Assessment of Knowledge and Practices of Staff Nurses towards Infectious Diseases Isolation Precautions in Tertiary Care Hospitals: A Multi-Center Study

Abstract Background For every newborn who dies within the first month after birth, as many as eight more suffer life-threatening complications but survive. Such events, termed ‘neonatal near-misses’, are becoming increasingly important indicators for epidemiologic surveillance and quality of care assessment. However, to date, there is no universally agreed-upon definition of a neonatal near-miss (NNM) nor a standard assessment mechanism. This study sought to describe the development of the Neonatal Near-Miss Assessment Tool (NNMAT) for low-resource settings, identify the incidence of NNM at three tertiary care hospitals in Ghana, compare the incidence rates of NNM to institutional records of neonatal mortality, and identify the strongest predictors of death when comparing NNM cases to those who died. Methods This prospective, observational, multi-center study was conducted at three tertiary care hospitals in southern Ghana from April – July 2015. Newborns with evidence of complications and those admitted to the NICUs were screened for inclusion using the NNMAT. Incidence of NNM was determined and compared against institutional neonatal mortality rates. NNM cases were compared with newborns not classified as near-misses and followed to 28 days to determine odds of survival. The main outcome measures were incidence of NNM, NNM:mortality ratio, and factors associated with NNM classification. Results Out of 735 newborns with complications, 578 (approximately 80%) were classified as near-misses using the NNMAT. Those newborns with complications who were classified as near-misses using the NNMAT had eight times the odds of dying before 28 days than those classified as non-near-misses. While most newborns qualified as NNM via intervention-based criteria, nearly two-thirds (approximately 65%) of newborns qualified based on two or more of the four NNMAT categories. When disaggregated, the most predictive elements of the NNMAT were gestational age < 33 weeks, presence of a major congenital abnormality, neurologic dysfunction and respiratory dysfunction. The ratio of near-misses to deaths was slightly less than 1:1, yet this varied widely across the three study sites. Conclusions This research suggests that the NNMAT is an effective tool for assessing neonatal near-misses in low-resource settings. We believe this approach has significant systems-level, continuous quality improvement, clinical and policy-level implications.

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CIScoSI Study [Children Immunization Status and cases of Systemic Illness]

Medical & Clinical Research ◽

10.33140/mcr.03.03.02 ◽

2018 ◽

Vol 3 (3) ◽

Keyword(s):

Infectious Diseases ◽

East Asia ◽

Pediatric Patients ◽

Severe Disease ◽

Tertiary Care ◽

Immunization Coverage ◽

South East Asia ◽

Immunization Status ◽

Tertiary Care Hospitals ◽

Total Coverage

To determine the immunization status of pediatric patients under age of 5 years visiting pediatric department of tertiary care hospitals in South East Asia. The aim of this study was to appreciate the awareness and implementation of vaccination in pediatric patients who came into pediatric outpatient Department with presenting complain other than routine vaccination. we can also know the count of patients who do not complete their vaccination after birth. we can differentiate between vaccinated and unvaccinated patients and incidence of severe disease in both groups. Immunization is a protective process which makes a person resistant to the harmful diseases prevailing in the community, typically by vaccine administration either orally or intravenously. It is proven for controlling and eliminating many threatening diseases from the community. WHO report that licensed vaccines are available for the prevention of many infectious diseases. After the implementation of effective immunization the rate of many infectious diseases have declined in many countries of the world. South-East Asia is far behind in the immunization coverage. An estimated total coverage is 56%-88% for a fully immunized child, which is variable between countries. Also the coverage is highest for BCG and lowest for Polio.

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Efficacy of interventional package on knowledge regarding tracheostomy care among staff nurses in tertiary care Hospitals, Udaipur (Rajasthan)

International Journal of Nursing Education ◽

10.5958/0974-9357.2018.00073.9 ◽

2018 ◽

Vol 10 (3) ◽

pp. 87

Author(s):

Rakhi Gaur ◽

Shiv Kumar Mudgal

Keyword(s):

Tertiary Care ◽

Staff Nurses ◽

Tertiary Care Hospitals

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Adequacy of equipment available for the insertion of chest drains in tertiary care units in Sri Lanka: a multi center study

Sri Lanka Journal of Surgery ◽

10.4038/sljs.v36i1.8473 ◽

2018 ◽

Vol 36 (1) ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

D.V.T. Harischandra ◽

H.V.G. Hewage ◽

L. Amarashriyan ◽

K. Indrapala ◽

N. Perera ◽

...

Keyword(s):

Sri Lanka ◽

Tertiary Care ◽

Multi Center Study ◽

Center Study

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Nature of dispensing errors in selected hospitals providing free healthcare: a multi-center study in Sri Lanka

BMC Health Services Research ◽

10.1186/s12913-020-05968-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

R. A. N. Dilsha ◽

H. M. I. P. Kularathne ◽

M. T. M. Mujammil ◽

S. M. M. Irshad ◽

N. R. Samaranayake

Keyword(s):

Sri Lanka ◽

Tertiary Care ◽

Sri Lankan ◽

Cross Sectional ◽

Free Healthcare ◽

Clinically Significant ◽

Multi Center Study ◽

Dispensing Error ◽

Dispensing Errors ◽

Center Study

Abstract Background Dispensing errors, known to result in significant patient harm, are preventable if their nature is known and recognized. However, there is a scarcity of such data on dispensing errors particularly in resource poor settings, where healthcare is provided free-of-charge. Therefore, the purpose of this study was to determine the types, and prevalence of dispensing errors in a selected group of hospitals in Sri Lanka. Methods A prospective, cross sectional, multi-center study on dispensing errors was conducted, in a single tertiary care, and two secondary care hospitals, in a cohort of 420 patients attending medical, surgical, diabetic and pediatric clinics. The patients were selected according to the population size, through consecutive sampling. The prescription audit was conducted in terms of dispensing errors which were categorized as i) content, ii) labelling, iii) documentation, iv) concomitant, and v) other errors based on in-house developed definitions. Results A total of 420 prescriptions (1849 medicines) were analyzed (Hospital-I, 248 prescriptions-1010 medicines; Hospital-II, 84 prescriptions-400 medicines; Hospital-III, 88 prescriptions-439 medicines), and a cumulative total of 16,689 dispensing errors (at least one dispensing error in a prescription) were detected. Labelling errors were the most frequent dispensing error (63.1%; N = 10,523; Mostly missing information on the dispensing label), followed by concomitant prescribing and dispensing errors (20.5%; N = 3425; Missing prescribing information overlooked by the pharmacist), documentation errors (10.6%; N = 1772 Missing identification of pharmacist on dispensing label), clinically significant medication interactions overlooked by pharmacists (0.5%; N = 82), content errors (4.9%; N = 812; Discrepancies between medication dispensed and prescription order), medications dispensed in unsuitable packaging (0.4%; N = 74), and lastly medication dispensed to the wrong patient (0.01%; N = 1). Conclusions Dispensing errors are frequent in Sri Lankan hospitals which operate with limited resources and provide free healthcare to all citizenry. Over one half of the errors were labeling errors with minimal content errors. Awareness on common types of dispensing errors and emphasis on detecting them could improve medication safety in Sri Lankan hospitals.

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