scholarly journals Implementation of a trauma registry in a brazilian public hospital: the first 1,000 patients

2014 ◽  
Vol 41 (4) ◽  
pp. 251-255 ◽  
Author(s):  
Paulo Roberto Lima Carreiro ◽  
Domingos André Fernandes Drumond ◽  
Sizenando Vieira Starling ◽  
Mônica Moritz ◽  
Roberto Marini Ladeira
Keyword(s):  
Medical Records ◽  
Public Hospital ◽  
Trauma Registry ◽  
Average Length ◽  
Young Male ◽  
Successful Implementation ◽  
Male Victims ◽  
Quality Of Data ◽  
Trauma Registries ◽  
Epidemiological Characteristics

OBJECTIVE: Show the steps of a Trauma Registry (TR) implementation in a Brazilian public hospital and evaluate the initial data from the database.METHODS: Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais) and analysis of the initial results of the first 1,000 patients.RESULTS: The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS) could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7%) and the importance of aggression as a cause of injuries in our environment (47.5%), surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%.CONCLUSION: Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

Evaluation of Low-Dose Gentamicin Once Daily Dosing Regimen at A General Hospital in Malaysia

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Ab Rahman A F ◽  
Md Sahak N. ◽  
Ali A. M.
Keyword(s):  
Medical Records ◽  
Public Hospital ◽  
Low Dose ◽  
Dosing Regimen ◽  
Once Daily ◽  
Neutropenic Sepsis ◽  
Wide Acceptance ◽  
The Mean ◽  
Initiation Of Therapy ◽  
Almost All

Objective: Once daily dosing (ODD) aminoglycoside is gaining wide acceptance as an alternative way of dosing. In our setting it is the regimen of choice whenever gentamicin is indicated. The objective of this study was to evaluate the practice of gentamicin ODD in a public hospital in Malaysia. Methods: We conducted a retrospective review of medical records of patients on gentamicin ODD who were admitted to Hospital Melaka during January 2002 until March 2010. All adult patients who were on ODD gentamicin with various level of renal function were included in the study. Patients on gentamicin less than 72 hours and pregnant women were excluded. Results: From 110 patients, 75 (68.2%) were male and 35 (31.8%) were female. Indications for ODD gentamicin included pneumonia, 34 (31.0%) neutropenic sepsis, 27 (24.5%) and sepsis, 11 (10.0%). The mean dose and duration of gentamicin was 3.2 mg/kg/day and 7 days, respectively. Almost all patients were on gentamicin combined with other antibiotics. Clinical cure based on fever resolution was found in 89.1% of patients treated with ODD. Resolution of fever took an average of 48 hours after initiation of therapy. The evaluation for bacteriologic cure could not be performed because of insufficient data on culture and sensitivity. Out of 38 patients with analyzable serum creatinine data, four patients might have developed nephrotoxicity. Conclusion: In our setting, lower dosages of ODD gentamicin when used in combination with other antibiotics seemed to be effective and safe in treating most gram negative infections.

scholarly journals Epidemiological characteristics of neonatal admissions in a public maternity / Características epidemiológicas das internações neonatais em uma maternidade pública / Características epidemiológicas de admisión neonatal en una maternidad..

2018 ◽  
Vol 6 (4) ◽  
pp. 28
Author(s):  
Danubia Jacomo Da Silva Cardoso ◽  
Beatriz Schumacher
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Medical Records ◽  
Preterm Labor ◽  
Neonatal Intensive Care ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Epidemiological Characteristics

Descriptive retrospective Research with quantitative approach. Aims: Meet the epidemiological characteristics of hospitalization in Neonatal intensive care unit, relating them to the possible maternal factors, in a public maternity in southern Brazil. Performed with newborns that they put in the NICU, forwarded with the clinical summary to the Municipal program precious baby. The data were collected, with the following variables: maternal age, type of birth, number of pre-natal consultations, complications in pregnancy, and number of days of hospitalization in neonatal intensive care unit, in the period from January to December 2013. Were analyzed medical records 72, prematurity was the most prevalent with 61% of the babies, and their consequences such as the use of mechanical ventilation and apneas 55.5% were repeated and 52.7% respectively. Among the most frequent maternal complications was observed the Preterm Labor (31.3%) and premature rupture of membranes (23.8%). Thus the identification of the factors that lead to preterm labor and premature rupture of membranes, could meet the maternal background and consequently reduce the prematurity and low birth weight.

Optimizing EMR User Experience: A Human Factors Approach to Hardware Assessment and Design for Inpatient and Emergency Units

2018 ◽  
Vol 7 (1) ◽  
pp. 97-102 ◽  
Author(s):  
Catherine Dulude ◽  
Chantal Trudel ◽  
W. James King ◽  
Karen Macaulay ◽  
Jennifer Gillert ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
User Satisfaction ◽  
Medical Records ◽  
Participatory Design ◽  
Easy Access ◽  
Just In Time ◽  
Successful Implementation ◽  
End User ◽  
System A ◽  
Emergency Units

Many factors contribute to the successful implementation and adoption of electronic medical records (EMRs). Easy access to the EMR, where and when required by clinicians, is a key component of adoption and end-user satisfaction with the system. A pediatric hospital implementing an integrated EMR used multiple methods within an iterative human-centered design (HCD) framework to develop hardware and access solutions supporting future EMR workflows in Inpatient and Emergency Departments. Context of use analysis, participatory design methods, preliminary analysis of evaluative simulations and tacit knowledge of the project team led to the development of guiding principles for hardware implementation and solutions supporting just-in-time documentation within the constraints of existing facility design.

Physician Characteristics and EMR Attitudes

2011 ◽  
pp. 138-149
Author(s):  
David Meinert ◽  
Dane K. Peterson
Keyword(s):  
Primary Care ◽  
Medical Records ◽  
Primary Care Physicians ◽  
Medical Profession ◽  
Successful Implementation ◽  
Negative Attitudes ◽  
Specialty Clinic ◽  
Medical Specialists ◽  
Positive Attitudes ◽  
Physician Characteristics

Despite the numerous purported benefits of Electronic Medical Records (EMR), the medical profession has been extremely reluctant to embrace the technology. One of the barriers believed to be responsible for the slow adoption of EMR technology is resistance by many physicians who are not convinced of the advantages of using EMR systems. This study examined potential characteristics of physicians that might help identify those individuals that are most likely to pose a threat to the successful implementation of an EMR system in a multi-specialty clinic. The results demonstrated that older physicians and physicians with only minimal computer skills are more likely to have negative attitudes regarding EMR technology. Medical specialists were most likely to have positive attitudes with respects to the use of EMR systems, while primary care physicians were most likely to have doubts regarding the purported benefits of EMR technology. [Article copies are available for purchase from InfoSci-on-Demand.com]

scholarly journals Nutritional Care of Patients Admitted to Hospital for Alcohol Withdrawal: A 5-Year Retrospective Audit

2020 ◽  
Vol 55 (5) ◽  
pp. 489-496
Author(s):  
Cameron McLean ◽  
Linda Tapsell ◽  
Sara Grafenauer ◽  
Anne-Therese McMahon
Keyword(s):  
Alcohol Withdrawal ◽  
Medical Records ◽  
Management Practices ◽  
Nutritional Assessment ◽  
Average Length ◽  
Population Group ◽  
Future Research ◽  
Multivitamin Supplementation ◽  
Nutritional Care ◽  
Retrospective Audit

ABSTRACT Aim The aim of this study was to describe the characteristics and the nutritional approaches implemented with patients undergoing alcohol withdrawal. Methods A retrospective analysis of medical records for patients admitted to a tertiary hospital for alcohol withdrawal was completed over a 5-year period 2013–2017. Data on nutrition-related assessment and management were extracted and descriptively analysed. Results A total of 109 medical records were included (M = 73, F = 36), with the mean age of patients 47.3 years (SD ± 11.2, range 22–70). The average length of stay was 3.7 days (SD ± 3.9, range 0.70–27.8). Approaches towards nutritional care emerged from micronutrient assessment and supplementation and/or dietetic consultation. Nutrition-related biochemistry data was available for most patients, notably serum levels of sodium, urea and creatinine (102 patients; 93.5%) and magnesium and phosphate (66 patients, 60.5%). There was evidence of some electrolyte abnormalities on admission to hospital. Eight patients had serum micronutrient status assessed; no patients had serum thiamine levels assessed. Parenteral thiamine was provided to 96 patients (88.0%) for 1.9 days (SD ± 1.1, range 1.0–6.0) with a mean dose of 2458.7 mg (SD ± 1347.6, range 300–6700 mg). Multivitamin supplementation was provided to 24 patients (22.0%). Only 23 patients (21.2%) were seen by a dietician of whom 16 underwent a comprehensive nutritional assessment and 3 were screened using the malnutrition screening tool. Conclusion Inconsistent nutritional assessment and management practices were identified across a diverse population group, whilst nutritional professionals were underutilized. Future research should benchmark current guidelines and multidisciplinary approaches considering the role of nutritional specialists in the team.

scholarly journals The cost of excessive postoperative use of antimicrobials: the context of a public hospital

2014 ◽  
Vol 41 (3) ◽  
pp. 149-154 ◽  
Author(s):  
Rafael Santos Santana ◽  
Ariane de Carvalho Viana ◽  
Jozimário da Silva Santiago ◽  
Michelle Santos Menezes ◽  
Iza Maria Fraga Lobo ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Medical Records ◽  
Public Hospital ◽  
Antimicrobial Prophylaxis ◽  
Therapy Cost ◽  
Improper Use ◽  
Compromise Patient Safety ◽  
Total Therapy ◽  
The Cost ◽  
The Impact

OBJECTIVE: To evaluate the improper use of antimicrobials during the postoperative period and its economic impact. METHODS: We conducted a prospective cohort study by collecting data from medical records of 237 patients operated on between 01/11/08 and 31/12/08. RESULTS: from the 237 patients with the information collected, 217 (91.56%) received antimicrobials. During the postoperative period, 125 (57.7%) patients received more than two antimicrobials. On average, 1.7 ± 0.6 antimicrobials were prescribed to patients, the most commonly prescribed antibiotic being cephalothin, in 41.5% (154) of cases. The direct cost of antimicrobial therapy accounted for 63.78% of all drug therapy, this large percentage being attributed in part to the extended antimicrobial prophylaxis. In the case of clean operations, where there was a mean duration of 5.2 days of antibiotics, antimicrobials represented 44.3% of the total therapy cost. CONCLUSION: The data illustrate the impact of overuse of antimicrobials, with questionable indications, creating situations that compromise patient safety and increasing costs in the assessed hospital.

scholarly journals Restrictive measure for the commercialization of antimicrobials in Brazil: results achieved

2019 ◽  
Vol 53 ◽  
pp. 68 ◽  
Author(s):  
Josiane Moreira da Costa ◽  
Cristiano Soares de Moura ◽  
Cristiane Aparecida Menezes de Pádua ◽  
Aline Siqueira Fogal Vegi ◽  
Sérgia Maria Starling Magalhães ◽  
...  
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
National Health ◽  
Medical Records ◽  
Public Hospital ◽  
Health Surveillance ◽  
Hospital Infection ◽  
Historical Cohort ◽  
Restrictive Measure ◽  
Resistant Microorganism

OBJECTIVE: To assess whether the incidence of hospital infection by a resistant microorganism decreased after the implementation of the restrictive measure of the National Health Surveillance Agency for the commercialization of antimicrobials. METHODS: A historical cohort study of medical records of adult patients admitted to a general and public hospital from May 2010 to July 2011. A cohort was formed with patients admitted in the period before the restrictive measure for the commercialization of antimicrobials (Phase I) and a second cohort was formed with patients admitted after the implementation of the restrictive measure (Phase II). RESULTS: The instantaneous risk of hospital infection by a resistant microorganism was estimated at seven by 1,000 people-time (95%CI 0.006–0.008) in Phase I, and four by 1,000 people-time (95%CI 0.003–0.005) in Phase II of the study. The differences between the survival curves in the different phases of the study and stratified by age group were also significant (p < 0.05). CONCLUSIONS: The results suggest that the implementation of the restrictive measure of the commercialization of antimicrobials by the National Health Surveillance Agency reduced the incidence of hospital infection by a resistant microorganism.

scholarly journals Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care

2020 ◽  
Vol 17 (21) ◽  
pp. 8085
Author(s):  
Eva Glaeser ◽  
Bart Jacobs ◽  
Bernd Appelt ◽  
Elias Engelking ◽  
Ir Por ◽  
...  
Keyword(s):  
Health Care Services ◽  
Public Hospital ◽  
Average Length ◽  
Unit Cost ◽  
Obstetric Care ◽  
Hospital Staff ◽  
Activity Based Costing ◽  
Middle Income ◽  
The Public ◽  
The Cost

Knowing the cost of health care services is a prerequisite for evidence-based management and decision making. However, only limited costing data is available in many low- and middle-income countries. With a substantially increasing number of facility-based births in Cambodia, costing data for efficient and fair resource allocation is required. This paper evaluates the costs for cesarean section (CS) at a public and a Non-Governmental (NGO) hospital in Cambodia in the year 2018. We performed a full and a marginal cost analysis, i.e., we developed a cost function and calculated the respective unit costs from the provider’s perspective. We distinguished fixed, step-fixed, and variable costs and followed an activity-based costing approach. The processes were determined by personal observation of CS-patients and all procedures; the resource consumption was calculated based on the existing accounting documentation, observations, and time-studies. Afterwards, we did a comparative analysis between the two hospitals and performed a sensitivity analysis, i.e., parameters were changed to cater for uncertainty. The public hospital performed 54 monthly CS with an average length of stay (ALOS) of 7.4 days, compared to 18 monthly CS with an ALOS of 3.4 days at the NGO hospital. Staff members at the NGO hospital invest more time per patient. The cost per CS at the current patient numbers is US$470.03 at the public and US$683.23 at the NGO hospital. However, the unit cost at the NGO hospital would be less than at the public hospital if the patient numbers were the same. The study provides detailed costing data to inform decisionmakers and can be seen as a steppingstone for further costing exercises.

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