scholarly journals Quality of care for peripheral intravenous catheters (PIVCs) in Nepal: a cross-sectional study on feasibility and inter-rater agreement of the Peripheral Intravenous Catheters-mini Questionnaire (PIVC-miniQ) in a tertiary care hospital

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048370
Author(s):  
Sulekha Shrestha ◽  
Johannes Vieler ◽  
Nikolai Juliussen Haug ◽  
Jan Egil Afset ◽  
Lise Husby Høvik ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Secondary Outcome ◽  
Care Hospital ◽  
Rater Agreement ◽  
Cross Sectional ◽  
Sum Score ◽  
Intravenous Catheters

ObjectivesThere is a lack of data regarding the quality of peripheral intravenous catheter (PIVC)-related care from low-income and middle-income countries, even though the use of PIVCs may lead to local or severe systemic infections. Our main objective was to assess the feasibility and inter-rater agreement on the PIVC-mini Questionnaire (PIVC-miniQ) in a tertiary care hospital in Nepal.DesignWe performed an observational cross-sectional quantitative study using the PIVC-miniQ to collect information on PIVC quality.SettingSecondary care in a Nepalese hospital. All patients with PIVCs in selected wards were included in the study and PIVCs were assessed independently by two raters. Eight Nepalese nurses, one Nepalese student and three Norwegian students participated as raters.Primary and secondary outcome measuresThe intraclass correlation coefficient (ICC), positive, negative, absolute agreement, Scott’s pi and sum score were calculated using PIVC-miniQ. We also aimed to describe PIVC quality of care, as it is important to prevent PIVC-associated complications such as phlebitis or catheter-associated bloodstream infections.ResultsA total of 390 patients (409 PIVCs) were included in the study. The ICC between raters was 0.716 for Nepalese raters, 0.644 for Norwegian raters and 0.481 for the pooled data. The most frequently observed problems associated with PIVCs were blood in the intravenous line (51.5%), pain and tenderness on palpation (43.4%), and fixation with opaque tape (38.5%). The average sum score was 3.32 deviations from best practice for PIVCs fixed with non-sterile opaque tape and 2.37 for those fixed with transparent dressing (p<0.001).ConclusionThe PIVC-miniQ is a feasible and reliable tool for nurses assessing PIVC quality in hospitalised patients in Nepal. The study revealed gaps in PIVC quality and care that could be improved by providing transparent PIVC dressings for all patients and requiring all PIVC insertions to be documented in patient charts.

scholarly journals Cancellation of Elective Surgeries in A Tertiary Care Hospital in North India

2021 ◽  
Author(s):  
Nyla Farooq ◽  
Tauyiba Farooq Mir
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Cancellation Rate ◽  
Surgical Treatments ◽  
Operational Time

Background: Cancellation of elective surgical treatments is a quality-of-care issue as well as a huge waste of health-care resources. Patients may experience emotional distress as a result of this, as well as difficulty for their families. Aim: To find the significant reasons of cancellation of scheduled surgical cases. Methods: A total of 300 elective operations in our institution were chosen. The completed surgeries were planned on the scheduled operation day, and the anaesthesiologist noted down a list of cancellations along with their reasons. Results: A total of 300 patients were scheduled for surgery. A total of 60 patients were cancelled, resulting in a 20% cancellation rate. Lack of operational time was the most prevalent reason for cancellation. Conclusion: The majority of the reasons for cancellation should have been avoided with proper list preparation and the surgical team's meticulous planning.

scholarly journals Perceptions of Sound Quality and Enjoyment After Cochlear Implantation

OTO Open ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 2473974X2110314
Author(s):  
Sarah Y. Bessen ◽  
James E. Saunders ◽  
Eric A. Eisen ◽  
Isabelle L. Magro
Keyword(s):  
Cochlear Implantation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sound Quality ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sound Perception ◽  
Age Related ◽  
Over Time

Objectives To characterize the quality and enjoyment of sound by cochlear implant (CI) recipients and identify predictors of these outcomes after cochlear implantation. Study Design Cross-sectional study. Setting A tertiary care hospital. Methods Surveys based on the Hearing Implant Sound Quality Index were sent to all patients who received a CI at a tertiary care hospital from 2000 to 2019. Survey questions prompted CI recipients to characterize enjoyment and quality of voices, music, and various sounds. Results Of the 339 surveys, 60 (17.7%) were returned with complete data. CI recipients had a mean ± SD age of 62.5 ± 17.4 years with a mean 8.0 ± 6.1 years since CI surgery. Older current age and age at implantation significantly predicted lower current sound quality ( P < .05) and sound enjoyment ( P < .05), as well as worsening of sound quality ( P < .05) and sound enjoyment ( P < .05) over time. Greater length of implantation was associated with higher reported quality and enjoyment ( r = 0.4, P < .001; r = 0.4, P < .05), as well as improvement of sound quality ( r = 0.3, P < .05) but not sound enjoyment over time. Conclusion Recipients who had CIs for a longer period had improved quality of sound perception, suggesting a degree of adaptation. However, CI recipients with implantation at an older age reported poorer sound quality and enjoyment as well as worsening sound quality and enjoyment over time, indicating that age-related changes influence outcomes of cochlear implantation.

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