scholarly journals Perceptions and practices regarding the process of obtaining informed consent from surgical patients at a tertiary care hospital

2021 ◽  
pp. 103195
Author(s):  
Muhammad Asharib Arshad ◽  
Naureen Omar ◽  
Muhammad Zaid Amjad ◽  
Khalid Bashir ◽  
Muhammad Irfan ◽  
...  
Keyword(s):  
Informed Consent ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Patients ◽  
Care Hospital

scholarly journals Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025299
Author(s):  
Udagedara Mudiyanselage Jayami Esha Samaranayake ◽  
Yasith Mathangasinghe ◽  
Anura Sarath Kumara Banagala
Keyword(s):  
Informed Consent ◽  
Qualitative Study ◽  
Tertiary Care Hospital ◽  
Comparative Method ◽  
Tertiary Care ◽  
Lifestyle Changes ◽  
Cultural Norms ◽  
Sri Lankan ◽  
Care Hospital ◽  
Asking Questions

ObjectiveTo identify the different perceptions on informed surgical consent in a group of Sri Lankan patients.MethodsA qualitative study was conducted in a single surgical unit at a tertiary care hospital from January to May 2018. The protocol conformed to the Declaration of Helsinki. Patients undergoing elective major surgeries were recruited using initial purposive and later theoretical sampling. In-depth interviews were conducted in their native language based on the grounded theory. Initial codes were generated after analysing the transcripts. Constant comparative method was employed during intermediate and advanced coding. Data collection and analyses were conducted simultaneously, until the saturation of the themes. Finally, advanced coding was used for theoretical integrations.ResultsThirty patients (male:female=12:18) were assessed. The mean age was 41±9 years. Sinhalese predominated (50.0%, n=15). Majority underwent thyroidectomy (36.7%, n=11). The generated theory categorises the process of obtaining informed consent in four phases: initial interaction phase, reasoning phase, convincing phase and decision-making phase. Giving consent for surgery was a dependent role between patient, family members and the surgeon, as opposed to an individual decision by the patient. Some patients abstained from asking questions from doctors since doctors were ‘busy’, ‘short-tempered’ or ‘stressed out’. Some found nurses to be more approachable than doctors. Patients admitted that having a bystander while obtaining consent would relieve their stress. They needed doctors to emphasise more on postoperative lifestyle changes and preprocedure counselling at the clinic level. To educate patients about their procedure, some suggested leaflets or booklets to be distributed at the clinic before ward admission. The majority disliked watching educational videos because they were ‘scared’ to look at surgical dissections and blood.ConclusionThe informed consent process should include key elements that are non-culture specific along with elements or practices that consider the cultural norms of the society.

scholarly journals Practice of Informed Consent, Confidentiality and Privacy by Physicians at a Tertiary Care Teaching Hospital

2015 ◽  
Vol 5 (3) ◽  
pp. 1-5
Author(s):  
Zoheb Rafique Rafique ◽  
Urooj Bhatti
Keyword(s):  
Informed Consent ◽  
Medical Ethics ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Public Sector Hospital ◽  
Privacy And Confidentiality ◽  
Structured Questionnaire

Objective: The aim of this paper was to assess the practice of medical ethics by the physicians at a public sector hospital in Jamshoro Sindh. Material and methods: This survey was conducted at four medical units of tertiary care hospital at jamshoro in the month of august 2014. Participants were randomly selected from patients aged over 18 years. A structured questionnaire was designed and the participants were asked about their demographic profile and their physician’s practice regarding informed consent, maintaining confidentiality, privacy and other treatment formalities. Written consent was taken from all the participants before interview.Results: A total of 100 patients were randomly selected for this study. The majority of patients reported that informed consent was taken from them. The patients also responded that privacy and confidentiality is maintained during their treatment. However, many patients agreed that they were not properly informed about the laboratory findings, role of proposed drugs and also side effects of drugs. Conclusion: There is marked improvement in the practice of medical ethics by physicians of this tertiary care hospital. However, awareness workshops should be conducted to update and improve the knowledge of medical ethics among physicians. This will surely help them translate the knowledge into practice. DOI: http://dx.doi.org/10.3329/bioethics.v5i3.21531 Bangladesh Journal of Bioethics 2014 Vol.5 (3): 1-5.

scholarly journals Surgical outcome of COVID-19 infected patients: experience in a tertiary care hospital in India

2021 ◽  
Vol 8 (3) ◽  
pp. 899
Author(s):  
Charan Singh ◽  
Lileswar Kaman ◽  
Aruj Shah ◽  
Uttam Kumar Thakur ◽  
Krishna Ramavath ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Surgical Outcome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Adverse Impact ◽  
Surgical Patients ◽  
Care Hospital ◽  
Patients Experience ◽  
Serum Crp ◽  
Overall Mortality

Background: COVID-19 disease caused by SARS-COV-2 has become a pandemic. Outcome of surgical patients infected with COVID-19 is not very clear.Methods: Retrospective analysis of the surgical outcome of COVID-19 infected patients admitted in emergency and elective surgical settings in a designated COVID care center.Results: Total 53 patients were included. Surgery was done in 47.16% (n=25) patients and 52.84% (n=28) patients were managed non-operatively. Overall mortality was 37.7 % (n=20). In operated group it was 52% (n=13) and 25% (n=7) in the non-operative group (p=0.043). The total leukocyte (p=0.018), serum CRP (p=0.031), urea and creatinine level (p=0.025) were higher in the mortality group. Patients aged more than 50 years had a significantly higher mortality compared to less than 50 years (p=0.010). Patients having multiple comorbidities had higher mortality (p=0.159).Conclusions: COVID-19 infection has a definite adverse impact on the outcomes of surgical patients.

scholarly journals Study of prescription pattern of antimicrobials used in post-operative surgical patients in tertiary care hospital

2021 ◽  
Vol 10 (6) ◽  
pp. 627
Author(s):  
Jitendra H. Hotwani ◽  
Nishikant H. Madkholkar
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Duration ◽  
Hospital Setting ◽  
Surgical Site Infections ◽  
The Body ◽  
Brand Names ◽  
Surgical Patients ◽  
Care Hospital ◽  
Prescription Pattern

Background: Antimicrobials are used for prophylaxis and treatment of infections which occur following surgical procedures, to reduce the morbidity and mortality associated with surgical site infections (SSIs). A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. These are infections of the tissues, organs, or spaces exposed by surgeons during performance of an invasive procedure.Methods: A prospective, non-interventional, observational study in tertiary care hospital for duration of 9 months. Sample size was 330.Results: The prescription pattern shows that nitroimidazoles were the most commonly prescribed group of antimicrobials in 72% of patients followed by penicillins (58%) and cephalosporins (42%). Metronidazole (72%), amoxicillin and clavulanic acid (51.21%) ceftriaxone (20.90%) were most commonly prescribed antimicrobials in these groups. Two antimicrobials were prescribed in 47% patients with nitroimidazole and penicillins being the most commonly prescribed combination of antimicrobial. Three antimicrobials were prescribed in 25% patients and four antimicrobials in 8% patients. This shows trend towards polypharmacy. About 82% of antimicrobials were prescribed by brand names and 64% of total antimicrobials prescribed from outside the hospital pharmacy source. About 12.42% of patients changed antimicrobial therapy after culture and sensitivity report.Conclusions: Total duration, number of anti-microbial used was more in clean-contaminated, contaminated, dirty wound surgeries as compare to clean wound surgeries. Our study provides a framework for continuous prescription audit of antimicrobials in a hospital setting and thus can help in rational use of antimicrobials in post-operative surgical patients.

scholarly journals Cases of Left Against Medical Advice from the Emergency Department of a Tertiary Care Hospital in Kathmandu: A Descriptive Cross-Sectional Study

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Manish Nath Pant ◽  
Saswat Kumar Jha ◽  
Sauravi Shrestha
Keyword(s):  
Emergency Department ◽  
Informed Consent ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Medical Advice ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Against Medical Advice

Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Left against medical advice do not provide the health professionals with legal impunity. A well-informed consent should be present with surety that they are well understood by the patient before they leave. The study was undertaken to study the prevalence of patients that leave against medical advice. Methods: This is a descriptive cross-sectional study done in the emergency department of a tertiary care hospital from 1st February 2020 to 31 July 2020. Ethical approval was taken from the Institutional Review Committee (ref. no. 130120205). The sample size was calculated and the convenient sampling method was used. Data were analyzed in the Statistical Package of the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 5834 visits, 332 (5.96%) (4.70-7.22 at 95% Confidence Interval) patients left against medical advice. The mean age was 36.48 years (3 days-91 years) and males 173 (52.3%) were prone to leave than females. Only 50 (15.1%) cases had well-informed consent with complications documented. Hundred (30.5%) patients had wanted to come on follow up the next day in the out-patient department while 41 (12.4%) had to leave because of financial reasons. Only seven (2.9%) of well-oriented patients gave their consent and the remaining 233 (97.1%) were by the kin present. Only 76 (23%) patients were sent home with a well-documented medicine prescription. Conclusions: The proportion of patients who left against medical advice was more than the studies done in a similar setting.

scholarly journals POST CAESAREAN SECTION WOUND INFECTION: MICROBIOLOGICAL PATTERN AND SUSCEPTIBILITY IN A TERTIARY CARE HOSPITAL, JHALAWAR

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Dr.Shilpi Hora ◽  
Dr. Manish Pokra ◽  
Dr.Pawan Sharma ◽  
Dr.Tarun Vijaywargiya Vijaywargiya ◽  
Dr.Anshul Jhanwar
Keyword(s):  
Nosocomial Infection ◽  
Surveillance System ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Surgical Patients ◽  
Care Hospital ◽  
The Third ◽  
Infection Surveillance ◽  
Surgical Operations

Surgical site infection (SSI) is the third most common nosocomial infection. According to CDC’s National Nosocomial Infection Surveillance system 38% of all nosocomial infections in surgical patients are surgical site infections (SSI).1 They have been responsible for the increasing cost, morbidity and mortality related to surgical operations .Even in hospitals, with modern facilities and following standard protocols of pre operative preparation and antibiotic prophylaxis, SSI continues to be a major problem

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