scholarly journals Occurrence of Potential Adverse Drug Events from Prescribing Errors in a Pediatric Intensive and High Dependency Unit in Hong Kong: An Observational Study

2017 ◽  
Vol 19 (4) ◽  
pp. 347-355 ◽  
Author(s):  
Celeste L. Y. Ewig ◽  
Hon Ming Cheung ◽  
Kwok Ho Kam ◽  
Hiu Lam Wong ◽  
Chad A. Knoderer
Keyword(s):  
Hong Kong ◽  
Observational Study ◽  
Adverse Drug Events ◽  
High Dependency Unit ◽  
Prescribing Errors ◽  
High Dependency

scholarly journals Reducing the number of missed isolation days in a paediatric high-dependency unit using semi-permanent pods

2017 ◽  
Vol 18 (2) ◽  
pp. 67-71
Author(s):  
Josephine Keward ◽  
Pauline Bradshaw ◽  
Jonathan A. Otter
Keyword(s):  
Observational Study ◽  
Confidence Interval ◽  
Transmission Risk ◽  
First Year ◽  
High Dependency Unit ◽  
Exact Tests ◽  
Short Supply ◽  
High Dependency ◽  
Isolation Facilities ◽  
The Impact

Background: Single rooms are in short supply in many hospitals. Aim: To evaluate the impact of introducing semi-permanent pods to convert multi-occupancy bays into single occupancy pods. Methods: We performed a 24-month pre–post observational study in a 15-bed paediatric high dependency unit. Three semi-permanent pods were installed in February 2013, in the middle of the 24-month period. The percentage of missed isolation days and the proportion of days for which >4 patients required isolation (which would exceed existing isolation facilities) were compared for the year prior to the pods with the first year of pod use using a Fisher’s exact tests. Results: Missed isolation days fell from 58.2% (662/1138; 95% confidence interval [CI], 55.3–61.0) pre-pod to 14.8% (205/1382; 95% CI, 13.0–16.8) during the first year of pod use ( P <0.001). The percentage of days for which >4 patients required isolation was 74.5% overall (95% CI, 70.5–78.8), and increased from 63% (95% CI, 56.2–69.4) pre-Pod to 86% (95% CI, 80.9–90.3) during pod use ( P <0.001). Discussion: The introduction of three semi-permanent pods was feasible in our paediatric HDU setting and reduced the number of missed isolation days, and hence transmission risk, for important hospital pathogens.

scholarly journals Preventable adverse drug events causing hospitalisation: identifying root causes and developing a surveillance and learning system at an urban community hospital, a cross-sectional observational study

2021 ◽  
Vol 10 (1) ◽  
pp. e001161
Author(s):  
Jane de Lemos ◽  
Peter Loewen ◽  
Cheryl Nagle ◽  
Robert McKenzie ◽  
Yong Dong You ◽  
...  
Keyword(s):  
Observational Study ◽  
Adverse Drug Events ◽  
Healthcare Providers ◽  
Medication Use ◽  
Learning System ◽  
Chronic Obstructive ◽  
Action Plans ◽  
Medical Conditions ◽  
Cross Sectional ◽  
Medication Changes

ObjectivesTo identify root causes of preventable adverse drug events (pADEs) contributing to hospital admission; to develop key messages which identify actions patients/families and healthcare providers can take to prevent common pADEs found; to develop a surveillance learning system for the community.MethodsCross-sectional observational study; 120 patients and families, 61 associated healthcare providers were interviewed then root cause analysis was performed to develop key learning messages and an electronic reporting tool was designed. Most common pADE-related medical conditions and their root causes and most common pADE root causes of entire cohort are reported.ResultsMost common pADE-related medical conditions: chronic obstructive pulmonary disease/asthma (13.3%), bleeding (12.5%), hypotension (12%), heart failure (10%), acute kidney injury (5%) and pneumonia (5%). Most common root causes were: providers not confirming that the patient/family understands information given (29.2%), can identify how a medication helps them/have their concerns addressed (16.7%), can identify if a medication is working (14.1%) or causing a side effect (23.3%); can enact medication changes (7.5%); absence of a sick day management plan (12.5%), and other action plans to help patients respond to changes in their clinical status (10.8%); providers not assessing medication use and monitoring competency (19.2%). Ten key learning messages were developed and a pADE surveillance learning system was implemented.ConclusionsTo prevent pADEs, providers need to confirm that patients/families understand information given, how a medication helps them, how to recognise and respond to side effects, how to enact medication changes and follow action plans; providers should assess patient’s/families’ medication use and monitoring competency.

Outcomes of elderly patients with acute kidney injury on a renal high dependency unit

2015 ◽  
Vol 69 (10) ◽  
pp. 1209-1210 ◽  
Author(s):  
J.-H. Wang ◽  
J. Joslin ◽  
R. Jenkins ◽  
C. C. Sharpe ◽  
S. Jayawardene ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Elderly Patients ◽  
Kidney Injury ◽  
High Dependency Unit ◽  
High Dependency

Primary Casualty Reception Ship: the hospital within—Operation Granby

1992 ◽  
Vol 78 (2) ◽  
pp. 55-64
Author(s):  
E. P. Dewa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Support Services ◽  
Persian Gulf ◽  
Medical Team ◽  
High Dependency Unit ◽  
Full Support ◽  
Hospital Facility ◽  
High Dependency

SummaryAs the build-up of Operation Granby forces developed in the Gulf, casualty estimates indicated the need for a 100-bed hospital facility to care for the possible maritime casualties. RF A Argus, the Air Training Ship, was identified as the potential Primary Casualty Reception Ship (PCRS) and at the end of September 1990 plans were drawn up to convert the forward hangar into a two-storey 100-bed hospital in collective protection (COLPRO).In the three weeks prior to deployment, the hospital was designed, built, equipped and staffed.Argus arrived in the Gulf in mid-November as the PCRS with, all in COLPRO, a 10-bed intensive care unit (ICU), a 14-bed high dependency unit (HDU), a 76-bed low dependency unit (LDU) plus four operating tables in two theatres with full support services.The hospital was staffed by a medical team of 136 personnel and supported by the Air department with four casualty evacuation helicopters, an RN Party and the staff of the RFA.One hundred and five patients were treated of which 78 were returned to duty. Argus as PCRS spent longer in the northern Persian Gulf than any other ship, UK or US.

Reorganizing the respiratory high dependency unit for pandemics

2021 ◽  
Author(s):  
Juan Fernando Masa ◽  
Maxime Patout ◽  
Raffaele Scala ◽  
Joao Carlos Winck
Keyword(s):  
High Dependency Unit ◽  
High Dependency

scholarly journals Invasive pneumococcal disease, pneumococcal pneumonia and all-cause pneumonia in Hong Kong during the COVID-19 pandemic compared with the preceding 5 years: a retrospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e055575
Author(s):  
King-Pui Florence Chan ◽  
Ting-Fung Ma ◽  
Mary Sau-Man Ip ◽  
Pak-Leung Ho
Keyword(s):  
Hong Kong ◽  
Length Of Stay ◽  
Observational Study ◽  
Pneumococcal Pneumonia ◽  
Transitional Period ◽  
Retrospective Observational Study ◽  
Health Seeking ◽  
Social Distancing ◽  
Hospitalised Patients ◽  
Secondary Outcomes

ObjectivesTo compare the incidence and severity of invasive pneumococcal diseases (IPDs), pneumococcal pneumonia and all-cause pneumonia during the COVID-19 pandemic period with universal masking and social distancing with that of previous 5 years.DesignRetrospective observational study on incidence of IPDs, pneumococcal pneumonia and all-cause pneumonia between January 2015–December 2019 and March 2020–March 2021. January–February 2020 was excluded from analysis as it was treated as a transitional period between normal time and pandemic.SettingEpisode-based data by retrieval of hospitalisation records from the Hospital Authority’s territory-wide electronic medical record database in Hong Kong.ParticipantsHospitalised patients with IPD (n=742), pneumococcal pneumonia (n=2163) and all-cause pneumonia (including COVID-19 pneumonia, n=453 999) aged 18 years or above. Control diagnoses were included to assess confounding from health-seeking behaviours.Primary and secondary outcomesPrimary outcome is the incidence of diseases between two periods. Secondary outcomes include disease severity surrogated by length of stay and mortality.ResultsMonthly average number of IPD, pneumococcal pneumonia and all-cause pneumonia hospitalisation significantly decreased by 88.9% (95% CI 79.8% to 98.0%, p<0.0005), 72.5% (95% CI 65.9% to 79.1%, p<0.0005) and 17.5% (95% CI 16.8% to 18.2%, p<0.0005), respectively. Changes in trend from January 2015–December 2019 to March 2020–March 2021 were −70% (95% CI −87% to −35%, p=0.0025), –43% (95% CI −59% to −19%, p=0.0014) and −11% (95% CI −13% to −10%, p<0.0005), respectively. Length of stay for IPD and pneumococcal pneumonia episodes were insignificantly different in the two periods. No reductions in hospitalisations for control diagnoses were observed.ConclusionsIncidence of IPD, pneumococcal pneumonia and all-cause pneumonia decreased during the COVID-19 pandemic. This was observed with universal masking and social distancing. We postulated this is related to reduced transmission of respiratory viruses and bacteria.

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