scholarly journals Role of Informed Consent in Reducing Pre-Operative Anxiety

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Informed Consent ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Preoperative Anxiety ◽  
Care Hospital ◽  
Post Intervention ◽  
Public And Private ◽  
Surgical Units ◽  
Quasi Experimental

Background: Preoperative anxiety is challenging concept in preoperative patients. It could reduce by various methods; one of them is informed consent in which information is provided to patients regarding anesthesia and surgical procedure, it also helps patients to make autonomous decision. Objective: The aim this study was to identify the role of informed consent in preoperative anxiety, in surgical patients of both public and private tertiary care hospital Peshawar. Method: A quasi experimental study design was carried out among preoperative patients of surgical units. The sample of 65 participants was selected through convenient sampling technique. First, the preoperative anxiety was measured with valid adopted questionnaire APAIS. Second, the informed consent was explained to patients and after this again preoperative anxiety was measured to see the effect of informed consent on preoperative anxiety. Results: Among 65 participants 41 (63.1%) were males and 24 (36.9%) were females. 58 (89.2%) were married and 7 (10.8%) were unmarried. The mean age of participants was 49.92 +16.76 years. 24 (36.9%) of the participants were uneducated, 17 (26.2%) primary, 13 (20.0%) secondary, 6 (9.2%) bachelor, and 5 (7.7%) had higher education. The participants were graded for preoperative anxiety, 3 (4.6%) had somewhat, 9 (13.8%) moderate, 27 (41.5%) moderately high, and 26 (40.0%) had extremely high anxiety. while the post-intervention anxiety grades were identified as 20 (30.8%) somewhat, 18 (27.7%) moderate, 17 (26.2%) moderately high, and 10 (15.4%) extremely high. The study shows that well explained informed consent reduced the patient pre-operative anxiety. Conclusion: Preoperative anxiety is common phenomena experienced by patient undergoing through surgical procedures, informed consent is a tool that ensure the respect of patient autonomy and reduce their preoperative anxiety.

scholarly journals Practice of Informed Consent, Confidentiality and Privacy by Physicians at a Tertiary Care Teaching Hospital

2015 ◽  
Vol 5 (3) ◽  
pp. 1-5
Author(s):  
Zoheb Rafique Rafique ◽  
Urooj Bhatti
Keyword(s):  
Informed Consent ◽  
Medical Ethics ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Public Sector Hospital ◽  
Privacy And Confidentiality ◽  
Structured Questionnaire

Objective: The aim of this paper was to assess the practice of medical ethics by the physicians at a public sector hospital in Jamshoro Sindh. Material and methods: This survey was conducted at four medical units of tertiary care hospital at jamshoro in the month of august 2014. Participants were randomly selected from patients aged over 18 years. A structured questionnaire was designed and the participants were asked about their demographic profile and their physician’s practice regarding informed consent, maintaining confidentiality, privacy and other treatment formalities. Written consent was taken from all the participants before interview.Results: A total of 100 patients were randomly selected for this study. The majority of patients reported that informed consent was taken from them. The patients also responded that privacy and confidentiality is maintained during their treatment. However, many patients agreed that they were not properly informed about the laboratory findings, role of proposed drugs and also side effects of drugs. Conclusion: There is marked improvement in the practice of medical ethics by physicians of this tertiary care hospital. However, awareness workshops should be conducted to update and improve the knowledge of medical ethics among physicians. This will surely help them translate the knowledge into practice. DOI: http://dx.doi.org/10.3329/bioethics.v5i3.21531 Bangladesh Journal of Bioethics 2014 Vol.5 (3): 1-5.

scholarly journals Effect of Abdominal Physiotherapy in Reduction of Inter Recti Distance in Postpartum Females

2021 ◽  
Vol 15 (6) ◽  
pp. 1446-1448
Author(s):  
K. Kazmi ◽  
G. M. Hashmi ◽  
M. Bilal ◽  
N. Iqbal ◽  
Wajeeha . ◽  
...  
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Abdominal Muscle ◽  
Postnatal Period ◽  
P Value ◽  
Care Hospital ◽  
Post Intervention ◽  
Gynecology And Obstetrics ◽  
Diastasis Recti ◽  
Quasi Experimental

Aim: To see the effect of abdominal exercises in the recovery of diastasis recti in post natal females. Methodology: A Quasi Experimental study design was used to enroll 40 participants from OPD of Gynecology and Obstetrics from a Tertiary Care Hospital Lahore between ages ranged from 18 to 30 years. Using purposive sampling all postpartum females having diastasis of rectus abdominis muscles with inter recti distance more than 2 fingers width were enrolled. All the study participants received abdominal muscle exercises program for 30 min a day in 8 week program. inter recti distance was measured by using two finger palpation method. All the pre intervention and post intervention data were recorded into a short structured proforma.Results were considered significant for p value ≤ 0.05. Results: 40 participants were selected in this study with an age from 18- 30 years. The inter recti distance was significantly reduced as p value was ≤ 0.05 for both (above umbilicus and below umbilicus) groups. Conclusion: It was observed that abdominal exercises helped in the recovery of diastasis and reduced the separation between the muscles in postpartum women. It also enlightens the importance of the prescription of physiotherapy in reduction of post partum complications. Keywords: Abdominal Exercises, Diastasis Recti, Pregnancy, Postnatal period,

scholarly journals EFFECTIVENESS OF VIRTUAL REALITY IN RECOVERY OF MOTOR FUNCTION IN POST-STROKE HEMIPARESIS: A QUASI-EXPERIMENTAL STUDY

2018 ◽  
Vol 7 (2) ◽  
pp. 45-51
Author(s):  
Bakhtawar Saleem
Keyword(s):  
Virtual Reality ◽  
Motor Function ◽  
Functional Performance ◽  
Tertiary Care ◽  
Rehabilitation Program ◽  
Sensorimotor Function ◽  
Care Hospital ◽  
Post Intervention ◽  
Post Stroke ◽  
Quasi Experimental

Virtual Reality(VR) is a novel treatment approach for stroke rehabilitation as it enables individuals to reproduce standard controlled movements to accomplish functional task. In contrast to conventional rehabilitation that is monotonous, long-term and challenging, VR increases patient interest in rehabilitation thereby reduces the boredom and adaptation therefore enhances the visuo-spatial feedback. It has been observed that approximately 65% of the stroke survivors suffer hemiparesis that predominantly leads difficulty in performing daily living activities. Therefore, this study aims to assess the sensorimotor and functional performance in post-stroke hemiparetic patients using VR based gaming system. A total of 81 participants who had first-ever ischemic or hemorrhagic stroke with onset of >6 months, enrolled in post-acute rehabilitation program at Tertiary Care Hospital were included. The VR gaming software named Wonder Tree (WT) © was used for the intervention. All participants were required to play two different games i.e. bucket ball and bubble pop for 15-20 minutes, 3 days/week for the duration of 8th weeks. Participants were assessed on baseline and post-intervention on Fugyl-Meyer Assessment for Upper Extremity (FMA-UE) and Wolf Motor Function Test (W.MFT) to assess sensorimotor function and functional skills. Participants showed significant improvement in sensorimotor function and functional abilities (p<0.05) after 8th weeks of intervention.

Measuring the Effect of Dimensional Analysis on Nurses' Level of Self-Efficacy in Medication Calculation Errors

2021 ◽  
Vol 15 (12) ◽  
pp. 3579-3582
Author(s):  
Tariq Ullah ◽  
Muhammad Afzal ◽  
Hajra Sarwar ◽  
Asif Hanif ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Experimental Study ◽  
Dimensional Analysis ◽  
Self Efficacy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Post Intervention ◽  
Quasi Experimental ◽  
Care Improvement ◽  
Medication Calculation

Aims of The Study: The main aim of this study is to improve the calculation of medicines in nurses and develop a master plan for drug calculation competencies which will be yearly renewable. Objective: To evaluate the effects of dimensional analysis on the self-efficacy levels of nurses, specifically regards to their medication calculation abilities. Methodology: Quasi experimental study design was used in this study. This quasi-experimental study was conducted at the teaching hospital of the University of Lahore. It is a tertiary care hospital with 450-bedded capacities where almost 113 registered nurses are performing their duties in different shifts. Results: the frequency and classification of gender, in which male were 22% and female were 78%, the classification of age in which 21- 25 years old participants were 12.45%, some participants age between 26-30 years were 28.3%, participants of 31-35 years were 37.2%, the participants whose age were 36-40 years were 15% and above 40 years participants age were 701%. Classification of education in which 16.8% participants were General Nurse, 36.3% participants were Post RN and 46.9% participants were Generic BSN. The classification of Designation also discusses such as, 47.8% participants were charge nurses, 32.7% were Shift In charge and 19.5% were unit In charge. Conclusion: This study focusses to enhance the mathematical skills of the nurses and minimize the calculation errors of nurses during medication which is a challenging issue among nurses. This study is to extend focus on improving nurse’s medication calculation accuracy. To accomplish the stated purpose, a single intervention dimensional analysis was used which provide a situation for health-care improvement and to find techniques for improving the rate of medication errors. Statistically 39.86% difference recorded in pre-and post-intervention data. Keywords: Self Efficacy, Dimensional Analysis, medication calculation, mathematical calculation confidence level

TO DETERMINE THE ROLE OF CA125 IN THE DIAGNOSIS OF ACUTE APPENDICITIS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Vinod Kumar ◽  
Bhupen Songra ◽  
Richa Jain ◽  
Deeksha Mehta
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Ca 125 ◽  
Care Hospital ◽  
Serum Samples ◽  
Roc Curve Analysis ◽  
Surgery Department

Background: the present study was under taken to determine the role of CA-125 in the diagnosis of acute appendicitis (AA), to prevent its complications and also in preventing negative appendicectomies in tertiary care hospital. Methods: The study was conducted at a tertiary care and research center between 01/03/2018 to 30/06/2019. Patients admitted to the surgery department with diagnosis of AA were considered for the study. After informed consent, a, standardized history was obtained as a case Performa. Serum samples from all the cases with clinical diagnosis of AA were obtained and stored. Only the cases with histopathologically approved AA were included in the study. Cases operated for clinical diagnosis of AA, but not histopathologically proven AA was not included in the study. CA125 levels in cases with definitive diagnosis of AA were measured. Results: In present study, ROC curve analysis revealed the sensitivity of 87.27 % and specificity of 90.91 % when the CA 125 cut-off value of > 16.8 was taken to diagnose acute appendicitis. AUC was 0.911 with a standard error of 0.0292. Conclusion: In this study we have observed that CA125 showed a positive correlation with acute appendicitis, that was statistically not significant (P>0.05). We didn’t evaluate the correlation with the disease severity. We consider that CA125 can be used as a marker in acute appendicitis cases although further research is still needed. Keywords: CA125, Acute Appendicitis, Surgery.

The role of the clinical pharmacist in guiding adjuvant hormonal therapy in patients with breast cancer

2021 ◽  
pp. 107815522110293
Author(s):  
Amanda V Pirolli ◽  
Tatiana Brusamarello ◽  
Stella S Everton ◽  
Vânia M S Andrzejevski
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Hormonal Therapy ◽  
Clinical Pharmacist ◽  
Tertiary Care ◽  
Structured Interview ◽  
Care Hospital ◽  
Adjuvant Hormonal Therapy ◽  
Breast Cancers

Breast cancer is the most prevalent type of cancer among women, affecting about 2.1 million worldwide and is responsible for the highest number of cancer-related deaths among women. Approximately 80% of breast cancers express on the surface of hormone receptor cells, such as progesterone and estrogen. In these cases, Adjuvant Hormonal Therapy (AHT) is indicated for a period of five to ten years and consists of taking a daily oral pill. The two most used drugs in AHT are tamoxifen and Aromatase Inhibitors. One of the issues most faced by individuals who are subjected to long periods of treatment is the lack of medication adherence and, consequently, therapeutic inefficiency. It is believed that the monitoring by the pharmacist can contribute to the reduction of errors inherent to the medication, making the treatment more effective and improving the patient's quality of life. The present study aimed to know the perception of patients who live with breast cancer and who do AHT in relation to the educational performance of the clinical pharmacist. This is a qualitative, descriptive and exploratory study, carried out from March to October 2020, with 15 women undergoing treatment at the oncology unit of a tertiary-care hospital in south of Brazil. The data were obtained through a semi-structured interview using an instrument composed of two parts, one referring to the characterization of the participants and the other with the guiding question of the research: "How do you perceive the role of the pharmacist in relation to the guidelines for the use of adjuvant hormonal therapy?". The method of theoretical saturation was used to perform the sample closure and the thematic analysis was used to analyze the data. The participants were between 32 and 74 years old, seven were on tamoxifen therapy and eight on anastrozole, ten were on the first year of treatment, two on the second and three on the third year. The themes that emerged were: pharmacist-patient interaction as a safety factor in hormone therapy; role of the pharmacist in the development of strategies for self-management of the patients during hormone therapy; and, challenges for the pharmacist in relation to hormone therapy through continued guidance. It was evident that the pharmacist's educational action encouraged the participants to carry out the treatment in a more confident and assertive manner according to their particularities and beliefs.

scholarly journals 600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S362-S363
Author(s):  
Gaurav Agnihotri ◽  
Alan E Gross ◽  
Minji Seok ◽  
Cheng Yu Yen ◽  
Farah Khan ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Intervention Group ◽  
Care Hospital ◽  
Full Time ◽  
Post Intervention ◽  
Before And After ◽  
The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p&lt; 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

scholarly journals The effect of care transition pathway implementation on patients undergoing joint replacement during the COVID-19 pandemic: a quasi-experimental study from a tertiary care hospital orthopedic department in Beijing, China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ya-ping Xu ◽  
Pei-yu Zhao ◽  
Yi-tong Bai ◽  
Shuang Li
Keyword(s):  
Joint Replacement ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Transition ◽  
Control Group ◽  
Care Hospital ◽  
Quasi Experimental ◽  
And Control ◽  
Beijing China

Abstract Background The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. Methods A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. Results The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. Conclusions A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care.

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