Quality improvement initiative to improve the duration of kangaroo mother care for twin preterm neonates born at a tertiary care hospital in resource‐limited settings

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused an upsurge of cases in many countries leading to inadequate quarantine facilities and hospital beds. Studies on the feasibility of home isolation for COVID-19 patients are the need of the hour. This is the first study from India on the feasibility of home isolation to the best of the author's knowledge.Methods: This methodical study was conducted at a designated COVID-19 tertiary care hospital in India, which included all patients enrolled for the home isolation programme from the 4 July to 3 August 2020. Laboratory confirmed COVID-19 patients were assessed during the enrolment for their eligibility for home isolation. The enrolled patients were followed up once daily over a telephonic call with objective parameters like temperature, pulse and oxygen saturation.Results: There were a total of 447 adults and 67 children. Amongst adults, hypertension was the most common co-morbid condition seen in 23 (5.15%) followed by diabetes in 18 (4.03%) patients. Only 24 (5.37%) patients were hospitalised during the duration of home isolation due to reasons like persistent fever, decreased SpO2, and non-medical ones like anxiety regarding the disease. Age and the presence of co-morbidities were directly related to the requirement of hospitalisation. No children required hospitalisation. There were no deaths.Conclusions: Home isolation is effective for COVID-19 patients in resource limited settings. We provide strong evidence for adapting it for asymptomatic and mild symptomatic cases with judicious use of resources and without compromising the risk to patients.

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Implementation and Evaluation of a Diabetic Ketoacidosis Order Set in Pediatric Type 1 Diabetes at a Tertiary Care Hospital: A Quality-Improvement Initiative

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2018.12.005 ◽

2019 ◽

Vol 43 (5) ◽

pp. 297-303 ◽

Cited By ~ 2

Author(s):

Kayla Flood ◽

Munier Nour ◽

Tanya Holt ◽

Vicki Cattell ◽

Carla Krochak ◽

...

Keyword(s):

Type 1 Diabetes ◽

Quality Improvement ◽

Diabetic Ketoacidosis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Quality Improvement Initiative ◽

Care Hospital ◽

Pediatric Type 1 Diabetes ◽

Order Set

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A Quality Improvement Initiative to Reduce “Out-of-ICU” Cardiopulmonary Arrests in a Tertiary Care Hospital in India

Quality Management in Health Care ◽

10.1097/qmh.0000000000000160 ◽

2018 ◽

Vol 27 (1) ◽

pp. 39-49

Author(s):

Vidya P. Menon ◽

Preetha Prasanna ◽

Fabia Edathadathil ◽

Sabarish Balachandran ◽

Merlin Moni ◽

...

Keyword(s):

Quality Improvement ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Quality Improvement Initiative ◽

Care Hospital

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Decreasing antibiotic over-use by implementation of an antibiotic stewardship programme in preterm neonates in resource limited settings – a quality improvement initiative

Paediatrics and International Child Health ◽

10.1080/20469047.2021.1886545 ◽

2021 ◽

pp. 1-9

Author(s):

Anitha Kommalur ◽

Vidyalakshmi Baddadka ◽

Sahana Devadas ◽

Mallesh Kariyappa ◽

B. Dakshayani ◽

...

Keyword(s):

Quality Improvement ◽

Antibiotic Stewardship ◽

Preterm Neonates ◽

Quality Improvement Initiative ◽

Resource Limited Settings ◽

Resource Limited ◽

Antibiotic Stewardship Programme

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A RETROSPECTIVE ANALYSIS OF MATERNALAND FETAL OUTCOMES OF PRETERM DELIVERIES IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA.

10.36106/ijsr/0701516 ◽

2021 ◽

pp. 42-44

Author(s):

Varsha Konyala ◽

Poornima M ◽

Suma K.B

Keyword(s):

Preterm Delivery ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Preterm Births ◽

Late Preterm ◽

Preterm Neonates ◽

Care Hospital ◽

Maternal Complications ◽

Record Keeping

Aim:To study preterm delivery outcomes in a tertiary care hospital in South India. Methods: The study was conducted for a 7 month period from July 1, 2020 to January 31, 2021at JSS Hospital, Mysuru. Relevant details of every pregnant woman who underwent a preterm delivery and the subsequent neonate born were collected and followed till discharge. Results: The prevalence rate of preterm births was 11.81%. There were 44 early preterm deliveries and 88 late preterm deliveries. The most common maternal complications that lead to preterm births PPROM and preeclampsia.36 early preterm and 29 late preterm neonates required an NICU admission. This included 7 pairs of twins in the early preterm and 1 pair of twins in the late preterm. In the NICU, the most common complications noted were RDS, and sepsis.4 neonates remained by mother's side soon after delivery in the early preterm subset, whereas 54 of late preterm neonates were kept by the mother's side soon after delivery. 31 of 40 early preterm, 86 of the 88 of late preterm neonates were healthy and t for discharge. Conclusion:The prevalence of preterm birth rate in our study stands comparable to the reported global average. Preterm births have a multifactorial etiology. Timely referral to higher centers, experienced obstetricians, and a good NICU facility proved helpful to both the mother and neonate. Thorough record keeping also allows a true picture of preterm prevalence on the basis of which, policies and decisions can be made to further improve preterm care.

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Data-driven quality improvement in the Emergency Department at a level one trauma and tertiary care hospital

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2005.07.007 ◽

2006 ◽

Vol 30 (3) ◽

pp. 269-276 ◽

Cited By ~ 15

Author(s):

Shari J. Welch ◽

Todd L. Allen

Keyword(s):

Emergency Department ◽

Quality Improvement ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Data Driven ◽

Care Hospital

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Prevalence and Specificity of RBC Alloantibodies in Indian Patients Attending a Tertiary Care Hospital

Advances in Hematology ◽

10.1155/2014/749218 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Shamsuz Zaman ◽

Rahul Chaurasia ◽

Kabita Chatterjee ◽

Rakesh Mohan Thapliyal

Keyword(s):

Blood Cell ◽

Red Blood Cell ◽

Patient Population ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

North India ◽

Care Hospital ◽

Antibody Screening ◽

Resource Limited ◽

Transfusion Requirements

Background.Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. Data about alloimmunization rate in general patient population is scarce especially from resource limited countries. We undertook this study to determine prevalence and specificity of RBC alloantibodies in patients admitted in various clinical specialties at a tertiary care hospital in North India.Methods.Antibody screening was carried out in 11,235 patients on automated QWALYS 3 platform (Diagast, Loos, France). Antibody identification was carried out with an 11-cell identification panel (ID-Diapanel, Diamed GmbH, Switzerland).Results.The overall incidence of RBC alloimmunization in transfused patients was 1.4% (157/11235), with anti-E being the most common specificity (36.3%), followed by anti-D (16%), anti-c (6.4%), anti-c + E (6.4%), anti-C + D (5.1%), and anti-K (4.5%). The highest incidence of alloimmunization was observed in hematology/oncology patients (1.9%), whereas in other specialties the range was 0.7–1%.Conclusion.As alloimmunization complicates the transfusion outcomes, authors recommend pretransfusion antibody screening and issue of Rh and Kell matched blood to patients who warrant high transfusion requirements in future.

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