scholarly journals Assessment of facility-based emergency care services for road traffic injuries in tertiary care hospital, Larkana

2020 ◽  
Vol 3 (1) ◽  
pp. 16-26
Author(s):  
Mansoor Ahmed Qazi ◽  
Saima Rafi
Keyword(s):  
Health Care Providers ◽  
Emergency Care ◽  
Road Traffic ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Road Traffic Injuries ◽  
Record Keeping ◽  
Care Services ◽  
Emergency Care Services

Background: Road traffic injuries are considered as main public health problem; strenuous efforts are required for its prevention. Facility based emergency care for road traffic injuries is considered as an important but challenging component of post-crash care response. It demands healthcare providers to make quick life-and-death decisions based on minimal information.  The objective of our study was to explore the challenges for emergency services for road traffic injuries within Tertiary care hospital. Methodology: Qualitative methods were used including 15 interviews and 02 focus group discussions. Topic guide was developed for all the participant’s interviews, in order to explore the challenges for effective emergency care services at tertiary care level in Larkana city, Sindh. Topic guide was developed for all the participant’s interviews. Results: After making the transcripts of qualitative data, thematic analysis framework was used to analyze the transcripts, by which two main themes; recognition of causes and adverse consequences of road traffic accidents and health system challenges for delivering emergency care were extracted. Results suggest that improvement in documentation and record keeping system, security for health care providers, provision of timely interventions and proper training for health professionals at hospital level can be helpful for the provision of effective emergency care services. Conclusion: An integrated trauma care system along with the improvement in documentation, efficient record keeping system, security for health care providers, provision of timely interventions and training for health professionals is needed for effective post-crash care management at the hospital level.

scholarly journals Attitude and Knowledge of Indian Emergency Care Residents towards Use of Proton Pump Inhibitors

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Biswa Mohan Padhy ◽  
Hemant Singh Bhadauria ◽  
Yogendra Kumar Gupta
Keyword(s):  
Health Care Providers ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Emergency Care ◽  
Tertiary Care ◽  
Developed Countries ◽  
North India ◽  
Care Hospital ◽  
Care Providers ◽  
First Choice

Objective. Several studies carried out in developed countries have reported disproportionately high usage of acid suppressive drugs, especially proton pump inhibitors (PPIs). However, systematic assessment of attitude and practices of health care providers towards the use of these drugs in developing countries is lacking. In this study, we assessed the knowledge, attitude, and preferences of resident doctors posted in the emergency department of a tertiary care hospital in North India, towards the use of PPIs. Methods. A questionnaire based survey was carried out. Results. Fifty resident doctors responded to the questionnaire. Thirty-six percent reported prescribing acid suppressive drugs for majority of their patients, while 12% prescribed them to almost all patients they attended. Acute gastritis was the most common indication for prescribing PPI/H2 blockers (50%). The majority of respondents (92%) regarded PPIs as their first choice in acid suppressive agents and 58% administered it through intravenous route. Knowledge about PPI related adverse effects was low. Conclusions. Emergency care residents in India also tend to overuse PPIs in a manner similar to their counterparts in developed countries. Specific measures may be helpful in preventing such practices.

scholarly journals A Study of Cost incurred in providing Emergency Care Services in an Apex Tertiary Care Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 45-50
Author(s):  
Neeraj Garg ◽  
Amit Lathwal ◽  
Shakti K Gupta ◽  
Ruchi Garg
Keyword(s):  
Emergency Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Facility ◽  
Care Hospital ◽  
Total Cost ◽  
Care Services ◽  
Tertiary Care Facility ◽  
The Cost ◽  
Emergency Care Services

ABSTRACT Introduction An emergency department (ED), also known as accident and emergency (A8E), emergency room (ER), or casualty department, is a medical treatment facility specializing for acute care of patients who present without prior appointment, either by their own means or by ambulance. In spite of the emergency beds forming only a fraction of the hospital beds, they consume a relatively large proportion of the hospitals resources. There is a requirement to ascertain the cost incurred in providing emergency care treatment to the patients coming to an apex tertiary care center, whose principal mandate is to provide tertiary care treatment. The study will not only help in allocating funds to the ED in an apex tertiary care facility but will also be useful if the hospital authorities decide to outsource the emergency services to a third party. Aims and objectives To study the cost incurred in providing emergency care services in an apex tertiary care hospital. To identify the various cost centers pertaining to patient care in the emergency care department and to estimate the cost of rendering patient care in ED and the cost of running the emergency per day. Materials and methods Six months’ retrospective data were collected from the ED, accounts section, engineering section, stores department, radiology department, emergency lab, computer facility, etc. The cost was apportioned to per patient as well per hour in rendering emergency care services. Observations The total cost incurred in providing emergency care services in the hospital under study was Rs 2034 per patient, while Rs 31,000 are spent per hour in running the emergency care facility. Discussion Almost 40 to 50% of the total cost incurred on providing emergency care services goes to the salary head of the staff working in the ED. The next major sources of expenditure are the radiology and lab investigations. Conclusion The study suggests that a considerable amount of hospital funds are spent on providing emergency care services in the apex tertiary care facility, whose primary mandate is to provide tertiary care services. The possibility of complete outsourcing or partial outsourcing in the form of radiology investigations and hiring humanpower on a contract basis can be a viable solution, to reduce the cost on providing emergency care, which can better be utilized in providing high-end tertiary care facilities. How to cite this article Garg N, Gupta SK, Lathwal A, Garg R. A Study of Cost incurred in providing Emergency Care Services in an Apex Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2016;4(1):45-50.

scholarly journals Outcome and complications of self-administration of over-the-counter abortion pills: an observational study in a tertiary care hospital of a medical college in New Delhi

2021 ◽  
Vol 10 (8) ◽  
pp. 3148
Author(s):  
Anjali Singh ◽  
Sruthi Bhaskaran ◽  
Anshuja Singla
Keyword(s):  
Observational Study ◽  
Health Care Providers ◽  
Tertiary Care ◽  
New Delhi ◽  
Care Hospital ◽  
Care Providers ◽  
Self Administration ◽  
Over The Counter ◽  
Gynecology And Obstetrics ◽  
Medical Termination

Background: Due to unrestricted free availability of abortion pills, despite of national policies, guidelines and medical termination of pregnancy (MTP) act, unsafe abortions by self-administration of these drugs for termination of unwanted pregnancies without prescription are becoming common in our country, leading to associated morbidity and mortality.Methods: A prospective Observational study was done at Guru Teg Bahadur hospital, university college of medical sciences, New Delhi, from November 2019 to April 2020, in the department of gynecology and obstetrics, on women visiting the outpatient department and casualty department with the history of self-administration of medical termination pills without prescription. This study was done to study the outcome and complications occurring due to self-administration of over-the-counter abortion pills that are freely available in the market. 95 women were included in study and data was collected regarding age, education level, parity, presenting complaints, complications and their management. Descriptive analysis of the collected data was done.Results: In this study 95 women were included 71.6% took pills before 8 weeks of gestation, 1% took in second trimester. 46.3% landed up in incomplete abortion and 33.68% needed surgical evacuation, 8.42% had ectopic out, 2.1% had scar site pregnancy and 7.36% needed laparotomy, 1.05% had rupture uterus followed by abortion pill intake while 1.05% suffered from acute kidney injury (AKI). There was no ICU admission nor any mortality.Conclusions: There is urgent need of strict legislation to curtail this bad practice and free availability of over-the-counter abortion pills which leads to unexpected morbidity and mortality, such drugs should be given only by health care providers under supervision, there is need of community level awareness so as to impart knowledge regarding this problem. 

Factors associated with choice of delivery with or without epidural analgesia among laboring women: a cross-sectional survey at a tertiary care hospital of a developing country

2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Samina Ismail ◽  
Shemila Abbasi ◽  
Sobia Khan ◽  
Abdul Monem ◽  
Gauhar Afshan
Keyword(s):  
Epidural Analgesia ◽  
Health Care Providers ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Sources Of Information ◽  
Hospital Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Natural Birth

AbstractAims:The aim of this study was to evaluate the factors responsible for epidural analgesia (EA) refusal among parturient patients.Methods:In this prospective cross-sectional study of six months, we included all consenting postpartum patients having a non-operative delivery in the obstetric unit of our hospital. Data were collected on a predesigned questionnaire and included information such as parity, education, reasons for delivering with or without EA, source of information and patient satisfaction. Knowledge regarding EA was assessed from patients delivering without EA.Results:From 933 patients enrolled, 730 (78.2%) delivered without EA, and 203 (21.7%) with EA. Only 11 (1.5%) patients refused EA for the reason of having natural birth process. Otherwise common reasons were misconceptions (65.9%) and lack of awareness about EA (20.5%); 70.5% had no knowledge of common side effects of EA. Among patients delivering with EA, 92.6% were offered EA by health care providers and had obstetricians and anesthesiologists as their sources of information.Conclusions:Patients in developing countries are laboring without EA, even in centers where there is a provision for it. The main reasons for not availing themselves of EA are lack of awareness and knowledge and misconceptions, rather than the desire to have un-medicated natural birth.

scholarly journals P023: Code Resus - using a quality improvement approach to improve health care provider response during resuscitations

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S86-S86
Author(s):  
L.B. Chartier ◽  
S. Hansen ◽  
D. Lim ◽  
S. Yi ◽  
B. McGovern ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care Providers ◽  
Rating Scale ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Change Initiatives ◽  
Chi Square ◽  
Before And After

Introduction: In order to achieve the best possible outcomes for patients requiring resuscitation (PRRs) in the emergency department (ED), health care providers (HCPs) must provide an efficient, multi-disciplinary and coordinated response. A quality improvement (QI) project was undertaken to improve HCP response to PRRs at two tertiary care hospital EDs in Toronto. Methods: We conducted a before-and-after mixed-method survey to evaluate the perception of the adequacy of HCP response and clarity of HCP role when responding to PRRs. The results were compared using the Chi-square test. Qualitative responses to the first survey were also used to inform the development of the QI project. Through interviews of key stakeholders and with continuous input from front-line ED HCPs, a multi-disciplinary team modified the ED resuscitation protocol. This included standardized pre-hospital communication form with paramedics, ED-wide overhead announcement of ‘Code Resus’, dedicated HCPs assigned to respond to PRRs, and specific duties assigned to each responder. Change initiatives were reinforced through education and posters in the ED. Six months after implementation, a second survey was conducted to evaluate the sustained effects of the intervention. Results: Baseline measures indicated that 16 of 52 (30.8%) nurses surveyed believed their role was often or always apparent to themselves and others when they attended to a PRR (on a 5-point rating scale). This proportion increased to 35 of 55 (63.6%) nurses in the post-implementation survey (p < 0.001). Regarding adequacy of the number of HCPs responding to PRRs, 17 of 39 (43.6%) physicians and 23 of 53 (43.4%) nurses surveyed thought the appropriate number of HCPs responded to PRRs; the remainder thought that there were too few or too many HCPs. In the post-implementation survey, 34 of 41 (82.9%) physicians (p < 0.001) and 36 of 56 (64.3%) nurses (p = 0.029) surveyed felt that the appropriate number of HCPs attended to PRRs. Conclusion: Using a quality improvement approach, we identified and quantified perceived deficiencies in HCP response to PRRs in the ED. Through feedback-based modifications of the ED resuscitation protocol and by engaging HCP stakeholders, change initiatives were implemented to improve HCP response. As a result, this project achieved significant and sustained improvements in HCPs’ perceived response to PRRs.

scholarly journals Antenatal determinants of maternal weight gain during pregnancy in nulliparous women of urban and suburban parts of Maharashtra

2020 ◽  
Vol 7 (2) ◽  
pp. 642
Author(s):  
Swati T. Dahake ◽  
Uzma Shaikh
Keyword(s):  
Weight Gain ◽  
Health Care Providers ◽  
Educational Level ◽  
Statistical Tests ◽  
Tertiary Care ◽  
Care Hospital ◽  
Maternal Weight Gain ◽  
Care Providers ◽  
Maternal Weight ◽  
Weight Gain During Pregnancy

Background: Weight gain in pregnancy remains a matter of great concern for women and health care providers.  Adherence to a balanced diet throughout pregnancy, influences maternal body weight as well as short- and long-term health of mother and child. Objective of this study was to study antenatal maternal and social factors affecting maternal weight gain among Nulliparous women.Methods: study was carried out in antenatal clinics of tertiary care hospital and a suburban health center with sample size 197 and 97 respectively. Maternal weight was measured at the first antenatal clinic visit and at delivery. Statistical analysis was done with SPSS version 20. Statistical tests used were mean, percentages and chi square.Results: The antenatal determinants of maternal weight gain were: being underweight at the booking visit, maternal complications during pregnancy, passive cigarette smoking during third trimester, low educational level and low per capita income, controlling for the effect of gestational age.Conclusions: maternal educational level, per capital income, passive smoking, caloric and protein deficiency, early pregnancy body mass index determines the weight gain during pregnancy.

scholarly journals Rising trend in cesarean sections: a retrospective study at tertiary care hospital in Jammu

2021 ◽  
Vol 10 (5) ◽  
pp. 1958
Author(s):  
Shazia Zargar ◽  
Nikita Gandotra
Keyword(s):  
Retrospective Study ◽  
Health Care Providers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Care Hospital ◽  
Care Providers ◽  
Cesarean Sections ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity

Background: The uncontrolled wave of cesarean rates has increased globally which has resulted in a significant amount of maternal mortality and morbidity. The present study aims to evaluate the trend in cesarean section rates in Jammu, India. Methods: The present retrospective study was carried out at the department of Obstetrics and Gynecology, SMGS Hospital, Jammu, India. We collected data based on total number of deliveries and cesarean sections performed at the hospital during (March2015-Feb2020) along with indications for CS.Results: The percentage of cesarean sections has increased drastically from 39.4% during (2015-16) to 49.9% in (2019-20). The study shows that the most common indication for CS is post CS followed by NPOL, Fetal distress, breech, APH, CPD, PIH and others.Conclusions: There is a growing concern among public and health care providers regarding the escalating and uncontrolled trend of cesarean sections which needs to be curtailed within optimal limits recommended by WHO. 

scholarly journals Accreditation is not a One-time Process: Quality Assessment of Intensive Care Unit during Post-NABH Accreditation Period in a Tertiary Care Hospital

2017 ◽  
Vol 5 (1) ◽  
pp. 29-41
Author(s):  
Suneeta Dubey ◽  
VK Tadia ◽  
Monalisa LNU
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Assessment ◽  
Health Care Providers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Process Quality ◽  
Care Hospital ◽  
Time Process ◽  
Care Providers

ABSTRACT Accreditation is an integral part of quality and it is not a onetime process. This study was done to know the extent to which hospitals maintain the standards after obtaining accreditation. This study tries to find out the gaps in standards during the postaccreditation period. The objective of the study was to assess the policies of the intensive care unit (ICU) with reference to standard protocols of the National Accreditation Board for Hospital and Health Care Providers (NABH) and measures taken by the management to maintain the standards. Data was collected from a 285-bedded NABH-accredited hospital that had five ICUs and four recovery rooms by means of nonparticipant observation, semistructured interviews. Data on indicators was collected by using the hospital management information system; the questionnaire on satisfaction was filled by 30 patients/relatives who were admitted in the ICU for more than a week. Quality team was interviewed to know the perception of the management toward quality and accreditation. To know the compliance of the staff to the NABH standards, a surprise check was done in three ICUs of the hospital. Data analysis showed that the organization was not able to maintain the standards, as it had done at the time of accreditation. The quality team strongly accepted that accreditation helps in maintaining and improving quality, whereas the data from ICUs showed a wide variation in compliance. Three ICUs from the same hospital were having different compliance rates for standards, which shows that staff was not aware about the standard protocol to be followed. The patient-satisfaction questionnaire also showed that the patients were not satisfied with the services given. How to cite this article Tadia VK, Monalisa, Dubey S. Accreditation is not a One-time Process: Quality Assessment of Intensive Care Unit during Post-NABH Accreditation Period in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2017;5(1):29-41.

Sign in / Sign up

Export Citation Format

Share Document