scholarly journals Rapid response infrastructure for pandemic preparedness in a tertiary care hospital: lessons learned from the COVID-19 outbreak in Cologne, Germany, February to March 2020

2020 ◽  
Vol 25 (21) ◽  
Author(s):  
Max Augustin ◽  
Philipp Schommers ◽  
Isabelle Suárez ◽  
Philipp Koehler ◽  
Henning Gruell ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Epidemiological Data ◽  
Lessons Learned ◽  
Rapid Response ◽  
Care Hospital ◽  
Emergency Rooms ◽  
Pandemic Preparedness ◽  
Effective Response ◽  
Large Numbers ◽  
Outpatient Departments

The coronavirus disease (COVID-19) pandemic has caused tremendous pressure on hospital infrastructures such as emergency rooms (ER) and outpatient departments. To avoid malfunctioning of critical services because of large numbers of potentially infected patients seeking consultation, we established a COVID-19 rapid response infrastructure (CRRI), which instantly restored ER functionality. The CRRI was also used for testing of hospital personnel, provided epidemiological data and was a highly effective response to increasing numbers of suspected COVID-19 cases.

scholarly journals Dealing with the impact of the COVID-19 pandemic on a rapid response team operation in Brazil: Quality in practice

2020 ◽  
Author(s):  
Hermano Alexandre Lima Rocha ◽  
Antonia Célia de Castro Alcântara ◽  
Fernanda Colares de Borba Netto ◽  
Flavio Lucio Pontes Ibiapina ◽  
Livia Amaral Lopes ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Rapid Response Team ◽  
Lessons Learned ◽  
Rapid Response ◽  
Initial Assessment ◽  
Care Hospital ◽  
Large Tertiary Care ◽  
Response Team ◽  
Hospital Wards ◽  
The Impact

Abstract Quality problem or issue Up to 13 July 2020, >12 million laboratory-confirmed cases of coronavirus disease of 2019 (COVID-19) infection have been reported worldwide, 1 864 681 in Brazil. We aimed to assess an intervention to deal with the impact of the COVID-19 pandemic on the operations of a rapid response team (RRT). Initial assessment An observational study with medical record review was carried out at a large tertiary care hospital in Fortaleza, a 400-bed quaternary hospital, 96 of which are intensive care unit beds. All adult patients admitted to hospital wards, treated by the RRTs during the study period, were included, and a total of 15 461 RRT calls were analyzed. Choice of solution Adequacy of workforce sizing. Implementation The hospital adjusted the size of its RRTs during the period, going from two to four simultaneous on-duty medical professionals. Evaluation After the beginning of the pandemic, the number of treated cases in general went from an average of 30.6 daily calls to 79.2, whereas the extremely critical cases went from 3.5 to 22 on average. In percentages, the extremely critical care cases went from 10.47 to 20%, with P < 0.001. Patient mortality remained unchanged. The number of critically ill cases and the number of treated patients increased 2-fold in relation to the prepandemic period, but the effectiveness of the RRT in relation to mortality was not affected. Lessons learned The observation of these data is important for hospital managers to adjust the size of their RRTs according to the new scenario, aiming to maintain the intervention effectiveness.

A STUDY OF WASTE MANAGEMENT OF SAIDU TEACHING HOSPITAL

1969 ◽  
Vol 2 (1) ◽  
pp. 105-110
Author(s):  
Bushra Iftikhar ◽  
Muhammad Jan ◽  
Khurshid Ahmad ◽  
Satea Arif
Keyword(s):  
Waste Management ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Water Channel ◽  
Liquid Waste ◽  
Care Hospital ◽  
Operation Theatre ◽  
Blood Banks ◽  
Outpatient Departments ◽  
Infectious Waste

Objectives: The study was designed to find out the type and quantity of different type of wastes generated inthe two wings of Saidu Group of teaching Hospitals. The study also aimed at finding that whether facilitiesare available in different units for the segregation, storage, disinfection of infectious waste at the onset andmethods of disposal of waste within and outside the hospital. Also, types of items reused and their methodsof sterilization and the fate of used syringes was found out.Study Design: ObservationalMethodology: The study focus was Saidu Teaching Hospital (STH), a tertiary care hospital providingservices to the people of Swat, Malakand, Dir, Kohistan and areas far up to Chitral. Situated 1.5 Km apartSTH consists of two administrative units,Saidu Wing and Central Wing.A qualitative analysis of various aspects of waste management was done by reviewing the availableauthentic record and discussion with the sanitary and administrative staff of the hospital. All the data wascollected according to, and filled in a pre-designed questionnaire.Results: It was found that Saidu Teaching Hospital generates more than 550 Kg of solid waste and 1295liters of liquid waste per day, which makes 1.2 Kg/bed/day. As a whole 80% of the waste generated wasordinary garbage, 12% was infectious, 4% was Pharmacological, 3% pathological and 0.8% consisted ofsharps.The provision of facilities for the segregation of waste at outpatient departments, Wards, Operation theatreand Laboratories/Blood Banks were 7.5%, 7%, 20% and 28.5% respectively and for storage of waste beforedisposal at outpatient departments, Wards, Operation theatre and Laboratories / Blood Banks were 22%,8%, 0% and 28.5% respectively.Disinfection of infectious waste at outpatient departments, wards, operation theatre and laboratories / bloodbanks was 10%, 12%, 0% and 17% respectively. Methods used were treatment with phenyl and burning inopen air.About the removal of waste from hospital premises, 78% mentioned sweepers, 17% said rig pickers while5% said that there is no one to take away the waste.54% admitted that they threw the syringes as such in thebins.The study found that 80% of the waste went to the municipal corporation land fills, the rest was either burntor thrown as such into the water channel passing through the hospital (12% & 8% respectively). 67% blamedthe administration, 25 % held the doctors responsible, 37% charged the nursing staff and 67% blamed thesweepers for the faulty management of hospital waste.Conclusion: It is thus concluded that Saidu Teaching Hospital generates huge amount of solid and liquidwaste, which is not properly disposed off currently, therefore it needs modern and scientific waste disposalsystems.Keywords: Waste Management, hospital waste management, waste disposal

scholarly journals Immediate Outcomes of Traumatic Brain Injury at a Tertiary Care Hospital Of Pakistan- A Retrospective Study

2020 ◽  
Author(s):  
Maria Khan ◽  
Uzair Yaqoob ◽  
Zair Hassan ◽  
Muhammad Muizz Uddin
Keyword(s):  
Traumatic Brain Injury ◽  
Retrospective Study ◽  
Brain Injury ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Initial Assessment ◽  
Care Hospital ◽  
Hospital Data ◽  
Epidemiological Characteristics ◽  
The Impact

Abstract Background: Traumatic Brain Injury (TBI) which is the leading cause of morbidity and mortality all over the world and the impact is much worse in Pakistan. The objective of the study is to describe the epidemiological characteristics of patients with TBI in our country and to determine the immediate outcomes of patients with TBI after the presentation.Method: This retrospective study was conducted at the Lady Reading Hospital. Data were extracted from the medical record room from January 1st to December 31st, 2019. The severity of TBI was based on Glasgow Coma Scale (GCS) and was divided into mild (GCS 13-15), moderate (GCS 9-12), and severe TBI (GCS <8) based on the GCS. SPSS v.23 was used for data analysis. Results: Out of 5047 patients, 3689 (73.1%) males and 1358 (26.9%) females. The most commonly affected age group was 0-10 years (25.6%) and 21-30 years (20.1%). was the predominant cause of injury (38.8%, n=1960) followed by fall (32.7%, n=1649). Most (93.6%, n=4710) of the TBIs were mild. After the full initial assessment and workup, and completing all first-aid management, the immediate outcome was divided into four, most frequent (67.2%, n=3393) of which was “disposed (discharged)”, and 9.3% (n=470) were admitted for further management.Conclusion: Our study represents a relatively conclusive picture of epidemiological data on the burden of TBI in Pakistan. Although a large proportion of patients had a mild TBI, they may likely be under-diagnosed. This warrants for further investigation of MTBI in population-based studies across the globe.

scholarly journals Clinical trends of scalp alopecia areata: a tertiary care hospital based observational study

2020 ◽  
Vol 6 (2) ◽  
pp. 193
Author(s):  
Pallavi Singh ◽  
Milind A. Patvekar ◽  
Bhavika Shah ◽  
Alisha Mittal ◽  
Asmita Kapoor
Keyword(s):  
Family History ◽  
Observational Study ◽  
Alopecia Areata ◽  
Tertiary Care Hospital ◽  
Past History ◽  
Tertiary Care ◽  
Disease Onset ◽  
Epidemiological Data ◽  
Care Hospital ◽  
History Of

<p class="abstract"><strong>Background:</strong> Alopecia areata is one of the commonest types of non-scarring alopecia involving the scalp and/or body. As there is paucity of recent epidemiological data from our country, this study was conducted to determine the latest clinical and epidemiological trends of scalp alopecia areata.</p><p class="abstract"><strong>Methods:</strong> A hospital-based observational study consisting of 100 cases of clinically diagnosed scalp alopecia areata who reported to the Dermatology OPD, Dr. D.Y. Patil Medical College, Pune, was conducted for a period of six months. Socio-demographic and clinical information was collected and clinical examination was performed on all patients. The data was evaluated using appropriate statistical methods.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of the 100 cases enrolled, males (64%) outnumbered females (36%). The commonest presenting age group was 21-30 years (44%). Disease onset was sudden in 80% patients and 59% cases had a progressive disease course. Majority (75%) had a disease duration of less than 3 months. Majority cases were asymptomatic (80%) with no precipitating factors (90%). Past history and family history of alopecia areata were present in 13% and 9% cases, respectively. Personal and family history of associated diseases were present in 27% and 22% patients, respectively. Most patients had single (61%), patchy (83%) lesions with occiput (45%) being the commonest initial site. Nail changes were present in 22% cases, of which pitting (13%) was the commonest nail finding.</p><p class="abstract"><strong>Conclusions:</strong> This study reflects the clinical profile of scalp alopecia areata in a tertiary care hospital.</p>

A PROSPECTIVE STUDY ON CLINICAL PROFILE AND OUTCOME OF PATIENTS WITH TUBERCULOUS MENINGITIS AT A TERTIARY CARE CENTRE IN MAHARASHTRA

2021 ◽  
pp. 7-10
Author(s):  
Nupoor Vaghasia ◽  
Bharatsing D. Rathod ◽  
Vidya Nagar
Keyword(s):  
Tuberculous Meningitis ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Acute Onset ◽  
P Value ◽  
Western India ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Altered Sensorium ◽  
Low Sensitivity

BACKGROUND: Tuberculous meningitis (TBM) is one of the most fatal forms of tuberculosis, early diagnosis and treatment of which can reduce morbidity and mortality. This study was undertaken to achieve data regarding clinical prole and outcome of patients from western India as epidemiological data is lacking from this region. METHODS: This prospective observational study was conducted on 136 patients admitted in medical ward and critical care unit of a tertiary care hospital in Maharashtra over 18 months. Clinical, biochemical, radiological and microbiological evaluation was done. Data was analyzed using SPSS 22 version software and p value of <0.05 as signicant. RESULTS: The mean age of cases was 35.2 ± 14.69 years, majority from age group of 18 - 40 years. Out of 136 cases, 62 (45.6%) were males and 74 (54.4%) females. Commonest clinical features were fever and headache, followed by altered sensorium and seizure. Symptoms were mostly of acute onset (<14 days). 42 cases (30.9%) were associated with present or past pulmonary tuberculosis and 34 (25%) with retroviral disease. 7 cases (5.2%) had hemiparesis and 3 (2.2%) had ophthalmoplegia. Mean ESR was 56.59 + 22.87. CSF showed lymphocytosis (mean 88.4 + 18.09 %), low glucose percentage (mean 39.57 + 0.2 %) and high protein (mean 146.02 + 106.62 mg/dl). 117 cases (86%) showed positive neuroimaging. Outcome was poor in stage III disease. CONCLUSION: Tuberculous meningitis usually presents as acute onset illness with fever, headache or altered sensorium. CSF Gene Xpert has low sensitivity as compared to neuroimaging. Advanced disease was associated with poor outcome.

scholarly journals 531. Practical and Evidence-Based Considerations for Implementation of Bacterial Whole-Genome Sequencing Within Longitudinal Infection Control Practice

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S255-S255
Author(s):  
Donald S Chen ◽  
Moira Quinn ◽  
Rita M Sussner ◽  
Guiqing Wang ◽  
John T Fallon ◽  
...  
Keyword(s):  
Infection Control ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Tertiary Care ◽  
False Negative ◽  
Lessons Learned ◽  
Evidence Based ◽  
Guidance Document ◽  
Whole Genome ◽  
Care Hospital

Abstract Background Whole-genome sequencing (WGS) of bacteria is becoming a routine tool within microbiology, yet its utility to help guide infection control (IC) practice longitudinally is underexplored. As with any technology adopted in the hospital, the integration of WGS into IC practice must be carefully managed and considered. We qualitatively report an evidence-based implementation workflow that considers WGS to help proactively guide IC professionals during investigation of infectious outbreaks. Methods We built upon lessons learned in an ongoing surveillance effort at a tertiary care hospital—utilizing retrospective WGS data within the Philips IntelliSpace Epidemiology system—to understand facilitators and barriers to the use of bacterial WGS longitudinally to inform IC workflow. Our team established a 9-month workgroup to study the practical aspects of implementing WGS in routine IC practice. From expert opinion collected via the workgroup, in addition to evidence from the literature, a workflow guidance document and checklist were codified. New ideas included incorporating education to promote the establishment of an IC triage process. Results Facilitators to implementation included ability to display genomic relatedness alongside relevant patient data to enable clinical actionability, ability to pivot time and resources rapidly when infections are a pseudo outbreak (false positive) or missed outbreak (false negative), opportunities for nuanced staff education, and willingness to be a first-of-kind adopter. Barriers were communication of genomic concepts to IC professionals and relevant institutional stakeholders, maintaining sharable notes of active investigations to promote data-sharing practices, and timing and review of relevant interventions into the facility workflow. Strategies to address these issues are considered. Conclusion This study provides a novel framework for adaptation of existing IC workflow strategies to leverage the utility of bacterial WGS, and it presents a schema to effectively engage relevant stakeholders, based on an analysis of the unique challenges inherent within IC practice. It also offers an innovative model for the development and implementation of IC workflows to account for, and adapt to, site-specific conditions. Disclosures All authors: No reported disclosures.

scholarly journals Study of referral pattern for psychiatric evaluation in psychiatric OPD in a rural tertiary care hospital

KYAMC Journal ◽  
2013 ◽  
Vol 2 (1) ◽  
pp. 128-131
Author(s):  
Muhammad Abdul Kayum Shaikh ◽  
Md Zulfikar Ali ◽  
Md Saiful Islam ◽  
AKM Mokhlesuzzaman
Keyword(s):  
Somatoform Disorders ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Rural Setting ◽  
Psychiatric Evaluation ◽  
Care Hospital ◽  
Major Depressive ◽  
Outpatient Departments ◽  
Level Hospital

Health includes both physical and psychological well being of an individual. There is strong chance that every physical illness has psychological component and in many cases psychological disorders present with somatic symptoms; so psychiatric referral is very important to the proper management of a patient. The aim of this study was to find out the pattern of referral from different outpatient departments in a tertiary level hospital in rural setting of Bangladesh. In this descriptive study total 237 patients were evaluated in 7 months period and most of the diagnoses were anxiety disorders (40%), major depressive disorder (35%) and somatoform disorders (17%). Departments of medicine (cardiology 34%, internal medicine 28% and neurology 26%) referred most of the patients than the surgical or gynecological departments.DOI: http://dx.doi.org/10.3329/kyamcj.v2i1.13517 KYAMC Journal Vol.2(1) 2011 pp.128-131

scholarly journals Seroprevalence of transfusion transmitted infections in voluntary and replacement blood donors in a tertiary care hospital blood bank of Anantapur, Andhra Pradesh, India: 5 years retrospective study

2020 ◽  
Vol 8 (2) ◽  
pp. 455
Author(s):  
V. Siva Sankara Naik ◽  
Neeraja M. ◽  
Sujeeva Swapna R. ◽  
Bhavani C. ◽  
Sravani P. ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Donors ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Blood Bank ◽  
Care Hospital ◽  
Donor Population ◽  
Screening Assays ◽  
Blood Screening

Background: Critical part of transfusion is effective screening of TTI, to reduce the risk of transmission is as safe as possible. The present study has undertaken to focus on seroprevalence of TTIs among both voluntary and replacement donors and also to project epidemiological data of TTIs in this community.Methods: This is a retrospective study conducted from January 2014 to December 2018. All blood samples collected from donors were screened for HIV, HBV, HCV, Syphilis and malaria according to blood bank policy. Before drawing blood, donors were asked to fill pre structured Blood bank questionnaire and consent form.Results: In this present 5-year study, total number of blood donor population was 54937, among them voluntary donors were 33891 and replacement donors were 21046. Out of 33891 voluntary donors, 33486(98.8%) were males and remaining 405(1.19%) were females. All replacement donors (21046) were males. The seroprevalence of HBV was highest, 1.82% (1003/54937) followed by HCV 0.31% (175/54937) in all the donors. The seropositivity for HIV is 0.23% (129/54937), for syphilis 0.04% (24/54937) and for malaria 0.01% (6/54937).Conclusions: National blood transfusion policy should be strengthening the standards and quality of screening across the country. For blood screening, resources and appropriate screening assays must be available at all health centres.

scholarly journals Maternal mortality in tertiary care hospital: a 2-year review

2018 ◽  
Vol 8 (1) ◽  
pp. 184
Author(s):  
Juhi Ankit Patel ◽  
Kanaklata D. Nakum ◽  
Aditi Vithal ◽  
Mayank R. Lunagariya
Keyword(s):  
Maternal Mortality ◽  
Low Socioeconomic Status ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Epidemiological Data ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Set Up

Background: Epidemiological data pertaining to maternal mortality is valuable in each set up to design interventional programs to favourably reduce the ratio. This study was done to evaluate the maternal mortality rate in our hospital, to assess the epidemiological aspects and causes of maternal mortality, and to suggest recommendations for improvement.Methods: This was a 2-year retrospective study. Epidemiological data was collected from the Last 2 years of Facility Based Maternal Death Review Form. Maternal mortality ratio, epidemiological factors and causes affecting maternal mortality were assessed.Results: A total of 72 maternal deaths occurred. Most maternal deaths occurred in the age group of 20–24 years (40.27%), multiparous women (70.83%), women from rural areas (65.27%), illiterate women, unbooked patients (83.33%), and patients of low socioeconomic status. Direct causes accounted for 62.4% of maternal deaths where as 37.4% of maternal deaths were due to indirect causes.Conclusions: There is a wide scope for improvement as a large proportion of the observed deaths could be preventable.

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