scholarly journals 157. Impact of Pharmacist-Generated Oral Antimicrobial Test Prescription on Discharge Medication Access and Outcome

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S95-S95
Author(s):  
Surafel Mulugeta ◽  
Susan L Davis ◽  
Susan L Davis ◽  
Rachel Kenney
Keyword(s):  
Length Of Stay ◽  
Bivariate Analysis ◽  
First Line ◽  
Public Insurance ◽  
Cross Sectional ◽  
Antimicrobial Test ◽  
Medication Access ◽  
Secondary Endpoints ◽  
Comorbidity Index ◽  
Future Work

Abstract Background Cost barriers to accessing discharge oral antimicrobials (ABX) may delay discharges and result in suboptimal discharge ABX. Use of electronic test prescriptions (eTP) or “price checks” is controversial due to potential for erroneous dispensing. This study evaluated discharge ABX access and outcome after implementation of a standardized, inpatient pharmacist-initiated ABX eTP process in collaboration with discharge pharmacy. Methods IRB approved, retrospective, cross-sectional cohort pilot-study. Inclusion: home bound adults admitted for ≥ 72 hours from 1/1/18-2/28/19 and discharged on oral ABX. Patients with an ABX eTP prior to discharge were compared to those discharged on ABX but no eTP. Data were reported using descriptive statistics and bivariate analysis. Primary endpoint: discharge delay after medical stability. Secondary endpoints: medication access, unplanned encounters, and % of patients discharged on first-line ABX. Results 84 patients included: 43 no-ETP and 41 eTP. 75 ABX eTP evaluated among 41 patients. Patients in the no-eTP group had higher Charlson comorbidity index (P = 0.004) and immunosuppression (24% vs. 12%; P = 0.014). Median length of stay, days: 6 (5 – 9) eTP vs. 8 (5 – 15) no-eTP (P = 0.026). Most common eTP requested by pharmacist: linezolid (17, 23%) and oral vancomycin (12, 16%) (Figure 1). eTP results were documented in the medical record in < 24 hours for 66 (88%) of inquiries. 49 (65%) prescriptions were approved by insurance; 16 (21%) had no out of pocket cost and 8 (11%) required prior authorization (PA) (Table 1). Linezolid (5, 35%) and public insurance (10, 71%) were frequently associated with barriers. 29 (70%) patients were discharged on the same ABX as the eTP. There were no discharge delays or erroneous dispensing. 14 (33%) no-eTP and 15 (37%) eTP patients experienced unplanned healthcare encounters after discharge. 9/84 (11%) patients were discharged on suboptimal ABX. Non-white race 8/9 (89%) P = 0.047 and public insurance 8/9 (89%) P = 0.063 were associated with suboptimal discharge ABX. Figure 1. Oral Antimicrobial Test Prescription Pattern (n=75) Table 1. Oral Antimicrobial Test Prescription Result (n=75) Conclusion A standardized eTP process appears to be a safe way to evaluate out of pocket cost without prolonging length of stay. Future work will focus on inequity in access to first line ABX. Disclosures Susan L. Davis, PharmD, Nothing to disclose Rachel Kenney, PharmD, Medtronic, Inc. (Other Financial or Material Support, spouse is an employee and shareholder)

scholarly journals Risk Factors for Undernutrition at Admission Among Adult Hospitalized Patients at a Referral Hospital in Indonesia

SAGE Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 215824402098331
Author(s):  
Nur Chandra Bunawan ◽  
Dwi Suseno ◽  
Drupadi H. S. Dillon ◽  
Ikhwan Rinaldi ◽  
Dyah Purnamasari
Keyword(s):  
Associated Factors ◽  
Multivariate Analyses ◽  
Gastrointestinal Disease ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Initial Hospital ◽  
Comorbidity Index

Patients with undernutrition at admission have higher risks to worsen their nutritional status, which is linked to an increase in morbidity and mortality. This study investigated the prevalence of undernutrition at admission and its associated factors. A cross-sectional study was conducted on patients aged 18 to 59 years old in Internal Medicine ward at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, between July and September 2019. Factors that might be associated with undernutrition at admission, such as age, sex, marital status, Charlson Comorbidity Index (CCI) and type of comorbidity, depression, and neutrophil–lymphocyte ratio (NLR), were assessed. Bivariate and multivariate analyses were used to determine the associated factors. Sixty hospitalized patients with median age of 42 years and 76.7% with married status joined the study. The most common reason for hospitalization was acute gastrointestinal disease with gallstones as the most common comorbidity. Undernutrition exists in 26.7% of subjects. High CCI score was observed among 11.7% subjects and half of subjects had NLR category ≥5. Bivariate analysis revealed that unmarried status, age ≥40 years, and malignancy were associated with undernutrition at admission. Logistic regression analysis showed malignancy as an independent predictor of undernutrition during the initial hospital admission (odds ratio [OR] = 11.8; 95% confidence interval [CI]: [1.1, 125.7]). The prevalence of undernutrition at admission was 26.7%. Factors associated with an increased prevalence of undernutrition at admission were age <40 years, unmarried status, and malignancy. Malignancy was an independent factor of the prevalence of undernutrition at admission.

Adverse Safety Event Characteristics and Predictive Factors in Hospital Encounters for Patients with Chronic Kidney Disease

2019 ◽  
Vol 50 (1) ◽  
pp. 72-80
Author(s):  
Mary Lynn Davis-Ajami ◽  
Jeffery C. Fink ◽  
Marianne Baernholdt ◽  
Jun Wu
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Length Of Stay ◽  
Female Gender ◽  
Healthcare Research ◽  
Geographical Region ◽  
Bivariate Analysis ◽  
Total Charge ◽  
Electrolyte Disorders ◽  
Cross Sectional

Background: Adverse safety events (ASE) during hospitalization may contribute to renal decline or poor outcomes. Understanding factors contributing to ASE in chronic kidney disease (CKD) is limited. The objective is to compare differences and determine predictors of renal pertinent ASE in discharges for CKD. Method: A cross-sectional analysis of the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality 2012 data. The study included adults age ≥18 years with discharge diagnosis for CKD stages 1–4, excluding cancer of the kidney and renal pelvis, renal transplant, end-stage renal disease. Predictors included study sample characteristics, including patient demographics, comorbidity, and hospitalization-related variables. Outcomes assessed included distribution of ASE (angioedema, confusion, muscle weakness or cramps, lower extremity edema (LEE), falls, hypoglycemia, nausea-vomiting-diarrhea (NVD), and skin rash), mean total charge per hospital event, and length-of-stay. The analytical approach used descriptive statistics (means and proportions) and bivariate analysis to compare differences (ASE versus none). Predictors of ASE were explored using multivariate logistic regression. Results: 10.3% of inpatient discharges for CKD showed an ASE. Mean charges (USD 48,072 vs. 46,996), days length-of-stay (6.8 vs. 5.7), number of diagnosis on record (6.8 vs. 5.7), geographical region (Midwest, and West), and type of hospital (rural) were significantly associated with ASE. Most common ASEs were confusion (18%), LEE (21.3%), and NVD (50.7%). Odds of ASE increased for age, female gender, rural hospitals, geographical region, and diagnosis for anemia, coagulopathies, depression, fluid and electrolyte disorders, neurological disorders, psychoses, and weight loss. Conclusions: We identified key factors that increase the risk of ASE in patients with CKD. Opportunities exist to reduce ASE in CKD.

scholarly journals IDENTIFICATION AND ANALYSIS OF DRUG-RELATED PROBLEMS INCIDENCE AT HOSPITALIZED PATIENTS IN HAJI REGIONAL GENERAL HOSPITAL, MAKASSAR

2021 ◽  
pp. 130-133
Author(s):  
MUHAMMAD ALDILA SATRIA ◽  
SUDIBYO SUPARDI
Keyword(s):  
Length Of Stay ◽  
Drug Treatment ◽  
General Hospital ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Sectional Study ◽  
Medical Record Data ◽  
Cross Sectional ◽  
Record Data

Objective: This study aims to identify inpatient medication problems and analyze the association between patient characteristics and the incidence of the drug-related problem (DRP) experienced by patients. Methods: The cross-sectional study was conducted at Haji Regional General Hospital, Makassar, using medical record data for inpatients from January to February 2020. Data were collected from September to October 2020. A total of 247 inpatients were identified using the Indonesian version of the Pharmaceutical Care Network Europe. Results: The most common DRP problem found is the effect of drug treatment not optimal (P1.2) by 35.76% and the most common cause found is no or incomplete drug treatment despite existing indication (C1.6) by 20.16%. Bivariate analysis shows that age, length of stay, and the number of drugs received are significant different with the incidence of DRP in patients (p < 0,01) respectively. Multivariate analysis using logistic regression shows that age, sex, and the number of drugs could significantly affect the incidence of DRP (p<0.05) with the r-square (R2) of 21.6%. According to this model, the largest odds ratio number and the most likely to experience DRP in a patient are age, the number of drugs, then gender (5,2; 4,6; and 2,3). Conclusion: Age, length of stay, and the number of drugs received affect the DRP incidence in a patient, while gender together with age and the number of drugs affecting the incidence of DRP in a patient.

scholarly journals Hubungan karakteristik dengan kejadian depresi pada lansia

2019 ◽  
Vol 7 (2) ◽  
pp. 183
Author(s):  
Novi Herawati ◽  
Deharnita Deharnita
Keyword(s):  
At Risk ◽  
Length Of Stay ◽  
Sex Education ◽  
Sampling Technique ◽  
The Elderly ◽  
Education Level ◽  
Bivariate Analysis ◽  
Chi Square ◽  
Cross Sectional ◽  
Loved One

Depresi merupakan gangguan psikiatrik yang sangat sering terjadi pada lanjut usia. Faktor penyebab depresi lansia antara lain ditinggal oleh semua anak, tidak lagi bekerja, tidak mempunyai kegiatan, kematian orang yang dicintai. Tujuan penelitian untuk mengetahui hubungan karakteristik dengan tingkat depresi pada lansia di panti sosial tresna werdha Sicincin tahun 2018. Penelitian ini merupakan studi analisis dengan pendekatan cross sectional. Variabel penelitian yaitu umur, jenis kelamin, pendidikan dan lama tinggal, serta tingkat depresi. Populasinya seluruh lansia di PSTW, jumlah 110 orang. Teknik sampling secara total sampling. Analisa bivariat dengan uji chi square. Hasil penelitian didapatkan bahwa sebagian besar lansia mengalami depresi, berusia beresiko yaitu > 65 tahun, mayoritas lansia berjenis kelamin laki-laki, tingkat pendidikan lansia mayoritas rendah,  lama tinggal lansia di panti sebagian besar beresiko ≥ 4 tahun. Uji bivariatnya tidak ada hubungan umur, jenis kelamin dan lama tinggal dengan depresi serta ada hubungan tingkat pendidikan dengan depresi. Kata kunci: depresi, karakteristik lansia RELATIONSHIP CHARACTERISTICS WITH INCIDENCE OF DEPRESSION IN THE ELDERLY ABSTRACTDepression is a psychiatric disorder that is very common in the elderly. Factors causing depression in the elderly include being abandoned by all children, no longer working, no activity, death of a loved one. The purpose of this study was to determine the relationship of characteristics with the level of depression in the elderly in the social home of Vesna Sicincin in 2018. This study was an analytical study with a cross sectional approach. The research variables are age, sex, education and length of stay, and the level of depression. The population is all elderly in PSTW, the number of 110 people. Sampling technique in total sampling. Bivariate analysis with chi square test. The results showed that most of the elderly are depressed, aged at risk that is> 65 years, the majority of the elderly are male, the majority of the elderly's education level is low, the length of stay of the elderly at home is mostly at risk ≥ 4 years. The bivariate test had no relationship with age, sex and length of stay with depression and there was a relationship between education level and depression. Keywords: depression, characteristics of the elderly

scholarly journals Thyroid Function Test as First-line Investigation of Hypernatremia: Is It Necessary?

2020 ◽  
Vol 4 (1) ◽  
pp. 12-18
Author(s):  
Nada Syazana ◽  
Huzairi Sani ◽  
Zahir Izuan Azhar
Keyword(s):  
Thyroid Function ◽  
Strong Association ◽  
Thyroid Function Test ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Bivariate Analysis ◽  
Thyroid Function Tests ◽  
First Line ◽  
Cross Sectional

Non-severe hypothyroidism has no strong association with hyponatremia. However, thyroid function tests (TFT) continue to be ordered as a first-line investigation. The objective of this study was to establish the prevalence of inpatient hyponatremia and to reiterate the association between thyroid disorders and hyponatremia based on study findings and current literature. A cross-sectional study on 3,478 in-patients adults of both gender admitted to a Malaysian tertiary hospital was carried out.  Age, gender, sodium levels, thyroid stimulating hormone (TSH), free thyroxine (fT4) and clinical notes between 1/11/17-31/12/17 were extracted from the hospital’s information system. Bivariate analysis was performed using Mann-Whitney U, Chi-square and Spearman correlation tests. 21.9% of inpatients had hyponatremia of which 52% were mild. 359 (69%) of hyponatremic patients had a TFT sent where 71.9% were euthyroid. Sodium level is significantly correlated with age (R=-0.257, P<0.001). No correlations were found between sodium and TSH and fT4. Sodium was significantly lower in the non-thyroidal illness (NTI) group compared to the hypothyroid group. No significant differences in sodium were found between the hypothyroid group and other thyroid states. Hence it was conclude that in hyponatremia, TFT is indicated when there is clinical evidence of severe hypothyroidism, suspicion of hypothalamus-pituitary-axis disorder or when no cause of SIADH is apparent. Otherwise, TFT is unnecessary and costly as a first-line investigation.   Keywords: hyponatremia, hypothyroidism, hypothyroid, non-thyroidal illness, sodium

Hubungan Antara Anemia dan Kebiasaan Merokok pada Ibu Hamil dengan Kejadian BBLR di Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Tahun 2016

2018 ◽  
Vol 1 (2) ◽  
pp. 89-94
Author(s):  
Intan Sari
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
General Hospital ◽  
Smoking Habit ◽  
Complete Information ◽  
Developed Countries ◽  
Statistical Test ◽  
Survey Method ◽  
Bivariate Analysis ◽  
Cross Sectional

Low Birth Weight (LBW) is an infant born with a birth weight of less than 2500 grams regardless of gestation. Birth weight is the weight of the baby weighed in 1 hour after birth. (Depkes RI, 2009). Based on WHO and UNICEF data, in 2013 about 222 million babies were born in the world, of which 16% were born with low birth weight. The percentage of LBW in developing countries is 16.5% twice that of developed countries (7%) (Scholar Unand, 2014). The purpose of this study was to determine whether there is a relationship between anemia and Smoking Habit in Pregnant Women with LBW occurrence in General Hospital Dr. Mohammad Hoesin Palembang Year 2016. This research use analytical survey method with cross sectional approach. The population in this study were all mothers who gave birth monthly in Midwifery Installation of Dr. General Hospital Mohammad Hoesin Palembang in 2016 as many as 315 respondents. The sample of this research is some of mothers who give birth enough month in Midwifery Installation of Dr. General Hospital Mohammad Hoesin Palembang Year 2016 as many as 315 respondents. ". From the results of bivariate analysis of anemic respondents with the occurrence of LBW obtained statistical test X2 count = 23.22 which means there is a significant relationship between anemia with the incidence of BBLR. Respondents smoking with the occurrence of LBWR obtained statistical test X2 count = 41.20 which means there is a relationship Meaningful between smoking and LBW incidence. From the results of this study is expected that this research can be a reference material and is a complete information and useful for the development of knowledge about LBW.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN KEKURANGAN ENERGI KRONIS PADA IBU HAMIL

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Febriyeni Febriyeni
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Negative Impact ◽  
Univariate Analysis ◽  
Good Condition ◽  
Health Centers ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Energy Deficiency ◽  
Chronic Energy Deficiency

<pre>Chronic Energy Deficiency is a situation where the nutritional status someone is on the Less Good Condition. Among the 22 health centers in the district of Lima Puluh Kota, CED highest coverage at the health center are Banja Laweh Namely Case 17 (16.50%) of 103 pregnant mothers. Preliminary Survey of 10 pregnant women at health centers Banja Laweh, note 4 people (40%) of them suffered CED. Based on the findings of interviews stating Not pregnant women know the importance of the size upper arm circumference on Against her pregnancy, in addition to pregnant women consume no food Diversified, because lust Eating Less and Economics not sufficient. Objectives for review determine factors related to the occurrence of Chronic energy deficiency on pregnant women. Methods descriptive analytic with cross sectional approach. Data collection is done on Date in January-February 2017. CASE is a whole population of pregnant women in the region are working Health Center Banja Laweh Year 2017, amounted to 55 people, with sampling total sampling. Operating data analysis using univariate and bivariate statistical test Chi Square. Results of univariate analysis 87,3% of respondents experienced Genesis not CED, (60,0%) High Knowledge, (56,4%) Economy High, and 61,8% of Eating Well. Bivariate analysis known Relationship of Knowledge (p = 0.013 and OR = 12,000, Economics (p = 0.035 and OR = 10,000), and Diet (p = 0.019 and OR = 13,200) with the Genesis CED pregnant women. Can be concluded that the factors related to the occurrence of CED pregnant women is Science, Economics and the Diet. Expected to conduct monitoring of the health center and Supervision of pregnant women at risk Against The Genesis CED, so the negative impact of the CED can be addressed early on.</pre>

HUBUNGAN BEBAN KERJA PERAWAT DENGAN KELENGKAPAN PENGISIAN DOKUMENTASI ASUHAN KEPERAWATAN

2020 ◽  
Vol 5 (2) ◽  
pp. 588
Author(s):  
Etlida Wati ◽  
Ulva Arini
Keyword(s):  
Nursing Care ◽  
Rank Correlation ◽  
Bivariate Analysis ◽  
Spearman Rank Correlation ◽  
Cross Sectional ◽  
Weight Category ◽  
Spearman Rank ◽  
Hospital Room ◽  
Analysis Technique ◽  
Nurse Workload

<p>Documentation is an activity of recording, reporting or recording an event and activities carried out in the form of providing services that are considered important and valuable. One factor that can influence documentation is the nurse's workload. The purpose of this study is to identify the relationship between nurses' workload and the application of documentation in the Hj. Anna Lasmanah Banjarnegara. This  research is quantitative with a cross sectional approach descriptive correlation design. Samples were taken with a total sampling of 65 nurses. Instruments to measure documentation using observation sheets. While the nurse workload instrument uses a questionnaire sheet. The analysis technique uses Spearman Rank correlation. Based on the research results of the workload of a nurse in the hospital room , most of them are in the weight category, as many as 46 respondents (70.8%). Application of nursing care documentation in the hospital room Hj. Anna Lasmanah Banjarnegara, most of them are respondents in the incomplete category as many as 63 respondents (96.9%). There is a significant relationship between nurse workload with the application of documentation, this is evidenced by the results of the Spearman Rank correlation bivariate analysis, which is r = 0.688 with p = 0.000 &lt;0.05. It is hoped that management will motivate nurses to complete the documentation of nursing care</p>

THE RELATIONSHIP OF NUTRITIONAL STATUS TO URIC ACID LEVEL IN COMMUNITY OF PONDOK PESANTREN AL-HIDAYAH, NGAWI

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Marselli Widya Lestari ◽  
Tri Wahyuni Bintarti
Keyword(s):  
Uric Acid ◽  
Nutritional Status ◽  
Gouty Arthritis ◽  
Extracellular Fluid ◽  
Boarding School ◽  
Clinical Syndrome ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Knowledge And Attitude ◽  
Cross Sectional Design

Gout or Gouty Arthritis is a degenerative disease. Gouty arthritis is a clinical syndrome that is caused by deposition of purine crystals in the tissues, due to levels of uric acid (hyperuricemia) in the extracellular fluid that passes through saturation. The etiology of gout arthritis included age, sex, history of medication, obesity, consumption of purine and alcohol. Aging is an important risk factor for men and women. This study uses an analytical-descriptive approach with cross-sectional design. This study was conducted to obtain a relationship between nutritional status and uric acid levels in the community in the area of ​​Al-Hidayah Islamic Boarding School, Ngawi. This research was conducted in Majasem Village, Kendal District, Ngawi Regency, starting from 7 June - 31 August 2018. The results showed that there was a relationship between nutritional status and uric acid levels in the community in the area of ​​Al-Hidayah Islamic Boarding School, Ngawi (p=0,008). Suggestions for further research are bivariate analysis based on gender, knowledge and attitude to response to diet so that other factors that influence can be seen clearly

Analisis Faktor Determinan Pelaksanaan Inisiasi Menyusu Dini Oleh Bidan Di Rumah Sakit Umum Anutapura Palu

2018 ◽  
Vol 1 (1) ◽  
pp. 34
Author(s):  
Ni Nyoman Novita ◽  
Gusman Arsyad
Keyword(s):  
Emergency Room ◽  
Peer Support ◽  
Statistical Tests ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Implementation Processes ◽  
Chi Square Test ◽  
The Government

Implementation of IMD in hospitals has decreased from the previous year and has not reached the target set by the government. Some IMD implementation processes have not been carried out according to applicable standards. So that babies do not get an IMD in accordance with existing SOPs. The purpose of this study was to determine the determinant factors associated with the implementation of the IMD by midwives in the Midwifery and Maternity Room Emergency Room (IGD) at the Anutapura General Hospital in Palu. This research method is analytical with cross sectional approach. The population of this study was that all midwives in the obstetrics emergency room and maternity room at Anutapura Palu Hospital were 37 respondents. The sample in this study is total sampling. The analysis used was univariate, and bivariate analysis using the chi square test with a confidence level of 95% (α = 0.05). The results of statistical tests on variable knowledge of midwives with the implementation of IMD p value: 0.018 (p value <0.05). APN training with the implementation of IMD p value: 0.697 (p value> 0.05). length of work with the implementation of IMD p value: 0.029 (p value <0.05). and peer support with the implementation of IMD p value: 0.007 (p value <0.05). Conclusions there is a relationship between knowledge, length of work, peer support with the implementation of the IMD, and training factors that have nothing to do with IMD implementation. The strongest factor in the relationship is peer support. It is recommended that the Anutarapura Palu Hospital be able to motivate midwives so that they can further enhance their role in the implementation and provide support to their colleagues so that the implementation of the IMD can be carried out in accordance with applicable standards.Keywords: Knowledge, APN Training, Duration of work, Implementation of IMD

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