scholarly journals Developing a Dashboard Software for the ICUs and Studying its Impact on Reducing the Ventilator-Associated Pneumonia

2018 ◽  
Vol 12 (1) ◽  
pp. 42-50
Author(s):  
Mohammad Fathi ◽  
Hamid Moghaddasi ◽  
Azamossadat Hosseini ◽  
Monir Ebrahimi Aghdam
Keyword(s):  
User Satisfaction ◽  
Pilot Project ◽  
Point Of View ◽  
P Value ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Organizations ◽  
Survey Tool ◽  
Usability Assessment ◽  
Before And After ◽  
The Impact

Objective: Ventilator-Associated Pneumonia (VAP), a lung infection developing in patients on a ventilator in Intensive Care Units (ICU), is the second most common nosocomial infection and a leading cause of morbidity and mortality in ICUs. To reduce the incidence rate of VAP complication, many healthcare organizations have already developed certain strategies and guidelines. However, there are still high rates of VAP infections mainly due to: conflicting guidelines from different sources, implementing the guidelines at different times and conditions, different ICU caregivers at different shifts, and of course the human mistakes. Methods: The present study aimed to develop a dashboard to help reducing VAP incidences in ICUs. To achieve the objective of the research, first, the VAP prevention guidelines were compiled. The object-oriented analysis approach was adopted for designing of the dashboard software. To assess the impact of the developed dashboard on the reduction of VAP events, a pilot hospital was selected and a pilot project was prepared. For the dashboard usability assessment based on user satisfaction, a questionnaire was developed as the survey tool. Conclusion: The dashboard was developed and put into operation in a pilot ICU. The results from the t-test (with a probable error of 0.05 percent) indicated a meaningful difference between the number of VAP patients before and after the dashboard implementation with p-value ˂ 0.02. Also, the developed software was evaluated from a usability point of view based on user satisfaction, with health professionals and caregivers of the pilot ICU as the users of the software. The total score was equivalent to 95 percent, falling within the acceptable range of 75-100 percent.

scholarly journals effects of anemia education using web-based she smart to improve knowledge, attitudes, and practice in adolescent girls

2022 ◽  
Vol 5 (1) ◽  
pp. 44-49
Author(s):  
Ernawati Ernawati ◽  
Yusring Sanusi Baso ◽  
Healthy Hidayanty ◽  
Syafruddin Syarif ◽  
Aminuddin Aminuddin ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Statistical Tests ◽  
Sampling Technique ◽  
P Value ◽  
Growth Disorders ◽  
Normal Numbers ◽  
Web Based ◽  
Before And After ◽  
Smart Education ◽  
The Impact

Anemia is a state of hemoglobin levels in the bloodless than normal numbers according to the sex and age group. The impact of anemia in adolescents is a decrease in achievement and learning spirit and can cause symptoms such as paleness, lethargy, decreased appetite, and growth disorders. Anemia has an impact not only on the health of adolescent girls but can have a long impact on the health of the mother and fetus. You can see the influence of anemia education on knowledge, attitudes, and practice. Uses the Pre-experimental method with the design of one group pretest and posttest. Sampling technique using purposive sampling with the number of 47 adolescent girls. The research was conducted at Senior High School 12 Makassar in September-October 2021. Data analysis using the McNemar test. From the results of statistical tests showed that there was an influence on the use of web-based she smart education model on the use of adolescent girls about anemia with p-value = 0.000 (p<0.05), attitude p-value = 0.016 (p<0.05) and action p-value = 0.001 (p<0.05). Anemia education using web-based she smart can improve knowledge, attitudes, and practice before and after an intervention.

scholarly journals Effects of Extracorporeal Membrane Oxygenation Initiation on Oxygenation and Pulmonary Opacities

2021 ◽  
Vol 7 (1) ◽  
pp. 6-13
Author(s):  
Kiran Batra ◽  
Manish Mohanka ◽  
Srinivas Bollineni ◽  
Vaidehi Kaza ◽  
Prabhakar Rajiah ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
P Value ◽  
Limited Data ◽  
Hospital Survival ◽  
Membrane Oxygenation ◽  
Pulmonary Physiology ◽  
Before And After ◽  
Laboratory Variables ◽  
The Difference ◽  
The Impact

Abstract Introduction There is limited data on the impact of extracorporeal membrane oxygenation (ECMO) on pulmonary physiology and imaging in adult patients. The current study sought to evaluate the serial changes in oxygenation and pulmonary opacities after ECMO initiation. Methods Records of patients started on veno-venous, or veno-arterial ECMO were reviewed (n=33; mean (SD): age 50(16) years; Male: Female 20:13). Clinical and laboratory variables before and after ECMO, including daily PaO2 to FiO2 ratio (PFR), were recorded. Daily chest radiographs (CXR) were prospectively appraised in a blinded fashion and scored for the extent and severity of opacities using an objective scoring system. Results ECMO was associated with impaired oxygenation as reflected by the drop in median PFR from 101 (interquartile range, IQR: 63-151) at the initiation of ECMO to a post-ECMO trough of 74 (IQR: 56-98) on post-ECMO day 5. However, the difference was not statistically significant. The appraisal of daily CXR revealed progressively worsening opacities, as reflected by a significant increase in the opacity score (Wilk’s Lambda statistic 7.59, p=0.001). During the post-ECMO period, a >10% increase in the opacity score was recorded in 93.9% of patients. There was a negative association between PFR and opacity scores, with an average one-unit decrease in the PFR corresponding to a +0.010 increase in the opacity score (95% confidence interval: 0.002 to 0.019, p-value=0.0162). The median opacity score on each day after ECMO initiation remained significantly higher than the pre-ECMO score. The most significant increase in the opacity score (9, IQR: -8 to 16) was noted on radiographs between pre-ECMO and forty-eight hours post-ECMO. The severity of deteriorating oxygenation or pulmonary opacities was not associated with hospital survival. Conclusions The use of ECMO is associated with an increase in bilateral opacities and a deterioration in oxygenation that starts early and peaks around 48 hours after ECMO initiation.

scholarly journals The Impact of a Policy-Based Multicomponent Nutrition Pilot Intervention on Young Adult Employee’s Diet and Health Outcomes

2018 ◽  
Vol 33 (3) ◽  
pp. 342-357 ◽  
Author(s):  
Désirée Schliemann ◽  
Michelle McKinley ◽  
Jayne V. Woodside
Keyword(s):  
Young Adult ◽  
P Value ◽  
Insurance Company ◽  
Diet Intervention ◽  
Work Related ◽  
Paired Samples ◽  
Before And After ◽  
Strict Diet ◽  
Pilot Intervention ◽  
The Impact

Purpose: Evaluate the effect of a policy-based, multicomponent workplace diet intervention on young adult employees’ diet and health. Design: A 6-month, single-armed pilot study with before and after assessments. Setting: Insurance company in Belfast, Northern Ireland. Participants: Employees who worked at the company throughout the intervention period were included. Employees were excluded if pregnant, breast-feeding, or following a strict diet. Intervention: Multicomponent diet intervention: ban of unhealthy foods brought into the premises, free fruit, education, individual advice, and further support. Measures: Mixed-methods approach: Diet-, health-, and work-related measures were assessed quantitatively. The campaign was evaluated quantitatively (via questionnaire) and qualitatively (via semistructured interviews). Analysis: Changes in measures were analyzed using paired samples t tests. Interviews were analyzed using thematic analysis. Results: Sixty (75.9%) staff completed all assessments. Males reduced their sugar intake on working days (−8.7% of total energy standard deviation [SD]: 20.1; P value <.01). Systolic blood pressure reduced in males and females (−3.3 SD: 9.9; P value <.05 and −8.0 SD: 7.7; P value <.001, respectively); 85.2% of staff strongly agreed/agreed that they appreciated the healthy eating ethos. This was supported by the qualitative analysis which furthermore suggested that the education, team support, individual advice, and free fruit were beneficial. Conclusion: Influencing workplace policies and offering additional dietary support could lead to meaningful changes in employees’ diet and health and may change workplace culture.

The impact of sorafenib on the treatment and survival of advanced hepatocellular carcinoma (HCC): Analysis of the National Cancer Database (NCDB) from 2004 to 2014.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15682-e15682
Author(s):  
Aman Opneja ◽  
Gino Cioffi ◽  
Asrar Alahmadi ◽  
Nirav Patil ◽  
David Lawrence Bajor ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Single Agent ◽  
Cox Proportional Hazards ◽  
P Value ◽  
Advanced Hepatocellular Carcinoma ◽  
Advanced Hcc ◽  
Cox Proportional Hazards Models ◽  
Before And After ◽  
Time Frames ◽  
The Impact

e15682 Background: HCC is a common cause of mortality in the U.S. among men and women (5thand 7th, respectively) with overall five-year survival of ~18%. Sorafenib was the only FDA approved therapy for advanced HCC from 2007 until 2018. This study analyzes trends in the treatment and survival of advanced HCC before and after sorafenib approval. Methods: Adult patients ( > 18 years) with diagnosis of HCC treated with only chemotherapy from 2004 – 2014 were identified in NCDB database. Comparisons were made between 3 time frames: 2004 – 2007 (pre-sorafenib), 2008 – 2011 (early sorafenib) and 2012 – 2014 (late sorafenib). Patients treated with single or multi-agent chemotherapy were analyzed. Cox proportional hazards models were used for univariate and multivariable analyses. Kaplan-Meier method was used for survival analysis. Results: The NCDB contained 33,136 patients with HCC diagnosed between 2004 – 2014 and treated with chemotherapy alone. Patients were generally men (77.4%), over the age of 50 years (92.4%), with an elevated AFP at diagnosis (64.4%), and had limited co-morbidities (76.0%, Charlson/Deyo score of 0-1). The T-stages were T1 (26.3%), T2 (20.5%), T3 (25.6%), and T4 (16.2%). The number and proportion of patients treated with single agent chemotherapy increased significantly during the study period: 2,733 (45.3%) pre-sorafenib, 9,723 (72.7%) early sorafenib, and 13,502 (86.1%) late sorafenib. The proportion of all HCC patients in the NCDB receiving only chemotherapy increased from 17.2% to 26.4% to 28.3% across the 3 time frames. The survival of patients with advanced HCC treated only with chemotherapy improved significantly in the early and late sorafenib cohorts compared to the pre-sorafenib cohort (10.3 months (95% CI: 9.8-10.6) vs. 12.3 months (12.0-12.7) vs. 15.5 months (15.1-15.9), p-value < 0.001). Age > 70 years, male sex, higher Charlson/Deyo score ( > 1), elevated AFP at diagnosis, and higher T-stage were associated with worse survival (p value < 0.001). Conclusions: The approval of sorafenib has dramatically increased the use of chemotherapy for the treatment of advanced HCC and has resulted in a significant survival advantage.

Identification and Analysis of Residual Stresses in the Axisymmetric Workpiece Existing before and after Machining

2016 ◽  
Vol 686 ◽  
pp. 33-38 ◽  
Author(s):  
Tadeusz Otko ◽  
Wojciech Zębala
Keyword(s):  
Point Of View ◽  
Internal Stresses ◽  
Entire Volume ◽  
Shape Accuracy ◽  
Workpiece Surface ◽  
Plastic Processing ◽  
Machining Allowance ◽  
Before And After ◽  
The Impact

Semi-manufactured parts dedicated for precise machining often have internal stresses which have remained after previous cutting and plastic processing. These stresses reside in a fixed state of balance over the entire volume of the workpiece. Removal of the machining allowance is associated with a change in the state of balance and deformation of the workpiece, which affect its dimensional and shape accuracy. The study, involving non-stress removal of precisely defined volume of the machining allowance and determination of the impact of this treatment on the deformation of the workpiece surface is presented. It is important from the point of view of dimensional tolerance of the axially symmetrical workpiece, finally processed by turning.

scholarly journals Enhancing usability using Near Field Communication for mobile application

2018 ◽  
Vol 154 ◽  
pp. 03013
Author(s):  
Endar Wihidayat ◽  
Ovide D.W. Ardi
Keyword(s):  
User Satisfaction ◽  
Mobile Application ◽  
Near Field ◽  
Point Of View ◽  
Near Field Communication ◽  
Input Device ◽  
Communication Tool ◽  
Teachers And Parents ◽  
Application Developers ◽  
The Impact

Near Field Communication (NFC) as relatively new wireless communication technology pushes new challenges to application developers to make their applications easier to use and simpler to operate. This point of view known as usability element. Usability is one of the elements for creating good quality applications. This study aims to analyse the usability of mobile-based application embeds with NFC. We also try to evaluate usability in applications used by children. We developed an application called Receptionist which has a primary function as a communication tool between students, teachers and parents at a middle school. To know the impact of the NFC, the Receptionist input system is designed with two methods, via conventional navigation (using buttons) and via NFC. To understand the usability of each method, we do user testing and questioners on students. The results show, using the NFC there is a significant increase in usability attributes: efficiency, effectiveness, and learnability. On the other hand, there is decreases of user satisfaction comparing to conventional method. In general, this study demonstrates the potential of new input device technologies that can improve the usability of mobile-based applications.

scholarly journals The Effect Of Optimization Of The Utilization Of Mother And Child's Health Book On The Attitudes Of Midwives In The Completeness Of Filling In Kia Books

2021 ◽  
pp. 72-78
Author(s):  
Morita Wibowo ◽  
Suryo Ediyono ◽  
Heni Nur Kusumawati
Keyword(s):  
Simple Random Sampling ◽  
Total Sample ◽  
Child Health Services ◽  
Control Group ◽  
P Value ◽  
Validity And Reliability ◽  
District Health ◽  
Control Group Design ◽  
Before And After ◽  
The Impact

Background: One of the efforts that have been carried out by the Ministry of Health in supporting the acceleration of MMR reduction is optimizing PONED. Apart from being poned, the use of the MCH Handbook is one way of maintaining health and obtaining quality maternal and child health services. The purpose of this study was to determine the impact of training on the optimization of the use of the MCH book on the attitudes of the PONED midwives in completing the MCH booklet filling by village midwives in the working area of ​​the Paser District Health Center.  Methods: A Quantitative research method uses Quasy Experiment nonequivalent control group design. By involving 1 control group and 1 treatment group with a total sample size of 43 midwives in each group, using simple random sampling. Data analysis using Wilcoxon. Instrument that use can measure attitudes of midwives with good validity and reliability. Results: The results showed that there were significant differences in attitudes before and after treatment with a p-value of 0,000, but the mean value of attitudes before and after showed that training could not change the attitudes of midwives. The training held is not sufficient to change the attitude of midwives in compliance with the filling of the MCH handbook. Conclusion: It needs further and intense training for all PONED and non-PONED midwives and further identification is needed about things that can motivate the attitudes of midwives to improve poned midwives towards the implementation of optimization MCH books.

scholarly journals Impact of a mobile decision support tool on antimicrobial stewardship indicators in St. John’s, Canada

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252407
Author(s):  
Daniel Doyle ◽  
Gerald McDonald ◽  
Claire Pratt ◽  
Zahra Rehan ◽  
Tammy Benteau ◽  
...  
Keyword(s):  
Decision Support ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Cost Savings ◽  
Antibiotic Use ◽  
Defined Daily Dose ◽  
Support Tool ◽  
Survey Tool ◽  
Before And After ◽  
The Impact

Objectives Inappropriate antibiotic use contributes to antimicrobial resistance. The SpectrumTM app provides antibiotic decision support, based on local antimicrobial resistance rates. We determined the impact of regional implementation of the app on inpatient antimicrobial appropriateness, inpatient antimicrobial usage (AMU), population-based Clostridioides difficile infection (CDI) rates and cost, using a retrospective, before and after quasi-experimental design, including a one-year study period. Methods The SpectrumTM app was released to prescribers in February, 2019. We performed two one-day inpatient point prevalence surveys using the National Antimicrobial Prescribing Survey tool, six months before (June 25, 2018) and six months after (June 25, 2019) app dissemination. Inpatient AMU in Defined Daily Dose/1000 patient days and CDI incidence were compared, before and after app dissemination. Results The pre-survey included 184 prescriptions, and the post-survey included 197 prescriptions. Appropriateness was 97/176 (55.1%) pre, and 126/192 (65.6%) post (+10.5%, p = 0.051). Inpatient AMU declined by 6.6 DDD/1000 patient days per month, and CDI declined by 0.3 cases per month. Cost savings associated with reduced AMU were $403.98/bed/year and associated with reduced CDI were $82,078/year. Conclusion We observed improvement in antimicrobial stewardship indicators following SpectrumTM implementation. We cannot determine the cause of these improvements.

scholarly journals HUBUNGAN LAMA HARI RAWAT DENGAN TANDA DAN GEJALA SERTA KEMAMPUAN PASIEN DALAM MENGONTROL HALUSINASI

2019 ◽  
Vol 6 (2) ◽  
pp. 106
Author(s):  
Prastiwi Puji Rahayu ◽  
Retno Utami
Keyword(s):  
Mental Hospital ◽  
Sampling Technique ◽  
Signs And Symptoms ◽  
Statistical Test ◽  
P Value ◽  
The Family ◽  
Before And After ◽  
Hospital Boards ◽  
The Impact

Dampak adanya halusinasi dapat mengakibatkan seseorang mengalami ketidakmampuan untuk berkomunikasi atau mengenali realitas yang menimbulkan kesukaran dalam kemampuan seseorang untuk berperan sebagaimana mestinya dalam kehidupan sehari-hari. Dampak bagi keluarga halusinasi sulit diterima oleh masyarakat, individu dan dipandang negatif oleh lingkungan.Mengetahui hubungan lama hari rawat dengan tanda dan gejala serta kemampuan pasien dalam mengontrol halusinasi di RSJ Grhasia Yogyakarta. Penelitian ini menggunakan menggunakan Desain penelitian studi korelasional (Corrrelation study). Penelitian ini menggunakan teknik total sampling, Sampel yang digunakan dalam penelitian ini berjumlah 45 pasien halusinasi yang ada diruang inap Rumah Sakit Jiwa Grhasia Yogyakarta. Metode analisis yang digunakan adalah uji statistik menggunakan kendal Tau. Hasil penelitian ini menunjukkan bahwa berdasarkan lama hari rawat pasien halusinasi Di RSJ Grhasia Yogyakarta didapatkan  paling banyak lebih dari 30 hari sebanyak 42 responden, tanda dan gejala pasien halusinasi Di RSJ Grhasia Yogyakarta didapatkan paling banyak kategori kurang sebanyak 30 responden, dan kemampuan pasien dalam mengontrol halusinasi Di RSJ Grhasia Yogyakarta didapatkan paling banyak  kategori cukup sebanyak 27 responden.Tidak ada  hubungan lama hari rawat dengan tanda dan gejala dilihat dari nilai p-value sebesar 0,170<0,05, dan terdapat hubungan lama hari rawat dengan kontrol halusinasi dilihat dari nilai p-value sebesar 0,030<0,05 dengan nilai keeratan hubungan 0,325 dalam kategori rendah. Bagi pimpinan RS agar memberikan pengembangan pelayanan kesehatan pada pasien dalam meningkatkan kualitas pelayanan, khususnya dalam lama hari rawat dengan tanda dan gejala kemampuan pasien dalam mengontrol halusinasi. Alahkah baiknya ada perbandingan antara tanda dan gejala sebelum di teliti dan sesudah di teliti. Kata kunci: Lama hari rawat, tanda dan gejala, kemampuan mengontrol halusinasi THE CORRELATION BETWEEN INPATIENT DURATION, AND SIGNS, SYMPTHOMS AND PATIENT’S ABILITY TO CONTROL HALLUCINATIONS ABSTRACTHallucinations can cause disability to communicate or recognize the reality that creates difficulties to act properly in everyday life. The impact of hallucinations on the family is hard to accept by society and individuals, and it is viewed as negative thing by the environment. The study aims to identify the correlation between inpatient duration and signs, symptoms and patient's ability to control the hallucinations at Grhasia Mental Hospital of Yogyakarta. This study used correlational study design. This study used total sampling technique. The samples were 45 hallucination patients at impatient wards at Grhasia Mental Hospital of Yogyakarta. The analytical method used statistical test using Tau constraints. The results of this study indicated that based on the hallucination of inpatient duration at Grhasia Mental Hospital of Yogyakarta, there were 42 respondents who had 30 days of inpatient duration; there were 30 respondents of hallucination patients at Grhasia Mental Hospital of Yogyakarta who have signs and symptoms in low category; there were 27 respondents at Grhasia Mental Hospital of Yogyakarta who had the ability in controlling hallucinations in moderate category. There was not any correlation between inpatient duration and signs and symptoms that can be seen from the p-value of 0.170 <0.05, and there was correlation between the inpatient duration and the control of hallucinations that can be seen from the p-value of 0.030 <0.05 with the closeness value 0.325 in low category. Hospital boards are suggested to provide the development of health services to patients in improving the quality of care, especially about inpatient duration and signs and symptoms of the patient's ability to control hallucinations. Is it better to have a comparison between the signs and symptoms before and after being studied. Keywords: Inpatient Duration, signs and symptoms, ability to control hallucinations

scholarly journals Achieving Continuous Improvement in CSSD Management through Performance Measurements using User Satisfaction Surveys and Interventions

2021 ◽  
Author(s):  
Lallu Joseph ◽  
B. Rabindranath ◽  
Florence Ponnie ◽  
Premila Lee
Keyword(s):  
Continuous Improvement ◽  
User Satisfaction ◽  
Steering Committee ◽  
Baseline Survey ◽  
P Value ◽  
Performance Measurements ◽  
User Perceptions ◽  
Continuous Quality ◽  
The Impact ◽  
Satisfaction Surveys

ABSTRACT Introduction The objective of the study was to achieve continuous improvement in Central Sterile Supply Department (CSSD) management through performance measurements using user satisfaction surveys and interventions. Methods A brainstorming session was conducted with the multidisciplinary process improvement team in 2012 on the reasons for dissatisfaction with CSSD services. A baseline survey questionnaire was prepared to assess levels of dissatisfaction for key indicators and to establish target benchmarks for improvement. Charge nurses in the wards were chosen as respondents. The report was presented by the Quality Management Cell (QMC) to the steering committee in the presence of the CSSD managers. Solutions and support were offered to the team for improvement. Similar surveys were conducted in 2014, 2016, 2017, 2018, and 2019 to understand the impact of the changes implemented. Results The overall satisfaction of the respondents with the CSSD services increased from 54% in 2012 to 89% in 2019, which is statistically significant (95% Cl: −0.56 to −0.25) with p-value &lt; 0.001. Conclusion This exercise helped to build a strong team and create a culture of openness in the CSSD. Improvement measures were data driven and other departments like Radiology and Laundry were motivated to embrace the idea of understanding their user perceptions. This study demonstrates the effectiveness of internal user satisfaction surveys as a valuable tool for continuous quality improvement. This exercise proved beyond doubt that regular monitoring improves quality of services.

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