scholarly journals Egypt: Expand access to postabortion care

2000 ◽  
Author(s):  
Keyword(s):  
Infection Control ◽  
Case Management ◽  
Teaching Hospitals ◽  
Population Council ◽  
Vacuum Aspiration ◽  
Brief Training ◽  
Postabortion Care ◽  
Management Protocol ◽  
Training Physicians

The Population Council has supported a series of studies to improve the quality of postabortion care (PAC) in Egypt. A 1994 pilot study in two Egyptian hospitals showed that upgrading PAC and training physicians in manual vacuum aspiration (MVA), infection control, and counseling led to significant improvements in the care of postabortion patients. The 1997 study, conducted by the Egyptian Fertility Care Society with support from the Population Council, sought to institutionalize improved postabortion medical care and counseling procedures in ten hospitals. Five senior physicians from each hospital attended a five-day training course in MVA, infection control, and family planning (FP) counseling. The physicians then supervised four months of on-the-job training of doctors and nurses at the ten hospitals. A case management protocol, including emergency medical treatment, pain control, and FP counseling, was also introduced. As reported in this brief, training providers and introducing a case management protocol led to improved PAC at ten government and teaching hospitals in Egypt.

scholarly journals Tuberculosis care quality in urban Nigeria: A cross-sectional study of adherence to screening and treatment initiation guidelines in multi-cadre networks of private health service providers

2022 ◽  
Vol 2 (1) ◽  
pp. e0000150
Author(s):  
Lauren A. Rosapep ◽  
Sophie Faye ◽  
Benjamin Johns ◽  
Bolanle Olusola-Faleye ◽  
Elaine M. Baruwa ◽  
...  
Keyword(s):  
Case Management ◽  
Private Sector ◽  
Treatment Initiation ◽  
Service Providers ◽  
Protocol Adherence ◽  
High Burden ◽  
Private Providers ◽  
Bottleneck Analysis ◽  
Management Protocol

Nigeria has a high burden of tuberculosis (TB) and low case detection rates. Nigeria’s large private health sector footprint represents an untapped resource for combating the disease. To examine the quality of private sector contributions to TB, the USAID-funded Sustaining Health Outcomes through the Private Sector (SHOPS) Plus program evaluated adherence to national standards for management of presumptive and confirmed TB among the clinical facilities, laboratories, pharmacies, and drug shops it trained to deliver TB services. The study used a standardized patient (SP) survey methodology to measure case management protocol adherence among 837 private and 206 public providers in urban Lagos and Kano. It examined two different scenarios: a “textbook” case of presumptive TB and a treatment initiation case where SPs presented as referred patients with confirmed TB diagnoses. Private sector results were benchmarked against public sector results. A bottleneck analysis examined protocol adherence departures at key points along the case management sequence that providers were trained to follow. Except for laboratories, few providers met the criteria for fully correct management of presumptive TB, though more than 70% of providers correctly engaged in TB screening. In the treatment initiation case 18% of clinical providers demonstrated fully correct case management. Private and public providers’ adherence was not significantly different. Bottleneck analysis revealed that the most common deviations from correct management were failure to initiate sputum collection for presumptive patients and failure to conduct sufficiently thorough treatment initiation counseling for confirmed patients. This study found the quality of private providers’ TB case management to be comparable to public providers in Nigeria, as well as to providers in other high burden countries. Findings support continued efforts to include private providers in Nigeria’s national TB program. Though most providers fell short of desired quality, the bottleneck analysis points to specific issues that TB stakeholders can feasibly address with system- and provider-level interventions.

scholarly journals Senegal: Train more providers in postabortion care

2000 ◽  
Author(s):  
Keyword(s):  
Emergency Treatment ◽  
Contraceptive Use ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Care Services ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Health Strategy ◽  
The Government ◽  
The Impact

Recognizing unsafe abortion as a serious health problem, the government of Senegal adopted a national health strategy in 1997 that aims to halve the number of unsafe abortions by 2001. In 1997, the Center for Training and Research in Reproductive Health (CEFOREP) and the Obstetrics and Gynecology clinic (CGO) at Le Dantec University Teaching Hospital in Dakar introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage or abortion. CGO and two other teaching hospitals served as pilot sites. Physicians, nurses, and midwives at the three sites received training in manual vacuum aspiration, family planning, and counseling. To measure the impact of the training, CEFOREP interviewed 320 women receiving emergency treatment and 204 providers before the intervention, and 543 patients and 175 providers after. This brief states that improving postabortion care services can result in shorter hospital stays, decreased patient costs, better communication between providers and patients, increased acceptance of contraceptive use by women treated for abortion or miscarriage, and that local anesthesia is needed for pain control.

scholarly journals Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025692 ◽  
Author(s):  
Corita R Grudzen ◽  
Deborah J Shim ◽  
Abigail M Schmucker ◽  
Jeanne Cho ◽  
Keith S Goldfeld
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Palliative Care ◽  
Randomised Controlled Trial ◽  
Case Management ◽  
Controlled Trial ◽  
Chronic Obstructive ◽  
Randomised Controlled ◽  
End Stage

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.

scholarly journals Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
High Volume ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Care Services ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Products Of Conception ◽  
Family Planning Counseling

Abstract Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

Impact of hospital accreditation on infection control programs in teaching hospitals in Japan

2008 ◽  
Vol 36 (3) ◽  
pp. 212-219 ◽  
Author(s):  
Miho Sekimoto ◽  
Yuichi Imanaka ◽  
Hiroyoshi Kobayashi ◽  
Takashi Okubo ◽  
Junko Kizu ◽  
...  
Keyword(s):  
Infection Control ◽  
Teaching Hospitals ◽  
Hospital Accreditation ◽  
Control Programs

Effects of Case Management on Drug Users' Risky Sex

1998 ◽  
Vol 78 (1) ◽  
pp. 6-30 ◽  
Author(s):  
DOUGLAS LONGSHORE ◽  
SUSAN TURNER ◽  
M. DOUGLAS ANGLIN
Keyword(s):  
Drug Use ◽  
Case Management ◽  
Risk Behavior ◽  
Problem Behaviors ◽  
Drug Users ◽  
Unprotected Sex ◽  
Hiv Risk Behavior ◽  
Favorable Effect ◽  
Street Crime ◽  
Management Protocol

Case management for crime-involved drug users is designed mainly to reduce further drug use and crime but may also promote reductions in HIV risk behavior. In a five-site evaluation, the authors examined the effects of a case-management protocol known as Treatment Alternatives to Street Crime (TASC) on drug users' frequency of unprotected sex and frequency of sex while high on drugs and/or alcohol. At one site, case management had a favorable effect on the frequency of unprotected sex. At four sites, case management had a favorable effect on the frequency of sex while high. These effects were moderated by users' baseline level of risk behavior or history of related problem behaviors (drug use and criminal conduct). Implications for case management and drug use treatment are discussed.

Quality of life outcome in a randomized controlled trial of case management

2001 ◽  
Vol 36 (5) ◽  
pp. 249-255 ◽  
Author(s):  
Peter Huxley ◽  
Sherrill Evans ◽  
Tom Burns ◽  
Tom Fahy ◽  
John Green
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Case Management ◽  
Controlled Trial ◽  
Randomized Controlled

scholarly journals Knowledge, Perceptions and Practices of Community Pharmacists Towards Antimicrobial Stewardship: A Systematic Scoping Review

Antibiotics ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 263 ◽  
Author(s):  
Sajal K. Saha ◽  
Chris Barton ◽  
Shukla Promite ◽  
Danielle Mazza
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Antimicrobial Stewardship ◽  
Scoping Review ◽  
Community Pharmacists ◽  
Antibiotic Use ◽  
Methodological Framework ◽  
Medical Databases ◽  
Further Development

The scope of antimicrobial stewardship (AMS) surveys on community pharmacists (CPs) is uncertain. This study examines the breadth and quality of AMS survey tools measuring the stewardship knowledge, perceptions and practices (KPP) of CPs and analyse survey outcomes. Following PRISMA-ScR checklist and Arksey and O’Malley’s methodological framework seven medical databases were searched. Two reviewers independently screened the literatures, assessed quality of surveys and KPP outcomes were analysed and described. Ten surveys were identified that assessed CPs’ AMS perceptions (n = 7) and practices (n = 8) but none that assessed AMS knowledge. Three survey tools had been formally validated. Most CPs perceived that AMS improved patient care (median 86.0%, IQR, 83.3–93.5%, n = 6), and reduced inappropriate antibiotic use (84.0%, IQR, 83–85%, n = 2). CPs collaborated with prescribers for infection control (54.7%, IQR 34.8–63.2%, n = 4) and for uncertain antibiotic treatment (77.0%, IQR 55.2–77.8%, n = 5). CPs educated patients (53.0%, IQR, 43.2–67.4%, n = 5) and screened guideline-compliance of antimicrobial prescriptions (47.5%, IQR, 25.2–58.3%, n = 3). Guidelines, training, interactions with prescribers, and reimbursement models were major barriers to CP-led AMS implementation. A limited number of validated survey tools are available to assess AMS perceptions and practices of CPs. AMS survey tools require further development to assess stewardship knowledge, stewardship targets, and implementation by CPs.

scholarly journals Impact of case management on rural women's quality of life and substance use

2007 ◽  
Author(s):  
Megan Passey ◽  
Michelle Sheldrake ◽  
Kerry Leitch ◽  
Val Gilmore
Keyword(s):  
Quality Of Life ◽  
Substance Use ◽  
Case Management
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