scholarly journals Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations

2020 ◽  
Vol 17 (24) ◽  
pp. 9281
Author(s):  
Abera Kenay Tura ◽  
Yasmin Aboul-Ela ◽  
Sagni Girma Fage ◽  
Semir Sultan Ahmed ◽  
Sicco Scherjon ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Hospital Setting ◽  
Hospital Staff ◽  
University Hospital ◽  
Local Hospital ◽  
Eastern Ethiopia ◽  
Self Reflection ◽  
Intervention Plan ◽  
Cross Matching

With postpartum hemorrhage (PPH) continuing to be the leading cause of maternal mortality in most low-resource settings, an audit of the quality of care in health facilities is essential. The purpose of this study was to identify areas of substandard care and establish recommendations for the management of PPH in Hiwot Fana Specialized University Hospital, eastern Ethiopia. Using standard criteria (n = 8) adapted to the local hospital setting, we audited 45 women with PPH admitted from August 2018 to March 2019. Four criteria were agreed as being low: IV line-setup (32 women, 71.1%), accurate postpartum vital sign monitoring (23 women, 51.1%), performing typing and cross-matching (22 women, 48.9%), and fluid intake/output chart maintenance (6 women, 13.3%). In only 3 out of 45 women (6.7%), all eight standard criteria were met. Deficiencies in the case of note documentation and clinical monitoring, non-availability of medical resources and blood for transfusion, as well as delays in clinical management were identified. The audit created awareness, resulting in self-reflection of current practice and promoted a sense of responsibility to improve care among hospital staff. Locally appropriate recommendations and an intervention plan based on available resources were formulated.

Abstract TP307: Promising Practices to Improve the Quality of Pre-Hospital Stroke Care Transitions

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Stephanie M Teixeira-Poit ◽  
Jacqueline Amoozegar ◽  
Joanna Elmi ◽  
Megan Chambard ◽  
Kyle Emery ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Care Transitions ◽  
Hospital Setting ◽  
Signs And Symptoms ◽  
Stroke Care ◽  
Hospital Staff ◽  
Promising Practices ◽  
Stroke Patients ◽  
Suspected Stroke

Introduction: Between 2012-2015 the Centers for Disease Control and Prevention’s (CDC) Paul Coverdell National Acute Stroke Program (PCNASP) funded 11 state health departments to improve the quality of stroke care across the continuum, beginning with the initial signs and symptoms of stroke through the transition from hospital to post-hospital setting. Hypothesis: We assessed the hypothesis that PCNASP quality improvement activities enhanced the quality of pre-hospital stroke care transitions. Methods: We conducted 72 semi-structured telephone interviews with stakeholders of the 11 PCNASP grantees, including program administrators, epidemiologists, quality improvement consultants, partners, emergency medical services (EMS) and hospital staff. Using grounded theory (Glaser and Strauss), we developed and applied a coding scheme to the interview transcripts to identify emerging themes related to pre-hospital quality improvement activities. Results: Many PCNASP grantees provided training and support for EMS and hospital staff that improved calling of a stroke code team and recognition of stroke, improved EMS pre-notifications about suspected stroke patients, advanced hospital holding of CT scanners in anticipation of suspected stroke patients, and reduced door-to-CT and door-to-needle time. PCNASP grantees had different approaches to balancing timeliness and quality of care. Some grantees developed statewide destination protocols that required EMS to bypass proximate hospitals for certified stroke care hospitals. Other grantees had challenges implementing statewide destination protocols because EMS agencies were decentralized with local authority to determine where to transport patients. In other cases, grantees promoted a “drip and ship” model where EMS transported patients to proximate hospitals for IV-tPA and then to a primary stroke center and focused on increasing the reach of stroke telemedicine. Conclusion: PCNASP grantees developed promising practices to improve the quality of pre-hospital stroke care transitions that accounted for their unique state context. These approaches may become the basis for best practices for improving pre-hospital transitions of stroke care across the nation.

scholarly journals Frequency of orthognathic surgery treatment in a university hospital setting - A retrospective study

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 552-556
Author(s):  
Ramya G ◽  
Remmiya Mary Varghese ◽  
Jeevitha M
Keyword(s):  
Orthognathic Surgery ◽  
Sense Of Self ◽  
Age Groups ◽  
Hospital Setting ◽  
Well Being ◽  
University Hospital ◽  
Software Analysis ◽  
Facial Surgery ◽  
Dentofacial Deformities

Orthognathic surgery is a unique endeavour in facial surgery, a patient’s appearance and occlusal function can be improved significantly, which has a great impact on the patient’s sense of self and well-being. Successful outcomes in modern orthognathic surgery rely on a close collaboration between the surgeon and the orthodontist across all stages of treatment. To assess the frequency of orthognathic surgery in a university hospital setting. Data required for the study was procured by reviewing patient records and analyzed data of 86000 patients between June 2019 to March 2020. The data was sorted in excel and statistically analyzed using the IBM SPSS software analysis and the results tabulated. The frequency of orthognathic surgery in this study was found to be 22.4%. Orthognathic surgery improves the quality of life for all age groups of dentofacial deformities and hence it is imperative to educate people regarding the same.

scholarly journals Analysis of the preparation and administration of medications in the hospital context based on Lean thinking

2018 ◽  
Vol 22 (4) ◽  
Author(s):  
Diovane Ghignatti da Costa ◽  
Simone Silveira Pasin ◽  
Ana Maria Müller de Magalhães ◽  
Gisela Maria Schebella Souto de Moura ◽  
Caroline Brum Rosso ◽  
...  
Keyword(s):  
Hospital Setting ◽  
University Hospital ◽  
Lean Thinking ◽  
Descriptive Case Study ◽  
Value Stream ◽  
Medication Process ◽  
A Value ◽  
Improve Planning

Abstract Objectives: To analyze the current way medications are prepared and administered in the hospital setting and to apply a method to establish priorities for problems detected. Method: This is an exploratory-descriptive case study. The data were collected through observation and focus groups with 13 participants who were part of a health team in a surgical inpatient unit of a public university hospital. The analysis was based on a lean production framework. Results: A value stream map was constructed of the current way drugs are prepared and administered, identifying the clients in the process and their requirements. Forty-five current problems were identified, based on requirements that were not met with eight being prioritized to improve planning. Conclusion: Having prioritized the problems, the planning and implementation of continuous improvements in the medication process were started in order to reduce errors and improve the quality of services.

Palliative Care — Could Your Patient Have Been Managed at Home?

1992 ◽  
Vol 8 (2) ◽  
pp. 18-22 ◽  
Author(s):  
Stan Lubin
Keyword(s):  
Palliative Care ◽  
Cost Reduction ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
University Hospital ◽  
Care Hospital ◽  
Care At Home ◽  
Care Period ◽  
At Home

Palliative care, supportive care of the dying, is rapidly changing to better meet the needs of the patients and families. If palliative care is provided in the home rather than in hospital, there is a potential for improvement in the quality of life for patients and their families and a potential for cost reduction in the health care system. Our study was undertaken to determine whether or not palliative care patients admitted to University Hospital could have been cared for at home rather than in the hospital. The hospital charts of 96 palliative care patients were reviewed retrospectively. The results indicated that 61 % of these palliative care patients did not receive any palliative care at home and that 94% died in an acute care hospital setting. Only 18% lived in a setting other than their own home, and 68% had a spouse or other family member living with them at the time of their final admission. Based on the level of support in the place of residence prior to final admission and the reasons for admission, we determined that many of the patients could have been managed at home for at least some of the palliative care period if appropriate support from a home care team had been available.

Pain prevalence in a university hospital in Iceland

2012 ◽  
Vol 3 (3) ◽  
pp. 184-184
Author(s):  
S. Zoëga ◽  
S. Ward ◽  
T. Aspelund ◽  
H. Sveinsdóttir ◽  
G. Sigurdsson ◽  
...  
Keyword(s):  
Pain Management ◽  
Severe Pain ◽  
Hospital Setting ◽  
Pain Severity ◽  
University Hospital ◽  
Surgical Services ◽  
Pain Prevalence ◽  
The Mean ◽  
And Gender

Abstract Background/aims Despite multiple efforts to improve practice, pain is prevalent in many hospital settings causing unnecessary complications and suffering. The aim of the study was to explore the epidemiology of pain in a university hospital in Iceland. Methods A point prevalence study was conducted in 23 departments in medical and surgical services in a 650 bed university hospital in January 2011. Data was collected from medical charts and with a questionnaire (APS-POQ-R) assessing pain severity and quality of pain management. Participants had to be 18 years or older, hospitalized for at least 24 h, speak Icelandic, alert, and able to participate. Results Of the 369 participants the mean (SD) age was 67.9 (17.6) years (range 18–100) and gender proportions were equal. Response rate was 80%. Of patients in pain (scoring ≥1 on a 0–10 scale) the mean (SD) worst pain severity was 5.6 (2.5). Total pain prevalence was 80.4%, but of patients in pain 36.5% had mild (1–4) pain, 22.6% moderate (5–6) and 40.9% had severe (7–10) pain. The mean (SD) proportion of time spent in severe pain was 25.9% (27.0%). Pain was both more prevalent, [χ2(1, N= 367) = 7.05, p = 0.008] and severe [t(365) =−4.16, p = 0.000] in women compared to men. Similarly, pain was more prevalent [χ2(1, N= 368) = 9.71, p = 0.002] and severe [t(216,2) =−3.18, p = 0.002] in surgical services compared to medical. Worst pain severity was weakly negatively associated with age [r(369) =−0.23, p = 0.000]. Worst pain severity was higher in patients receiving pain medications [t(357) =−9.84, p = 0.000] and in patients using non-pharmacological methods to treat their pain [t(311.7) =−5.76, p = 0.000]. Conclusions Pain was prevalent in the hospital and an unsatisfactory proportion of patients experienced moderate to severe pain. The quality of pain management in the hospital needs to be improved. Further studies are needed to test and evaluate the efficacy and effectiveness of interventions aimed at advancing pain practice in the hospital setting.

scholarly journals Evaluation of Cancer Patient Satisfaction: A Transversal Study in Radiotherapy Department, Hassan II University Hospital, Fez, Morocco

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Boujemaa EL Marnissi ◽  
Fouad Abbass ◽  
Hafida Charaka ◽  
Nawal Mouhoute ◽  
Abdelaziz Tritha ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Cancer Patient ◽  
Hospital Setting ◽  
Care Quality ◽  
University Hospital ◽  
Structured Interviews ◽  
Radiotherapy Department ◽  
Transversal Study

Patient satisfaction is an important quality outcome indicator of health care in the hospital setting. Patients are nowadays care-partners with caregivers. This relation is practically important for patients presenting chronic diseases, especially cancer. The aim of this study is to evaluate cancer patient satisfaction, treated at the Department of Radiotherapy in Hassan II University Hospital, and to study the different components of this satisfaction. A prospective transversal study was conducted between December 2016 and January 2017. Data was collected by three investigators based on structured interviews, a validated, anonymous and a standardized questionnaire. During this period, we have included 230 patients: 159 women (69.1%), 71 men (30.9%) and the sex ratio (women/men) was 2.23. Half of the investigated patients have never been schooled (52.61%). The majority had urban origin (71.3%) and 90% of patients declared being satisfied with the care at Radiotherapy department. 93.48% of cases recommended Radiotherapy department to other patients and 95.65% will want to continue their treatment at this department. Reception conditions were judged as favorable in 92.14%. Satisfaction rates regarding the availability of medical and paramedics, health-care workers were 86.52% and 83.9%, respectively. The quality of medical and paramedical care was judged as excellent or good in 78% cases. However, 44.34% of patients complained about the complexity of administrative formalities. 60.87% of cases judged that the waiting time was too long, whereas 31.4% of patients claimed that care-quality of their pain was insufficient or bad. The majority of patients declared being very satisfied or at least satisfied with different care services. For items that were judged as less satisfactory, some recommendations will be taken especially at the level of pain’s and palliative care as well as the organization of patients’ circuit inside the department. The satisfaction’s variations can be attributed to personally patients factors as well as systemic ones at the level of the hospital. Assessing and understanding these factors are essential in developing appropriate measures to improve patient satisfaction.

Acceptance of a Pharmacy-Based, Physician-Edited Hospital Pharmacy and Therapeutics Committee Newsletter

1992 ◽  
Vol 26 (7-8) ◽  
pp. 886-889 ◽  
Author(s):  
David J. Ritchie ◽  
Robert F. Manchester ◽  
Michael W. Rich ◽  
Mary M. Rockwell ◽  
Paul M. Stein
Keyword(s):  
Drug Class ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Perceived Usefulness ◽  
New Drugs ◽  
University Hospital ◽  
Care Hospital ◽  
Survey Results ◽  
Initial Survey

OBJECTIVE: To assess the level of physician acceptance and perceived usefulness of a pharmacy-prepared, physician-edited pharmacy and therapeutics (P&T) committee newsletter. DESIGN: Two separate surveys conducted after 7 and 24 months of publication, respectively. SETTING: 500-bed, university-affiliated, tertiary-care hospital. MAIN OUTCOME MEASURES: The initial survey was mailed to physicians after 7 months of publication and they were requested to rate various aspects of the newsletter, including timeliness of articles, usefulness of articles, quality of writing and design, and overall value of the publication on a scale of 1–4: (1 = excellent, 2 = good, 3 = fair, 4 = poor). Physicians were also asked to rank different categories of articles (articles on new drugs, drug-class reviews, topical reviews, formulary news, and articles providing P&T committee information) and were encouraged to provide comments. A separate follow-up survey conducted at 24 months asked physicians to indicate whether they (1) regularly received the newsletter, (2) regularly read the newsletter, (3) found the information in the newsletter to be useful, and (4) desired to continue receiving the newsletter. RESULTS: Initial survey results yielded mean newsletter quality scores ranging from 1.54 to 1.66. Respondents preferred, in descending order, articles on new drugs, drug-class reviews, topical reviews, formulary news, and P&T committee information. The 24-month survey revealed that 96 percent of the physicians regularly receiving and reading the newsletter found the information useful and 97 percent felt that the newsletter should continue to be published. Favorable comments were also received from several prominent physicians. CONCLUSIONS: The results indicate strong physician acceptance of a pharmacy-prepared, physician-edited newsletter and provide information about the types of articles preferred by physicians in a university hospital setting.

Topographische Orientierung bei Patienten mit erworbener Hirnschädigung

1999 ◽  
Vol 10 (2) ◽  
pp. 77-86
Author(s):  
Martina Kindsmüller ◽  
Andrea Kaindl ◽  
Uwe Schuri ◽  
Alf Zimmer
Keyword(s):  
Brain Damage ◽  
Cognitive Deficits ◽  
Hospital Setting ◽  
Hospital Staff ◽  
Reading Test ◽  
Map Reading ◽  
Several Variables ◽  
Topographical Orientation ◽  
The One ◽  
Behavioral Memory

Topographical Orientation in Patients with Acquired Brain Damage Abstract: A study was conducted to investigate the abilities of topographical orientation in patients with acquired brain damage. The first study investigates the correlation between wayfinding in a hospital setting and various sensory and cognitive deficits as well as the predictability of navigating performance by specific tests, self-rating of orientation ability and rating by staff. The investigation included 35 neuropsychological patients as well as 9 control subjects. Several variables predicted the wayfinding performance reasonably well: memory tests like the one introduced by Muramoto and a subtest of the Rivermead Behavioral Memory Test, the Map Reading Test and the rating by hospital staff. Patients with hemianopia experienced significant difficulty in the task.

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