scholarly journals Mannitol Dosing Error during Pre-neurosurgical Care of Head Injury: A Neurosurgical In-Hospital Survey from Ibadan, Nigeria

2021 ◽  
Vol 12 (01) ◽  
pp. 171-176
Author(s):  
Amos Olufemi Adeleye ◽  
Toyin Ayofe Oyemolade ◽  
Toluyemi Adefolarin Malomo ◽  
Oghenekevwe Efe Okere
Keyword(s):  
Head Injury ◽  
Medical Error ◽  
Health Facilities ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Inappropriate Use ◽  
Dosing Error ◽  
Care Givers ◽  
Clinically Significant ◽  
Sectional Analysis

Abstract Objectives Inappropriate use of mannitol is a medical error seen frequently in pre-neurosurgical head injury (HI) care that may result in serious adverse effects. This study explored this medical error amongst HI patients in a Nigerian neurosurgery unit. Methods We performed a cross-sectional analysis of a prospective cohort of HI patients who were administered mannitol by their initial non-neurosurgical health care givers before referral to our center over a 22-month period. Statistical Analysis A statistical software was used for the analysis with which an α value of <0.05 was deemed clinically significant. Results Seventy-one patients were recruited: 17 (23.9%) from private hospitals, 13 (18.3%) from primary health facilities (PHFs), 20 (28.2%) from secondary health facilities (SHFs), and 21 (29.6%) from tertiary health facilities (THFs). Thirteen patients (18.3%) had mild HI; 29 (40.8%) each had moderate and severe HI, respectively. Pupillary abnormalities were documented in five patients (7.04%) with severe HI and neurological deterioration in two with mild HI.Mannitol administration was deemed appropriate in only 43.7% (31/71). Data on mannitol dosing in 60.6% (43/71) of the patients showed 8/43 (18.6%) receiving continuous 10% mannitol infusion. The remaining 35/43 received mannitol as a 20% solution but also showing dosing error in 62.9% (22/35): overdosing in 7/35 (20%), and nonbolus administration in 15/35 (42.9%). The distribution of the dosing error among the referring health facilities (all the 13 [100%] patients from private hospitals, 66.7% from PHF, 60% from SHF, and 45.5% from THF) showed a trend of better performance (p = 0.002) by the THFs. Conclusion Mannitol use is apparently fraught with an understudied medical error in the pre-neurosurgical care of the head injured.

scholarly journals Analysis of patterns of antibiotic prescribing in public health facilities in Nepal

2020 ◽  
Vol 14 (01) ◽  
pp. 18-27 ◽  
Author(s):  
Anant Nepal ◽  
Delia Hendrie ◽  
Suzanne Robinson ◽  
Linda A Selvey
Keyword(s):  
Public Health ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Antibiotic Prescribing ◽  
Who Guidelines ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Middle Income ◽  
Public Health Facilities ◽  
Inappropriate Use

Introduction: Inappropriate use of antibiotics is recognised as a leading cause of antibiotic resistance. Little is known about antibiotic prescribing practices at public health facilities in low- and middle-income countries. We examined patterns of antibiotic prescribing in public health facilities in Nepal and explored factors influencing these practices. Methodology: A cross-sectional study of antibiotic prescribing in public health facilities was conducted in the Rupandehi district of Nepal. Six public health facilities were selected based on WHO guidelines, and data were extracted from administrative records for 6,860 patient encounters. Patterns of antibiotic prescribing were investigated using descriptive statistics. Chi-squared tests and logistic regressions were applied to explore factors associated with antibiotic prescribing. Results: Of patients attending public health facilities, the proportion prescribed at least one antibiotic (44.7%) was approximately twice the WHO recommended value (20.0 to 26.8%). The antibiotic prescribing rate for hospital inpatients (64.6%) was higher than for other facilities, with the prescribing rate also high in primary health care centres (50.4%) and health posts (52.2%). The most frequently (29.9%) prescribed antibiotic classes were third-generation cephalosporins. Females (p = 0.005) and younger (p < 0.001) patients were more likely to be prescribed antibiotics. High prescribing rates of antibiotics for selected diseases appeared contrary to international recommendations. Conclusion: Antibiotic prescribing in public health facilities was high compared with WHO guidelines, suggesting the need for strategies to reduce misuse of antibiotics. This study provides useful information to assist in formulating policies and guidelines to promote more appropriate use of antibiotics in Nepal.

scholarly journals ‘Bipolarity’ in bipolar disorder: Distribution of manic and depressive symptoms in a treated population

2005 ◽  
Vol 187 (1) ◽  
pp. 87-88 ◽  
Author(s):  
Mark S. Bauer ◽  
Gregory E. Simon ◽  
Evette Ludman ◽  
Jurgen Unützer
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Health Maintenance Organisation ◽  
Cross Sectional ◽  
Health Maintenance ◽  
Manic Symptoms ◽  
Clinically Significant ◽  
Sectional Analysis ◽  
Depressive And Manic Symptoms

SummaryCross-sectional analysis of 441 individuals with bipolar disorder treated at a US health maintenance organisation investigated the distribution of manic and depressive symptoms in that illness. Clinically significant depressive symptoms occurred in 94.1% of those with (hypo)mania, while70.1% inadepressive episode had clinically significant manic symptoms. DSM-unrecognised depression-plus-hypomania was over twice as prevalent as DSM-recognised mixed episodes. Depressive symptoms were unimodally distributed in (hypo)mania. Depressive and manic symptoms were positively, not inversely correlated, and their co-occurrence was associated with worse quality of life. Implications for the DSM and ICD nosological systems are discussed.

scholarly journals Quality of care and its determinants in longer term mental health facilities across Europe; a cross-sectional analysis

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Helen Killaspy ◽  
Graça Cardoso ◽  
Sarah White ◽  
Christine Wright ◽  
José Miguel Caldas de Almeida ◽  
...  
Keyword(s):  
Mental Health ◽  
Quality Of Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Mental Health Facilities ◽  
Sectional Analysis

Antenatal Care Services and Preparedness of Health Facilities in Bangladesh: Evidence From Two Nationally Representative Surveys

2021 ◽  
Author(s):  
Shariful Hakim ◽  
Muhammad Abdul Baker Chowdhury ◽  
Zobayer Ahmed ◽  
Md Jamal Uddin
Keyword(s):  
Health Planning ◽  
Health Facilities ◽  
Outcome Variable ◽  
P Value ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Public Facilities ◽  
Care Services ◽  
Nationally Representative ◽  
Sectional Analysis

Abstract ObjectiveTo assess whether health facilities in Bangladesh are prepared to provide ANC services and to investigate facility characteristics that are linked to preparedness.Methods This cross-sectional analysis used publicly available data from two waves of Bangladesh Health Facilities Survey (BHFS) that was conducted in 2014 and 2017 using stratified random sample of facilities. 1508 and 1506 health facilities were included as study samples from the 2014 and 2017 BHFS respectively. The outcome variable ‘ANC services preparedness’ was calculated as an index score using a group of tracer indicators. Multivariable logistic regression models were used to identify the important correlates of ANC service preparednessResultsThe percentage of facilities providing ANC services has increased slightly from 97.4% in 2014 to 98.8% in 2017. Union level public facilities were less likely to be prepared for providing ANC service than district level public facilities in 2014 (Odds ratio (OR): 0.20, Confidence interval (CI): 0.08-0.50, P-value=<0.001). Similar results were also found in 2017 (OR: 0.14, CI: 0.06-0.33, P-Value=<0.001). The facilities with high basic amenities score were more likely to be prepared for providing ANC than the facilities with low basic amenities score in 2014 (OR: 2.52, CI: 1.02-6.12, P-Value=0.04) and in 2017 (OR: 1.79, CI: 1.08-2.99, P-Value=0.02). Conclusion The overall preparedness score to offer ANC service was also poor. Our findings may be considered for not only health planning but also decision making in order to produce a healthy mother and a baby at the end of pregnancy.

scholarly journals Publicly insured caesarean sections in private hospitals: a repeated cross-sectional analysis in Chile

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024241 ◽  
Author(s):  
Florencia Borrescio-Higa ◽  
Nieves Valdés
Keyword(s):  
Public Insurance ◽  
Cross Sectional ◽  
Private Hospitals ◽  
The Public ◽  
Cross Sectional Analysis ◽  
Maternal Morbidity And Mortality ◽  
Hospital Births ◽  
Publicly Insured ◽  
Sectional Analysis ◽  
Privately Insured

ObjectiveTo measure the likelihood of delivery by caesarean section (C-section) for publicly insured births as compared with privately insured births, across all hospitals and within private hospitals.DesignRepeated cross-sectional analysis.SettingThe universe of hospital births in 15 regions of Chile.Participants2 405 082 singleton births between 2001 and 2014.Outcome measuresC-section rates by type of hospital and type of insurance; contribution to overall C-section rates of subgroups by type of insurance and type of hospital; adjusted OR of privately insured births delivered by C-section compared with publicly insured births, across all hospitals and within private hospitals; percentage of discharges related to maternal morbidity and mortality across groups; length of stay after delivery.ResultsAn increasing percentage of publicly insured births occur in private facilities each year. Approximately three out of four publicly insured births in private hospitals are delivered by C-section. The adjusted odd of C-section delivery in a private maternity unit is lower for those privately insured than for those with public insurance: OR 0.6, 95% CI 0.56 to 0.64. There is no evidence that these women would have been more likely to have a C-section out of medical necessity.ConclusionsWe find an association between high C-section rates and publicly insured women delivering at private institutions in Chile, and show that this group is driving the overall high and growing rates. There is a need for a more informed surveillance on the part of the public insurance system of its private providers’ C-section practices.

scholarly journals Potentially Inappropriate Prescribing and Potential Clinically Significant Drug–Drug Interactions in Older Outpatients: Is There Any Association?

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 332
Author(s):  
Zorica Cvetković ◽  
Aneta Perić ◽  
Silva Dobrić
Keyword(s):  
Drug Interactions ◽  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medications ◽  
Potentially Inappropriate Prescribing ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Inappropriate Drugs ◽  
Stopp Criteria ◽  
Clinically Significant

Background and Objectives: The purpose of the study was to determine the prevalence rate of potentially inappropriate prescribing (PIP), by using the Screening Tool of Older Person’s potentially inappropriate Prescriptions (STOPP) criteria in older outpatients, and its association with potential clinically significant drug–drug interactions (csDDIs). Materials and Methods: A cross-sectional study included 248 outpatients ≥65 years old divided into two groups depending on the presence of csDDIs. For estimating the clinical significance of csDDIs we used Medscape′s "Drug Interaction Checker". We applied the thirty PIP indicators from the STOPP criteria. Results: The presence of PIP (25.00%; all patients) was significantly higher in the group with potential csDDIs compared to the other group (43 vs. 19, respectively; Chi-square test, χ2 = 9.947; p < 0.01). The most common PIP included the inappropriate use of proton pump inhibitors, long acting benzodiazepines, usage of thiazide diuretic in patients with gout, and duplication of therapeutic class. Patients with potential csDDIs had 43 potentially inappropriate medications (PIMs) prescribed. Out of this number, 12 (27.91%) PIMs were identified to participate in potential csDDIs. There was a correlation between the number of medications prescribed and the number of PIMs (ρ = 0.297; p < 0.01) and between the number of PIPs and the number of potential csDDIs (ρ = 0.170; p < 0.01). Conclusions: Older outpatients with potential csDDIs in relation to those with no potential csDDIs had significantly more prescribed drugs in total as well as inappropriate drugs. Almost 30% of these PIMs were included in potential csDDIs.

scholarly journals Knowledge, attitudes and practices of hospital cleaning services staff towards Coronavirus Disease-2019 (COVID-19) in a Middle Eastern country: A web-based cross-sectional study

2021 ◽  
Author(s):  
Dalal Youssef ◽  
Linda Abou Abass ◽  
Hamad Hassan
Keyword(s):  
Cross Sectional Study ◽  
Health Facilities ◽  
P Value ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Attitudes And Practices ◽  
Preventive Practices ◽  
Health Authorities ◽  
Cleaning And Disinfection ◽  
Hospital Cleaning

Abstract Background Hospital cleaners are the unsung heroes in the fight against the COVID-19 pandemic. This study aims to assess the knowledge, attitudes, and practices (KAP) of hospital cleaners towards COVID-19 and to determine factors associated with good practices. Methods A cross-sectional study was conducted in Lebanon between 1st and 14th November 2020. Data was collected through an online survey that was sent to governmental-run and private hospitals. The questionnaire consisted of socio-demographic characteristics, clinical information, and KAP of hospital cleaners towards Covid-19. The collected data was exported to SPSS for analysis. The relation between nominal variables was tested using the chi-squared test. The variables in bivariate analysis with p-value<0.2 were entered into multivariable logistic regression. Adjusted odds ratio and their 95% confidence intervals were reported. The level of statistical significance was set at a p-value < 0.05. Results A total of 453 cleaners completed the survey of which 54.3% were females. Most of the participants had a good level of COVID-19 knowledge (98%) and good preventive practices (89.7%). Regarding attitude, 90.7% had a positive attitude toward health facilities, 78.8% towards cleaning and disinfection, and 73.5% towards health authorities. Sociodemographic characteristics including younger age, higher levels of education, working in private hospitals, and having more than 3 years of experience were positively associated with good preventive practices. Our results also showed that participants with good knowledge about COVID-19, COVID-19 prevention and treatment, cleaning and disinfection process, and COVID-19 risk factors had a higher likelihood of positive preventive practices. Finally, a positive attitude towards health facilities, health authorities, and cleaning and disinfection were positively associated with good practices. Conclusion Our results indicate that cleaners have a high level of knowledge, expressed positive attitudes towards health facilities and health authorities, and good preventive practices. Understanding the determinants of cleaning performance is critical in tailoring interventions to improve hospital cleaning.

scholarly journals Psychological and social wellbeing of paramedics in Riyadh City during the COVID-19 pandemic

2021 ◽  
Vol 18 ◽  
Author(s):  
Abdulrahman Alqahtani ◽  
Saleh Alqahtani ◽  
Abdullah Alhodaib ◽  
Amin Daoulah ◽  
Abdulmajeed Mobarad ◽  
...  
Keyword(s):  
Hospital Care ◽  
Cross Sectional ◽  
Riyadh City ◽  
Care Givers ◽  
Social Wellbeing ◽  
Psychological Difficulties ◽  
The Mean ◽  
Therapeutic Assistance ◽  
Sectional Analysis ◽  
Support Score

Introduction Our research sought to assess the psychological and social wellbeing of paramedics in Riyadh City in Saudi Arabia during the COVID 19 pandemic. It also aimed to assess the therapeutic assistance provided to pre-hospital care givers during the pandemic. Methods In this quantitative cross-sectional analysis an assessment of 106 paramedics was undertaken from data obtained from 28 September to 10 November 2020. The authenticity and durability of Pilot and the Cronbach have been added. Results Of the 106 paramedics surveyed, 60 (56.6%) were 30–39 years of age; 101 were male (95.3%). The mean average psychological wellbeing of the paramedics was 6.41 with the standard deviation of 2.42. Family and friends’ average social support score was 9.2 in norm 2.6 deviation. Conclusion Our study showed that during the COVID-19 pandemic paramedics suffered from social and psychological depression. Paramedics must be protected from the socioeconomic and psychological difficulties they face every day in order to combat the COVID-19 pandemic.

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