scholarly journals 1505. Shorter-Course Antibiotic Treatment for Pediatric Ventilator-Associated Tracheitis Is Safe and Effective

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S548-S548
Author(s):  
Mirela Grabic ◽  
Jason G Lake ◽  
Jelena Debelnogich ◽  
Christina Krucylak ◽  
Jason Newland
Keyword(s):  
Antibiotic Treatment ◽  
Pediatric Intensive Care ◽  
Chi Square ◽  
Stewardship Program ◽  
Short Course ◽  
Antibiotic Duration ◽  
Physician Perception ◽  
The Impact ◽  
Common Infection ◽  
Made In

Abstract Background Ventilator-associated tracheitis (VAT) is a common infection in children cared for in pediatric intensive care units (PICU). Short-course antibiotic treatment (5 days) has been shown to be effective. In October 2016, we implemented a PICU VAT guideline for short-course therapy. We assessed the impact of this intervention. Methods We conducted a retrospective cohort study of PICU patients diagnosed with VAT from October 2016 to June 2018. The antimicrobial stewardship program (ASP) identified potential patients through daily chart review. Only those patients with a clinician diagnosis and who were receiving antibiotics for VAT, either enterally or parenterally, were included. Frequencies and proportions were calculated. Chi-square or Fisher exact tests were used to compare proportions. Results ASP identified 251 potential patients, 105 (42%) of whom met inclusion criteria. The median age was 7 years (range: 0–21). Twenty-eight (27%) were tracheostomy dependent. The most commonly prescribed antibiotics were cefepime (43%), ceftriaxone (17%), and vancomycin (14%). Median antibiotic duration was 13 days (range: 1–29); 57 (52%) received > 5 days and 48 (44%) received 5 days. Only 3 (6%) patients who received 5 days of antibiotics required retreatment within 10 days of their initial course vs. 11 (19%) who received > 5 days (P = 0.09). A diagnosis of ventilator-associated pneumonia (VAP) within 10 days of completing VAT treatment was made in 2 (4%) patients who received 5 days vs. 3 (5%) of patients who received > 5 days (P = 1.0). C. difficile infection within 90 days occurred in 2 (4%) patients who received > 5 days vs. 1 (2%) who received 5 days (P = 1.0). Conclusion Short-course antibiotic therapy for VAT was not associated with retreatment for VAT or subsequent diagnosis of VAP. Development of C. difficile was similar between groups. Adherence to the guideline was approximately 50%, perhaps due to physician perception of disease severity. Additional work is needed to refine the diagnosis of VAT and assess the interaction between illness severity and treatment duration. Disclosures All authors: No reported disclosures.

scholarly journals 452. Antibiotic Duration, but Not Size, Impacts Clinical Cure of Limited Skin and Soft-Tissue Infection After Incision and Drainage

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S222-S223
Author(s):  
Jason G Lake ◽  
Stephanie Fritz
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Clinical Cure ◽  
Day Treatment ◽  
Treatment Protocol ◽  
Chi Square ◽  
Incision And Drainage ◽  
Exact Test ◽  
Days Of Therapy ◽  
Antibiotic Duration

Abstract Background Incision and drainage (I&D) is the most common treatment for skin abscesses. A recent randomized clinical trial (RCT) of outpatients with limited (≤5 cm) skin abscesses demonstrated antibiotic therapy with clindamycin or trimethoprim-sulfamethoxazole (TMP-SMX) was superior to I&D alone. We performed a subgroup analysis to measure the effect of antibiotic duration and abscess size on clinical cure at 7–10 days after antibiotic completion. Methods Participants with complete data regarding adherence to the 10-day treatment were included. Demographic and baseline clinical features were compared using t-test, Pearson’s chi-square or Fisher’s exact test, or a non-parametric equivalent where appropriate. Largest abscess dimension (cm) was dichotomized by median size. The effect of antibiotic duration, abscess size (≤ median vs. >median) and covariates on clinical cure were measured using logistic regression. Breslow-Day Test for Homogeneity was used to assess the interaction between treatment and abscess size. Results Of 786 participants in the intention-to-treat analysis, complete adherence data were available for 680 (87%) participants. Of these, 463 (68%) received either antibiotic: 421 (91%) completed 10 days of therapy, 29 (6.3%) ≤7 days and 20 (4.3%) ≤5 days. Only antibiotic treatment duration was associated with clinical cure (table). Odds of clinical cure were 1.7 (95% CI: 1.5, 2.0) times higher for each additional day of treatment. Median abscess size was 2.5 cm (range: 0.2–5); 364 participants had abscesses ≤ median vs. 316 >median. Assessed continuously, abscess size was not associated with cure within antibiotic groups (table) or between placebo and treatment groups (OR 0.94, 95% CI: 0.58–1.5). Stratifying on size, no significant interaction was observed with antibiotic treatment (Breslow-Day P = 0.13). Conclusion Adherence to the treatment protocol was high. These data suggest that longer courses of antibiotic therapy in conjunction with I&D are associated with successful treatment of limited skin abscesses. Size was not associated with clinical cure. Prospective RCTs to determine the optimal length of treatment are needed. Disclosures All authors: No reported disclosures.

scholarly journals MP43: Evaluating factors related to quality of audio transmission during mandatory paramedic patches and technical barriers to efficient communication in the prehospital setting

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S58-S58
Author(s):  
D. Kelton ◽  
S. Doran ◽  
M. Davis ◽  
K. Van Aarsen ◽  
J. Momic
Keyword(s):  
Prehospital Care ◽  
Prehospital Setting ◽  
Chi Square ◽  
Audio Quality ◽  
Audio Recordings ◽  
Efficient Communication ◽  
Transmission Quality ◽  
Audio Transmission ◽  
The Impact ◽  
Made In

Introduction: Delegation of controlled medical acts by physicians to paramedics is an important component of the prehospital care framework. Where directives indicate that physician input is needed before proceeding with certain interventions, online medical control (a “patch”) exists to facilitate communication between a paramedic and a Base Hospital Physician (BHP) to request an order to proceed with that intervention. The quality and clarity of audio transmission is paramount for effective and efficient communication. The aim of this study was to examine the impact of audio transmission quality on the results of paramedic patch calls. Methods: Prehospital paramedic calls that included a mandatory patch point (excluding requests exclusively for termination of resuscitation and those records which were unavailable) were identified through review of all patch records from January 1, 2014 to December 31, 2017 for Paramedic Services in our region. Written Ambulance Call Reports (ACRs) and audio recordings of paramedic patches were obtained and reviewed. Pre-specified patch audio quality metrics, markers of transmission quality and comprehension as well as the resulting orders from the BHP were extracted. Differences between groups was compared using chi-square analyses. Results: 214 records were identified and screened initially. 91 ACRs and audio records were included in the analysis. At least one explicit reference to poor or inadequate call audio quality was made in 55/91 (60.4%) of calls and on average, 1.4 times per call. Of the 91 audited call records, 48 of 91 (52.7%) patches experienced an interruption of the call. Each time a call was interrupted, re-initiation of the call was required, introducing a mean [IQR] delay of 81 [33-68] seconds to re-establish verbal communication. Order requests made by paramedics in calls with no interruptions were approved in 30 of 43 patches (70%) while those requests made in calls with one or more interruptions were approved in only 21 of 48 cases (44%) (Δ26.0%; 95%CI 5.6-43.5%, p = 0.01). Conclusion: This retrospective review suggests that audio quality and interruptions of patch calls may impact a physician's ability to approve orders for interventions in the prehospital setting. Focus on infrastructure and technology underlying this important mode of communication may be a fruitful avenue for future improvements in systems where this may be an issue.

Study to Know the Impact of Ayurvedic Lifestyle on Dark Circles Around Eyes

2020 ◽  
Vol 06 ◽  
Author(s):  
P. Ankita ◽  
Shivakumar Harti ◽  
Mangalagowri V. Rao
Keyword(s):  
Lower Eyelid ◽  
Daily Regimen ◽  
Chi Square ◽  
Stress Scale ◽  
Chi Square Test ◽  
Lack Of Sleep ◽  
Control Survey ◽  
The Impact ◽  
Allergic Disorders ◽  
Made In

Background: The Dark circles under the eyes, is very common and frustrating cosmetic grievance in both male and female especially among the stress prone population. Due to various reasons, skin becomes very thin and dry leading to the visible appearance of veins. This makes skin appear very dark. Possible causes include excessive pigmenta-tion, thin and luminous lower eyelid, lack of sleep, excessive fatigue, heredity, allergic disorders and aging. Dark circles comes under the broad umbrella of features of aggravation of Vata like blackish discoloration (Karshnya), Dark coloration (Shyavata) which can also be categorized under disease predominant in Vata (Vata Nanatmaja Vikara). In spite of its prevalence and cosmetic importance, there are very few reported works regarding dark circles. Objectives: This study was an attempt to find the most probable and commonest factor that influences dark circles so that modifications can be made in lifestyle as mentioned in Ayurveda in the form of daily regimen (Dinacharya) and Night regimen (Ratricharya). Methods: 30 subjects (20-40 years) each with or without dark circles were registered and Case Control survey was con-ducted using a standard questionnaire. A questionnaire was prepared comprising of different processes of daily regimen (Dinacharya vidhis) as per ideal Ayurveda lifestyle. The perceived stress scale that may influence the development of dark circles was also included in the study. The data collected were computed in the excel sheet .The data was analyzed by applying odd’s ratio and Chi square test. Results: A positive relationship between intake of ghee and milk and absence of dark circles was observed and odd’s ratio calculated as 1.5 and 3.54 respectively. The subjects practicing Yoga were found less affected by dark circles odd’s ratio was calculated 3.7. Stress was moderately high among the subjects having dark circles. Conclusion: The present study shows that individuals following Ayurvedic lifestyle in the form of processes of daily reg-imen (Dinacharya vidhis) like head and feet massage with oil, Yogic practices, taking milk and ghee in diet regularly and taking adequate sleep, are less prone to loss of lusture in the form of dark circles around the eyes.

HUBUNGAN PEMBERIAN ASI EKSKLUSIF DENGAN KEJADIAN STUNTING PADA BALITA USIA 1-5 TAHUN DIPUSKESMAS SUKAHENING KECAMATAN SUKAHENING KABUPATEN TASIKMALAYA

2020 ◽  
Vol 13 (2) ◽  
pp. 109
Author(s):  
Yuyun Sarinengsih
Keyword(s):  
Public Health ◽  
Health Center ◽  
Exclusive Breastfeeding ◽  
Growth Failure ◽  
Sampling Technique ◽  
Not Given ◽  
Chi Square ◽  
Cross Sectional ◽  
Public Health Center ◽  
The Impact

ABSTRAKStunting yaitu keadaan gagal tumbuh akibat dari kekurangan gizi kronis. Prevalensi stunting di Kabupaten Tasikmalaya menempati urutan keempat, dimana kecamatan Sukahening menempati urutan pertama tertinggi dengan jumlah 155 balita mengalami stunting. Faktor yang dapat mempengaruhi kejadian stunting yaitu pengasuhan anak yang kurang baik dimana tidak diberikannya ASI secara Ekslusif. Pencegahan stunting yaitu pada 1000 hari kehidupan dimana salah satunya pemberian ASI secara Ekslusif.Penelitian ini bertujuan untuk mengetahui hubungan antara pemberian ASI Ekslusif dengan kejadian stunting pada balita 1-5 tahun di Puskesmas Sukahening Kecamatan Sukahening Kabupaten Tasikmalaya.Jenis Penelitian yang digunakan adalah deskriptif korelasional dengan pendekatan cross-sectional. Populasi total sampling sebanyak 95 responden menggunakan teknik purposive sampling.Hasil Penelitian diperoleh lebih dari setengah responden 51,6% tidak diberikan ASI secara Ekslusif, dan sebagian besar 65,3% balita mengalami stunting. Hasil perhitungan chi-square diperoleh ρ.value (0,000<0,05) maka H0 ditolak sehingga terdapat hubungan antara Pemberian ASI Ekslusif dengan kejadian stunting pada balita 1-5 tahun di Puskesmas Sukahening Kecamatan Sukahening Kabupaten Tasikmalaya.Hasil penelitian ini diharapkan dapat memberi informasi yang bermanfaat dan perlu dilakukan pendidikan kesehatan ulang yang terjadwal terkait nutrisi yang terjangkau dan sehat sehingga dapat meningkatkan cakupan ASI Ekslusif dan dapat menurunkan angka stunting.Kata Kunci : ASI Ekslusif, StuntingDaftar Pustaka : 25 buku (2010-2018)9 jurnal (2013-2019)2 Website (2010-2017) ABSTRACTStunting is a condition of growth failure due to chronic malnutrition. The stunting prevalence in Tasikmalaya Regency was at the fourth place where Sukahening sub-district was at the highest with 155 stunting. Factor that can influence the occurrence of stunting is a poor parenting where exclusive breastfeeding is not given. The best prevention of stunting is on 1000 days of life where exclusive breastfeeding is given. The impact, if the baby is not given exclusive breastfeeding, they will lack of nutrition and also will have an impact on the growth or inappropriate height. This aims of the research is to determine the relationship between exclusive breastfeeding and the incidence of stunting on toddler under 5 years of at Sukahening Public Health Center, Sukahening Sub district, Tasikmalaya Regency. The type of research used is descriptive correlation with a cross-sectional approach. The total samplings were 95 respondents which used purposive sampling technique. The results of the research were obtained more than half of the respondents 51.6% were given exclusive breastfeeding, and most 65.3% of children under five had stunting. The chi-square calculation results obtained that ρ.value (0,000 <0,05) then H0 is rejected so that there is a relationship between exclusive breastfeeding and the incidence of stunting on toddlers under 5 years in Sukahening Public Health Center, Sukahening Sub district, Tasikmalaya Regency. Performed the health education related to affordable and healthy nutrition so that it can increase the coverage of exclusive breastfeeding and can reduce stunting rates. Keywords : Exclusive breastfeeding, Stunting Bibliography : 25 books (2010-2018) 9 journals (2013-2019) 2 Websites (2010-2017) 

Development of REDCAHOR—a Vegetable Research and Development Network in Central America

HortScience ◽  
1998 ◽  
Vol 33 (3) ◽  
pp. 531b-531
Author(s):  
J. Nienhuis
Keyword(s):  
Integrated Pest Management ◽  
Pest Management ◽  
Central America ◽  
Organic Production ◽  
Vegetable Production ◽  
Greenhouse Production ◽  
Short Course ◽  
Development Network ◽  
Breeding And Genetics ◽  
The Impact

REDCAHOR is the Spanish acronym for “Central American Vegetable Network.” Vegetables have traditionally been an important source of nutrients and vitamins in the diet in Central America. Vegetable production in this region is now changing as local consumers are demanding increased diversity and quality and international markets are expanding with “non-traditional” vegetable exports. The present restraints to expanded research and production of vegetables in the region include i) need for cultivars with increased insect and disease resistance, ii) poor and excessive use of pesticides, and iii) inadequate postharvest technology. In addition, there are few vegetable researchers in the region and response to their activities have not been coordinated. The goal of REDCAHOR is to develop a regional network of national institutions that can prioritize agendas and cooperate to maximize the impact of available resources. Establishment of a system of regional trials and cooperative regional programs in integrated pest management and plant breeding are currently under development. A series of regional workshops are planned, including integrated pest management, maintenance and use of genetic resources, organic production, and greenhouse production. In addition, REDCAHOR, in collaboration with the Escuela Agricola Panamerica in Honduras, will offer regional short-course training in vegetable breeding and genetics as well as vegetable production and management, including integrated pest management.

Impact of firm’s specific factors on audit fee of quoted consumer goods firms

2020 ◽  
Vol 4 (1) ◽  
pp. 47-55
Author(s):  
Wasiu Ajani Musa ◽  
Ramat Titilayo Salman ◽  
Ibrahim Olayiwola Amoo ◽  
Muhammed Lawal Subair
Keyword(s):  
Consumer Goods ◽  
Audit Quality ◽  
Audit Fees ◽  
Ordinary Least Squares ◽  
P Value ◽  
Chi Square ◽  
Ifrs Adoption ◽  
Audit Fee ◽  
Specific Factors ◽  
The Impact

Greater pricing presume on audit service has been put by the regulations of the auditing and accounting practices for the disclosure of audit fees, since audit fee is directly related to audit quality. However, the audit fees perceived by the client is often different from the amount charged by the auditors. Hence, this study investigated the impact of firm-specific characteristics on audit fees of quoted consumer goods firms in Nigeria using a purposive sampling technique. Secondary data were obtained from annual reports of the companies for the period from 2009-2016. The empirical result from Breusch-Pagan Lagrange Multiplier Test (BP-LM) produced a chi-square value of 13.94 with p-value of 0.0001 indicating that pooled ordinary least squares (OLS) will not be appropriate for the study. The Hausman test showed a chi-square of 23.55 with a p-value of 0.001 indicating that the null hypothesis is strongly rejected. Thus, the only estimate from the fixed effect model was interpreted to explain the relationship between firm-specific characteristics and audit fees of quoted consumer goods firms in Nigeria. The result revealed that auditee size, auditee risk, auditee profitability and IFRS adoption are the firm specific characteristics that impact on audit fees with only auditee size and IFRS adoption being positively related to audit fees while the other factors are negatively related to audit fees. Based on this finding, this study concluded that the firm’s specific factors are the major drivers of audit fees in Nigeria consumer goods firms. This study recommends among others that companies should implement corporate governance principles that address issues relating to board independence and committee sizes to guide activities in the consumer goods sector since profitability behave negatively with audit fees.

scholarly journals The Impact of Dynamic Capabilities on Sustainable Competitive Advantage in the Pharmaceutical Sector in Egypt

2017 ◽  
Vol 6 (2) ◽  
pp. 1
Author(s):  
Albert Naiem Naguib ◽  
Eahab Elsaid ◽  
Abdel Moneim Elsaid
Keyword(s):  
Competitive Advantage ◽  
Dynamic Capabilities ◽  
Secondary Data ◽  
Primary Data ◽  
Sustainable Competitive Advantage ◽  
Firm Characteristics ◽  
Pharmaceutical Sector ◽  
Chi Square ◽  
Pharmaceutical Firms ◽  
The Impact

This study examines the relationship between dynamic capabilities (experience, routine, skills, firm characteristics, knowledge and technology) and competitive advantage sustainability in the Egyptian pharmaceutical sector. The data was collected using primary and secondary data sources. Primary data was collected from questionnaires distributed to 160 top managers in 20 pharmaceutical firms. The secondary data about pharmaceutical firms like rankings, revenues and market share was collected from external sources such as Intercontinental Marketing Service (IMS). The questionnaires examine six independent variables based on a five-scale Likert scale. The methodology used in the study is non-probability sampling (judgmental sampling), Cronbach’s alpha reliability coefficient and Chi-square tests. The results support the notion that there is a significant relationship between four of the six dynamic capabilities (experience, skills, firm characteristics and knowledge) and the competitive advantage sustainability for pharmaceutical firms in Egypt. Designing the questionnaire and formulating the questions to target the required field was challenging, given that the topic is dynamic and the business scene in Egypt has witnessed drastic political changes since January 2011. The study should assist pharmaceutical companies in Egypt in directing their investments properly and in determining the weaknesses in their dynamic capabilities that need to be addressed.

scholarly journals The impact of COVID-19 related national lockdown on ophthalmic emergency in Italy: A multicenter study

2021 ◽  
pp. 112067212110280
Author(s):  
Maria L Salvetat ◽  
Carlo Salati ◽  
Patrizia Busatto ◽  
Marco Zeppieri
Keyword(s):  
Gender Bias ◽  
Tertiary Care ◽  
Lower Number ◽  
Electronic Records ◽  
Chi Square ◽  
Efficient Access ◽  
Chi Square Test ◽  
Unpaired Student ◽  
The Impact ◽  
Wet Amd

Purpose: To assess ocular pathologies admitted to Italian Emergency Eye Departments (EEDs) during the COVID-19 pandemic national lockdown in 2020 in comparison with the same period in 2019. Methods: Electronic records of all patients presenting at EEDs of two tertiary-care Eye Centers during the COVID-19 national lockdown in Italy (March 10–May 3, 2020) were compared with the equivalent period in 2019. Main outcomes were patient age, gender, and diagnoses. Statistical analysis included unpaired Student t-tests, Poisson regression, and chi-square test. Results: Overall EED visits significantly decreased by 54.1% during the 2020 lockdown compared to 2019 (851 vs 1854, p < 0.001). During lockdown, patients showed comparable mean age (52.8 years in 2020 vs 53.3 years in 2019, p = 0.52) and significant male gender bias (61.1% in 2020 vs 55.8% in 2019, p < 0.0001). The most frequent pathologies were eye inflammations, trauma-related incidents, and spontaneous acute vitreous detachment. Patients with inflammation, headache/hemicrania, and spontaneous subconjunctival hemorrhages were significantly less, whereas those with trauma-related diagnoses were significantly higher during the lockdown as compared with 2019 ( p < 0.05). The proportion of non-urgent visits decreased from 17% in 2019 to 8% in 2020 ( p < 0.001). Conclusions: During the 2020 lockdown, there was a significant reduction of accesses to EED, especially for non-urgent pathologies. Potentially visual function threatening conditions, such as trauma-related pathologies, retinal detachment or ruptures, and wet AMD, showed lower number of cases but higher or stable proportion relative to the total caseload, suggesting a correct and efficient access to ophthalmic health care during the pandemic period.

scholarly journals 288. Follow-Up Blood Cultures in Gram-Negative Bacteremia: How Do They Impact Outcomes

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S144-S144
Author(s):  
Azza Elamin ◽  
Faisal Khan ◽  
Ali Abunayla ◽  
Rajasekhar Jagarlamudi ◽  
aditee Dash
Keyword(s):  
Clinical Outcomes ◽  
Antibiotic Treatment ◽  
Readmission Rate ◽  
Blood Cultures ◽  
Categorical Variables ◽  
Gram Negative ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Background As opposed to Staphylococcus. aureus bacteremia, there are no guidelines to recommend repeating blood cultures in Gram-negative bacilli bacteremia (GNB). Several studies have questioned the utility of follow-up blood cultures (FUBCs) in GNB, but the impact of this practice on clinical outcomes is not fully understood. Our aim was to study the practice of obtaining FUBCs in GNB at our institution and to assess it’s impact on clinical outcomes. Methods We conducted a retrospective, single-center study of adult patients, ≥ 18 years of age admitted with GNB between January 2017 and December 2018. We aimed to compare clinical outcomes in those with and without FUBCs. Data collected included demographics, comorbidities, presumed source of bacteremia and need for intensive care unit (ICU) admission. Presence of fever, hypotension /shock and white blood cell (WBC) count on the day of FUBC was recorded. The primary objective was to compare 30-day mortality between the two groups. Secondary objectives were to compare differences in 30-day readmission rate, hospital length of stay (LOS) and duration of antibiotic treatment. Mean and standard deviation were used for continuous variables, frequency and proportion were used for categorical variables. P-value &lt; 0.05 was defined as statistically significant. Results 482 patients were included, and of these, 321 (67%) had FUBCs. 96% of FUBCs were negative and 2.8% had persistent bacteremia. There was no significant difference in 30-day mortality between those with and without FUBCs (2.9% and 2.7% respectively), or in 30-day readmission rate (21.4% and 23.4% respectively). In patients with FUBCs compared to those without FUBCs, hospital LOS was longer (7 days vs 5 days, P &lt; 0.001), and mean duration of antibiotic treatment was longer (14 days vs 11 days, P &lt; 0.001). A higher number of patients with FUBCs needed ICU care compared to those without FUBCs (41.4% and 25.5% respectively, P &lt; 0.001) Microbiology of index blood culture in those with and without FUBCs Outcomes in those with and without FUBCs FUBCs characteristics Conclusion Obtaining FUBCs in GNB had no impact on 30-day mortality or 30-day readmission rate. It was associated with longer LOS and antibiotic duration. Our findings suggest that FUBCs in GNB are low yield and may not be recommended in all patients. Prospective studies are needed to further examine the utility of this practice in GNB. Disclosures All Authors: No reported disclosures

scholarly journals 49 A Quality Improvement Project to Assess and Refine the Handover Process at Morning Trauma Meetings

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Sadiq ◽  
M Tahir ◽  
I Nur ◽  
S Elerian ◽  
A Malik
Keyword(s):  
Categorical Variables ◽  
Next Of Kin ◽  
Chi Square ◽  
Neck Of Femur ◽  
Improvement Project ◽  
Handover Process ◽  
Neck Of Femur Fracture ◽  
The Impact ◽  
Standard Operating Protocol

Abstract Introduction Poor handover between shifts can result in patient harm. This study was designed to evaluate the impact of implementing a handover protocol on the quality of information exchanged in the trauma handover meetings in a UK hospital. Method A prospective single-centre observational study was performed at an NHS Trust. Ten consecutive weekday trauma meetings, involving 43 patients, were observed to identify poor practices in handover. This data was used in conjunction with the Royal College of Surgeons’ recommendations for effective handover (2007) to create and implement a standard operating protocol (SOP). Following its implementation, a further 8 consecutive meetings, involving a further 47 patients, were observed. The data was analysed using t-test for quantitative variables and chi-square or Fisher’s exact tests for categorical variables. Results An improvement was demonstrated in multiple aspects of trauma handover including past medical history, injury date, results, diagnosis, consent, mark, and starvation status (all p &lt; 0.001). Subgroup analyses showed that handover of neck-of-femur fracture patients including information on baseline mobility (p = 0.04), Nottingham-Hip-Fracture Score (p = 0.01), next-of-kin discussion (p = 0.075) and resuscitation status (p = 0.001) all improved following the intervention. Conclusions These results demonstrate that the implementation of a well-structured handover protocol can improve the transmission of critical information in trauma meetings.

Sign in / Sign up

Export Citation Format

Share Document