scholarly journals Antibiotic usage in surgical prophylaxis: A prospective observational study in the surgical ward of Nekemte referral hospital

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0203523 ◽  
Author(s):  
Getachew Alemkere
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Antibiotic Usage ◽  
Referral Hospital ◽  
Surgical Prophylaxis ◽  
Surgical Ward

Antimicrobial Use in Outpatient Hemodialysis Units

2013 ◽  
Vol 34 (4) ◽  
pp. 349-357 ◽  
Author(s):  
Graham M. Snyder ◽  
Priti R. Patel ◽  
Alexander J. Kallen ◽  
James A. Strom ◽  
J. Kevin Tucker ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Observational Study ◽  
Prospective Study ◽  
Prospective Observational Study ◽  
Chronic Hemodialysis ◽  
Fourth Generation ◽  
Antimicrobial Use ◽  
National Guidelines ◽  
Surgical Prophylaxis ◽  
Narrow Spectrum

Objective.To quantify and characterize overall antimicrobial use, including appropriateness of indication, among patients receiving chronic hemodialysis.Design.Retrospective and prospective observational study.Setting.Two outpatient hemodialysis units.Patients.All patients receiving chronic hemodialysis.Methods.The rate of parenteral antimicrobial use (number of doses per 100 patient-months) was calculated retrospectively from September 2008 through July 2011. Indication and appropriateness of antimicrobial doses were characterized prospectively from August 2010 through July 2011. Inappropriate administration was defined as occasions when criteria for infection based on national guidelines were not met, failure to choose a more narrow-spectrum antimicrobial on the basis of culture data, or occasions when indications for surgical prophylaxis were not met.Results.Over the 35-month retrospective study period, the rate of parenteral antimicrobial use was 32.9 doses per 100 patient-months. Vancomycin was the most commonly prescribed antimicrobial, followed by cefazolin and third- or fourth-generation cephalosporins. Over the 12-month prospective study, 1,003 antimicrobial doses were prescribed. Among the 926 (92.3%) doses for which an indication for administration was available, 276 (29.8%) were classified as inappropriate. Of these, a total of 146 (52.9%) did not meet criteria for infection, 74 (26.8%) represented failure to choose a more narrow-spectrum antimicrobial, and 56 (20.3%) did not meet criteria for surgical prophylaxis. The most common inappropriately prescribed antimicrobials were vancomycin and third- or fourth- generation cephalosporins.Conclusions.Parenteral antimicrobial use was extensive, and as much as one-third was categorized as inappropriate. The findings of this study provide novel information toward minimizing inappropriate antimicrobial use.

scholarly journals The Value of Modified Early Warning Score (MEWS) in Surgical In-Patients: A Prospective Observational Study

2006 ◽  
Vol 88 (6) ◽  
pp. 571-575 ◽  
Author(s):  
J Gardner-Thorpe ◽  
N Love ◽  
J Wrightson ◽  
S Walsh ◽  
N Keeling
Keyword(s):  
Risk Management ◽  
Observational Study ◽  
Critically Ill ◽  
Early Warning ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Early Warning Score ◽  
Management Tool ◽  
Quality And Safety ◽  
Surgical Ward

INTRODUCTION The Modified Early Warning Score (MEWS) is a simple, physiological score that may allow improvement in the quality and safety of management provided to surgical ward patients. The primary purpose is to prevent delay in intervention or transfer of critically ill patients. PATIENTS AND METHODS A total of 334 consecutive ward patients were prospectively studied. MEWS were recorded on all patients and the primary end-point was transfer to ITU or HDU. RESULTS Fifty-seven (17%) ward patients triggered the call-out algorithm by scoring four or more on MEWS. Emergency patients were more likely to trigger the system than elective patients. Sixteen (5% of the total) patients were admitted to the ITU or HDU. MEWS with a threshold of four or more was 75% sensitive and 83% specific for patients who required transfer to ITU or HDU. CONCLUSIONS The MEWS in association with a call-out algorithm is a useful and appropriate risk-management tool that should be implemented for all surgical in-patients.

scholarly journals Perioperative Risk Factors for Intraoperative Hypothermia in Adult Patients Undergoing Elective Surgery at a National Referral Hospital in Bhutan: A Prospective Observational Study

2019 ◽  
Author(s):  
Kinley Zangmo ◽  
Sunisa Chatmongkolchart ◽  
Pasuree Sangsupawanich
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Elective Surgery ◽  
Perioperative Risk ◽  
Referral Hospital ◽  
Adult Patients ◽  
Intraoperative Hypothermia ◽  
National Referral Hospital

Objective: Intraoperative hypothermia is commonly encountered in anesthetic practice. It is related to several risk factors and can lead to various adverse events. It is important to detect it early and prevent the complications related to it. This study was done to identify incidence and perioperative risk factors of intraoperative hypothermia at a national referral hospital in Bhutan.Material and Methods: A prospective observational study was conducted in adult patients who underwent elective surgery lasting more than 30 minutes. Patient characteristics, incidence of hypothermia, and any interventions for treatment of hypothermia during the operation were recorded. Intraoperative hypothermia was defined as a core body temperature less than 36 °C measured with an esophageal probe.Results: Data were obtained from 91 patients with a mean (±standard deviation; S.D.) age of 42.3 (17.2) and American Society of Anesthesiologists (ASA) scores of 1 and 2 in 62.6% and 37.4% of the patients, respectively The patients underwent elective surgery with a mean (S.D.) duration of 73.24 (48.1) minutes and a mean (S.D.) duration of anaesthesia of 80.9 (49.2) minutes. The incidence of intraoperative hypothermia was 61.5% (56/91). Preoperative heart rate more than 80 beats per minute [hazard ratio (HR) 0.45, 95% confidence interval (CI), 0.26-0.77] was a protective factor and duration of anesthesia more than 60 minutes (HR 1.82, 95% CI, 0.98–3.38) was a risk factor for intraoperative hypothermia.Conclusion: Patients with a preoperative heart rate less than 80 beats per minute and undergoing duration of anesthesia more than 60 minutes should be assessed from the preoperative period and continuously monitored throughout the intraoperative period.

scholarly journals Risk factors of thrombophlebitis at infusion sites in patients admitted in surgical ward: a prospective observational study

2018 ◽  
Vol 5 (5) ◽  
pp. 1781 ◽  
Author(s):  
Atul Kumar Singh ◽  
Rajeev Dwivedi ◽  
A. P. S. Ghaharwar
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Burden Of Disease ◽  
Prospective Observational Study ◽  
Causative Factor ◽  
Postoperative Recovery ◽  
Age Group ◽  
Infusion Site ◽  
Medical College ◽  
Surgical Ward

Background: Peripheral venous canualation is indispensable in admitted patients in surgical ward, thrombophlebitis following infusion is seldom serious, but it effects on postoperative recovery, hospital stay and hence burden of disease are magnanimous. The main aim and objective of the study to find out the incidence of thrombophlebitis at the intravenous infusion site in surgical ward.Methods: This prospective observational study was conducted on 300 patients admitted in surgical ward of S.S Medical College and associated S.G.M. hospital, Rewa (M.P.) patients selected randomly. These Patients were visited daily for any sign and symptoms at infusion site. The incidence of thrombophlebitis according to age, sex and duration of infusion were recorded. The tool designed to collect the data were socio demographic performa and observational check list.Results: In total 300 patients the incidence of thrombophlebits is highest in age group of 41-50(20%), Male (64.66%) and incidence increases as the duration of infusion increased it is 100% after 5 days. The incidence of Grade -1 thrmbophlebitis (71.33%) is higher as compared to Grade- 2 (22.67%).Conclusions: Thrombophelebitis is still an important ongoing problem in admitted patients in surgical ward. Incidence of grade-I thrombophlebitis is higher. It is more in male in the age group of 40-50 and duration of infusion is main causative factor for development of thrombophlebitis.

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