scholarly journals COVID-19 Pandemic—Frontline Experiences and Lessons Learned From a Tertiary Care Teaching Hospital at a Suburban Location of Southeastern India

2021 ◽  
Vol 9 ◽  
Author(s):  
V. Nirmal Coumare ◽  
Swati Jayant Pawar ◽  
P. S. Manoharan ◽  
R. Pajanivel ◽  
Lokesh Shanmugam ◽  
...  
Keyword(s):  
Health Care ◽  
Teaching Hospital ◽  
Local Population ◽  
Tertiary Care ◽  
Ground Level ◽  
Lessons Learned ◽  
Infection Prevention And Control ◽  
Local Conditions ◽  
Tertiary Teaching ◽  
Hospital Preparedness

The key challenges to any health care setup during emergency situations, such as that of the COVID-19 pandemic would be to rapidly address hospital preparedness and response tailored to the local population, societal influences, political factors within the existing infrastructure, and workforce. Second, to adopt and moderate policies, standard operating procedures (SOPs) and guidelines issued by national and international agencies, such as WHO, CDC, and the Indian Council for Medical Research (ICMR) were tailor-made to the local conditions of the hospital and community. In this publication, we have discussed the challenges and experiences in preparation and responses to the ongoing COVID-19 pandemic at a tertiary teaching hospital situated at a suburban locale in a small union territory. Puducherry is located in the South Eastern Coromandel Coast of India. The core processes, such as hospital preparedness, adoption, and amendments to SOPs based on dynamic changes in guidelines released by the central and local government, training given to health care workers, setting up the in-house diagnostic facility, surge capacity, management of supplies during the lockdown, infection prevention, and control and patient care are discussed. We have also reinforced our experiences in translating COVID-related opportunities for research and innovation in the form of awards and research proposals for the faculty and students of our institute. The lessons learned in terms of strength and limitations on the ground level of public health during this process is worth sharing as it would provide guidance in preparing the health care setups for pre- and post-pandemic.

scholarly journals External validation for sensitivity of the Ottawa subarachnoid hemorrhage rule in a Japanese tertiary teaching hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomoharu Suzuki ◽  
David Itokazu ◽  
Yasuharu Tokuda
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
External Validation ◽  
False Negative ◽  
False Negative Rate ◽  
Prediction Rule ◽  
Japanese Patients ◽  
Inclusion Criteria ◽  
Tertiary Teaching

AbstractThe Ottawa subarachnoid hemorrhage (OSAH) rule is a validated clinical prediction rule for ruling out subarachnoid hemorrhage (SAH). Another SAH rule (Ottawa-like rule) was developed in Japan but was not well validated. We aimed to validate both rules by examining the sensitivity for ruling out SAH in Japanese patients diagnosed with SAH. We conducted a retrospective cohort study by reviewing the medical records of consecutive adult patients hospitalized with SAH at a tertiary-care teaching hospital in Japan who visited our emergency department between July 2009 and June 2019. Sensitivity and its 95% confidence interval (CI) were estimated for each rule for the diagnosis of SAH. In a total of 280 patients with SAH, 56 (20.0%) patients met the inclusion criteria and were analyzed for the OSAH rule, and a sensitivity of the OSAH rule was 56/56 (100%; 95% CI 93.6–100%). While, 126 (45%) patients met the inclusion criteria of the Ottawa-like rule, and the rule showed a sensitivity of 125/126 (99.2%; 95%CI 95.7–100%). The OSAH rule showed 100% sensitivity among our Japanese patients diagnosed with SAH. The implementation of the Ottawa-like rule should be cautious because the false-negative rate is up to 4%.

scholarly journals Use of the Fluoride Varnish Billing Code in a Tertiary Care Center Setting

2020 ◽  
Vol 11 ◽  
pp. 215013272091373
Author(s):  
Peter Kim ◽  
Jeanette M. Daly ◽  
Sharon Berkowitz ◽  
Barcey T. Levy
Keyword(s):  
Teaching Hospital ◽  
Task Force ◽  
Care Center ◽  
Tertiary Care ◽  
The United States ◽  
Fluoride Varnish ◽  
Successful Implementation ◽  
Clinical Notes ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

Introduction: Dental caries is the most common chronic disease in children from birth through 5 years of age. Application of fluoride varnish (FV) is recommended for children younger than 6 years every 3 to 6 months by the United States Preventive Services Task Force. The purposes of this study were to (1) assess use and reimbursement of Current Dental Terminology (CDT) D1206 and Current Procedural Terminology (CPT) 99188 codes, which are the billing codes for FV application; (2) determine when and by whom each FV code was used; and (3) summarize the associated clinical notes. Methods: Using the electronic medical record data warehouse from a single tertiary teaching hospital and its affiliated primary care clinics, the dates of service, departments, provider names, and patient identifiers associated with codes CDT D1206 and CPT 99188 were collected. The content of clinical notes was reviewed and summarized. The study period was from May 1, 2009 through May 17, 2019. Results: During the 10-year time period, CDT D1206 was used 5 times and CPT 99188 was used 35 times. FV was applied exclusively during well-child visits. Only pediatricians, and no family physicians, applied FV in this setting. Discussion: A single pediatrician championing for FV application increased both the completion of procedure and the appropriate billing in 2019. Conclusion: FV application has been likely underutilized in this Midwestern tertiary teaching hospital and its affiliated clinics. For both family medicine and pediatric offices, an advocate for caries prevention is likely needed for successful implementation of FV application at well-child visits.

scholarly journals Prevalence of Depression among Medical Students of a Tertiary Care Teaching Hospital

2019 ◽  
Vol 57 (220) ◽  
Author(s):  
Nikhil Shrestha ◽  
Neharika Shrestha ◽  
Smriti Khanal ◽  
Sujata Dahal ◽  
Roshan Lama ◽  
...  
Keyword(s):  
Medical Students ◽  
Cognitive Functioning ◽  
Teaching Hospital ◽  
Binary Data ◽  
Tertiary Care ◽  
Point Estimate ◽  
Cross Sectional ◽  
Tertiary Teaching ◽  
Prevalence Of Depression ◽  
Negative Effect

Introduction: Depression is one of the major problems encountered by medical students. This maycause a negative effect on cognitive functioning and learning of students resulting in poor healthcare and service delivery in future. The presence of this major problem is necessary to be evaluated.Enough recent data regarding its prevalence is not available in our country. Thus, the main aim ofthis study is to find the prevalence of depression among medical students of a tertiary care teachinghospital. Methods: This is a descriptive cross-sectional study which was conducted among undergraduatemedical students of a tertiary teaching hospital over a four-month period (July to October 2019).Ethical clearance was received from the Institutional Review Committee of the same tertiary teachinghospital. Random sampling technique was used to collect data to meet the calculated sample size.Data analysis was done in the Statistical Package for Social Sciences. Point estimate at 95% ConfidenceInterval was calculated along with frequency and proportion for binary data. Results: The prevalence of depression among selected medical students of Kathmandu MedicalCollege and Teaching Hospital is 59 (27.2%) at 95% Confidence Interval (21.28-33.12%). Thirty (14%)of the participants were mildly depressed, 21 (10%) moderately depressed while 8 (4%) were severelydepressed according to Beck’s Depression Index II. Conclusions: Prevalence of depression among medical students is relatively significant as foundin similar studies done in other centres. Thus appropriate programs and strategies should beimplemented to avoid depression from causing a negative effect on cognitive functioning andlearning of students. Favourable environment where students are able to talk about their mentalhealth issues is a must.

scholarly journals Perception of doctors and nurses regarding prevention of COVID-19 infection at a Teaching Hospital, Nepal

2020 ◽  
Vol 7 (3) ◽  
pp. 13-21
Author(s):  
Lucky Sharma ◽  
Abhiskar Thapa ◽  
Hema Chand ◽  
Subash Pant ◽  
Arpana Neopane
Keyword(s):  
Health Care ◽  
Teaching Hospital ◽  
Personal Protective Equipment ◽  
Care Center ◽  
College Teaching ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Health Care Center ◽  
Service Demand

Introduction: The use of personal protective equipment can be burdensome and the risk of COVID-19 infection for this group is high. This study details to evaluate how prepared Health Care Workers consider themselves to be regarding the delivery of infection prevention and control procedures in their place of work. Method: This is a cross-sectional study conducted at Kathmandu Medical College Teaching Hospital in September 2020. A questionnaire was given to participants along with the information about the study. Service demand, skills, beliefs about capabilities, beliefs about consequences, intentions, environmental context and resources, social influences, emotion, WHO Wellbeing (over the last two weeks) were taken as dependent variables. Result: Out of 112 participants, 58(51.7%) were doctors and 54(48.3%) nurses; 65(58.1%) female and 47(41.9%) were male. The mean age was 31.2±4.1 y. Service demand was scored lowest (mean 0.7 out of 7) and beliefs about consequences were scored highest (mean 5.7 out of 7). Conclusion: Healthcare workers agreed that personal protective equipment at work is sufficiently effective to prevent the spread of COVID-19. They were not confident that the health care center at present can manage or can continue to manage the current patient surge related to COVID-19.

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