Post-injection thrombophlebitis in patients undergoing peripheral IV catheterization in a tertiary care hospital: incidence and risk factors

Background: Intravenous catheters cause endothelial damage and trauma, which can predispose to venous thrombosis. Peripheral vein infusion thrombophlebitis occurs in 25- 35% of hospitalized patients with intravenous catheters and has both patient-related implications (e.g., sepsis) and economic consequences (e.g., extra nursing time). This study is designed to address this issue, by assessing the potential risk factors in those who have developed phlebitis, and deriving conclusions based on the same.Methods: A total of 830 patients were observed over a period of 2 months. All details of the patient were collected. Thrombophlebitis was graded using Visual Infusion Phlebitis Score. Each case was compared with a matching control. Results: 53 of 830 patients observed, developed thrombophlebitis giving an incidence of 6.4%. 92.5% had IV cannulation flushed after insertion. IV cannula had to be changed at least 2 times during the hospital stay. All had an average IV cannulation for 5 days. All had insertion of same size cannula (20G). Level 1 Phlebitis was identified in 64.15% patients, level 2 Phlebitis in 33.96% patients and Level 3 Phlebitis was seen 1.88% patients.Conclusions: Significant association was noted between the number of times the catheter was changed since admission and administration of Potassium chloride and Certain Medications such as Piperacillin through the cannula.

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Functional constipation in Bangladeshi children: experience of demography and probable risk factors from a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202627 ◽

2020 ◽

Vol 7 (7) ◽

pp. 1619

Author(s):

Md. Wahiduzzaman Mazumder ◽

Maimuna Sayeed ◽

Md. Benzamin ◽

Mahfuza Chowdhury

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Tertiary Care ◽

Functional Constipation ◽

Cow’S Milk ◽

Care Hospital ◽

Age Group ◽

Cow's Milk ◽

Academic Activity ◽

Potential Risk Factors

Background: Constipation is a common problem throughout childhood. It is important to be fully aware of the factors involved in developing constipation in children. There are few published articles on childhood constipation in Bangladesh. In this study, our aim was to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children.Methods: The study was carried out among 179 children from May 2018 to June 2019 in the department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU) both indoor and outdoor basis. Children with constipation who fulfilled the ROME III criteria were evaluated for demography and probable/potential risk factors of constipation.Results: A total of 179 subjects were included in the final analysis. Among them, 54.75% were boys and 45.25% were girls. Constipation was found more in the age group above 5 years (56.42%), then in 2 to 5 years age group (33.52%) and lower in below 2 years of age (10.6%). Constipation was more among children living in urban area (55.3%) than in rural area (44.69%). Constipation was the presenting complaint in 76.54% subjects, other complaints were abdominal pain (47.49%), anorexia (24.02%), vomiting (19.56%). Diet low in fiber (72.63%) was found as the most common potential risk factor, other factors were ingestion of cow’s milk (32.96%), not having regular meals with parents (19.55%), consumption of junk foods (28.49%). Staying with grandparents (16.76%), living in hostel or madrasa / residential religious institute (5.03%), long period of academic activity, [homework (10.61%) / tutor and coaching (7.26%)], unhygienic toilet in school (6.14%) were also found to be probable associated factors in this study.Conclusions: Functional constipation was found more in boy’s and above five year age group. Low dietary fiber, consumption of cow’s milk and junk food, unwillingness to use toilets in school, long time in academic activity, were found to be potential underlying risk factors of constipation.

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Risk factors for the development of neonatal sepsis in a neonatal intensive care unit of a tertiary care hospital of Nepal

BMC Infectious Diseases ◽

10.1186/s12879-021-06261-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sulochana Manandhar ◽

Puja Amatya ◽

Imran Ansari ◽

Niva Joshi ◽

Nhukesh Maharjan ◽

...

Keyword(s):

Risk Factors ◽

Antimicrobial Resistance ◽

Low Income ◽

Potential Risk ◽

Neonatal Sepsis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Antimicrobial Resistance Genes ◽

Potential Risk Factors

Abstract Background Sepsis is an overwhelming and life-threatening response to bacteria in bloodstream and a major cause of neonatal morbidity and mortality. Understanding the etiology and potential risk factors for neonatal sepsis is urgently required, particularly in low-income countries where burden of infection is high and its epidemiology is poorly understood. Methods A prospective observational cohort study was conducted between April 2016 and October 2017 in a level three NICU at a tertiary care hospital in Nepal to determine the bacterial etiology and potential risk factors for neonatal sepsis. Results Among 142 NICU admitted neonates, 15% (21/142) and 32% (46/142) developed blood culture-positive and -negative neonatal sepsis respectively. Klebsiella pneumoniae (34%, 15/44) and Enterobacter spp. (25%, 11/44) were the most common isolates. The antimicrobial resistance of isolates to ampicillin (100%, 43/43), cefotaxime (74%, 31/42) and ampicillin-sulbactam (55%, 21/38) were the highest. BlaTEM (53%, 18/34) and blaKPC (46%, 13/28) were the commonest ESBL and carbapenemase genes respectively. In univariate logistic regression, the odds of sepsis increased with each additional day of use of invasive procedures such as mechanical ventilation (OR 1.086, 95% CI 1.008–1.170), umbilical artery catheter (OR 1.375, 95% CI 1.049–1.803), intravenous cannula (OR 1.140, 95% CI 1.062–1.225); blood transfusion events (OR 3.084, 95% CI 1.407–6.760); NICU stay (OR 1.109, 95% CI 1.040–1.182) and failure to breast feed (OR 1.130, 95% CI 1.060–1.205). Sepsis odds also increased with leukopenia (OR 1.790, 95% CI 1.04–3.082), increase in C-reactive protein (OR 1.028, 95% CI 1.016–1.040) and decrease in platelets count (OR 0.992, 95% CI 0.989–0.994). In multivariate analysis, increase in IV cannula insertion days (OR 1.147, 95% CI 1.039–1.267) and CRP level (OR 1.028, 95% CI 1.008–1.049) increased the odds of sepsis. Conclusions Our study indicated various nosocomial risk factors and underscored the need to improve local infection control measures so as to reduce the existing burden of sepsis. We have highlighted certain sepsis associated laboratory parameters along with identification of antimicrobial resistance genes, which can guide for early and better therapeutic management of sepsis. These findings could be extrapolated to other low-income settings within the region.

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Factors Correlating with Burnout in Practicing Otolaryngologists

Otolaryngology ◽

10.1177/0194599811428585 ◽

2011 ◽

Vol 146 (2) ◽

pp. 234-239 ◽

Cited By ~ 19

Author(s):

Aaron M. Fletcher ◽

Nitin Pagedar ◽

Richard J. H. Smith

Keyword(s):

Risk Factors ◽

Tertiary Care ◽

Maslach Burnout Inventory ◽

Burnout Syndrome ◽

Care Hospital ◽

Continuous Variables ◽

Cross Sectional Survey ◽

University Of Iowa ◽

Cross Sectional ◽

Potential Risk Factors

Objective. This study sought to determine which demographic and practice characteristics were predictive of professional burnout in otolaryngologists. Study Design. Cross-sectional survey. Setting. Tertiary care hospital. Subjects and Methods. Postal mailings, including the Maslach Burnout Inventory (MBI), were sent to alumni of the University of Iowa Hospitals and Clinics otolaryngology program. Participants completed the MBI according to the enclosed instructions. In addition, they answered a brief questionnaire comprising 8 items designed to collect demographic information. The MBI was then scored and subjects were classified according to their degree of burnout. Statistical analysis was then performed, and correlations were used to summarize associations between continuous variables. Results. This study had a response rate of 49% to the survey. Of the respondents, 3.5% met criteria for burnout syndrome, and 16% were classified as having high levels of burnout according to the MBI. Young age, number of hours worked per week, and length of time in practice were found to be statistically significant predictors of burnout. In addition, the length of time married and the presence of children in the home were also significant predictors of burnout. Conclusion. The authors report an investigation of burnout in practicing otolaryngologists using a validated instrument with correlation to potentially modifiable risk factors. The experience of burnout was found to correlate significantly with both personal and professional factors, each of which can potentially be addressed to curb the incidence of burnout. Further understanding of the potential risk factors for burnout is necessary to minimize and prevent burnout among practicing otolaryngologists.

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Assessment of Potential Risk Factors for 2019-Novel Coronavirus (2019-nCov) Infection among Health Care Workers in a Tertiary Care Hospital, North India

Journal of Primary Care & Community Health ◽

10.1177/21501327211002099 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110020

Author(s):

Sugandhi Sharma ◽

Ritin Mohindra ◽

Kirtan Rana ◽

Vikas Suri ◽

Ashish Bhalla ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Health Care Workers ◽

Potential Risk ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Care Workers ◽

Potential Risk Factors ◽

Novel Coronavirus

Introduction Health care workers (HCWs) are at the forefront to fight against COVID-19 pandemic. They are at more risk of contracting the infection. This study was planned to assess potential risk factors of 2019-novel coronavirus infection among HCWs working in a health facility and to evaluate the effectiveness of infection prevention and control measures among them. Methods A study was conducted in a tertiary care hospital among HCWs who were directly or indirectly involved in the management of a confirmed or suspected case of COVID-19. The socio-demographic characteristics, history of exposure, IPC measures followed and clinical symptoms were compared between health care workers in COVID and non-COVID areas. Results Majority (45%) of HCWs were nurses, followed by hospital/sanitary/technical attendants (30%) and doctors (24%). Out of a total of 256 HCWs, 2% tested positive. Around 80% of HCWs had ever attended any IPC training. A statistically significant association was found between posting area of HCWs and their exposure to COVID patients (duration of exposure, PPE has worn by HCWs, direct contact of HCWs with the patient’s material) and COVID positivity ( P value <.001). Conclusion If health care workers were trained and take adequate precautions then the risk of getting an infection is minimized.

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Routine Replacement versus Clinically Indicated Replacement of Peripheral Venous Catheters through Assessment of Incidences and Grades of Phlebitis in Patients with IV Cannula at a Tertiary Care Hospital, Mumbai

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i46b32922 ◽

2021 ◽

pp. 116-120

Author(s):

Bhavnani Namrata ◽

Ahire Neha ◽

Prakash Kalke ◽

Shrikrishna Dhale

Keyword(s):

Private Hospital ◽

Descriptive Analysis ◽

Tertiary Care ◽

Cost Effective ◽

Routine Practice ◽

Care Hospital ◽

Improve Patient Satisfaction ◽

Infusion Phlebitis ◽

Improve Patient ◽

Intravenous Catheters

Background: The current study assesses the incidences and grades of phlebitis among patients with IV cannula to determine the association of grades of phlebitis. The purpose of the study was to study the feasibility of Routine replacement versus Clinically indicated replacement of peripheral venous catheters. The study observes the incidences of removing peripheral intravenous catheters when clinically indicated compared with removing and re‐siting the catheter routinely. Methods: An observational study was conducted in the tertiary care private hospital of Mumbai, India. The study was conducted over 5 weeks from May -June 2020. Purposive sampling was considered during the collection of data. The sample size of the study was 117 patients admitted having peripheral venous catheters. The standard visual infusion phlebitis (VIP) score was used as a tool for data collection. Descriptive analysis was done. Results: Out of 117 patients (VIP score 0 -56, Score 1- 49, Score -12 no cases with score 3, 4, and 5). Routine replacement of IV cannula after every 5 days is judiciously followed, 45 healthy lines were replaced at score 0; which is the major concern (Rs. 633/- the total cost of replacing 1 PVC line). Conclusion: Following the routine practice of IV cannula replacement based on VIP score to avoid phlebitis is equally good but simultaneously clinically indicated replacement of IV cannula is advisable to make it cost-effective and reduced number of a prick to the patients; this will help to improve patient satisfaction.

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Functional Constipation in Children: Demography and risk factors analysis from a Tertiary Care Hospital of Bangladesh

Bangladesh Journal of Child Health ◽

10.3329/bjch.v44i3.52705 ◽

2021 ◽

Vol 44 (3) ◽

pp. 148-152

Author(s):

Md Wahiduzzaman Mazumder ◽

Shariful Hasan ◽

Kaniz Fathema ◽

Md Rukunuzzaman ◽

ASM Bazlul Karim

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Urban Areas ◽

Tertiary Care ◽

Functional Constipation ◽

Cow’S Milk ◽

Care Hospital ◽

Cross Sectional ◽

Cow's Milk ◽

Potential Risk Factors

Background: Constipation is not uncommon in childhood. This study was aimed to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children. Materials & Method: This cross-sectional study was carried out among 179 children from May 2018 to June 2019 in the department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka both indoor and outdoor basis. Collected data from children with constipation who fulfilled the Rome III criteria were analyzed by SPSS 20. Results: Among 179 children, 54.75% were boys, and 45.25% girls. It was found more in age group above 5 years (56.42%), then in 2 to 5 years (33.52%) and lower in below 2 years (10.6%). Constipation was more in urban areas (55.3%) than in rural (44.69%). Among potential risk factors, low fiber in diet (72.63%) was most common, other factors were ingestion of cow’s milk (32.96%), not having regular meals with parents (19.55%), consumption of junk foods (28.49%), Staying with grandparents (16.76%), living in hostel or madrasa / residential, religious institute (5.03%), long period of academic activity (7.26%), unhygienic toilet in school (6.14%) were also found to be probable risk factors in this study. Conclusion: Functional constipation was found more in boys & above five-year age groups. Low dietary fiber, consumption of cow’s milk & junk food, unwillingness to use toilets in school were found as potential underlying risk factors of constipation. Bangladesh J Child Health 2020; VOL 44 (3) :148-152

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Risk factors for the development of neonatal sepsis in a neonatal intensive care unit of a tertiary care hospital of Nepal

10.21203/rs.3.rs-122783/v1 ◽

2020 ◽

Author(s):

Sulochana Manandhar ◽

Puja Amatya ◽

Imran Ansari ◽

Niva Joshi ◽

Nhukesh Maharjan ◽

...

Keyword(s):

Risk Factors ◽

Antimicrobial Resistance ◽

Low Income ◽

Potential Risk ◽

Neonatal Sepsis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Laboratory Parameters ◽

Potential Risk Factors

Abstract Background: Sepsis is an overwhelming and life-threatening response to bacteria in bloodstream and a major cause of neonatal morbidity and mortality. Understanding the etiology and potential risk factors for neonatal sepsis is urgently required, particularly in low-income countries where burden of pathogens is high and epidemiology is poorly understood.Methods: A prospective observational cohort study was conducted between April 2016 and October 2017 in a level three NICU of a tertiary care hospital in Nepal to determine the bacterial etiology and potential risk factors for neonatal sepsis.Results: Among 142 NICU admitted neonates, 15% (21/142) and 32% (46/142) developed blood culture-positive and -negative neonatal sepsis respectively. Klebsiella pneumoniae (34%, 15/44) and Enterobacter spp. (25%, 11/44) were the most common isolates. The antimicrobial resistance of isolates to ampicillin (100%, 43/43), cefotaxime (74%, 31/42) and ampicillin-sulbactam (55%, 21/38) were the highest with blaTEM (53%, 18/34) and blaKPC (46%, 13/28) being the commonest ESBL and carbapenemase genes. In univariate logistic regression, various potential neonatal, maternal, environmental and laboratory parameters were tested. Of these, the odds of sepsis increased with each additional day of use of invasive procedures such as mechanical ventilation (OR 1.086, 95% CI 1.008–1.170), umbilical artery catheter (OR 1.375, 95% CI 1.049–1.803), intravenous cannula (OR 1.140, 95% CI 1.062–1.225); blood transfusion events (OR 3.084, 95% CI 1.407–6.760); NICU stay (OR 1.109, 95% CI 1.040–1.182); failure to breast feed (OR 1.130, 95% CI 1.060–1.205); leukopenia (OR 1.790, 95% CI 1.04–3.082),thrombocytopenia (OR 0.992, 95% CI 0.989–0.994) and increase in C-reactive protein (OR 1.028, 95% CI 1.016–1.040). In multivariate analysis, increase in IV cannula insertion days (OR 1.140, 95% CI 1.024–1.269) and CRP level (OR 1.021, 95% CI 1.003–1.040) increased the odds of sepsis.Conclusions: Our study indicated various nosocomial risk factors and underscored the need to improve local infection control measures so as to reduce the existing burden of sepsis. We have highlighted certain sepsis associated laboratory parameters along with identification of antimicrobial resistance genes, which can guide for early and better therapeutic management of sepsis. These findings could be extrapolated to other low-income settings within the region.

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