scholarly journals Emergency Department length of stay and disposal of patients in Chitwan medical college, Nepal

2019 ◽  
Vol 9 (4) ◽  
pp. 39-42
Author(s):  
Daya Ram Lamsal ◽  
Krishna Bahadur Raut ◽  
Parash Adhikari
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Developed Countries ◽  
Ethical Review ◽  
Review Committee ◽  
Emergency Operations ◽  
Medical College ◽  
Ethical Approval ◽  
Time Standard ◽  
Record Section

Background: Measuring patients Length of Stay (LOS) in the emergency Department (ED) is one of the assessments of quality indicators in terms of clinical, managerial and public satisfaction pro­spective. Waiting time standard is defined and its impact is analyzed in many hospitals especially in developed countries. Policy of emergency operations to reduce length of stay helps to manage overcrowding, spares time to treat critical patient and minimize preventable death. The study was done to assess length of stay and disposal of patients visiting emergency department in Chitwan Medical College. Methods: This was a retrospective study conducted from 01/10/2018 to 30/09/2019 at Chitwan Medical college, Nepal. Patients electronic records were retrieved from medical record section of all patients visiting to emergency department. Ethical approval was obtained from ethical review committee. Results: Medial Length of Stay (LOS) was 3.84 hours (Interquartile range 0.4 hours to 84 hours) 54.54% discharged, 40.83% admitted from ED. Conclusion: Median Length of Stay (LOS) in the Emergency Department (ED) was 3.84 hours which is satisfactory as compared to similar studies. Majority of patients discharged after treatment from ED.  

scholarly journals Morphological Variations of the Lungs: A Cadaveric Study

2021 ◽  
Vol 23 (4) ◽  
pp. 315-318
Author(s):  
Ajeevan Gautam ◽  
Rajib Chaulagain ◽  
Deepesh Dhungel
Keyword(s):  
Blood Circulation ◽  
Pleural Cavity ◽  
Left Lung ◽  
Water Tank ◽  
Review Committee ◽  
Morphological Variations ◽  
Medical College ◽  
Institutional Review ◽  
Ethical Approval ◽  
Oblique Fissure

The lungs are the organs of respiration which are situated on either side of the heart and other mediastinal contents in its pleural cavity. A fresh lung is spongy, can float in water and crepitates when handled. Lungs are important with respect to its blood circulation. The lungs are divided by fissures into lobes which facilitate movements of lobes in relation to one another. The hilum of each lung is its gateway. In the present study, we aim to assess the morphological variations of human cadaveric lungs at Chitwan Medical College (CMC). An observational study was conducted at dissection hall of anatomy department at Chitwan Medical College from September 2019 to October 2020 after taking ethical approval form Institutional Review Committee of CMC. All the intact 70 lungs present in the department were studied. Photographs of the intact lungs were taken from different surface. The lungs were porus, highly elastic and spongy in texture. On keeping lungs to water tank it got floated. We found 34(80.96%) of the studied specimen of right side had horizontal fissure present in it. The remaining 8 (19.04%) specimens did not have horizontal fissures, while 3 (5.88%) specimens had incomplete fissures. The oblique fissure was not present in 2 (2.38%) of the study specimens. The left side of the study specimen has a variance of 1(4.16%). When the hilum right lung was examined, 40 (95.23%) of the structure had the usual organization pattern. In the left lung, the usual pattern of organization was 21(75%). The differences are thought to be present in the lung’s fissure and hilum. The current study’s findings are therapeutically important. The findings could prove beneficial to cardiovascular and thoracic surgeons.

scholarly journals Prevalence of Anemia in Adolescent Girls attending Specific Schools of Kavrepalanchok, Nepal

2021 ◽  
Vol 59 (235) ◽  
Author(s):  
Lee Budhathoki ◽  
Bikal Shrestha ◽  
Naveen Phuyal ◽  
Lochana Shrestha
Keyword(s):  
Adolescent Girls ◽  
Private School ◽  
Descriptive Analysis ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Gradual Transition ◽  
Cross Sectional ◽  
Medical College ◽  
Ethical Approval ◽  
Prevalence Of Anemia

Introduction: Adolescents comprise individuals in the age group 10 to 19 who are undergoing a period of gradual transition of growth and development. Adolescent girls are at high risk of anemia and malnutrition. This research has been aimed to find the prevalence of anemia in adolescent girls attending specific schools of Panchkhal municipality in Kavrepalanchowk in Nepal. Methods: A descriptive cross-sectional study was conducted in one government and one private school of Panchkhal Municipality of Kavre district in adolescent girls of age 10 to 19 from December 2017 to April 2018 attending grade five till ten in the field practice area of a medical college. After ethical approval, anthropometric measurements of height, weight, and blood were taken for hemoglobin estimation. Descriptive analysis was done in Microsoft excel 2016. Results: Out of 95 adolescent girls, fourteen (14.74%) adolescent girls were anemic. The mean age was 13.35±1.629 years, mean height and weight were 1.58m and 44.11kg, respectively. Conclusions: This study shows a lower prevalence of anemia than reported by national data, but it is higher than that reported by developed countries. Anemia and undernutrition have long terms detrimental effects on adolescent girls, so health education and prevention is necessary.

Perceptions of Final Year Medical Students about Family Medicine as A Career Choice in Pakistan

2020 ◽  
Author(s):  
Dur-e- Nishat
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical Profession ◽  
Healthcare Services ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Chi Square Test

Background: Family medicine is a field in which complete and detailed set of healthcare services are provided to the patients and their families. In developed countries, freshly graduated students choose family medicine as a priority for their career. However, in Pakistan it is not the case. The present study is undertaken to determine the perceptions of final year medical students’ about Family Medicine as a viable career. Methods: A total number of 504 students participated in the study. This was a cross-sectional study. The study participants were in their final year of medical college. Data was collected using a preapproved questionnaire. Data was entered and analyzed via SPSS version 17 and Chi-Square test was used post-stratification. Results: Only 14.3% (n=72) medical students had heard about Family Medicine. Only 18% (n=92) would select family medicine as a profession. The most frequent rationale for choosing the field of Family Medicine was the variety of patients seen in general practice (55.4% n=51). Conclusion: There is a dire need to focus on increasing awareness about the field of family medicine among medical students. The students should be counseled on the advantages along with the disadvantages of choosing this field as a medical profession.

scholarly journals National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Akshay Pendyal ◽  
Craig Rothenberg ◽  
Jean E. Scofi ◽  
Harlan M. Krumholz ◽  
Basmah Safdar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Length Of Stay ◽  
Real World ◽  
The United States ◽  
Emergency Department Care ◽  
Care Processes ◽  
Ed Visits

Background Despite investments to improve quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real‐world trends in AMI care in the emergency department (ED). We aimed to describe trends in the epidemiology and quality of AMI care in US EDs over a recent 11‐year period, from 2005 to 2015. Methods and Results We conducted an observational study of ED visits for AMI using the National Hospital Ambulatory Medical Care Survey, a nationally representative probability sample of US EDs. AMI visits were classified as ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI. Outcomes included annual incidence of AMI, median ED length of stay, ED disposition type, and ED administration of evidence‐based medications. Annual ED visits for AMI decreased from 1 493 145 in 2005 to 581 924 in 2015. Estimated yearly incidence of ED visits for STEMI decreased from 1 402 768 to 315 813. The proportion of STEMI sent for immediate, same‐hospital catheterization increased from 12% to 37%. Among patients with STEMI sent directly for catheterization, median ED length of stay decreased from 62 to 37 minutes. ED administration of antithrombotic and nonaspirin antiplatelet agents rose for STEMI (23%–31% and 10%–27%, respectively). Conclusions National, real‐world trends in the epidemiology of AMI in the ED parallel those of clinical registries, with decreases in AMI incidence and STEMI proportion. ED care processes for STEMI mirror evolving guidelines that favor high‐intensity antiplatelet therapy, early invasive strategies, and regionalization of care.

Effect of Undertriage on the Outcomes of Cancer Patients with Febrile Neutropenia, Sepsis, and Septic Shock

2021 ◽  
pp. 105477382199968
Author(s):  
Anas Alsharawneh
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Length Of Stay ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Emergency Setting ◽  
Extended Length ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
Timely Treatment

Sepsis and neutropenia are considered the primary life-threatening complications of cancer treatment and are the leading cause of hospitalization and death. The objective was to study whether patients with neutropenia, sepsis, and septic shock were identified appropriately at triage and receive timely treatment within the emergency setting. Also, we investigated the effect of undertriage on key treatment outcomes. We conducted a retrospective analysis of all accessible records of admitted adult cancer patients with febrile neutropenia, sepsis, and septic shock. Our results identified that the majority of patients were inappropriately triaged to less urgent triage categories. Patients’ undertriage significantly prolonged multiple emergency timeliness indicators and extended length of stay within the emergency department and hospital. These effects suggest that triage implementation must be objective, consistent, and accurate because of the several influences of the assigned triage scoring on treatment and health outcomes.

scholarly journals Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110114
Author(s):  
Andrew Nyce ◽  
Snehal Gandhi ◽  
Brian Freeze ◽  
Joshua Bosire ◽  
Terry Ricca ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Experience ◽  
Waiting Times ◽  
Hospital Length ◽  
Short Length ◽  
Hospital Length Of Stay ◽  
Patient’S Experience ◽  
Discharged Patients ◽  
The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

scholarly journals Reporting ethical approval in health and social science articles: an audit of adherence to GDPR and national legislation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kjell Asplund ◽  
Kerstin Hulter Åsberg
Keyword(s):  
Social Sciences ◽  
Social Science ◽  
Social Science Research ◽  
Personal Data ◽  
Science Research ◽  
Health Sciences ◽  
Health Science ◽  
Ethical Review ◽  
General Data Protection Regulation ◽  
Ethical Approval

Abstract Background Previous studies have indicated that failure to report ethical approval is common in health science articles. In social sciences, the occurrence is unknown. The Swedish Ethics Review Act requests that sensitive personal data, in accordance with the EU General Data Protection Regulation (GDPR), should undergo independent ethical review, irrespective of academic discipline. We have explored the adherence to this regulation. Methods Using the Web of Science databases, we reviewed 600 consecutive articles from three domains (health sciences with and without somatic focus and social sciences) based on identifiable personal data published in 2020. Results Information on ethical review was lacking in 12 of 200 health science articles with somatic focus (6%), 21 of 200 health science articles with non-somatic focus (11%), and in 54 of 200 social science articles (27%; p < 0.001 vs. both groups of health science articles). Failure to report on ethical approval was more common in (a) observational than in interventional studies (p < 0.01), (b) articles with only 1–2 authors (p < 0.001) and (c) health science articles from universities without a medical school (p < 0.001). There was no significant association between journal impact factor and failure to report ethical approval. Conclusions We conclude that reporting of research ethics approval is reasonably good, but not strict, in health science articles. Failure to report ethical approval is about three times more frequent in social sciences compared to health sciences. Improved adherence seems needed particularly in observational studies, in articles with few authors and in social science research.

scholarly journals Healthcare Utilization Due to Suicide Attempts among Homeless Youth in New York State

2021 ◽  
Author(s):  
Rie Sakai-Bizmark ◽  
Hiraku Kumamaru ◽  
Dennys Estevez ◽  
Emily H Marr ◽  
Edith Haghnazarian ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
Length Of Stay ◽  
Suicide Attempt ◽  
Healthcare Utilization ◽  
Regression Models ◽  
Homeless Youth ◽  
Suicide Attempts ◽  
New York State ◽  
Individual Characteristics

Abstract Suicide remains the leading cause of death among homeless youth. We assessed differences in healthcare utilization between homeless and non-homeless youth presenting to the emergency department or hospital after a suicide attempt. New York Statewide Inpatient and Emergency Department Databases (2009–2014) were used to identify homeless and non-homeless youth ages 10 to 17 who utilized healthcare services following a suicide attempt. To evaluate associations with homelessness, we used logistic regression models for mortality, use of violent means, intensive care unit utilization, log-transformed linear regression models for hospitalization cost, and negative binomial regression models for length of stay. All models were adjusted by individual characteristics with a hospital random effect and year fixed effect. We identified 18,026 suicide attempts with healthcare utilization rates of 347.2 (95% Confidence Interval [CI]: 317.5, 377.0) and 67.3 (95%CI: 66.3, 68.3) per 100,000 person-years for homeless and non-homeless youth, respectively. Length of stay for homeless youth was statistically longer than non-homeless youth (Incidence Rate Ratio 1.53; 95%CI: 1.32, 1.77). All homeless youth who visited the emergency department after a suicide attempt were subsequently hospitalized. This could suggest a higher acuity upon presentation among homeless youth compared with non-homeless youth. Interventions tailored to homeless youth should be developed.

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