A Research Project to Improve Human Resource Record Management System of Nurses In A Teaching Hospital, Sri Lanka

Background: Poor quality records management in Sri Lankan Hospital offices is a major dissatisfaction and demotivation for healthcare staff. An intervention research project to improve the record management of selected Human Resource (HR) records of nurses in an Office of a Tertiary Care Hospital in Sri Lanka was carried out to identify the gaps, implement improvements and to test the outcome. Methods: Grade promotion and annual increment HR processes considered for the improvements. Qualitative and quantitative techniques used for gap identification, planning of interventions and assessment of the effectiveness. A package of quality improvements initiatives implemented following literature review and stakeholder participation. Results: Absence of instructions/sample filled-forms and issues in the document flow were the inconsistencies noted. The record processing time was 30.83 days with an SD of ±4.84 for completion of annual increments and 24.33 days with an SD of ±4.21 for authorisation of grade promotions. The package of interventions included e-based/ paper-based guides and specimen request forms and a document movement register to track the records. Increased accessibility, accuracy, improved quality, timeliness and improved traceability of submitted forms and improvements in the average time spent for annual increments and grade promotions noted; 17.52 days (SD ±3.39) and 12.13 days (SD ±2.33) respectively, a statistically significant reduction (p<0.05). Conclusion: Implementation of quality improvement interventions using computer based initiatives with stakeholder participation can improve office management issues in the tertiary hospital setting.

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Detection of Oxacillin (Methicillin)-resistant Staphylococcus aureus Isolated from a Tertiary-care Hospital, Georgetown, Guyana

Microbiology Research Journal International ◽

10.9734/mrji/2019/v29i630182 ◽

2020 ◽

pp. 1-7

Author(s):

Paul Cheddie ◽

Drovashti Seepersaud ◽

Tereasia Ramlochan

Keyword(s):

Staphylococcus Aureus ◽

Tertiary Care Hospital ◽

Methicillin Resistance ◽

Tertiary Care ◽

Hospital Setting ◽

Tertiary Hospital ◽

Care Hospital ◽

Prevalence Survey ◽

Methicillin Resistant ◽

Broth Microdilution Method

Background and Aim: Methicillin-resistant Staphylocccus aureus (MRSA) continues to be a major problem globally. Previous data had suggested that the prevalence of MRSA infections in the tertiary hospital setting was 51%. The aim of this study was to conduct a point prevalence survey of MRSA infections occurring at a tertiary-care hospital in Georgetown, Guyana, and to determine to what extent methicillin-resistance was occurring among Staphylococcus aureus isolates utilising the minimum inhibitory concentration (MIC) data. Study Design: This study was based on a prospective, analytical design. Place and Duration of Study: Microbiology department, Georgetown Public Hospital Corporation (GPHC), and Department of Medical Technology, University of Guyana, between May 2019 and July 2019. Methodology: A total of 101 consecutive, non-repetitive, laboratory-identified MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) isolates were tested using an oxacillin broth microdilution method. Results: We found that 65.4% of Staphylococcus aureus were oxacillin (methicillin) resistant with a majority of the isolates being high level oxacillin resistant strains (i.e., MICs > 256 μg/ml) (84.85%). Most of the resistant isolates were collected from patients admitted to medical and surgical wards. Conclusion: Methicillin-resistance continues to be a major problem in the hospital setting and conventional techniques are unlikely to identify all of the potentially resistant isolates.

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Genomic diversity of antibiotic multi-resistant Staphylococcus epidermidis isolated from a tertiary care hospital in México City

10.7287/peerj.preprints.27693v1 ◽

2019 ◽

Author(s):

Roberto Cabrera-Contreras ◽

Rosa I Santamaría ◽

Patricia Bustos ◽

Irma Martínez-Flores ◽

Enrique Meléndez ◽

...

Keyword(s):

Mexico City ◽

Staphylococcus Epidermidis ◽

Tertiary Care ◽

Hospital Setting ◽

Opportunistic Pathogen ◽

Tertiary Hospital ◽

Genomic Diversity ◽

Whole Genome ◽

Care Hospital ◽

Worldwide Distribution

Staphylococcus epidermidis is a human commensal and opportunistic pathogen worldwide distributed. To ascertain which pathogenic S. epidermidis clones are circulating in a local tertiary hospital setting, we sequenced the complete genomes of 17 S. epidermidis isolates obtained from neonatal infections at a Hospital Care Unit in México City. Genomic comparisons between S. epidermidis isolates revealed high pairwise whole genome nucleotide identities of about 97% to 99% and essentially a clonal structure. We inferred eight Multilocus Sequence Types (MLST´s), six of them of worldwide distribution, and two showing allelic variants, not in MLST databases. The profile of virulence includes genes involved in biofilm and modulin formation; most of the strains are multi-resistant to methicillin and several other beta-lactams, fluoroquinolones, and macrolides. Uneven distribution of insertion sequences, phages, and CRISPR-Cas immunity phage systems suggest frequent horizontal gene transfer. Rates of recombination between S. epidermidis strains were more frequent than the mutation rate and affected the whole genome. Therefore, recombination properties shape the population structure of local nosocomial S. epidermidis strains, formed by pathogenic and probably, non-pathogenic clones.

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Needle stick injury reporting among surgeons in tertiary hospitals of Lahore

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.06.3593 ◽

2019 ◽

Vol 26 (06) ◽

Author(s):

Muhammad Umar Younis ◽

Syed Faraz-ul- Hassan Shah ◽

Aliya Muzafar ◽

Muhammad Zeeshan Sarwar ◽

Fakeha Rehman ◽

...

Keyword(s):

Tertiary Care ◽

Hospital Setting ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Needle Stick Injury ◽

Care Hospital ◽

Cross Sectional ◽

Surgical Practice ◽

Needle Stick ◽

Needle Stick Injuries

Background: Needle stick injuries have a fairly common incidence in surgical practice exposing surgeons to an array of transmissible diseases. The aim of the study was to assess the prevalence of needle stick injury, and their reporting among surgeons in tertiary hospital setting. Study Design: Cross-sectional study. Setting: Various tertiary care hospital of Lahore. Period: January 2016 through April, 2016. Methods: Our sample size was 935 Surgeons. We determined the prevalence of needle stick injuries, reporting of NSI, the reasons for not reporting and the reasons for acquired injuries. Results: Needle stick injury was reported by only 85 (9.1%) participants. The reasons for not reporting varied; 363 (38.8%) did not report due to unawareness of the existence of a relevant system, 250 (26.7%) did not know whom to report, 86 (9.2%) were not able to spare time to report, 81 (8.7%) were afraid of results, 48 (5.1%) thought that patient was low risk and 107 (11.4%) did not bother. Conclusion: There was a lack of hospital policy to cater to the reporting of injuries sustained during surgical practice. A dire need for a system was observed to educate the healthcare workers and provide a medium to assist the process of reporting.

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An observational study on usage of insulin and self-injection practises among patients with diabetes attending to Diabetic Centre and Medical outpatient clinics of a tertiary care hospital of Northern Sri Lanka

10.21203/rs.3.rs-122005/v1 ◽

2020 ◽

Author(s):

Sathyasagaran Narayanapillai ◽

Peranantharajah Thambipillai ◽

Aravinthan Mahalingam ◽

Rajeshkannan Nadarajah

Keyword(s):

Sri Lanka ◽

Injection Site ◽

Low Income ◽

Tertiary Care ◽

Insulin Injection ◽

Tertiary Hospital ◽

Low Income Countries ◽

Care Hospital ◽

Premixed Insulin ◽

Cross Sectional

Abstract Background: Prevalence of diabetes increasing world-wide particularly in low income countries. Management of diabetes sometimes requires insulin injection due to various reasons. Proper usage of insulin and injection techniques are important for diabetes control among who requires insulin. This study was aimed to assess current insulin practices and associated complications.Methods and material: This was a cross sectional study conducted among diabetes patients attended all medical clinics and Diabetic Centre in Jaffna teaching Hospital which is the only tertiary hospital in the Northern Sri Lanka in May 2020.Insulin practices retrieved by using interviewer administered questionnaire. Data was analyses by using SPSS 26.Results: Out of 360 patients 64.2% were female and mean age was 58.19 (12-89).Majority (61.9%) of them belongs to low income category and most (73.3%) of them using insulin more than 1 year. Main reason for the insulin initiation was oral hypoglycaemic failure (81.7%) and majority of them (80.0%) were using twice daily premixed insulin regime followed by daily basal insulin (11.4%) and basal bolus insulin (5.6%) regime. Most of the participants (81.4%) reported they do cleaning of the injection site before injection and 89.7% usually rotate the injection site. Approximately half of them (50.8%) inject themselves and majority use syringes (91.4%). Common injection site complications reported were skin changes (25%), followed by 15.3% persistent swelling (15.3%) and thinning of skin(7.8%). Angle of injection (P-0.039) and insulin regime (P<0.001) showed statistically significant association with skin changes.High proportion of participants 68.6% (95%CI: 63.7%-73.2%) experienced hypoglycaemia, using syringes 2.21 times (95%CI-1.05-4.64) more risk of compare to pen users and missing meals 2.22 times more risk of hypoglycaemic events (95%CI: 1.18-4.17). Majority of them reported reusing the needles for injection (83.6%) and 35% were disposing needle into common garbage pin.Conclusion: This study revealed significant gaps in current insulin practices from expected norm and hypoglycaemic events alarmingly high among participants. Exploring Continuous Glucose Monitoring Devices or flash monitoring can be a mitigation strategy and urgent attention from health professionals needed to improve the safe insulin practices.

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Illness Representations of Hypertension among Nepali Patients at a Tertiary Care Hospital Clinic: An exploratory survey

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i4.2526 ◽

2021 ◽

Vol 18 (4) ◽

pp. 758-762

Author(s):

Ram Kishor Sah ◽

Andrea Straus ◽

Deepak Sundar Shrestha ◽

Hari Har Khanal ◽

Bishnu Dutta Paudel ◽

...

Keyword(s):

Common Sense ◽

Tertiary Care ◽

Self Regulation ◽

Hospital Setting ◽

Tertiary Hospital ◽

Illness Representations ◽

Care Hospital ◽

Common Sense Model ◽

Coping Responses ◽

Sense Model

Background: The prevalence of stage 2 hypertension approaches one-third in adult Nepalis and despite inexpensive effective treatment, long-term compliance is poor. World-wide, a major impediment is the incongruity between hypertension and patients’ symptom-based illness representations. The Common-Sense Model of Self-regulation was used to investigate Nepali illness representations through open-ended interviews of patients with hypertension.Methods: In a tertiary hospital setting, 50 self-identified hypertensive patients were interviewed about their representations of health, hypertension, and hypertensive treatment. Responses were analyzed with a modified Interpretative Phenomenological Analysis.Results: An Ayurvedic-influenced health model appeared in illness identity and coping responses. Hypertension was identified as a serious disease having observable, wide-ranging symptoms with chronic and intermittent timelines. Concerns included side-effects and barriers to treatment. Conclusions: Further confirmation and investigation of Nepali common-sense hypertension models in a sample size sufficient for factor analysis is warranted for effective adherence interventions.Keywords: Common-sense model; hypertension adherence; illness representations; Nepal

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Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v7i2.19326 ◽

2013 ◽

Vol 7 (2) ◽

pp. 06-12

Author(s):

Zahidul Hasan ◽

Md. Kamrul Islam ◽

Arifa Hossain

Keyword(s):

Blood Stream Infection ◽

Tertiary Care ◽

Blood Stream ◽

Tertiary Hospital ◽

Healthcare Associated Infections ◽

Care Hospital ◽

Gram Negative ◽

Acinetobacter Spp ◽

Tract Infections ◽

Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

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Prevalence and clinical correlation of hepatitis E virus antibody in the patients’ serum samples from a tertiary care hospital in Thailand during 2015–2018

Virology Journal ◽

10.1186/s12985-021-01616-x ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Atiporn Boonyai ◽

Anchalee Thongput ◽

Thidarat Sisaeng ◽

Parisut Phumchan ◽

Navin Horthongkham ◽

...

Keyword(s):

Pregnant Women ◽

Tertiary Care ◽

Laboratory Data ◽

Organ Transplant ◽

Hospital Setting ◽

Antibody Detection ◽

Enzyme Linked Immunosorbent Assay ◽

Care Hospital ◽

Serum Samples ◽

Igm Antibodies

Abstract Background Prevalence and incidence of hepatitis caused by HEV infection are usually higher in developing countries. This study demonstrated the HEV seroprevalence and incidence of HEV infection in patients with clinical hepatitis in a tertiary hospital in Thailand. Methods A laboratory-based cross-sectional study was conducted using 1106 serum samples from patients suspected of HEV infection sent to the Serology laboratory, Siriraj Hospital, for detecting HEV antibodies during 2015–2018. Prevalence of anti-HEV IgG and IgM antibodies in general patients, including organ transplant recipients and pregnant women in a hospital setting, were determined using indirect enzyme-linked immunosorbent assay (ELISA) kits. Comparison of laboratory data between groups with different HEV serological statuses was performed. Results HEV IgG antibodies were detected in 40.82% of 904 serum samples, while HEV IgM antibodies were detected in 11.75% of 1081 serum samples. Similar IgG and IgM antibody detection rates were found in pregnant women. Interestingly, anti-HEV IgM antibodies were detected in 38.5% of patients who underwent organ transplantation. Patients who tested positive for anti-HEV IgM antibodies had higher alanine aminotransferase levels than those who had not. In contrast, patients who tested positive for anti-HEV IgG had more elevated levels of total bilirubin than those who tested negative. Conclusions HEV seroprevalence and incidence in patients with clinical hepatitis were relatively high in the Thai population, including the pregnancy and organ transplant subgroups. The results potentially benefit the clinicians in decision-making to investigate HEV antibodies and facilitating proper management for patients.

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