Proposed Regulations Take Aim at Errors in Inpatient Care

2008 ◽  
Vol 7 (3) ◽  
pp. 39
Author(s):  
DENISE NAPOLI
Keyword(s):  
Inpatient Care

Anticholinergic Burden among Hospitalised Older Adults with Psychiatric Illnesses- A retrospective study

2020 ◽  
Vol 15 ◽  
Author(s):  
Shiva Shanker Reddy Mukku ◽  
Preeti Sinha ◽  
Palanimuthu Thangaraju Sivakumar ◽  
Mathew Varghese
Keyword(s):  
Older Adults ◽  
Retrospective Study ◽  
Psychiatric Disorders ◽  
Psychotropic Drugs ◽  
Inpatient Care ◽  
Medical Illness ◽  
Anticholinergic Effects ◽  
Psychiatric Illnesses ◽  
Anticholinergic Burden ◽  
Number Of Males

Background: Drugs with anticholinergic properties are known to be associated with deleterious effects on cognition in older adults. There is a paucity of literature in this aspect in older adults with psychiatric disorders. Objective: To examine the anticholinergic cognitive burden and its predictors in hospitalised older adults having psychiatric disorders. Methods: Case records of older adults who sought inpatient care under the Geriatric Psychiatry Unit from January, 2019 to June, 2019 were reviewed. The anticholinergic burden was assessed with Anticholinergic Cognitive Burden (ACB) scale updated version, 2012. Results: Sample included 129 older adults with an almost equal number of males (53.48%) and females (46.52%) having a mean age of 67.84 (SD = 6.96) years. The diagnostic spectrum included depression (34.89%), dementia (31.01%), mania (10.85%), psychosis (13.95%), delirium (6.20%) and others (3.1%). 60.47% of the patients had more than one medical illness. 48.84% of the older adults had clinically relevant anticholinergic cognitive burden ( ACB score ≥ 3). Use of 3 or more psychotropic drugs (OR = 4.88), diagnosis of psychosis/ mania (OR = 7.62) and dementia/ delirium (neurocognitive disorders group) (OR = 5.17) increased the risk of ACB score ≥ 3. Conclusion: Nearly half of the older adults in psychiatry in-patient setting had clinically relevant anticholinergic burden, which was associated with higher use of psychotropics. Our study highlights the importance of monitoring for anticholinergic effects of psychotropics in older adults.

HUBUNGAN SUPERVISI DAN MOTIVASI DENGAN PEMBERIAN CAIRAN INFUS SESUAI SPO OLEH PERAWAT PELAKSANA

2017 ◽  
Vol 2 (3) ◽  
pp. 280
Author(s):  
Susi Widiawati ◽  
Ona Apriana ◽  
Diah Merdekawati
Keyword(s):  
Medical Care ◽  
Inpatient Care ◽  
Univariate Analysis ◽  
Care Facility ◽  
P Value ◽  
Intravenous Therapy ◽  
Operational Procedure ◽  
High Motivation

<p><em>Intravenous therapy (VI) is the therapy frequently used on medical care. More than 60% of clients treated at hospital applied the therapy.  The problem found was inappropriate standard operational procedure in applying Intravenous therapy. The purpose of this study was to know the correlation of supervision and motivation in  applying Intravenous therapy based on standard operational procedure  done by nurse at inpatient care facility of Siloam Hospital, Jambi.Populations were all nurses worked at the hospital. The samples were 51 nurses; it was a total sampling. The result of univariate analysis revealed that the number of respondents who had a good supervision was 30 nurses (58.9%). Meanwhile, the respondents having high motivation were 26 (51%), and the respondents who applied intravenous therapy based on standard operational procedure were 43 nurses (64.3%). The biavariate showed that there was a significant correlation between supervision and applying intravenous therapy based on standard operational procedure (p-value 0.034&lt;0.05) and there was a significant correlation between motivation and applying intravenous therapy based on standard operational procedure (p-value 0.018&lt;0.05). In summary, there was a significant correlation of supervision and motivation in  applying Intravenous therapy based on standard operational procedure  done by nurse at inpatient care facility of Siloam Hospital Jambi.</em></p>

scholarly journals Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 ‘lockdown’ policy in 10 UK sites: a regression discontinuity in time design

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049721
Author(s):  
Ioannis Bakolis ◽  
Robert Stewart ◽  
David Baldwin ◽  
Jane Beenstock ◽  
Paul Bibby ◽  
...  
Keyword(s):  
Mental Health ◽  
Inpatient Care ◽  
Service Use ◽  
Regression Discontinuity ◽  
Mental Healthcare ◽  
Service Level ◽  
Community Services ◽  
Mental Health Service Use ◽  
Healthcare Data ◽  
Early Intervention In Psychosis

ObjectivesTo investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020.DesignA regression discontinuity in time (RDiT) analysis of daily service-level activity.Setting and participantsMental healthcare data were extracted from 10 UK providers.Outcome measuresDaily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 ‘lockdown’ policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites.ResultsPooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect.ConclusionsMH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.

Is there a real need for sputum culture for community-acquired pneumonia diagnostics? Results from a retrospective study in Russia

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Olga S. Kobyakova ◽  
Ivan A. Deev ◽  
Daria A. Vinokurova ◽  
Anastasia P. Zima ◽  
Denis S. Tyufilin ◽  
...  
Keyword(s):  
Software Package ◽  
Inpatient Care ◽  
Antimicrobial Agents ◽  
Bacterial Culture ◽  
Community Acquired Pneumonia ◽  
Bacteriological Study ◽  
Leading Position ◽  
Oropharyngeal Flora ◽  
Pass Through ◽  
Quantitative Indicators

AbstractObjectivesThe mortality rate associated with community-acquired pneumonia is still considered high as it occupies a leading position among all infectious diseases. The primary purpose of this study is to evaluate the implementation of the respiratory bacterial culture sampling in the clinical practice of the Russian Federation’s therapeutic departments and its impact on inpatient care.MethodsThe study included 1,344 patients with community-acquired pneumonia. The analysis of the obtained data was performed using the statistical software package SPSS 23.0 (IBM SPSS Statistics). The description of quantitative indicators was carried out with an indication of the median (25; 75 percentile). Qualitative with an indication of the absolute and relative frequencies n (%).ResultsIt was noted that a third of the sample did not pass through the first stage (bacterioscopy). We noticed the predominance of oropharyngeal flora in the results. The sputum collection was carried out on average 3 (1; 5) days after the start of hospitalization, while antibiotic therapy was prescribed to all patients on the first day, the results of the bacteriological study were ready on average 6 (4; 8th) calendar days after hospitalization, while in 20 (1.5%) cases, the patient was already discharged. Due to the inefficiency of the starting regimen, antimicrobial agents have changed in 84 (6.3%) patients and averaged 5.5 (4.0; 10.0) days from the start of hospitalization.ConclusionsThe violation of the technique and the time of sputum collection resulted in a reduction in the method’s value.

scholarly journals The Patient Experience of Inpatient Care During the COVID-19 Pandemic: Exploring Patient Perceptions, Communication, and Quality of Care at a University Teaching Hospital in the United Kingdom

2021 ◽  
Vol 8 ◽  
pp. 237437352199774
Author(s):  
Thomas Key ◽  
Avadhut Kulkarni ◽  
Vikram Kandhari ◽  
Zayd Jawad ◽  
Angela Hughes ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Patient Experience ◽  
Health Care Professionals ◽  
Disease Transmission ◽  
Inpatient Care ◽  
University Teaching ◽  
Health Board ◽  
Experience Of Care

The coronavirus disease 2019 (COVID-19) pandemic has necessitated many rapid changes in the provision and delivery of health care in hospital. This study aimed to explore the patient experience of inpatient care during COVID-19 pandemic. An electronic questionnaire was designed and distributed to inpatients treated at a large University Health Board over a 6-week period. It focused on hospital inpatients’ experience of being cared for by health care professionals wearing personal protective equipment (PPE), explored communication, and patients’ perceptions of the quality of care. A total of 704 patients completed the survey. Results demonstrated that patients believe PPE is important to protect the health of both patients and staff and does not negatively impact on their care. In spite of routine use of PPE, patients were still able to identify and communicate with staff. Although visiting restrictions were enforced to limit disease transmission, patients maintained contact with their relatives by using various electronic forms of communication. Overall, patients rated the quality of care they received at 9/10. This single-center study demonstrates a positive patient experience of care at an unprecedented time.

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