scholarly journals Medical learning in a private hospital: patients' and companions' perspectives

2009 ◽  
Vol 127 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Arthur de Carvalho Jatobá e Sousa ◽  
Carolina da Rocha Machado Tajra ◽  
Rodolfo de Souza Coelho ◽  
Ciro Martins Gomes ◽  
Ricardo Afonso Teixeira

CONTEXT AND OBJECTIVE: Contact with patients has important implications for medical students' education. Previous studies have shown that patients in teaching hospitals have positive views about medical education. The aim here was to assess the acceptability of medical education among patients and their companions in a non-teaching private hospital that is planning to implement a medical teaching program in the near future. DESIGN AND SETTING: Cross-sectional study conducted in a 200-bed tertiary-care private hospital in Brasília. METHODS: Between March and April 2005, patients and their companions in three different sections of the hospital (intensive care unit, ward and emergency waiting room) were surveyed using a questionnaire. RESULTS: The questionnaire was completed by 209 volunteers. The majority of the volunteers (178; 85%) said that they would allow a student to be present during consultations. Of these, 102 (57%) said that they would like to have a student present. Acceptance of the presence of students was higher among males (males 93%; females 81%; P = 0.026). Intensive care unit respondents said that they would like medical students to be present more frequently than the other two groups said this (ward 48%; emergency room 49%; intensive care unit 74%; P = 0.011). CONCLUSIONS: Not only were medical students well accepted but also their presence during consultations was desired by many patients and their companions. These findings may be of great value for plans to implement medical teaching programs in private hospitals.

Author(s):  
Saswat Satapathy ◽  
Yajnesh P. Sahu ◽  
Ashok K. Panigrahi ◽  
Bhabagrahi Rath ◽  
Ananta N. Patra

Background: The intensive care unit is a setting where the multiple medications are prescribed to patients. Antimicrobials are heavily prescribed in the ICUs, which in turn enhance the risk of antimicrobial resistance, increase the side effects and increases the cost of treatment. Drug utilization study is a component of medical auditing that aims to monitor and evaluate the drug prescription patterns and to suggest necessary modifications in the prescribing practices to achieve rational therapeutic practice.Methods: A cross-sectional study was conducted in which data of patients admitted to ICU during the period from June 2019 to August 2019 was collected from the Medical Record Section of the hospital. Drug utilization pattern of antimicrobials in ICU was analyzed.Results: Out of 90 patients, 60 were males and 30 were females. The average duration of stay in ICU was 7.53 days. The most common antibiotic prescribed was ceftriaxone followed by piperacillin and tazobactam with DDD/100 bed days of 24.2 and 17.3 respectively.Conclusions: In this study, the results appeared to be similar to those reported in previous studies. However, prescription protocols need to be addressed to guide appropriate use of antimicrobials in the ICU setting. Therefore, it is necessary to conduct drug utilization research to understand the drug consumption and for implementation of protocols to improve the quality of healthcare. 


2007 ◽  
Vol 28 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Amanda Banks Christini ◽  
Kathleen A. Shutt ◽  
Karin E. Byers

Background.The rate of influenza vaccination among healthcare workers (HCWs) is approximately 40%. Differences in vaccination rates among HCW groups and reasons for accepting or rejecting vaccination are poorly understood.Objectives.To determine vaccination rates and motivators among different HCW groups during the 2004-2005 influenza season.Design.Cross-sectional survey conducted between July 10 and September 30, 2005.Setting.Two tertiary care teaching hospitals in an urban center.Participants.Physicians, nurses, nursing aides, and other staff. Surveys were collected from 1,042 HCWs (response rate, 42%).Results.Sixty-nine percent of physicians (n = 282) and 63% of medical students (n = 145) were vaccinated, compared with 46% of nurses (n = 336), 42% of nursing aides (n = 135), and 29% of administrative personnel (n = 144). Physicians and medical students were significantly more likely to be vaccinated than all other groups (P < .0001). Pediatricians (84%) were more likely than internists (69%) and surgeons (43%) to be vaccinated (P < .0001). Among the HCWs who were vaccinated, 33.4% received the live attenuated influenza vaccine (LAIV) and 66.6% received trivalent inactivated influenza vaccine (TIV). Vaccinated HCWs were less likely than unvaccinated HCWs to report an influenza-like illness (P = .03). Vaccination with LAIV resulted in fewer episodes of influenza-like illness than did receiving no vaccine (P = .03). The most common reason for rejecting vaccination was a concern about availability. Understanding that HCWs may transmit the virus to patients correlated with vaccine acceptance (P = .0004).Conclusions.Significant differences in vaccination exist among physician specialties and employee groups, and there are inadequate vaccination rates among those with the greatest amount of patient contact, potentially providing a basis for group-specific interventions.


Author(s):  
B. Maharani ◽  
A. Lourdu Jafrin ◽  
M. Prakash ◽  
P. Priyadarshini

Background: Patients with varied demographic characteristics, admission criteria and heterogeneous group are admitted to medical Intensive Care Unit (ICU) and are usually associated with co-morbid illnesses. Instituting rational pharmacotherapy is the need of the hour for saving the life of critically-ill patients while irrational drug use may be life threatening. Drug use patterns and prescribing behaviour are the essential tools to measure drug use in health care facilities.Methods: A record based, cross-sectional, observational study was done at medical ICU, IGMC and RI, Puducherry after obtaining IEC approval. Systemic random sampling was followed and data was collected for a period of one year. Data were analysed based on demographic characteristics, prescribing pattern and WHO drug use indicators.Results: The data of 151 patients were analysed. Mean age of the patients admitted in ICU was 52.9±17.7 years. Percentage of male patients (57.6) admitted in ICU were more when compared to female patients (42.4). Infective etiology was the most common factor for ICU admission followed by cardiac disorders. Diabetes mellitus and hypertension were the most common co-morbidities. The average length of stay in ICU was 4.11±2.99 days. Duration of stay in ICU ranged from 1-5 days (78.8% patients) to 15-20 days (0.1% patients). On an average 10.6±4.3 drugs were prescribed for each patient. Percentage of drugs prescribed by generic name was 45.8%. Majority of the drugs (87.4%) were from essential medicine list. Antibiotics in the prescription was 13.8% and 44.4% of drugs were administered in parenteral route. The prescription was complete in 145 case sheets (96%). Majority of the patients (68.9%) were discharged with improvement in the condition for which they were admitted.Conclusions: This drug utilization study has highlighted the strengths and shortcomings of the prescription pattern of patients who were admitted in the critical care setup. The information derived from this research work will be transmitted to the stakeholders for implementing the modifications wherever applicable for the betterment of the patient and the community.


2014 ◽  
Vol 9 (2) ◽  
pp. 46-50
Author(s):  
B Shakya ◽  
P Chaudhary ◽  
M Tumbahangphe

Aims: The objective of the study was to determine the outcome of the obstetric admissions to Maternal Intensive Care Unit in the setting of a tertiary care hospital. Methods: This was a cross-sectional study undertaken at Paropakar Maternity and Women’s Hospital from April 1, 2012 to March 31, 2013. Patient characteristics, gestational age, booking status, indication for intensive care unit admission, intervention, length of stay and outcome were analyzed. Results: During the study period, 19,247 deliveries occurred and 247 women were admitted to maternal intensive care unit. This accounts for 1.28% of all deliveries. The most common indication of admission to intensive care unit was hypertensive disorders in pregnancy (45.3%) followed by obstetric hemorrhage (39.27%). Sepsis was the cause in ten (4.04%) cases. Ten cases (4.04%) of postpartum hemorrhage were managed by balloon tamponade, seven (2.83%) by B-Lynch compression sutures and three (1.21%) necessitated cesarean hysterectomy. Among 18 cases of ruptured uterus, 13 (5.26%) were repaired while five (2.02%) required hysterectomy. Maternal mortality occurred in four (1.61%) of the cases. One was a case of severe preeclampsia who died on 4th post-operative day due to pulmonary embolism, another due to anesthetic complication and the other two died of septic shock and multiorgan failure. Conclusions: Hypertensive disorders of pregnancy and obstetric hemorrhage appeared as the major risk factors for admission to an intensive care unit thereby influencing maternal outcomes in obstetric patients. DOI: http://dx.doi.org/10.3126/njog.v9i2.11762 


2019 ◽  
Vol 30 (Number 1) ◽  
pp. 20-25
Author(s):  
S Hoque ◽  
ASM N U Ahmed

Noninvasive ventilation (NIV) has now become an integral tool within the treatment of both acute and chronic respiratory failure, and at an equivalent time reducing the necessity for invasive ventilation. A cross sectional, retrospective study based on a retrospective review of hospital medical records of patients who underwent NIV in the period between January 2017 and December 2019, to determinate the efficacy of NIV in pediatrics whom admitted to Pediatric intensive care unit (PICU) with respiratory failure (short term evaluation), demographic and clinical data were collected before and after applying the NIV. The data included heart rate (HR), respiratory rate (RR), oxygen concentration (P02) and CO2 concentration (PCO2). NIV was used for a total of 61 pediatric patients admitted to PICU during the period of the study. Pneumonia was the commonest indication for the NIV (n=25, 41.0%), and continuous positive airway pressure (CPAP) was used in 52(85.2%) patients. The mean duration of NIV was 817.2 days, there was a significant clinical improvement after one hour from application of NIV The mean improvement in RR was from 48.412.2 to 35.01I.5 (P=0.000), SPO2 was improved from 88.111.8 to 96.510.7 (P= 0.000), and the PCO2 was improved from 61.4±6.1 to 48.713 7 (P=0.002). Five patients were failing to respond to the NIV and shifted to mechanical ventilation. The NIV is a useful tool for treatment of respiratory failure in pediatrics, especially under the age of one year. Pneumonia was the commonest indication for the use of the NB!. More investigation is needed to fully evaluate the ramifications of increased use of this technology in the PICU.


2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Brajesh Raj Chaudhary ◽  
Kalpana Karmacharya Malla ◽  
Sajan Poudel ◽  
Brajesh Kumar Jha

Introduction: Neonatal sepsis is a major cause of neonatal morbidity and mortality worldwide, especially in developing countries like Nepal. Antibiotic resistance among microorganisms poses new challenges in the treatment of neonatal sepsis. The present study is conducted with the objectives of determining clinico-bacteriological profile and antibiotic susceptibility among isolated bacteria in a neonatal intensive care unit. Methods: A descriptive cross-sectional study was conducted from January 1, 2017, to December 31, 2019, in the neonatal intensive care unit of a tertiary care hospital after obtaining ethical clearance from Institutional Review Committee (Reference Number: 2020-064). The sample size was calculated and 77 neonates with culture-proven sepsis were included in the study. The antibiotic susceptibility tests of the isolates were done by Kirby-Bauer disc diffusion method. Data entry was done in Statistical Packages for the Social Sciences version 20. Results: Of the 841 specimens (blood, cerebrospinal fluid, urine, tracheal aspirate and pus) processed for culture, bacteria were isolated in 84 (10.0%) specimens. Among the 84, gram-negative bacilli were the predominant isolates 76 (90.5%); of which Acinetobacter baumannii was the most common 27 (32.1%). Both the Gram-negative and the Gram-positive bacteria showed high resistance to Penicillin and Cephalosporins. Gram-negative bacteria showed maximum sensitivity to Colistin, Carbapenems, Tigecycline and Fluoroquinolones. Gram-positive bacteria showed maximum susceptibility to Amikacin, Vancomycin and Carbapenems. Conclusions: Judicious use of antibiotics based on the updated knowledge of prevalent organisms in the local hospital setting and their antibiotic sensitivity pattern is of utmost importance for the effective treatment of neonatal sepsis.


2019 ◽  
Author(s):  
Mohammed Altyb Alshykh Aboshanab

Abstract Background: Malaria is a protozoan disease which can lead to serious complications if not treated early and correctly. The aim of this study to assess the knowledge about malaria management guidelines among house officers.Methods: this is the cross sectional observational study conducted at 6 of Khartoum teaching hospitalsResults: The study showed that among the 115 participants evaluated there were 70.4% females and 29.6% were males. 94.8% of participants knew there is malaria management guidelines and 5.2% didn't knew about presence of this guidelines, 58.3% have some information and 10.4% just hear about this guidelines. 89.6% knew the management of simple malaria is an outpatient management. 65.2% of the participants were aware about where to manage the cases of complicated malaria (inpatient or in Intensive Care Unit). 27.8% of the participants were aware about the management of simple malaria in the second and third trimester.Conclusion: Different levels of awareness about malaria management guidelines as whole: 4.3% had an overall poor level of awareness, and 74.8% had an overall average level of awareness and 20.9% had an overall good level of awareness.


SCIENTIARVM ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 37-42
Author(s):  
Ángel Mamani Ruelas ◽  
◽  
Katherine Quispe Medina ◽  
Claudia Butrón Vargas ◽  
Felipe Apaza Huamán ◽  
...  

The appreciation of care by families is of great importance in the evaluation of the quality of care in an intensive care unit (ICU). This study used the adaptation of the Family Satisfaction with Care in the Intensive Care Unit questionnaire: FS-ICU (24). Our objective was to know the degree of satisfaction of family members for the care received from the patient admitted to the Emergency Intensive Care Unit (UCIE) as well as with the decision-making process for patient care. This is a cross-sectional, observational, descriptive and prospective study for 5 months. A sample of 69 main relatives of patients admitted to the unit with more than 24 hours of stay was studied, applying the FS-ICU (24) questionnaire. The following results were obtained: In relation to the care of the patient in the ICUE, 68.12% of relatives perceived an excellent or very good concern for the patient, a very good pain management in 49.28%, very good management of dyspnea in 40%, regarding family care, 43.48% considered it very good, with good emotional support in 46.38%. 47.83% considered the coordination of care as good, as well as the concern of the staff. When assessing professional care, the nurse's skills and competencies were considered very good at 43.48%, and communication as good at 43.48%; The doctor's skills and competencies were also very good at 43.48%. Regarding the environment of the UCIE, it was considered good in 44,935, the waiting room as sufficient in 47.83%, and the amount of care as very good in 43.48%. We conclude that most family members have a high degree of satisfaction, result that is similar to international studies; it also gives us aspects to improve such as the waiting room and the privacy of the patients. keywords: Satisfaction; Care; Quality; Intensive Care Unit; Emergency; FS-ICU.


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