Management of COVID-19 patients, with emphasis on limited resource setting: is less optimum?

Background: There is scarcity of essential medications, medical talent and health care facilities to treat covid-19, at remote places. This study explores various modalities in resource-limited settings for the management of COVID-19 patients.Methods: We retrospectively analysed data of 266 consecutive discharged and death Covid-19 patients from 26December 2020 to 29May 2021. All patients were admitted and received appropriate supportive care, regular clinical and laboratory monitoring.Results: Of total 266 patients the mean age of patients was 49.19 (SD 14.1) years and 185 (69.54%) of them were males. 99 (37%) cases were moderate, 83(31%)were severe cases remaining 84 (32%) were mild cases. 16 (6.01%) patients expired and remaining 250 patients were subsequently discharged. Median duration of stay in the hospital was 9 (37) days. Of total 266 admitted patients’ mortality rate was only 6.01%.Conclusions: We emphasize that even in healthcare facilities with limited resource, poor infrastructure and lack of ICU facilities, clinical observation-based managementt can help to reduce mortality considerably. Unique features of our study include; use of progesterone as an immunomodulator, use of dual antiviral agents, use of age-related lower limit of oxygen saturation.

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Assessing the Preparedness of Healthcare Facilities for Disasters and Emergencies in Damghan, Iran

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.104 ◽

2021 ◽

pp. 1-7

Author(s):

Behrad Pourmohammadi ◽

Ahad Heydari ◽

Farin Fatemi ◽

Ali Modarresi

Keyword(s):

Health Care ◽

Cross Sectional Study ◽

Health Care Facilities ◽

Mitigation Measures ◽

Health Staff ◽

Cross Sectional ◽

Healthcare Facilities ◽

Wide Range ◽

Care Facilities ◽

The Impact

Abstract Objectives: Iran is exposed to a wide range of natural and man-made hazards. Health-care facilities can play a significant role in providing life-saving measures in the minutes and hours immediately following the impact or exposure. The aim of this study was to determine the preparedness of health-care facilities in disasters and emergencies. Methods: This cross-sectional study was conducted in Damghan, Semnan Province, in 2019. The samples consisted of all the 11 health-care facilities located in Damghan County. A developed checklist was used to collect the data, including 272 questions in 4 sections: understanding threatening hazards, functional, structural, and nonstructural vulnerability of health-care facilities. The data were analyzed using SPSS 21. Results: The results revealed that the health-care facilities were exposed to 22 different natural and man-made hazards throughout the county. The total level of preparedness of the health-care centers under assessment was 45.8%. The average functional, structural, and nonstructural vulnerability was assessed at 49.3%, 31.6%, and 56.4%, respectively. Conclusions: Conducting mitigation measures is necessary for promoting the functional and structural preparedness. Disaster educational programs and exercises are recommended among the health staff in health-care facilities.

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A National Accessibility Audit of Primary Health Care Facilities in Brazil—Are People with Disabilities Being Denied Their Right to Health?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062953 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2953

Author(s):

Alexandro Pinto ◽

Luciana Sepúlveda Köpcke ◽

Renata David ◽

Hannah Kuper

Keyword(s):

Health Care ◽

Primary Health Care ◽

People With Disabilities ◽

Health Care Facilities ◽

Internal Space ◽

Major Barrier ◽

Healthcare Facilities ◽

Primary Health ◽

Care Facilities ◽

Primary Health Care Facilities

Poor accessibility of healthcare facilities is a major barrier for people with disabilities when seeking care. Yet, accessibility is rarely routinely audited. This study reports findings from the first national assessment of the accessibility of primary health care facilities, undertaken in Brazil. A national accessibility audit was conducted by trained staff of all 38,812 primary healthcare facilities in Brazil in 2012, using a 22-item structured questionnaire. An overall accessibility score was created (22 items), and three sub-scales: external accessibility (eight items), internal accessibility (eight items), information accessibility (six items). The main finding is that the overall accessibility score of primary care facilities in Brazil was low (mean of 22, standard deviation (SD) of 0.21, on a 0–100 scale). Accessibility of different aspects of the healthcare facilities was also low, including external space (mean = 31.0, SD = 2.0), internal space (18.9, 1.9) and accessibility features for people with other visual or hearing impairments (6.3, SD = 1.0). Scores were consistently better in the least poor regions of Brazil and in facilities in larger municipality size (indicating more urban areas). In conclusion, large-scale accessibility audits are feasible to undertake. Poor accessibility means that people with disabilities will experience difficulties in accessing healthcare, and this is a violation of their rights according to international and Brazilian laws.

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Delayed access to treatment and frequency of acute respiratory infection as risk factors of severe pneumonia among children aged 12-59 months in Denpasar, Bali

Public Health and Preventive Medicine Archive ◽

10.15562/phpma.v5i1.45 ◽

2017 ◽

Vol 5 (1) ◽

pp. 61

Author(s):

Dewa Ayu Ketut Sri Abadi ◽

Dewa Nyoman Wirawan ◽

Anak Agung Sagung Sawitri ◽

I Gusti Ayu Trisna Windiani

Keyword(s):

Risk Factors ◽

Health Care ◽

Access To Health Care ◽

Respiratory Infections ◽

Severe Pneumonia ◽

Health Care Facilities ◽

First Episode ◽

Access To Treatment ◽

Healthcare Facilities ◽

Care Facilities

Background and purpose: Period prevalence of pneumonia among children in Indonesia increased from 2.1 in 2007 to 2.7 per 1000 children in 2013. The highest incidence was found among children aged 12-23 months. This study aims to examine association between delayed access to health care facilities and severity of children pneumonia.Methods: A case control study was conducted in Denpasar City. A total of 132 children were recruited to participate in this study, consisted of 44 cases and 88 controls. Cases were selected from 161 children with severe pneumonia who registered at Pulmonology Department of Sanglah General Hospital between January 2015 to April 2016. Controls were selected from 261 children aged 12-59 months with mild pneumonia who visited out-patient service at all community health centres in Denpasar City between January 2015 and April 2016. Cases and controls were matched by sex. Data were collected by interview with the parents in their houses. Data were analysed using multivariate analysis with logistic regression.Results: Risk factors associated to severity of pneumonia among children aged 12-59 months were delayed access to treatment for more than three days (AOR=2.15;95%CI: 1.39-3.32), non-health care facilities at first episode of illness (AOR=4.02; 95%CI: 1.53-10.61) and frequent episodes of respiratory infections (>4 times) over the last 6 months (AOR=5.45; 95%CI: 2.13-13.96).Conclusion: Delayed access to treatment, did not access healthcare facilities at first episode of illness, and high frequency of acute respiratory infections are risk factors of severe pneumonia among children.

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Sickness and Treatment: A Situation Analysis among the Garments Workers

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v4i1.13678 ◽

2013 ◽

Vol 4 (1) ◽

pp. 10-14 ◽

Cited By ~ 4

Author(s):

Md Atiqur Rahman ◽

Md Mahfuzar Rahman

Keyword(s):

Age Groups ◽

Cross Sectional Study ◽

Health Care Facilities ◽

Cross Sectional ◽

Duration Of Illness ◽

Care Facilities ◽

Seeking Behavior ◽

The Mean ◽

Tract Infections ◽

Scientific Treatment

This was a descriptive type of cross sectional study among 522 garments workers as respondents. It was aimed to identify morbidity pattern, duration of illness among garments workers and also to determine treatment seeking behavior during illness. The socio-demographic characteristics of the respondents were the points of investigations. It was revealed from the findings that the mean age of the respondents were 23.1years. They were mostly female (80%) and married (60%). About 60% respondents were found primarily educated and no one found illiterate. 90% respondents were found from nucleated family. The study shows 79% respondents were suffering from illness during the last 02 months and majority suffers (18.6%) and (43.6%) were found among 26-30 years age groups and 21-25 years age groups respectively. However, female sufferers were more (33.6%) than male (10%) in the 21- 25 years age groups. Moreover about 42% respondents were suffering for 1-2 weeks and 28.8 are suffering for less than 02 weeks. On the otherhands, Loose motion, Cough, and Breathlessness were found prominent sign/symptoms among 38%, 29%, 28% sufferers respectively. Diarrhoea, Common cold and Respiratory Tract Infections were found as predominant diagnosis among 40.5%, 22.5% & 15.1% respondents respectively. Nevertheless majority 56% were seeking treatment from LMAF doctors. Conclusion: The study findings highlight awareness program among factory owners and garments workers towards preventing infectious and chronic diseases as well as to undertake modern scientific treatment. Improved health care facilities in the garments factory may be considered for early detection and treatment of cases to avoid complications. DOI: http://dx.doi.org/10.3329/akmmcj.v4i1.13678 AKMMC J 2013: 4(1): 10-14

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ANALYSIS OF TOURIST TRAVEL PATTERNS TOWARD HEALTH CARE FACILITIES

Geosfera Indonesia ◽

10.19184/geosi.v3i2.7845 ◽

2018 ◽

Vol 3 (2) ◽

pp. 1

Author(s):

Nida Hanifah ◽

Marta Nilasari Catur Pujianingsih ◽

Dea Handika Pratiwi ◽

Linta Alfi Fahmi ◽

Fathurohim Anhari ◽

...

Keyword(s):

Health Care ◽

Network Analysis ◽

Health Service ◽

Health Sector ◽

Route Planning ◽

Health Care Facilities ◽

Travel Patterns ◽

Service Facility ◽

Healthcare Facilities ◽

Care Facilities

One of the sectors that are closely related and reasonably determining for the growth and development of the tourism sector is the health sector. The aim of this research was to a) know the affordability of health care facilities from tourism Prambanan and Plaosan Temple, b) to know the travel patterns of tourists headed for healthcare facilities. This research uses qualitative descriptive method by using data collection observation techniques, documentation, and data analysis using network analysis. The network analysis method that used is the closest facility. The results of this research show that a) the affordability of the nearest health service facility from the Plaosan Temple object is Kebondalem Lor Puskesmas which is traveled by 1.7 km distance and takes about 4 minutes from the location of Plaosan Temple, while the closest health service facility from the Prambanan Temple is Prambanan Puskesmas which is taken with distance of 5.3 km and travel time 14 minutes from location of Prambanan Temple. to be known travelers can use private vehicles at tourism Plaosan Temple, because the attractions have a radius of 1.7 km. While on the tourist object of tourism Prambanan Temple can not use private vehicle because the mileage exceeds 3 km, and b) The travel pattern of tourists to health care facilities is categorized good, because the tourists can access health services with the nearest route and adequate facilities. Keywords: Travel Patterns, Health Facilities, Network Analysis ReferencesAnwar, A. (2010). Introduction to Health Administration.Jakarta: Binarupa Aksara.Groenou, M. V., & Tilburg, T. V. (1975). Network Anaysis. Vrije Universitet, Amsterdam, The Netherland.Kuntarto, A., & Purwanto, T. H. (2012). Use of Geographic Information Network Analysis System for Route Planning Tourists in Sleman. Journal of The Earth Indonesia of Vol 1 Number 2, 141.Laksono, A. D., & dkk. (2016). The accessibility of health service in Indonesia. Yogyakarta: KANISIUS PT.Law number. 36 Year 2009 About HealthLaw number. 47 Year 2016 About Health Facilities.Moeleong, L. (2002). Qualitative Research Methods. Bandung: Teens Rosdakarya.Muta'ali, L. (2013). Regional and City Spatial Planning (Tinjauan Normatif-Teknis). Yogyakarta: Badan Penerbit Fakultas Geografi (BPFG) Gadjah Mada University.Narsid, S. (1988). Development Geography. Jakarta: Space.O.Z, T. (1997). Transport Planning and Modeling. Bandung: Institut Teknologi Bandung.

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Disinfection efficacy studies on three different disinfection methods in health care facilities by ATP method

BCIT Environmental Public Health Journal ◽

10.47339/ephj.2015.118 ◽

2015 ◽

Author(s):

Harry Zhuang ◽

BCIT School of Health Sciences, Environmental Health ◽

Helen Heacock ◽

Fred Shaw

Keyword(s):

Health Care ◽

Medical Equipment ◽

Health Care Facilities ◽

Relative Light Unit ◽

Monitoring Methods ◽

Log Reduction ◽

Disinfection Methods ◽

Care Facilities ◽

The Mean ◽

High Level

Objectives: Nosocomial infection has always been a significant topic in the field of public health. The disinfection procedures involved in health care facilities are extremely important to prevent potential transmission of diseases. Therefore, this study was performed to compare the disinfection efficacy between three different disinfection methods (Accel wipes, Hubscrub industrial washer, and Steam vapor) on three pieces of non-critical medical equipment: wheelchairs, mattresses and bath chairs. Methods: The method used to evaluate the disinfection efficacy compared the reduction of contaminants count in the relative light unit using ATP monitoring methods. 30 samples of each of the three types of medical equipment were swabbed pre-disinfection and post-disinfection using the three disinfection methods. The recorded reduction number was then converted using log transformation. Statistical analysis was conducted using NCSS to assess differences between the disinfection methods. Results: The mean log-reduction of disinfection for Accel wipes, Hubscrub, and steam vapor were 1.067, 1.490, and 1.485 respectively. Steam vapor and Hubscrub displayed statistically significantly better disinfection efficacy compared to Accel wipes in terms of log reduction (overall p=0.000002). Conclusion: Hubscrub and steam vapor are better disinfectants compared to Accel wipes in terms of mean log reduction values; however, all three disinfection methods demonstrated effectiveness when cleaning and disinfecting non-critical medical equipment. For critical medical equipment, steam vapor and Hubscrub industrial washing are effective while Accel wipes do not meet the standards of high-level disinfection. As a result, combination usages of all three disinfection methods are recommended at health care facilities based on the categories of the medical equipment.

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Hubungan Pengetahuan dan Sikap Ibu Postpartum tentang Persalinan di Fasyankes dengan Pemilihan Pertolongan Persalinan

Jurnal Ilmiah Universitas Batanghari Jambi ◽

10.33087/jiubj.v18i3.519 ◽

2018 ◽

Vol 18 (3) ◽

pp. 522

Author(s):

Ratu Kusuma

Keyword(s):

Public Health ◽

Health Care ◽

Health Center ◽

Health Care Facilities ◽

Healthcare Facilities ◽

Public Health Center ◽

The Public ◽

Care Facilities ◽

Postpartum Mothers ◽

Selection Of

Safe childbirth is childbirth that helped by health personnel in health care facilities. Coverage of childbirth in health care facilities in Jambi province did not reach strategic plan target yet (77.00%), achievement (63.03%), Jambi city (93.86%) and the public health center did not reach target province yet (90%) that is the public health center Talang Bakung (79.00%) and Pal Merah II (78.00%). This study aimed to determine the correlation of knowledge and postpartum mothers attitude about childbirth in health care facilities with a selection of helping in childbirth at the public health center Talang Bakung. This is an analytic descriptive research; with total populations were 32 postpartum mothers, it used total sampling technique. Instrument test was conducted at the public health center Pal Merah II toward 10 postpartum mothers; an instrument used demographic data instrument, knowledge instrument, attitude instrument, and selection of helping in childbirth instrument, with fisher exact test and contingency coefficient. The findings indicated that there is no significant correlation between knowledge and attitudes of childbirth in healthcare facilities with a selection of helping in childbirth with each score p is (p=0.444 p=1.000), contingency coefficient (p=0.399, p=1.000). It is concluded that knowledge and attitude of the postpartum mother about childbirth in healthcare facilities did not affect in a selection of childbirth place chosen by the mother. For the next researcher to research about childbirth in healthcare facilities with the different method.

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The Correlation Between ATP Measurement and Microbial Contamination of Inanimate Surfaces

10.21203/rs.3.rs-428499/v1 ◽

2021 ◽

Author(s):

Andreas van Arkel ◽

Ina Willemsen ◽

Jan Kluytmans

Keyword(s):

Health Care ◽

Nursing Home ◽

Microbial Contamination ◽

Bacterial Load ◽

Agar Plate ◽

Health Care Facilities ◽

Home Setting ◽

Care Facilities ◽

Nursing Home Setting ◽

The Mean

Abstract Background:The objective of this study was to determine the correlation between adenosine triphosphate (ATP) measurements and microbial contamination using a standardized method. Methods: ATP measurements and aerobic colony counts (ACC’s) were conducted on 10 pre-defined fomites in a hospital and nursing home setting. Per fomite two ATP measurements and two agar plate measurements were conducted, each measurement was conducted on a 25 cm2 surface. Both measurements were compared and analyzed for correlation. Results: In total 200 paired measurements were conducted, 200 ATP measurements and 200 ACC’s. The mean of all ATP measurements tested on the same surface was calculated, as was for all 200 ACC’s. There was a strong correlation between the mean of two ATP measurements on two different sites on the same fomite (R=0.800, p<0.001) as well as between two ACC measurements on the same fomite (R=0.667, p<0.001). A much weaker correlation was found between RLU values and ACC’s (R=0.244, p<0.001). Conclusions: Reproducibility of ATP measurements and ACC’s on the same fomite was good. However, the correlation between RLU values and ACC’s on hospital surfaces was much lower. This may be explained by the wide variety of biological material that is measured with ATP, of which the bacterial load is only one of many components. ATP measurement can be used to give a quantifiable outcome for the rating of cleanliness in health care facilities, however the results cannot be translated into the level of microbial contamination.

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КРІ model impact on employee motivation and competitiveness of private healthcare facilities

10.21272/hem.2021.2-04 ◽

2021 ◽

Vol 2 (2) ◽

pp. 31-42

Author(s):

Stanislav Kotenko ◽

Iana Kobushko ◽

Iryna Heiets ◽

Oleksandr Rusanov

Keyword(s):

Health Care ◽

Medical Staff ◽

Care Quality ◽

Health Care Facilities ◽

Private Health Care ◽

Healthcare Facilities ◽

Private Healthcare ◽

Care Facilities ◽

Private Medicine ◽

Health And Economic Development

The Constitution of Ukraine stipulates that an individual, his/her life, and health are the highest state social values. The authors highlighted that the health care system is the basis of social policy, national security, public health, and economic development. The current reformation of medical and legal reforms in Ukraine are fully covered by health legislation. In the context of these laws, the government promotes the development of private, communal, and state healthcare facilities. The authors noted that private medicine is snowballing in Ukraine, but the competitiveness of private health care facilities is insufficient in state medical reform. The study emphasized the absence of appropriate tools and mechanisms to motivate staff in private healthcare facilities. Based on the findings, the authors proposed introducing a set of evaluation indicators combined into a single integrated system – key performance indicators (KPIs), which would be the basis for calculating the bonus payroll. In turn, this system of material incentives should encourage medical staff to work effectively, be active, and initiative. The mechanism for developing a set of KPIs should be approved at the administration of the private health care facility. At the same time, medical workers of all levels must participate in KPIs elaborating. The indicators of medical care quality could be further used to improve healthcare, differentiated work assessment of medical staff, and healthcare facility in general, in accreditation and certification of private health care facilities. In the study, the authors formed and analyzed groups of indicators for different categories of the medical staff of private medical institutions. The obtained results showed that different bonus rates are needed to motivate employees at various levels to create an additional incentive to build a medical career. Thus, it could be argued that private healthcare facilities should develop motivation policy and strategy, revise system and forms of remuneration, improve the mechanism of motivation and incentives, focus on increasing competitiveness indicators in private medicine.

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Notes From the Field: Availability of Satellite Pharmacies and Pharmacy Service Units in Nigerian Hospitals—Implications for Pharmaceutical Care

Evaluation & the Health Professions ◽

10.1177/0163278720934174 ◽

2020 ◽

pp. 016327872093417

Author(s):

Ene Daniel-Ebune ◽

Abubakar Ibrahim Jatau ◽

Sai’du Lawal Burji ◽

Mustapha Mohammed

Keyword(s):

Health Care ◽

Pharmaceutical Care ◽

Emergency Departments ◽

Drug Information ◽

Health Care Facilities ◽

Pharmacy Service ◽

Healthcare Facilities ◽

Care Services ◽

Care Facilities ◽

Hospital Pharmacies

The optimal provision of pharmaceutical care services requires an adequate number of pharmacists, satellite pharmacies and service units at healthcare facilities. We examined the availability of these requirements at Nigerian hospitals using the 2016 nationwide inspection reports of hospital pharmacies conducted by the Pharmacists Council of Nigeria. Records of 254 hospitals inspected were retrieved, of which 171 (67.3%) were public. The total number of pharmacists across facilities was 753. The most common satellite pharmacy units recorded were antiretroviral 80 (31.5%) and emergency departments 48 (18.8%). The most common service units were drug revolving funds 176 (69.3%) and drug information 112 (44.1%) units. These findings suggest the availability of pharmacists, satellite pharmacies and service units are inadequate for the optimal delivery of pharmaceutical care services at healthcare facilities in Nigeria. Therefore, there is a need for interventions to improve the provision of pharmaceutical care services at health care facilities in Nigeria.

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