Drug shortages in a state-owned academic hospital during the COVID-19 pandemic in Ecuador

Abstract Background During a pandemic, medical supplies are at increased risk of being depleted rapidly. The COVID-19 sanitary emergency has generated global shortages in critical supplies, like personal protective equipment and medicines. This study aimed to describe the pharmaceutical procurement challenges to overcome medicine shortages in a state-owned academic hospital during the COVID-19 pandemic in Ecuador. Methods We conducted a cross-sectional study using secondary administrative data of documented public tenders for medicines and drug prescriptions for the critical care unit at Hospital Pablo Arturo Suárez in Quito, Ecuador. The occurrence of shortages, their frequency, and the procurement mechanisms used to overcome them were documented by the pharmacy service between January 1st and July 31th, 2020. The units purchased and unitary price of pharmaceuticals procured by the hospital was also documented and compared to data from 2019. Results From 38 medicines analyzed from 12 ATC groups, there were 84 shortages during the sanitary emergency period covered by the study, and 25 medicines had one or more shortages. Norepinephrine and midazolam shortages were most frequent. Retail or emergency direct purchase and loan-stock from other public hospitals were the main procurement methods to overcome the shortages. The purchase mechanism directly influenced the price. Drugs purchased in small tenders via retail or emergency direct purchase had the most significant price increase (up to 819%), while medicines acquired via the electronic catalog managed by the public procurement service experienced no price changes. Conclusion Monitoring and responding to drug shortages during a pandemic can be challenging, and governments must adapt quickly, providing specific guidance on how to deal with shortages.

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Knowledge Attitudes and Practice of Breast Milk Expression and Storage Among Working Mothers With Infants Under 6 Months of Age in Public Well Baby Clinics

10.21203/rs.3.rs-67599/v1 ◽

2020 ◽

Author(s):

PRISCILLAH wanini EDEMBA ◽

Grace Irimu ◽

RACHEL MUSOKE

Keyword(s):

Breast Milk ◽

Working Mothers ◽

Tertiary Education ◽

Working Women ◽

Cross Sectional Study ◽

Public Hospitals ◽

Cross Sectional ◽

Study Objective ◽

The Public ◽

And Storage

Abstract Background: Many studies show that working mothers are unable to exclusively breastfeed successfully. Expression and storage of breastmilk is a strategy that ensures continued breastmilk consumption in the event of temporary separation of an infant from the mother. The 2017 Kenyan Health Act mandates employers to provide lactation rooms with guidance for appropriate utilization.Methodology: The study objective was to assess knowledge attitude and practice of breastmilk expression and storage among working women with infants below six months of age in Public Well Baby Clinics. This was a cross sectional study among 395 working women attending two large public hospitals in Nairobi Kenya. A structured questionnaire with open and closed ended questions was used to establish the knowledge and practice while a Likert scale was used to explore attitudes of the mothers towards expression and storage of breast milk. Results: Only 161(41%) were expressing breast milk. Those with tertiary education and those working in the public sector had significantly higher odds of having satisfactory knowledge OR4.47(95%CI 2.01-11.07) and OR2.26(95%CI 1.33-3.85) respectively. Attaining tertiary education was significantly associated with a possibility of expressing and storing breastmilk OR3.6(95% CI 1.81-7.95). The workplace did not provide adequate equipment to facilitate breastmilk expression. Challenges experienced were breast pain and cumbersome nature of expressing milk.Conclusion: The study revealed knowledge gaps in expression and storage of breastmilk that need to be addressed to enable the mothers fully utilize the lactation rooms when they become available at the workplace.

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TO EVALUATE THE PERFORMANCE OF A TEACHING HOSPITAL BY COMBINING THE HOSPITAL INDICES USING THE PABON LOSSO MODEL DURING THE SURVEILLANCE BY AUTHORITIES:HAWTHORNE EFFECT

10.36106/ijsr/1625869 ◽

2021 ◽

pp. 75-77

Author(s):

C. Narender Kumar

Keyword(s):

Teaching Hospital ◽

Public Hospital ◽

Quality Care ◽

Hospital Performance ◽

Cross Sectional Study ◽

Public Hospitals ◽

Hawthorne Effect ◽

Cross Sectional ◽

Policy Makers ◽

The Public

BACKGROUND:The patients' health care choice is diverting from the private health provider to the public hospital due to introduction of various schemes and incentives by the policy makers. The limited resources are posing a challenge to the hospital administrator in escalating demands, diversity and complexity of diseases of patients. The hospital performance enhances steadily by the monitoring authorities' surveillance. It is an effective method for improving quality care in the public hospital. The Hawthorne effect is a term referring to the tendency of people to work harder and increases in effectiveness of organization when they are being observed. OBJECTIVES: 1. To assess the performance of a teaching hospital during surveillance by calculating the hospital indices, using the Pabon Losso Model. 2. To evaluate whether the Hawthorne effect is the cause of the increase in the effectiveness of hospital. MATERIALS AND METHODS: The study was a prospective and record based cross-sectional study and conducted at Government teaching hospital over a period of 18 months. RESULTS: st A total of 18 months period census report was recorded from January 2016 to June 2017and hospital indices were estimated. The 1 phase of surveillance (January- 2016 to May -2016), where immense supervision was present, with performance feed- back, BOR was 88.65, nd ALOS was 3.932, BTR was 7.074 and BTI was 0.54, 2 phase of surveillance which was intensied with communication and committee meetings rd (June-2016 to October- 2016), BOR was 95.59, ALOS was 3.49, BTR was 7.03 and BTI was 0.886, 3 phase weaning period, where a little th supervision (November -2016 to February-2017) BOR was 87.8, ALOS was 4.1, BTR was 6.413 and BTI was 0.5725 and 4 phase self sustain stage or no observations phase, BOR was 92.6, ALOS was 3.47, BTR was 6.547 and BTI was 0.28. CONCLUSION: The surveillance of higher authorities over the hospital had increased the performance. Hospital efciency is reected by increased hospital indices. The cause and effect is the “Hawthorne effect”. Therefore it is concluded that the surveillance increases the performance and efciency of the public hospitals.

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Assessment of surgical capacity in Chiapas, Mexico: a cross-sectional study of the public and private sector

BMJ Open ◽

10.1136/bmjopen-2020-044160 ◽

2021 ◽

Vol 11 (7) ◽

pp. e044160

Author(s):

Lina Roa ◽

Ellie Moeller ◽

Zachary Fowler ◽

Fernando Carrillo ◽

Sebastian Mohar ◽

...

Keyword(s):

Cross Sectional Study ◽

Public Hospitals ◽

Surgical Volume ◽

Sectional Study ◽

Surgical Capacity ◽

Catastrophic Expenditure ◽

Cross Sectional ◽

Private Hospitals ◽

Public And Private ◽

The Public

IntroductionSurgical, anaesthesia and obstetric (SAO) care are essential, life-saving components of universal healthcare. In Chiapas, Mexico’s southernmost state, the capacity of SAO care is unknown. This study aims to assess the surgical capacity in Chiapas, Mexico, as it relates to access, infrastructure, service delivery, surgical volume, quality, workforce and financial risk protection.MethodsA cross-sectional study of Ministry of Health public hospitals and private hospitals in Chiapas was performed. The translated Surgical Assessment Tool (SAT) was implemented in sampled hospitals. Surgical volume was collected retrospectively from hospital logbooks. Fisher’s exact test and Mann-Whitney U test were used to compare public and private hospitals. Catastrophic expenditure from surgical care was calculated.ResultsData were collected from 17 public hospitals and 20 private hospitals in Chiapas. Private hospitals were smaller than public hospitals and public hospitals performed more surgeries per operating room. Not all hospitals reported consistent electricity, running water or oxygen, but private hospitals were more likely to have these basic infrastructure components compared with public hospitals (84% vs 95%; 60% vs 100%; 94.1% vs 100%, respectively). Bellwether surgical procedures performed in private hospitals cost significantly more, and posed a higher risk of catastrophic expenditure, than those performed in public hospitals.ConclusionCapacity limitations are greater in public hospitals compared with private hospitals. However, the cost of care in the private sector is significantly higher than the public sector and may result in catastrophic expenditures. Targeted interventions to improve the infrastructure, workforce availability and data collection are needed.

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Availability and use of personal protective equipment and satisfaction of healthcare professionals during COVID-19 pandemic in Addis Ababa, Ethiopia

Archives of Public Health ◽

10.1186/s13690-021-00668-3 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Wakgari Deressa ◽

Alemayehu Worku ◽

Workeabeba Abebe ◽

Muluken Gizaw ◽

Wondwossen Amogne

Keyword(s):

Personal Protective Equipment ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Addis Ababa ◽

Cross Sectional Study ◽

Public Hospitals ◽

Protective Equipment ◽

Cross Sectional ◽

Healthcare Facilities ◽

Increased Risk

Abstract Background Healthcare professionals (HCPs) are at the frontline in the fight against COVID-19 and are at an increased risk of becoming infected with coronavirus. Risk of infection can be minimized by use of proper personal protective equipment (PPE). The aim of this study was to assess the availability and use of PPE, and satisfaction of HCPs with PPE in six public hospitals in Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted among 1134 HCPs in June 2020. A systematic random sampling and consecutive sampling techniques were used to select the study participants. Data were collected using a self-administered questionnaire. Descriptive statistics were used to describe the data and Chi-square test was used to assess the association between the groups. Bivariate and multivariable logistic regression models were used to assess factors associated with satisfaction of healthcare workers. Results The mean (±SD) age of the participants was 30.26 ± 6.43 year and 52.6% were females. Nurses constituted about 40% of the overall sample, followed by physicians (22.2%), interns (10.8%), midwives (10.3%) and others (16.7%). The majority (77%) of the HCPs reported that their hospital did not have adequate PPE. A critical shortage of N95 respirators was particularly reported, it only increased from 13 to 24% before and during COVID-19, respectively. The use of N95 increased from 9 to 21% before and during COVID-19, respectively. Almost 72% of the respondents were dissatisfied with the availability and use of PPE in their hospital. The independent predictors of the respondents’ satisfaction level about PPE were healthcare workers who reported that PPE was adequately available in the hospital (adjusted OR = 7.65, 95% CI:5.09–11.51), and preparedness to provide care to COVID-19 cases (adjusted OR = 2.07, 95% CI:1.42–3.03). Conclusions A critical shortage of appropriate PPE and high level of dissatisfaction with the availability and use of PPE were identified. Therefore, urgent efforts are needed to adequately supply the healthcare facilities with appropriate PPE to alleviate the challenges.

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An Assessment of Work Environment Factors Correlating with Burnout Status of Physicians Employed with the Public Hospitals Authority in The Bahamas

Caribbean Medical Journal ◽

10.48107/cmj.2021.07.002 ◽

2021 ◽

Author(s):

Merrilyn Wallace-Bain

Keyword(s):

Work Environment ◽

Maslach Burnout Inventory ◽

Cross Sectional Study ◽

Demographic Variables ◽

Public Hospitals ◽

Burnout Syndrome ◽

The Bahamas ◽

Cross Sectional ◽

The Public ◽

Study Participants

Objective To identify the prevalence and factors associated with the Burnout Syndrome in physicians working in the Public Hospitals Authority (PHA), Nassau, Bahamas. Methods A cross-sectional study was done in 2014 utilising a self-administered survey comprising of demographics, general health, work environment, and Maslach Burnout Inventory items to assess burnout among physicians working in nine (9) departments of PHA. The IBM SPSS (v. 20.0 or more current) Statistical Analyses software was used for data analysis. Results The study participants were 153 physicians. Their mean age was 35.84 (± 7.09) years old; median 34.00 (IQR: 31.00, 40.00) years old, 99 (64.7%) were females. No associations were found among these, other socio-demographic variables measured and burnout status. Physicians in the department of Internal Medicine represented 34 (22.2%), Family Medicine 31 (20.3%), Emergency Medicine 30 (19.6%), Paediatrics 21 (13.7%), and physicians in other departments 34 (22.3%). Of the physicians employed under the PHA, 55.7% collectively exhibited burnout. Poor balance of family life, 15 work environment potential stressors and 4 potential stress relievers were found to each be weakly or very weakly related to burnout status. Postgraduate programme year, irregular sleep pattern and lack of appreciation were moderately strong positively related. Logistic regression analysis showed the key predictors of burnout status to be lack of appreciation (OR=1.69, p=.002) and number of years worked post-internship (OR=.94, p=.039). Conclusion: Physician’s sense of appreciation and number of years post internship were clear predictors of burnout.

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FACTORS INFLUENCING THE JOB SATISFACTION AMONG NURSES AND MIDWIVES WORKING IN THE PUBLIC HOSPITALS IN QUANG TRI PROVINCE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.6.19 ◽

2017 ◽

pp. 135-141

Author(s):

Lam Chi Ha ◽

Van Thang Vo ◽

Thi Hue Man Vo

Keyword(s):

Job Satisfaction ◽

Cross Sectional Study ◽

Public Hospitals ◽

Cross Sectional ◽

The Public ◽

Satisfaction Rate ◽

Clinical Departments ◽

Nurses And Midwives ◽

Caring Service

Introduction: Caring service provided by nurses was one of the main factor of medical service system of Viet Nam. During recent years, nurses and midwives service had made significant progress in improving the quality of health caring service. However, jobs of nurses and midwives in Vietnam were still facing some problems and challenges: lack of both quality and quantity, discrepant structure. This study aimed to evaluate the human resource situation as well as the satisfaction level of nurse and midwife staff in state –run local hospitals, which would be the foundation for the plan of developing nurse and midwife system in order to satisfy the healthcare need of the patients. Objectives: To investigate the satisfaction rate and satisfaction involved factors with particular jobs of nurses and midwives at treatment systems in the public hospitals in Quang Tri province in year 2015. Data was collected using self-administrative questionnaires and entered and analysed by the statistical software of SPSS Version 20.0. Methodology: A cross sectional study was carried out in Dec. 2015 on a total of 433 nurses, midwives working at clinical departments of 12 governmental hospitals in Quang Tri province. Results: General job satisfaction rate with the particular jobs was 52.9%. Factors involving satisfaction of nurses, midwives with their jobs included: working position, hospital level of care, clinical departments, and monthly income getting from hospital (p<0.05). Conclusions: It was highly necessary to improve working conditions and environment, and income, to ensure treatment regimens and policies, to make further training and higher working position feasible, to heighten role and responsibility on working and to develop hospital in order to raise the satisfaction rate of nurses and midwives, and hence to enhance the quality of patient care in hospitals. Key words: Nurses, midwives, satisfaction, quality of care

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Assessment of drug use pattern using WHO core drug use indicators in selected general hospitals: a cross-sectional study in Tigray region, Ethiopia

BMJ Open ◽

10.1136/bmjopen-2020-045805 ◽

2021 ◽

Vol 11 (10) ◽

pp. e045805

Author(s):

Segen Gebremeskel Tassew ◽

Haftom Niguse Abraha ◽

Kidu Gidey ◽

Abadi Kahsu Gebre

Keyword(s):

Drug Use ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Cross Sectional ◽

General Hospitals ◽

The Public ◽

Tigray Region ◽

Use Pattern ◽

Drug Use Pattern

ObjectiveInappropriate use of medicine is a global challenge with greater impact on developing countries. Assessment of drug use pattern is used to identify gaps in medicine utilisation to implement strategies for promoting rational drug use. This study aimed to assess drug use pattern using the WHO drug use indicators in selected general hospitals in Tigray region, Ethiopia.DesignA cross-sectional study was conducted using WHO drug use indicators in two public hospitals located in Tigray.SettingPrescriptions recorded from 1 January 2017 to 1 June 2019 were randomly selected, and participants who visited the public hospitals from 1 March 2019 to 30 August 2019 and hospital pharmacies were interviewed.Participants100 patients who visited both outpatient clinics and hospital pharmacy departments of the public hospitals.ResultsThe average number of medicines per prescription was 1.69 (±0.81). Prescriptions containing antibiotics and injectables were 58.2% and 15.9%, respectively. The percentages of medicines prescribed with a generic name from essential medicines list of Ethiopia were 97.5% (974) and 88.1% (970) in Mekelle Hospital and Quiha Hospital, respectively. The patients spent an average of 6.6(±3.5) min with their general practitioners, while only 22.8 (±21.7) s with their pharmacists. Of the patients interviewed, 56.9% knew their dosing regimen and 32.7% of them had their medication labelled.ConclusionThe finding of the present study revealed deviation of drug use pattern from the WHO optimal levels suggesting the hospitals had limitations in appropriate utilisation of medicines. Understanding the factors attributed to the observed gaps and implementing corrective measures are required to conform with the recommended standards of appropriate drug utilisation.

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Factors Influencing the Degree of Physician-pharmacists Collaboration within governmental Hospitals of Jigjiga Town, Ethiopia

10.21203/rs.3.rs-558202/v1 ◽

2021 ◽

Author(s):

Workineh Diriba Gemmechu ◽

Endalkachew Mekonnen Eticha

Keyword(s):

Multiple Regression ◽

Collaborative Care ◽

Cross Sectional Study ◽

Public Hospitals ◽

Cross Sectional ◽

The Public ◽

Relationship Initiation ◽

Factors Influencing ◽

Relationship Model ◽

Collaborative Working

Abstract Background: Inter-professional collaboration can improve medication safety, patient outcome and minimize healthcare costs. This study aimed to explore the degree of collaboration and factors influencing collaboration between the physicians and pharmacists within the public hospitals of Jigjiga town, Ethiopia. Methods: A cross-sectional study was conducted among 149 participants in the two governmental hospitals of the Jigjiga town with a response rate of 79.87%. The collaborative working relationship model and the physician-pharmacist collaborative instrument with three main exchange domains (trustworthiness, role specification, and relationship initiation) and collaborative care items were used. An independent sample t-test was used to compute the differences of the mean scores of physician-pharmacist collaborative instrument domains and collaborative care. Separate multiple regression was employed to assess factors influencing collaborative care for pharmacists and physicians. Results: This study showed that pharmacists reported higher mean of collaborative care (10.66 ± 4.75) than physicians (9.17 ± 3.92). The multiple regression indicated that area of practice influence both professionals’ collaborative practice. A significant association between collaborative care and the two PPCI domains (trustworthiness and relationship initiation for the physicians; role specification and relationship initiation for pharmacists) was established. Conclusion: The study showed that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant influence on their collaboration.

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Collaboration among healthcare professionals at the public hospitals in Gaza: a quantitative study

Journal of Integrated Care ◽

10.1108/jica-09-2020-0057 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Iyad Ibrahim Shaqura ◽

Radwan Baroud ◽

Ali Akbari Sari

Keyword(s):

Healthcare Professionals ◽

Assessment Tool ◽

Interprofessional Collaboration ◽

Statistical Significance ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Cross Sectional ◽

Content Type ◽

The Public

PurposeThis study aimed at assessing the current interprofessional collaboration (IPC) among healthcare professionals at the public hospitals in the Gaza Strip in 2016 through measuring the average level, and also examind the influence of professionals' characteristics on their collaboration.Design/methodology/approachA quantitative, cross-sectional study using a valid and reliable self-administered questionnaire on a 5-point Likert scale was conducted. A total of 323 participants from six health professions completed the questionnaire which was analyzed using SPSS version 20 by applying descriptive tests, t-test, ANOVA and inferential analysis (Scheffe test); the statistical significance was considered at p = 0.05.FindingsThe interprofessional collaboration was moderate (71.66%). “General relationships” elicited the highest mean score (3.943) due to participants' belief in its importance, whereas “community linkages and coordination of care” was the lowest (3.181) as a result of the restricted policy in this regard. Gender, age, profession and position have shown statistically significant variables on the overall collaboration. In short, there are differences in the performance of IPC domains and even within items of the same domain.Research limitations/implicationsThis study was conducted at only public hospitals; in addition, it was a cross-sectional study, so the causation relationships are difficult to assess. Moreover, the questionnaire was on self-administered basis which might result in misread or misunderstood bias.Originality/valueThis was the first study in the Palestinian context on collaboration between multiple professions using a comprehensive and reliable assessment tool.

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Low Back Pain and Its Associated Factors among Nurses in Public Hospitals of Penang, Malaysia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16214254 ◽

2019 ◽

Vol 16 (21) ◽

pp. 4254 ◽

Cited By ~ 2

Author(s):

Mohd Ismail Ibrahim ◽

Izani Uzair Zubair ◽

Najib Majdi Yaacob ◽

Mohd Izmi Ahmad ◽

Mohd Nazri Shafei

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Associated Factors ◽

Cross Sectional Study ◽

The Body ◽

Public Hospitals ◽

Low Back ◽

Cross Sectional ◽

The Public ◽

Manual Handling

Objectives: To determine the prevalence of low back pain (LBP) and its associated factors among the nurses working in the public hospitals of Penang, Malaysia. Methods: A cross-sectional study was conducted on nurses, aged 25–60 years, who had been working for at least three months at six public hospitals of Penang. A proportionate stratified random sampling method was applied to select 1292 respondents. The Malay-validated BACKS Tool questionnaire using a 5-point Likert scale was used to obtain data. Simple and multiple logistic regression analyses were performed. Results: A total of 989 (76.5%) nurses suffered from LBP at a point of time. The factors significantly associated with LBP among the nurses included working more than seven hours [adjusted odds ratio (AOR) (95% confidence interval (CI)) 1.48 (1.06, 1.98)], twisting of the body while working [AOR (95% CI) 1.60 (1.13, 2.26)], manual handling of patients in wards [AOR (95% CI) 1.44 (1.08, 2.07)], and fatigue [AOR (95% CI) 2.63 (1.94, 3.58)]. Conclusion: The prevalence of LBP among the nurses in the public hospitals of Penang was relatively high. The factors predicting LBP included working more than seven hours a day, twisting of the body while working, manual handling, and fatigue. The findings from this study may better enable policymakers to devote resources to minimize low back pain among nurses. The nurses should be encouraged to comply with safe working procedures.

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