scholarly journals The Prevalence and Characters of Pressure Injuries in Hospital: A Hospital Study in Southeast China

2021 ◽  
Author(s):  
Jie Xu ◽  
Xiaofang Deng ◽  
Caixia Sun ◽  
Xiaoyun Pan
Keyword(s):  
Tertiary Hospital ◽  
General Information ◽  
Southeast China ◽  
Epidemiological Features ◽  
Braden Scale ◽  
Number Of Patients ◽  
Scale Scores ◽  
The Moment ◽  
Hospital Acquired ◽  
Hospital Study

Abstract Background and objective: Hospital-acquired pressure injuries (HAPIs) carry many adverse consequences (such as pain, wound odors, long lengths of hospital stay), and are a concern internationally. The aim of this study was to describe the incidence, clinical and epidemiological features of HAPI in a tertiary hospital. Methods A retrospective, qualitative study was conducted from 2017 to 2018. A questionnaire was designed around the existing literature about HAPI, including general information, Braden Scale scores (on admission, the moment that patients developed HAPI, and discharge), and the assessment of HAPI. Results 419 patients had HAPI, representing an incidence of 0.12%. On average, patients developed HAPI after 12 days. The intensive care unit (ICU; 79,18.9%) saw the largest number of patients with HAPI. HAPIs were most commonly at Stage 2 (71.4%) and of a sacral location (42.3%). Braden Scale scores at first development of HAPI were lower than those on admission or discharge (with a low score signifying high risk). Conclusion The incidence of HAPI in a tertiary hospital was lower than at other hospitals. Braden Scale scores predicted the highest HAPI risk occurring at the point where HAPI were first developed.

scholarly journals Protection and Response of a Tertiary Hospital in Shenzhen, China to the COVID-19 Outbreak—the Practice of the Comprehensive Response Mode

2021 ◽  
pp. 1-17
Author(s):  
Benling Hu ◽  
Le Yang ◽  
Chan Wei ◽  
Min Luo
Keyword(s):  
Prevention And Control ◽  
Tertiary Hospital ◽  
Control Model ◽  
Normal Operation ◽  
Process Reengineering ◽  
Equipment Management ◽  
Hospital Acquired Infection ◽  
Public Health Emergencies ◽  
Hospital Acquired ◽  
And Control

ABSTRACT Objective: To evaluate the management mode for the prevention and control of coronavirus 2019 (COVID-19) transmission utilized at a general hospital in Shenzhen, China, with the aim to maintain the normal operation of the hospital. Methods: From January 2, 2020 to April 23, 2020, Hong Kong–Shenzhen Hospital, a tertiary hospital in Shenzhen, has operated a special response protocol named comprehensive pandemic prevention and control model, which mainly includes six aspects: 1) human resource management; 2) equipment management; 3) logistics management; 4) cleaning, disinfection and process reengineering; 5) environment layout; 6) and training and assessment. The detail of every aspect was described and its efficiency was evaluated. Results: A total of 198,802 patients were received. Of those, 10,821 were hospitalized; 26,767 were received by the emergency department and fever clinics; 288 patients were admitted for observation with fever; and 324 were admitted as suspected cases for isolation. Under the protocol of comprehensive pandemic prevention and control model, no case of hospital-acquired infection with COVID-19 occurred among the inpatients or staff. Conclusion: The present comprehensive response model may be useful in large public health emergencies to ensure appropriate management and protect the health and life of individuals.

scholarly journals A comparative two-cohort study of pediatric patients with long term stay in ICUs

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julia García Mancebo ◽  
Sara de la Mata Navazo ◽  
Estíbaliz López-Herce Arteta ◽  
Rosario Montero Mateo ◽  
Isabel María López Esteban ◽  
...  
Keyword(s):  
Healthcare Resources ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Number Of Patients ◽  
Single Center Study ◽  
High Flow Oxygen ◽  
Hospital Acquired ◽  
Complications And Mortality ◽  
Second Period

AbstractDuring the last decades, the number of patients with long stay admissions (LSA) in PICU has increased. The purpose of this study was to identify factors associated with PICU LSA, assessing healthcare resources use and changes in the profile of these patients. A retrospective, observational, single-center study was carried out. Characteristics of LSA were compared between two periods (2006–2010 and 2011–2015). During the earlier period there were 2,118 admissions (3.9% of them LSA), whereas during the second period, there were 1,763 (5.4% of them LSA) (p = 0.025). LSA accounted for 33.7% PICU stay days during the first period and 46.7% during the second (p < 0.001). Higher use of non-invasive ventilation (80.2% vs. 37.8%, p = 0.001) and high-flow oxygen therapy (68.8% vs. 37.8%, p = 0.005) was observed in the 2011–2015 cohort, whereas the use of arterial catheter (77.1% vs. 92.6%, p = 0.005), continuous infusion of adrenaline (55.2% vs. 75.9%, p = 0.004), and hemoderivative transfusion (74% vs. 89.2%, p = 0.010) was less frequent. In the 2006–2010 cohort, hospital-acquired infections were more common (95.2% vs. 68.8%, p < 0.001) and mortality was higher (26.8% vs. 13.8%, p = 0.026). The number of long-stay PICU admissions have increased entailing an intensive use of healthcare resources. These patients have a high risk for complications and mortality.

scholarly journals Clinical and financial impacts of introducing an endoscopic mucosal resection service for treatment of patients with large colonic polyps into a regional tertiary hospital

2019 ◽  
Vol 07 (11) ◽  
pp. E1386-E1392
Author(s):  
Thomas Worland ◽  
Oliver Cronin ◽  
Benjamin Harrison ◽  
Linda Alexander ◽  
Nik Ding ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Surgical Procedures ◽  
Colonic Polyps ◽  
Tertiary Hospital ◽  
Safe Alternative ◽  
Intention To Treat ◽  
Mucosal Resection ◽  
Regional Center ◽  
Financial Benefits ◽  
Number Of Patients

Abstract Background and study aims Endoscopic mucosal resection (EMR) of large sessile or laterally spreading colonic lesions is a safe alternative to surgery. We assessed reductions in Surgical Resection (SR) rates and associated clinical and financial benefits following the introduction of an EMR service to a large regional center. Patients and methods Ongoing prospective intention-to-treat analysis of EMR was undertaken from time of service inception in 2009 to 2017. Retrospective data for SR of large sessile/laterally spreading colonic lesions were collected for the period 4 years before commencement of the EMR service (2005 – 2008) and 9 years after its introduction (2009 – 2017). Results From 2005 to 2008, 32 surgical procedures were performed for non-malignant colonic neoplasia (50 % male, median age 68 years, median Length of Stay (LoS) 10 days). Following the introduction of the EMR service, there was a 56 % reduction in the number of patients referred for surgery (32 surgical procedures, 47 % male, median age 70 years, median LoS 8.5 days). During this period, EMR was successfully performed in 183 patients with 216 lesions resected (60 % male, median age 68 years, median LoS 1 day). Compared to the SR group, the EMR cohort had a lower peri-procedural complication rate (7.7 % vs 54.7 %, P < 0.0001), and shorter average LoS (1 vs 9 days, P < 0.0001). A cost saving of AUD $ 19 543.5 was seen per lesion removed with EMR compared to SR. Conclusions The introduction of a dedicated EMR service into a large regional center as an alternative to SR can lead to a substantial decrease in unnecessary surgery with subsequent clinical and financial benefits.

scholarly journals Impact of the COVID-19 Pandemic on the Patient’s Decision about Bariatric Surgery: Results of a National Survey

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 756
Author(s):  
Maciej Walędziak ◽  
Anna Różańska-Walędziak ◽  
Paweł Bartnik ◽  
Joanna Kacperczyk-Bartnik ◽  
Andrzej Kwiatkowski ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Online Survey ◽  
Negative Impact ◽  
Weight Loss Surgery ◽  
General Information ◽  
Open Questions ◽  
Increased Risk ◽  
Bariatric Patients ◽  
The Moment ◽  
The Impact

Background: the COVID-19 pandemic and the implemented restrictions have changed the functioning of healthcare systems worldwide. The purpose of the study was to evaluate the impact of the present epidemiological situation on patients’ decisions about undergoing weight loss surgery. Methods: data were collected from 906 bariatric patients by the means of a national online survey, the majority of whom were women (87.9%). The survey started on 9 April 2020 and was open until 28 April 2020. The questionnaire included multiple choice and open questions, divided into three chapters: general information about the patient, life during the COVID-19 pandemic, and bariatric care during the COVID-19 pandemic. Results: despite the pandemic and the associated risk of COVID-19 infection, 443 responders (48.9%) would have decided to undergo bariatric surgery. Awareness of the negative impact of obesity on the course of COVID-19 illness had only marginable impact on patients’ decision-making (76.6% vs. 75.3%; p < 0.80). Contact with COVID-19 prior to the survey had a negative impact on the willingness to undergo bariatric surgery (3.0% vs. 4.4%; p < 0.55). There was a positive correlation between the BMI and preference for bariatric surgery in the time of the pandemic (37.4 ± 9.0 vs. 34.9 ± 8.7; p < 0.001). Conclusions: the level of awareness about the advantages of operative treatment of obesity is high among bariatric patients. The majority of patients awaiting bariatric surgery at the moment of the survey were positive about undergoing bariatric surgery despite the increased risk of a serious course of COVID-19 infection. Therefore, a large proportion of patients was determined to have bariatric treatment even during the pandemic, being aware of the increased risk of worse pace of COVID-19 disease in case of obesity and related diseases.

Factors associated with pressure ulcer onset after knee replacement

2021 ◽  
Vol 30 (11) ◽  
pp. 924-929
Author(s):  
Cristiana Forni ◽  
Nicola Cerantola ◽  
Gianfranco Ferrarelli ◽  
Luana Lombrosi ◽  
Andrea Bolzon ◽  
...  
Keyword(s):  
Knee Replacement ◽  
Predictive Factors ◽  
Conflicts Of Interest ◽  
Area Under The Curve ◽  
Factors Associated ◽  
Replacement Surgery ◽  
Braden Scale ◽  
Combined Use ◽  
Number Of Patients ◽  
Knee Replacements

Objective: The aim of this study was to find the rate of pressure ulcers (PUs) in patients with knee replacements and identify predictive factors. The ability of the Braden scale to predict the onset of PUs was also investigated. Method: A retrospective prognostic cohort study was carried out involving all consecutive patients undergoing knee replacement surgery. The data were collected from patient records. The variables collected were grouped into two categories: those connected to the patient's own characteristics; and those linked to the care methods used. Results: The total number of patients included in the study was 565. Of these, 2.3% had developed a PU: 0.5% at the heel and 1.8% at the sacrum. Multivariate analysis showed that the variables actually correlated to the outcome were age (p=0.074; odds ratio (OR)=1.08), body mass index (BMI, p=0.037; OR=1.13) and Braden scale (p=0.029; OR=0.72). A combination of these three parameters showed better predictivity of PUs (area under the curve (AUC) 84%). Conclusion: Age, BMI and preoperative Braden score were shown to be independent predictive factors of the onset of PUs in patients with knee replacements. The combined use of all three variables increased the ability to identify the patients at most risk of developing a PU. Declaration of interest: The study was financed by the Professional Nurse Register of Bologna as winner of a competition for research projects in the province of Bologna. The authors declare no conflicts of interest.

Abstract WMP118: In Safe Hands: Implementation on the Stroke Unit. Does it Improve Patient Care and Ward Efficiency?

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Sheila M Jala ◽  
Sarah Giaccari ◽  
Melissa Passer ◽  
Carin Bertmar ◽  
Susan Day ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Stroke Unit ◽  
Oral Intake ◽  
Improve Patient Care ◽  
Tertiary Hospital ◽  
Study Data ◽  
Acute Hospital ◽  
Staff Satisfaction ◽  
Number Of Patients ◽  
Significant Difference

The ‘In Safe Hands” (ISH) is a structured interdisciplinary bedside round developed to increase patients participation in their care in acute hospital wards. This has shown to improve quality of care by reducing communication errors and complications, enhancing a culture of safety in an acute hospital. The purpose of this study was to assess the effect of ISH on length of stay (LOS), in-hospital complications and assess whether the ISH enhances patient and staff satisfaction in a stroke unit of a tertiary hospital in Sydney, Australia. This was a longitudinal study pre and post implementation. A total of 200 patients participated in the study. Data on the length of stay, incidence rate relating to patient safety and patient and staff satisfaction surveys using Patient Experience Tracker (PET) devices were collected pre and post implementation. ISH increased the number of patients with at least 72hours in stroke unit care by 80 percent (P < 0.001). Fever and hyperglycaemia were treated in all patients following ISH implementation vs only 50% and 64% respectively of patients pre ISH implementation. Swallow screen was completed in all patients prior oral intake compared to 92% of patients of the pre ISH group (P = 0.03). There was no significant difference in the LOS and complications. All stroke patients received stroke education and there were no readmissions post implementation. There was no significant difference in the patient and staff satisfaction. In conclusion, although ISH did not improve the primary endpoints of LOS, complications and satisfaction it did improve protocol adherence.

Clinical Characteristics and Therapeutic Results in a Series of 68 Patients with Occipital Neuralgia

Pain Medicine ◽  
2019 ◽  
Author(s):  
Enrique Martínez-Pías ◽  
Javier Trigo-López ◽  
David García-Azorín ◽  
Aisling McGreal ◽  
Ángel Luis Guerrero Peral
Keyword(s):  
Clinical Characteristics ◽  
Negative Impact ◽  
International Headache Society ◽  
Tertiary Hospital ◽  
Occipital Neuralgia ◽  
Headache Disorders ◽  
Number Of Patients ◽  
Therapeutic Results ◽  
Prolonged Latency

Abstract Objective Cranial pain is a condition that has a negative impact on human lives, and occipital neuralgia is among its causes. This study aims to evaluate the clinical characteristics and therapeutic results of a series of patients with occipital neuralgia. Design Prospective registry (observational study). Settings Headache outpatient clinic in a tertiary hospital. Subjects Sixty-eight cases. Methods Demographic and nosological characteristics have been analyzed, as well as treatment response of occipital neuralgia. All patients were recruited between January 2008 and January 2018, and the diagnosis of occipital neuralgia was made according to the International Headache Society (International Classification of Headache Disorders) criteria being utilized at the time of diagnosis. Results Sixty-eight patients were diagnosed with occipital neuralgia, which corresponded to 1.2% of the total number of patients (5,515) who visited our Headache Unit during the aforementioned period. Fifty-four (79.4%) of them were female. Baseline pain was present in 62 (91.1%) patients, and exacerbations in 42 (61.8%). Latency from onset (range) was 27.7 ± 56.1 (1–360) months. Conclusions Occipital neuralgia is an uncommon disorder in the sample explored. The prolonged latency between the onset of symptoms and diagnosis suggests that there should be an increased awareness of this disorder.

The Effect of Distraction during Labor Induction on Timing of Analgesia Request: A Randomized Clinical Trial

2019 ◽  
Vol 36 (13) ◽  
pp. 1351-1356
Author(s):  
C. Luke Dixon ◽  
Luis Monsivais ◽  
Petra Chamseddine ◽  
Gayle Olson ◽  
Luis D. Pacheco ◽  
...  
Keyword(s):  
Video Games ◽  
Pregnant Women ◽  
Pain Medication ◽  
Labor Induction ◽  
Chi Square ◽  
Number Of Patients ◽  
Scale Scores ◽  
Pain Outcomes ◽  
Pain Visual Analog Scale ◽  
Secondary Outcomes

Objective To assess whether distraction using music and/or video games influences timing of analgesia request and improves pain outcomes in women undergoing labor induction. Study Design A total of 219 pregnant women with singleton gestation undergoing labor induction with a Foley bulb (FB) at term were randomized to distraction with music and video games via iPod (n = 109) or no iPod (n = 110). The primary outcome was the time from FB placement to request for pain medication. Secondary outcomes included number of patients requesting pain medication within 6 and 12 hours, type of pain medication received, pain visual analog scale scores, and patient satisfaction. Mann–Whitney's, chi-square, Kaplan–Meier's curves, and Pearson's product moment correlation were used for statistical analysis (significance: p < 0.05). Results Baseline characteristics were similar between the two groups. There was no difference in the time from FB placement until pain medication request between the groups. There were no significant differences in secondary outcomes. Increased per cent time of iPod use correlated with a longer time until pain medication request (R 2 = 0.22, p = 0.03). Conclusion We were not able to show that distraction using music and video games delays timing of analgesia request or improve pain outcomes in pregnant women undergoing mechanical labor induction at term.

scholarly journals Clinical characteristics and outcomes of inpatients with neurologic disease and COVID-19 in Brescia, Lombardy, Italy

Neurology ◽  
2020 ◽  
Vol 95 (7) ◽  
pp. e910-e920 ◽  
Author(s):  
Alberto Benussi ◽  
Andrea Pilotto ◽  
Enrico Premi ◽  
Ilenia Libri ◽  
Marcello Giunta ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Cerebrovascular Disorders ◽  
Laboratory Data ◽  
Hospital Death ◽  
Neurologic Disease ◽  
Neurologic Diseases ◽  
Number Of Patients ◽  
Failure Assessment ◽  
Scale Scores ◽  
Qsofa Score

ObjectiveTo report clinical and laboratory characteristics, treatment, and clinical outcomes of patients admitted for neurologic diseases with and without coronavirus disease 2019 (COVID-19).MethodsIn this retrospective, single-center cohort study, we included all adult inpatients with confirmed COVID-19 admitted to a neuro-COVID unit beginning February 21, 2020, who had been discharged or died by April 5, 2020. Demographic, clinical, treatment, and laboratory data were extracted from medical records and compared (false discovery rate corrected) to those of neurologic patients without COVID-19 admitted in the same period.ResultsOne hundred seventy-three patients were included in this study, of whom 56 were positive and 117 were negative for COVID-19. Patients with COVID-19 were older (77.0 years, interquartile range [IQR] 67.0–83.8 years vs 70.1 years, IQR 52.9–78.6 years, p = 0.006), had a different distribution regarding admission diagnoses, including cerebrovascular disorders (n = 43, 76.8% vs n = 68, 58.1%), and had a higher quick Sequential Organ Failure Assessment (qSOFA) score on admission (0.9, IQR 0.7–1.1 vs 0.5, IQR 0.4–0.6, p = 0.006). In-hospital mortality rates (n = 21, 37.5% vs n = 5, 4.3%, p < 0.001) and incident delirium (n = 15, 26.8% vs n = 9, 7.7%, p = 0.003) were significantly higher in the COVID-19 group. Patients with COVID-19 and without COVID with stroke had similar baseline characteristics, but patients with COVID-19 had higher modified Rankin Scale scores at discharge (5.0, IQR 2.0–6.0 vs 2.0, IQR 1.0–3.0, p < 0.001), with a significantly lower number of patients with a good outcome (n = 11, 25.6% vs n = 48, 70.6%, p < 0.001). In patients with COVID-19, multivariable regressions showed increasing odds of in-hospital death associated with higher qSOFA scores (odds ratio [OR] 4.47, 95% confidence interval [CI] 1.21–16.5, p = 0.025), lower platelet count (OR 0.98, 95% CI 0.97–0.99, p = 0.005), and higher lactate dehydrogenase (OR 1.01, 95% CI 1.00–1.03, p = 0.009) on admission.ConclusionsPatients with COVID-19 admitted with neurologic disease, including stroke, have a significantly higher in-hospital mortality and incident delirium and higher disability than patients without COVID-19.

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