obtain molecular signatures of semi-volatile organic fraction. A consolidated procedure consisting of ultra-sonic bath extraction, semi-preparative column chromatography and gas chromatographic - mass spectrometric analysis was applied for chemical characterization of dusts. n-Alkanes ranged from 3.8 to 41 μg/m2 in dust and 0.17-2.42 μg/m3 in gas phase. PAHs concentrations were 17-89 ng/m2 and 45-182 ng/m3, respectively. Caffeine and nicotine were found both in dust (63-2,02 ng/m2 and 7-284 ng/m2, respectively) and as vapors in air (4-416 ng/m3 and 3.5-60 ng/m3). Two sites were affected by cannabinoids, while traces of nonylphenols occurred at all locations. External air was, on the average, more affected by PAHs than the interiors of school and hospital, but not of university. The compound concentrations show that Ouargla city is seriously polluted and requires actions to improve air quality.

  15. Multidimensional evaluation of performance: experimental application of the balanced scorecard in Ferrara university hospital

    PubMed Central

    Verzola, Adriano; Bentivegna, Roberto; Carandina, Gianni; Trevisani, Lucio; Gregorio, Pasquale; Mandini, Alberto

    2009-01-01

    Background and Aims One of the best-known performance planning and evaluation techniques utilising both monetary and non-monetary data is the Balanced Scorecard (BSC). This is a means of rationalising the global activity of a business in the attempt to create value, and to translate the company vision into a set of tactical objectives and measurable strategies. The aim of this study was to implement and evaluate the use of BSC in two departments of the St. Anna University Hospital, Ferrara: the Analysis Laboratory and Digestive Endoscopy operating units (OU). Materials and methods With the collaboration of the health workers involved, a precise methodological programme was pursued: Definition of the strategic map from 4 perspectives, according to Kaplan and Norton, Definition of the Key Performance Areas (KPA), or macro-objectives, Identification of the cause-effect relationships between KPAs, Identification of the sub-objectives of each KPA, Definition of the Key Performance Indicators (KPI), Definition of the weight/importance of each objective in the global evaluation. Results The information gathered permitted the definition of macro- and sub-objectives for each perspective, as well as determining the relevant indicators, standards, weights, frequency of detection and means of acquisition. Strategic maps showing the cause/effect relationships in each OU were created, as were 'evaluation panels', which describe the global performance of each department. For each perspective, the fundamental data were summarised in one table. Evaluation of each perspective yielded a positive result for the majority of the objectives, and the global result (including all 4 perspectives) was found to be satisfactory. Discussion-Conclusion The Balanced Scorecard was implemented in the abovementioned OUs of St. Anna University Hospital, Ferrara, after the health workers themselves realised the need for change. In our research the employees were pleased to be evaluated, not only for

  16. Characterization of methicillin-resistant Staphylococcus aureus associated with nosocomial infections in the University Hospital, Kuala Lumpur.

    PubMed

    Hanifah, Y A; Hiramatsu, K; Yokota, T

    1992-05-01

    Methicillin-resistant Staphylococcus aureus (MRSA) as a hospital pathogen has presented many clinical problems in the University Hospital, Kuala Lumpur, Malaysia since 1978. The need for control of spread of these organisms became evident by 1985 when it was noted that the incidence of MRSA among S. aureus isolated from hospital inpatients had increased from 11.5% in 1979 to 18.8% in 1985. The characteristics of 50 MRSA isolates associated with nosocomial infections in the hospital are described here. The predominant strains produced Type IV coagulase and 84% of isolates studied showed moderate to high resistance to methicillin with MIC values of 25 mg l-1 or higher. All the MRSA isolates that could be phagetyped were susceptible to Group III phages, with 76.6% of the isolates being susceptible to phage 85. At least 10 different patterns were distinguishable by plasmid typing, the majority of isolates harbouring up to four small plasmids.

  17. [Overcrowding in emergency departments: the case of the San Giovanni Battista (Molinette) university hospital in Turin (Italy)].

    PubMed

    Fornero, Giulio; Arione, Roberto; Fiandra, Umberto; Rapellino, Marco; Bono, Alessia; Moiraghi, Corrado; Gianino, Maria Michela

    2011-01-01

    Overcrowding in Emergency Departments (ED) is a common phenomenon worldwide, especially in metropolitan areas. The main reason for overcrowding is not inappropriate emergency department use by patients but rather a shortage of available hospital beds which results in extended ED stays for patients who need emergency admission. The aims of this study, conducted at the San Giovanni Battista (Molinette) University hospital in Turin (Italy), were a) to verify the existence of overcrowding in the hospital ED and b) to test whether, as stated in the literature, overcrowding is due to restricted access to hospital beds for patients needing emergency admission, and to identify contributing factors. Results show the existence of overcrowding and confirm the hypothesized cause. PMID:22508607

  18. Patients' satisfaction with inpatient services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2011-2013.

    PubMed

    Makarem, Jalil; Larijani, Bagher; Joodaki, Kobra; Ghaderi, Sahar; Nayeri, Fatemeh; Mohammadpoor, Masoud

    2016-01-01

    Implementation of patient feedback is considered as a critical part of effective and efficient management in developed countries. The main objectives of this study were to assess patient satisfaction with the services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, identify areas of patient dissatisfaction, and find ways to improve patient satisfaction with hospital services. This cross-sectional study was conducted in 3 phases. After 2 initial preparation phases, the valid instrument was applied through telephone interviews with 21476 participants from 26 hospitals during August, 2011 to February, 2013.Using the Satisfaction Survey tool, information of patient's demographic characteristics were collected and patient satisfaction with 15 areas of hospital services and the intent to return the same hospitals were assessed. The mean score of overall satisfaction with hospital services was 16.86 ± 2.72 out of 20. It was found that 58% of participants were highly satisfied with the services provided. Comparison of mean scores showed physician and medical services (17.75 ± 4.02), laboratory and radiology services (17.67 ± 3.66), and privacy and religious issues (17.55 ± 4.32) had the highest satisfaction. The patients were the most dissatisfied with the food services (15.50 ± 5.54). It was also found that 83.7% of the participants intended to return to the same hospital in case of need, which supported the measured satisfaction level. Patient satisfaction in hospitals affiliated to Tehran University of Medical Sciences was high. It seems that the present study, with its large sample size, has sufficient reliability to express the patient satisfaction status. Moreover, appropriate measures should be taken in some areas (food, cost, and etc.) to increase patient satisfaction. PMID:27471589

  19. Patients' satisfaction with inpatient services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2011-2013.

    PubMed

    Makarem, Jalil; Larijani, Bagher; Joodaki, Kobra; Ghaderi, Sahar; Nayeri, Fatemeh; Mohammadpoor, Masoud

    2016-01-01

    Implementation of patient feedback is considered as a critical part of effective and efficient management in developed countries. The main objectives of this study were to assess patient satisfaction with the services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, identify areas of patient dissatisfaction, and find ways to improve patient satisfaction with hospital services. This cross-sectional study was conducted in 3 phases. After 2 initial preparation phases, the valid instrument was applied through telephone interviews with 21476 participants from 26 hospitals during August, 2011 to February, 2013.Using the Satisfaction Survey tool, information of patient's demographic characteristics were collected and patient satisfaction with 15 areas of hospital services and the intent to return the same hospitals were assessed. The mean score of overall satisfaction with hospital services was 16.86 ± 2.72 out of 20. It was found that 58% of participants were highly satisfied with the services provided. Comparison of mean scores showed physician and medical services (17.75 ± 4.02), laboratory and radiology services (17.67 ± 3.66), and privacy and religious issues (17.55 ± 4.32) had the highest satisfaction. The patients were the most dissatisfied with the food services (15.50 ± 5.54). It was also found that 83.7% of the participants intended to return to the same hospital in case of need, which supported the measured satisfaction level. Patient satisfaction in hospitals affiliated to Tehran University of Medical Sciences was high. It seems that the present study, with its large sample size, has sufficient reliability to express the patient satisfaction status. Moreover, appropriate measures should be taken in some areas (food, cost, and etc.) to increase patient satisfaction.

  20. Patients' satisfaction with inpatient services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2011-2013

    PubMed Central

    Makarem, Jalil; Larijani, Bagher; Joodaki, Kobra; Ghaderi, Sahar; Nayeri, Fatemeh; Mohammadpoor, Masoud

    2016-01-01

    Implementation of patient feedback is considered as a critical part of effective and efficient management in developed countries. The main objectives of this study were to assess patient satisfaction with the services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, identify areas of patient dissatisfaction, and find ways to improve patient satisfaction with hospital services. This cross-sectional study was conducted in 3 phases. After 2 initial preparation phases, the valid instrument was applied through telephone interviews with 21476 participants from 26 hospitals during August, 2011 to February, 2013.Using the Satisfaction Survey tool, information of patient's demographic characteristics were collected and patient satisfaction with 15 areas of hospital services and the intent to return the same hospitals were assessed. The mean score of overall satisfaction with hospital services was 16.86 ± 2.72 out of 20. It was found that 58% of participants were highly satisfied with the services provided. Comparison of mean scores showed physician and medical services (17.75 ± 4.02), laboratory and radiology services (17.67 ± 3.66), and privacy and religious issues (17.55 ± 4.32) had the highest satisfaction. The patients were the most dissatisfied with the food services (15.50 ± 5.54). It was also found that 83.7% of the participants intended to return to the same hospital in case of need, which supported the measured satisfaction level. Patient satisfaction in hospitals affiliated to Tehran University of Medical Sciences was high. It seems that the present study, with its large sample size, has sufficient reliability to express the patient satisfaction status. Moreover, appropriate measures should be taken in some areas (food, cost, and etc.) to increase patient satisfaction. PMID:27471589

  1. The Role of Hospital Information Systems in Universal Health Coverage Monitoring in Rwanda.

    PubMed

    Karara, Gustave; Verbeke, Frank; Nyssen, Marc

    2015-01-01

    In this retrospective study, the authors monitored the patient health coverage in 6 Rwandan hospitals in the period between 2011 and 2014. Among the 6 hospitals, 2 are third level hospitals, 2 district hospitals and 2 private hospitals. Patient insurance and financial data were extracted and analyzed from OpenClinic GA, an open source hospital information system (HIS) used in those 6 hospitals. The percentage of patients who had no health insurer globally decreased from 35% in 2011 to 15% in 2014. The rate of health insurance coverage in hospitals varied between 75% in private hospitals and 84% in public hospitals. The amounts paid by the patients for health services decreased in private hospitals to 25% of the total costs in 2014 (-7.4%) and vary between 14% and 19% in public hospitals. Although the number of insured patients has increased and the patient share decreased over the four years of study, the patients' out-of-pocket payments increased especially for in-patients. This study emphasizes the value of integrated hospital information systems for this kind of health economics research in developing countries.

  2. Clinical outcomes of dialysis-treated acute kidney injury patients at the university of port harcourt teaching hospital, Nigeria.

    PubMed

    Emem-Chioma, Pedro Chimezie; Alasia, Datonye Dennis; Wokoma, Friday Samuel

    2013-01-01

    Background. Acute kidney injury in adults is a common cause of hospitalization, associated with high morbidity and mortality especially in developing countries. In spite of RRT the in-hospital mortality rates remain high even in the developed countries. Though a proportion of our patients receive renal replacement therapy as part of their management, data on outcomes are sparse. Study Objective. To determine the clinical outcomes of dialysis-treated AKI in our hospital. Methods. A retrospective analysis of the clinical data of all adult AKI patients treated with haemodialysis at the University of Teaching Hospital during an interrupted six-year period was conducted. Analysis was done using SPSS version 17.0. Results. 34 males and 28 females with mean age of 41.3 ± 18.5 years were studied. The leading causes of AKI were sepsis (22.7%), acute glomerulonephritis (20.5%), acute gastroenteritis (15.9%), and toxic nephropathies (11.4%) and presented with mean e-GFR of 14.7 ± 5.8 mls/min/1.73 m(2). Of the 62 patients, 29 (46.8%) were discharged from the hospital, 27 (43.5%) died in hospital, while 6 (9.7%) absconded from treatment. Survivors had better Rifle grade than those who died (P < 0.001). Conclusion. Hospital mortality rate of dialysis-treated AKI patients is high and the severity of renal damage at presentation may be an important factor.

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

    PubMed Central

    Onwuchekwa, Arthur C; Chinenye, Sunday

    2010-01-01

    Background: Hypertension in Nigeria is a widespread problem of immense social and economic importance because of its high prevalence and the severity of its complications. Aim: To define the morbidity and mortality pattern of hypertension at the University of Port Harcourt Teaching Hospital (UPTH). Method: Records of all patients admitted to the medical wards of the UPTH over a 5-year period with essential hypertension or any of its complications were retrieved from the ward and medical records and reviewed. Result: A total of 780 hypertensive patients were reviewed, constituting 28.2% of all medical admissions. Only 424 (15.2%) had complete records and were analyzed. Record keeping was poor. There were 173 (41%) males and 251 (59%) females with a male to female ratio of 1:1.5. The ages ranged from 18 years to 100 years with a mean of 56.5 ± 16.2. Stroke was responsible for 169 (39.9%) hypertensive complications. Heart failure occurred in 97 (22%) cases while renal failure and encephalopathy accounted for 40 (9.4%) and 7 (1.7%) hypertensive complications respectively. There were 99 deaths out of which 51 (51.5%) were due to stroke, 14 (14.12%) were due to heart failure, and 12 (12.1%) were due to renal failure. Conclusion: The contribution of systemic hypertension to the morbidity and mortality of adults at UPTH is quite significant. PMID:20730067

  4. Pattern of suicide: a review of autopsies conducted at the University Hospital, Kuala Lumpur.

    PubMed

    Nadesan, K

    1999-12-01

    Suicide is one of the ten leading causes of death in the world, accounting for more than 400,000 deaths annually. The pattern of suicide and the incidence of suicide vary from country to country. Cultural, religious and social values play some role in suicide. Compared to the West and some of the countries in the Asian region the incidence of suicide is low in Malaysia. A three-year retrospective study of all the autopsies performed at the University Hospital, Kuala Lumpur was analysed and the cases that were definitely determined as suicides were further studied. 48.8% of all suicides were ethnic Indians though Indians formed only 8% of the Malaysian population. 38.1% of suicides were Chinese who formed 26% of the population while only 3.6% were Malays, who formed 59% of the population. The preferred methods of suicide were poisoning and hanging. The majority were in the age group 20-40 yr. The study may have missed some cases that would have been wrongly concluded as accidental deaths and a few others where the police would have released the bodies without postmortem examinations. PMID:11068413

  5. An evaluation of hospital emergency department (HED) adherence to universal precautions.

    PubMed

    Rydman, R J; Tannebaum, R D; Zalenski, R J

    1994-08-01

    A longitudinal cross sectional study of Hospital Emergency Department (HED) procedures over a nine month period was conducted. A total of 1,541 procedures were observed on 56 randomly selected 8-h work shifts. Shifts were distributed: 34% day shift; 34% evening shift; and 32% on the night shift. Observations on the evening shift were oversampled to capture an adequate number of trauma patients. Observations were distributed: 33% day shift; 39% evening shift; and 28% on the night shift. Measurements included: type of procedure; adherence to specific barrier technique, i.e., use of gloves, gowns, masks, and eye protection; and occurrence of adverse exposure. Ten types of HED procedures were documented and analyzed. Computerized tracking of study observations established periodic rates of HED health care worker (HCW) adherence to universal precautions. These data are important for internal quality control/assurance programs and rate comparisons within and across institutions over time. The longitudinal evaluation of the database revealed that glove compliance increased over the period of the study and adverse exposure decreased. Conducting ongoing or periodic observational studies of this kind are important and necessary in order to gauge HED response to the epidemiologic challenges of urban society. PMID:7829982

  6. 50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

    PubMed

    Lertakyamanee, Jariya

    2016-05-01

    Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters. We look after pre-anesthesia assessment, inside and outside operating room anesthesia, post-operative pain relief Intensive Care Unit, and chronic pain management. The number of patients and their diseases increase; so do the complexities of surgeries. There are tremendous changes in drugs and equipment. There is the fourth mission on administration, IT and resource management. And the fifth mission which is corporate social responsibility. However, we still believe that compassion, responsibility and integrity are most important. We have taught and tried to live by the teaching of HRH the King's Father. And these will contribute to our progress and shine in the next 50 years.

  7. Multidrug Resistance of Acinetobacter Baumannii in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria

    PubMed Central

    Odewale, G.; Adefioye, O. J.; Ojo, J.; Adewumi, F. A.; Olowe, O. A.

    2016-01-01

    Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections at Ladoke Akintola University Teaching Hospital. Isolates were assayed according to standard protocol. The isolates were subjected to molecular techniques to detect blaOXA, blaTEM, blaCTX-M, and blaSHV genes in strains of the A. baumannii isolates. The prevalence of A. baumannii was 8.5% and was most prevalent among patients in the age group 51–60 (36%); the male patients (63.6%) were more infected than their female counterparts. Patients (72.7%) in the intensive care unit (ICU) were most infected with this organism. The isolates showed 100% resistance to both amikacin and ciprofloxacin and 90.9% to both ceftriaxone and ceftazidime, while resistance to the other antibiotics used in this study were: piperacillin (81.8%), imipenem (72.7%), gentamycin (72.2%), and meropenem (63.6%). None of the isolates was, however, resistant to colistin. PCR results showed that blaOXA, blaTEM, and blaCTX-M genes were positive in some isolates, while blaSHV was not detected in any of the isolates. This study has revealed that the strains of A. baumannii isolated are multiple drug resistant. Regular monitoring, judicious prescription, and early detection of resistance to these antibiotics are, therefore, necessary to check further dissemination of the organism. PMID:27766173

  8. Assessment of the structural and process aspects of pharmaceutical care at a university hospital in Ethiopia

    PubMed Central

    Surur, Abdrrahman Shemsu; Teni, Fitsum Sebsibe; Girmay, Genet; Moges, Elsabet; Tesfa, Meseret; Abraha, Messele

    2015-01-01

    Objective: To assess the structural and process components of the pharmaceutical care at Gondar University Referral Hospital (GURH). Materials and Methods: An institution-based cross-sectional study was conducted on all the four pharmacies at GURH from October 1 to December 31, 2013. By adopting data collection instruments from a previously done study, the structural aspects of the pharmacies were assessed using an observation checklist and the process of pharmaceutical care delivery using a self-administered questionnaire. The data collected was entered to and analyzed using Statistical Packages for Social Sciences (SPSS) version 16.0. Results: none of the pharmacies had a private counseling room, fire extinguisher and meeting area. None of the pharmacy stores were equipped with fan and air ventilation system and had no cross aisles. The mean values for documentation, patient assessment and implementation of therapeutic objective were 12.14, 14.03 and 5.64 respectively. Many pharmacists (64.29%) did not participate in ward rotation with physicians. The overall pharmacy professionals’ level of job satisfaction was found to be 2.77. Conclusion: There were gaps in the structure and the process of the provision of pharmaceutical care in GURH. PMID:25883512

  9. Transmission of a multiresistant Pseudomonas aeruginosa strain at a German University Hospital.

    PubMed

    Pitten, F A; Panzig, B; Schröder, G; Tietze, K; Kramer, A

    2001-02-01

    Over 15 months, 60 patients at a German University Hospital became infected or colonized by a multiresistant Pseudomonas aeruginosa strain, which was isolated from tracheal secretions, blood, urine, venous catheters, ascites and several wounds. Most patients had undergone invasive treatment (surgery, cancer therapy). The genetic relationship of the isolates was investigated by pulsed field gel electrophoresis. The isolates were resistant to beta-lactam antibiotics, including carbapenems and aztreonam, to aminoglycosides and quinolones. The only in vitro susceptibility was to polymyxin B. Extensive sampling was carried out to identify contaminated medical devices, surfaces or media (water, food). Samples were taken from doctors and nursing staff and various treatment procedures were observed for several weeks. The handling of respirators, resuscitation tubes, urine bottles, and bedpans resulted in the contamination of the patients' environment, although most devices were cleaned and disinfected with automatic washer/disinfectors. Several wash basins on the intensive care unit were contaminated, but none of the drinking water samples showed any growth of P. aeruginosa. We recommend the strict use of gloves and strict application of alcoholic hand disinfectants immediately after discarding the gloves. The chain of infection ceased after strict cohort isolation and the subsequent introduction of the specific hygiene regime.

  10. Cesarean Section Rate Analysis in University Hospital Tuzla - According to Robson’s Classification

    PubMed Central

    Fatusic, Jasenko; Hudic, Igor; Fatusic, Zlatan; Zildzic-Moralic, Aida; Zivkovic, Milorad

    2016-01-01

    Objective: For last decades, there has public concern about increasing Cesarean Section (CS) rates, and it is an issue of international public health concern. According to World Health Organisation (WHO) there is no justification to have more than 10-15% CS births. WHO proposes the Robson ten-group classification, as a global standard for assessing, monitoring and comparing cesarean section rates. The aim of this study was to investigate Cesarean section rate at University Hospital Tuzla, Bosnia and Herzegovina. Methods: Cross sectional study was conducted for one-year period, 2015. Statistical analysis and graph-table presentation was performed using Excel 2010 and Microsoft Office programs. Results: Out of 3,672 births, a total of 936 births were performed by CS. Percentage of the total number of CS to the total birth number was 25,47%. According to Robson classification, the largest was group 5 with relative contribution of 29,80%. On second and third place were group 1 and 2 with relative contribution of 26,06% and 15,78% respectively. Groups 1, 2, 5 made account of realtive contribution of 71,65%. All other groups had entirely relative contribution of 28,35%. Conclusion: Robson 10-group classification provides easy way in collecting information about CS rate. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS. Data from our study confirm this attitude. PMID:27594749

  11. Direct patient treatment costs in the Allergology Service of a University Hospital.

    PubMed

    Negro Alvarez, J M; Murcia Alemán, T; Aparicio García, C; Jiménez Molina, J L; Hernández García, J; Puerta Jiménez, J; Ródenas Checa, J; Ferrándiz Gomis, R; Alcaraz Quiñonero, M

    2006-01-01

    Health resources are limited and consequently real cost generators must be identified to optimize resources. In the present article, we describe the structure of the Allergy Unit of the University Hospital Virgen de la Arrixaca in Murcia (Spain), the health area in which allergic patients are attended, and the final healthcare products generated. Based on the 2004-2005 budget, variable costing was used to calculate the costs of the healthcare products generated (first visits, subsequent visits, and diverse laboratory tests) by two of the three homogeneous functional groups (HFG), i.e., HFG of the ambulatory service and HFG of complementary tests. The following conclusions can be drawn: 1) the current system of variable costing provides information, which should be useful to health professionals; 2) the real cost generators in the microcosm of daily clinical practice should be identified to allow resource reallocation; 3) the costing system used enables modifications to be made that allow decision making on optimal use of the budget; 4) clinical management and complementary tests should go hand in hand with a view to optimizing resources.

  12. Anaesthesia for operative deliveries at the University Hospital of the West Indies: a change of practice.

    PubMed

    Crawford-Sykes, A; Scarlett, M; Hambleton, I R; Nelson, M; Rattray, C

    2005-06-01

    There has been an increasing trend worldwide to use regional anaesthesia for operative deliveries. The Confidential Enquiry into Maternal Deaths in the United Kingdom has demonstrated a steady decline in the anaesthesia-related deaths since the introduction of regional anaesthesia. There are lower morbidity profiles in mothers delivering under regional anaesthesia as well as better infant Apgar scores. In 1997, a decision was taken to have at least 60% of all elective Caesarean sections done at the University Hospital of the West Indies (UHWI) performed under spinal anaesthesia. This is a review of the anaesthetic technique for Caesarean sections at the UHWI since 1996. The Deliveries and Anaesthetic Books on the labour ward were reviewed and the type of anaesthesia for elective and emergency Caesarean sections recorded for the period January 1996 to December 2001. At the beginning of the period under study, more than 90% of the Caesarean sections were being done under general anaesthesia. By the middle of 1998, spinal anaesthesia was more commonly employed than general anaesthesia for Caesarean sections and by December 2001, more than eight out of every ten Caesarean sections were being done under spinal anaesthesia. The main reasons for the successful change of practice were that it was consultant-led, there was good communication between relevant departments, the junior staff were properly trained, there was a consistent supply of appropriate drugs and there was a high level of patient satisfaction. PMID:16209224

  13. Thymectomy for Myasthenia Gravis: A 10-year Review of Cases at the Hospital Universiti Sains Malaysia

    PubMed Central

    Muhammed, Julieana; Chen, Chui Yin; Wan Hitam, Wan Hazabbah; Ghazali, Mohamad Ziyadi

    2016-01-01

    Background A thymectomy is considered effective for patients with myasthenia gravis (MG). Although a few studies have described the role of a thymectomy in the treatment of MG in Asians countries, there are no published data on the application of this surgical approach for MG in Malaysia. We aimed to describe the clinical outcomes of MG patients who underwent a thymectomy and the factors affecting these outcomes. Methods This was a retrospective study involving 16 patients with MG who underwent a thymectomy at the Hospital Universiti Sains Malaysia (HUSM) from January 2002 until December 2012, with a follow-up period ranging from 3–120 months. Results The study consisted of 16 patients aged 22–78 years, 10 of whom were males. The overall remission/improvement rate was 87.5%, and the rate of clinical outcomes classified as unchanged/worsened was 12.5%. Thymomamatous or non-thymomamatous MG, histology features, Osserman stage and the duration of follow-up were not significant prognostic factors. Post-operative mortality was 6.2% (1 of 16 patients died of septic shock). Conclusion A thymectomy seems to be an effective treatment for MG, with low surgical morbidity. Patients with a lower Osserman stage and those with/without thymomas had favourable outcomes.

  14. [Hand washing: comparison between professionals and students behaviours in a large University hospital of Rome].

    PubMed

    Sansoni, Julita; Mariani, Paola; De Caro, Walter; Sorrentino, Milena; Marucci, Anna Rita; Giammarco, Enrichetta; Di Foggia, Fernanda; Cristofaro, Domenico; van de Mortel, Thea

    2011-01-01

    The main objective of the study is assessing knowledge, opinions and compliance with the procedures of health professionals (physician, nurses, medical and nursing students) about Hand Hygiene (HH). There is a number of research which indicates that physicians respect less than nurses Hand Hygiene, there are a smaller number which investigates the differences in the attitude of the aforementioned subjects during their studies. A questionnaire was administered to a sample of 756 participants (252 doctors, 268 nurses, 117 nursing students and 119 students of medicine) at a large University Hospital in Rome, to determine their knowledge, compliance and procedures with Hand Hygiene. Knowledge of medical students is lower than that of nursing students, as well as they have lower values in adherence to practice. In both HH Beliefs Scale (HBS) and HH Practices Inventory (HHPI) questionnaires, nursing students have higher scores than nurses, doctors and medical students. The questions on the use of alcohol-based cleaners have been those where there was the lowest number of correct responses, across all professions. Physicians compared to nurses have a lower adherence to Hand Hygiene. Future research should clarify what the differences are in the construction of the study on the practice of washing hands, what are the barriers to health professionals and best methods for teaching habits, namely the effectiveness of hand washing. Professionals should be more involved in the fight against Healthcare-associated infections.

  15. [Clinical characteristics of perioperative pulmonary thromboembolism: analysis of 18 patients in Kitasato University Hospital].

    PubMed

    Kuroiwa, Masayuki; Arai, Masayasu; Kinoshita, Shin; Takenaka, Tomoaki; Okamoto, Hirotsugu; Hoka, Sumio

    2002-09-01

    Clinical characteristics of perioperative pulmonary thromboembolism (PTE) at Kitasato University Hospital in Japan were analyzed. Eighteen patients were documented as apparent diagnosis of PTE which developed perioperatively in the period of 1991-1999. The incidence of PTE was 18 out of approximately 50,000 surgical cases. Mean age of patients was 48 years (range, 21 to 79 years). There were 4 men and 14 women. Perioperative risk factors included obesity with body mass index over 26.4 (6/18), and prolonged bed rest after surgery more than 4 days (6/18). Perioperative PTE tended to occur in patients with laparoscopic cholecystectomy (3/18) and cesarean section (3/18). Seven out of 18 PTE patients died. It should be noted that perioperative PTE is prevalent in patients with risk factors of obesity and prolonged bed rest after surgery, and that laparoscopic cholecystectomy and cesarean section may become additional risk factors in patients who are otherwise healthy young adults.

  16. Knowledge, perceptions and practices towards medical ethics among physician residents of University of Alexandria Hospitals, Egypt.

    PubMed

    Mohamed, A M; Ghanem, M A; Kassem, A

    2012-09-01

    This cross-sectional study was conducted to assess the knowledge, perceptions and practices towards medical ethics of physician residents at university hospitals in Alexandria, Egypt. A self-administered structured questionnaire was used for knowledge and perceptions and a checklist for observations of doctor-patient interactions in the outpatient setting. Only 18.0% ofthe 128 participating residents had obtained their knowledge from their medical education and 29.9% were dissatisfied with the roles played by the ethics committee. Most of the residents had satisfactory knowledge and 60.2% had satisfactory perceptions regarding ethical issues. The lowest perception score was in the domain of disclosing medical errors. Only 48.0% of the residents were compliant with the principles of medical ethics in practice and 52.0% of patients were dissatisfied with their treating physicians. The study identified areas of unsatisfactory knowledge and practices towards ethical issues so as to devise means to sensitize residents to these issues and train them appropriately.

  17. An Epidemiological Study of Hyperhidrosis Patients Visiting the Ajou University Hospital Hyperhidrosis Center in Korea

    PubMed Central

    Park, Eun Jung; Han, Kyung Ream; Choi, Ho; Kim, Do Wan

    2010-01-01

    Hyperhidrosis is a disorder of perspiration in excess of the body's physiologic need and significantly impacts one's occupational, physical, emotional, and social life. The purpose of our study was to investigate the characteristics of primary hyperhidrosis in 255 patients at Ajou University Hospital Hyperhidrosis Center from March 2006, to February 2008. Information collected from the medical records was: sex, sites of hyperhidrosis, age at visit, age of onset, aggravating factors, hyperhidrosis disease severity scale (HDSS) rank, family history, occupation, and past treatment. A total of 255 patient records were reviewed; 57.6% were male. Patients with a family history (34.1%) showed a lower age of onset (13.21±5.80 yr vs. 16.04±9.83 yr in those without family history); 16.5% had previous treatment, most commonly oriental medicine. Palmar and plantar sites were the most commonly affected, and 87.9% of patients felt their sweating was intolerable and always interfered with their daily activities. Our study provides some original information on the Korean primary hyperhidrosis population. Patients who have a family history show signs of disease in early age than those without family history. PMID:20436716

  18. HIV infection in Malaysia: a report of cases seen at the University Hospital, Kuala Lumpur.

    PubMed

    Ismail, R; Doi, S; Naganathna, N

    1995-12-01

    The spread of HIV infection into Malaysia is estimated to have occurred in the early 1980's. The first case of AIDS was reported here in 1986. As of March 31, 1994, the numbers have increased to 8049 HIV positive individuals detected in the country. The risk behaviours among those tested positive were intravenous drug use in 77.2%, sexual transmission in 4.5%, while the remainder are still under investigation. Pediatric AIDS constitutes 0.2% of positives. The high prevalence among intravenous drug users (IVDU) is likely to be due to mandatory testing for HIV upon entry to rehabilitation centres. The trend of HIV infection in this country seems to be highest amongst the intravenous drug users. The increasing number of HIV infected prostitutes and heterosexuals in our population is worrying. Since 1986, a total of 104 HIV positive individuals have been treated at the University Hospital, Kuala Lumpur, Malaysia. Of these, 25 have died and of those still alive, 5 have symptomatic disease. The most common AIDS-defining illness is Pneumocystis carinii pneumonia. Education programmes have been developed targeting the various high risk groups and the general population.

  19. 50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

    PubMed

    Lertakyamanee, Jariya

    2016-05-01

    Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters. We look after pre-anesthesia assessment, inside and outside operating room anesthesia, post-operative pain relief Intensive Care Unit, and chronic pain management. The number of patients and their diseases increase; so do the complexities of surgeries. There are tremendous changes in drugs and equipment. There is the fourth mission on administration, IT and resource management. And the fifth mission which is corporate social responsibility. However, we still believe that compassion, responsibility and integrity are most important. We have taught and tried to live by the teaching of HRH the King's Father. And these will contribute to our progress and shine in the next 50 years. PMID:27501620

  20. Thymectomy for Myasthenia Gravis: A 10-year Review of Cases at the Hospital Universiti Sains Malaysia

    PubMed Central

    Muhammed, Julieana; Chen, Chui Yin; Wan Hitam, Wan Hazabbah; Ghazali, Mohamad Ziyadi

    2016-01-01

    Background A thymectomy is considered effective for patients with myasthenia gravis (MG). Although a few studies have described the role of a thymectomy in the treatment of MG in Asians countries, there are no published data on the application of this surgical approach for MG in Malaysia. We aimed to describe the clinical outcomes of MG patients who underwent a thymectomy and the factors affecting these outcomes. Methods This was a retrospective study involving 16 patients with MG who underwent a thymectomy at the Hospital Universiti Sains Malaysia (HUSM) from January 2002 until December 2012, with a follow-up period ranging from 3–120 months. Results The study consisted of 16 patients aged 22–78 years, 10 of whom were males. The overall remission/improvement rate was 87.5%, and the rate of clinical outcomes classified as unchanged/worsened was 12.5%. Thymomamatous or non-thymomamatous MG, histology features, Osserman stage and the duration of follow-up were not significant prognostic factors. Post-operative mortality was 6.2% (1 of 16 patients died of septic shock). Conclusion A thymectomy seems to be an effective treatment for MG, with low surgical morbidity. Patients with a lower Osserman stage and those with/without thymomas had favourable outcomes. PMID:27660548

  1. Trends in the resistance profiles of Acinetobacter baumannii endemic clones in a university hospital of Argentina.

    PubMed

    Rodríguez, Carlos Hernan; Nastro, Marcela; Fiorilli, Graciela; Dabos, Laura; Lopez Calvo, Jimena; Fariña, Maria Elisa; Vay, Carlos; Famiglietti, Angela

    2016-01-01

    A total of 925 Acinetobacter spp. isolates were collected from routine clinical samples of patients admitted to the university hospital of Buenos Aires city during the period 2004-2012. From this collection, 129 isolates identified as Acinetobacter baumannii were selected for molecular studies. Minimal inhibitory concentrations (MICs) of antimicrobials were determined by agar dilution method. Colistin (COL) heteroresistance was investigated by means of population analysis studies. PCR-based methods were used for epidemiological analysis and for the screening of carbapenemases and the bla(tetB) gene. We have observed a steady rise in the MIC50 of imipenem (IMI)-resistant isolates and an increment in the presence of bla(OXA-23)-like gene (74-100%) as well. A rapid increasing rate of minocycline (MIN) resistance and a rise of the MIC50 of the resistant isolates have been detected since the year 2008. All isolates harboured the tet (B) gene. An increase in the value of the tigecycline (TIG) MIC was seen from the year 2007 onwards. This loss of activity was observed among different clones. A rise of COL heteroresistance from 46.4% in 2004 to 95% in 2012 was detected. During this period, COL consumption also increased (11.1-fold). However, COL resistance remained sporadic.

  2. [Attitudes of health personnel in a university hospital toward evidence-based medicine].

    PubMed

    Markulin, Helena; Petrak, Jelka

    2010-01-01

    Over the last few years the concepts and methods of the evidence-based medicine (EBM) have been increasingly recognized and applied in the Croatian medical community. Central Medical Library at Zagreb university Medical School has been developing a web-based service aimed to help practitioners find best evidence for solving specific clinical problems. Therefore, the health personnel affiliated to a teaching hospital were surveyed. The questionnaire included 18 questions evaluating attitudes towards EBM. It was displayed by the library's information desk. There were 204 respondents, 62% of them clinical specialists. Most respondents agreed that EBM is useful in clinical decision making (57.4%) as well as in improving patient care (55.4%). Lack of personal time (60.8%) and insufficient skills (60.3%) were percieved as the main barriers to practising EBM. The vast majority of respondents (96.6%) reported never having received EBM training. The study results show that medical librarians can play an expanded role in saving the practitioners' time by searching EBM resources and assessing the quality of the information. PMID:20857805

  3. First clinical and microbiological characterization of Clostridium difficile infection in a Croatian University Hospital.

    PubMed

    Novak, Anita; Spigaglia, Patrizia; Barbanti, Fabrizio; Goic-Barisic, Ivana; Tonkic, Marija

    2014-12-01

    Clinical background and molecular epidemiology of Clostridium difficile infection (CDI) in the University Hospital Centre Split were investigated from January 2010 to December 2011. In total, 54 patients with first episode of CDI were consecutively included in the study based on the positive EIA test specific for A and B toxins. Demographic and clinical data were prospectively analyzed from medical records. CDI incidence rate was 0.6 per 10,000 patient-days. Thirty six cases (70.6%) were healthcare-associated, twelve cases (23.5%) were community-associated and three (5.9%) were indeterminate. Six patients (11.7%) had suffered one or more recurrences and 37 patients (72.5%) showed severe CDI. Prior therapy with third generation cephalosporin was significantly associated with severe CDI (P<0.021). Fifty four toxigenic C. difficile strains were isolated and 50 of them were available for PCR-ribotyping. Sixteen different PCR-ribotypes were identified. The most prevalent were PCR-ribotype 001 (27.8%) and 014/020 (24.1%). Twenty three strains were resistant to at least one of the antibiotics tested. Among resistant strains, three (13.0%)--all PCR-ribotype 001--were multi-resistant. Resistance to fluoroquinolones was significantly higher in strains that caused infection after previous use of fluoroquinolones (P=0.04).

  4. The prevalence of adenoviral conjunctivitis at the Clinical Hospital of the State University of Campinas, Brazil

    PubMed Central

    Pinto, Roberto Damian Pacheco; Lira, Rodrigo Pessoa Cavalcanti; Arieta, Carlos Eduardo Leite; de Castro, Rosane Silvestre; Bonon, Sandra Helena Alves

    2015-01-01

    OBJECTIVES: Viral conjunctivitis is a common, highly contagious disease that is often caused by an adenovirus. The aim of this study was to evaluate the prevalence of adenoviral conjunctivitis by analyzing data from a prospective clinical study of 122 consecutively enrolled patients who were treated at the Clinical Hospital of the State University of Campinas (UNICAMP) after a clinical diagnosis of infectious conjunctivitis between November 2011 and June 2012. METHODS: Polymerase chain reaction was used to evaluate all cases of clinically diagnosed infectious conjunctivitis and based on the laboratory findings, the prevalence of adenoviral infections was determined. The incidence of subepithelial corneal infiltrates was also investigated. RESULTS: Of the 122 patients with acute infectious conjunctivitis included, 72 had positive polymerase chain reaction results for adenoviruses and 17 patients developed subepithelial corneal infiltrates (13.93%). CONCLUSIONS: The polymerase chain reaction revealed that the prevalence of adenoviral conjunctivitis was 59% in all patients who presented with a clinical diagnosis of infectious conjunctivitis from November 2011 to June 2012. The prevalence of adenoviral conjunctivitis in the study population was similar to its prevalence in other regions of the world. PMID:26602522

  5. Diagnostic work-up in patients with possible asthma referred to a university hospital

    PubMed Central

    Backer, Vibeke; Sverrild, Asger; Ulrik, Charlotte Suppli; Bødtger, Uffe; Seersholm, Niels; Porsbjerg, Celeste

    2015-01-01

    Objective The best strategy for diagnosing asthma remains unclear. Accordingly, the aim of this study was to evaluate diagnostic strategies in individuals with possible asthma referred to a respiratory outpatient clinic at a university hospital. Methods All individuals with symptoms suggestive of asthma referred over 12 months underwent spirometry, bronchodilator reversibility test, Peak expiratory flow rate (PEF) registration, and bronchial challenge test with methacholine and mannitol on three separate days. The results of these tests were compared against an asthma diagnosis based on symptoms, presence of atopy and baseline spirometry made by a panel of three independent respiratory specialists. Results Of the 190 individuals examined, 63% (n=122) were classified as having asthma. Reversibility to β2-agonist had the lowest sensitivity of 13%, whereas airway hyperresponsiveness to methacholine had the highest (69%). In contrast, specificity was the highest for reversibility testing (93%), whereas methacholine had the lowest specificity (57%). The combination of reversibility, peak-flow variability, and methacholine yielded a cumulative sensitivity of 78%, albeit a specificity of 41%. In comparison, a combination of reversibility and mannitol resulted in a specificity of 82% and a sensitivity of 42%. Conclusion In this real-life population, different diagnostic test combinations were required to achieve a high specificity for diagnosing asthma and a high sensitivity, respectively: Our findings suggest that the diagnostic test approach should be based on whether the aim is to exclude asthma (high sensitivity required) or confirm a diagnosis of asthma (high specificity required). PMID:26557251

  6. [Epidemiology of Pandemic Influenza (H1N1) 2009 in Aichi Medical University Hospital].

    PubMed

    Tani, Hiroya; Yamagishi, Yuka; Fuzimaki, Eriko; Kishi, Takahiko; Goto, Minehiro; Mikamo, Hiroshige

    2010-01-01

    We have analyzed epidemiology of pandemic influenza (H1N1) 2009 in Aichi Medical University hospital. As a result, the characteristics of pandemic influenza (H1N1) 2009 was as follows. (1) The number of ordered rapid diagnostic test was 2.8 times compared with the seasonal influenza period. The number of ordered rapid diagnostic test of the seasonal influenza period had the peak in January to March. However, the peak in pandemic influenza (H1N1) 2009 was November. Also, the number of samples on the weekend had been more than that of the weekday. (2) Positive rate of each diagnostic kit did not have the difference between the seasonal influenza (31.3 ± 1.8%) and pandemic influenza (H1N1) 2009 (29.6%). (3) Age on most ordered samples were less than ten years old, and the number of samples in 11 to 20 years old was twice in comparison with the seasonal influenza. (4) Pandemic influenza (H1N1) 2009 in influenza A accounted for 96.9%. (5) Sensitivity and specificity of ESPLINE Influenza A&B-N (FUJIREBIO, Inc., Tokyo, Japan) to the pandemic influenza (H1N1) 2009 were 100% and 100%, respectively. Also, sensitivity and specificity of prorasuto Flu (Mitsubishi Chemical Medience Corporation, Tokyo, Japan) were 77.3%and 98.5%, respectively.

  7. Sustainability in a Hospital-Based Biobank and University-Based DNA Biorepository: Strategic Roadmaps.

    PubMed

    Seiler, Catherine Y; Eschbacher, Jennifer; Bowser, Robert; LaBaer, Joshua

    2015-12-01

    Sustainability in the biobanking community has recently become an important and oft-discussed issue as biorepositories struggle to balance limited external funding and complex cost recovery models with high operating costs and the desire to provide the highest quality materials and services to the research community. A multi-faceted view of biobanking sustainability requires consideration of operational and social sustainability in addition to the historical focus exclusively on financial sustainability. Planning and implementing this three pillar model creates a well-rounded biorepository that meets the needs of all the major stakeholders: the funders, the patients/depositors, and the researcher recipients. Often the creation of a detailed business plan is the first step to develop goals and objectives that lead down a path towards sustainability. The definition of sustainability and the complexity of a sustainable business plan may differ for each biorepository. The DNASU Plasmid Repository at Arizona State University stores and distributes DNA plasmids to researchers worldwide, and the Biobank Core Facility at St. Joseph's Hospital and Barrow Neurological Institute consents patients and collects, stores, and distributes human tissue and blood samples. We will discuss these two biorepositories, their similar and different approaches to sustainability and business planning, their challenges in creating and implementing their sustainability plan, and their responses to some of these challenges. From these experiences, the biobanks share lessons learned about planning for sustainability that are applicable to all biorepositories. PMID:26697909

  8. An audit of secondary peritonitis at a tertiary care university hospital of Sindh, Pakistan

    PubMed Central

    2012-01-01

    Objective Peritonitis is the most common life threatening surgical emergency, which requires urgent surgical intervention and is a significant cause of morbidity and mortality. The objective of this study was to highlight the frequency of secondary peritonitis and to analyze the site and causes of perforation, in our tertiary care setup. Methods A retrospective analysis of 311 patients of secondary peritonitis was done from July 2008 to June 2010 at Liaquat University Hospital Jamshoro, Hyderabad, Sindh, Pakistan. All cases found to have peritonitis as a result of perforation of any part of gastrointestinal tract at the time of surgery were included in the study. All cases with either primary peritonitis or that due to anastomotic dehiscence were excluded. Results A total of 311 patients were studied. Most of the patients were males (77%) and (89%) were in the third and fourth decades of life. Majority of the patients presented with pain (97%) associated with bowel symptoms. Most common site of perforation was small bowel (ileal 59%, jujenal 2%). In this series, most common risk factor of perforation was typhoid (43%). Ileostomy was the most commonly performed procedure. Overall morbidity was 48.5% and mortality was 17%. Conclusion Considering the relatively higher rate of typhoid perforation quoted in this study, it is vital that typhoid fever ought to be eliminated by improved sanitation and immunizing programmes, otherwise surgeons will be confronted with its complications. PMID:22423629

  9. Emergence of rifampicin resistance in methicillin-resistant Staphylococcus aureus isolated at a Turkish university hospital.

    PubMed

    Tosun, Ilknur; Udo, Edet E; Noronha, Bobby; Caylan, Rahmet; Aydin, Faruk; Yetiskul, Serpil; Koksal, Iftihar

    2005-01-01

    Twenty-three rifampicin-resistant methicillin-resistant Staphylococcus aureus (MRSA) isolated in three wards at a university hospital in Turkey between June, 2000, and February, 2001, were studied for their genetic relatedness using a combination of antibiogram, coagulase serotyping, coagulase gene polymorphism (coa-RFLP), and pulsed-field gel electrophoresis (PFGE). They all expressed high-level rifampicin resistance (MIC, >256 mg/L) and were resistant to gentamicin, kanamycin, amikacin, ciprofloxacin, tetracycline, and cadmium acetate and were susceptible to fusidic acid, vancomycin, trimethoprim, and mupirocin. They belonged to the same coagulase serotype (serotype IV) and had identical coa-RFLP patterns. In contrast, PFGE generated nine banding patterns designated type A, types A1-A5, B, C, and D. The most common PFGE pattern (type A) and its subtypes (types A1-A5) were seen in 20 (87%) of the 23 isolates in the three wards. The results demonstrated the acquisition of rifampicin resistance by different MRSA clones and the spread of one clone among patients in the three wards.

  10. Strontium 89 in the treatment of pain due to diffuse osseous metastases: a university hospital experience.

    PubMed Central

    Ashayeri, Ebrahim; Omogbehin, Adedamola; Sridhar, Rajagopalan; Shankar, Ravi A.

    2002-01-01

    More than two-thirds of the patients with osseous metastases experience debilitating bone pain, requiring some form of pain relief. Analgesics are limited in their efficacy. Palliative application of hemi-body external beam radiation therapy in the treatment of multiple osseous metastases also is limited due to toxicity associated with large treatment ports. Intravenous injections of bone seeking radioisotopes are effective in the palliation of pain with fewer side effects. Forty-one patients with multiple osseous metastases due to prostate and breast cancer were treated with strontium chloride 89 (89Sr) at the department of radiation oncology, in a university hospital. A retrospective analysis of these patients indicated that all subjects had severe pain that diminished their quality of life. Most of these patients had multiple co-morbid factors. Many were on opioids leading to adverse effects such as nausea, constipation, and drowsiness that required additional medication. Objective findings and evaluation of the responses were not always available for all patients. Following treatmentwith 89Sr, over two-thirds of the patients responded favorably and required lower doses of opioids. PMID:12152927

  11. Emergence of ST147 Klebsiella pneumoniae Producing OXA-204 Carbapenemase in a University Hospital, Tunisia.

    PubMed

    Grami, Raoudha; Mansour, Wejdene; Ben Haj Khalifa, Anis; Dahmen, Safia; Chatre, Pierre; Haenni, Marisa; Aouni, Mahjoub; Madec, Jean-Yves

    2016-03-01

    Molecular features of the first carbapenem-resistant Klebsiella pneumoniae isolates (KP1 and KP2) from the University Hospital Tahar Sfar, Tunisia, were investigated. Antimicrobial susceptibility testing, multilocus sequence typing, S1 nuclease pulsed-field gel electrophoresis, Southern blot, and polymerase chain reaction (PCR)-based replicon typing were performed. Extended-spectrum β-lactamases and carbapenemase genes were detected by PCR and sequencing. Both isolates were multidrug resistant. KP1 was of sequence type (ST) ST101 and exhibited blaCTX-M-15 and blaTEM-1 on an untypeable plasmid and blaOXA-48 on an IncL/M plasmid. KP2 was genetically unrelated to KP1 (ST147) and harbored an IncA/C plasmid carrying blaCMY-4 and the blaOXA-48 derivative gene: blaOXA-204. This study reports the second case worldwide of an OXA-204-producing K. pneumoniae isolate from the same country, however, in a different genetic background.

  12. Sustainability in a Hospital-Based Biobank and University-Based DNA Biorepository: Strategic Roadmaps.

    PubMed

    Seiler, Catherine Y; Eschbacher, Jennifer; Bowser, Robert; LaBaer, Joshua

    2015-12-01

    Sustainability in the biobanking community has recently become an important and oft-discussed issue as biorepositories struggle to balance limited external funding and complex cost recovery models with high operating costs and the desire to provide the highest quality materials and services to the research community. A multi-faceted view of biobanking sustainability requires consideration of operational and social sustainability in addition to the historical focus exclusively on financial sustainability. Planning and implementing this three pillar model creates a well-rounded biorepository that meets the needs of all the major stakeholders: the funders, the patients/depositors, and the researcher recipients. Often the creation of a detailed business plan is the first step to develop goals and objectives that lead down a path towards sustainability. The definition of sustainability and the complexity of a sustainable business plan may differ for each biorepository. The DNASU Plasmid Repository at Arizona State University stores and distributes DNA plasmids to researchers worldwide, and the Biobank Core Facility at St. Joseph's Hospital and Barrow Neurological Institute consents patients and collects, stores, and distributes human tissue and blood samples. We will discuss these two biorepositories, their similar and different approaches to sustainability and business planning, their challenges in creating and implementing their sustainability plan, and their responses to some of these challenges. From these experiences, the biobanks share lessons learned about planning for sustainability that are applicable to all biorepositories.

  13. Detection of Rotavirus in children with acute gastroenteritis in Zagazig University Hospitals in Egypt

    PubMed Central

    Ibrahim, Salwa Badrelsabbah; El-Bialy, Abdallah Abdelkader; Mohammed, Mervat Soliman; El-Sheikh, Azza Omar; Elhewala, Ahmed; Bahgat, Shereen

    2015-01-01

    Introduction: Rotavirus is the major cause of acute gastroenteritis (AGE) in infants and young children all over the world. The objective of the study was to compare different methods for detecting rotavirus and to assess the burden of rotavirus as a causative agent for AGE in children younger than five. Methods: This case control study included 65 children with AGE and 35 healthy control children. They were chosen from the Pediatric Department of Zagazig University Hospitals from October 2014 to March 2015. Stool samples were obtained and assayed for rotavirus by the immunochromatography test (ICT), enzyme linked immunosorbent assay (ELISA) and quantitative real time RT-PCR (qr RT-PCR). Results: Fifty out of the 65 patients (76.9%) were positive for qr RT-PCR. Forty-five (69.2%) and 44 (67.7%) were positive for ICT and ELISA, respectively. There was a significant association between the severity of the disease as determined by the Vesikari score and rotavirus infection. Conclusion: This study demonstrated that ICT is a useful method for the rapid screening of group A rotavirus in fecal specimens, because it is rapid, inexpensive, easy to perform, and requires very little equipment. In addition, this study highlights the substantial health burden of rotavirus AGE among children less than five. PMID:26435821

  14. Pattern of suicide: a review of autopsies conducted at the University Hospital, Kuala Lumpur.

    PubMed

    Nadesan, K

    1999-12-01

    Suicide is one of the ten leading causes of death in the world, accounting for more than 400,000 deaths annually. The pattern of suicide and the incidence of suicide vary from country to country. Cultural, religious and social values play some role in suicide. Compared to the West and some of the countries in the Asian region the incidence of suicide is low in Malaysia. A three-year retrospective study of all the autopsies performed at the University Hospital, Kuala Lumpur was analysed and the cases that were definitely determined as suicides were further studied. 48.8% of all suicides were ethnic Indians though Indians formed only 8% of the Malaysian population. 38.1% of suicides were Chinese who formed 26% of the population while only 3.6% were Malays, who formed 59% of the population. The preferred methods of suicide were poisoning and hanging. The majority were in the age group 20-40 yr. The study may have missed some cases that would have been wrongly concluded as accidental deaths and a few others where the police would have released the bodies without postmortem examinations.

  15. The clinical pattern of diabetes Insipidus in a large university hospital in the Middle East.

    PubMed

    Babiker, Amir M I; Al Jurayyan, Nasir A M; Al Jurayyan, Rushaid N A; Al Gadi, Iman; Drop, Stenvert L S

    2015-04-01

    Diabetes insipidus is a rare but serious endocrine disorder. Paediatric patients were evaluated for polyuria at King Khalid University Hospital, Riyadh, Saudi Arabia, over a decade (2000-13). Relevant clinical examination and/or a triad of high serum osmolality, hypernatremia and low urine osmolality due to increased urine output confirmed the diagnosis. Water deprivation test was required in some cases with non-classic presentations. Appropriate brain imaging was performed whenever central diabetes insipidus (CDI) was suspected. Twenty-eight patients, 15 males (53.6%) and 13 females (46.4%), aged 0-17 years (mean: 6 years) were included. The calculated period prevalence was 7 in 10,000. In our cohort, 60.7% (17 of 28 patients) had CDI, 21.4% (6 of 28) were diagnosed with nephrogenic diabetes insipidus (NDI) and 17.9% (5 of 30) had psychogenic polydipsia. CDI was due to variable aetiology. Though CDI was the commonest, NDI was not a rare encounter in our community, possibly because of high consanguineous marriages.

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

    PubMed

    Bartůněk, Petr

    2016-01-01

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

  17. Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital

    PubMed Central

    Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

    2015-01-01

    Objective The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. Methods In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. Results After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012–August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. Conclusion At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure. PMID:27366486

  18. Assessment of patient safety culture among personnel in the hospitals associated with Islamic Azad University in Tehran in 2013

    PubMed Central

    Moussavi, Fatemeh; Moghri, Javad; Gholizadeh, Yavar; Karami, Atiyeh; Najjari, Sedigheh; Mehmandust, Reza; Asghari, Mehdi; Asghari, Habib

    2013-01-01

    Background: Patient safety is an essential element in the quality of healthcare, and a clear knowledge of its culture in healthcare organizations will lead to both improved healthcare and patient safety. The aim of this study was to assess the patient safety culture at Islamic Azad University hospitals in Tehran, Iran, in 2013. Methods: This cross-sectional study was conducted on clinical and diagnostic staff in all Islamic Azad University hospitals in Tehran in June 2013. The international “Hospital Survey on Patient Safety Culture” questionnaire was used as the measurement tool. Results: In these hospitals, the overall positive score of patient safety culture was 35%. “Teamwork within units” (48% positive) was evaluated as reflecting the most knowledge of the aspects of patient safety culture, and “non-punitive response to error” (12% positive) was evaluated as reflecting the least knowledge of the aspects of patient safety culture. Conclusion: The patient safety culture in the hospitals that were studied should be improved. This goal could be achieved by reinforcing the basics of patient safety culture by teaching the staff members about the aspects of a positive patient safety culture and encouraging them to incorporate these aspects in their day-to-day activities. PMID:26120401

  19. Implementation Issues of Virtual Desktop Infrastructure and Its Case Study for a Physician's Round at Seoul National University Bundang Hospital

    PubMed Central

    Yoo, Sooyoung; Kim, Seok; Kim, Taegi; Kim, Jon Soo; Baek, Rong-Min; Suh, Chang Suk; Chung, Chin Youb

    2012-01-01

    Objectives The cloud computing-based virtual desktop infrastructure (VDI) allows access to computing environments with no limitations in terms of time or place such that it can permit the rapid establishment of a mobile hospital environment. The objective of this study was to investigate the empirical issues to be considered when establishing a virtual mobile environment using VDI technology in a hospital setting and to examine the utility of the technology with an Apple iPad during a physician's rounds as a case study. Methods Empirical implementation issues were derived from a 910-bed tertiary national university hospital that recently launched a VDI system. During the physicians' rounds, we surveyed patient satisfaction levels with the VDI-based mobile consultation service with the iPad and the relationship between these levels of satisfaction and hospital revisits, hospital recommendations, and the hospital brand image. Thirty-five inpatients (including their next-of-kin) and seven physicians participated in the survey. Results Implementation issues pertaining to the VDI system arose with regard to the highly availability system architecture, wireless network infrastructure, and screen resolution of the system. Other issues were related to privacy and security, mobile device management, and user education. When the system was used in rounds, patients and their next-of-kin expressed high satisfaction levels, and a positive relationship was noted as regards patients' decisions to revisit the hospital and whether the use of the VDI system improved the brand image of the hospital. Conclusions Mobile hospital environments have the potential to benefit both physicians and patients. The issues related to the implementation of VDI system discussed here should be examined in advance for its successful adoption and implementation. PMID:23346476

  20. 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

  1. Consultations by Asylum Seekers: Recent Trends in the Emergency Department of a Swiss University Hospital

    PubMed Central

    Srivastava, David; Exadaktylos, Aristomenis K.

    2016-01-01

    Background Large-scale war-related migration to Switzerland and other European countries is currently challenging European health systems. Little is known about recent patterns and trends in Emergency Department (ED) consultations by Asylum Seekers (AS). Methods A retrospective single-centre analysis was performed of the data from all adult patients with the official status of “Asylum Seeker” or “Refugee” who consulted the ED of Bern University Hospital, Switzerland, between June 2012 and June 2015. Patient characteristics and clinical information, such as triage category, type of referral and discharge, violence-related injury and diagnostic group on discharge, were extracted from the computerised database or determined from the medical reports. Changes in categorical variables between the three studied years were described. Results A total of 1,653 eligible adult patients were identified in the 3-year period. Between the first (06/12–06/13) and third periods (06/14–06/15), the number of presentations per year increased by about 45%. The AS came from 62 different nations, the most common countries being Eritrea (13%), Somalia (13%) and Syria (11%). The mean age was 33.3 years (SD 12.3) and two thirds (65.7%) were male. The proportion of women increased over time. Moreover the relative proportions shifted from patients between 20 and 50 years to patients of under 20 or over 60 years. Nearly two thirds of the patients were walk-in emergencies and this proportion increased over time. The mean triage score was 2.9 (SD 0.7), with more than 90% presenting as “urgent consultation”. About half of the patients were treated for trauma (17.2%), infections (16.8%) or psychiatric problems (14.2%). Trauma was seen in a higher proportion of male than female patients. About 25% of the patients were admitted for in-hospital treatment. Conclusions The recent rise in AS in the population has lead to an increase in AS presenting to EDs. This changes the composition of

  2. Mechanisms of ertapenem resistance in Enterobacteriaceae isolates in a tertiary university hospital.

    PubMed

    Chung, Hae-Sun; Yong, Dongeun; Lee, Miae

    2016-06-01

    The aim of this study was to investigate the molecular mechanisms of ertapenem resistance among Enterobacteriaceae isolates in a clinical microbiology laboratory at a tertiary university hospital. A total of 40 clinical isolates including 20 resistant and 20 intermediate isolates were collected from August 2012 to July 2013. Ertapenem susceptibility was confirmed by the broth microdilution method. PCR and sequencing analysis of carbapenemase, AmpC β-lactamase, and extended-spectrum β-lactamase (ESBL) genes were performed. Outer membrane proteins (OMPs) were examined by urea-sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Molecular epidemiology studies were performed by pulsed-field gel electrophoresis (PFGE). AmpC β-lactamases and ESBLs were found in 32 (80.0%) and 20 (50.0%) of the 40 isolates with ertapenem non-susceptibility, respectively. Distributions of β-lactamase genes differed among the species. One Citrobacter freundii isolate among the 40 isolates with ertapenem non-susceptibility carrying the blaIMP-1 associated class 1 integron was detected. SDS-PAGE of OMPs showed altered or greatly diminished expression of porins in all isolates of Klebsiella pneumoniae (n=5) and Enterobacter cloacae (n=11) with ertapenem resistance. Porin alterations were less common among the isolates with intermediate susceptibility (4/19). Integration of the results of molecular analysis of β-lactamases and OMP analysis revealed that most of the isolates with ertapenem resistance exhibited β-lactamase activity and porin alteration. PFGE revealed that most isolates were epidemiologically unrelated. Ertapenem resistance in clinical Enterobacteriaceae isolates was associated with β-lactamase activity and porin alteration. Even though carbapenemase-producing Enterobacteriaceae are still rare, continuous monitoring and infection control for carbapenem-resistant Enterobacteriaceae are necessary. PMID:27101841

  3. Evaluation of social and demographic characteristics of incest cases in a university hospital in Turkey

    PubMed Central

    Yildirim, Ali; Ozer, Erdal; Bozkurt, Hasan; Ozsoy, Sait; Enginyurt, Ozgur; Evcuman, Durmus; Yilmaz, Riza; Kuyucu, Yunus Emre

    2014-01-01

    Background Incest is defined as any sexual activity between close blood relatives including step relatives and family members who are forbidden by law to marry. It is a problem that can be seen in all the social classes in developed and undeveloped societies. The World Health Organization classifies this problem as a silent health emergency. Father-daughter incest is reported to be the most common incest type followed by the other types like brother-sister, sister-sister and mother-son incest. Material/Methods Subjects for this study were recruited from a sample of incest cases referred to Forensic Medicine Department of Gaziosmanpasa University Medical Faculty Hospital between 2008 and 2012. Data involved social and demographic characteristics and clinical features of victims, perpetrators and the families. The ethical committee of the faculty of medicine approved the study. Results The study sample consisted of 43 incest cases (36 females and 7 males) with an age rage 4–40 years. Two third of the victims were under 18 years old. All perpetrators were males. Father – daughter incest (34.9%) was found to be most common incest type followed by brother – sister incest (14%). 75% of the perpetrators were family members and relatives with consanguinity while 25% of them were not consanguineous but faithful and intimate relatives to victims. Conclusions Increasing awareness about incest and its damaging effects is so important and clinicians should keep in mind sexual abuse or incest when examining the risky population. Multidisciplinary approach is necessary for determining short term or long term results and preventing the negative consequences of incest. PMID:24770724

  4. The pattern of malocclusion among orthodontic patients seen in Dental Centre, University College Hospital, Ibadan, Nigeria.

    PubMed

    Onyeaso, C O; Aderinokun, G A; Arowojolu, M O

    2002-09-01

    The aim of this study was to analyse the malocclusion pattern among patients who presented for treatment in the Orthodontic Unit of the Dental Centre, University College Hospital, Ibadan, as baseline data for proper treatment planning, teaching and further research. A total of 289 subjects aged 5-34 years with mean age of 10.6 +/- 1.5 (S.D.) years were seen. Angle's classification of molar relationships among those seen is as follows: class I - 76.5%, Class II - 15.5% and Class III - 8.0%. There was increased overjet in 16.2% of the patients, reduced overjet in 0.7% while 2.1% had reversed overjet. Other occlusal abnormalities included: increased overbite (3.8%), reduced overbite (1.4%); anterior open bite (5.2%; crossbite (8.4%) and scissorsbite (0.6%). Crowding, spacing and retained primary incisors constituted 29.7%, 1.4% and 40.1%, respectively. Delayed eruption of canine (1.0%), Bimaxillary protrusion (0.7%), incompetent lips (0.7%), supernumerary teeth (0.7%) malformed tooth (0.3%), mandibular deviation on closure (1.0%) and oral habits (4.5%) were other forms of malocclusion diagnosed. Males were found to have significantly more of classes II and III molar relationships than females (P < 0.05). Occurrence of retained primary teeth as well as overjet deviations from normal were significantly higher in females (P < 0.05). No significant sex differences were found in the other occlusal disorders (P > 0.05): The findings were comparable with previous epidemiological surveys in other parts of the country. PMID:12751558

  5. Female sterilization with Hulka clips--initial experience at the University Hospital, Kuala Lumpur.

    PubMed

    Rahman, A A; Sivanesaratnam, V; Nuruddin, A A

    1982-09-01

    The initial experience with the use of Hulka clips for sterilization in 100 patients is reported. In July, 1979, University Hospital physicians in Kuala Lumpur introduced spring-loaded clips, and have found the procedure to be safe and the method acceptable. The 86 patients available for the followup were admitted 1 day prior to the operation for a detailed interview, physical and pelvic examinations, pap smear, and hemoglobin estimation. The laparoscopy was performed under general anesthesia, although others report using local anesthesia, and the patients were discharged the following day. Follow-up was conducted at 3, 6, and 12 months. The women were between 25-40 years old and the majority were para 3-5; 10.5% had only 2 live births. The average age of the patients' youngest child at the time of sterilization was 2.8. Indians comprised the largest ethnic group. The problems encountered at laparoscopy generally occurred in the initial stages of the study and included: difficulty at insertion of trochar, inability to visualize fimbria, tubal transection, and the need for additional clips to ensure occlusion. 2 pregnancies were reported, 1 patient had a luteal phase pregnancy and in the other patient, the left tube was only partially occluded. The actual failure rate in the series was 1.16%, which is acceptable and similar to other reports. A distinct advantage of the clip was the low incidence of tubal transection, .6%, which is a more common occurrence with silastic bands. In addition, the clips offer good prospects for reversibility, compared to other sterilization methods.

  6. [The Eppendorf University Hospital, Hamburg--a cradle of German- speaking anesthesia?].

    PubMed

    Goerig, M

    1999-10-01

    "The time will come when German medicine, too, will have to concern itself with the issue of a professional narcotiseur. Until then it will be our duty to keep the interest in narcosis, which has increased satisfactorily in the past years, alive." With this statement the editors of the journal "Der Schmerz" substantiated the publication og a German-speaking anestesiological journal in 1928. Ernst von der Porten, a professional anesthesist working in Hamburg was the chief initiator for the appearance of the new journal. Possible he was incited by his former teacher, the Eppendorf surgeon Paul Sudeck, to delve deeper into our special field. Very early Sudeck himself began to concern himself with anesthesiological questions and he found an ardent supporter of the idea of specialisation in anesthesiology (quite unheard of in Germany at that time) in Helmut Schmidt, a staff member. Schmidt habilitated on an anesthesiological theme and that again was reason enough for the editors to write an editorial about. Schmidt who one of the chief organizers of the "90. Tagung Deutscher Naturforscher und Arzte" in the late summer of 1928 was hindered by the surgeons on founding the Deutsche Narkosege-sellschaft (German Narcosis Society) with colleagues. After World War II German surgeons rethought their position, mainly influenced by Anglo-American narcosis specialists. After the foundation of the Deutsche Gesellschaft für Anaesthesiein the year 1953, the first professorate for the special field of anesthesiology was given to Karl Horatz--one of the founding members--10 years later. Not surprisingly the professorate was instituted at the university hospital in Eppendorf which could be called the cradle of German-speaking anesthesia. The following concerns itself with some of the impulses that were given by the "Neues Allgemeines Krankenhaus Eppendorf" and became important stepping stones in our special field through the decades. PMID:10548957

  7. Knowledge about missed contraceptive pills among married women at King Abdulaziz University Hospital

    PubMed Central

    Iftikhar, Rahila; Aba Al Khail, Bahaa Abdulrahman

    2015-01-01

    Background Oral contraceptive pills (OCPs) are one of the most reliable methods of contraception. However, lack of knowledge about oral contraceptive use and inconsistent pill-taking might result in decreased efficacy. The study reported here aimed to explore women’s knowledge about oral contraceptive use and assess the factors associated with knowledge about OCPs among users. Methods This cross-sectional survey was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between April and June 2014. We included married, non-pregnant women >18 years old who had used a combined 21-day OCP for at least 3 months prior to recruitment. A questionnaire was used to collect the participants’ demographic information. It also assessed their knowledge about OCPs. Data were entered into and analyzed using SPSS software. Results A total of 357 women were recruited. Of these, 57.7% reported they knew what to do after missing one or two pills, but only 18.3% knew exactly what to do after missing more than two pills consecutively. Postgraduate women had a significantly higher knowledge score than illiterate women (P=0.002) and those who had completed at least primary education (P=0.001). Conversely, there was no difference in knowledge scores between Saudi and expatriate women (P=0.2). Monthly incomes (P=0.2) and mode of OCP selection (P=0.2) were also not significantly associated with knowledge scores. Conclusion Women had poor knowledge about OCP use. Appropriate measures should be taken to educate women about proper oral contraceptive use. PMID:25792813

  8. Assessment of nurse’s knowledge about Glasgow coma scale at a university hospital

    PubMed Central

    Santos, Wesley Cajaíba; Vancini-Campanharo, Cássia Regina; Lopes, Maria Carolina Barbosa Teixeira; Okuno, Meiry Fernanda Pinto; Batista, Ruth Ester Assayag

    2016-01-01

    ABSTRACT Objective To assess knowledge of nurses of emergency services and intensive care units about Glasgow Coma Scale. Methods This cross-sectional analytical study included 127 nurses of critical units of an university hospital. We used structured interview with 12 questions to evaluate their knowledge about the scale. Association of Knowledge with professionals’ sociodemographic variables were verified by the Fisher-test, χ2 and likelihood ratio. Results Most of participants were women mean aged 31.1 years, they had graduated more than 5 years previously, and had 1 to 3 years of work experience. In the assessment of best score possible for Glasgow scale (question 3) nurses who had graduate more than 5 years ago presented a lower percentage success rate (p=0.0476). However, in the question 7, which evaluated what interval of the scale indicated moderate severity of brain trauma injury, those with more years of experience had higher percentage of correct answers (p=0.0251). In addition, nurses from emergency service had more correct answers than nurses from intensive care unit (p=0.0143) in the same question. Nurses graduated for more than 5 years ago had a lower percentage of correct answers in question 7 (p=0.0161). Nurses with more work experience had a better score (p=0.0119) to identify how assessment of motor response should be started. Conclusion Number of year since graduation, experience, and work at critical care units interfered in nurses’ knowledge about the scale, which indicates the need of training. PMID:27462896

  9. [Stress level assessment of the nursing staff in the Intensive Care Unit of a university hospital].

    PubMed

    Carrillo-García, C; Ríos-Rísquez, M I; Martínez-Hurtado, R; Noguera-Villaescusa, P

    2016-01-01

    The objective was to determine the work stress level among nursing staff in the Intensive Care Unit of a university hospital and to analyse its relationship with the various sociodemographic and working variables of the studied sample. A study was designed using a quantitative, descriptive and cross-sectional approach. The target population of the study was the nursing staff selected by non-random sampling. The instrument used was the Job Content Questionnaire. Data analysis was performed using SPSS 20. The mean, ranges and standard deviation for each of the variables were calculated. A bivariate analysis was also performed on the social and occupational variables of the sample. The participation rate was 80.90% (N=89). The mean of the Social support dimension was 3.13±0.397, for the Psychological demands at work dimension it was 3.10±0.384, with a mean of 2.96±0.436 being obtained for the Control over the work dimension. In the analysis of sociodemographic and work variables of the sample, only the professional category was significant, with nurses recording higher values in perception of job demands and control over their work compared to nursing assistants. In conclusion, there is a moderate perception of work stress in the analysed group of professionals. Among the sources of stress in the workplace was the low control in decision-making by practitioners, as well as the need to continually learn new things. On the other hand, the support received from colleagues is valued positively by the sample.

  10. Catheter-associated urinary tract infections in intensive care units at a university hospital in Turkey.

    PubMed

    Keten, Derya; Aktas, Firdevs; Guzel Tunccan, Ozlem; Dizbay, Murat; Kalkanci, Ayse; Biter, Gülsah; Keten, Hamit Sirri

    2014-01-01

    In this study, urinary catheter utilization rates, the causative agents for catheter-associated urinary tract infection (CAUTI) and their antimicrobial susceptibilities in intensive care units (ICUs) in 2009 were investigated at Gazi university hospital. We aimed to determine the causative agents and risk factors for CAUTIs, and antimicrobial susceptibilities of the pathogens; and also sensitivities of Candida spp. to antifungal agents with Microdilution and E-test. The most common etiological agents of CAUTIs were Candida spp. (34.7%). The most frequently isolated Candida spp. was C.albicans (52.4%). All C. albicans spp. were sensitive to fluconazole. Microdilution, used as a reference method to determine the sensitivity to antifungal agents, was compared with E test. E test was found to be sufficient to analyze sensitivity to amphotericin B, caspofungin, fluconazole and voriconazole, but inappropriate for itraconazole. E.coli and Klebsiella spp. were found to be causative agents for CAUTI in 20.6% and 9.9% of cases respectively. Pseudomonas spp. and Acinetobacter spp. were isolated in 14% and 8.2% of the cases, respectively. All E.coli and Klebsiella strains were found sensitive to carbapenems. Carbapenem sensitivity was found in 47.1% and 30% of the cases infected with Pseudomonas and Acinetobacter strains, respectively. According to our results, fluconazole therapy seems to be an appropriate choice for the treatment of CAUTIs caused by C.albicans. Third and fourth generation cephalosporins should not be used for empirical treatment because of the high prevalence of extended spectrum beta-lactamase production among E.coli and Klebsiella isolates.

  11. Moral Distress in Physicians Practicing in Hospitals Affiliated to Medical Sciences Universities

    PubMed Central

    Abbasi, Mahmoud; Nejadsarvari, Nasrin; Kiani, Mehrzad; Borhani, Fariba; Bazmi, Shabnam; Nazari Tavaokkoli, Saeid; Rasouli, Hamidreza

    2014-01-01

    Background: Researchers have regarded moral distress as a major concern in the health care system. Symptoms associated with moral distress may manifest as frustration, dissatisfaction, and anxiety and may lead to burnout, job leaving, and finally, failure to provide safe and competent care to patients. Proper management of this phenomenon can be fulfilled through study of its causes at different levels of health services and taking necessary measures to solve them. Objectives: This study aimed to determine the status of moral distress in physicians practicing in hospitals affiliated to Medical Sciences Universities in Tehran. Materials and Methods: This cross-sectional study was carried out using the Standard Hamric Scale to collect data after modification and evaluation of its reliability and validity. A total of 399 physicians responded to the scale. Data analysis was performed using descriptive and correlation statistics with respect to the variables. Results: Results showed that the frequency of moral distress of physicians was 1.24 ± 0.63 and the intensity of moral distress and composite score of moral distress were 2.14 ± 0.80 and 2.94 ± 2.38, respectively. A significant negative correlation existed between age and frequency and composite score (r = -0.15, P < 0.01 and r = -0.16, P < 0.01, respectively) as well as years of experience and composite score (r = -0.11, P = 0.04). Moral distress composite score in adults specialists was higher than pediatricians (P = 0.002), but lower in physicians participated in medical ethics training courses compared to those not participated. Conclusions: Physicians may encounter moral distress during their practice; therefore, the common causes of distress should be identified in order to prevent its occurrence. PMID:25558387

  12. Incorrect diagnosis of Clostridium difficile infection in a university hospital in Japan.

    PubMed

    Mori, Nobuaki; Yoshizawa, Sadako; Saga, Tomoo; Ishii, Yoshikazu; Murakami, Hinako; Iwata, Morihiro; Collins, Deirdre A; Riley, Thomas V; Tateda, Kazuhiro

    2015-10-01

    Physicians often fail to suspect Clostridium difficile infection (CDI) and many microbiology laboratories use suboptimal diagnostic techniques. To estimate the extent of and reasons for incorrect diagnosis of CDI in Japan, we investigated toxigenic C. difficile isolated from all stool culture samples and clinical course. Over a 12-month period in 2010, all stool culture samples (n = 975) submitted from inpatients in a university hospital in Japan were cultured for C. difficile and routine microbiological testing was conducted. In total, 177 C. difficile isolates were recovered, and 127 isolates were toxigenic. Among the toxin-A-positive/toxin-B-positive isolates, 12 were also positive for the binary toxin gene. However, clinically important ribotypes, such as 027 and 078, were not identified. A total of 58 (45.7%) cases with toxigenic C. difficile had unformed stool, and the incidence CDI was 1.6 cases per 10,000 patient-days. Of these 58 cases, 40 were not diagnosed in routine testing due to a lack of clinical suspicion (24.1%, 14/58) or a negative C. difficile toxin assay result (44.8%, 26/58). A stool toxin assay was performed in 54 patients (78.2%, 54/69) who did not have unformed stool. The present study demonstrated that a significant number of CDI cases in Japan might be overlooked or misdiagnosed in clinical practice due to a lack of clinical suspicion and limitations of microbiological testing for CDI in Japan. Providing education to promote awareness of CDI among physicians is important to improve the accuracy of diagnosis in Japan.

  13. Penile cancer: about ten cases at the University Hospital of Rabat, review of the literature

    PubMed Central

    Slaoui, Amine; Jabbour, Youness; El Ghazoui, Anouar; Karmouni, Tarik; Elkhader, Khalid; Koutani, Abdelatif; Attaya, Ahmed Ibn

    2015-01-01

    The aim of our study was to report the status of penile cancer sites in the urology department at the University Hospital of Rabat and evaluate long-term results of surgical treatment of this cancer. Patients and Methods: Between 1989 and 2015, 10 patients were treated for penile cancer. 10 cases were retrospectively reviewed and the following data were recorded: mode of revelation, seat, staging, TNM stage, treatment, evolution and survival. The mean age of patients was 58,1 years (48-81 years). All patients had squamous cell carcinoma of the penis. Six patients had a partial amputation of the penis, and three patients underwent total amputation. The median size of the lesion was 4.25 cm (1.5-8 cm). All tumors had a distal seat (gland- Furrow balanopreputial), 8 were localized and non-invasive (PT1 - PT2) and 2 had infiltrated the urethra (PT3). Four patients had lymph node localization. A single bilateral lymphadenectomy was performed and was positive only on one side, with a node <3 cm and no extracapsular extension. Two patients were referred for chemotherapy, a neoadjuvant referred to basic (Bleomycin - Methotrexate, Cisplatin) the other in a palliative goal. Median follow-up was 42 months (6 -72mois). Four patients died, one of which was presented immediately with metastatic mode. Six patients were alive at last node or local recurrence negative. Cancer of the penis seems rare in Morocco. His oncologic and functional outcomes (sexual and urinary) depend on the precocity of the treatment. The surgery of lymph node resection with lymphadenectomy remains the reference treatment. PMID:26664554

  14. Assessment of a self-deferral form for screening blood donors, Chiang Mai University Hospital, Thailand.

    PubMed

    Thaikruea, Lakkana; Nantachit, Niwes; Leetrakool, Nipapan; Fongsatitkul, Ladda; Sompan, Prakai; Heaton, Andrew; Nelson, Kenrad E

    2008-09-01

    A self-deferral form has been used to screen Chiang Mai University Hospital blood donors and was improved in 2005. It has never been evaluated. The study aimed to assess the self-deferral form procedures in detecting infected donors. Sera from 5,083 donors, who passed the self-deferral screening form, were tested with the routine immuno-assays (serology) for HIV 1 and 2 antibodies, P24 antigen, HCV antibodies, HBV surface antigen, and syphilis. Antibody negative sera were also tested individually with the the Procleix Ultrio Assay for HIV-1 DNA, HCV RNA, and HBV DNA. The donors who had discrepant results between serology and NAT were evaluated with additional tests, including a more sensitive Alternative Nucleic Acid Test, AntiBcore IgM, AntiBcore IgG, HBsAg and Anti HBs. Among 5,083 donors, 331 (6.5%) had at least one positive marker. In multiple logistic regression analysis, the statistically significant factors (adjusted odds ratio and 95% CI) for infection were age 30 years or below [1.45 (1.03, 2.03)], male gender [2.73 (1.64, 4.56)], primary school or lower education [1.56 (1.09, 2.23)], first-time donation [1.82 (1.25, 2.67)], and frequent donation [0.80 (0.70, 0.92)]. The safest donors were females, older than 30 years, with an education more than primary school, and frequent donation. Because of missing responses to some sensitive questions, there remains a need for further improvement of the self-deferral form.

  15. [Stress level assessment of the nursing staff in the Intensive Care Unit of a university hospital].

    PubMed

    Carrillo-García, C; Ríos-Rísquez, M I; Martínez-Hurtado, R; Noguera-Villaescusa, P

    2016-01-01

    The objective was to determine the work stress level among nursing staff in the Intensive Care Unit of a university hospital and to analyse its relationship with the various sociodemographic and working variables of the studied sample. A study was designed using a quantitative, descriptive and cross-sectional approach. The target population of the study was the nursing staff selected by non-random sampling. The instrument used was the Job Content Questionnaire. Data analysis was performed using SPSS 20. The mean, ranges and standard deviation for each of the variables were calculated. A bivariate analysis was also performed on the social and occupational variables of the sample. The participation rate was 80.90% (N=89). The mean of the Social support dimension was 3.13±0.397, for the Psychological demands at work dimension it was 3.10±0.384, with a mean of 2.96±0.436 being obtained for the Control over the work dimension. In the analysis of sociodemographic and work variables of the sample, only the professional category was significant, with nurses recording higher values in perception of job demands and control over their work compared to nursing assistants. In conclusion, there is a moderate perception of work stress in the analysed group of professionals. Among the sources of stress in the workplace was the low control in decision-making by practitioners, as well as the need to continually learn new things. On the other hand, the support received from colleagues is valued positively by the sample. PMID:27267958

  16. Seropositivity of Toxoplasmosis in Pregnant Women by ELISA at Minia University Hospital, Egypt

    PubMed Central

    Kamal, Amany M.; Ahmed, Azza K.; Abdellatif, Manal Z. M.; Tawfik, Mohamed; Hassan, Ebtesam E.

    2015-01-01

    Toxoplasmosis is considered as an important risk factor for bad obstetric history (BOH) and one of the major causes of congenitally acquired infections. The present study aimed to estimate the seropositivity of T. gondii infection and associated risk factors among the attendees of high risk pregnancy and low risk antenatal care clinic of Minia Maternity and Pediatric University Hospital, Minia, Egypt. The study was carried out from April 2013 to April 2014 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. A total of 120 high risk pregnant and 120 normal pregnant females were submitted to clinical examinations, serological screening for anti-Toxoplasma IgM and IgG antibodies by ELISA, and an interview questionnaire. Seropositive cases were subjected to spiramycin course treatment. The results showed that the seroprevalence of toxoplasmosis in high-risk pregnancy group was 50.8%, which was significantly different from that of normal pregnancy group (P<0.05). Analysis of seropositive women in relation to BOH showed that abortion was the commonest form of the pregnancy wastage (56.5%). The high prevalence of T. gondii seropositive cases was observed in the age group of 21-30 years. Post-delivery adverse outcome was observed in 80.3% of high-risk pregnancy group compared to 20% of normal pregnancy group. There was a statistically significant relationship between seropositivity and living in rural area, low socioeconomic level, and undercooked meat consumption (P<0.05). Serological screening for anti-Toxoplasma antibodies should be routine tests especially among high-risk pregnant women. PMID:26537040

  17. Seropositivity of Toxoplasmosis in Pregnant Women by ELISA at Minia University Hospital, Egypt.

    PubMed

    Kamal, Amany M; Ahmed, Azza K; Abdellatif, Manal Z M; Tawfik, Mohamed; Hassan, Ebtesam E

    2015-10-01

    Toxoplasmosis is considered as an important risk factor for bad obstetric history (BOH) and one of the major causes of congenitally acquired infections. The present study aimed to estimate the seropositivity of T. gondii infection and associated risk factors among the attendees of high risk pregnancy and low risk antenatal care clinic of Minia Maternity and Pediatric University Hospital, Minia, Egypt. The study was carried out from April 2013 to April 2014 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. A total of 120 high risk pregnant and 120 normal pregnant females were submitted to clinical examinations, serological screening for anti-Toxoplasma IgM and IgG antibodies by ELISA, and an interview questionnaire. Seropositive cases were subjected to spiramycin course treatment. The results showed that the seroprevalence of toxoplasmosis in high-risk pregnancy group was 50.8%, which was significantly different from that of normal pregnancy group (P<0.05). Analysis of seropositive women in relation to BOH showed that abortion was the commonest form of the pregnancy wastage (56.5%). The high prevalence of T. gondii seropositive cases was observed in the age group of 21-30 years. Post-delivery adverse outcome was observed in 80.3% of high-risk pregnancy group compared to 20% of normal pregnancy group. There was a statistically significant relationship between seropositivity and living in rural area, low socioeconomic level, and undercooked meat consumption (P<0.05). Serological screening for anti-Toxoplasma antibodies should be routine tests especially among high-risk pregnant women.

  18. Needle Stick Injuries and their Related Safety Measures among Nurses in a University Hospital, Shiraz, Iran

    PubMed Central

    Jahangiri, Mehdi; Rostamabadi, Akbar; Hoboubi, Naser; Tadayon, Neda; Soleimani, Ali

    2015-01-01

    Background This study aimed to determine the prevalence and factors related to needle stick injuries (NSIs) and to assess related safety measures among a sample of Iranian nurses. Methods In this cross-sectional study, a random sample of 168 registered active nurses was selected from different wards of one of the hospitals of Shiraz University of Medical Sciences (SUMS). Data were collected by an anonymous questionnaire and a checklist based observational method among the 168 registered active nurses. Results The prevalence of NSIs in the total of work experience and the last year was 76% and 54%, respectively. Hollow-bore needles were the most common devices involved in the injuries (85.5%). The majority of NSIs occurred in the morning shift (57.8%) and the most common activity leading to NSIs was recapping needles (41.4%). The rate of underreporting NSIs was 60.2% and the major reasons for not reporting the NSIs were heavy clinical schedule (46.7%) and perception of low risk of infection (37.7%). A statistically significant relationship was found between the occurrence of NSIs and sex, hours worked/week, and frequency of shifts/month. Conclusion The study showed a high prevalence of NSIs among nurses. Supportive measures such as improving injection practices, modification of working schedule, planning training programs targeted at using personal protective equipment, and providing an adequate number of safety facilities such as puncture resistant disposal containers and engineered safe devices are essential for the effective prevention of NSI incidents among the studied nurses. PMID:27014494

  19. Characterisations of adverse events detected in a university hospital: a 4-year study using the Global Trigger Tool method

    PubMed Central

    Rutberg, Hans; Borgstedt Risberg, Madeleine; Sjödahl, Rune; Nordqvist, Pernilla; Valter, Lars; Nilsson, Lena

    2014-01-01

    Objectives To describe the level, preventability and categories of adverse events (AEs) identified by medical record review using the Global Trigger Tool (GTT). To estimate when the AE occurred in the course of the hospital stay and to compare voluntary AE reporting with medical record reviewing. Design Two-stage retrospective record review. Setting 650-bed university hospital. Participants 20 randomly selected medical records were reviewed every month from 2009 to 2012. Primary and secondary outcome measures AE/1000 patient-days. Proportion of AEs found by GTT found also in the voluntary reporting system. AE categorisation. Description of when during hospital stay AEs occur. Results A total of 271 AEs were detected in the 960 medical records reviewed, corresponding to 33.2 AEs/1000 patient-days or 20.5% of the patients. Of the AEs, 6.3% were reported in the voluntary AE reporting system. Hospital-acquired infections were the most common AE category. The AEs occurred and were detected during the hospital stay in 65.5% of cases; the rest occurred or were detected within 30 days before or after the hospital stay. The AE usually occurred early during the hospital stay, and the hospital stay was 5 days longer on average for patients with an AE. Conclusions Record reviewing identified AEs to a much larger extent than voluntary AE reporting. Healthcare organisations should consider using a portfolio of tools to gain a comprehensive picture of AEs. Substantial costs could be saved if AEs were prevented. PMID:24871538

  20. Internal quality audit and quality standards as a method of quality improvement at the Department of Ophthalmology, University Hospital.

    PubMed

    Nasić, Mirjana; Pokupec, Rajko; Katusić, Damir; Miklić, Pavle; Suić, Ivan; Galić, Slobodan

    2005-01-01

    Quality assessment of clinical health care with the programme of quality standard is a method of health management, through which better efficiency and safety of health outcomes can be achieved. In the period from 2002 to 2004, a pilot program of quality has been carried out on the Department of Ophthalmology, University Hospital Center in Zagreb. Seven internal audit teams of hospital commission and teams of hospital departments were evaluating introducing practice for quality standards every three months. In the period of two years improvement in all standards of quality has been noticed (expressed in percent of progress towards the ideal result of 100%): personnel 20%, patient rights 15%, medical equipment 40%, quality of emergency service 60%, implementation of clinical guidelines and criteria for elective admission 55%, quality of risk prevention 70%, quality of medical records 60%. The two-years-improvement dynamics of about 46%, first year 24%.

  1. Prevalence of child malnutrition at a university hospital using the World Health Organization criteria and bioelectrical impedance data

    PubMed Central

    Pileggi, V.N.; Monteiro, J.P.; Margutti, A.V.B.; Camelo, J.S.

    2016-01-01

    Malnutrition constitutes a major public health concern worldwide and serves as an indicator of hospitalized patients’ prognosis. Although various methods with which to conduct nutritional assessments exist, large hospitals seldom employ them to diagnose malnutrition. The aim of this study was to understand the prevalence of child malnutrition at the University Hospital of the Ribeirão Preto Medical School, University of São, Brazil. A cross-sectional descriptive study was conducted to compare the nutritional status of 292 hospitalized children with that of a healthy control group (n=234). Information regarding patients’ weight, height, and bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained, and the phase angle was calculated. Using the World Health Organization (WHO) criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10% had undernutrition and 19.17% were overweight. Classification according to the bioelectrical impedance results of nutritional status was more sensitive than the WHO criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited undernutrition and 4.20% were overweight. After applying the WHO criteria in the unpaired control group (n=234), we observed that 100.00% of the subjects were eutrophic; however, 23.34% of the controls were malnourished according to impedance analysis. The phase angle was significantly lower in the hospitalized group than in the control group (P<0.05). Therefore, this study suggests that a protocol to obtain patients’ weight and height must be followed, and bioimpedance data must be examined upon hospital admission of all children. PMID:26840712

  2. Multidrug-resistant organisms detected in refugee patients admitted to a University Hospital, Germany June‒December 2015.

    PubMed

    Reinheimer, Claudia; Kempf, Volkhard A J; Göttig, Stephan; Hogardt, Michael; Wichelhaus, Thomas A; O'Rourke, Fiona; Brandt, Christian

    2016-01-01

    Multidrug-resistant Gram-negative bacteria (MDR GNB) were found to colonise 60.8% (95% confidence interval: 52.3-68.9) of 143 refugee patients mainly from Syria (47), Afghanistan (29), and Somalia (14) admitted to the University Hospital Frankfurt, Germany, between June and December 2015. This percentage exceeds the prevalence of MDR GNB in resident patients four-fold. Healthcare personnel should be aware of this and the need to implement or adapt adequate infection control measures. PMID:26794850

  3. Multidrug-resistant organisms detected in refugee patients admitted to a University Hospital, Germany June‒December 2015.

    PubMed

    Reinheimer, Claudia; Kempf, Volkhard A J; Göttig, Stephan; Hogardt, Michael; Wichelhaus, Thomas A; O'Rourke, Fiona; Brandt, Christian

    2016-01-01

    Multidrug-resistant Gram-negative bacteria (MDR GNB) were found to colonise 60.8% (95% confidence interval: 52.3-68.9) of 143 refugee patients mainly from Syria (47), Afghanistan (29), and Somalia (14) admitted to the University Hospital Frankfurt, Germany, between June and December 2015. This percentage exceeds the prevalence of MDR GNB in resident patients four-fold. Healthcare personnel should be aware of this and the need to implement or adapt adequate infection control measures.

  4. Analysis of clinical records of dental patients attending Jordan University Hospital: Documentation of drug prescriptions and local anesthetic injections

    PubMed Central

    Dar-Odeh, Najla; Ryalat, Soukaina; Shayyab, Mohammad; Abu-Hammad, Osama

    2008-01-01

    Objectives: The aim of this study was to analyze clinical records of dental patients attending the Dental Department at the University of Jordan Hospital: a teaching hospital in Jordan. Analysis aimed at determining whether dental specialists properly documented the drug prescriptions and local anesthetic injections given to their patients. Methods: Dental records of the Dental Department at the Jordan University Hospital were reviewed during the period from April 3rd until April 26th 2007 along with the issued prescriptions during that period. Results: A total of 1000 records were reviewed with a total of 53 prescriptions issued during that period. Thirty records documented the prescription by stating the category of the prescribed drug. Only 13 records stated the generic or the trade names of the prescribed drugs. Of these, 5 records contained the full elements of a prescription. As for local anesthetic injections, the term “LA used” was found in 22 records while the names and quantities of the local anesthetics used were documented in only 13 records. Only 5 records documented the full elements of a local anesthetic injection. Conclusion: The essential data of drug prescriptions and local anesthetic injections were poorly documented by the investigated group of dental specialists. It is recommended that the administration of the hospital and the dental department implement clear and firm guidelines for dental practitioners in particular to do the required documentation procedure. PMID:19209291

  5. [Cocooning strategy: Effectiveness of a pertussis vaccination program for parents in the maternity unit of a university hospital].

    PubMed

    Decréquy, A; de Vienne, C; Bellot, A; Guillois, B; Dreyfus, M; Brouard, J

    2016-08-01

    The aim of this study was to evaluate the impact on vaccination coverage of a protocol in which promotion and administration of pertussis vaccine in the maternity ward were proposed upon discharge from a French university hospital. Pertussis is a potentially fatal bacterial respiratory infection, especially in young infants. Since 2004 the High Council of Public Health has recommended vaccinating adults who may become parents. This recommendation is not widely applied in France. The study, organized as a professional practice evaluation (EPP) was conducted by a multidisciplinary team at Caen University Hospital. Thirty couples were included for each period. The primary endpoint was the rate of vaccination coverage for both parents at hospital discharge. Before the information campaign (first period, January 2012), immunization coverage of mothers and fathers was 20% and 13%, respectively. No couple had received a prescription for vaccines. During the second period (June 2013), vaccination coverage was 77% at hospital discharge for mothers and 57% for fathers. Parental immunization coverage against pertussis was multiplied by four to five during the study, which is very encouraging, and it is important to continue this campaign at the region and national levels. PMID:27345559

  6. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university.

    PubMed

    Barati, Omid; Dorosti, Hesam; Talebzadeh, Alireza; Bastani, Peivand

    2016-01-01

    Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014-2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively). Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran. PMID:27429924

  7. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university

    PubMed Central

    Barati, Omid; Dorosti, Hesam; Talebzadeh, Alireza; Bastani, Peivand

    2016-01-01

    Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014–2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively). Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran. PMID:27429924

  8. Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital

    PubMed Central

    Yang, Dong

    2016-01-01

    Background Universal Zero-Markup Drug Policy (UZMDP) mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China’s National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST). Methods This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT) 2009–2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively. Results In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH) in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively) and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively), while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4%) and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%). Conclusion Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital. PMID:27627811

  9. Changes in bacterial resistance patterns in children with urinary tract infections on antimicrobial prophylaxis at University Hospital in Split

    PubMed Central

    Ilić, Tanja; Gračan, Sanda; Arapović, Adela; Čapkun, Vesna; Šubat-Dežulović, Mirna; Saraga, Marijan

    2011-01-01

    Summary Background We assessed prevalence and resistance of uropathogens on antimicrobial agents (AA) from urine cultures (UC) in children hospitalized with urinary tract infections (UTI) at University Hospital in Split. Material/Methods During the 7-year period, children hospitalized only once with UTI alone were compared to those repeatedly hospitalized, and who received long-term antimicrobial prophylaxis (LTAP), as well as those with associated anomalies of the urinary system (US). Results E. coli was the most frequent isolate (67.7%) with resistance to ampicillin by 69.5%, amoxicillin/clavulonic acid by 3.5%, cephalexin by 6.6%, trimethoprim/sulfamethoxazole (TMP-SMX) by 27.5%, and nitrofurantoin by 0.4%. For other uropathogens, AA resistance rates were the following: 64.3%, 5.8%, 10.5%, 21.3%, and 7.9%. The high or increasing resistance to TMP-SMX is characterized by all uropathogens. Patients with anomalies of US showed a lower prevalence of E. coli and Enterococcus sp., but a higher prevalence of Pseudomonas sp., ESBL-producing E. coli and Klebsiella sp. than those without US anomalies. Repeatedly hospitalized patients showed a lower prevalence of E. coli, but a higher prevalence of Pseudomonas sp. and Klebsiella sp. than patients hospitalized only once. Both groups displayed significantly less resistance of Enterococcus sp. In patients receiving LTAP before hospitalization, E. coli was significantly more resistant to ampicillin, amoxicillin/clavulonic acid and TMP/SMX than in those without LTAP. Conclusions Based on our results, we recommend excluding ampicillin altogether, and reconsideration of further use of TMP-SMX, as well as use of nitrofurantoin, cephalexin and amoxicillin/clavulonic acid for LTAP in our region. PMID:21709628

  10. Antimicrobial susceptibility of clinically isolated anaerobic bacteria in a University Hospital Centre Split, Croatia in 2013.

    PubMed

    Novak, Anita; Rubic, Zana; Dogas, Varja; Goic-Barisic, Ivana; Radic, Marina; Tonkic, Marija

    2015-02-01

    Anaerobic bacteria play a significant role in many endogenous polymicrobial infections. Since antimicrobial resistance among anaerobes has increased worldwide, it is useful to provide local susceptibility data to guide empirical therapy. The present study reports recent data on the susceptibility of clinically relevant anaerobes in a University Hospital Centre (UHC) Split, Croatia. A total of 63 Gram-negative and 59 Gram-positive anaerobic clinical isolates from various body sites were consecutively collected from January to December 2013. Antimicrobial susceptibility testing was performed using standardized methods and interpreted using EUCAST criteria. Patient's clinical and demographic data were recorded by clinical microbiologist. Among 35 isolates of Bacteroides spp., 97.1% were resistant to penicillin (PCN), 5.7% to amoxicillin/clavulanic acid (AMC), 8.6% to piperacillin/tazobactam (TZP), 29.0% to clindamycin (CLI) and 2.9% to metronidazole (MZ). Percentages of susceptible strains to imipenem (IPM), meropenem (MEM) and ertapenem (ETP) were 94.3. Resistance of other Gram-negative bacilli was 76.0% to PCN, 8.0% to AMC, 12.0% to TZP, 28.0% to CLI and 8% to MZ. All other Gram-negative strains were fully susceptible to MEM and ETP, while 96.0% were susceptible to IPM. Clostridium spp. isolates were 100% susceptible to all tested antibiotics except to CLI (two of four tested isolates were resistant). Propionibacterium spp. showed resistance to CLI in 4.3%, while 100% were resistant to MZ. Among other Gram-positive bacilli, 18.2% were resistant to PCN, 9.1% to CLI and 54.5% to MZ, while 81.8% of isolates were susceptible to carbapenems. Gram-positive cocci were 100% susceptible to all tested antimicrobials except to MZ, where 28.6% of resistant strains were recorded. Abdomen was the most common source of isolates (82.5%). The most prevalent types of infection were abscess (22.1%), sepsis (14.8%), appendicitis (13.9%) and peritonitis (6.6%). Twenty four patients (19

  11. Antimicrobial susceptibility of clinically isolated anaerobic bacteria in a University Hospital Centre Split, Croatia in 2013.

    PubMed

    Novak, Anita; Rubic, Zana; Dogas, Varja; Goic-Barisic, Ivana; Radic, Marina; Tonkic, Marija

    2015-02-01

    Anaerobic bacteria play a significant role in many endogenous polymicrobial infections. Since antimicrobial resistance among anaerobes has increased worldwide, it is useful to provide local susceptibility data to guide empirical therapy. The present study reports recent data on the susceptibility of clinically relevant anaerobes in a University Hospital Centre (UHC) Split, Croatia. A total of 63 Gram-negative and 59 Gram-positive anaerobic clinical isolates from various body sites were consecutively collected from January to December 2013. Antimicrobial susceptibility testing was performed using standardized methods and interpreted using EUCAST criteria. Patient's clinical and demographic data were recorded by clinical microbiologist. Among 35 isolates of Bacteroides spp., 97.1% were resistant to penicillin (PCN), 5.7% to amoxicillin/clavulanic acid (AMC), 8.6% to piperacillin/tazobactam (TZP), 29.0% to clindamycin (CLI) and 2.9% to metronidazole (MZ). Percentages of susceptible strains to imipenem (IPM), meropenem (MEM) and ertapenem (ETP) were 94.3. Resistance of other Gram-negative bacilli was 76.0% to PCN, 8.0% to AMC, 12.0% to TZP, 28.0% to CLI and 8% to MZ. All other Gram-negative strains were fully susceptible to MEM and ETP, while 96.0% were susceptible to IPM. Clostridium spp. isolates were 100% susceptible to all tested antibiotics except to CLI (two of four tested isolates were resistant). Propionibacterium spp. showed resistance to CLI in 4.3%, while 100% were resistant to MZ. Among other Gram-positive bacilli, 18.2% were resistant to PCN, 9.1% to CLI and 54.5% to MZ, while 81.8% of isolates were susceptible to carbapenems. Gram-positive cocci were 100% susceptible to all tested antimicrobials except to MZ, where 28.6% of resistant strains were recorded. Abdomen was the most common source of isolates (82.5%). The most prevalent types of infection were abscess (22.1%), sepsis (14.8%), appendicitis (13.9%) and peritonitis (6.6%). Twenty four patients (19

  12. A Survey of Blood Request Versus Blood Utilization at a University Hospital in Iran

    PubMed Central

    Yazdi, Arash Peivandi; Alipour, Mohammad; Jahanbakhsh, Seyyed Saeed; Gharavifard, Mohammad; Gilani, Mehryar Taghavi

    2016-01-01

    Background: Reservation of blood leads to blood wastage if the blood is not transfused. Therefore, in some centers only blood type and screen are evaluated. In this study, the efficacy of a blood crossmatch-to-transfusion ratio was measured and then compared with the standard levels. Methods: This prospective study was conducted during one year in a university hospital. During this period, 398 patients for whom blood had been requested were studied. In these patients, at the first surgical type, the laboratory tests (hematocrit, hemoglobin, platelet count, and prothrombin time) and the number of preoperative crossmatched and intraoperative transfused blood units were recorded. Then the crossmatch-to-transfusion ratio, transfusion probability, transfusion index, and correlation between related factors, and the transfusion ratio were evaluated. Results: In this cross-sectional study, blood was requested for 398 patients. According to available blood unit deficiency, from 961 blood unit requisitions, only 456 units were crossmatched and 123 units were transfused. The crossmatch-to-transfusion ratio, transfusion probability, and transfusion index were 3.71 (7.81 if all requisitions were crossmatched), 16.83%, and 0.31, respectively. The most unfavorable indexes were observed in patients who had ear, nose, and throat surgeries (0 transfused from 19 crossmatched blood units) and obstetric and gynecologic surgery (crossmatch-to-transfusion ratio was 18.6). The best indexes were related to thoracic surgery and neurosurgery (crossmatch-to-transfusion ratio was 1.53 and 1.54, respectively). There were no significant correlations between hemoglobin, hematocrit, platelet count, and prothrombin time with the number of transfused blood units (P = 0.2, 0.14, 0.26, and 0.06, respectively). Conclusion: The data for the crossmatch-to-transfusion ratio, transfusion probability, and transfusion index were suboptimal at this center, especially for ear, nose, and throat and obstetric

  13. Retrospective Analysis of the Blood Component Utilization in a University Hospital of Maximum Medical Care

    PubMed Central

    Geißler, R. Georg; Franz, Dominik; Buddendick, Hubert; Krakowitzky, Petra; Bunzemeier, Holger; Roeder, Norbert; Van Aken, Hugo; Kessler, Torsten; Berdel, Wolfgang; Sibrowski, Walter; Schlenke, Peter

    2012-01-01

    Background Demographic data illustrate clearly that people in highly developed countries get older, and the elderly need more blood transfusions than younger patients. Additionally, special extensive therapies result in an increased consumption of blood components. Beyond that the aging of the population reduces the total number of preferably young and healthy blood donors. Therefore, Patient Blood Management will become more and more important in order to secure an increasing blood supply under fair-minded conditions. Methods At the University Hospital of Münster (UKM) a comprehensive retrospective analysis of the utilization of all conventional blood components was performed including all medical and surgical disciplines. In parallel, a new medical reporting system was installed to provide a monthly analysis of the transfusional treatments in the whole infirmary, in every department, and in special blood-consuming cases of interest, as well. Results The study refers to all UKM in-patient cases from 2009 to 2011. It clearly demonstrates that older patients (>60 years, 35.2–35.7% of all cases, but 49.4–52.6% of all cases with red blood cell (RBC) transfusions, 36.4–41. 6% of all cases with platelet (PTL, apheresis only) transfusions, 45.2–48.0% of all cases with fresh frozen plasma (FFP) transfusions) need more blood products than younger patients. Male patients (54.4–63.9% of all cases with transfusions) are more susceptible to blood transfusions than female patients (36.1–45.6% of all cases with transfusions). Most blood components are used in cardiac, visceral, and orthopedic surgery (49.3–55.9% of all RBC units, 45.8–61.0% of all FFP units). When regarding medical disciplines, most transfusions are administered to hematologic and oncologic patients (12.9–17.7% of all RBC units, 9.2–12.0% of all FFP units). The consumption of PTL in this special patient cohort (40.6–50.9% of all PTL units) is more pronounced than in all other surgical or

  14. [Current status of the predictive genetic testing for hereditary neurological diseases in Shinshu University Hospital].

    PubMed

    Tanaka, Keiko; Sekijima, Yoshiki; Yoshida, Kunihiro; Mizuuchi, Asako; Yamashita, Hiromi; Tamai, Mariko; Ikeda, Shu-ichi; Fukushima, Yoshimitsu

    2013-01-01

    The current status of predictive genetic testing for late-onset hereditary neurological diseases in Japan is largely unknown. In this study, we analyzed data from 73 clients who visited the Division of Clinical and Molecular Genetics, Shinshu University Hospital, for the purpose of predictive genetic testing. The clients consisted of individuals with family histories of familial amyloid polyneuropathy (FAP; n=30), Huntington's disease (HD; n=16), spinocerebellar degeneration (SCD; n=14), myotonic dystrophy type 1 (DM1; n=9), familial amyotrophic lateral sclerosis type 1 (ALS1; n=3), and Alzheimer's disease (AD; n=1). Forty-nine of the 73 (67.1%) clients were in their twenties or thirties. Twenty-seven of the 73 (37.0%) clients visited a medical institution within 3 months after becoming aware of predictive genetic testing. The most common reason for requesting predictive genetic testing was a need for certainty or to reduce uncertainty and anxiety. The decision-making about marriage and having a child was also a main reason in clients in the twenties and thirties. The numbers of clients who actually underwent predictive genetic testing was 22 of 30 (73.3%) in FAP, 3 of 16 (18.8%) in HD, 6 of 10 (60.0%) in SCD, 7 of 9 (77.8%) in DM1, and 0 of 3 (0%) in ALS1 (responsible gene of the disease was unknown in 4 SCD patients and an AD patient). The percentage of test usage was lower in untreatable diseases such as HD and SCD than that in FAP, suggesting that many clients changed their way of thinking on the significance of testing through multiple genetic counseling sessions. In addition, it was obvious that existence of disease-modifying therapy promoted usage of predictive genetic testing in FAP. Improvement of genetic counseling system to manage predictive genetic testing is necessary, as consultation concerning predictive genetic testing is the main motivation to visit genetic counseling clinic in many at-risk clients.

  15. Getting "Entangled": A Focus on the Hotel and Hospitality Curriculum Implementation in Public Universities in Kenya

    ERIC Educational Resources Information Center

    Mukolwe, Eunice; Cheloti, Isabela Mapelu

    2016-01-01

    Universities play a critical role in achieving Kenya Vision 2030 and the sustainable development goals. The demand for university education in Kenya has significantly increased and continues to swell. Many secondary school graduates and the working class look for opportunities to pursue university education, yet the process of curriculum…

  16. Comatose and noncomatose adult diabetic ketoacidosis patients at the University Teaching Hospital, Zambia: Clinical profiles, risk factors, and mortality outcomes

    PubMed Central

    Kakusa, Mwanja; Kamanga, Brown; Ngalamika, Owen; Nyirenda, Soka

    2016-01-01

    Background: Diabetic ketoacidosis (DKA) is one of the commonly encountered diabetes mellitus emergencies. Aim: This study aimed at describing the clinical profiles and hospitalization outcomes of DKA patients at the University Teaching Hospital (UTH) in Lusaka, Zambia and to investigate the role of coma on mortality outcome. Materials and Methods: This was a cross-sectional analytical study of hospitalized DKA patients at UTH. The data collected included clinical presentation, precipitating factors, laboratory profiles, complications, and hospitalization outcomes. Primary outcome measured was all-cause in-hospital mortality. Results: The median age was 40 years. Treatment noncompliance was the single highest identified risk factor for development of DKA, followed by new detection of diabetes, then infections. Comatose patients were significantly younger, had lower baseline blood pressure readings, and higher baseline respiratory rates compared to noncomatose patients. In addition, comatose patients had higher baseline admission random blood glucose readings. Their baseline sodium and chloride levels were also higher. The prevalences of hypokalemia, hypernatremia, and hyperchloremia were also higher among comatose patients compared to noncomatose patients. Development of aspiration during admission with DKA, pneumonia at baseline, development of renal failure, and altered mental status were associated with an increased risk of mortality. Development of renal failure was independently predictive of mortality. Conclusion: The mortality rate from DKA hospitalizations is high at UTH. Treatment noncompliance is the single highest identifiable precipitant of DKA. Aspiration, development of renal failure, altered sensorium, and pneumonia at baseline are associated with an increased risk of mortality. Development of renal failure during admission is predictive of mortality. PMID:27042416

  17. Clinical Features and Treatment Modes of Mandibular Fracture at the Department of Oral and Maxillofacial Surgery, Shimane University Hospital, Japan

    PubMed Central

    Nakatani, Eiji; Kagimura, Tatsuo; Sekine, Joji

    2015-01-01

    Background The number of elderly patients with maxillofacial trauma is rapidly increasing due to active lifestyles and longevity. Shimane prefecture has the fastest growing proportion of elderly individuals in Japan. The aim of this study was to reveal the distinctive features and treatment modes of mandibular fracture treatment mode in patients requiring hospitalization at the Department of Oral and Maxillofacial Surgery, Shimane University Hospital, Japan. Patients and Methods Patient age, sex, period between injury and first consultation, years since injury, cause of injury, fracture site, treatment, and duration of hospitalization were evaluated. Univariate Poisson regression, relative risk with 95% confidence interval based on the Wald test, Fisher’s exact test, and Kruskal-Wallis test were used to explore associations among clinical and demographic variables. Results In total, 305 patients were diagnosed with and hospitalized for mandibular fracture from 1980 to 2010. Younger age increased the risk for mandibular fracture. Incidence was higher in males than females, particularly in the young, but the male to female ratio decreased with age. The period until first hospital consultation decreased progressively over the study period. Fall was a much more frequent cause in patients aged ≥60 than in those aged <60 years. Mandibular fracture with condyle, symphysis, and angle involvement were most common and were associated with sex, age, and treatment mode. Length of hospitalization has decreased since 1980. Conclusion In our department, patients aged ≥60 years accounted for a greater proportion of mandibular fracture cases than in many previous studies, reflecting the greater proportion of elderly residents in Shimane prefecture. PMID:26334627

  18. Healthcare-associated vancomycin resistant Enterococcus faecium infections in the Mansoura University Hospitals intensive care units, Egypt.

    PubMed

    Moemen, Dalia; Tawfeek, Doaa; Badawy, Wafaa

    2015-01-01

    Vancomycin resistant Enterococcus faecium (VREF) ia an emerging and challenging nosocomial pathogen. This study aimed to determine the prevalence, risk factors and clonal relationships between different VREF isolates in the intensive care units (ICUs) of the university hospitals in our geographic location. This prospective study was conducted from July, 2012 until September, 2013 on 781 patients who were admitted to the ICUs of the Mansoura University Hospitals (MUHs), and fulfilled the healthcare-associated infection (HAI) criteria. Susceptibility testing was determined using the disk diffusion method. The clonal relationships were evaluated with pulsed field gel electrophoresis (PFGE). Out of 52 E. faecium isolates, 12 (23.1%) were vancomycin resistant. The significant risk factors for the VREF infections were: transfer to the ICU from a ward, renal failure, an extended ICU stay and use of third-generation cephalosporins, gentamicin, or ciprofloxacin. PFGE with the 12 isolates showed 9 different patterns; 3 belonged to the same pulsotype and another 2 carried a second pulsotypes. The similar pulsotypes isolates were isolated from ICUs of one hospital (EICUs); however, all of the isolates from the other ICUs had different patterns. Infection control policy, in conjunction with antibiotic stewardship, is important to combat VREF transmission in these high-risk patients.

  19. Variations in Implementation of Acute Care Surgery: Results from a national survey of university-affiliated hospitals

    PubMed Central

    Santry, Heena P.; Madore, John C.; Collins, Courtney E.; Ayturk, M. Didem; Velmahos, George C.; Britt, LD; Kiefe, Catarina I.

    2015-01-01

    BACKGROUND To date, no studies have reported nationwide adoption of Acute Care Surgery (ACS) or identified structural and/or process variations for the care of emergency general surgery (EGS) patients within such models. METHODS We surveyed surgeons responsible for EGS coverage at University HealthSystems Consortium hospitals using an 8-page postal/email questionnaire querying respondents on hospital and EGS structure/process measures. Survey responses were analyzed using descriptive statistics, univariate comparisons, and multivariable regression models. RESULTS 258 of 319 (81%) potential respondents completed surveys. 81 hospitals (31%) had implemented ACS while 134 (52%) had a traditional general surgeon on-call model (GSOC). 38 (15%) hospitals had another model (HYBRID). Larger bed, university-based, teaching hospitals with Level 1 trauma center verification status located in urban areas were more likely to have adopted ACS. In multivariable modeling, hospital type, setting, and trauma center verification predicted ACS implementation. EGS processes of care varied with 28% GSOC having block time vs 67% ACS (p<0.0001); 45% GSOC providing ICU care to EGS patients in a surgical/trauma ICU vs 93% ACS (p<0.0001); GSOC sharing call among 5.7 (+/− 3.2) surgeons vs 7.9 (+/−2.3) ACS surgeons (p<0.0001); and 13% GSOC taking in-house EGS call vs 75% ACS (p<0.0001). Among ACS hospitals there were variations in patient cohorting (25% EGS patients alone; 21% EGS+trauma; 17% EGS+elective; 30% EGS+trauma+elective), data collection (26% had prospective EGS registries), and patient handoffs (56% had attending surgeon presence), call responsibilities (averaging 4.8 (+/− 1.3) calls per month with 60% providing extra call stipend and 40% with no post-call clinical duties). CONCLUSION The potential of the ACS on the national crisis in access to EGS care is not fully met. Variations in EGS processes of care among adopters of ACS suggest that standardized criteria for ACS

  20. [Improving the medical treatment of minors who are victims of sexual assault or physical abuse: a receiving center and partnership between a psychiatric hospital and university hospital].

    PubMed

    Fremy, D

    2003-04-01

    The aim of the partnership is the establishment and operation of a centre open 24 hours a day which receives and treats adults and underage victims of sexual assault and physical abuse coming from the greater metropolitan area of Besançon. The centre also provides the victims and their families with adapted forensic and psychotherapeutic assistance. The mechanisms to carry out the project will be set out in a contract between the two hospitals, including the resources of the two institutions. The centre will fit into the existing network of partners which is already operational in Besançon. The role of the University of Besançon and the Faculty of Medicine will be to promote research in the field of physical abuse, its causes and effects, and to train future physicians who will later be in charge of handling these types of cases in their careers. PMID:12784493

  1. [Epidemiological study of very preterm infants at Rouen University Hospital: changes in mortality, morbidity, and care over 11 years].

    PubMed

    Pinto Cardoso, G; Abily-Donval, L; Chadie, A; Guerrot, A-M; Pinquier, D; Marret, S

    2013-02-01

    The very preterm birth rate has increased in the past few years. Despite advances in neonatal medicine, neurodevelopmental sequelae have not decreased, despite a perinatal plan published in France in 1994. We conducted an epidemiological comparative survey at Rouen University Hospital in order to analyze morbidity, mortality, and care of very of premature infants by comparing the years 2000, 2005, and 2010. This hospital draws on an area of 17,000 births per year. Our survey was a single-center prospective, descriptive, and comparative study. The three cohorts had the same characteristics and the mortality rate was constant for 11 years. Use of medically assisted procreation and maternal age increased over this period. Chorioamnionitis halved, whereas duration of intrapartum antibiotic therapy increased. Neonatal morbidity was stable for hyaline membrane disease, bronchopulmonary dysplasia, maternofetal or nosocomial infections, and necrotizing enterocolitis. Regarding neurological complications, intraventricular hemorrhages decreased and white matter lesions remained constant. The rate of severe retinopathy remained low. The duration of parenteral nutrition and assisted ventilation, use of postnatal corticosteroids, and length of hospitalization decreased. The breastfeeding rate has increased since 2000 in parallel with postnatal growth restriction : 39% of the premature infants had a weight under the 10th percentile at hospital discharge. Our study allowed us to follow up the changes in neonatal epidemiological characteristics, the mortality and morbidity of extreme premature infants over a period of 11 years and showed few significant changes. Knowledge of medical practices is essential to improve the short- and long-term outcome of premature infants.

  2. Peritonsillar abscess (PTA): clinical characteristics, microbiology, drug exposures and outcomes of a large multicenter cohort survey of 412 patients hospitalized in 13 French university hospitals.

    PubMed

    Lepelletier, D; Pinaud, V; Le Conte, P; Bourigault, C; Asseray, N; Ballereau, F; Caillon, J; Ferron, C; Righini, C; Batard, E; Potel, G

    2016-05-01

    The aim of this study was to describe the epidemiology of hospitalized patients with peritonsillar abscess (PTA). We conducted a multicenter survey in 13 French university hospitals in 2009-2012 describing 412 patients. Median age was 29 year (range, 2-84) and current smoking habit was reported by 177 (43 %) patients. Most of the patients (92 %) had consulted a physician for sore throat within 10 days before admission for PTA diagnosis. Additional symptoms such as visible tonsil abnormalities (83 %), tender cervical adenopathy (57 %) and fever ≥ 38.5 °C (53 %) were also reported. A total of 65 % patients (269/412) reported recent systemic anti-inflammatory agents (AIAs) exposure by medical prescription (70 %), self-medication (22 %), or both (8 %); 61 % and 27 % reported recent exposure to antibiotic and topical treatments for sore throat, respectively. Non-steroidal AIAs were used most often (45 %), particularly arylpropionic derivatives. A rapid diagnosis antigen test (RDT) for Streptococcus pyogenes was performed in 70 (17 %) patients and was positive in 17 (24 %), of whom 9 (53 %) were exposed to AIAs and 14 (82 %) to antibiotics. To treat PTA, antibiotic therapy was given to 392 (95 %) patients. Of 333 antibiotic prescriptions, amoxicillin-clavulanic acid and metronidazole were the most prescribed antibiotics (42 and 17 %, respectively). Surgical drainage of the abscess was performed in 119 (29 %) cases and tonsillectomy in 75 (18 %) cases. The clinical outcome was favorable during the hospital stay in 404 (98 %) patients. In conclusion, patients with sore throat are often exposed to AIAs before PTA diagnosis, and antibiotic prescription was not often based on the RDT positivity.

  3. Peritonsillar abscess (PTA): clinical characteristics, microbiology, drug exposures and outcomes of a large multicenter cohort survey of 412 patients hospitalized in 13 French university hospitals.

    PubMed

    Lepelletier, D; Pinaud, V; Le Conte, P; Bourigault, C; Asseray, N; Ballereau, F; Caillon, J; Ferron, C; Righini, C; Batard, E; Potel, G

    2016-05-01

    The aim of this study was to describe the epidemiology of hospitalized patients with peritonsillar abscess (PTA). We conducted a multicenter survey in 13 French university hospitals in 2009-2012 describing 412 patients. Median age was 29 year (range, 2-84) and current smoking habit was reported by 177 (43 %) patients. Most of the patients (92 %) had consulted a physician for sore throat within 10 days before admission for PTA diagnosis. Additional symptoms such as visible tonsil abnormalities (83 %), tender cervical adenopathy (57 %) and fever ≥ 38.5 °C (53 %) were also reported. A total of 65 % patients (269/412) reported recent systemic anti-inflammatory agents (AIAs) exposure by medical prescription (70 %), self-medication (22 %), or both (8 %); 61 % and 27 % reported recent exposure to antibiotic and topical treatments for sore throat, respectively. Non-steroidal AIAs were used most often (45 %), particularly arylpropionic derivatives. A rapid diagnosis antigen test (RDT) for Streptococcus pyogenes was performed in 70 (17 %) patients and was positive in 17 (24 %), of whom 9 (53 %) were exposed to AIAs and 14 (82 %) to antibiotics. To treat PTA, antibiotic therapy was given to 392 (95 %) patients. Of 333 antibiotic prescriptions, amoxicillin-clavulanic acid and metronidazole were the most prescribed antibiotics (42 and 17 %, respectively). Surgical drainage of the abscess was performed in 119 (29 %) cases and tonsillectomy in 75 (18 %) cases. The clinical outcome was favorable during the hospital stay in 404 (98 %) patients. In conclusion, patients with sore throat are often exposed to AIAs before PTA diagnosis, and antibiotic prescription was not often based on the RDT positivity. PMID:26942743

  4. Attitudes of Registered and Licensed Practical Nurses About the Importance of Families in Surgical Hospital Units: Findings From the Landspitali University Hospital Family Nursing Implementation Project.

    PubMed

    Blöndal, Katrin; Zoëga, Sigridur; Hafsteinsdottir, Jorunn E; Olafsdottir, Olof Asdis; Thorvardardottir, Audur B; Hafsteinsdottir, Sigrun A; Sveinsdóttir, Herdis

    2014-07-15

    The purpose of this study was to examine attitudes of registered nurses and licensed practical nurses about the importance of the family in surgical hospital units before (T1) and after (T2) implementation of a Family Systems Nursing educational intervention based on the Calgary Family Assessment and Intervention Models. This study was part of the Landspitali University Hospital Family Nursing Implementation Project and used a nonrandomized, quasi-experimental design with nonequivalent group before and after and without a control group. There were 181 participants at T1 and 130 at T2. No difference was found in nurses' attitudes as measured by the Families Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire, before and after the educational intervention. Attitudes toward families were favorable at both times. Analysis of demographic variables showed that age, work experience, and workplace (inpatient vs. outpatient units) had an effect on the nurses' attitudes toward families. The influence of work experience on attitudes toward family care warrants further exploration.

  5. [Drug prescriptions of patients treated in a geriatric outpatient ward of a university hospital: a descriptive cross-sectional study].

    PubMed

    Cuentro, Vanessa da Silva; Andrade, Marcieni Ataide de; Gerlack, Letícia Farias; Bós, Angelo José Gonçalves; Silva, Marcos Valério Santos da; Oliveira, Alex Ferreira de

    2014-08-01

    The scope of this study was to evaluate drug prescriptions for elderly patients in the geriatric outpatient ward of a hospital. A cross-sectional descriptive study was conducted in a university hospital, with the application of a questionnaire. Patients aged >60 years were interviewed about their drug prescriptions and a total of 208 patients were interviewed. The average number of drugs used per person was 3.8 and the drugs most used were for the cardiovascular system (37%). 406 potential interactions were identified in 140 patients (67.3%), and duplicate therapy was found in two prescriptions. The potentially inappropriate drug most used for the elderly was nifedipine (2.4%). Data from this study support the relevance of the issue of drug use among the elderly, thus reinforcing the importance of the evaluation of the process of the prescription of drugs for this population. PMID:25119075

  6. [Communication, participation and leadership in the perception of the emotional climate in a university hospital in Andalusia, Spain].

    PubMed

    Danet, Alina; March, Joan Carles; Romera, Inmaculada García

    2014-03-01

    The aim of this study was to identify and analyze perceptions and opinions among health professionals in a university hospital in Andalusia, Spain, regarding the emotional climate, leadership style, quality of information, and internal communication. The study also aimed to collect health professionals' suggestions for improving these workplace characteristics. The study included 730 participants and used a quantitative and qualitative methodology. The results reflect a medium-to-low level of emotional climate, correlated with the leadership style and information and internal communication. Statistically significant differences appeared when comparing professional categories and hospital units. The health professionals provided a positive assessment of the administrators' work, although requiring more task-oriented, participative, and affiliative leadership skills.

  7. [Communication, participation and leadership in the perception of the emotional climate in a university hospital in Andalusia, Spain].

    PubMed

    Danet, Alina; March, Joan Carles; Romera, Inmaculada García

    2014-03-01

    The aim of this study was to identify and analyze perceptions and opinions among health professionals in a university hospital in Andalusia, Spain, regarding the emotional climate, leadership style, quality of information, and internal communication. The study also aimed to collect health professionals' suggestions for improving these workplace characteristics. The study included 730 participants and used a quantitative and qualitative methodology. The results reflect a medium-to-low level of emotional climate, correlated with the leadership style and information and internal communication. Statistically significant differences appeared when comparing professional categories and hospital units. The health professionals provided a positive assessment of the administrators' work, although requiring more task-oriented, participative, and affiliative leadership skills. PMID:24714944

  8. [Investigation of the hepatitis E virus seroprevalence in cases admitted to Hacettepe University Medical Faculty Hospital].

    PubMed

    Aydın, Nesibe Nur; Ergünay, Koray; Karagül, Aydan; Pınar, Ahmet; Us, Dürdal

    2015-10-01

    Hepatitis E virus (HEV), classified in Hepeviridae family, Hepevirus genus, is a non-enveloped virus with icosahedral capsid containing single-stranded positive sense RNA genome. HEV infections may be asymptomatic especially in children, however it may present as fulminant hepatitis in pregnant women, as well as chronic hepatitis in immunocompromised patients. There are four well-known genotypes of HEV that infect humans and many mammalian species. Genotype 1 and 2 are frequently responsible for water-borne infections transmitted by fecal-oral way in developing countries, while genotype 3 and 4 cause zoonotic infections in developed countries. Turkey is considered as an endemic country with a total seroprevalence rate of 6.3% for normal population, showing significant variation (0-73%) according to the regions and study groups. The aims of this study were to investigate the HEV seropositivity in cases admitted to Hacettepe University Medical Faculty Hospital (HUMFH), to evaluate the results according to the demographic features of patients, and to determine the current HEV seroprevalence in our region, contributing seroepidemiological data in Turkey. A total of 1043 serum samples (514 female, 529 male; age range: 1-90 years, mean age: 38.03) obtained from 327 blood donors (32 female, 295 male; age range: 19-59 years, mean age: 31.1) who were admitted to HUMFH Blood Center, and 716 sera (482 female, 234 male; age range: 1-90 years, mean age: 41.7) that were sent to HUMFH Central Laboratory from various outpatient/inpatient clinics, between November 2012 to November 2013, were included in the study. The presence of HEV-IgG antibodies in serum samples was detected by a commercial ELISA method (Euroimmun, Germany), and the presence of HEV-IgM antibodies was also investigated in the sera with IgG-positive results. The overall HEV-IgG seropositivity rate was determined as 4.4% (46/1043), and the seropositivity rates for blood donors and in/outpatients were as 0.92% (3

  9. [Investigation of the hepatitis E virus seroprevalence in cases admitted to Hacettepe University Medical Faculty Hospital].

    PubMed

    Aydın, Nesibe Nur; Ergünay, Koray; Karagül, Aydan; Pınar, Ahmet; Us, Dürdal

    2015-10-01

    Hepatitis E virus (HEV), classified in Hepeviridae family, Hepevirus genus, is a non-enveloped virus with icosahedral capsid containing single-stranded positive sense RNA genome. HEV infections may be asymptomatic especially in children, however it may present as fulminant hepatitis in pregnant women, as well as chronic hepatitis in immunocompromised patients. There are four well-known genotypes of HEV that infect humans and many mammalian species. Genotype 1 and 2 are frequently responsible for water-borne infections transmitted by fecal-oral way in developing countries, while genotype 3 and 4 cause zoonotic infections in developed countries. Turkey is considered as an endemic country with a total seroprevalence rate of 6.3% for normal population, showing significant variation (0-73%) according to the regions and study groups. The aims of this study were to investigate the HEV seropositivity in cases admitted to Hacettepe University Medical Faculty Hospital (HUMFH), to evaluate the results according to the demographic features of patients, and to determine the current HEV seroprevalence in our region, contributing seroepidemiological data in Turkey. A total of 1043 serum samples (514 female, 529 male; age range: 1-90 years, mean age: 38.03) obtained from 327 blood donors (32 female, 295 male; age range: 19-59 years, mean age: 31.1) who were admitted to HUMFH Blood Center, and 716 sera (482 female, 234 male; age range: 1-90 years, mean age: 41.7) that were sent to HUMFH Central Laboratory from various outpatient/inpatient clinics, between November 2012 to November 2013, were included in the study. The presence of HEV-IgG antibodies in serum samples was detected by a commercial ELISA method (Euroimmun, Germany), and the presence of HEV-IgM antibodies was also investigated in the sera with IgG-positive results. The overall HEV-IgG seropositivity rate was determined as 4.4% (46/1043), and the seropositivity rates for blood donors and in/outpatients were as 0.92% (3

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

    PubMed Central

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

    2009-01-01

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

  11. Bacterial contamination, bacterial profile and antimicrobial susceptibility pattern of isolates from stethoscopes at Jimma University Specialized Hospital

    PubMed Central

    2013-01-01

    Introduction Hospital acquired infections are recognized as critical public health problems. Infections are frequently caused by organisms residing in healthcare environment, including contaminated medical equipment like Stethoscopes. Objective To determine bacterial contamination, bacterial profile and anti-microbial susceptibility pattern of the isolates from stethoscopes at Jimma University Specialized Hospital. Methodology Cross-sectional study conducted from May to September 2011 at Jimma University Specialized Hospital. One hundred seventy-six stethoscopes owned by Health Care Workers (HCWs) and Medical students were randomly selected and studied. Self-administered structured questionnaire was used to collect socio-demographic data. Specimen was collected using moisten sterile cotton swab and 1 ml normal saline was used to transport the specimen, all laboratory investigations were done following standard microbiological techniques, at Microbiology Laboratory, Jimma University. SPSS windows version 16 used for data analysis and P <0.05 was considered statistically significant. Result: A total, of 151 (85.8%) stethoscopes were contaminated. A total of 256 bacterial strains and a mean of 1.44×104 CFUs/diaphragm of stethoscopes was isolated. Of the 256 isolates, 133 (52%) were potential pathogens like S. aureus, Klebsiella spp., Citrobacter spp., Salmonella spp., Proteus spp., Enterobacter spp., P. aeruginosa and E. coli. All strains were resistant to multiple classes of antibiotics (two to eight classes of antibiotics). Disinfection practice was poor. Disinfection practice was found to be associated with bacterial contamination of stethoscopes (P < 0.05). High contamination rate 100 (90.9%) was observed among stethoscopes that had never been disinfected; while the least contamination 29 (72.2%) was found on those disinfected a week or less before the survey. Conclusion Bacterial contamination of the stethoscope was significant. The isolates were potential

  12. Decision Support Systems and Line Performance: Case of Gold Coast University Hospital.

    PubMed

    Connor, Martin; Ghapanchi, Amir Hossein; Blumenstein, Michael; Amrollahi, Alireza; Najaftorkaman, Mohammadreza

    2015-01-01

    Computer-based decision support information systems have been promoted for their potential to improve physician performance and patient outcomes and support clinical decision making. The current case study reported design and implementation of a high-level decision support system (DSS) which facilitated the flow of data from operational level to top managers and leadership level of hospitals. The results shows that development of a DSS improve data connectivity, timing, and responsiveness issues via centralised sourcing and storing of principal health-related information in the hospital. The implementation of the system has resulted in significant enhancements in outpatient waiting times management.

  13. [Guidelines for a prevalence survey of nosocomial infections in the University Hospital "Madre Teresa" in Tirana, Albania].

    PubMed

    Sodano, L; Faria, S; Gjata, A; Kasneci, A; Byku, B; Schinaia, N

    2003-01-01

    The authors present guidelines for the first prevalence survey of nosocomial infections in the University Hospital "Madre Teresa" in Tirana (almost 1,600 beds), the only tertiary health-care centre in Albania. The survey is a joint project involving Italy and Albania, to be coordinated by the Italian National Health Institute. The paper describes goals, methodology and organization of the prevalence survey. The improvement of local expertise in epidemiology and microbiology is one of the most important goals. Therefore, Albanian personnel training and improvement of the infection microbiological diagnosis are fundamental aspects of the project.

  14. [Burnout in healthcare workers of a university teaching hospital in Rome, Italy: a cross-sectional study].

    PubMed

    Agostinelli, Alessandro; La Torre, Giuseppe; Bevilacqua, Francesca; Chiaradia, Giacomina; Specchia, Maria Lucia; Ricciardi, Walter

    2008-01-01

    A cross-sectional study was performed to assess the frequency of burnout in healthcare workers of a university teaching hospital in Rome (Italy), by means of the Maslach Burnout Inventory. In total 142 healthcare workers participated in the study. Average levels of emotional exhaustion and depersonalization were observed in the study population. Working in emergency care services was found to be correlated with lower levels of personal accomplishment with respect to working in other services. Monitoring burnout in social service and healthcare workers is an effective tool for identifying critical situations in the workplace. PMID:18379605

  15. Time trends in pediatric hospitalizations for hepatitis A in Greece (1999-2013): Assessment of the impact of universal infant immunization in 2008.

    PubMed

    Papaevangelou, V; Alexopoulou, Z; Hadjichristodoulou, C; Kourlamba, G; Katsioulis, A; Theodoridou, K; Spoulou, V; Theodoridou, M

    2016-07-01

    Hepatitis A vaccine was introduced in the Greek National Immunization Program in 2008. To estimate possible impact of the universal vaccination implementation, time trends of hospitalizations for hepatitis A at the Infectious Diseases Unit of a Tertiary Pediatric Hospital in Athens during 1999-2013 were analyzed. Hepatitis A hospitalizations were recorded from the discharge database and were expressed as frequencies and rate of annual departmental hospitalizations. Time series analysis (ARIMA) was used to explore trends and the impact of the vaccination. Moreover, changes in patient age, population group distribution and the duration of hospitalization were also examined. Hepatitis A hospitalizations rate significantly decreased between pre-vaccination (1999-2008) and post-vaccination (2009-2013) era from 50.5 to 20.8/1000 hospitalizations (p = 0.005). A 3-year periodicity and a trend of reduction on hepatitis A hospitalizations rates across years were noted. Roma children had significant higher rates of hepatitis A hospitalization, followed by immigrant children. Importantly, possibly due to preceding vaccine availability with considerable uptake in private market and unvaccinated group/pockets of children (Roma), overall vaccination effect was less apparent when compared to data from other countries that implemented universal vaccination. No significant change in patient age, population group distribution, or duration of hospitalization was observed. High risk groups such as Roma children should be targeted for vaccination to reduce future outbreaks. PMID:27141813

  16. Time trends in pediatric hospitalizations for hepatitis A in Greece (1999-2013): Assessment of the impact of universal infant immunization in 2008.

    PubMed

    Papaevangelou, V; Alexopoulou, Z; Hadjichristodoulou, C; Kourlamba, G; Katsioulis, A; Theodoridou, K; Spoulou, V; Theodoridou, M

    2016-07-01

    Hepatitis A vaccine was introduced in the Greek National Immunization Program in 2008. To estimate possible impact of the universal vaccination implementation, time trends of hospitalizations for hepatitis A at the Infectious Diseases Unit of a Tertiary Pediatric Hospital in Athens during 1999-2013 were analyzed. Hepatitis A hospitalizations were recorded from the discharge database and were expressed as frequencies and rate of annual departmental hospitalizations. Time series analysis (ARIMA) was used to explore trends and the impact of the vaccination. Moreover, changes in patient age, population group distribution and the duration of hospitalization were also examined. Hepatitis A hospitalizations rate significantly decreased between pre-vaccination (1999-2008) and post-vaccination (2009-2013) era from 50.5 to 20.8/1000 hospitalizations (p = 0.005). A 3-year periodicity and a trend of reduction on hepatitis A hospitalizations rates across years were noted. Roma children had significant higher rates of hepatitis A hospitalization, followed by immigrant children. Importantly, possibly due to preceding vaccine availability with considerable uptake in private market and unvaccinated group/pockets of children (Roma), overall vaccination effect was less apparent when compared to data from other countries that implemented universal vaccination. No significant change in patient age, population group distribution, or duration of hospitalization was observed. High risk groups such as Roma children should be targeted for vaccination to reduce future outbreaks.

  17. [Hysterectomies at the Conakry university hospitals: social, demographic, and clinical characteristics, types, indications, surgical approaches, and prognosis].

    PubMed

    Baldé, I S; Sy, T; Diallo, B S; Diallo, Y; Mamy, M N; Diallo, M H; Bah, E M; Diallo, T S; Keita, N

    2014-01-01

    The objectives of this study were to calculate the frequency of hysterectomies at the Conakry university hospitals (Donka Hospital and Ignace Deen Hospital), describe the women's social, demographic, and clinical characteristics, and identify the key indications, the surgical techniques used, and the prognosis. This was a 2-year descriptive study, retrospective for the first year (May 2011-April 2012) and prospective for the second (May 2012-April 2013), of 333 consecutive hysterectomies performed in the obstetrics and gynecology departments of these two hospitals. Hysterectomy is one of the surgical procedures most commonly performed in these departments (following cesarean deliveries), with frequency of 4.4% interventions. The profile of the women undergoing this surgery was that of a woman aged younger than 49 years (61%), married (75.7%), multiparous (33%), of childbearing age (61%), and with no history of abdominal or pelvic surgery (79.6%). Nearly all hysterectomies were total (95%, compared with 5% subtotal; the approach was abdominal in 82.25% of procedures and vaginal in 17.75%. The most common indication for surgery was uterine fibroids (39.6%), followed by genital prolapse (22.2%), and obstetric emergencies (17.8%). The average duration of surgery was 96 minutes for abdominal and 55 minutes for vaginal hysterectomies. The principal intraoperative complication was hemorrhage (12.31%), and the main postoperative complication parietal suppuration (21.02%). The average length of hospital stay was 10.3 days for abdominal hysterectomies and 7.15 days for vaginal procedures. We recorded 14 deaths for a lethality rate of 4.2%; most of these deaths were associated with hemorrhagic shock during or after an obstetric hysterectomy (93%). Hysterectomy remains a common intervention in developing countries. Its indications are common during the pregnancy and postpartum period, with high morbidity and mortality rates. Improving obstetric coverage could reduce its

  18. A review of daycase GA services for Special Care patients at University Hospital, Bristol.

    PubMed

    Ali, S; Sims, C; Foy, S; McIndoe, A; Yates, R; Brooke, T

    2016-03-01

    This paper describes and discusses a review of adult special care dentistry day cases in a UK hospital over a two year period and makes recommendations for other such reviews and for practice. Dental public health competencies illustrated: oral health needs assessment and evaluation of dental health services. PMID:27149766

  19. State Hospital-University Collaborations: A 25-Year Follow-Up

    ERIC Educational Resources Information Center

    Talbott, John A.; Faulkner, Larry R.; Buckley, Peter F.

    2010-01-01

    Objective: A formative survey of psychiatry departments 25 years ago showed strong and valued relationships between these departments and state hospitals. The authors sought to evaluate the extent of present-day collaborative relationships. Methods: A repeat of a similar survey was sent in 2005 to 119 chairs of departments of psychiatry. Results:…

  20. Factors Affecting Code Status in a University Hospital Intensive Care Unit

    ERIC Educational Resources Information Center

    Van Scoy, Lauren Jodi; Sherman, Michael

    2013-01-01

    The authors collected data on diagnosis, hospital course, and end-of-life preparedness in patients who died in the intensive care unit (ICU) with "full code" status (defined as receiving cardiopulmonary resuscitation), compared with those who didn't. Differences were analyzed using binary and stepwise logistic regression. They found…

  1. University of Salford's £1.7m training facilities recreate real hospital environment.

    PubMed

    2016-08-01

    The next generation of nurses and midwives will be honing their skills on manikins that can breathe, 'speak', sweat and blink at a £1.7 million training suite at the University of Salford. PMID:27484529

  2. Two Programs for Primary Care Practitioners: Family Medicine Training in an Affiliated University Hospital Program and Primary Care Graduate Training in an Urban Private Medical Center

    ERIC Educational Resources Information Center

    Farley, Eugene S.; Piemme, Thomas E.

    1975-01-01

    Eugene Farley describes the University of Rochester and Highland Hospital Family Medicine Program for teaching of primary care internists, primary care pediatricians, and family doctors. Thomas Piemme presents the George Washington University School of Medicine alternative, a 2-year program in an ambulatory setting leading to broad eligibility in…

  3. Higher HIV RNA Viral Load in Recent Patients with Symptomatic Acute HIV Infection in Lyon University Hospitals

    PubMed Central

    Girerd-Genessay, Isabelle; Baratin, Dominique; Ferry, Tristan; Chidiac, Christian; Ronin, Vincent; Vanhems, Philippe

    2016-01-01

    Introduction Increased human immunodeficiency virus (HIV) virulence at infection has been suggested by a meta-analysis based on viral load and CD4 T lymphocytes (CD4) count during acute infection. This result was obtained after secondary analyses of large databases, facilitating the detection of differences. Similar finding in cohorts of more modest sample size would indicate that the effect could be more substantial. Methods Change from initial CD4 count and HIV viral load after acute HIV infection by calendar year was explored in patients treated at Lyon University hospitals. All patients admitted to our hospitals with acute HIV infection between 1996 and 2013 were included in our study. Initial CD4 count and viral load before the start of anti-retroviral treatment were analyzed. Trends over time were assessed in linear models. Results Initial CD4 count remained similar over time. However, in 2006–2013, initial viral load rose significantly (+1.12 log10/ml/year, p = 0.01). Conclusion Our data, obtained from a single hospital cohort, confirmed findings from a large meta-analysis, showed increased initial viremia at acute HIV infection since 2006 and suggesting potentially higher HIV virulence in recent years. PMID:26799390

  4. Clinical and environmental distribution of Legionella pneumophila in a university hospital in Italy: efficacy of ultraviolet disinfection.

    PubMed

    Triassi, M; Di Popolo, A; Ribera D'Alcalà, G; Albanese, Z; Cuccurullo, S; Montegrosso, S; Crispino, M; Borella, P; Zarrilli, R

    2006-04-01

    The molecular epidemiology of Legionella pneumophila in the 'V. Monaldi' University Hospital was studied. Seven cases of nosocomial Legionnaires' disease were diagnosed between 1999 and 2003. Two clinical legionella strains obtained from two patients in the adult cardiac surgery unit (CSU) and 30 environmental legionella strains from the paediatric and adult CSUs, neonatal intensive care unit (NICU) and the cardiorespiratory intensive care unit (CR-ICU) were serotyped and genotyped. L. pneumophila serogroup 1/Philadelphia with an identical pulsed-field gel electrophoresis (PFGE) profile A was isolated from two patients in the adult CSU, and from three and one water samples taken in the adult CSU and the paediatric CSU, respectively, from 2001 to 2002. Furthermore, L. pneumophila serogroup 3 with an identical PFGE profile B was identified in 20 environmental strains from all wards, L. pneumophila serogroup 3 with PFGE profile C was identified in a single environmental strain from the CR-ICU, and non-pneumophila Legionella with identical PFGE profile D was identified in five environmental strains from the adult CSU, paediatric CSU and NICU. Ultraviolet irradiation was effective in disinfection of the hospital water supplies in the adult and paediatric CSUs contaminated by L. pneumophila clone associated with nosocomial Legionnaires' disease. In conclusion, these data demonstrate that two cases of nosocomial legionellosis were caused by the persistence of a single clone of L. pneumophila serogroup 1/Philadelphia in the hospital environment, and that disinfection by ultraviolet irradiation may represent an effective measure to prevent nosocomial Legionnaires' disease.

  5. [Dissemination of an extended spectrum beta-lactamase producing Klebsiella pneumoniae strains in a Tunisian university hospital center].

    PubMed

    Elhani, D; Bakir, L; Aouni, M

    2006-01-01

    On a period of four years (january 1999-december 2002), 49 strains (non redundant) of extended spectrum beta-lactamase-producing Klebsiella pneumoniae from 43 hospitalised patients and three strains from the environment hospital were collected at Mongi Slim University Hospital Center. The objectives of our work were to investigate for clonality of strains, to clarify transmission fashions and reservoirs of the infection by reviewing clinical records and typing strains. Antibiotic susceptibility testing, plasmid analysis and Random Amplified Polymorphic DNA (RAPD) have been done. 84% of the patients were hospitalized in the intensive care and pediatric units. Urinary infections and septicaemias were the more frequent infections (74.2%). The 49 isolats have been classified in 13 antibiotypes. The plasmid analysis showed 16 patterns. The RAPD revealed 28 patterns and variation within patterns in five cases. Our results showed a diversity of the strains suggesting endemicity, possible transmission of plasmids and persistence of some clones which circulated between services. The used markers permitted the evaluation of a long-term strategy of prevention requiring a strict observance of hygiene rules and rational use of antibiotics.

  6. Compliance with Evidence-Based Guidelines in Acute Pancreatitis: an Audit of Practices in University of Toronto Hospitals.

    PubMed

    Greenberg, J A; Hsu, J; Bawazeer, M; Marshall, J; Friedrich, J O; Nathens, A; Coburn, N; Huang, H; McLeod, R S

    2016-02-01

    Despite existing evidence-based practice guidelines for the management of acute pancreatitis, clinical compliance with recommendations is poor. We conducted a retrospective review of 248 patients admitted between 2010 and 2012 with acute pancreatitis at eight University of Toronto affiliated hospitals. We included all patients admitted to ICU (52) and 25 ward patients from each site (196). Management was compared with the most current evidence used in the Best Practice in General Surgery Management of Acute Pancreatitis Guideline. Fifty-six patients (22.6 %) had only serum lipase tested for biochemical diagnosis. Admission ultrasound was performed in 174 (70.2 %) patients, with 69 (27.8 %) undergoing ultrasound and CT. Of non-ICU patients, 158 (80.6 %) were maintained nil per os, and only 18 (34.6 %) ICU patients received enteral nutrition, commencing an average 7.5 days post-admission. Fifty (25.5 %) non-ICU patients and 25 (48.1 %) ICU patients received prophylactic antibiotics. Only 24 patients (22.6 %) with gallstone pancreatitis underwent index admission cholecystectomy. ERCP with sphincterotomy was under-utilized among patients with biliary obstruction (16 [31 %]) and candidates for prophylactic sphincterotomy (18 [22 %]). Discrepancies exist between the most current evidence and clinical practice within the University of Toronto hospitals. A guideline, knowledge translation strategy, and assessment of barriers to clinical uptake are required to change current clinical practice.

  7. Role of the midwife and the obstetrician in obstetric critical care - a case study from the James Cook University Hospital.

    PubMed

    Simpson, Helen; Barker, Debbie

    2008-10-01

    The role of the obstetrician and the midwife are fundamental to the successful antenatal management, delivery and postpartum management of the critically ill obstetric patient. However, there is a dearth of published literature on the integrated management of these roles. This chapter addresses these issues by reporting on experiences at James Cook University Hospital in developing a more holistic approach to patient management and critical care through appraisal of these roles, and resulting extension of the role of the midwife to encompass physiological assessment, understanding the effects of pregnancy on disease, interpretation of, and acting on, blood results including arterial gases, and development of the service through the development of guidelines and undertaking audits. The role of the midwife has been extended taking an overview of critical care of the mother, baby and family. The resulting development of the role of the obstetrician encompasses leadership, clinical knowledge, documentation, guideline development, risk management and the communication functions of debrief, audit and education. Development of the roles has reduced admissions to intensive care and increased patient satisfaction and adherence to policies at James Cook University Hospital. This paper provides a critical appraisal of this role development and discusses some of the lessons learned.

  8. [Frequency and antimicrobial resistance of Acinetobacter species in a university hospital of Buenos Aires City].

    PubMed

    Rodríguez, Carlos Hernán; Nastro, Marcela; Dabos, Laura; Vay, Carlos; Famiglietti, Angela

    2014-01-01

    Two-hundred Acinetobacter isolates belonging to 200 patients admitted to Hospital de Clínicas José de San Martín during the period March 2013-June 2014 were analyzed. The identification was performed by mass spectrometry and was confirmed by molecular methods. Susceptibility to antimicrobials was studied by the Vitek-2 system. A 94% correlation of both identification methods was found. Multidrug resistant Acinetobacter baumannii was the predominant genomic species (92.6%) in hospital-acquired infections, whereas Acinetobacter pitti and Acinetobacter nosocomialis accounted for 3.5% and 0.5% of the isolates recovered, respectively. In community-acquired infections a major predominance of the different genomic species was observed. Acinetobacter johnsonii and A. baumannii are the most frequent species, accounting for 45.9% of the isolates recovered. Resistance to carbapenems and minocycline was only observed in A. baumannii. Mass spectrophotometry was an effective tool for the identification of the different genomic species.

  9. An assessment of internship at the teaching hospitals of the University of the Witwatersrand.

    PubMed

    Touyz, R M; Kelly, A; Tollman, S; Milne, F J

    1988-08-20

    Medical internship can be a physically exhausting and emotionally traumatic experience. This study assesses various aspects of internship, including continuing medical education, workload and stress, at the five Johannesburg teaching hospitals during 1985 and 1986. Data were analysed from a confidential questionnaire. Eighty-two interns completed the questionnaire at the end of 1985 and 120 at the end of 1986. Problem areas defined were excessive patient load, sleep deprivation and severe stress. The commonest symptoms of stress were fatigue, irritability and weight loss. In 1985, 53% of interns stated that they could not cope, and in 1986 this increased to 65%. Forty-eight per cent of 1985 and 69% of 1986 interns lost interest in medicine during their intern year. The implications of these results are discussed and the importance and impact on the medical profession and hospital services analysed.

  10. Intranet and HTML at a major university hospital--experiences from Munich.

    PubMed

    Dugas, M

    1997-01-01

    Intranet-technology is the application of Internet-Tools in local networks. With this technique electronic information systems for large hospitals can be realized very easily. This technology has been in routine use in 'Klinikum Grosshadern' for more than one year on over 50 wards and more than 200 computers. The following clinical application areas are described: drug information, nursing information, electronic literature retrieval systems, multimedia teaching und laboratory information systems.

  11. [What Has Been Done in Surugadai Nihon University Hospital as a Laboratory Physician--Encounter with FAB Classification and Establishing the Additional Laboratory Management Fee].

    PubMed

    Tsuchiya, Tatsuyuki

    2015-02-01

    I was requested by Nihon University to contribute to the official journal of the Japanese Society of Laboratory Medicine (Rinsho Byori). A special review of the final lecture at Surugadai Nihon University Hospital was requested by the editorial board of the Japanese Society of Laboratory Medicine. I submitted a review under the heading of "I have carried out upon retirement, ..." based on the final lecture at Surugadai Nihon University Hospital. The contents of the lecture were how to widely disseminate the FAB classification of acute leukemia and how to establish an additional laboratory management fee. Finally, I showed how to charge an additional management fee correctly based on a laboratory physician's activities in Surugadai Nihon University Hospital. I summarize the lecture in this article. PMID:26529971

  12. [Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

    PubMed

    Kawanishi, Chiaki

    2016-01-01

    In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate

  13. Modelling the Costs and Effects of Selective and Universal Hospital Admission Screening for Methicillin-Resistant Staphylococcus aureus

    PubMed Central

    Hubben, Gijs; Bootsma, Martin; Luteijn, Michiel; Glynn, Diarmuid; Bishai, David

    2011-01-01

    Background Screening at hospital admission for carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been proposed as a strategy to reduce nosocomial infections. The objective of this study was to determine the long-term costs and health benefits of selective and universal screening for MRSA at hospital admission, using both PCR-based and chromogenic media-based tests in various settings. Methodology/Principal Findings A simulation model of MRSA transmission was used to determine costs and effects over 15 years from a US healthcare perspective. We compared admission screening together with isolation of identified carriers against a baseline policy without screening or isolation. Strategies included selective screening of high risk patients or universal admission screening, with PCR-based or chromogenic media-based tests, in medium (5%) or high nosocomial prevalence (15%) settings. The costs of screening and isolation per averted MRSA infection were lowest using selective chromogenic-based screening in high and medium prevalence settings, at $4,100 and $10,300, respectively. Replacing the chromogenic-based test with a PCR-based test costs $13,000 and $36,200 per additional infection averted, and subsequent extension to universal screening with PCR would cost $131,000 and $232,700 per additional infection averted, in high and medium prevalence settings respectively. Assuming $17,645 benefit per infection averted, the most cost-saving strategies in high and medium prevalence settings were selective screening with PCR and selective screening with chromogenic, respectively. Conclusions/Significance Admission screening costs $4,100–$21,200 per infection averted, depending on strategy and setting. Including financial benefits from averted infections, screening could well be cost saving. PMID:21483492

  14. [University professors in the Soviet Occupation Zone and the German Democratic Republic up to 1961: Academic alternation of generations at university psychiatric hospitals].

    PubMed

    Kumbier, E; Haack, K

    2015-05-01

    After WWII a politically guided staffing policy foresaw an exchange program for professors from the Soviet Occupation Zone and the German Democratic Republic (GDR). In the field of medicine this initiative was not successful. With respect to university psychiatric/neurological hospitals this experiment failed as a result of a shortage of personnel due to the consequences of war, denazification and people migrating into western occupation zones. Criteria for politically selecting promising young talent which had been propagated by the Socialist Unity Party of Germany (Sozialistische Einheitspartei Deutschlands, SED) were thus not relevant in academic medicine until 1961; however, the communist rulers had great interest in bringing professional and academic resources up to date. Politically implicated representatives in the field were also included in this process. At the forefront was the interest in functioning medical care and education in order to be able to train much needed health professionals. At the end of the 1950s a new generation of professors was established at the university hospitals. This generation rotation demonstrated the politically intended replacement of the "old" professor generation and the transition to a new GDR generation that had been trained after 1945. This second generation of professors inherited vacant professorships and defined and shaped research and academia until the end of the GDR much more than the previous generation had and also more than the one that followed. The generation of professors continued to feel a strong affiliation with their academic teachers and consequently continued their tradition in the sense of a school, for the most part independent of political circumstances.

  15. [History of the University of Chile Faculty of Medicine and clinical hospital location].

    PubMed

    Osorio A, Carlos G

    2015-02-01

    The history of the location of the University of Chile Faculty of Medicine North Campus is derived from a farm of Pedro de Valdivia founder of the city of Santiago de la Nueva Extremadura and governor of the “Reyno de Chile”. This work narrates succinctly the history of this particular location from the Spanish Conquest period to present days.

  16. Evaluating Usability of Radiology Information Systems in Hospitals of Tabriz University of Medical Sciences

    PubMed Central

    Rezaei-Hachesu, Peyman; Pesianian, Esmaeil; Mohammadian, Mohsen

    2016-01-01

    Introduction and purpose: Radiology information system (RIS) in order to reduce workload and improve the quality of services must be well-designed. Heuristic evaluation is one of the methods that understand usability problems with the least time, cost and resources. The aim of present study is to evaluate the usability of RISs in hospitals. Research Method: This is a cross-sectional descriptive study (2015) that uses heuristic evaluation method to evaluate the usability of RIS used in 3 hospitals of Tabriz city. The data are collected using a standard checklist based on 13 principles of Nielsen Heuristic evaluation method. Usability of RISs was investigated based on the number of components observed from Nielsen principles and problems of usability based on the number of non-observed components as well as non-existent or unrecognizable components. Results: by evaluation of RISs in each of the hospitals 1, 2 and 3, total numbers of observed components were obtained as 173, 202 and 196, respectively. It was concluded that the usability of RISs in the studied population, on average and with observing 190 components of the 291 components related to the 13 principles of Nielsen is 65.41 %. Furthermore, problems of usability were obtained as 26.35%. Discussion and Conclusion: The established and visible nature of some components such as response time of application, visual feedbacks, colors, view and design and arrangement of software objects cause more attention to these components as principal components in designing UI software. Also, incorrect analysis before system design leads to a lack of attention to secondary needs like Help software and security issues. PMID:27041810

  17. Is anticoagulation required in plasmapheresis? A University Hospital Experience in Bogota, Colombia.

    PubMed

    Córdoba, Juan Pablo; Larrarte, Carolina; Ruiz, Alvaro

    2013-06-01

    Anticoagulation has been considered essential during plasmapheresis. International publications and guidelines state that anticoagulation should be administered during therapy to avoid circuit clotting and impaired effectiveness. However, anticoagulation has also been associated with bleeding, fluid and electrolyte imbalances and hematological alterations. No published studies have looked at the risk to benefit ratio of the common practice of circuit anticoagulation. We describe the experience with 367 plasmapheresis sessions, in the Hospital Universitario San Ignacio, a tertiary care center in Bogota, Colombia, where no anticoagulation is used in any case. Patient characteristics and therapy complications are described. Coagulation of circuit was never reported.

  18. Molecular epidemiology of methicillin-resistant Staphylococcus aureus in a university hospital in northwestern Spain.

    PubMed

    Ariza-Miguel, Jaime; Hernández, Marta; Fernández-Natal, Isabel; Rodríguez-Lázaro, David

    2014-09-01

    Continuous monitoring of methicillin-resistant Staphylococcus aureus (MRSA) is necessary to understand the clonal evolution of successful lineages. In this study, we identified the MRSA clones circulating in a Spanish hospital during a 2-year period, assessed their relationship with antimicrobial resistance profiles, and investigated the presence of the emerging community-associated and livestock-associated MRSA lineages (CA-MRSA, LA-MRSA). CC5-MRSA-IV isolates were the most frequently recovered, which supports the previously reported prevalence of this clone in Spanish hospitals. We observed ST125 isolates that harbored specific cassette chromosome recombinase (ccr) gene elements of the staphylococcal cassette chromosome mec (SCCmec) types IV and VI. That clone, which was first detected only recently, has increased resistance to erythromycin. Furthermore, 94% of the infections were caused by non-multiresistant isolates. Neither CA-MRSA nor LA-MRSA isolates were observed. These findings, along with related events over the last decade, suggest the establishment of a clonal endemic population in the Spanish clinical environment. PMID:26419454

  19. Detection of Neisseria meningitidis in asymptomatic carriers in a university hospital from Brazil.

    PubMed

    Coch Gioia, Carolina A; Silva de Lemos, Ana P; Outeiro Gorla, Maria C; Mendoza-Sassi, Raul A; Ballester, Teresa; Von Groll, Andrea; Wedig, Bruna; Ethur, Nathalia de Vargas; Bragança, Letícia; Milagres, Lucimar Gonçalves; Almeida da Silva, Pedro E

    2015-01-01

    Asymptomatic meningococcus carriers in hospitals is a risk factor for acquiring meningococcal disease. Meningococcal carrier (MC) frequency was investigated in oropharyngeal swab samples collected from 200 staff members at a teaching hospital from Brazil. MC prevalence was 9% (95% CI 5-13%). Risk factors associated with MC were: mean age of 26.5 years, male gender, bar attendance frequency and number of persons/house. Of 18 isolated meningococcal strains, 14 were non-group able (NG), 3 corresponded to serogroup B and 1 to serogroup 29E. The frequency of serotypes and serosubtypes was heterogenous, with a slight predominance of serotypes 4 and 7 and serosubtypes P1.7 and P1.5. Most strains (n=13) were susceptible to the antimicrobials tested. The ctrA gene (PCR) was identified in 9 (64.3%) of the 14 NG strains, suggesting virulence in most of the NG isolated strains. Therefore, a constant surveillance of these asymptomatic carriers is required.

  20. 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

  1. A significant and consistent reduction in rotavirus gastroenteritis hospitalization of children under 5 years of age, following the introduction of universal rotavirus immunization in Israel.

    PubMed

    Muhsen, Khitam; Rubenstein, Uri; Kassem, Eias; Goren, Sophy; Schachter, Yaakov; Kremer, Adi; Shulman, Lester M; Ephros, Moshe; Cohen, Dani

    2015-01-01

    Universal rotavirus vaccination with RotaTeq was introduced in Israel in December 2010. We examined hospitalization rates of children under 5 years of age due to all-cause and rotavirus gastroenteritis, both before and 3 years after universal introduction of the vaccination. An ongoing hospital-based surveillance network that was established in November 2007, accessed information regarding hospitalization of children due to gastroenteritis (n = 6205) in 3 hospitals in northern Israel, with an annual average of about 60,000 children under 5 years of age living in the catchment area of these hospitals. Stool samples were tested for rotavirus by immunochromatography. Compared to the period preceding implementation of the universal rotavirus vaccination (2008-2010), hospitalizations due to rotavirus gastroenteritis in children <5 years of age decreased significantly, by 55% (95% CI 43%-67%) during the period of universal vaccination (2011-2013), a decrease that was sustained throughout the 3 year period. This reduction was greater in children aged 0-23 months (60-61%) than in toddlers aged 24-59 months (36%). A 32% (95% CI 21%-45%) decrease in the incidence of all-cause gastroenteritis was also observed. During the period preceding universal vaccination, rotavirus diarrhea showed typical winter seasonality, with highest incidence in December. However, the winter peak was substantially blunted during the period of universal immunization. Surveillance of rotavirus gastroenteritis should continue to assess the long-term impact of such a program. Our findings are of relevance to high and middle-income countries considering the introduction of a universal rotavirus immunization program.

  2. Performance of Bedside Diagnostic Ultrasound in an Ebola Isolation Unit: The Emory University Hospital Experience

    PubMed Central

    Moreno, Courtney C.; Kraft, Colleen S.; Vanairsdale, Sharon; Kandiah, Prem; Klopman, Matthew A.; Ribner, Bruce S.; Tridandapani, Srini

    2015-01-01

    OBJECTIVE Individuals with Ebola virus disease, a contagious and potentially lethal infection, are now being treated in specialized units in the United States. We describe Emory University's initial experience, current operating procedures, and ongoing planning with diagnostic ultrasound in the isolation unit. CONCLUSION Ultrasound use has been limited to date. Future planning considerations include deciding what types of ultrasound studies will be performed, which personnel will acquire the images, and which ultrasound machine will be used. PMID:25730332

  3. Trend and forecasting rate of cancer deaths at a public university hospital using univariate modeling

    NASA Astrophysics Data System (ADS)

    Ismail, A.; Hassan, Noor I.

    2013-09-01

    Cancer is one of the principal causes of death in Malaysia. This study was performed to determine the pattern of rate of cancer deaths at a public hospital in Malaysia over an 11 year period from year 2001 to 2011, to determine the best fitted model of forecasting the rate of cancer deaths using Univariate Modeling and to forecast the rates for the next two years (2012 to 2013). The medical records of the death of patients with cancer admitted at this Hospital over 11 year's period were reviewed, with a total of 663 cases. The cancers were classified according to 10th Revision International Classification of Diseases (ICD-10). Data collected include socio-demographic background of patients such as registration number, age, gender, ethnicity, ward and diagnosis. Data entry and analysis was accomplished using SPSS 19.0 and Minitab 16.0. The five Univariate Models used were Naïve with Trend Model, Average Percent Change Model (ACPM), Single Exponential Smoothing, Double Exponential Smoothing and Holt's Method. The overall 11 years rate of cancer deaths showed that at this hospital, Malay patients have the highest percentage (88.10%) compared to other ethnic groups with males (51.30%) higher than females. Lung and breast cancer have the most number of cancer deaths among gender. About 29.60% of the patients who died due to cancer were aged 61 years old and above. The best Univariate Model used for forecasting the rate of cancer deaths is Single Exponential Smoothing Technique with alpha of 0.10. The forecast for the rate of cancer deaths shows a horizontally or flat value. The forecasted mortality trend remains at 6.84% from January 2012 to December 2013. All the government and private sectors and non-governmental organizations need to highlight issues on cancer especially lung and breast cancers to the public through campaigns using mass media, media electronics, posters and pamphlets in the attempt to decrease the rate of cancer deaths in Malaysia.

  4. [Staff-patient meetings at the psychiatric unit of a university hospital center].

    PubMed

    Gelin, E; Havet, J M; Wargny-Citti, E; Lesage, V; Pascalis, G

    1987-10-01

    Staff/patients meetings have been held for 10 years within a mental teaching hospital for adults. The meeting was initiated by a clinical psychologist still in charge of it. The patients have developed the following themes: (i) entrance conditions, (ii) everyday life information, (iii) inconveniences, (iv) mental illness, (v) the exclusion process. The least severely affected patients will exclude the other ones on ground of insanity. Yet all patients consider themselves banned from society, and even feel rejected by the stall at times. The meeting is meant as a regular talk scène. Individual or collective conflicts arising between the patients can be settled there. Patient passivity may also be counteracted. Staff seminar should work up clearly the data provided by the meeting.

  5. Fireworks related injuries during Hari Raya festival in Hospital Universiti Sains Malaysia--1986 to 1990.

    PubMed

    Isa, A R; Moe, H

    1991-12-01

    A total of 38 cases of fireworks related injuries from Hospital USM over a 5-year period from 1986 to 1990 during Hari Raya festival were analysed. The majority (68.5%) of the patients were teenagers, between 10 to 19 years of age. All the cases were Malays and most of the accidents occurred before the Hari Raya Idilfitri festive seasons. Fourteen cases were caused by self-made fireworks and another 16 cases were due to modified fire-works. Twenty-four cases suffered permanent disabilities mostly finger amputations. Such injuries could be prevented by law enforcement coupled with public health education to modify social behaviour especially when the ban against the use of fireworks is lifted on religious grounds.

  6. Soccer-related Facial Trauma: Multicenter Experience in 2 Brazilian University Hospitals

    PubMed Central

    Dini, Gal M.; Pereira, Max D.; Gurgel, Augusto; Bastos, Endrigo O.; Nagarkar, Purushottam; Gemperli, Rolf; Ferreira, Lydia M.

    2014-01-01

    Background: Soccer is the most popular sport in Brazil and a high incidence of related trauma is reported. Maxillofacial trauma can be quite common, sometimes requiring prolonged hospitalization and invasive procedures. To characterize soccer-related facial fractures needing surgery in 2 major Brazilian Centers. Methods: A retrospective review of trauma medical records from the Plastic Surgery Divisions at the Universidade Federal de São Paulo–Escola Paulista de Medicina and the Hospital das Clinicas–Universidade de São Paulo was carried out to identify patients who underwent invasive surgical procedures due to acute soccer-related facial fractures. Data points reviewed included gender, date of injury, type of fracture, date of surgery, and procedure performed. Results: A total of 45 patients (31 from Escola Paulista de Medicina and 14 from Universidade de São Paulo) underwent surgical procedures to address facial fractures between March 2000 and September 2013. Forty-four patients were men, and mean age was 28 years. The fracture patterns seen were nasal bones (16 patients, 35%), orbitozygomatic (16 patients, 35%), mandibular (7 patients, 16%), orbital (6 patients, 13%), frontal (1 patient, 2%), and naso-orbito-ethmoid (1 patient, 2%). Mechanisms of injury included collisions with another player (n = 39) and being struck by the ball (n = 6). Conclusions: Although it is less common than orthopedic injuries, soccer players do sustain maxillofacial trauma. Knowledge of its frequency is important to first responders, nurses, and physicians who have initial contact with patients. Missed diagnosis or delayed treatment can lead to facial deformities and functional problems in the physiological actions of breathing, vision, and chewing. PMID:25289361

  7. Antimicrobial stewardship auditing of patients reviewed by infectious diseases physicians in a tertiary university hospital

    PubMed Central

    2013-01-01

    Background The optimal way for antimicrobial stewardship programs (ASPs) to interact with existing infectious disease physician (IDP) services within the same institution is unknown. In our institution, IDPs and our prospective audit and feedback ASP operate independently, with occasionally differing recommendations offered for the same inpatient. We performed a retrospective audit on inpatients that had been reviewed by both IDPs and ASP within a 7-day period, focusing on cases where different therapy-modifying recommendations had been offered. We analyzed the outcomes in inpatients where the ASP recommendations were accepted and compared these with the inpatients where the IDP recommendations were accepted instead. Outcomes assessed were 30-day mortality post-ASP review, unplanned re-admission within 30 days post-discharge from hospital, and clinical deterioration at 7 days post-ASP review. Findings There were 143 (18.9%) patients where differing recommendations had been offered, with primary physicians accepting 69.9% of ASP recommendations. No significant differences in terms of demographics, clinical characteristics, 30-day mortality, and re-admission rates were observed, although clinical deterioration rates were lower in patients where the ASP recommendation was accepted (8.0% vs. 27.9%; p = 0.002). On multivariate analysis, hematology-oncology inpatients were associated with unplanned readmission. Increasing age and hematology-oncology inpatients were associated with clinical deterioration 7 days post-recommendation, whereas acceptance of ASP recommendations was protective. No characteristic was independently associated with 30-day mortality. Conclusion In conclusion, independent reviews by both IDPs and ASPs can be compatible within large tertiary hospitals, providing primary physicians even in situations of conflicting recommendations viable alternative antimicrobial prescribing advice. PMID:24176042

  8. Epidemiology of carbapenem-resistant Klebsiella pneumoniae colonization: a surveillance study at a Turkish university hospital from 2009 to 2013.

    PubMed

    Zarakolu, Pinar; Eser, Ozgen Koseoglu; Aladag, Elifcan; Al-Zahrani, Ibrahim A; Day, Kathryn M; Atmaca, Ozgur; Boral, Baris; Cakir, Banu; Perry, John D; Akova, Murat

    2016-08-01

    Between June 2009 and December 2013, 4105 patients were screened for carbapenem-resistant Klebsiella pneumoniae (CR-Kp) colonization in a tertiary care university hospital. The antimicrobial susceptibility and resistance determinants of 279 (6.8%) CR-Kp isolates from single patients were investigated. Additional analysis was performed to evaluate the characteristics and various risk factors for infection in patients with colonization. Of the 279 isolates, 270 harboured OXA-48-like enzymes, and a single isolate harboured IMP-type carbapenemase. A high proportion of isolates were susceptible to carbapenems - except ertapenem. All isolates were susceptible to amikacin and most (94%) were susceptible to colistin and fosfomycin. There was consistent high-level resistance for all isolates to temocillin, piperacillin-tazobactam, amoxicillin-clavulanate and ticarcillin-clavulanate. When colonized and infected patients were compared, only prior carbapenem administration (P = 0.003), was found to be significantly associated with patients with CR-Kp infection. PMID:27306118

  9. Determining Optimal Nursing Resources in Relation to Functions During the Oulu University Hospital Nurse Staffing Management Project.

    PubMed

    Liljamo, Pia; Lavander, Päivi; Kejonen, Pirjo

    2016-01-01

    The Oulu University Hospital's staffing management project sought information on the number of nursing staff in relation to treatment days and visits, using existing indicators to describe the activities involved. The retrospective data obtained was compared to human resources and the personnel structure. On this basis an optimal number of staff was determined for the units, taking account of a range of explanatory indicator data. The project made use of the computational model for nurse staffing and the World Health Organisation's (WHO) Workload Indicators of Staffing Need (WISN) method. The project provided extensive information on human resources issues within the units. Its results indicated the differences between wards with respect to the number and structure of resources. In addition, the nurse administrators lacked skills in gathering and using data from administrative datasets. This information will provide support for the further development of nursing operations and nursing management decision-making. PMID:27332151

  10. Pregnancy outcome after cerclage for cervical incompetence at the University of Port Harcourt Teaching Hospital, Port Harcourt.

    PubMed

    Ikimalo, John I; Izuchukwu, Kenneth E; Inimgba, Nestor

    2012-09-01

    Cervical incompetence is often associated with mid trimester pregnancy losses and preterm labour. cervical cerclage to prevent miscarriage and preterm labour is practiced world wide. The objective of this study was to document the feto-maternal outcome following cervical cerclage for cervical incompetence. The study reviewed all case files of pregnant women who had cervical cerclage for cervical incompetence between January 1, 2004 to December 31, 2008, at the University of Port Harcourt Teaching Hospital. The study found an incidence of 0.17% of cervical incompetence among the antenatal population. Following cervical cerclage, miscarriage rate was 9.4%. Preterm delivery occurred in 21.8% while term pregnancy occurred in 68.8% of the women. There is improvement in pregnancy outcome after cervical cerclage for cervical incompetence hence we recommend the insertion for true cases of cervical incompetence.

  11. Use of pressurised aerosol inhalers among patients attending the Chest Clinic and Primary Care Department of University Hospital, Kuala Lumpur.

    PubMed

    Liam, C K; Lo, Y L; Yap, B H; Low, S H; Ariwalagam, M

    1993-09-01

    Eighty consecutive patients who came to collect their prescriptions for pressurised aerosol inhalers at the Pharmacy of the University Hospital, Kuala Lumpur, were interviewed regarding their use of the pressurised inhaler. Their inhaler technique was also assessed. A significant proportion inhaled the steroid aerosol before the bronchodilator and 23.5% used the steroid inhaler for relief of acute dyspnoea. Only 28.8% of the 80 patients performed correctly all 6 steps necessary for the proper use of inhalers. The most common mistake was the failure to inhale slowly and deeply. Patients who had used the device for more than 5 years performed better, while correct inhaler technique was not dependent on the patient's sex, age or level of education.

  12. Infections due to beta-lactamase-producing Neisseria gonorrhoeae at the University Hospital Medical Center, Kuala Lumpur, Malaysia.

    PubMed

    Ismail, R

    1987-01-01

    The incidence of infections due to beta-lactamase-producing Neisseria gonorrhoeae is increasing in many parts of the world. An epidemiologic survey of infections caused by beta-lactamase-producing strains of N. gonorrhoeae at the University Hospital, Kuala Lumpur, from February 1977 to December 1985 (106 months) showed that the incidence rose from 4.8% (two cases) in 1977 to 49.4% (39 cases) by the end of 1985. The highest incidence of gonococcal infections was found to be in the group aged 20-39 years; the male-to-female ratio was 1.55:1. The mean inhibitory concentrations of benzylpenicillin were 0.12 microgram/ml for non-beta-lactamase-producing strains and 16 micrograms/ml for isolates of N. gonorrhoeae that produce beta-lactamase.

  13. Profile of patients receiving medical care at a reference, support, and treatment center for psoriasis patients at a university hospital*

    PubMed Central

    Cordeiro Júnior, Túlio Germano Machado; Andrade, Bruno D' Paula; Palitot, Esther Bastos; Piuvezam, Márcia Regina; Mascarenhas, Sandra Rodrigues

    2016-01-01

    Psoriasis is a chronic, inflammatory, immune-mediated disease affecting 1-3% of the population worldwide. This work seeks to draw a profile of patients with psoriasis, analyzing socioeconomic, anthropometric, and clinical aspects. For this, medical records from 81 individuals who received medical care in a university hospital in 2014 were consulted. It was observed that the patients were mostly dark-skinned black adult men, with a low education level and a low income, who were sedentary, former smokers, obese, with an increase in waist circumference, and who did not consume alcohol. Psoriasis vulgaris predominated, beginning mainly on the scalp, hands, and feet. In addition, many presented some type of associated comorbidity and had relatives with psoriasis.

  14. Computer tools to support collaborative organization design: definition and analysis of the work at the Vanderbilt University Hospital and Clinic.

    PubMed Central

    Sittig, D. F.

    1994-01-01

    In November, 1993 The Vanderbilt University Hospital and Clinic (VUH/TVC) convened a 10-member Collaborative Organization Design (COD) team that represented a diagonal slice through the organization. This team, lead by Gelinas & James, an outside consulting firm, was charged to develop, recommend, and implement a new organizational design which would promote a stronger patient focus, increased efficiency, and lower costs. The COD process is structured to inspire and enable employees to rebuild their organization so that it can respond to the challenges and opportunities that exist within their environment, to customer needs, and their own aspirations. This manuscript describes several of the computer tools which were utilized in the definition and analysis of the work of patient care at VUH/TVC. Specific examples of the findings from this phase of the work are utilized to illustrate their use and value. PMID:7949956

  15. Factors determining the choice of contraceptive methods at the Family Planning Clinic, University College Hospital, Ibadan, Nigeria.

    PubMed

    Konje, J C; Oladini, F; Otolorin, E O; Ladipo, O O

    1998-10-01

    In a study of 2000 women volunteers seeking contraceptive services at the Family Planning Clinic (FPC), University College Hospital, Ibadan, Nigeria, 66.2 per cent chose the intrauterine device (IUD) making it the most common method of contraception. Factors influencing choice of contraceptive methods were advice from friends and family members, intended duration of use and information from the media. Ignorance, fear and unfounded cultural beliefs were factors responsible for the delay in seeking contraceptive advice. The mass media was an important source of information for most of the women. We conclude that the IUD is the contraceptive of choice in our clinic because of the highly selective nature of our clients. In order to provide a service with a broader clientele, we suggest the incorporation of other priority reproductive health services such as cervical and breast cancer screening, prevention and treatment of reproductive tract infections and sexually transmitted diseases including HIV/AIDS.

  16. Serratia marcescens-contaminated baby shampoo causing an outbreak among newborns at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

    PubMed

    Madani, T A; Alsaedi, S; James, L; Eldeek, B S; Jiman-Fatani, A A; Alawi, M M; Marwan, D; Cudal, M; Macapagal, M; Bahlas, R; Farouq, M

    2011-05-01

    During November 2008 to January 2009, 11 babies in the neonatal intensive care (NICU) and three babies in the nursery were infected with Serratia marcescens at King Abdulaziz University Hospital in Saudi Arabia. Overall, fifteen infections were identified among 11 newborns in the NICU: septicaemia (five cases), purulent conjunctivitis (three), urinary tract infection (two), meningitis (two) and cellulitis (one). Three newborns in the nursery had three infections: purulent conjunctivitis (two cases) and omphalitis (one). Thirteen of 14 babies recovered fully but one died from S. marcescens meningitis and septicaemia. All infections were traced to intrinsically contaminated baby shampoo introduced to the units five days before the first reported case. The outbreak terminated following withdrawal of the shampoo product.

  17. Factors determining the choice of contraceptive methods at the Family Planning Clinic, University College Hospital, Ibadan, Nigeria.

    PubMed

    Konje, J C; Oladini, F; Otolorin, E O; Ladipo, O O

    1998-10-01

    In a study of 2000 women volunteers seeking contraceptive services at the Family Planning Clinic (FPC), University College Hospital, Ibadan, Nigeria, 66.2 per cent chose the intrauterine device (IUD) making it the most common method of contraception. Factors influencing choice of contraceptive methods were advice from friends and family members, intended duration of use and information from the media. Ignorance, fear and unfounded cultural beliefs were factors responsible for the delay in seeking contraceptive advice. The mass media was an important source of information for most of the women. We conclude that the IUD is the contraceptive of choice in our clinic because of the highly selective nature of our clients. In order to provide a service with a broader clientele, we suggest the incorporation of other priority reproductive health services such as cervical and breast cancer screening, prevention and treatment of reproductive tract infections and sexually transmitted diseases including HIV/AIDS. PMID:9855717

  18. Hepatitis C virus infection and risk factors in health-care workers at Ain Shams University Hospitals, Cairo, Egypt.

    PubMed

    Okasha, O; Munier, A; Delarocque-Astagneau, E; El Houssinie, M; Rafik, M; Bassim, H; Hamid, M Abdel; Mohamed, M K; Fontanet, A

    2015-03-01

    The objectives of this study were to document the background prevalence and incidence of HCV infection among HCWs in Ain Shams University Hospitals in Cairo and analyse the risk factors for HCV infection. A cross-sectional survey was conducted in 2008 among 1770 HCWs. Anti-HCV prevalence was age-standardized using the Cairo population. A prospective cohort was followed for a period of 18 months to estimate HCV incidence. The crude anti-HCV prevalence was 8.0% and the age-standardized seroprevalence was 8.1%. Risk factors independently associated with HCV seropositivity were: age, manual worker, history of blood transfusions and history of parenteral anti-schistosomiasis treatment. The estimated incidence of HCV infection was 7.3 per 1000 person-years. HCWs in this setting had a similar high HCV seroprevalence as the general population of greater Cairo.

  19. [Epidemiology, microbiology, and outcomes of septicemia in children treated at the Charles de Gaulle University Pediatric Hospital in Burkina Faso].

    PubMed

    Ouédraogo, Abdoul-Salam; Dakouré-Kissou, Aimée; Poda, Gandaaza Euthyme Armel; Koueta, Fla; Yé-Ouattara, Diarra; Ouédraogo-Traoré, Rasmata

    2011-01-01

    The aim of this study is to describe the epidemiological and microbiological characteristics and outcome of children with septicemia at the Charles de Gaulle University Pediatric Hospital of Ouagadougou to help improve probabilistic antibiotic therapy in this type of infection. This retrospective descriptive study covered all the children from 0 to 15 years old seen over a period of 7 years in any hospital department with suspected bacteriemia and for whom the bacteriology laboratory performed a blood culture. During the study period, the laboratory received 842 requests for blood cultures and found 154 (18.3%) of them to be positive. Files for 81 of the 154 patients could be found and examined. The distribution according to age showed septicemia was most frequent among those aged 6-15 years (61.7% of the cases). Microbial identification showed the dominant species to be Salmonella enterica (serovars paratyphi and typhi) (58%) followed by Staphylococcus aureus (12.3%). The salmonella isolates had a high rate of resistance to amoxicillin, chloramphenicol and cotrimoxazole. Staphylococci were always sensitive to the antibiotics with which they were tested, although to a lesser extent for penicillin G. All patients routinely received antibiotic treatment, and 81.5% (n=66) were cured (5 children died and 10 left the hospital against medical advice). This study shows that the bacterial epidemiology of septicemia in our setting is dominated by salmonella. Trends in bacterial resistance to antibiotics showed that common antibiotics such as amoxicillin and cotrimoxazole are no longer acceptable as probabilist therapy here. They should be replaced in this type of infection by injectable third generation cephalosporin alone or combined with aminoglycosides.

  20. Prevalence of Non-drug Poisoning in Patients Admitted to Hospitals of Mazandaran University of Medical Sciences, 2010-2011

    PubMed Central

    Mohseni Saravi, Benyamin; kabirzadeh, Azar; Asghari, Zolaykha; Reza Zadeh, Ismaeil; Bagherian Farahabbadi, Ebrahim; Siamian, Hasan

    2013-01-01

    Introduction: Every year million people have poisoning. Most of them will duo to severity of complications. Identifying the pattern of poisoning will help to prevent of them. Because of the non-medicine substance have a wide variety range and easily is used among people, so the aim of this study was to determine frequency of non-medicinal poisoning according to 10th revision of International Classification of Diseases (ICD-10) in hospitalized patient. Method: This is a descriptive cross section study. The medical records of inpatient hospitalized in hospitals of Mazandaran University of Medical Sciences during 2010-2011 were reviewed. The ICD-10 codes for retrieval patient records were T51-T65 which was included alcohol, organic solvent, halogen derivatives, corrosive substance, detergent, metals, inorganic substance, carbon monoxide, gases, fumes and vapors, pesticide, noxious substance has eaten as seafood, noxious substance has eaten as food, unspecified substances. The data were analyzed with SPSS and descriptive and X2 statistics. Results: Of the 1546 in patient with diagnosed poisoning, the 581(37.5%) were non medicine poisoning. Median of age 29±17 years, 231(51.6%) female, 300(51.6%) are intentional, and the most material were insecticide276 (47.5%), sting 96(16.3%) and alcohol 76(13%) and organic solvent 40 cases and the 38(95%) of them was children. Conclusion: According the result of this study the most cause of poisoning was insecticides. Preventive program for all the groups are suggested and for intentional self-harms and suicide attempted the program of consultation is necessary. PMID:24167390

  1. Impacts of outsourcing in educational hospitals in Iran: A study on Isfahan University of Medical Sciences-2010

    PubMed Central

    Karimi, Saeed; Agharahimi, Zahra; Yaghoubi, Maryam

    2012-01-01

    Purpose: Outsourcing in healthcare is a cost-effective strategy that can lead to increase services quality. The aim of this study was to determine the types of services that have been outsourced in educational hospitals in Isfahan and to investigate managers’ view about the impact of Outsourcing. Design/Methodology/Approach: A descriptive-survey study carried out in 2010. Our samples consisted of 100 educational hospital and treatment deputy senior managers of Isfahan University of Medical Sciences and 53 usable questionnaires were received. Survey instrument main points were the extent to which educational hospital outsource services and the impact of Outsourcing. Reliability and validity of the questionnaire have been verified. Data are analyzed with SPSS18 software. Findings: The results for medical-diagnostics services showed physiotherapy, radiology, and ultrasound that have the highest rate (33%) of being outsourced. Between logistic and administrative activities, housekeeping, and facility engineering maintenance services are the highest rate of outsourced (100%) and green space, CSR, laundry, and medical records are the lowest rate of outsourced (16%). In managers’ view, in relation to advantages of outsourcing, pay more attention to internal and external customers in private sector (57.2%) was the highest. In relation to disadvantages of outsourcing, costs increase for the patients (45.6%) was the highest. In relation to barriers of outsourcing, forgetting the goal of outsourcing (efficiency) (60.6%) was the highest. Conclusion: Finally, managers’ views about outsourcing in health services organizations were rather acceptable, but in their views, there are barriers in implementation of outsourcing and they are focused on removing the barriers before outsourcing. Fundamental infrastructure developments as making competing market, promoting of cultures, education, modifying the management attitude and approach, and establishing incentive policies are

  2. Rates of and Experiences with Corneal Donation at the University Hospital Tübingen From 2002 To 2015.

    PubMed

    Röck, Daniel; Bartz-Schmidt, Karl Ulrich; Röck, Tobias

    2016-01-01

    BACKGROUND This study aimed to report the rates and experiences of corneal donation at the University Hospital Tübingen. MATERIAL AND METHODS Data from all cornea donors from January 2002 to December 2015 were analyzed. The rates of corneal donation were examined. From 2002 to 2008, an ophthalmic resident handled the corneal donor procurement in addition to his ward work. From 2009 to 2015, an ophthalmic resident handled the corneal donor procurement on a full-time basis. RESULTS Among the 10 260 deaths, consent for corneal donation was obtained in 892 cases. The mean annual corneal donation rate was 8.7 donors per 100 deaths (range: 2.0-17.8). The mean corneal donation rate in the first period without a full-time ophthalmic resident in the eye bank team was 4.0 donors per 100 deaths (95 % confidence interval [CI]: 1.0-6.9) and in the second period 12.3 donors per 100 deaths (95 % CI: 3.2-21.5) (P<0.0001). Comparing the periods before and after the modification of the eye bank team, the corneal donation rate was increased by more than 3 times. CONCLUSIONS Our study showed the influence of the eye banking team on the corneal donation rate. Modification of the eye bank team, by recruiting a full-time resident at a University Hospital with 1500 beds, increased the corneal donation rate by more than 3 times. It appears necessary to strengthen this team with sufficient staff levels to improve donor rates.

  3. Rates of and Experiences with Corneal Donation at the University Hospital Tübingen From 2002 To 2015.

    PubMed

    Röck, Daniel; Bartz-Schmidt, Karl Ulrich; Röck, Tobias

    2016-01-01

    BACKGROUND This study aimed to report the rates and experiences of corneal donation at the University Hospital Tübingen. MATERIAL AND METHODS Data from all cornea donors from January 2002 to December 2015 were analyzed. The rates of corneal donation were examined. From 2002 to 2008, an ophthalmic resident handled the corneal donor procurement in addition to his ward work. From 2009 to 2015, an ophthalmic resident handled the corneal donor procurement on a full-time basis. RESULTS Among the 10 260 deaths, consent for corneal donation was obtained in 892 cases. The mean annual corneal donation rate was 8.7 donors per 100 deaths (range: 2.0-17.8). The mean corneal donation rate in the first period without a full-time ophthalmic resident in the eye bank team was 4.0 donors per 100 deaths (95 % confidence interval [CI]: 1.0-6.9) and in the second period 12.3 donors per 100 deaths (95 % CI: 3.2-21.5) (P<0.0001). Comparing the periods before and after the modification of the eye bank team, the corneal donation rate was increased by more than 3 times. CONCLUSIONS Our study showed the influence of the eye banking team on the corneal donation rate. Modification of the eye bank team, by recruiting a full-time resident at a University Hospital with 1500 beds, increased the corneal donation rate by more than 3 times. It appears necessary to strengthen this team with sufficient staff levels to improve donor rates. PMID:27402149

  4. Tissue procurement system in Japan: the role of a tissue bank in medical center for translational research, Osaka University Hospital.

    PubMed

    Ohkawara, H; Fukushima, N; Kitagawa, T; Ito, T; Masutani, Y; Sawa, Y

    2010-01-01

    Although organ procurement has been regulated by The Organ Transplantation Law (brain-dead donors since 1997, donors after cardiac death since 1979), there has been no law or governmental procurement network (except for cornea) in Japan. Since the late 1980s, some university hospitals have developed original banks. Finally, in 2001 guidelines for tissue procurement were established by The Japanese Society of Tissue Transplantation and Japan Tissue Transplant Network (JTTN) to coordinate tissue harvesting. Five tissue banks were joined to the tissue transplant network (skin in one, heart valves in two, and bone in two). As the number of tissue banks is small, each bank cooperates on procurement, but cannot cover the entire country. With regard to skin transplantation, only one skin bank-The Japan Skin Bank Network (JSBN), which is located in Tokyo-has organized skin procurement. Therefore, it has been difficult to procure skin in areas distant from Tokyo, especially around Osaka. In order to improve such a situation, a tissue bank collaborating with the JSBN was established at The Medical Center for Translational Research (MTR), Osaka University Hospital in April 2008. The bank has played a role in skin procurement center in western Japan and supported procurement and preservation at the time of the skin procurement. Between April 2008 and September 2009, the bank participated in eight tissue procurements in the western area. In the future, the bank is planning to procure and preserve pancreatic islets and bones. Moreover, there is a plan to set up an induced pluripotent stem cells center and stem cell bank in MTR. This tissue bank may play a role to increase tissue procurement in Japan, especially in the western area.

  5. Feasibility of an antibiotic order form. First experience in the department of internal medicine of a university hospital.

    PubMed

    Blok, W L; Gyssens, I C; Hekster, Y A; Koopmans, P P; van der Meer, J W

    1996-08-01

    Inadequate control of antimicrobial drug use may lead to excessive expenditure for antimicrobial drugs and improper prescribing it may also result in the emergence of multiresistant bacteria. An antibiotic order form may improve the quality of prescriptions by increasing the awareness of the physician of the antimicrobial spectrum needed (i.e. which microorganism is expected in a given patient), the desired duration of treatment, the potential need to adjust dosage, and the potential allergy of the patient to the drug. Furthermore, such an antibiotic order form facilitates prospective evaluation of both the quantity and the quality of prescribing practice. However, the introduction of yet another form to fill in may be met with opposition from prescribers. We have developed an easy-to-use antibiotic order form that incorporated the conventional medication order that was already in use in our hospital. Compliance (percentage of antimicrobial drug prescriptions for which an order form was used) was on average 58% in the first two weeks after introduction, and remained thereafter between 60% and 90%, varying between the different wards. Data retrieved from the antibiotic order forms could be used for surveillance We conclude that this antibiotic order form was feasible in a large department of internal medicine of a university hospital. Future usefulness will depend on compliance and on personnel support for data processing and intervention. PMID:8873229

  6. Factor analysis of the perception of clinical attire in the Dental Hospital, Tokyo Medical and Dental University.

    PubMed

    Tonami, Ken-ichi; Umemori, Sachi; Nitta, Hiroshi; Mataki, Shiro

    2014-06-27

    This study analysed the perceptions of dental clinical attire among patients, dentists and dental students at the Dental Hospital, Tokyo Medical and Dental University using factor analysis to investigate what kinds of factors would underlie the perceptions and would guide evaluation of wearing items of dentist. The subjects comprised 146 patients, 97 dentists, and 81 students of the Dental Hospital. Using a five-point Likert scale, the subjects were asked to score their preferences for 35 items that might be worn by a dentist in the clinic. These scores were analysed using factor analysis and seven factors were extracted. The factors were classified into three categories; the first was a traditional factor representing the public self of dentists, next was casual factors representing the private self of individual dentists, and the other was practical factors. Using MANOVA and univariate ANOVA, differences in perceptions among the subjects were found for factors of casual items while that for traditional items not (P<0.05). Thus, clinical attire would be evaluated from the viewpoint of interplay between public self and private self of the clinician as well as practical aspects. The variation in perceptions would be influenced by wearers' gender and observers' age.

  7. Improvement of teamwork and safety climate following implementation of the WHO surgical safety checklist at a university hospital in Japan.

    PubMed

    Kawano, Takashi; Taniwaki, Miki; Ogata, Kimiyo; Sakamoto, Miwa; Yokoyama, Masataka

    2014-06-01

    With the aim to optimize surgical safety, the World Health Organization (WHO) introduced the Surgical Safety Checklist (SSCL) in 2008. The SSCL has been piloted in many countries worldwide and shown to improve both safety attitudes within surgical teams and patient outcomes. In the study reported here we investigated whether implementation of the SSCL improved the teamwork and safety climate at a single university hospital in Japan. All surgical teams at the hospital implemented the SSCL in all surgical procedures with strict adherence to the SSCL implementation manual developed by WHO. Changes in safety attitudes were evaluated using the modified operating-room version of the Safety Attitudes Questionnaire (SAQ). A before and after design was used, with the questionnaire administered before and 3 months after SSCL implementation. Our analysis revealed that the mean scores on the SAQ had significantly improved 3 months after implementation of the SSCL compared to those before implementation. This finding implies that effective implementation of the SSCL could improve patient outcomes in Japan, similar to the findings of the WHO pilot study.

  8. [Gender-inclusive care of victims of violence : The model project "Gender Gewaltkonzept" at the University Hospital Aachen].

    PubMed

    Evler, A; Scheller, M; Wagels, L; Bergs, R; Clemens, B; Kohn, N; Pütz, A; Voss, B; Schneider, F; Habel, U

    2016-07-01

    Violence is a topic of great social relevance, frequently causing tremendous health consequences for those affected and high consequential costs for health care and the national economy. The established consulting and assistance services are usually restricted to offers for ambulant supply, mainly from private agencies or societies. As a result, there is no identification and care for patients who have experienced violence and who are treated in hospital. Another deficiency is the identification and care of male victims of violence. Despite wide-ranging offers of assistance, only very few gender-specific consulting and support services have been available to date.Therefore, the model project "Gender Gewaltkonzept" was initiated at Aachen University Hospital to assess the prevalence of violence and the potential consequences of the violence experienced on the patients' health. In addition, we investigated whether males and females are in need of different supply requirements.Based on the results of the project "Gender Gewaltkonzept" so far, and on prevalence estimates proving that there is a high rate of violent experiences in both males and females, this overview is aimed at presenting the aid and protection concepts available for victims of violence, in addition to the existing deficiencies of the care system. We present approaches to resolving these deficiencies to be able to establish all-encompassing gender-appropriate support for victims of violence.

  9. Kaposi Sarcoma among HIV Infected Patients in Lagos University Teaching Hospital, Nigeria: A 14-Year Retrospective Clinicopathological Study

    PubMed Central

    Akinde, Olakanmi; Adeyemo, Titilope; Omoseebi, Oladipo; Ikeri, Nzechukwu; Okonkwo, Ikechukwu; Afolayan, Olatunji

    2016-01-01

    Background. Despite the increased incidence of Kaposi sarcoma (KS) resulting from the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic, there is still significant underreporting of KS in this environment. Objectives. This study was aimed at determining the incidence and clinicopathologic patterns of KS among HIV infected patients in Lagos University Teaching Hospital (LUTH), Nigeria, over a 14-year period: January 2000 to December 2013. Methodology. The materials for this study included patients' hospital clinical files, duplicate copies of histopathologic reports, and tissue blocks and corresponding archival slides in the Anatomic and Molecular Pathology Department and the HIV/AIDS unit of the Department of Haematology. Results. Within the study period, 182 cases of KS were diagnosed, accounting for 1.2% of all patients managed for HIV/AIDS and 2.99% of solid malignant tumours. The male-to-female ratio and modal age group were 1 : 1.3 and 5th decade, respectively. Most cases (90%) had purely mucocutaneous involvement with the lower limb being the commonest site (65.8%). The majority of lesions were plaques (65.8%). Vascular formation was the predominant histologic type seen (43.5%). Conclusion. KS in Lagos followed the same epidemiologic trend as other centers in Nigeria, with an increasing incidence in this era of HIV/AIDS. PMID:27034839

  10. 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 < 0.001). The overall median duration of hospitalization was 12 days. Patients who had postoperative complications stayed longer in the hospital and this was

  11. Planning, expectation, and image evaluation for PACS at the University of Iowa Hospitals and Clinics

    NASA Astrophysics Data System (ADS)

    Franken, E. A., Jr.; Smith, Wilbur L.; Berbaum, Kevin S.; Owen, David A.; Hilsenrath, Peter

    1990-08-01

    Our strategy in studying PACS is to evaluate its clinical implementation working with equipment supplied by an established manufacturer. Fiscal and personnel resources required to design and integrate the hardware components and operational software to develop a functional PACS precluded a bottom up development approach at our institution. Imaging equipment vendors possess more abundant design development resources for this task and therefore can support a more rapid development of the initial components of PACS. For this reason we have chosen to serve as a beta test site to study the viability of the basic PACS components in a clinical setting. Our efforts primarily focus on: (1) image quality; (2) cost effectiveness; (3) PACS/HIS/RIS integration; (4) equipment and software reliability; and (5) overall system performance. The results of our studies are shared with the vendor for future PACS development and refi nement. To attain our investigational goals we have formed an interdisciplinary team of Radiologists, Perceptual Psychologist, Economist, Electrical and Industrial Engineers, Hospital Information System personnel and key departmental administrative staff. For several reasons Pediatric Radiology was targeted as the initial area for our PACS study: a small area representative of the overall operation,tight operational controls and willingness of physicians. We used a step-wise approach, the first step being the installation of PACS exclusively within the physical confines of Pediatric Radiology.

  12. Drug incompatibilities in the adult intensive care unit of a university hospital

    PubMed Central

    Marsilio, Naiane Roveda; da Silva, Daiandy; Bueno, Denise

    2016-01-01

    Objectives This study sought to identify the physical and chemical incompatibilities among the drugs administered intravenously to patients admitted to an adult intensive care unit. We also aimed to establish pharmaceutical guidelines for administering incompatible drugs. Methods This cross-sectional, prospective, and quantitative study was conducted from July to September 2015. Drug incompatibilities were identified based on an analysis of the patient prescriptions available in the hospital online management system. A pharmaceutical intervention was performed using the guidelines on the preparation and administration of incompatible drugs. Adherence to those guidelines was subsequently assessed among the nursing staff. Results A total of 100 prescriptions were analyzed; 68 were incompatible with the intravenous drugs prescribed. A total of 271 drug incompatibilities were found, averaging 4.0 ± 3.3 incompatibilities per prescription. The most commonly found drug incompatibilities were between midazolam and hydrocortisone (8.9%), between cefepime and midazolam (5.2%), and between hydrocortisone and vancomycin (5.2%). The drugs most commonly involved in incompatibilities were midazolam, hydrocortisone, and vancomycin. The most common incompatibilities occurred when a drug was administered via continuous infusion and another was administered intermittently (50%). Of the 68 prescriptions that led to pharmaceutical guidelines, 45 (66.2%) were fully adhered to by the nursing staff. Conclusion Patients under intensive care were subjected to a high rate of incompatibilities. Drug incompatibilities can be identified and eliminated by the pharmacist on the multidisciplinary team, thereby reducing undesirable effects among patients. PMID:27410410

  13. Torsemide versus furosemide in heart failure patients: insights from Duke University Hospital.

    PubMed

    Mentz, Robert J; Buggey, Jonathan; Fiuzat, Mona; Ersbøll, Mads K; Schulte, Phillip J; DeVore, Adam D; Eisenstein, Eric L; Anstrom, Kevin J; OʼConnor, Christopher M; Velazquez, Eric J

    2015-05-01

    Furosemide has historically been the primary loop diuretic in heart failure patients despite data suggesting potential advantages with torsemide. We used the Duke Echocardiography Lab Database to investigate patients admitted with heart failure to Duke Hospital from 2000 to 2010 who were discharged on either torsemide or furosemide. We described baseline characteristics based on discharge diuretic and assessed the relationship with all-cause mortality through 5 years. Of 4580 patients, 86% (n = 3955) received furosemide and 14% (n = 625) received torsemide. Patients receiving torsemide were more likely to be female and had more comorbidities compared with furosemide-treated patients. Survival was worse in torsemide-treated patients [5-year Kaplan-Meier estimated survival of 41.4% (95% CI: 36.7-46.0) vs. 51.5% (95% CI: 49.8-53.1)]. After risk adjustment, torsemide use was no longer associated with increased mortality (hazard ratio 1.16; 95% CI: 0.98-1.38; P = 0.0864). Prospective trials are needed to investigate the effect of torsemide versus furosemide because of the potential for residual confounding.

  14. [Religion and psychiatric disorders in patients admitted to a university general hospital].

    PubMed

    Soeiro, Rachel Esteves; Colombo, Elisabetta S; Ferreira, Marianne H F; Guimarães, Paula S A; Botega, Neury J; Dalgalarrondo, Paulo

    2008-04-01

    In order to evaluate the prevalence of psychiatric disorders in a Brazilian general hospital and their association with religious denomination and religiosity, 253 inpatients were interviewed. A socio-demographic questionnaire and an instrument for diagnosis of mental disorders (MINI-Plus) were applied. Distribution of religious denominations was: Catholic 63.2% (n=177), Evangelical Protestant 20.4% (n=57), Spiritist 4.3% (n=12), traditional Protestant 2.3% (n=8), and "no religion" 7.5% (n=21). Degree of religiosity was: very religious 43.2% (n=116), religious 46.9% (n=129), hardly religious 9.8% (n=27), and not at all religious 1.1% (n=3). Evangelical (Pentecostal) religious affiliation and frequent attendance at worship services were associated with fewer alcohol problems. Membership in an Evangelical (Pentecostal) church may thus have an inhibitory effect on alcohol dependence or abuse. Intensity of religiosity was moderately associated with overall prevalence of disorders, especially bipolar disorder. It is reasonable to conclude that extreme situations (very intense versus very limited religious participation) are related to this finding, associating both an exacerbated pursuit of religion and alienation from it with altered mental states.

  15. Genetic features and molecular epidemiology of Enterococcus faecium isolated in two university hospitals in Brazil.

    PubMed

    da Silva, Leila Priscilla Pinheiro; Pitondo-Silva, André; Martinez, Roberto; da Costa Darini, Ana Lúcia

    2012-11-01

    The global emergence of vancomycin-resistant Enterococcus faecium (VREfm) has been characterized by a clonal spread of strains belonging to clonal complex 17 (CC17). Genetic features and clonal relationships of 53 VREfm isolated from patients in 2 hospitals in Ribeirao Preto, São Paulo, Brazil, during 2005-2010 were determined as a contribution to the Brazilian evolutionary history of these nosocomial pathogens. All isolates were daptomycin susceptible, vancomycin-resistant, and had the vanA gene. The predominant virulence genes were acm and esp. Only 5 VREfm isolated in 2005-2006 had intact Tn1546, while 81% showed Tn1546 with deleted left extremity and insertion of IS1251 between the vanS and vanH genes. Multilocus sequence typing analysis permitted the identification of 9 different sequence types (STs), with 5 being new ones (656, 657, 658, 659, and 660). Predominant STs were ST412 and ST478, all belonging to CC17, except ST658. This is the first report of the ST78 in Brazil. PMID:22959818

  16. Assessment of informatization for the dispensing of medications at a university hospital

    PubMed Central

    Serafim, Sônia Aparecida Dias; Forster, Aldaisa Cassanho; Simões, Maria Jacira Silva; Penaforte, Thais Rodrigues

    2010-01-01

    INTRODUCTION Informatics and automation are important tools for the reduction of work, errors and costs in a hospital pharmacy. OBJECTIVES To describe the structuring and function of an informatized system for the dispensing of medications and to assess its effect on nursing and pharmacy services during the period from 1997 to 2003. MATERIALS AND METHODS In this descriptive and retrospective study, we performed an analysis of documents addressing the structuring and implementation of the informatized medication dispensing system. In addition, we analyzed the perceptions of nurses, pharmacists and pharmacy assistants who participated in the structuring phase of the system when interviewed about the effect of informatization on administrative aspects (e.g., requisition of medications, presentation of the dispensed medication and system operationalization). RESULTS The major advantages provided by the new system were 1) the elimination of manual transcripts for prescribed medications, 2) increased speed, 3) better identification of the doses prescribed by physicians, 4) medication labels containing all necessary identification and 5) practicality and safety of optical bar code-based verification of the requested and dispensed medications. CONCLUSIONS The great majority of the interviewees considered the informatized medication supply system to be of good quality. Analysis of the data provided information that could contribute to the expansion and refinement of the system, provide support for studies regarding the utilization of medications and offer new perspectives for work and productivity. PMID:20454500

  17. Professional burnout, stress and job satisfaction of nursing staff at a university hospital1

    PubMed Central

    Portero de la Cruz, Silvia; Vaquero Abellán, Manuel

    2015-01-01

    OBJECTIVES: to describe the social and work characteristics of the nursing staff at a tertiary hospital in the Public Health Service of Andalucía, to assess the degree of professional professional burnout and job satisfaction of those professionals and to study the possible relation between the professional burnout variables and the stress and job satisfaction levels on the one hand and social and employment variables on the other. METHOD: descriptive and cross-sectional study in a sample of 258 baccalaureate and auxiliary nurses. As research instruments, an original and specific questionnaire was used to collect social and employment variables, the Maslach Burnout Inventory, the Nursing Stress Scale and the Font-Roja questionnaire. Descriptive, inferential statistics and multivariate analysis were applied. RESULTS: average scores were found for professional stress and satisfaction, corresponding to 44,23 and 65,46 points, respectively. As regards professional burnout, an average score was found on the emotional exhaustion subscale; a high score for depersonalization and a low score for professional accomplishment. Studies are needed to identify the scores on these subscales in health organizations and to produce knowledge on their interrelations. PMID:26155012

  18. Evolution of a universal infant hearing screening program in an inner city hospital.

    PubMed

    Cox, L C; Toro, M R

    2001-06-01

    This study reports the evolution of a newborn hearing screening program which began in 1988. Data are reported from the period of time that universal newborn hearing screening was initiated, i.e. April 1996 to December 2000 (total screened=7128 babies). From 1996 to the present, the program has developed to the current form. During 2000, 1713 infants in the well-baby nursery and neonatal intensive care unit were screened at a cost of 18.44 dollars per child. Thirty (1.7%) infants failed the screen, of which 26 (86%) returned for follow-up testing. Fifteen infants were documented with hearing loss, 10 with conductive and five with sensorineural losses. The false positive rate was 0.96% and the overall sensorineural impairment rate was 1/343.

  19. Total hip arthroplasty in Malaysia--the Universiti Kebangsaan Malaysia and Hospital Kuala Lumpur experience.

    PubMed

    Tay, B H; Masbah, O; Razak, M; Ruslan, G N

    2000-09-01

    The results of 109 primary total hip arthroplasties in 92 patients performed in Hospital Kuala Lumpur from January 1987 to December 1996 were reviewed after a mean follow-up of 30.8 months. There were 22 males and 70 females with the average age of 49.9 years (range 19 to 94 years). Chinese females comprised the largest group of patients (52.2%). Avascular necrosis was the most common diagnosis (33.1%) followed by hip dysplasia and primary osteoarthritis (17.4%). The procedure was performed more on the right hip (64.2%) compared to the left (35.8%). All patients received prophylactic antibiotics but none were given deep vein thrombosis prophylaxis. The Charnley prosthesis was most commonly used and the majority of the arthroplasties were cemented (60.5%). About 80% of the THA were performed via the lateral approach. The functional hip score improved from an average of 8.9 to 15.0 with 66.3% of the patients categorized as good and excellent results. There were 16 patients (17.4%) with poor outcome. The most common complications encountered were dislocation (10.1%), aseptic loosening (9.2%) and periprosthetic fracture (5.5%). Other complications were deep infection (1.8%), deep vein thrombosis (0.9%), trochanteric osteotomy complications (1.8%), superficial infection (7.3%), urinary tract infection (5.5%), pressure sore (3.7%) and respiratory complication (1.8%). Fifteen hips (13.8%) required revision. The causes for revision were aseptic loosening, dislocation and infection. Technical anomalies were recognized as one of the factors contributing to poor results. Five-year survival rate was 87.3%. Better results can be expected with increasing experience and technical skulls.

  20. An evaluation of postoperative pain management in pediatric patients at a university teaching hospital.

    PubMed

    Cox, T H

    1995-11-01

    In recent years, pediatric pain management has begun to receive some much deserved attention. Many misconceptions regarding pediatric pain management have resulted in infants and children receiving inadequate pain control after surgical or invasive procedures. The purpose of this investigation was to evaluate appropriateness of pain management practices, emphasizing drug therapy, in children with acute pain after a surgical procedure. Analgesic use and pain assessment methods were evaluated for 30 pediatric patients undergoing an invasive medical procedure or surgery. Data were collected concurrently on the use of pain medications, potential for drug interactions/duplication of therapeutic classes, pain assessment, patient response to medication, and any adverse effects experienced by a child. Twenty patients (67%) had concurrent orders written for multiple analgesics on admission to the nursing unit. Only 6 of these 20 order sets (30%) designated specific indications for use. Ten of the 14 remaining order sets (those without specific directions for use) contained at least one medication that was inappropriate to treat the expected level of postoperative pain. Fifty-four percent of total physician orders fell outside study criteria for appropriate dosing and scheduling frequency. Patient records revealed that nursing administered the lowest ordered dose 47% of the time, and a failure to consistently conduct pain assessments or document patient response to medication. Eight patients (27%) experienced allergic-type reactions, whereas 7 patients (23%) experienced adverse drug reactions. Information gathered from this review will be used to determine if a need exists to develop hospital guidelines or adopt the Agency for Health Care Policy and Research guidelines for acute pain management in children.

  1. [Treatment Strategy for Non-Functional Pancreatic Neuroendocrine Tumors (P-NETs) at Kurume University Hospital].

    PubMed

    Kawashima, Yusuke; Ishikawa, Hiroto; Hisaka, Toru; Okuda, Kouji; Akagi, Yoshito

    2016-01-01

    Pancreatic neuroendocrine tumors (P-NETs) are relatively rare. Approximately 50-90% of non-functioning P-NETs are malignant, and the only curative treatment is surgical resection. Liver and lymph node metastases often occur. In Japan, the mTOR inhibitor everolimus is now covered by the national health insurance for treatment of P-NETs, including advanced and unresectable tumors. We present a case of P-NETs with liver metastases seen at our hospital and discuss our treatment strategy for this disease. Patients with tumors≤1 cm receive follow-up observation. For G1 and G2 (other than G3) tumors, if their size is >1 cm when first discovered, resection of the primary lesion along with lymph node dissection (as for pancreatic cancer) is performed. In G1 and G2 tumors with synchronous distant metastases, the primary lesion is first resected, and depending on the pathological findings, chemotherapy (LAR plus everolimus) may be administered. After 4 courses of chemotherapy, the response is assessed, and if further resection is possible, resection is performed. When there are synchronous liver metastases, if partial resection and local treatment (such as RFA) are possible, the primary lesion and synchronous lesions are resected. If a major hepatic resection procedure such as a segmentectomy or lobectomy is possible, the primary lesion is resected, followed by chemotherapy. After 4 courses of chemotherapy, the response is assessed, and if further resection is possible, hepatic resection is performed. G3 tumors are usually highly malignant, advanced, and often associated with metastases at the time of diagnosis. Chemotherapy may be an option for treating patients with G3 tumors. PMID:26809536

  2. Impact of a major hurricane on surgical services in a university hospital.

    PubMed

    Norcross, E D; Elliott, B M; Adams, D B; Crawford, F A

    1993-01-01

    Hurricane Hugo struck Charleston, South Carolina, on September 21, 1989. This report analyzes the impact this storm had upon surgical care at a university medical center. Although disaster planning began on September 17, hurricane damage by high winds and an 8.7-foot tidal surge led to loss of emergency power and water. Consequently, system failures occurred in air conditioning, vacuum suction, steam and ethylene oxide sterilization, plumbing, central paging, lighting, and refrigeration. The following surgical support services were affected. In the blood bank, lack of refrigeration meant no platelet packs for 2 days. In radiology, loss of electrical power damaged CT/MRI scanners and flooding ruined patient files, resulting in lost information. In the intensive care unit, loss of electricity meant no monitors and hand ventilation was used for 4 hours. In the operating room, lack of temperature and humidity control (steam, water, and suction supply) halted elective surgery until October 2. Ground and air transportation were limited by unsafe landing sites, impassable roads, and personnel exhaustion. Surgical planning for a major hurricane should include: 1) a fail-safe source of electrical power, 2) evacuation of as many critically ill patients as possible before the storm, 3) cancellation of all elective surgery, and 4) augmented ancillary service staffing with some, although limited, physician support.

  3. Factors associated with nonattendance at clinical medicine scheduled outpatient appointments in a university general hospital

    PubMed Central

    Giunta, Diego; Briatore, Agustina; Baum, Analía; Luna, Daniel; Waisman, Gabriel; de Quiros, Fernán Gonzalez Bernaldo

    2013-01-01

    Introduction Nonattendance at scheduled outpatient appointments for primary care is a major health care problem worldwide. Our aim was to estimate the prevalence of nonattendance at scheduled appointments for outpatients seeking primary care, to identify associated factors and build a model that predicts nonattendance at scheduled appointments. Methods A cohort study of adult patients, who had a scheduled outpatient appointment for primary care, was conducted between January 2010 and July 2011, at the Italian Hospital of Buenos Aires. We evaluated the history and characteristics of these patients, and their scheduling and attendance at appointments. Patients were divided into two groups: those who attended their scheduled appointments, and those who did not. We estimated the odds ratios (OR) and corresponding 95% confidence intervals (95% CI), and generated a predictive model for nonattendance, with logistic regression, using factors associated with lack of attendance, and those considered clinically relevant. Alternative models were compared using Akaike’s Information Criterion. A generation cohort and a validation cohort were assigned randomly. Results Of 113,716 appointments included in the study, 25,687 were missed (22.7%; 95% CI: 22.34%–22.83%). We found a statistically significant association between nonattendance and age (OR: 0.99; 95% CI: 0.99–0.99), number of issues in the personal health record (OR: 0.98; 95% CI: 0.98–0.99), time between the request for and date of appointment (OR: 1; 95% CI: 1–1), history of nonattendance (OR: 1.07; 95% CI: 1.07–1.07), appointment scheduled later than 4 pm (OR: 1.30; 95% CI: 1.24–1.35), and specific days of the week (OR: 1.00; 95% CI: 1.06–1.1). The predictive model for nonattendance included characteristics of the patient requesting the appointment, the appointment request, and the actual appointment date. The area under the receiver operating characteristic curve of the predictive model in the

  4. Spectrum of surgical trauma and associated head injuries at a university hospital in eastern Nepal

    PubMed Central

    Bajracharya, A; Agrawal, A; Yam, BR; Agrawal, CS; Lewis, Owen

    2010-01-01

    Background: Trauma is one of the common surgical emergencies presenting at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal, a tertiary referral center catering to the needs of the population of Eastern Nepal and nearby districts of India. Objective: The objective of this study is to analyze the magnitude, epidemiological, clinical profile and outcome of trauma at B P Koirala Institute of Health Sciences. Materials and Methods: This descriptive case series study includes all patients with history of trauma coming to BPKIHS emergency and referred to the surgery department. We noted the detailed clinical history and examination, demographics, mechanism of injury, nature of injury, time of reporting in emergency, treatment offered (operative or non operative management) and analyzed details of operative procedure (i.e. laparotomy, thoracotomy, craniotomy etc.), average length of hospital stay, morbidity and outcome (according to Glasgow outcome scale). Collected data were analyzed using EpiInfo 2000 statistical software. Results: There were 1848 patients eligible to be included in the study. The mean age of the patients was 28.9 ± 19.3 years. Majority of the patients (38%) belonged to the age group of 21 - 40 years and the male to female ratio was 2.7:1. Most of the trauma victims were students (30%) followed by laborers (27%) and farmers (22%) respectively. The commonest causes of injury were fall from height (39%), road traffic accident (38%) and physical assault (18%); 78% of the patients were managed conservatively and 22% underwent operative management. Postoperative complications were seen in 18%. Wound infection 7.5%, neurological deficit including cerebrospinal fluid (CSF) otrorrhea was seen in 2.2% patients. Good recovery was seen in 84%, moderate disability in 5.2% patients and severe disability in 1.4% patients. The mortally was 6.3% and most of the deaths were related to traumatic brain injuries. Conclusions: In Nepal, trauma-related injury

  5. [Features of Guillain-Barre syndrome in adults: results of a university hospital].

    PubMed

    De la O-Peña, Daniel; Robles-Figueroa, Martín; Chávez-Peña, Quetzalcóatl; Bedolla-Barajas, Martín

    2015-01-01

    Introducción: el Síndrome de Guillain-Barré (SGB) tiene una distribución cosmopolita. Usualmente su curso es benigno y tiende a autolimitarse, pero en casos severos puede ocasionar la muerte. El objetivo de este artículo es describir las características de un grupo de adultos con SGB diagnosticados y tratados en un hospital universitario. Métodos: se analizaron todos los casos de SGB ocurridos del 1 de enero de 2005 al 31 de diciembre de 2009. Se revisaron los expedientes clínicos a través de la aplicación de una cédula estructurada que comprendió las siguientes secciones: identificación del paciente, datos clínicos, historia de infección, estación del año de ocurrencia, tipos de variantes electrofisiológicas y letalidad. Resultados: en total se incluyeron 45 pacientes; la relación hombre-mujer fue de 1.4:1 y la edad media del grupo fue 48.2 ± 16.0 años. La estación del año con mayor número de casos fue el verano. La historia de infección intestinal estuvo presente en 40 % de los pacientes, y la infección respiratoria en 24.4 %. La letalidad asociada con SGB fue de 11.1 % (IC: 95 %, 4.4-23.9), los casos fatales se presentaron en los pacientes con mayor edad que los que sobrevivieron (65.2 ± 15.0 frente a 46.0 ± 14.9, p = 0.01). La variante más frecuente fue la neuropatía axonal motora aguda (64.4 %); hubo cuatro casos de síndrome de Miller Fisher. Conclusiones: la variante electromiográfica más frecuente del SGB fue la neuropatía axonal motora aguda. Se observó mayor número de casos durante la estación de verano.

  6. Compliance with infection control practices in an university hospital dental clinic

    PubMed Central

    Mutters, Nico T.; Hägele, Ulrike; Hagenfeld, Daniel; Hellwig, Elmar; Frank, Uwe

    2014-01-01

    Aim: Compliance with infection control practices is the key to quality care and excellence in dentistry. Infection control remains one of the most cost-beneficial interventions available. However, implementing control procedures requires full compliance of the whole dental team. The aim of our study was to measure the compliance in daily clinical practice. Methods: The compliance with infection control practices in dentistry by dental health care personnel (DHCP) in a German university dental clinic was observed during clinical work. In addition, a survey was conducted to assess the individual knowledge about infection control procedures. Contamination of the workplace during invasive dental procedures was tested, as well. Results: A total of 58 invasive dental treatments implying close contacts between HCWs and patients were scrutinized. All HCWs (100%) wore gloves during dental work, but in some cases (female dentists: 14.3%; dental assistants: 28.6%) gloves were neither changed nor hands were disinfected between different activities or patient contacts (female dentists: 68.6%; male dentists: 60.9%; dental assistants: 93%). Only 31.4% of female and 39.1% of male dentists carried out adequate hygienic hand disinfection after removing gloves. Male dentists wore significantly more often (100%) protective eyewear compared to 77.1% of female dentists (p<0.05). In addition, most of female dentists (62.9%) and dental assistants (80.7%) wore jewelry during dental procedures. Conclusion: Despite the knowledge of distinct hygiene procedures only a small percentage of dental staff performs hygiene practices according to recommended guidelines. Strict audit is clearly needed in the dental setting to ensure compliance with infection control guidelines to prevent transmission of pathogens. Our results provide insights for the development of a targeted education and training strategy to enhance compliance of dental staff especially of dental assistants with infection control

  7. Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

    PubMed Central

    Abebe, Solomon Mekonnen; Getachew, Assefa; Fasika, Solomon; Bayisa, Mulugeta; Girma Demisse, Abayneh; Mesfin, Nebiyu

    2016-01-01

    Objective To assess the prevalence of diabetes mellitus (DM) and associated factors among HIV-infected adults in northwest Ethiopia. Design Hospital-based cross-sectional study. Setting HIV clinic of the University of Gondar Hospital, Ethiopia. Participants All HIV-infected adults who visited the HIV clinic from December 2013 to the end of February 2014 were the source population. Measures A structured and pretested questionnaire incorporating the WHO STEPwise approach was used. A multivariate logistic regression analysis was applied to assess factors associated with DM. Results The overall prevalence of type 2 DM was 8% (95% CI 5.5% to 10.5%). The prevalence of DM was higher (13.2%; 95% CI 8.0% to 18.3%) among subjects receiving pre-antiretroviral treatment (pre-ART) than among those taking ART (5.1%; 95% CI 2.6% to 7.6%). Thirteen (35.1%) of the DM cases were newly identified during the study. Obesity (adjusted OR (AOR) 6.55; 1.20 to 35.8), hypertension (AOR 3.45; 1.50 to 7.90), being in the pre-ART group (AOR 4.47; 1.80 to 11.08), hypertriglyceridaemia (AOR 2.24; 1.02 to 49.5) and tertiary-level education (AOR 11.8; 2.28 to 61.4) were associated with DM. Conclusions Overall DM prevalence was high, particularly among subjects in the pre-ART group. More educated, hypertensive and obese HIV-infected adults were more likely to have DM as a comorbidity. Health policy and the clinical management of HIV-infected individuals should take into account the rising DM. PMID:27540099

  8. Reptiles with dermatological lesions: a retrospective study of 301 cases at two university veterinary teaching hospitals (1992-2008).

    PubMed

    White, Stephen D; Bourdeau, Patrick; Bruet, Vincent; Kass, Philip H; Tell, Lisa; Hawkins, Michelle G

    2011-04-01

    This retrospective study reviews the medical records of 301 reptiles with dermatological lesions that were examined at the Veterinary Medical Teaching Hospital, University of California at Davis (VMTH-UCD) and the Unité de Dermatologie-Parasitologie-Mycologie, Ecole Nationale Vétérinaire de Nantes (UDPM-ENVN) from 1 January 1992 to 1 July 2008. The most common reptile groups differed between the two hospitals, with lizards being the most common at the VMTH-UCD and chelonians at the UDPM-ENVN. At the VMTH-UCD, boa constrictors (Boa constrictor), ball pythons (Python regius) and other Python species were over-represented, and box turtles (Terrapene carolina) were under-represented in the dermatological lesion caseload. When institutional data were combined, 47% of all reptiles at both institutions with confirmed or suspected cases of sepsis had petechiae, with the highest association seen in chelonians at 82%. Dependent on institution and reptile group, from 29% to 64% of the cases had underlying husbandry issues. Sixty-two per cent of all cases were alive at final status. Veterinarians treating reptiles with skin disease should be aware of the following: (i) that boa constrictors and Python species may be predisposed to dermatological lesions; (ii) that client education is important for proper husbandry; and (iii) that there is a possible association between petechiae and sepsis, especially in chelonians. The conjectural association between certain skin lesions and sepsis remains to be confirmed by systematically derived data that demonstrate a causal relationship between the two.

  9. The Effects of Negative Reinforcement on Increasing Patient Adherence to Appointments at King Abdullah University Hospital in Jordan.

    PubMed

    Alyahya, Mohammad; Hijazi, Heba H; Nusairat, Farid T

    2016-01-01

    Appointment nonadherence is a health behavior that represents a burden to health care systems. On March 1, 2015, a new negative reinforcement intervention involving "service fees" for a visit without appointment was implemented at King Abdullah University Hospital in Jordan. To evaluate the effect of this intervention in improving patient adherence to medical appointment, a retrospective preintervention and postintervention analysis was used, including all patients (n = 65 535) who had scheduled appointments at 39 outpatient clinics. A repeated-measures analysis of variance was first performed. Then, a multivariate linear regression model was used to identify factors that might predict individuals who are likely to attend or miss their appointments and those who have a greater tendency to visit the hospital with or without appointments. Although the average percentage of appointments attended was more than missed preintervention and postintervention, the decrease in percentage of missed appointments was more pronounced postintervention. Also, the average percentage of visits without appointments was less than visits with appointments in both times, but the decrease in the percentage of visits without appointments was more prominent after. The regression analysis revealed that younger, married and male patients were more likely to miss their appointment before and after the intervention. Also, younger patients had a tendency to attend without appointments. Conversely, patients with the lower copayment rate had a tendency to adhere to appointment times. In conclusion, negative reinforcement interventions could improve patient appointment adherence rates. Accordingly, interventions designed that consider evidence and are theory-based are needed to change patient behavior. PMID:27444505

  10. The Effects of Negative Reinforcement on Increasing Patient Adherence to Appointments at King Abdullah University Hospital in Jordan.

    PubMed

    Alyahya, Mohammad; Hijazi, Heba H; Nusairat, Farid T

    2016-01-01

    Appointment nonadherence is a health behavior that represents a burden to health care systems. On March 1, 2015, a new negative reinforcement intervention involving "service fees" for a visit without appointment was implemented at King Abdullah University Hospital in Jordan. To evaluate the effect of this intervention in improving patient adherence to medical appointment, a retrospective preintervention and postintervention analysis was used, including all patients (n = 65 535) who had scheduled appointments at 39 outpatient clinics. A repeated-measures analysis of variance was first performed. Then, a multivariate linear regression model was used to identify factors that might predict individuals who are likely to attend or miss their appointments and those who have a greater tendency to visit the hospital with or without appointments. Although the average percentage of appointments attended was more than missed preintervention and postintervention, the decrease in percentage of missed appointments was more pronounced postintervention. Also, the average percentage of visits without appointments was less than visits with appointments in both times, but the decrease in the percentage of visits without appointments was more prominent after. The regression analysis revealed that younger, married and male patients were more likely to miss their appointment before and after the intervention. Also, younger patients had a tendency to attend without appointments. Conversely, patients with the lower copayment rate had a tendency to adhere to appointment times. In conclusion, negative reinforcement interventions could improve patient appointment adherence rates. Accordingly, interventions designed that consider evidence and are theory-based are needed to change patient behavior.

  11. Ebola virus disease: Case management in the Institute of Infectious Diseases, University Hospital of Sassari, Sardinia, Italy.

    PubMed

    Bertoli, Giulia; Mannazzu, Marco; Madeddu, Giordano; Are, Riccardo; Muredda, Alberto; Babudieri, Sergio; Calia, Giovanna; Lovigu, Carla; Maida, Ivana; Contini, Luciana; Miscali, Anna; Rubino, Salvatore; Delogu, Fiorenzo; Mura, Maria Stella

    2016-01-01

    Since the onset of the worst epidemic of Ebola virus disease in December 2013, 28,637 cases were reported as confirmed, probable, or suspected. Since the week of 3 January 2016, no more cases have been reported. The total number of deaths have amounted to 11,315 (39.5%). In developed countries, seven cases have been diagnosed: four in the United States, one in Spain, one in the United Kingdom, and one in Italy. On 20 July 2015, Italy was declared Ebola-free. On 9 May 2015, an Italian health worker came back to Italy after a long stay in Sierra Leone working for a non-governmental organization. Forty-eight hours after his arrival, he noticed headache, weakness, muscle pains, and slight fever. The following day, he was safely transported to the Infectious Diseases Unit of University Hospital of Sassari. The patient was hospitalized for 19 hours until an Italian Air Force medical division transferred him to Rome, to the Lazzaro Spallanzani Institute. Nineteen people who had contacts with the patient were monitored daily for 21 days by the Public Health Office of Sassari and none presented any symptoms. So far, neither vaccine nor treatment is available to be proposed on an international scale. Ebola is considered a re-emerging infectious disease which, unlike in the past, has been a worldwide emergency. This case study aimed to establish a discussion about the operative and logistic difficulties to be faced and about the discrepancy arising when protocols clash with the reality of facts.

  12. Ebola virus disease: Case management in the Institute of Infectious Diseases, University Hospital of Sassari, Sardinia, Italy.

    PubMed

    Bertoli, Giulia; Mannazzu, Marco; Madeddu, Giordano; Are, Riccardo; Muredda, Alberto; Babudieri, Sergio; Calia, Giovanna; Lovigu, Carla; Maida, Ivana; Contini, Luciana; Miscali, Anna; Rubino, Salvatore; Delogu, Fiorenzo; Mura, Maria Stella

    2016-01-01

    Since the onset of the worst epidemic of Ebola virus disease in December 2013, 28,637 cases were reported as confirmed, probable, or suspected. Since the week of 3 January 2016, no more cases have been reported. The total number of deaths have amounted to 11,315 (39.5%). In developed countries, seven cases have been diagnosed: four in the United States, one in Spain, one in the United Kingdom, and one in Italy. On 20 July 2015, Italy was declared Ebola-free. On 9 May 2015, an Italian health worker came back to Italy after a long stay in Sierra Leone working for a non-governmental organization. Forty-eight hours after his arrival, he noticed headache, weakness, muscle pains, and slight fever. The following day, he was safely transported to the Infectious Diseases Unit of University Hospital of Sassari. The patient was hospitalized for 19 hours until an Italian Air Force medical division transferred him to Rome, to the Lazzaro Spallanzani Institute. Nineteen people who had contacts with the patient were monitored daily for 21 days by the Public Health Office of Sassari and none presented any symptoms. So far, neither vaccine nor treatment is available to be proposed on an international scale. Ebola is considered a re-emerging infectious disease which, unlike in the past, has been a worldwide emergency. This case study aimed to establish a discussion about the operative and logistic difficulties to be faced and about the discrepancy arising when protocols clash with the reality of facts. PMID:27249532

  13. MRSA in a large German University Hospital: Male gender is a significant risk factor for MRSA acquisition

    PubMed Central

    Kupfer, Markus; Jatzwauk, Lutz; Monecke, Stephan; Möbius, Jana; Weusten, Axel

    2010-01-01

    Background: The continually rising number of hospital acquired infections and particularly MRSA (Methicillin-resistant Staphylococcus aureus) colonization poses a major challenge from both clinical and epidemiological perspectives. The assessment of risk factors is vital in determining the best prevention, diagnosis and treatment strategies. Materials and methods: We analyzed 798 cases of MRSA in a large German University Hospital over a 7-year period. Data was collected retro- and prospectively including patient age, sex, type of ward and duration of inpatient stay. In addition we analyzed all cases on ICU with regards to cross infection and MRSA genotyping via DNA MicroArray Technology. The years 2004 to 2007 were analyzed with a specific focus on gender. Results: Male gender is significantly correlated with increased risk of MRSA acquisition (p<0.001), the predominant setting for MRSA is on ICU. 75% of the MRSA positive patients are over 50 years of age (average age 59.8 years). The inpatient time was 4.15 times higher in MRSA carriers compared with non-MRSA cases, however this was not significant. MRSA genotyping on ICU showed mainly the subtypes ST 5, ST 22, ST 228, however cross contamination with identical genotypes was only detected in a minority of cases (5 out of 22). Conclusion: Unlike previous studies which show no or inconclusive evidence of gender as a risk factor, our data confirm that male gender is a significant risk factor for MRSA carrier status. Further research will be required to investigate the aetiology of these findings. PMID:20941335

  14. Phyllodes tumours of the breast: retrospective analysis of a University Hospital's experience.

    PubMed

    Toh, Y F; Cheah, P L; Looi, L M; Teoh, K H; Tan, P H

    2016-04-01

    Taking cognizance of the purported variation of phyllodes tumours in Asians compared with Western populations, this study looked at phyllodes tumours of the breast diagnosed at the Department of Pathology, University of Malaya Medical Centre over an 8-year period with regards to patient profiles, tumour parameters, treatment offered and outcome. Sixty-four new cases of phyllodes tumour were diagnosed during the period, however only 30 (21 benign, 4 borderline and 5 malignant) finally qualified for entry into the study. These were followed-up for 4-102 months (average = 41.7 months). Thirteen cases (8 benign, 3 borderline, 2 malignant) were Chinese, 9 (all benign) Malay, 7 (4 benign, 1 borderline, 2 malignant) Indian and 1 (malignant) Indonesian. Prevalence of benign versus combined borderline and malignant phyllodes showed a marginally significant difference (p=0.049) between the Malays and Chinese. Patients' ages ranged from 21-70 years with a mean of 44.9 years with no significant difference in age between benign, borderline or malignant phyllodes tumours. Except for benign phyllodes tumours (mean size = 5.8 cm) being significantly smaller at presentation compared with borderline (mean size = 12.5 cm) and malignant (mean size = 15.8 cm) (p<0.05) tumours, history of previous pregnancy, breast feeding, hormonal contraception and tumour laterality did not differ between the three categories. Family history of breast cancer was noted in 2 cases of benign phyllodes. Local excision was performed in 17 benign, 2 borderline and 3 malignant tumours and mastectomy in 4 benign, 2 borderline and 2 malignant tumours. Surgical clearance was not properly recorded in 10 benign phyllodes tumours. Six benign and all 4 borderline and 5 malignant tumours had clearances of <10 mm. Two benign tumours recurred locally at 15 and 49 months after local excision, however information regarding surgical clearance was not available in both cases. One patient with a malignant tumour developed

  15. Phyllodes tumours of the breast: retrospective analysis of a University Hospital's experience.

    PubMed

    Toh, Y F; Cheah, P L; Looi, L M; Teoh, K H; Tan, P H

    2016-04-01

    Taking cognizance of the purported variation of phyllodes tumours in Asians compared with Western populations, this study looked at phyllodes tumours of the breast diagnosed at the Department of Pathology, University of Malaya Medical Centre over an 8-year period with regards to patient profiles, tumour parameters, treatment offered and outcome. Sixty-four new cases of phyllodes tumour were diagnosed during the period, however only 30 (21 benign, 4 borderline and 5 malignant) finally qualified for entry into the study. These were followed-up for 4-102 months (average = 41.7 months). Thirteen cases (8 benign, 3 borderline, 2 malignant) were Chinese, 9 (all benign) Malay, 7 (4 benign, 1 borderline, 2 malignant) Indian and 1 (malignant) Indonesian. Prevalence of benign versus combined borderline and malignant phyllodes showed a marginally significant difference (p=0.049) between the Malays and Chinese. Patients' ages ranged from 21-70 years with a mean of 44.9 years with no significant difference in age between benign, borderline or malignant phyllodes tumours. Except for benign phyllodes tumours (mean size = 5.8 cm) being significantly smaller at presentation compared with borderline (mean size = 12.5 cm) and malignant (mean size = 15.8 cm) (p<0.05) tumours, history of previous pregnancy, breast feeding, hormonal contraception and tumour laterality did not differ between the three categories. Family history of breast cancer was noted in 2 cases of benign phyllodes. Local excision was performed in 17 benign, 2 borderline and 3 malignant tumours and mastectomy in 4 benign, 2 borderline and 2 malignant tumours. Surgical clearance was not properly recorded in 10 benign phyllodes tumours. Six benign and all 4 borderline and 5 malignant tumours had clearances of <10 mm. Two benign tumours recurred locally at 15 and 49 months after local excision, however information regarding surgical clearance was not available in both cases. One patient with a malignant tumour developed

  16. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    PubMed Central

    2011-01-01

    Background Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills

  17. Documentation of Medical Records in Hospitals of Mazandaran University of Medical Sciences in 2014: a Quantitative Study

    PubMed Central

    Saravi, Benyamin Mohseni; Asgari, Zolaykha; Siamian, Hasan; Farahabadi, Ebrahim Bagherian; Gorji, Alimorad Heidari; Motamed, Nima; Fallahkharyeki, Mohammad; Mohammadi, Ramin

    2016-01-01

    Introduction: Documentation of patient care in medical record formats is always emphasized. These documents are used as a means to go on treating the patients, staff in their own defense, assessment, care, any legal proceedings and medical science education. Therefore, in this study, each of the data elements available in patients’ records are important and filling them indicates the importance put by the documenting teams, so it has been dealt with the documentation the patient records in the hospitals of Mazandaran province. Method: This cross-sectional study aimed to review medical records in 16 hospitals of Mazandaran University of Medical Sciences (MazUMS). In order to collection data, a check list was prepared based on the data elements including four forms of the admission, summary, patients’ medical history and progress note. The data recording was defined as “Yes” with the value of 1, lack of recording was defined as “No” with the value of 2, and “Not applied” with the value of 0 for the cases in which the mentioned variable medical records are not applied. Results: The overall evaluation of the documentation was considered as 95-100% equal to “good”, 75-94% equal to “average” and below -75% equal to “poor”. Using the stratified random sample volume formula, 381 cases were reviewed. The data were analyzed by the SPSS version 19 and descriptive statistics. Results: The results showed that %62 of registration and all the four forms were in the “poor” category. There was no big difference in average registration among the hospitals. Among the educational groups Gynecology and Infectious were equal and had the highest average of documentation of %68. In the data categories, the highest documentation average belonged to the verification, %91. Conclusion: According to the overall assessment in which the rate of documentation was in the category “week”, we should make much more efforts to reach better conditions. Even if a data

  18. Analysis of vancomycin use and associated risk factors in a university teaching hospital: a prospective cohort study

    PubMed Central

    Junior, Moacyr S; Correa, Luci; Marra, Alexandre R; Camargo, Luis FA; Pereira, Carlos AP

    2007-01-01

    Background Vancomycin use is considered inappropriate in most hospitals. A particular concern is the recent emergence of S. aureus with decreased susceptibility to vancomycin, making it important to reduce overall exposure to vancomycin to minimize the incidence of VRE (vancomycin-resistant enterococci). The aim of this work was to analyze the use of vancomycin and the risk factors associated with inappropriate treatment. Methods A prospective survey was conducted on all patients receiving vancomycin between 1st March 2002 and 30th September 2002 in a university-school hospital. Appropriateness of vancomycin use was assessed, according to the criteria established by the Centers for Disease Control and Prevention (CDC), at two time points: first, at the beginning of therapy, and second, continuing after 72 hours. Results A total of 557 patients received vancomycin. Three hundred seventy-four (67.1%) were under 60 years old, 374 (67.1%) had prolonged stays (>two weeks) in hospital, and 455 (81.7%) were in the intensive care unit (ICU). Two hundred sixty-three patients (47.2%) had some invasive device. In 324 (58.2%) patients the duration of vancomycin treatment was up to two weeks. Vancomycin was inappropriately used in 65.7% during the first 24 hours and in 67% at the 72 hours point according to CDC criteria [4]. The inappropriateness of vancomycin use during the first 24 hours was related to: patients aged less than 60 (OR 1.7; CI 95% 1.1–2.5), non-ICU patients (OR 1.5; CI 95% 1.0–2.4) and patients without neutropenia (OR 7.5; CI 95% 2.4–22.7). At 72 hours, the inappropriateness of vancomycin use was related to: patients aged less than 60 (OR 1.5; CI 95% 1.0–2.3), non-ICU patients (OR 1.7; CI 95% 1.1–2.7) and patients without neutropenia (OR 8.0; CI 95% 2.6–24.3). Conclusion Vancomycin was abused. Patients aged less than 60, non-ICU patients and those who did not present neutropenia were the principal groups at risk of inappropriate use. PMID:17678541

  19. Medical school hotline: A History of the University of Hawai'i Postgraduate Medical Education Program at Okinawa Chubu Hospital, 1966-2012.

    PubMed

    Maeshiro, Masao; Izutsu, Satoru; Connolly, Kathleen Kihmm

    2014-06-01

    The University of Hawai'i (UH) has been collaborating with Okinawa Prefectural Chubu Hospital for over 46 years. This collaboration started as a post-World War II effort to increase the physician workforce. At the initiation of the US Army and State Department, the University of Hawai'i was recruited, in cooperation with the government of the Ryukyus and USCAR, to initiate a US style postgraduate clinical training program. The Postgraduate Medical Training Program of University of Hawai'i at Okinawa Chubu Hospital introduced a style of training similar to that in the US by offering a rotating internship. The initial contract had UH establish and run the Postgraduate Medical Training Program of University of Hawaii at Okinawa Central Hospital. After Okinawa's reversion to Japan, under a new contract, UH physicians participated as consultants by providing lectures at "grand rounds" and guidance to faculty, staff, and students. To date, 895 physicians have completed the University of Hawai'i Postgraduate Medical Training Program with 74 currently training. Approximately 662 (74%) of the trainees have remained in Okinawa Prefecture to practice medicine. As a result, the program has enhanced the physician workforce for the islands of Okinawa and neighbor archipelagos of Miyako and Yaeyama Islands.

  20. Identification and characterization of CTX-M-15 producing Klebsiella pneumoniae clone ST101 in a Hungarian university teaching hospital.

    PubMed

    Melegh, Szilvia; Schneider, György; Horváth, Marianna; Jakab, Ferenc; Emődy, Levente; Tigyi, Zoltán

    2015-09-01

    We investigated the molecular epidemiology of extended spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae isolates derived from the teaching hospitals of University of Pécs, Pécs, Hungary in the time period 2004-2008. Molecular typing, antimicrobial susceptibility testing, detection of common β-lactamase genes (bla(CTX-M), bla(TEM) and bla(SHV)) and virulence associated traits (hypermucoviscosity, magA, k2a, rmpA, siderophores, type 1 and 3 fimbria, biofilm formation, serum resistance) were performed for 102 isolates. The results showed the presence of three major ciprofloxacin resistant CTX-M-15 producing clones (ST15 n = 69, ST101 n = 10, and ST147 n = 9), of which ST15 was predominant and universally widespread. Considering distribution in time and place, ST101 and ST147 were detected at fewer inpatient units and within a narrower time frame, as compared to ST15. Beside major clones, eleven minor clones were identified, and were shown to harbour the following β-lactamase genes: six clones carried bla(CTX-M), four clones harboured bla(SHV-5) and one clone possessed both bla(CTX-M) and ESBL type bla(SHV). Among the SHV-5 producing K. pneumoniae clones a novel sequence type was found, namely ST1193, which harboured a unique infB allele. Different virulence factor content and peculiar antimicrobial susceptibility profile were characteristic for each clone. In contrast to major clone isolates, which showed high level resistance to ciprofloxacin, minor clone isolates displayed significantly lower MIC values for ciprofloxacin suggesting a role for fluoroquinolones in the dissemination of the major K. pneumoniae clones. This is the first description of the CTX-M-15 producing K. pneumoniae clone ST101 in Hungary. PMID:26551567

  1. Evaluation of the peer teaching program at the University Children´s Hospital Essen - a single center experience.

    PubMed

    Büscher, Rainer; Weber, Dominik; Büscher, Anja; Hölscher, Maite; Pohlhuis, Sandra; Groes, Bernhard; Hoyer, Peter F

    2013-01-01

    Since 1986 medical students at the University Children's Hospital Essen are trained as peers in a two week intensive course in order to teach basic paediatric examination techniques to younger students. Student peers are employed by the University for one year. Emphasis of the peer teaching program is laid on the mediation of affective and sensomotorical skills e.g. get into contact with parents and children, as well as manual paediatric examination techniques. The aim of this study is to analyse whether student peers are able to impart specific paediatric examination skills as good as an experienced senior paediatric lecturer. 123 students were randomly assigned to a group with either a senior lecturer or a student peer teacher. Following one-hour teaching-sessions in small groups students had to demonstrate the learned skills in a 10 minute modified OSCE. In comparison to a control group consisting of 23 students who never examined a child before, both groups achieved a significantly better result. Medical students taught by student peers almost reached the same examination result as the group taught by paediatric teachers (21,7±4,1 vs. 22,6±3,6 of 36 points, p=0,203). Especially the part of the OSCE where exclusively practical skills where examined revealed no difference between the two groups (7,44±2,15 vs. 7,97±1,87 of a maximum of 16 points, p=0,154). The majority of students (77%) evaluated peer teaching as stimulating and helpful. The results of this quantitative teaching study reveal that peer teaching of selected skills can be a useful addition to classical paediatric teaching classes.

  2. Evaluation of the peer teaching program at the University children´s hospital Essen – a single center experience

    PubMed Central

    Büscher, Rainer; Weber, Dominik; Büscher, Anja; Hölscher, Maite; Pohlhuis, Sandra; Groes, Bernhard; Hoyer, Peter F.

    2013-01-01

    Since 1986 medical students at the University Children’s Hospital Essen are trained as peers in a two week intensive course in order to teach basic paediatric examination techniques to younger students. Student peers are employed by the University for one year. Emphasis of the peer teaching program is laid on the mediation of affective and sensomotorical skills e.g. get into contact with parents and children, as well as manual paediatric examination techniques. The aim of this study is to analyse whether student peers are able to impart specific paediatric examination skills as good as an experienced senior paediatric lecturer. 123 students were randomly assigned to a group with either a senior lecturer or a student peer teacher. Following one-hour teaching-sessions in small groups students had to demonstrate the learned skills in a 10 minute modified OSCE. In comparison to a control group consisting of 23 students who never examined a child before, both groups achieved a significantly better result. Medical students taught by student peers almost reached the same examination result as the group taught by paediatric teachers (21,7±4,1 vs. 22,6±3,6 of 36 points, p=0,203). Especially the part of the OSCE where exclusively practical skills where examined revealed no difference between the two groups (7,44±2,15 vs. 7,97±1,87 of a maximum of 16 points, p=0,154). The majority of students (77%) evaluated peer teaching as stimulating and helpful. The results of this quantitative teaching study reveal that peer teaching of selected skills can be a useful addition to classical paediatric teaching classes. PMID:23737922

  3. Identification and characterization of CTX-M-15 producing Klebsiella pneumoniae clone ST101 in a Hungarian university teaching hospital.

    PubMed

    Melegh, Szilvia; Schneider, György; Horváth, Marianna; Jakab, Ferenc; Emődy, Levente; Tigyi, Zoltán

    2015-09-01

    We investigated the molecular epidemiology of extended spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae isolates derived from the teaching hospitals of University of Pécs, Pécs, Hungary in the time period 2004-2008. Molecular typing, antimicrobial susceptibility testing, detection of common β-lactamase genes (bla(CTX-M), bla(TEM) and bla(SHV)) and virulence associated traits (hypermucoviscosity, magA, k2a, rmpA, siderophores, type 1 and 3 fimbria, biofilm formation, serum resistance) were performed for 102 isolates. The results showed the presence of three major ciprofloxacin resistant CTX-M-15 producing clones (ST15 n = 69, ST101 n = 10, and ST147 n = 9), of which ST15 was predominant and universally widespread. Considering distribution in time and place, ST101 and ST147 were detected at fewer inpatient units and within a narrower time frame, as compared to ST15. Beside major clones, eleven minor clones were identified, and were shown to harbour the following β-lactamase genes: six clones carried bla(CTX-M), four clones harboured bla(SHV-5) and one clone possessed both bla(CTX-M) and ESBL type bla(SHV). Among the SHV-5 producing K. pneumoniae clones a novel sequence type was found, namely ST1193, which harboured a unique infB allele. Different virulence factor content and peculiar antimicrobial susceptibility profile were characteristic for each clone. In contrast to major clone isolates, which showed high level resistance to ciprofloxacin, minor clone isolates displayed significantly lower MIC values for ciprofloxacin suggesting a role for fluoroquinolones in the dissemination of the major K. pneumoniae clones. This is the first description of the CTX-M-15 producing K. pneumoniae clone ST101 in Hungary.

  4. Diffusion and transmission of carbapenem-resistant Klebsiella pneumoniae in the medical and surgical wards of a university hospital in Milan, Italy.

    PubMed

    Ridolfo, Anna L; Rimoldi, Sara G; Pagani, Cristina; Marino, Andrea F; Piol, Anna; Rimoldi, Matteo; Olivieri, Pietro; Galli, Massimo; Dolcetti, Lucia; Gismondo, Maria R

    2016-01-01

    Carbapenem-resistant Klebsiella pneumoniae (CRKP) is emerging as a public health problem worldwide. In Italy, a remarkable increase in CRKP cases has been reported since 2010. In this study, CRKP diffusion, distribution and in-hospital transmission trends were evaluated in a university hospital in Milan, Italy, from January 2012 to December 2013. Isolates from 63 newly detected CRKP-positive patients were genotyped, and possible transmission was determined by combining the molecular results with data concerning the patients' admission and in-hospital transfers. Most of the cases (90.4%) were from general medical and surgery wards, and the remaining 9.6% were from the intensive care unit. Fifteen of the 46 hospital-associated cases (32.6%) were attributable to in-hospital transmission. After the introduction of targeted and hospital-wide control measures, the transmission index significantly decreased from 0.65 to 0.13 (p=0.01). There was also a decrease in the overall nosocomial case incidence, from 0.37 to 0.17 per 1000 person-days (p=0.07). Our findings indicate that the spread of CRKP in Northern Italy hospitals may go far beyond high-risk settings (i.e., intensive care units) and that strict surveillance should be extended to general areas of care.

  5. Transfusion-Transmissible Infections among Voluntary Blood Donors at Wolaita Sodo University Teaching Referral Hospital, South Ethiopia

    PubMed Central

    Bekele, Fanuel Belayneh; Ageru, Temesgen Anjulo; Wada, Fiseha Wadilo

    2016-01-01

    Background. Transfusion-transmissible infections, human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis are among the greatest threats to blood safety and pose a serious public health problem. Objective. To determine the magnitude of blood borne infections among blood donors at Wolaita Sodo University Teaching Referral Hospital. Methods and Materials. A cross-sectional study was conducted from 10/11/2015 up to 10/12/2015. 390 donors were consecutively included and data on donor's age, sex, blood type, and serum screening results were obtained by structured questionnaire and laboratory investigation. The collected data were entered into Epi Data version 1.4 and then exported to SPSS version 20.0 for analysis. Result. The seroprevalence of blood borne pathogens is 29.5% of which HCV, HBV, HIV, and syphilis account for 8.5%, 9.5%, 6.4%, and 7.5%, respectively. Multiple infections were observed among 2.8% of the infected individuals. In addition, age ≥ 30 has a significant association with HCV. Conclusion. Significantly higher prevalence of transfusion-transmissible infections was identified from blood donors and they remain to be the greatest threat to blood safety, so comprehensive screening of donors' blood for HIV, HBV, HCV, and syphilis using standard methods is highly recommended to ensure the safety of blood recipient. PMID:27597875

  6. The effects of work on the health of nurses who work in clinical surgery departments at university hospitals 1

    PubMed Central

    da Silva, Rosângela Marion; Zeitoune, Regina Célia Gollner; Beck, Carmem Lúcia Colomé; de Martino, Milva Maria Figueiredo; Prestes, Francine Cassol

    2016-01-01

    ABSTRACT Objective: to analyze the effects of work on the health of nurses who work in clinical surgery departments at university hospitals in relation to physical, social and psychological suffering and pain. Methods: a quantitative transversal study was carried out between 2012 and 2013 in four institutions in a state located in the south of Brazil. We studied 65 nurses who responded to questions on their habits. We also obtained sociodemographical information on them as well as conducting an evaluation on work relational damage using an evaluation scale. Associations were checked through the use of the Chi-Sqaure and Fisher's exact test. Correlations were checked using the Spearmann test. Results: we found that physical ailments persisted and that there were connections between social and psychological pain/suffering and variable physical activities as well as connections with accidents in the work place and the option to work shifts. We noted correlations between social and psychological pain/suffering. Conclusion: nurses had their health compromised due to their work in clinical surgery departments. PMID:27508914

  7. Phenotypic Detection of Genitourinary Candidiasis among Sexually Transmitted Disease Clinic Attendees in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria

    PubMed Central

    Obisesan, Oluranti J.; Olowe, Olugbenga A.; Taiwo, Samuel S.

    2015-01-01

    The management of genitourinary candidiasis (GC) is fraught with challenges, especially, in an era of increasing antifungal resistance. This descriptive cross-sectional study conducted between May 2013 and January 2014 determined the prevalence and characteristics of GC and the species of Candida among 369 attendees of a Sexually Transmitted Disease (STD) clinic of Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria. Appropriate urogenital specimen collected from each attendee was examined by microscopy and culture for Candida, with preliminary species identification by CHROMAgar Candida and confirmation by Analytical Profile Index (API) 20C AUX. The age range of attendees was 1-80 years, mean age was 36.32 ± 11.34 years, and male to female ratio was 1 to 3. The prevalence of genitourinary candidiasis was 47.4%, with 4.9% in males and 42.5% in females (p < 0.0001). The age groups 31–45 and 16–30 have the highest prevalence of 23.3% and 16.8%, respectively. The species of Candida recovered include Candida glabrata 46.9%, Candida albicans 33.7%, Candida dubliniensis 9.7%, Candida tropicalis 5.7%, Candida krusei 1.7%, Candida lusitaniae 1.7%, and Candida utilis 0.6%. This study reported non-C. albicans Candida, especially C. glabrata, as the most frequently isolated species in GC, contrary to previous studies in this environment and elsewhere. PMID:26064140

  8. The experience with fine needle aspiration cytology in the management of palpable breast lumps in the University Hospital Kuala Lumpur.

    PubMed

    Yip, C H; Jayaram, G; Alhady, S F

    2000-09-01

    A total of 676 palpable breast lumps seen in the Breast Clinic, University Hospital, Kuala Lumpur from August 1993 to August 1994 were subjected to fine needle aspiration cytology. Fifty-four were reported as inadequate, 501 benign, 95 malignant and 26 suspicious. One hundred and eighty-seven aspirates had histological correlation, while 34 of the malignant aspirates had clinical correlation. The majority of the other 455 patients were followed up for a period of 60 to 72 months without any malignancies becoming apparent. For analysis, only the 221 cases with histological or clinical correlation were included, (the suspicious category was included into the positive group and the inadequate cases were excluded), giving a sensitivity of 91.7%, a specificity of 91.7% and a diagnostic accuracy of 91.7%. Breast cytology was an accurate and rapid method of diagnosis of breast diseases, and in a busy surgical unit with limited operating time, it allowed for the triage of patients with breast complaints in deciding which cases needed early open biopsy. A negative cytology does not exclude the possibility of cancer, as there was a false negative rate of 11%. However by utilising a diagnostic triad of clinical examination, radiological assessment and fine needle aspiration cytology, the risk of missing a malignancy is small.

  9. The pattern of homicidal slash/chop injuries: a 10 year retrospective study in University Hospital Kuala Lumpur.

    PubMed

    Ong, B B

    1999-03-01

    Homicides as a result of slash/chop injuries are not commonly reported in forensic literature. A 10 year retrospective study from 1987 to 1996 was performed on the pattern of homicidal slash/chop injuries in University Hospital, Kuala Lumpur. A total of 37 cases were analysed. The ages ranged from 17 to 85 years. The victims consisted of Indonesian (37.8%), Chinese (27.0%), Indian (24.3%) and Malay (8.1%) ethnic groups; 2.7% of the cases were not identified. Most of the cases were due to intentional violence (n = 27), while the rest consisted of domestic violence (n = 2), robbery (n = 2), psychiatric homicide (n = 1), accident (n = 2) and unclassified (n = 3). In the intentional violence group, the majority of the victims (n = 16) had more than five wounds. In contrast, the victims in other categories had less than five wounds each, with the exception of a single case in the psychiatric-homicide group. In homicide victims with a single wound, the most common site of injury was the neck. In those with multiple wounds, the common sites were the head and neck. Sixteen cases showed defence injuries, all of them belonging to the intentional-violence group. The reasons for the high incidence of homicidal slash/chop wounds are discussed, as well as the difficulties associated with interpretation of such wounds.

  10. The incidence of human herpesvirus 6 infection in children with febrile convulsion admitted to the University Hospital, Kuala Lumpur.

    PubMed

    Chua, K B; Lam, S K; AbuBakar, S; Koh, M T; Lee, W S

    1997-12-01

    From October 1996 to March 1997, 31 children with febrile convulsions were admitted to the University Hospital, Kuala Lumpur. Human Herpesvirus 6 (HHV 6) was virologically and/or serologically confirmed to be the cause of the febrile episode in 5 of these children (16.1%). Age, sex and other associated clinical features (diarrhoea, cough, running nose and type of seizure) were not useful in differentiating cases of febrile convulsion due to HHV 6 from those of other aetiology. However, uvulo-palatoglossal junctional ulcers were noted in children in whom the cause of the seizure could be attributed to HHV 6 but not in the remaining cases in the study group. HHV 6 DNA was detected in peripheral blood mononuclear cells from all patients with febrile convulsions attributed to HHV6, and in patients shown serologically to have already been exposed to the virus by nested polymerase chain reaction amplification. Only genotype HHV 6B was detected from patients with seizure due to HHV 6 but both genotype 6A and 6B were detected in the remaining cases studied.

  11. Prevalence and Antimicrobial Resistance in Salmonella and Shigella Species Isolated from Outpatients, Jimma University Specialized Hospital, Southwest Ethiopia.

    PubMed

    Lamboro, Tesfahun; Ketema, Tsige; Bacha, Ketema

    2016-01-01

    This study was designed to investigate the prevalence of Salmonella and Shigella among outpatients in Jimma University Specialized Hospital, Southwest Ethiopia. Cross-sectional study was conducted involving a total of 176 outpatients. Stool specimens from both adult and pediatric outpatients were collected and analyzed for the presence of presumptive Salmonella and Shigella colonies followed by confirmation by biochemical tests. Pure cultures of Salmonella and Shigella species were further subjected to test for antibiotic resistance against the commonly used antibiotics. Furthermore, growth potential of the isolates in selected foods items was assessed following standard procedures. The result indicated that the prevalence of Salmonella and Shigella among outpatients in the study area was 19 (10.8%) and 2 (1.1%), respectively. In addition, Salmonella species were resistant to ampicillin (100%) followed by tetracycline (47.4%) and nalidixic acid (26.3%) while Shigella species were highly resistant to ampicillin and tetracycline (100%, each). Multidrug resistance towards maximum of four drugs was observed in both pathogens. The pathogens were observed growing to their infective dose within 24 hours. In conclusion, Salmonella and Shigella are still among microbes of public health importance in the study area. Thus, this calls for frequent monitory and evaluation of their prevalence and drug resistance patterns besides awareness development on water sanitation and hygienic food handling practices to the public at large.

  12. Study of H. pylori infection in children with recurrent abdominal pain attending the pediatrics outpatient clinic of Zagazig University Hospitals.

    PubMed

    Badr, M A; El-Saadany, Hosam F; Ali, Adel S A; Abdelrahman, D

    2012-12-01

    This study assessed the prevalence of H. pylori infection in children with recurrent abdominal pain attending the Outpatient Pediatric Clinic of Zagazig University Hospitals. The study was conducted on 100 children suffering from different GIT symptoms mainly recurrent abdominal pain, they were categorized into 3 categories according to their ages. First category below 5 years, second category between 5 and 10 years and last category above 10 years. All subjects underwent full history taking, clinical examination and laboratory investigations. Protozoa infection was in 29% of patients, helminthes 10%, chronic constipation 4% and UTI 4%. The patients with apparent etiology were excluded. The data do not support the hypothesis that there is a direct role for H. pylori infection as a causative agent for Recurrent Abdominal Pain (RAP) in children. The mean +/- SD of age of patients were 5.7 +/- 3.7, with range of 1:18 years. Male to female ratio was 1:1.1. H. pylori serum IgG antibodies were in 26 patients (43.3%) and 24 controls (p = 0.71), and H. pylori stool Ag in stool of 22 cases and 20 controls (p = 0.7).

  13. Epidemiology and clinical consequences of occupational exposure to blood and other body fluids in a university hospital in Saudi Arabia

    PubMed Central

    Samargandy, Shireen A.; Bukhari, Lujain M.; Samargandy, Shaza A.; Bahlas, Rawiah S.; Aldigs, Eman K.; Alawi, Maha M.; Al-Abdullah, Nabeela A.; Madani, Tariq A.

    2016-01-01

    Objectives: To describe the epidemiological characteristics, clinical impact, and adequacy of post-exposure management of occupational exposure to blood and body fluids (BBFs). Methods: Retrospective chart review of individuals reporting exposure to BBFs from 2007 to 2013 at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Results: The total number of exposures reported was 326 exposures, of which 302 (92.6%) exposures were percutaneous, 21 (6.5%), mucocutaneous, and 3 (0.9%), bites. Nursing staff/students had the highest rate of exposure (149, or 45.6%), followed by physicians (57, or 17.5%). Surgeons were found to have a significantly higher risk for sharp injuries compared with other physicians (26.3%, or 15 exposures, p<0.005). Most (216, or 72.5%) percutaneous injuries were caused by hollow-bore needles. Majority of exposures (124, or 42.6%) occurred after using the needle/sharp item and before disposal. Two-thirds (219, or 67%) of exposed individuals were immune to hepatitis B at the time of exposure. With appropriate post-exposure management, none of exposed individuals seroconverted to HIV, hepatitis B or C virus infections. Conclusion: Occupational exposure to BBFs remains a concern among healthcare workers. Educational programs targeting high-risk groups entailing reinforcement of prevention and adherence to post-exposure management guidelines are needed. PMID:27381540

  14. Considerations for clinics and practitioners treating foreign patients with assisted reproductive technology: lessons from experiences at Ghent University Hospital, Belgium.

    PubMed

    De Sutter, Petra

    2011-11-01

    Cross-border reproductive care (CBRC) is not a new concept, having been around since the beginning of assisted reproductive technology. Countries having taken the lead in developing new technologies have seen an influx of patients from other countries, because of legal limitations or the unavailability of good-quality care in their home country. This paper describes the experience of the Ghent University Hospital fertility centre with Dutch and French patients and tries to set out standards of care for CBRC patients. Dutch patients usually have longer histories, more complex pathology and are better informed, more outspoken and more financially secure. Thus, the care for these patients is challenging. The standards of care should be the same for local patients and CBRC patients; however, the nature of the complexity of the problems they come with will necessitate more time investment. Experience shows that many patients who have no access to treatment in their own country obtain reasonably good results. Some of them, however, are beyond possible help and these patients need a high standard of psychological care. All should be done to avoid that cross-border patients compromise the local care system. Special arrangements should be taken to manage possible complications following treatment.

  15. Effect of an environmental health educational programme for paediatricians in an Egyptian University Hospital: before and after study

    PubMed Central

    Abbas, Reem A; Alghobashy, Ashgan A

    2012-01-01

    Objectives To study the effect of an educational intervention on paediatricians' knowledge, attitudes and practices regarding children's environmental health and to identify the sources of information and common environmental history taking constrains. Design Before and after study. Setting Zagazig University Paediatric Hospital. Participants Practising paediatricians from all specialty units. Main outcome measures The outcome of a specifically designed educational programme about paediatric environmental health was assessed using structured pre- and post-test questionnaires. Results Nearly half the participants were aware about most of the paediatric environmental health-related topics. Textbooks/guidelines (85.7%) and the Internet (64.3%) were the main sources of information. The participants demonstrated relatively strong positive attitudes towards the importance of children's environmental health. However, less than half of them (44.6%) reported environmental history taking as a routine practice; where lack of time (94.6%), wide range of hazardous exposures (91.1%) and lack of expertise and training (91.1%) were the main constrains. Significant improvement in participants' knowledge, attitudes and practices was revealed after the educational programme. Conclusions There is a demand for continuous medical education about environmental health in paediatric practice, particularly environmental and occupational history taking. PMID:23476728

  16. Candida albicans bloodstream isolates in a German university hospital are genetically heterogenous and susceptible to commonly used antifungals.

    PubMed

    Huyke, Johanna; Martin, Ronny; Walther, Grit; Weber, Michael; Kaerger, Kerstin; Bougnoux, Marie-Elisabeth; Elias, Johannes; Kurzai, Oliver

    2015-10-01

    From an eight-year-span, 99 Candida bloodstream isolates were collected at the University Hospital Wuerzburg, Germany. In this study, all strains were analyzed using molecular and phenotypic typing methods. Confirmatory species identification revealed three isolates that were initially diagnosed as C. albicans to be actually C. dubliniensis. Two isolates contained a mixed culture of C. albicans and C. glabrata, in one of the specimens both species could be separated while it was not possible to recover C. albicans in the other sample. The remaining 95 C. albicans isolates were profiled by multilocus sequence typing (MLST). Phylogenetic analyses showed a highly heterogenous collection of strains, associated with many different clades and constituting a set of new diploid sequence types (DST). For all strains with identical DST, patient data were reviewed for potential nosocomial transmission. In addition, all isolates were tested for their susceptibility to amphotericin B, caspofungin, fluconazole, itraconazole, posaconazole and voriconazole. No clinically relevant resistance could be detected. Furthermore, these data underline that correlation between minimal inhibitory concentrations for caspofungin and anidulafungin is low.

  17. Detection of selected intestinal helminths and protozoa at Hospital Universiti Sains Malaysia using multiplex real-time PCR.

    PubMed

    Basuni, M; Mohamed, Z; Ahmad, M; Zakaria, N Z; Noordin, R

    2012-09-01

    Intestinal parasites are the causative agents of a number of important human infections in developing countries. The objective of this study was to determine the prevalence of selected helminths and protozoan infections among patients admitted with gastrointestinal disorders at Hospital Universiti Sains Malaysia, Kelantan, Malaysia using multiplex real-time PCR. In addition microscopic examination was also performed following direct smear, zinc sulphate concentration and Kato-Katz thick smear techniques; and the presence of protozoan parasites was confirmed using trichrome and acid-fast stains. Of the 225 faecal samples analysed, 26.2% were positive for intestinal parasites by the multiplex real-time PCR, while 5.3% were positive by microscopy. As compared to microscopy, the multiplex real-time PCR detected 5.8 and 4.5 times more positives for the selected helminth and protozoan infections respectively. Among the selected helminths detected in this study, hookworm was the most prevalent by real-time PCR, while Ascaris lumbricoides was detected the most by microscopy. Meanwhile, among the selected protozoa detected in this study, Entamoeba histolytica was the most prevalent by real-time PCR, however microscopy detected equal number of cases with E. histolytica and Giardia lamblia. This study showed that real-time PCR can be used to obtain a more accurate prevalence data on intestinal helminths and protozoa.

  18. Early detection of pneumonia as a risk factor for mortality in burn patients in Menoufiya University Hospitals, Egypt.

    PubMed

    Mgahed, M; El-Helbawy, R; Omar, A; El-Meselhy, H; Abd El-Halim, R

    2013-09-30

    Pneumonia is common among critically ill burn patients and is a major cause of morbidity and mortality among them. Prediction of mortality in patients with severe burns remains unreliable. The aim of this research is to study the incidence, early diagnosis and management of nosocomial pneumonia, and to discuss the relationship between pneumonia and death in burn patients. This prospective study was carried out on 80 burn patients (35 males and 45 females) admitted to Menoufiya University Hospital Burn Center and Chest Department, Egypt, from September 2011 to March 2012. Our findings showed an overall burn patient mortality rate of 26.25 % (21/80), 15% (12/80) incidence of pneumonia, and a 50% (6/12) mortality rate among patients with pneumonia compared to 22 % (15/68) for those without pneumonia. The incidence of pneumonia was twice as high in the subset of patients with inhalation injury as among those without inhalation injury (P< 0.001). It was found that the presence of pneumonia, inhalation injury, increased burn size, and advanced age were all associated with increased mortality (P< 0.001). In the late onset pneumonia, other associated factors also contributed to mortality. Severity of disease, severity of illness (APACHE score), organ failure, underlying co-morbidities, and VAP PIRO score all have significant correlations with mortality rate. Pneumonia was an important factor for predicting burn patient mortality. Early detection and management of pneumonia are absolutely essential. PMID:24563638

  19. Risk Reduction of Needle Stick Injuries Due to Continuous Shift from Unsafe to Safe Instruments at a German University Hospital

    PubMed Central

    Frickmann, Hagen; Schmeja, Wibke; Reisinger, Emil; Mittlmeier, Thomas; Mitzner, Karen; Schwarz, Norbert Georg; Warnke, Philipp; Podbielski, Andreas

    2016-01-01

    This study assessed protective effects of a continuous introduction of safe instruments in terms of reduction of needle stick injuries. The retrospective study analyzed correlations between the increasing proportion of safe instruments and a reduction of the incidence of needle stick injuries linked to such instruments in a German university hospital over 5 years. Incidents declined about 17.6% from 80.3 incidents per 1000 employees to 66.2, associated with an increase in the proportions of injuries due to instruments without protective mechanisms such as scalpels or hypodermic needles by 12.2%. For injuries due to venipuncture cannulae in various surgical and internal medicine departments, there was a negative association between the proportion of safe instruments and the incidence of injuries. For injection needles, portacath needles, and lancets in selected internal medicine departments, the number of injuries also dropped during this study interval. However, there was no clear-cut association with the percentage of safe instruments. This observational study suggests a correlation between the implementation of use of safe instruments and the reduction of needle stick injuries in a case of a graduated implementation. However, the effects are much less pronounced than in previous interventional studies. PMID:27766172

  20. Prevalence and Antimicrobial Resistance in Salmonella and Shigella Species Isolated from Outpatients, Jimma University Specialized Hospital, Southwest Ethiopia

    PubMed Central

    Lamboro, Tesfahun; Bacha, Ketema

    2016-01-01

    This study was designed to investigate the prevalence of Salmonella and Shigella among outpatients in Jimma University Specialized Hospital, Southwest Ethiopia. Cross-sectional study was conducted involving a total of 176 outpatients. Stool specimens from both adult and pediatric outpatients were collected and analyzed for the presence of presumptive Salmonella and Shigella colonies followed by confirmation by biochemical tests. Pure cultures of Salmonella and Shigella species were further subjected to test for antibiotic resistance against the commonly used antibiotics. Furthermore, growth potential of the isolates in selected foods items was assessed following standard procedures. The result indicated that the prevalence of Salmonella and Shigella among outpatients in the study area was 19 (10.8%) and 2 (1.1%), respectively. In addition, Salmonella species were resistant to ampicillin (100%) followed by tetracycline (47.4%) and nalidixic acid (26.3%) while Shigella species were highly resistant to ampicillin and tetracycline (100%, each). Multidrug resistance towards maximum of four drugs was observed in both pathogens. The pathogens were observed growing to their infective dose within 24 hours. In conclusion, Salmonella and Shigella are still among microbes of public health importance in the study area. Thus, this calls for frequent monitory and evaluation of their prevalence and drug resistance patterns besides awareness development on water sanitation and hygienic food handling practices to the public at large. PMID:27642307

  1. Phenotypic Detection of Genitourinary Candidiasis among Sexually Transmitted Disease Clinic Attendees in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria.

    PubMed

    Obisesan, Oluranti J; Olowe, Olugbenga A; Taiwo, Samuel S

    2015-01-01

    The management of genitourinary candidiasis (GC) is fraught with challenges, especially, in an era of increasing antifungal resistance. This descriptive cross-sectional study conducted between May 2013 and January 2014 determined the prevalence and characteristics of GC and the species of Candida among 369 attendees of a Sexually Transmitted Disease (STD) clinic of Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria. Appropriate urogenital specimen collected from each attendee was examined by microscopy and culture for Candida, with preliminary species identification by CHROMAgar Candida and confirmation by Analytical Profile Index (API) 20C AUX. The age range of attendees was 1-80 years, mean age was 36.32 ± 11.34 years, and male to female ratio was 1 to 3. The prevalence of genitourinary candidiasis was 47.4%, with 4.9% in males and 42.5% in females (p < 0.0001). The age groups 31-45 and 16-30 have the highest prevalence of 23.3% and 16.8%, respectively. The species of Candida recovered include Candida glabrata 46.9%, Candida albicans 33.7%, Candida dubliniensis 9.7%, Candida tropicalis 5.7%, Candida krusei 1.7%, Candida lusitaniae 1.7%, and Candida utilis 0.6%. This study reported non-C. albicans Candida, especially C. glabrata, as the most frequently isolated species in GC, contrary to previous studies in this environment and elsewhere.

  2. Prevalence of depression and its associated factors among elderly patients in outpatient clinic of Universiti Sains Malaysia Hospital.

    PubMed

    Imran, A; Azidah, A K; Asrenee, A R; Rosediani, M

    2009-06-01

    Depression among elderly primary care patients is a serious problem with significant morbidity and mortality. This is a cross sectional study to determine the prevalence of depression and its associated factors among the elderly patients attending the outpatient clinic, Universiti Sains Malaysia Hospital. This study utilized Malay version Geriatric Depression Scale 14 (M-GDS 14) to screen for elderly depression among Malaysian population. It also looked into associated risk factors for elderly depression using sociodemographic, family dynamics, and medically related questionnaires. Out of 244 subjects, 34 or 13.9% were found to have depression. Three variables were found to be significantly associated with depression. Elderly patient with any illness that limits the patient's activity or mobility has more risk of developing depression (OR 2.68 CI 1.15 - 6.24). Elderly patients who were satisfied with their personal incomes (OR 0.29 CI 0.10 - 0.85), and who had children or son/daughter-in-law to take care of them when they are sick (OR 0.10 CI 0.01 - 0.83) have a lower chance of having depression. Screening the elderly for depression, would help in diagnosing the elderly depression better and offer them the treatment needed.

  3. Prevalence and Antimicrobial Resistance in Salmonella and Shigella Species Isolated from Outpatients, Jimma University Specialized Hospital, Southwest Ethiopia.

    PubMed

    Lamboro, Tesfahun; Ketema, Tsige; Bacha, Ketema

    2016-01-01

    This study was designed to investigate the prevalence of Salmonella and Shigella among outpatients in Jimma University Specialized Hospital, Southwest Ethiopia. Cross-sectional study was conducted involving a total of 176 outpatients. Stool specimens from both adult and pediatric outpatients were collected and analyzed for the presence of presumptive Salmonella and Shigella colonies followed by confirmation by biochemical tests. Pure cultures of Salmonella and Shigella species were further subjected to test for antibiotic resistance against the commonly used antibiotics. Furthermore, growth potential of the isolates in selected foods items was assessed following standard procedures. The result indicated that the prevalence of Salmonella and Shigella among outpatients in the study area was 19 (10.8%) and 2 (1.1%), respectively. In addition, Salmonella species were resistant to ampicillin (100%) followed by tetracycline (47.4%) and nalidixic acid (26.3%) while Shigella species were highly resistant to ampicillin and tetracycline (100%, each). Multidrug resistance towards maximum of four drugs was observed in both pathogens. The pathogens were observed growing to their infective dose within 24 hours. In conclusion, Salmonella and Shigella are still among microbes of public health importance in the study area. Thus, this calls for frequent monitory and evaluation of their prevalence and drug resistance patterns besides awareness development on water sanitation and hygienic food handling practices to the public at large. PMID:27642307

  4. Use of Complementary and Alternative Medicine in Children with Cancer: A Study at a Swiss University Hospital

    PubMed Central

    Magi, Tatjana; Kuehni, Claudia E.; Torchetti, Loredana; Wengenroth, Laura; Lüer, Sonja; Frei-Erb, Martin

    2015-01-01

    Background Though complementary and alternative medicine (CAM) are frequently used by children and adolescents with cancer, there is little information on how and why they use it. This study examined prevalence and methods of CAM, the therapists who applied it, reasons for and against using CAM and its perceived effectiveness. Parent-perceived communication was also evaluated. Parents were asked if medical staff provided information on CAM to patients, if parents reported use of CAM to physicians, and what attitude they thought physicians had toward CAM. Study Design All childhood cancer patients treated at the University Children’s Hospital Bern between 2002–2011 were retrospectively surveyed about their use of CAM. Results Data was collected from 133 patients (response rate: 52%). Of those, 53% had used CAM (mostly classical homeopathy) and 25% of patients received information about CAM from medical staff. Those diagnosed more recently were more likely to be informed about CAM options. The most frequent reason for choosing CAM was that parents thought it would improve the patient’s general condition. The most frequent reason for not using CAM was lack of information. Of those who used CAM, 87% perceived positive effects. Conclusions Since many pediatric oncology patients use CAM, patients’ needs should be addressed by open communication between families, treating oncologists and CAM therapists, which will allow parents to make informed and safe choices about using CAM. PMID:26694320

  5. Prevalence and associated factors of Carpal Tunnel Syndrome (CTS) among medical laboratory staff at King Saud University Hospitals, KSA

    PubMed Central

    Ahamed S, Shaffi; Anas M, Bardeesi; Aref A, Altwair; Abdulrahman A, AlMubarak

    2015-01-01

    Background and Objectives: Carpal tunnel syndrome (CTS) is a group of symptoms resulting from local compression of the median nerve at the wrist leading to its subsequent functional impairment and local ischemia of the nerve. Our objective was to determine the prevalence and commonly reported symptoms of CTS in the laboratory workers of King Saud University (KSU) hospitals and to identify the associated variables with CTS. Methods: This was a quantitative observational cross-sectional study which was conducted in KSU hospitals’ laboratories with a total of 225 participants by using a standardized questionnaire known as “ Boston Carpal Tunnel Questionnaire (BCTQ). Data Analysis was carried out by IBM SPSS Statistics software version 21.0. Results: Out of the 225 participants, 57 were found to be severely symptomatic with a prevalence of 25.3%. Among the severely affected participants, females were more than males (58% > 42%) and the difference was statistically significant (p=0.045). Technicians affected (91.2%) were more than attendants (8.8%) and the difference was statistically significant (p=0.042). Conclusion: The prevalence of Carpal tunnel syndrome in KSU hospitals’ medical laboratory staff (25.3%) was close to what was found in literature (21.5%). So laboratory workers are at risk of developing CTS, especially females and technicians with the dominant hand most likely to be affected. PMID:26101485

  6. Prevalence and risk factors for Staphylococcus aureus in health care workers at a university hospital of Recife-PE.

    PubMed

    Silva, Eduardo Caetano Brandão Ferreira da; Antas, Maria das Graças C; Monteiro B Neto, Armando; Rabelo, Marcelle Aquino; Melo, Fábio Lopes de; Maciel, Maria Amélia Vieira

    2008-12-01

    Staphylococcus aureus is the main human pathogen that colonizes individuals in general population. The objective of the study was evaluate the epidemiological and sensitivity profile of S. aureus lineage, isolated in health care workers (HCW) of a University Hospital in Pernambuco state, Brazil. Biological samples of hands and nasal cavities were sown in agar sheep blood. Colonies under suspicion of being S. aureus were identified using Gram staining, catalase test and coagulase, mannitol-salty agar fermentation and DNAse agar. The resistance to mupirocin was analyzed through the Kirby Bauer technique. In relation to methicillin and vancomycin the determination was by the minimum inhibitory concentration method (E-test). From the 202 HCW evaluated, 52 were colonized by S. aureus (25,7%). The factors associated to the colonization by S. aureus were: age-group, professional category, use of individual protection equipments (frequency and numbers). All S. aureus isolate lineages were sensitive to mupirocin and vancomycin, and three of them were identified as methicillin-resistant. The prevalence of MSSA and MRSA among HCW was considered low and was below the results described in the literature. The isolate S. aureus lineages have shown low resistance profile.

  7. Transfusion-Transmissible Infections among Voluntary Blood Donors at Wolaita Sodo University Teaching Referral Hospital, South Ethiopia.

    PubMed

    Bisetegen, Fithamlak Solomon; Bekele, Fanuel Belayneh; Ageru, Temesgen Anjulo; Wada, Fiseha Wadilo

    2016-01-01

    Background. Transfusion-transmissible infections, human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis are among the greatest threats to blood safety and pose a serious public health problem. Objective. To determine the magnitude of blood borne infections among blood donors at Wolaita Sodo University Teaching Referral Hospital. Methods and Materials. A cross-sectional study was conducted from 10/11/2015 up to 10/12/2015. 390 donors were consecutively included and data on donor's age, sex, blood type, and serum screening results were obtained by structured questionnaire and laboratory investigation. The collected data were entered into Epi Data version 1.4 and then exported to SPSS version 20.0 for analysis. Result. The seroprevalence of blood borne pathogens is 29.5% of which HCV, HBV, HIV, and syphilis account for 8.5%, 9.5%, 6.4%, and 7.5%, respectively. Multiple infections were observed among 2.8% of the infected individuals. In addition, age ≥ 30 has a significant association with HCV. Conclusion. Significantly higher prevalence of transfusion-transmissible infections was identified from blood donors and they remain to be the greatest threat to blood safety, so comprehensive screening of donors' blood for HIV, HBV, HCV, and syphilis using standard methods is highly recommended to ensure the safety of blood recipient. PMID:27597875

  8. Prevalence and Antimicrobial Resistance in Salmonella and Shigella Species Isolated from Outpatients, Jimma University Specialized Hospital, Southwest Ethiopia

    PubMed Central

    Lamboro, Tesfahun; Bacha, Ketema

    2016-01-01

    This study was designed to investigate the prevalence of Salmonella and Shigella among outpatients in Jimma University Specialized Hospital, Southwest Ethiopia. Cross-sectional study was conducted involving a total of 176 outpatients. Stool specimens from both adult and pediatric outpatients were collected and analyzed for the presence of presumptive Salmonella and Shigella colonies followed by confirmation by biochemical tests. Pure cultures of Salmonella and Shigella species were further subjected to test for antibiotic resistance against the commonly used antibiotics. Furthermore, growth potential of the isolates in selected foods items was assessed following standard procedures. The result indicated that the prevalence of Salmonella and Shigella among outpatients in the study area was 19 (10.8%) and 2 (1.1%), respectively. In addition, Salmonella species were resistant to ampicillin (100%) followed by tetracycline (47.4%) and nalidixic acid (26.3%) while Shigella species were highly resistant to ampicillin and tetracycline (100%, each). Multidrug resistance towards maximum of four drugs was observed in both pathogens. The pathogens were observed growing to their infective dose within 24 hours. In conclusion, Salmonella and Shigella are still among microbes of public health importance in the study area. Thus, this calls for frequent monitory and evaluation of their prevalence and drug resistance patterns besides awareness development on water sanitation and hygienic food handling practices to the public at large.

  9. Development of Clinical Pharmacy services at King Khalid University Hospital and its impact on the quality of healthcare provided.

    PubMed

    Saddique, Abdulaziz A

    2012-07-01

    Clinical Pharmacy is a unique service provided by the leading pharmacy departments in the United States. The concept of Clinical Pharmacy evolved after the significant increase in number of pharmaceuticals in the market and the increasing potential of drug interactions. However, the Clinical Pharmacist is not merely an individual who advises on drug interactions. There are a number of functions which include but are not limited to; the design of appropriate drug therapy, such as Pharmacokinetic assessment and evaluation to optimize drug therapy, drug information dissemination to the physicians and other healthcare providers and participation as a toxicology consultant in Poison management. At the King Khalid University Hospital (KKUH) the first Clinical Pharmacy services program began in 1983. The aim of this study is to evaluate the impact of our Clinical Pharmacy program on the patients' care as well as its perception by the Medical staff that came from different parts of the world. Our Clinical Pharmacists were asked to record any suggestions or interventions in the form. The forms were all collected at the end of each day and entered into a database for analysis. Each intervention was analyzed in order to assess the merit of the action in terms of the therapeutic, financial and direct cost impact. The study showed a positive impact on the patients' care as well as on the economy of the drugs prescribed. Meanwhile, the service was very much appreciated by the Medical staff as well as other healthcare providers. PMID:23960800

  10. At crossroads between laboratory disciplines and medical advancements-The Center for Molecular Medicine at the Karolinska University Hospital.

    PubMed

    Terenius, Lars

    2009-04-01

    The Center for Molecular Medicine (CMM) was conceived and built to respond to the challenges presented by the still common chronic diseases such as atherosclerosis, rheumatoid arthritis, diabetes, allergy, and alcoholism. The Karolinska University Hospital has a proud history of research with developments such as the pacemaker and the gamma-knife. The nearby Karolinska Institutet has a strong presence internationally on the basic sciences. However, the challenges of the "new biology" and the access to the complete human genome, transcriptome, and proteome raised the need for a new research institute that could meet the experimental requirements for translational research. A Foundation was established in 1994 with the goal to build and govern the new enterprise. After an intense fundraising campaign, building could start and CMM (Fig. 1) was inaugurated in 1997. Through more than 10 years of existence, it has evolved into a multidisciplinary research institute with research in four programs, Cardiovascular and Metabolic Diseases, Infection and Immunity, Neuropsychiatric Diseases, and Medical Genetics. Performance parameters have been introduced and scientific impact and relevance are followed annually. Transparency and collaboration between groups (now 28 groups with an approximate total of 400 people engaged in research) and leadership training for junior faculty are means to stimulate "centerness". PMID:19319499

  11. [Distribution of intestinal parasites among patients who presented at the parasitology laboratory of the Kocaeli University School of Medicine Hospital].

    PubMed

    Tamer, Gülden Sönmez; Calişkan, Seyda; Willke, Ayşe

    2008-01-01

    In this study, 5178 fecal samples collected from patients who applied to our university during May 2003 through June 2005 were examined for the presence of intestinal parasites. Out of 5178 samples, 4560 of them were collected with cellophane tape preparations. Fecal samples were examined using native- Lugol and the trichrome staining method after sedimentation by formal-ethyl acetate concentration. The prevalence of intestinal parasites was evaluated with respect to age, gender and the months in which cases were seen. One or more parasites were found in 553 (10.67%) of the 5178 stool samples. Of these, 39.8% were female and 60.2, male. The distribution of the intestinal parasites was as follows; G. intestinalis in 138 cases (24.9%), E. vermicularis in 129 cases (23.3%), D. fragilis in 10 cases (1.8%), I. bütschlii cysts in 26 cases (4.7%), Taenia spp in 17 cases (3.07%) and Chilomastix mesnili in one case (0.18%). The rate of the presence of intestinal parasites in the 0-14 age group was higher than that of other groups. The incidence of parasitic diseases was lower in this study as compared to the results previously reported from our hospital. In our region intestinal parasites were predominantly protozoan whereas a lower rate of helminth isolations was noticeable. Parasitic infections continue to be an important public health problem in our country. PMID:18645942

  12. Predicting Early Mortality in Adult Trauma Patients Admitted to Three Public University Hospitals in Urban India: A Prospective Multicentre Cohort Study

    PubMed Central

    Gerdin, Martin; Roy, Nobhojit; Khajanchi, Monty; Kumar, Vineet; Dharap, Satish; Felländer-Tsai, Li; Petzold, Max; Bhoi, Sanjeev; Saha, Makhan Lal; von Schreeb, Johan

    2014-01-01

    Background In India alone, more than one million people die yearly due to trauma. Identification of patients at risk of early mortality is crucial to guide clinical management and explain prognosis. Prediction models can support clinical judgement, but existing models have methodological limitations. The aim of this study was to derive a vital sign based prediction model for early mortality among adult trauma patients admitted to three public university hospitals in urban India. Methods We conducted a prospective cohort study of adult trauma patients admitted to three urban university hospitals in India between October 2013 and January 2014. The outcome measure was mortality within 24 hours. We used logistic regression with restricted cubic splines to derive our model. We assessed model performance in terms of discrimination, calibration, and optimism. Results A total of 1629 patients were included. Median age was 35, 80% were males. Mortality between admission and 24 hours was 6%. Our final model included systolic blood pressure, heart rate, and Glasgow coma scale. Our model displayed good discrimination, with an area under the receiver operating characteristics curve (AUROCC) of 0.85. Predicted mortality corresponded well with observed mortality, indicating good calibration. Conclusion This study showed that routinely recorded systolic blood pressure, heart rate, and Glasgow coma scale predicted early hospital mortality in trauma patients admitted to three public university hospitals in urban India. Our model needs to be externally validated before it can be applied in the clinical setting. PMID:25180494

  13. [The university hospital palliative care team's approach to the transfer of end-stage cancer patients from hospital care to home medical care].

    PubMed

    Yoshino, Kazuho; Nishiumi, Noboru; Kushino, Nobuhisa; Tsukada, Michiko; Douzono, Sachiko; Saito, Yuki; Yagame, Mitsunori; Tokuda, Yutaka

    2009-12-01

    The palliative care team's roles are to provide a symptom relief to cancer patients, help them accept their medical conditions, and offer advice regarding the selection of appropriate medical treatments to suit their needs. Seeking the comfort of their homes, patients prefer a home care of superior medical care provided at hospitals. In 2008, 25 of the end-stage cancer patients at hospitals were expressed their desires to have a home medical care, and 10 of them were allowed to do so. We considered the following contributing factors that a patient should have for a smooth transition from hospital care to home medical care: (1) life expectancy of more than 2 months, (2) no progressive breathing difficulties experienced daily, (3) good awareness of medical condition among patients and families, (4) living with someone who has a good understanding of the condition, (5) availability of an appropriate hospital in case of a sudden change in medical requirements, and (6) good collaboration between emergency care hospitals, home physicians, and visiting nurses. To treat the end-stage cancer patients at home, there is a need for information sharing and a joint training of physicians specialized in cancer therapy, palliative care teams, home physicians, and visiting nurses. This would ensure a sustainable "face-to-face collaboration" in community health care.

  14. Ventilator-Associated Pneumonia: Incidence, Risk Factors and Outcome in Paediatric Intensive Care Units at Cairo University Hospital

    PubMed Central

    Galal, Yasmine S.; Ibrahiem, Sally K.

    2016-01-01

    Introduction Ventilator-Associated Pneumonia (VAP) is a major cause of hospital morbidity, mortality and increased health care costs. Although the epidemiology, pathogenesis and outcome of VAP are well described in adults; few data exist regarding VAP in paediatric patients, especially in developing countries. Aim To determine the incidence, risk factors and outcome of VAP in two Paediatric Intensive Care Units (PICUs) at Cairo University Hospital. Materials and Methods A total of 427 patients who received Mechanical Ventilation (MV) were included in this prospective study during the period from September 2014 till September 2015. Patients were observed daily till VAP occurrence, discharge from the unit or death, whichever came first. Demographic, clinical characteristics, laboratory results, radiographic and microbiological reports were recorded for all patients. Results Nearly 31% patients developed VAP among the entire cohort. The incidence density was 21.3 per 1000 ventilator days. The most frequently isolated organisms from VAP patients were Pseudomonas aeruginosa (47.7%), Acinetobacter (18.2%) and Methicillin-resistant Staphylococcus aureus (MRSA) (14.4%). VAP patients were significantly younger than non-VAP ones. The incidence of VAP in comatose patients and those with MOSF was significantly higher. Prior antibiotic use for > 48 h before MV, supine body positioning and reintubation were significantly associated with VAP. On multiple logistic regression analysis, MOSF; prior antibiotic use > 48h; reintubation; coma; and age remained independent predictors of VAP. Mortality rate among the VAP group was significantly higher compared to the non-VAP one (68.2% vs. 48.5%, p<0.001). Survival curve analysis showed a shorter median survival time in VAP patients. Conclusion Identification of risk factors and outcome of VAP in PICUs may help in reducing the incidence and improving patients’ outcomes. The incidence of VAP in this study was relatively high. The most

  15. [Rehabilitation outcomes of terror victims with multiple trauma: the experience in Hadassah University Hospital 2000-2004].

    PubMed

    Meiner, Zeev; Tuchner, Maya; Shiri, Shimon; Tsenter, Jeanna; Shochina, Mara; Shoshan, Yigal; Katz-Leurer, Michal; Schwartz, Isabella

    2008-11-01

    From late September 2000 until 2005, the State of Israel was attacked by continuing acts of terrorism known as the Al Aqsa Intifada. During this period the number of terror victims treated in rehabilitation facilities has escalated significantly. The city of Jerusalem has a unique place in the heart of the Israel-Palestinian conflict and, therefore, almost 20% of national atrocities have been carried out in Jerusalem. Between September.2000 and September 2004, 72 terror victims were treated in the department of rehabilitation in Hadassah University Hospital. Among them, 47 (65%) suffered from multiple trauma without CNS involvment, 19 (26%) suffered from traumatic brain injury and 6 (8%) suffered from spinal cord injury. The rehabilitation outcomes of terror victims was compared to the rehabilitation outcomes of non-terror multiple trauma patients treated in the same rehabilitation facility over the same period. The rehabilitation outcomes were evaluted using the following parameters: length of hospitalization (LOH) in acute care departments, inpatient and outpatient rehabilitation departments, functional outcome (Functional Independence Measurement, FIM), occupational outcome (returning to previous occupation) and psychological outcome (Salomon PTSD questionnaire). The mean LOH of terror victims was 218 +/- 131 days as opposed to 152 +/- 114 days for the non-terror group (p < 0.01). The difference between FIM value at entry and discharge (delta FIM) was significantlly higher in terror victims as compared to controls (41.1 +/- 21.6 vs. 30.8 +/- 21.8, p = 0.002). The rate of PTSD was higher among terror victims than non-terror control (40.9% vs. 24.2%, p = 0.04). The rate of returning to previous occupation was similar between terror and non-terror victims (53% vs. 46.9% respectively). Long term study showed that terror victims still suffer from lower quality of life and life satisfaction 2 years after the insult. In summary, terror victims spent longer periods in

  16. Mechanical ventilation in patients in the intensive care unit of a general university hospital in southern Brazil: an epidemiological study

    PubMed Central

    Fialkow, Léa; Farenzena, Maurício; Wawrzeniak, Iuri Christmann; Brauner, Janete Salles; Vieira, Sílvia Regina Rios; Vigo, Alvaro; Bozzetti, Mary Clarisse

    2016-01-01

    OBJECTIVES: To determine the characteristics, the frequency and the mortality rates of patients needing mechanical ventilation and to identify the risk factors associated with mortality in the intensive care unit (ICU) of a general university hospital in southern Brazil. METHOD: Prospective cohort study in patients admitted to the ICU who needed mechanical ventilation for at least 24 hours between March 2004 and April 2007. RESULTS: A total of 1,115 patients admitted to the ICU needed mechanical ventilation. The mortality rate was 51%. The mean age (± standard deviation) was 57±18 years, and the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 22.6±8.3. The variables independently associated with mortality were (i) conditions present at the beginning of mechanical ventilation, age (hazard ratio: 1.01; p<0.001); the APACHE II score (hazard ratio: 1.01; p<0.005); acute lung injury/acute respiratory distress syndrome (hazard ratio: 1.38; p=0.009), sepsis (hazard ratio: 1.33; p=0.003), chronic obstructive pulmonary disease (hazard ratio: 0.58; p=0.042), and pneumonia (hazard ratio: 0.78; p=0.013) as causes of mechanical ventilation; and renal (hazard ratio: 1.29; p=0.011) and neurological (hazard ratio: 1.25; p=0.024) failure, and (ii) conditions occurring during the course of mechanical ventilation, acute lung injuri/acute respiratory distress syndrome (hazard ratio: 1.31; p<0.010); sepsis (hazard ratio: 1.53; p<0.001); and renal (hazard ratio: 1.75; p<0.001), cardiovascular (hazard ratio: 1.32; p≤0.009), and hepatic (hazard ratio: 1.67; p≤0.001) failure. CONCLUSIONS: This large cohort study provides a comprehensive profile of mechanical ventilation patients in South America. The mortality rate of patients who required mechanical ventilation was higher, which may have been related to the severity of illness of the patients admitted to our ICU. Risk factors for hospital mortality included conditions present at the start of mechanical

  17. Isolation, Identification, and In Vitro Antifungal Susceptibility Testing of Dermatophytes from Clinical Samples at Sohag University Hospital in Egypt

    PubMed Central

    Shalaby, Mona Fattouh Mohamed; El-din, Asmaa Nasr; El-Hamd, Mohammed Abu

    2016-01-01

    Aim The objective of this study was to isolate, identify, and explore the in-vitro antifungal susceptibility pattern of dermatophytes isolated from clinically suspected cases of dermatophytosis (tinea infections) attending the Dermatology Outpatient Clinic. Methods This study was conducted at Sohag University Hospital from December 2014 to December 2015. Clinical samples (e.g., skin scrapings and hair stumps) were collected under aseptic precautions. The identification of dermatophytes was performed through microscopic examination using 10% potassium hydroxide (KOH) with 40% dimethyl sulphoxide (DMSO) mounts and culture on Sabouraud dextrose agar (SDA) and on Dermasel agar base media, both supplemented with chloramphenicol and cycloheximide. All dermatophytes isolates were subjected to antifungal susceptibility testing using the agar-based disk diffusion (ABDD) method against Clotrimazole, Miconazole, Fluconazole, and Griseofulvin. Data were analyzed via SPSS 16, using Chi square and a screening test (cross-tabulation method). Results A total of 110 patients of dermatophytosis were studied. The patients were clinically diagnosed and mycologically confirmed as having tinea capitis (49), tinea corporis (30), tinea pedis (16), tinea cruris (9), or tinea barbae (6). The dermatophytes isolates belonged to 4 species: Microsporum canis 58 (52.7%), Microsporum gypseum 23 (20.9%), Trichophyton mentagrophytes 18 (16.4%), and Microsporum audouinii 11 (10%). The most effective antifungal drugs tested were Clotrimazole, followed by Miconazole (95.5% and 84.5% of isolates were susceptible, respectively). Conclusion Every patient with a tinea infection should be properly studied for a mycological examination and should be treated accordingly. Dermasel agar is more useful as an identification medium in the isolation of dermatophytes. The ABDD method appears to be a simple, cost-effective, and promising method for the evaluation of antifungal susceptibility of dermatophytes. PMID

  18. Medication adherence in patients in treatment for rheumatoid arthritis and systemic lupus erythematosus in a university hospital in Brazil

    PubMed Central

    Prudente, Luciana Resende; Diniz, Juliana de Souza; Ferreira, Tatyana Xavier Almeida Matteucci; Lima, Dione Marçal; Silva, Nílzio Antônio; Saraiva, Guylherme; Silveira, Erika Aparecida; Dewulf, Nathalie de Lourdes Souza; Amaral, Rita Goreti

    2016-01-01

    Medication adherence is essential for the control of symptoms and progression of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The aim of the study was to investigate medication adherence in outpatients in treatment for RA and SLE in a university hospital in Brazil. This was a quantitative, cross-sectional analytical study. A total of 92 patients (55 RA patients and 37 SLE patients) were included in the study. A structured questionnaire for patients’ interview and a form for collecting data from medical records were used for data collection. Adherence to drug treatment was assessed by the Morisky scale questionnaire. Data storage and analysis were performed using Epi Info 3.5.4 and statistical analysis by Stata/SE 12.0. The Pearson’s chi-squared test and Fisher’s exact test were applied for statistical and bivariate analyses. For multivariate data analysis the Poisson regression and the Wald test were used. The prevalence of adherence to drug treatment was 16.4% in RA patients and 45.9% in SLE patients. The final model of the multivariate analysis demonstrated associations between medication adherence and the following covariates for both RA and SLE groups: duration of therapy for rheumatic disease at the institution greater than 15 years and presence of more than six chronic comorbidities. The parameter “acquisition of medication at the high-cost pharmacy” was differently associated with medication adherence by group, and for the SLE group, living outside the city of Goiânia was a protective factor associated with adherence. This study demonstrated a low prevalence of medication adherence in patients in treatment for RA and SLE treated at this institution. These findings will serve as a base for future studies to elucidate what factors may positively or negatively affect medication adherence in this population. In addition, multidisciplinary approaches are needed to enhance adherence to drug treatment in patients in treatment for

  19. An assessment of the quality indicators of operative and non-operative times in a public university hospital

    PubMed Central

    Costa, Altair da Silva; Leão, Luiz Eduardo Villaça; de Novais, Maykon Anderson Pires; Zucchi, Paola

    2015-01-01

    ABSTRACT Objective To assess the operative time indicators in a public university hospital. Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays. Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes. Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency. PMID:26761557

  20. Anti-MRSA drug use and antibiotic susceptibilities of MRSA at a university hospital in Japan from 2007 to 2011.

    PubMed

    Shigemura, Katsumi; Osawa, Kayo; Mukai, Akira; Yoshida, Hiroyuki; Fujisawa, Masato; Arakawa, Soichi

    2013-05-01

    The purpose of this study is to examine the use of anti-methicillin-resistant Staphylococcus aureus (MRSA) drugs, such as vancomycin (VCM), teicoplanin (TEIC), arbekasin (ABK) and linezolid (LZD), and the antibiotic susceptibilities of MRSAs in Kobe University Hospital. We investigated MRSA isolation and use of anti-MRSA drugs and susceptibilities of MRSA, using linear regression analysis, from 2007 to 2011, and checked for correlation between the use of these drug and the antibiotic susceptibilities of MRSA. The overall monthly isolation rates of MRSA decreased from a mean of 84.8% in 2007 to 70.0% in 2011 (r=0.946, P=0.015, b=-0.220), and the monthly isolation rate of MRSA in inpatients decreased from a mean of 78.6% in 2007 to 57.7% in 2011 (r=0.952, P=0.012, b=-0.160). From 2007 to 2011, VCM consumption significantly increased (r=0.916, P=0.029, b=0.055), whereas TEIC and LZD use remained stable during the study period. In addition, ABK use significantly decreased from 23.8 defined daily dose (DDD) per 1000 patient-days in 2007 to 5.2 DDD per 1000 in 2011 (r=0.902, P=0.036, b=-0.216). Susceptibility rates of MRSA were almost 100% to TEIC and VCM. The rates of MRSA to ABK and LZD significantly increased (r=0.959, P=0.010, b=2.137 for ABK and r=0.933, P=0.020, b=3.111 for LZD). In conclusion, our findings indicated a decreased MRSA isolation rate and the effective use of anti-MRSA drugs (VCM, TEIC, ABK and LZD), and improved susceptibility rates to anti-MRSA drugs, suggesting the possibilities that appropriate and early use of anti-MRSA drugs may cause the decrease of MRSA isolation.

  1. Assessment of knowledge, attitude and practice of hand washing among health care workers in Ain Shams University hospitals in Cairo.

    PubMed

    Abd Elaziz, K M; Bakr, I M

    2009-03-01

    Most nosocomial infections are thought to be transmitted by the hands of health care workers. The aim of this work was to assess the knowledge, attitude and practice of hand washing among health care workers (HCW) in Ain-Shams University hospitals and to investigate the presence of the necessary facilities and supplies required for hand washing (HW) in ten wards. A cross-sectional descriptive and observational study was conducted for six months from June till November 2006. Observation of the HCW for hand washing practice was done at any opportunity of contact with the patients in the different wards by members of the infection control team. Knowledge & attitude of HCW towards hand hygiene was done through self-administered questionnaire to HCW in 10 different departments. The total opportunities observed were 2189 opportunities. Doctors showed a significantly higher compliance (37.5%) than other groups of HCW (P = 0.000), however only 11.6% of the opportunities observed for doctors were done appropriately. The most common type of HW practiced among HCW was the routine HW (64.2%) and the least was the antiseptic HW (3.9%). Having a short contact time and improper drying (23.2%) were the most common errors that lead to inappropriate HW. Most of the wards had available sinks (80%) but none of them had available paper towels. The mean knowledge score was higher in nurses compared to doctors (42.6 +/- 1.7 versus 39.1 +/- 10.5). Most of the nurses (97.3%) believe that administrative orders and continuous observation can improve hand washing practices. Implementation of multifaceted interventional behavioral hand hygiene program with continuous monitoring and performance feedback, increasing the supplies necessary for HW and institutional support are important for improving the compliance of hand hygiene guidelines. PMID:19771756

  2. Prevalence of Sleep Deprivation and Relation with Depressive Symptoms among Medical Residents in King Fahd University Hospital, Saudi Arabia

    PubMed Central

    Al-Maddah, Esraa M.; Al-Dabal, Badria K.; Khalil, Mohammad S.

    2015-01-01

    Objectives: Sleep deprivation is common among medical residents of all specialties. This study aimed to determine the prevalence of sleep deprivation and depressive symptoms among medical residents in King Fahd University Hospital (KFUH) in Al Khobar, Saudi Arabia. Furthermore, the association between sleep deprivation, sleepiness and depressive symptoms was examined. Methods: This cross-sectional study took place between February and April 2012 and involved 171 KFUH medical residents of different specialties. Data were collected using a specifically designed questionnaire eliciting demographic information, working hours and number of hours of sleep. In addition, validated Arabic versions of the Epworth Sleepiness Scale and the Beck Depression Inventory-2 (BDI-2) were used. Results: The prevalence of acute sleep deprivation and chronic sleep deprivation among residents in KFUH was 85.9% and 63.2%, respectively. The prevalence of overall sleepiness was 52%; 43.3% reported being excessively sleepy in certain situations while 8.8% reported being excessively sleepy regardless of the situation. Based on the BDI-2, the prevalence of mild, moderate and severe depressive symptoms was 43.3%, 15.2% and 4.7%, respectively. Significant associations were found between sleep deprivation and depressive symptoms; depressive symptoms and sleepiness, and depressive symptoms and being a female resident. Conclusion: The vast majority of medical residents had acute sleep deprivation, with more than half suffering from chronic sleep deprivation. The number of hours and quality of sleep among the residents were stro