Abstract 1122‐000094: EVD Weaning Criteria Decreases VPS/ETV Placement and Hospital Stay in Subarachnoid Hemorrhage Patients

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Sachin A Kothari ◽  
Mevish S Siddiq ◽  
Scott Rahimi ◽  
Manan Shah ◽  
Klepper A Garcia
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Neurocritical Care ◽  
External Ventricular Drain ◽  
Third Ventriculostomy ◽  
Chi Square ◽  
Normal Limits ◽  
Chi Square Analysis ◽  
Weaning Criteria

Introduction : The Neurocritical Care Society encourages an external ventricular drain (EVD) wean “as quickly as is clinically feasible” but guidelines on achieving it are limited (1). This study aims to improve quality of care by sharing a protocol to initiate EVD weaning. These criteria were developed over 7 years and showed a reduction in ventriculoperitoneal shunt/endoscopic third ventriculostomy (VPS/ETV) placement and length of stay (LOS) at our institute compared to national averages. Methods : 151 subarachnoid hemorrhage (SAH) patients from January 2016 to January 2019 were analyzed. 60 aneurysmal SAH (aSAH) and 18 non‐aneurysmal nontraumatic SAH (naSAH) patients required EVD placement. A gradual EVD weaning protocol was initiated if patients met the following criteria: the reason for EVD placement has resolved or is resolving, quantity of CSF output must be <250mL over 24 hours, quality of CSF must be nonbloody, ICP must be within normal limits, and the patient must be neurologically stable. It was acceptable to wean when the patient had mild cerebral vasospasm, but not moderate to severe cerebral vasospasm. EVD weaning was performed by increasing drain height by 5 millimeters of mercury every 24 hours if criteria were met. Charts were reviewed for LOS and rate of VPS/ETV. Gender, age, race, wean failure incidence, infection rates, and SIADH/CSW rates were obtained. Results : Average LOS for aSAH patients with EVD at our institute was 20.35 days. Incidence of VPS/ETV was 11%. Chi‐square analysis was performed, and aSAH patients were found to have higher rates of VPS/ETV placement (p<0.001) and EVD wean failures (p<0.001) than naSAH patients. Conclusions : Our criteria to initiate EVD weaning provided a reduction in VPS/ETV placement among aSAH patients compared to national averages and provides a standardized approach to EVD management. aSAH patients at our institute had a lower incidence of VPS/ETV placement of 11% compared to 21% nationally (2). aSAH patients at our institute also had a lower LOS at 20.35 days compared to 21.5 days nationally (3).

CUSTOMERS’ PREFERENCE FOR E – BANKING SERVICES: A CASE STUDY OF SELECTED BANKS IN SIERRA LEONE

2011 ◽  
Vol 01 (04) ◽  
pp. 108-116
Author(s):  
R. A. GBADEYAN ◽  
O. O. AKINYOSOYE GBONDA
Keyword(s):  
Sierra Leone ◽  
Software Verification ◽  
Banking Industry ◽  
Online Banking ◽  
Chi Square ◽  
Frequent Change ◽  
Banking Services ◽  
Chi Square Analysis ◽  
Almost All

The development and the increasing progress that is being experienced in the Information and Communication Technology have brought about a lot of changes in almost all facets of life. In the Banking Industry, it has been in the form of online banking, which is now replacing the traditional banking practice. Online banking has a lot of benefits which add value to customers’ satisfaction in terms of better quality of service offerings and at the same time enable the banks gain more competitive advantage over other competitors. There are some associated risks identified in the study that seem to hinder the success of e-banking services and thus constitute major concern to both financial institutions and customers. This paper therefore, examines, if customers’ choice of banks is influenced by the quality of e–banking services provided. Stratified sampling was used; while the survey Instrument was a developed Questionnaire comprising open ended and Likert type of questions. The Likert type questions have a 4 point scale (indicating 1 = very comfortable and 4 = uncomfortable) divided into two (2) sections: personal details and customers’ e-banking preference in Sierra Leone. The instrument contained 36 items and was administered to about 400 respondents, while 360 completed and returned their Questionnaire. The statistical techniques used for the analysis were the Chi–Square and correlation. The Chi–Square analysis revealed that the quality of e–banking services offered by banks have significant influence on their customers at 95%, 3 degree of freedom. The paper recommends that various measures should be put in place to ensure more security such as installation of encrypted software, verification system of customer’s identification cards, frequent change of password, examining test questions and using mixed password such as the use of alphanumeric amongst others. The paper concludes that e –banking has become important phenomenon in the banking industry and it will continue as more progress and innovations are made in information technology.

scholarly journals Faktor Perilaku yang Berhubungan dengan Hasil Pemeriksaan Jentik Pasca Keberadaan Surveilans Angka Bebas Jentik di Kecamatan Tembalang Kota Semarang

2019 ◽  
pp. 91-104
Author(s):  
Diana Andriyani Pratamawati ◽  
Widiarti Widiarti ◽  
Wiwik Trapsilowati ◽  
Riyani Setiyaningsih
Keyword(s):  
Case Fatality ◽  
Hemorrhagic Fever ◽  
City Government ◽  
Behavioral Factors ◽  
Chi Square ◽  
Cross Sectional ◽  
Monitoring Procedure ◽  
Quota Sampling ◽  
Chi Square Analysis

Tembalang Subdistrict is still ranked as the first highest IR Dengue in Semarang City in 2014-2016. Incidence rate of dengue in Tembalang Sub District in 2016 was Dengue hemorrhagic fever (DHF) IR 166.89/100,000 population with Case Fatality Rate (CFR) 1.02%. The Semarang City Government has implemented PERDA No.5 of 2010 concerning DHF control with the establishment of special larvae monitoring officers namely Semantik (Semarang Bebas Jentik) and Gasurkes (Health Surveillance Officer) to conduct routine larval monitoring and socialize PSN-3M Plus. However, dengue cases in Tembalang District continue to exist.The purpose of the study was to identify behavioral factors related to monitoring larva presence in Tembalang District, Semarang City. This study is based on the cross sectional method, with quota sampling was used to recruit 100 respondents. The criteria for the case were the latest DHF cases recorded in the Semarang City Health Office Data (January to September 2017). Samples were taken in quota with 100 respondents. Data were analyzed by analytic descriptive using chi-square analysis and odds ratio. The results showed behavioral factors to monitor larvae routinely related to the results of larvae examination (p <0,05) with risk factors OR = 5,02 and form observations obtained ABJ in Tembalang District by 89% in 2017. This needs additional attention in the larva monitoring procedure by Semantics and Gasurkes. The more complete the quality of the larvae examination, the existence of larvae can be eradicated, so that the incidence of DHF can be prevented

Number of Bleeding, Placenta Remaining, and Episiotomy Actions on the Incidence of Puerperal Sepsis

2021 ◽  
Vol 2 (2) ◽  
pp. 134-138
Author(s):  
Sheryl Putri Asri ◽  
Soetimah
Keyword(s):  
Sampling Method ◽  
Analytical Description ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Puerperal Sepsis ◽  
Birth Complications ◽  
Chi Square Analysis ◽  
Postpartum Mothers

It is estimated that 60% of maternal mortality resulting from gestation happened right after giving birth, and 50% of puerperium deaths happened in the first 24 hours. This research aims to know the relation between the amount of bleeding, remaining placenta, and the act of episiotomy to puerperal sepsis cases. This research uses analytical description methods with a cross-sectional approach. The population of this research was the postpartum mothers in puerperal sepsis cases in October – December 2017 at RSAB Harapan Kita Jakarta Barat counted 85 persons. The sampling method used in this research is an accidental sampling method with 32 respondents. The Instruments of this research are medical records and questionnaires with the chi-square analysis method. This research data analysis has the quality of univariate and bivariate, which means knowing about the relation between the amount of bleeding, remaining placenta, and the act of episiotomy to puerperal sepsis cases. This research shows a relation between the amount of bleeding with a p-value (0,035) and OR (7,200). There is a relation between remained placenta variable with a p-value (0,035) and OR (7,200). There is no relation in the act of episiotomy variable with p-value (0,142) and OR (3,500) to puerperal sepsis cases. The researcher suggests RSAB Harapan Kita increase the quality of their health services, mainly socialize information and give education for maternity women about various birth complications, such as bleeding and remaining placenta and sepsis puerperalis's risks.

Personal Attributes and Computer Writing Quality

1995 ◽  
Vol 13 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Randolph T. Barker ◽  
C. Glenn Pearce
Keyword(s):  
Word Processing ◽  
Curriculum And Instruction ◽  
Personal Attributes ◽  
Writing Quality ◽  
Chi Square ◽  
Writing Curriculum ◽  
Age Class ◽  
Chi Square Analysis ◽  
University Undergraduates

This article reports the results of a study testing whether any of seventeen personal attributes related to the quality of documents university undergraduates wrote by hand and on the computer. Chi-square analysis showed significant differences for age, class, and word processing and keyboarding experience. The researchers concluded that some attributes do relate to computer writing quality and suggest further study to benefit computer writers and computer writing curriculum and instruction.

scholarly journals Dietary Habit is Associated With Dysmenorrhea Among Adolescent

2020 ◽  
Vol 9 (2) ◽  
pp. 1359-1369
Author(s):  
Neti Sundari ◽  
Dian Nur Adkhana Sari ◽  
Endar Timiyatun ◽  
Viantika Kusumasari
Keyword(s):  
Negative Impact ◽  
Sampling Technique ◽  
Female Adolescent ◽  
Dietary Habit ◽  
Lower Abdomen ◽  
Chi Square ◽  
High Incidence ◽  
Testing Data ◽  
Chi Square Analysis

Dysmenorrhea is pain during menstruation which is felt in the lower abdomen and back. The high incidence of dysmenorrhea in adolescents still does not get enough concern, even though it can cause a person to become weak, pale, reduce concentration, disturb daily activities,  having a negative impact on quality of life. One of the factors that can cause dysmenorrhea is poor dietary habit. This study aims to analyze the correlation between dietary habit and dysmenorrhea in female adolescents. This type of research is quantitative, the number of samples are 262 respondents  and the sampling technique was accidental sampling. Testing data using the Chi Square analysis test.  From the results of the Chi Square analysis test, it was found that the value of p = 0.005 with a correlation value of 0.011, the study showed that there is a correlation between dietary habit with dysmenorrhea in female adolescent.

scholarly journals HUBUNGAN MOTIVASI DENGAN KEPATUHAN PERAWAT DALAM PELAKSANAAN IDENTIFIKASI PASIEN SEBAGAI BAGIAN DARI KESELAMATAN PASIEN DI RUANG RAWAT INAP

2020 ◽  
Vol 10 (1) ◽  
pp. 1253-1258
Author(s):  
Lin Herlina
Keyword(s):  
Patient Safety ◽  
Quantitative Research ◽  
P Value ◽  
Patient Identification ◽  
Chi Square ◽  
Correlational Research ◽  
Inner Self ◽  
Chi Square Analysis ◽  
The Relationship

Setiap rumah sakit mengupayakan pemenuhan sasaran keselamatan pasien  salah satunya adalah mengidentifikasi pasien dengan benar yang bertujuan agar rumah sakit melakukan perbaikan spesifik yang akan berdampak pada peningkatan mutu pelayanan dan keselamatan pasien. Kesalahan identifikasi pasien dapat terjadi disemua aspek diagnosis dan tindakan. Melakukan identifikasi perlu keinginan dari dalam diri perawat itu sendiri atau biasa disebutmotivasi. Jika seseorang memiliki motivasi maka seharusnya dapat menimbulkan kepatuhan untuk melakukan tindakan identifikasi. Tujuan dari penelitian ini adalah untuk mengetahui hubungan motivasi dengan kepatuhan perawat dalam pelaksanaan identifikasi pasien pasien sebagai bagian dari keselamatan pasien di Ruang Rawat Inap Rumah Sakit Karya Husada Karawang. Jenis penelitian ini adalah penelitian kuantitatif dengan desain penelitian korelasional. Populasi pada penelitian ini adalah Perawat yang berjumlah 104 orang dengan sampel 25% dari jumlah populasi yaitu sebanyak 26 orang. Teknik pengumpulan data dengan cara wawancara. Instrumen penelitian menggunakan kuisioner. Teknik analisa data terdiri dari analisa univariate dan bivariate (chi square) dengan menggunakan software SPSS. Berdasarkan hasil analisa didapatkan nilai p value = 0,004 (p<0,05). Sehingga disimpulkan bahwa ada hubungan motivasi perawat dengan kepatuhan pelaksanaan  identifikasi pasien sebagai bagian dari keselamatan pasien di Ruang Rawat Inap Rumah Sakit Karya Husada Karawang 2019.Kata Kunci : Keselamatan Pasien, Identifikasi, Motivasi, Kepatuhan.  ABSTRACTEach hospital strives to fulfill the Patient Safety Goals, one of which is to identify patients correctly which aims to make the Hospital make specific improvements that will have an impact on improving the quality of service and patient safety. Misidentification of patients can occur in all aspects of diagnosis and action. Identifying needs of the nurse's inner self or commonly called motivation. If someone has motivation then it should be able to cause compliance to carry out identification actions. The aim of this study was to determine the relationship between motivation and nurse compliance in the implementation of identifying patient patients as part of patient safety in the Inpatient Room of Karya Husada Hospital, Karawang.This type of research is quantitative research with correlational research design. The population in this study were nurses with a total of 104 people with a sample of 25% of the total population of 26 people. Data collection techniques by interview.  The research instrument uses questionnaires. Data analysis techniques consist of univariate and bivariate (chi square) analysis using SPSS software.Based on the analysis results, the value of p value = 0.004 (ρ <0.05) is obtained. So it was concluded that there was a relationship between nurse motivation and compliance with the implementation of patient identification as part of patient safety in the Inpatient Room of Karya Husada Karawang Hospital 2019.Keywords : Patient Safety, Identification, Motivation, Compliance.

scholarly journals Efektivitas Organisasi pelayanan Keperawatan Berdasarkan Komunikasi, Pengambilan Keputusan, Sosialisasi Karir, dan Jenjang Karir

2010 ◽  
Vol 13 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Ridwan Ridwan ◽  
Dewi Irawati ◽  
Sutanto P. Hastono
Keyword(s):  
Total Sample ◽  
Chi Square ◽  
Organizational Process ◽  
Nursing Services ◽  
Career Opportunity ◽  
Prediction Test ◽  
Chi Square Analysis ◽  
The Relationship ◽  
Centralization And Decentralization

AbstrakTujuan penelitian ini adalah mengetahui hubungan proses organisasi (komunikasi; pengambilan keputusan; sosialisasi karir dan jenjang karir) dengan efektivitas organisasi dalam pelayanan keperawatan pada struktur organisasi dengan pendekatan sentralisasi dan desentralisasi di Rumah Sakit. Kuesioner disebarkan kepada 104 responden yang merupakan total sampel, yaitu perawat pelaksana yang dipilih berdasarkan kriteria inklusi. Hubungan antara variabel independen dan dependen serta uji beda untuk setiap variabel pada pendekatan sentralisasi dan desentralisasi diuji menggunakan analisis Chi-square. Hasil analisis multivariat menggunakan uji regresi logistik prediksi menunjukkan adanya hubungan yang signifikan antara proses organisasi dengan efektivitas organisasi, baik pada pendekatan sentralisasi maupun desentralisasi (p< 0,05, α= 0,05). Pada aspek efektivitas, hasil penelitian menunjukkan hasil 31,7% pada pendekatan sentralisasi dan 42,3% pada pendekatan desetnralisasi. Untuk itu, pihak manajemen rumah sakit perlu mengupayakan berbagai strategi manajemen keperawatan untuk meningkatkan efektivitas dan mutu pelayanan keperawatan di rumah sakit. AbstractThe objective of this research is to find out the relationship within organizational process (communication, decision making, career socialization, and career opportunity) and the effectiveness of the organization in giving nursing care using centralization approach and decentralization approach in Hospital. The questioners were given to a total sample of 104 respondents; they were associate nurses who were chosen using inclusion criteria. The relationship between independent and dependent variable, and the test to differentiate each variable in both centralization and decentralization approach were tested using chi-square analysis. The multivariate analysis using logistic regression prediction test showed that there was a significant relationship between organizational process and the effectiveness of the organization, both in centralization and decentralization approach (p< 0,05; α= 0,05). Moreover this study also showed that the effectiveness in centralization approach was 31.7%, whilst in the decentralization approach was 42.3%. It is recommended that the hospital's management should apply several strategies of management in nursing in order to increase the effectiveness and the quality of nursing services in hospital.

Kepemilikan Jaminan Kesehatan dengan Kepuasan Pasien di Puskesmas Jetis 1 Bantul, Yogyakarta

2019 ◽  
Vol 4 (2) ◽  
pp. 325
Author(s):  
Aprianus Umbu Zogara
Keyword(s):  
Quality Of Service ◽  
Patient Satisfaction ◽  
Health Insurance ◽  
Quantitative Research ◽  
Sampling Technique ◽  
Chi Square ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Chi Square Analysis

<p><em>Quality of service is an important thing that must be considered by every facility of health services in providing service to patients. Quality of service is closely linked with comprehensive and systematic services to provide excellent service without distinguishing any patients either public or health-care users. The purpose of this study to determine the relationship between the ownership of health insurance with patient satisfaction in Puskesmas Jetis 1 Bantul, Yogyakarta. This research is a quantitative research with cross- sectional design. Samples in this study were patients who came to visit or seek treatment and enrolled in Puskesmas Jetis 1 Bantul as many as 97 people taken by accidental sampling technique. Data were analyzed using chi-square analysis. The results showed most of the respondents who have collateral such as Askes, JKN, Jamkesda, and Jamkesmas (67%) were satisfied with the services provided. The result of chi-square correlation test shows that there is correlation between assurance ownership and patients satisfaction at Puskesmas Jetis 1 Bantul, Yogyakarta which is shown by Sig value. of 0.00 (Sig &lt;0.05). This study can be concluded that there is a significant relationship between guarantee ownership and patient satisfaction with the majority of patients who have more satisfied health insurance.</em></p><p><em><br /></em></p><p><em>Kualitas pelayanan merupakan suatu hal penting yang harus diperhatikan oleh setiap fasilitas pelayanan kesehatan dalam memberikan pelayanan terhadap pasien.Kualitas pelayanan berhubungan erat dengan pelayanan yang komprehensif dan sistematis untuk memberikan pelayan yang prima tanpa membedakan setiap pasien baik umum maupun pengguna jaminan kesehatan. Tujuan penelitian ini untuk mengetahui hubungan antara kepemilikan jaminan kesehatan dengan kepuasan pasien di Puskesmas Jetis 1 Bantul, Yogyakarta. Penelitian ini merupakan penelitian kuantitatif dengan desain cross-sectional. Sampel dalam penelitian ini adalah pasien yang datang berkunjung atau berobat dan terdaftar di Puskesmas Jetis 1 Bantul sebanyak 97 orang yang diambil dengan menggunakan teknik accidental sampling.Data dianalisis menggunakan analisis chi-square. Hasil penelitian menunjukkan sebagian besar responden yang memiliki jaminan seperti Askes, JKN, Jamkesda, dan Jamkesmas (67%) merasa puas dengan pelayanan yang diberikan. Hasil uji korelasi chi-square menunjukkan terdapat hubungan antara kepemilikan jaminan dengan kepuasan pasien di Puskesmas Jetis 1 Bantul, Yogyakarta yang ditunjukkan dengan nilai Sig. sebesar 0,00 (Sig &lt; 0,05). Penelitian ini dapat disimpulkan terdapat hubungan yang signifikan antara kepemilikan jaminan dengan kepuasan pasien dengan mayoritas pasien yang memiliki jaminan kesehatan yang lebih merasa puas.</em></p>

Abstract P756: Bilirubin Oxidation and Cerebral Vasospasm in Subarachnoid Hemorrhage: A Feasibility Study

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Weston R Gordon ◽  
Shweta Goswami ◽  
Jane Yang ◽  
Bailey Yekzamen ◽  
Michael G Abraham ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Prospective Study ◽  
Cerebral Vasospasm ◽  
Biochemical Markers ◽  
Time Course ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
External Ventricular Drain ◽  
Endovascular Coiling ◽  
Bilirubin Metabolism ◽  
High Degree

Introduction: Cerebral vasospasm (CV) following aneurysmal subarachnoid hemorrhage (aSAH) is associated with a high degree of morbidity and mortality. In an adequate oxidative environment, certain products of bilirubin metabolism have been hypothesized to be a cause of CV. To our knowledge no prospective CSF collection has been performed to establish a time course for their formation in the clinical context of CV. We aimed to design a pilot study assessing the feasibility of collecting and storing CSF for analysis of potential biochemical markers for CV, and to evaluate which variables can accurately and reliably be measured for a larger prospective study. Methods: Adult patients with aSAH and an external ventricular drain (EVD) were enrolled. Patients who had complications following treatment of aSAH or who developed any neurological deterioration unrelated to the aSAH were excluded. CSF was extracted from patients on the initial day of EVD placement and then daily for a total of 10 days and frozen until data analysis. Heme, Heme Oxygenase (HO-1) and Cu/Zn-Superoxide Dismutase (SOD) were measured using commercially available assay kits. Results: Patients 1, 2 and 3 had modified Fisher grades of 2, 3 and 4, respectively. Patients 1 and 3 underwent endovascular coiling and patient 2 had surgical clipping. There were no complications and no CV. Heme concentrations were 40.0 ± 8.5 μm, 55.6 ± 7.7 μm, and 64.7 ± 0.4 μm on day of bleed (day 0) for patients 1, 2, and 3, respectively, and decreased in patients 1 and 2 on day 1. SOD concentrations peaked on day 2 for patient 1 (140.2 ± 15.6 ng/mL), on day 0 for patient 2 (25.8 ± 14.9 ng/mL), and on day 1 for patient 3 (215.9 ± 24.4 ng/mL). HO-1 concentrations peaked for all three patients on day 2 (14.6 ± 0.4, 17.6 ± 12.0 and 23.6 ± 5.4 ng/mL, respectively). Conclusions: The study was successful in completing our objective of establishing a protocol for collection, storage, and measurement of three potential biochemical markers in CSF. A larger prospective study will be performed to establish the time course of bilirubin metabolism and oxidation in the CSF relative to the clinical condition of CV in patients after aSAH.

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