scholarly journals The effects of the coronavirus disease 2019 pandemic on neurospine surgery practice in the referral center hospital developing country

2021 ◽  
Vol 12 ◽  
pp. 620
Author(s):  
Galih Indra Permana ◽  
Muhammad Faris ◽  
Eko Agus Subagio ◽  
Abdul Hafid Bajamal
Keyword(s):  
Emergency Department ◽  
Surgical Procedure ◽  
Outpatient Visit ◽  
Emergency Department Patient ◽  
Tertiary Hospital ◽  
Surgical Practice ◽  
Outpatient Visits ◽  
Center Hospital ◽  
Recorded Data ◽  
And Training

Background: The coronavirus disease 2019 (COVID-19) pandemic represents a once in a century challenge to human health care with over 4.5 million cases and over 300,000 deaths thus far. Surgical practice has been significantly impacted with all specialties writing guidelines for how to manage during this crisis. This study reported the effect of the COVID-19 pandemic on the neurosurgical practice, especially neurospine, in the outpatient visit, emergency department, and the surgical procedure. Methods: This study is the comparative retrospective about neurospine practice in the outpatient visit, emergency department, and the surgical procedure among before and during COVID-19 pandemic. We recorded data from January to December 2019 (before COVID-19 pandemic) and compared with the same period in the 2020 (during a COVID-19 pandemic). Results: A total of the outpatient visits, the average number per month was 28 ± 10.5 visits per month before the pandemic. The average number outpatient visit per month during the pandemic was 19 ± 11.1 visits per month, with the lowest in July 2020. The result of the average monthly neurospine surgical procedure before the pandemic was 5 ± 1.9 operations per month. Compared during the pandemic, there was decreased in the neurospine surgical procedure with the average number was 2 ± 2.7 operations per month. The decreased number significantly happens in the surgical procedure and emergency department patient (P < 0.05), while in the outpatient visit, the decreased statistically not significantly (P > 0.05). Conclusion: The COVID-19 pandemic changed all scopes of medical practice and training. Considering the limitation in the available resources, the number of educational cases may decrease in subspecialized disciplines such as neurospine neurosurgery. The COVID-19 pandemic affects in the neurospine and neurosurgery treatment policy in the referral tertiary hospital.

scholarly journals The Effect of Emergency Department Expansion on Emergency Department Patient Flow

2019 ◽  
Vol 34 (s1) ◽  
pp. s123-s124
Author(s):  
Min Joung Kim ◽  
Joon Min Park
Keyword(s):  
Emergency Department ◽  
Patient Flow ◽  
Emergency Department Patient ◽  
Tertiary Hospital ◽  
Hospitalized Patients ◽  
Emergency Ward ◽  
Admission Decision ◽  
Number Of Patients ◽  
Time Required ◽  
Post Period

Introduction:Overcrowding in the emergency department (ED) has been a global problem for a long time, but it is still not resolved.Aim:To determine if an ED expansion would be effective in resolving overcrowding.Methods:This was a retrospective study comparing two 10-month periods before (September 2015 to June 2016) and after (September 2017 to June 2018) the ED expansion in an urban tertiary hospital. The existing ED consisted of 45 beds in the adult area and eight beds in the pediatric area. After the construction, the number of beds was not increased, but a fast track area was newly established in the adult area, and a 25-bed ward for emergency hospitalized patients was opened.Results:The number of patients visiting the ED increased from 77,078 to 87,927. The proportion of patients who returned home without treatment significantly decreased from 11.5% to 0.9% (p<0.001). The number of adult patients increased from 40,814 to 60,720, but the number of patients who could be treated on the bed decreased (22,166 (54.3%) vs. 17,776 (29.3%), p<0.001). The number of pediatric patients was similar in both periods. Median ED length of stay (LOS) of total patients increased from 193.0 min to 205.8 min (p<0.001). Of the 18,900 hospitalized patients during post-period, 1,255 (6.64%) were admitted to the emergency ward, and the boarding (from admission decision to hospitalization) time of the admitted patients decreased from 239.2 min in the pre-period to 190.9 min in the post-period by 38.3 min. However, more time was required for admission decision in the post-period (216.8 vs. 253.3, p<0.001).Discussion:The ED expansion allowed more patients to be treated, and the emergency ward reduced boarding times of admitted patients. However, due to the increase in the number of patients, the time required for medical treatment increased.

scholarly journals Occupational Sharp Injury and Splash Exposure among Healthcare Workers in a Tertiary Hospital

2021 ◽  
Author(s):  
Roshan Mathew ◽  
Ritin Mohindra ◽  
Ankit Sahu ◽  
Rachana Bhat ◽  
Akshaya Ramaswami ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hepatitis B ◽  
Healthcare Workers ◽  
Hepatitis B Surface Antigen ◽  
Tertiary Hospital ◽  
Needle Stick Injury ◽  
Medical Procedures ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Hepatitis C Virus Antibody

Abstract Background Occupational hazards like sharp injury and splash exposure (SISE) are frequently encountered in health-care settings. The adoption of standard precautions by healthcare workers (HCWs) has led to significant reduction in the incidence of such injuries, still SISE continues to pose a serious threat to certain groups of HCWs. Materials and Methods This was a retrospective study which examined the available records of all patients from January 2015 to August 2019 who self-reported to our emergency department with history of sharp injury and/or splash exposure. Details of the patients, mechanism of injury, the circumstances leading to the injury, status of the source (hepatitis B surface antigen, human immunodeficiency virus, and hepatitis C virus antibody status), and the postexposure prophylaxis given were recorded and analyzed. Data were represented in frequency and percentages. Results During the defined period, a total of 834 HCWs reported with SISE, out of which 44.6% were doctors. Majority of the patients have SISE while performing medical procedures on patients (49.5%), while 19.2% were exposed during segregation of waste. The frequency of needle stick injury during cannulation, sampling, and recapping of needle were higher in emergency department than in wards. More than 80% of HCWs received hepatitis B vaccine and immunoglobulin postexposure. Conclusion There is need for periodical briefings on practices of sharp handling as well as re-emphasizing the use of personal protective equipment while performing procedures.

scholarly journals Delirium in the Older Emergency Department Patient: A Quiet Epidemic

2010 ◽  
Vol 28 (3) ◽  
pp. 611-631 ◽  
Author(s):  
Jin H. Han ◽  
Amanda Wilson ◽  
E. Wesley Ely
Keyword(s):  
Emergency Department ◽  
Emergency Department Patient

Evaluating the effects of increasing surgical volume on emergency department patient access

2011 ◽  
Vol 20 (2) ◽  
pp. 146-152 ◽  
Author(s):  
S. Levin ◽  
R. Dittus ◽  
D. Aronsky ◽  
M. Weinger ◽  
D. France
Keyword(s):  
Emergency Department ◽  
Emergency Department Patient ◽  
Surgical Volume ◽  
Patient Access

Accuracy of Computer Simulation to Predict Patient Flow during Mass-Casualty Incidents

2008 ◽  
Vol 23 (4) ◽  
pp. 354-360 ◽  
Author(s):  
Jeffrey M. Franc-Law ◽  
Micheal J. Bullard ◽  
F. Della Corte
Keyword(s):  
Emergency Department ◽  
Computer Simulation ◽  
Patient Care ◽  
Patient Flow ◽  
Emergency Department Patient ◽  
Simulation Software ◽  
Simulated Patients ◽  
Disaster Plan ◽  
Data Set ◽  
Patient Database

AbstractIntroduction:Although most hospitals have an emergency department disas- ter plan, most never have been implemented in a true disaster or been tested objectively. Computer simulation may be a useful tool to predict emergency department patient flow during a disaster.Purpose:The aim of this study was to compare the accuracy of a computer simulation in predicting emergency department patient flow during a masscasualty incident with that of a real-time, virtual, live exercise.Methods:History, physical examination findings, and laboratory results for 136 simulated patients were extracted from the disastermed.ca patient database as used as input into a computer simulation designed to represent the emergency department at the University of Alberta Hospital.The computer simulation was developed using a commercially available simulation software platform (2005, SimProcess, CACI Products, San Diego CA). Patient flow parameters were compared to a previous virtual, live exercise using the same data set.Results:Although results between the computer simulation and the live exercise appear similar, they differ statistically with respect to many patient benchmarks. There was a marked difference between the triage codes assigned during the live exercise and those from the patient database; however, this alone did not account for the differences between the patient groups. It is likely that novel approaches to patient care developed by the live exercise group, which are difficult to model by computer software, contributed to differences between the groups. Computer simulation was useful, however, in predicting how small changes to emergency department structure, such as adding staff or patient care areas, can influence patient flow.Conclusions:Computer simulation is helpful in defining the effects of changes to a hospital disaster plan. However, it cannot fully replace participant exercises. Rather, computer simulation and live exercises are complementary, and both may be useful for disaster plan evaluation.

scholarly journals A Survey of Competency-Based Training of Senior House Officers in Performing Minor Surgical Procedures

2006 ◽  
Vol 88 (6) ◽  
pp. 576-578 ◽  
Author(s):  
Samuel CL Leong ◽  
Alison J Waghorn
Keyword(s):  
Surgical Procedures ◽  
Surgical Procedure ◽  
Perianal Abscess ◽  
Incision And Drainage ◽  
Minor Surgical Procedures ◽  
Surgical Trainees ◽  
Competency Based ◽  
A Minor ◽  
Second Procedure ◽  
And Training

INTRODUCTION The aim of this survey was to ascertain the level of competency and training of basic surgical trainees (SHOs) in performing incision and drainage of a perianal abscess (a minor surgical procedure). MATERIALS AND METHODS Questionnaires were sent to SHOs enquiring about preferred methods of incision and drainage and the teaching received to perform this procedure. RESULTS Of respondent SHOs, 10% did not receive teaching when performing their first incision and drainage and over half did not received any feedback from their trainers. A mere 65% received practical supervision. Use of the curette and de-roofing of the abscess are not routine methods used. In addition, 13% reported inadequate incision and drainage, which required a second procedure. CONCLUSIONS Competency-based training in minor surgical procedures benefits not only from didactic teaching, immediate supervision and appraisal but also from frequent practise. This was found to be lacking for incision and drainage of perianal abscesses by basic surgical trainees surveyed in the study.

scholarly journals Assessing the discharge instructing in the emergency department: Patient perspective

2019 ◽  
Vol 43 ◽  
pp. 40-44 ◽  
Author(s):  
M. Mäkinen ◽  
M. Castrén ◽  
K. Huttunen ◽  
S. Sundell ◽  
J. Kaartinen ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Perspective ◽  
Emergency Department Patient
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