scholarly journals Assessing the Rates and Reasons of Elective Surgical Cancellations on the Day of Surgery: A Multicentre Study from Urban Indian Hospitals

2021 ◽  
Author(s):  
Bhakti Sarang ◽  
Geetu Bhandoria ◽  
Priti Patil ◽  
Anita Gadgil ◽  
Lovenish Bains ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Care Delivery ◽  
Financial Burden ◽  
Surgical Care ◽  
World Health Organisation ◽  
World Health ◽  
Cross Sectional ◽  
Patient Counselling ◽  
Cancellation Rate ◽  
Surgical Operations

Abstract Background Cancellations of elective surgeries on the day of surgery (DOS) can lead to added financial burden and wastage of resources for healthcare facilities; as well as social and emotional problems to patients. These cancellations act as barriers to delivering efficient surgical services. Optimal utilisation of the available resources is necessary for resource-constrained low-and-middle-income countries (LMIC). This study investigates the rate and causes of cancellations of elective surgeries on the DOS in various surgical departments across ten hospitals in India. Methods A research consortium ‘IndSurg’ led by World Health Organisation Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in LMICs, India conducted this multicentre retrospective cross-sectional study to analyse the cancellations of elective/planned surgical operations on DOS across urban secondary and tertiary level hospitals. We audited surgical records of a pre-decided period of six weeks for cancellations, documented relevant demographic information and reasons for cancellations. Results We analysed records from the participating hospitals, with an overall cancellation rate of 9.7% (508/5231) on the DOS for elective surgical operations. Of these, 74% were avoidable cancellations. A majority (30%) of these 508 cancellations were attributed to insufficient resources, 28% due to patient's refusal or failure to show-up, and 22% due to change in patient's medical status. Conclusion We saw a preponderance of avoidable reasons for elective surgery cancellations. A multidisciplinary approach with adequate preoperative patient counselling, timely communication between the patients and caregivers, adequate preoperative anaesthetic assessment, and planning by the surgical team may help reduce the cancellation rate.

scholarly journals Hepatitis B Vaccination in Senegalese Children: Coverage, Timeliness, and Sociodemographic Determinants of Non-Adherence to Immunisation Schedules (ANRS 12356 AmBASS Survey)

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 510
Author(s):  
Lauren Périères ◽  
Fabienne Marcellin ◽  
Gora Lo ◽  
Camelia Protopopescu ◽  
El Ba ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Dose Schedule ◽  
World Health Organisation ◽  
Sub Saharan Africa ◽  
World Health ◽  
Hepatitis B Vaccination ◽  
Detailed Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hbv Vaccination

Detailed knowledge about hepatitis B virus (HBV) vaccination coverage and timeliness for sub-Saharan Africa is scarce. We used data from a community-based cross-sectional survey conducted in 2018–2019 in the area of Niakhar, Senegal, to estimate coverage, timeliness, and factors associated with non-adherence to the World Health Organisation-recommended vaccination schedules in children born in 2016 (year of the birth dose (BD) introduction in Senegal) and 2017–2018. Vaccination status was assessed from vaccination cards, surveillance data, and healthcare post vaccination records. Among 241 children with available data, for 2016 and 2017–2018, respectively, 31.0% and 66.8% received the BD within 24 h of birth (BD schedule), and 24.3% and 53.7% received the BD plus at least two pentavalent vaccine doses within the recommended timeframes (three-dose schedule). In logistic regression models, home birth, dry season birth, and birth in 2016 were all associated with non-adherence to the recommended BD and three-dose schedules. Living over three kilometres from the nearest healthcare post, being the firstborn, and living in an agriculturally poorer household were only associated with non-adherence to the three-dose schedule. The substantial proportion of children not vaccinated according to recommended schedules highlights the importance of considering vaccination timeliness when evaluating vaccination programme effectiveness. Outreach vaccination activities and incentives to bring children born at home to healthcare facilities within 24 h of birth, must be strengthened to improve timely HBV vaccination.

scholarly journals Environmental Health in Perinatal and Early Childhood: Awareness, Representation, Knowledge and Practice of Southern France Perinatal Health Professionals

2018 ◽  
Vol 15 (10) ◽  
pp. 2259 ◽  
Author(s):  
Claire Sunyach ◽  
Barbara Antonelli ◽  
Sophie Tardieu ◽  
Michele Marcot ◽  
Jeanne Perrin ◽  
...  
Keyword(s):  
Environmental Health ◽  
Health Professionals ◽  
Perinatal Care ◽  
World Health Organisation ◽  
Cross Sectional Study ◽  
Perinatal Health ◽  
Reproductive Age ◽  
World Health ◽  
Environmental Toxicants ◽  
Cross Sectional

The exposure of adults of reproductive age as well as pregnant women and children to environmental contaminants is of particular concern, as it can impact fertility, in utero development, pregnancy outcomes and child health. Consequently, the World Health Organisation (WHO) and international societies advocate including Environmental Health (EH) in perinatal care, yet perinatal health professionals (HPs) hardly put these recommendations into practice. In 2017, a cross-sectional study was performed in a large panel of perinatal HPs in south-eastern France with the aim of painting a picture of their current attitudes, representation, knowledge, and training expectations. Quantitative and qualitative information was collected via auto-questionnaire. Questionnaires were completed by 962 participants, mainly midwives (41.1%), physicians (25.6%) and nursery nurses (11%). Indoor/outdoor air quality and endocrine disruptors were the best-mastered topics, whereas electromagnetic fields and diet gave rise to unsure responses. Overall, perinatal HPs were ill-trained and -informed about the reproductive risks linked to daily environmental exposure. HPs reported scarce knowledge, fear of patient reaction and lack of solutions as the main barriers to providing information regarding EH to the public. Our findings highlight the need to set up EH training programmes focused on scientific knowledge and to provide simple messages and tips to help perinatal HPs deliver advice to populations to mitigate exposure to environmental toxicants.

scholarly journals Knowledge, attitude, practice and stigma of tuberculosis among healthcare providers in hospital Sultan Haji Ahmad Shah, Temerloh, Pahang

2019 ◽  
Vol 10 (SPL1) ◽  
Author(s):  
Nuralia Akma ◽  
Mohamad Mustafa ◽  
Siti Aishah Suran ◽  
Abdul Aziz Marwan ◽  
Mohd Rahman Omar
Keyword(s):  
Disease Transmission ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
World Health ◽  
Occupational Hazard ◽  
Perceived Stigma ◽  
Cross Sectional ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Knowledge And Practice

Malaysia is categorized as an intermediate tuberculosis (TB) burden country by World Health Organisation. This cause great challenge as an occupational hazard for healthcare providers (HCPs) in Malaysia, as they received two- to three-fold greater risk of contracting TB than the general population. This cross-sectional questionnaire study aimed to assess HCPs' knowledge, attitude, practice, and stigma (KAPS) towards TB in Hospital Sultan Haji Ahmad Shah, Temerloh. A pilot-tested questionnaire was designed based on the WHO recommendation for KAPS study in TB. A survey was carried out between September 2018 and February 2019. Data were analyzed using SPSS version 25.The majority of respondents have moderate knowledge (75%) and practice (93%) on tuberculosis whilst scored lower on attitude (49%). Average self-perceived stigma was observed (67%) with higher sympathy (73%). Overall knowledge and practice on tuberculosis among HCPs in HOSHAS was good with some misconceptions about disease transmission. However, more works needed to improve the attitude and stigma towards TB, as it may affect health services delivery towards TB patients.

scholarly journals Increased incidence of complicated acute appendicitis after the first COVID-19 pandemic peak: Have patients a different attitude towards COVID-hospitals?

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
S Passoni ◽  
M Giuliani ◽  
M Arigoni
Keyword(s):  
Acute Appendicitis ◽  
Elective Surgery ◽  
Histopathological Examination ◽  
World Health Organisation ◽  
Complicated Appendicitis ◽  
World Health ◽  
Original Structure ◽  
Group A ◽  
Wbc Count ◽  
Complicated Acute Appendicitis

Abstract Objective The 11 March 2020 the World Health Organisation considered the COVID-19 Infection a pandemic disease. Between March and May 2020, the region of southern Switzerland was affected by the first pandemic peak, which was managed by dividing hospitals in Covid and non Covid facilities and by reducing elective surgery. At the end of the pandemic peak hospitals returned to their original structure but there was concern as to possible avoidance of former COVID facilities by patients because of fear of contracting of COVID-19 infection. For acute situations such as acute appendicitis, this could imply a delay of treatment. The aim of this retrospective study is to analyse the increment in incidence of complicated appendicitis in the post-pandemic period at our institution. Methods Clinical data of patients who underwent appendectomies in the period before and after the COVID-19 pandemic were analysed and compared. Diagnosis was based histopathological examination and/or on intra-operative or CT findings. Complicated appendicitis was defined as the presence of perforated or gangrenous appendicitis on histopathology or the presence of an abscess on CT scan. The incidence of complicated appendicitis, the time between onset of symptoms and patient admission (TOSA), the initial inflammatory blood tests and the complication rate was compared between the two periods. Results 79 patients were included in the study, 31 in the post-COVID-19 peak group (A), April - October 2020, and 48 in the pre-pandemic group (B), April - October 2019. Incidence of complicated appendicitis was significantly higher in group A (55% vs 14% p = 0.02). These findings correlate with a greater TOSA (mean time 35 hours vs 17 hours, p = 0.01) and higher inflammatory values in the initial blood test, (mean WBC count 14.8 G/l vs 12.9 G/l, p = 0.08 and mean CRP value 73 mg/l vs 43 mg/l, p = 0.01) in group A. Conclusion Our data show a clear increase of incidence of complicated acute appendicitis after the pandemic peak in our hospital. Indeed patients tended to wait longer to visit our emergency department after the pandemic peak. One explanation is a possible fear by the patients of contracting COVID-19 infection in a former COVID hospital. Management of surgical emergencies during and after a pandemic peak phase should take into account the fact that patients may wait longer to visit a doctor thus aggravating the degree of their disease.

Hubungan Komunikasi Terapeutik Perawat dan Fasilitas dengan Kepuasan Pasien Rawat Inap di Rumah Sakit Umum Cut Meutia Kota Langsa Tahun 2019

2020 ◽  
pp. 21-29
Author(s):  
Bambang Irawan ◽  
Erizal
Keyword(s):  
World Health Organisation ◽  
Cross Sectional Study ◽  
World Health ◽  
P Value ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional

Badan kesehatan dunia yaitu World Health Organisation (WHO) berupaya agar pelayanan kesehatan di dunia ini dapat memberikan suatu sistem pelayanan yang baik untuk meningkatkan derajat kesehatan masyarakat diberbagai belahan dunia. Penelitian ini bertujuan untuk mengetahui hubungan komunikasi terapeutik perawat dan fasilitas dengan kepuasan pasien rawat inap di Rumah Sakit Umum Cut Meutia Kota Langsa tahun 2019. Penelitian ini bersifat analitik dengan desain penelitian cross sectional study. Sampel dalam penelitian ini sebanyak 84 responden yang merupakan pasien rawat inap. Data dianalisa secara univarat dan bivariat menggunakan uji Chi square. Hasil penelitian diperoleh ada hubungan komunikasi terapeutik perawat dengan kepuasan pasien rawat inap di Rumah Sakit Umum Cut Meutia Kota Langsa tahun 2019 dengan nilai p-value (0,007) dan ada hubungan fasilitas dengan kepuasan pasien rawat inap di Rumah Sakit Umum Cut Meutia Kota Langsa tahun 2019 dengan nilai p-value (0,030).

scholarly journals SunSmart Accreditation and Use of a Professional Policy Drafting Service: Both Positively and Independently Associated with High Sun Protective Hat Scores Derived from Primary School Policies

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
A. I. Reeder ◽  
E. E. Iosua ◽  
B. McNoe ◽  
A.-C. L. Petersen
Keyword(s):  
Logistic Regression ◽  
Skin Cancer ◽  
Primary Schools ◽  
World Health Organisation ◽  
World Health ◽  
Solar Ultraviolet Radiation ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Accredited Schools ◽  
Prevention Programmes

Background. The head and neck are exposed to the highest solar ultraviolet radiation levels and experience a disproportionate skin cancer burden. Sun protective hats can provide an effective barrier. Since early life exposure contributes to skin cancer risk, the World Health Organisation recommends prevention programmes in schools. The New Zealand SunSmart Schools programme is one example. Two criteria concern wearing hat outdoors: students are required to wear a hat providing protection for the face, neck, and ears; if a suitable hat is not worn, students must play in shaded areas. Objectives. To investigate two internationally relevant interventions as plausible statistical predictors of hat policy strength: (1) skin cancer primary prevention programme membership, (2) use of a professional policy drafting service. Methods. Of 1,242 (62%) eligible schools participating in a 2017 national survey, 1,137 reported a sun protection policy and 842 were available for categorising and allocating protective scores (0–3). Results. In multinomial (polytomous) logistic regression models of cross-sectional association, adjusted for school characteristics, SunSmart accredited schools and those utilising a policy drafting service were independently significantly more likely than their counterparts to obtain the most protective compared to the least protective hat score (respectively, RRR 6.48: 95% CI 3.66, 11.47; 7.47: 3.67, and 15.20). For the dichotomous shade measure, similar associations were found using adjusted logistic regression (OR 3.28: 95% CI 2.11, 5.09; 2.70: 1.54, 4.74). Conclusions. Our findings provide support for two plausible interventions that could potentially be implemented beneficially in primary schools via established infrastructure in any jurisdiction, internationally.

scholarly journals Patients with more comorbidities have better detection of chronic conditions, but poorer management and control: findings from six middle-income countries

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Grace Sum ◽  
Gerald Choon-Huat Koh ◽  
Stewart W. Mercer ◽  
Lim Yee Wei ◽  
Azeem Majeed ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
World Health Organisation ◽  
World Health ◽  
Uncontrolled Hypertension ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increased Risk ◽  
And Control

Abstract Background The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs. Methods Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007–10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557). Results A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina. Conclusion Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems.

scholarly journals Socioeconomic influences on breastfeeding and weaning practices in a Mediterranean setting

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Justine Parnis ◽  
Neville Calleja ◽  
Petra Jones
Keyword(s):  
Demographic Data ◽  
World Health Organisation ◽  
Cross Sectional Study ◽  
World Health ◽  
Complementary Foods ◽  
Cross Sectional ◽  
Professional Advice ◽  
Level Of Education ◽  
High Level ◽  
Duration Of Breastfeeding

AbstractThe World Health Organisation (2016) recommends exclusive breastfeeding up to 6 months of age and the introduction of complementary foods at around 6 months. International literature suggests that although knowledge of the guidelines is high, only a minority of parents wait until 6 months to wean and sub-optimal weaning practices are common. The aim of this study was to assess breastfeeding and weaning practices and to evaluate the effect of socio-economic determinants on such behaviours in a Mediterranean setting.A cross-sectional study design was used. One-time short interviews with 250 consenting mothers having 8 month old infants were conducted using a structured questionnaire. Mothers attending all the well baby clinics in the primary health care centres of the Maltese Islands for a period of two months were included in the study. The questionnaire included socio-economic and demographic data, details on the initiation and duration of breastfeeding, weaning practices and a short assessment of the infant's usual diet at 8 months.Mothers between 25–34 years old (26%) and mothers with a high level of education (25%) were more likely to breastfeed only during the first 8 months of life without using any other type of milk, compared to younger (6.5%) or older (21%) mothers, and to mothers with a lower level of education (16%). The level of education was also positively associated with the continuation of breastfeeding, with the mean duration of breastfeeding for higher educated mothers being 4 months compared to 2.6 months in less educated mothers. Mothers with a lower level of education and mothers who are house-wives are more likely to give their infants only ready-made foods however associations were in this case borderline significant. On the other hand, appropriateness of weaning age was not associated with any socio-economic factors.The length of breastfeeding and the introduction of complementary foods varied widely between mothers. Compliance with infant feeding guidelines was poor. The mother's age, level of education and employment status all have an impact on breastfeeding and weaning practices. The provision of professional advice and a supportive environment for mothers, together with interventions for increasing awareness may promote maternal adherence to WHO guideline.

scholarly journals Prevalence and Predictors of Cancellation of Elective Surgical Procedures at a Tertiary Hospital in Uganda: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Alfred Ogwal ◽  
Felix Oyania ◽  
Emmanuel Nkonge ◽  
Timothy Makumbi ◽  
Moses Galukande
Keyword(s):  
Surgical Procedures ◽  
Orthopedic Surgery ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Mulago Hospital ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Elective Surgical Procedures ◽  
Cancellation Rate

Introduction. The cancellation of elective procedures has been shown to waste resources and to have the potential to increase morbidity and mortality among patients. This study aimed to determine the prevalence of the cancellation of elective surgical procedures and to identify the factors associated with these cancellations at Mulago Hospital, a large public hospital in Kampala, Uganda. Methods. A cross-sectional study was conducted from January 10, 2018, to February 20, 2018. We recruited patients of all ages who were admitted to surgical wards and scheduled for elective surgery. Data on patients’ demographic characteristics and diagnosis, as well as the specialty of the surgery, the planned procedure, the specific operating theatre, cancellation, and the reasons for cancellation were extracted and analyzed using logistic regression. Results. Of a total of 400 cases, 115 procedures were canceled—a cancellation prevalence of 28.8%. Orthopedic surgery had the highest cancellation rate, at 40.9% (n = 47). Facility-related factors were responsible for 67.8% of all cancellations. The most common reason for cancellation was insufficient time in the theatre to complete the procedure on the scheduled day. No procedures were canceled because of a lack of intensive care unit beds. There was a significant association between surgical specialty and cancellation (P<0.05) at multivariate analysis. Conclusion. The prevalence of cancellation of elective surgical procedures at Mulago Hospital was 28.8%, with orthopedic surgery having the highest cancellation rate. Two-thirds of the factors causing cancellations were facility-related, and more than 50% of all cancellations were potentially preventable. Quality-improvement strategies are necessary in the specialties that are susceptible to procedure cancellation because of facility factors.

Patients’ knowledge and practices on the drug regimens prescribed at the National Traditional Medicine Hospital: a call for a systematic approach to drug information services

2018 ◽  
Vol 4 (2) ◽  
pp. 30-34
Author(s):  
Kinga Jamphel ◽  
Dorji Gyeltshen ◽  
Sherab Tenzin ◽  
Thinley Dorji
Keyword(s):  
Medication Adherence ◽  
Traditional Medicine ◽  
Adverse Drug Events ◽  
Drug Information ◽  
Skin Irritation ◽  
Simple Random Sampling ◽  
World Health Organisation ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional

Introduction: The World Health Organisation estimates that only half of all medicines dispensed are used appropriately. The Bhutanese Traditional Medicine (BTM) system is no exception. Objectives: We studied the patients’ knowledge on the usage of traditional medicine regimens prescribed to them, their medication adherence and possible adverse events. Methods: This was a cross-sectional study conducted using an interviewer-administered questionnaire at the National Traditional Medicine Hospital, Thimphu in 2017. A simple random sampling was used. Ethical approval was sought from Research Ethics Board of Health, Thimphu. Results: A sample of 402 patients were studied. The mean age of the respondents was 45 years (±15 years) and 333 (82.8%) were old cases presenting to the hospital. The knowledge on the correct timing of the medicine, how to take the medicine and what to avoid while on those medicines were understood only by 62.7%, 34.6% and 22.9% respectively. Only 351 (87.3%) patients received verbal information on the usage of drugs from the dispensers, of which 119 (29.6%) said the information was not clear or not adequate. Failure to take medicines on time was reported by 224 (67.3%) among old cases. Undesirable events reported while using BTM were giddiness, vomiting, skin irritation, diarrhoea and fainting episodes. Conclusions: The drug information system and monitoring of medication adherence and adverse drug events require adoption of more effective toolsand methods.

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