scholarly journals Readiness of Medical Teams Caring for COVID-19 in the Intensive Care Units: A National Web-Based Survey in Indonesia

2021 ◽  
Vol 9 (B) ◽  
pp. 1785-1790
Author(s):  
Mochamat Helmi ◽  
Djayanti Sari ◽  
Andreasta Meliala ◽  
Laksono Trisnantoro
Keyword(s):  
Intensive Care ◽  
Substantial Effect ◽  
Medical Team ◽  
Cross Sectional ◽  
Web Based ◽  
Maximum Score ◽  
Five Dimensions ◽  
Number Of Patients ◽  
Referral Hospitals ◽  
Medical Teams

BACKGROUND: The coronavirus disease 2019 (COVID)-19 pandemic is a challenge for the intensive care unit (ICU) medical team. It requires management of space, stuff (medical equipment including drugs), staff, and system readiness (4S) to deal with the surge in the number of patients. AIM: This survey aims to describe the current readiness efforts among ICU medical team at the COVID-19 referral hospitals in Indonesia; space, stuff readiness, staff, and systems readiness. METHODS: We conducted a cross-sectional national web-based survey of ICUs across referral hospitals during pandemic COVID-19 in Indonesia from June to October 2020. The medical teams survey included 53 questions in multiple parts addressing five dimensions. A linear regression model was applied to determine the factors related with readiness. RESULTS: A total of 459 participants (83.6%) agreed to join in this study. The participants’ average age was 40.43 years (SD = 5.78). About 62.53% were male, 51.20% had bachelor degree, and 55.77% lived outside of Java Island. The mean of total score of medical team readiness was 2.76 (SD = 0.320) and the highest (maximum score) mean score of medical team readiness domain was stuff (2.81, SD = 7.72). Education, working experience, training, perception of risk of contracting COVID-19, and residence had a substantial effect on the readiness, with R2 values of 0.378, p < 0.05. CONCLUSIONS: This study provides an initial view of current preparedness efforts among a group of ICUs in Indonesia’s leading hospital during the first wave of pandemic. Interventions must be developed and implemented quickly to increase the medical team’s readiness to care for a future pandemic.

scholarly journals Functionality in the ICU in neurological patients-What we found in the evaluation?

2021 ◽  
Author(s):  
Elizabeth Viana Soares ◽  
Pedro Henrique Saramago de Lima ◽  
Eduardo Augusto da Silva Erthal Pinto
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Neurological Diseases ◽  
Functional Limitations ◽  
Cross Sectional ◽  
Care Environment ◽  
Maximum Score ◽  
Number Of Patients ◽  
Neurological Patients

The intensive care environment has been increasing its demand gradually in relation to the number of patients and the severity of the diseases. The functional limitations resulting from patients admitted to the ICU for neurological diseases are numerous and will depend on the severity, location and extent of the injury. The objective is to evaluate the function of neurocritical patients using the PERME scale. A cross-sectional observational study was carried out at the ICU of Hospital Ferreira Machado in Campos dos Goytacazes / RJ from November 2019 to November 2020, including patients with stroke and TBI. The sample consisted of 13 patients, 76.9% of whom were male, with a mean age of ± 51.2 years. The PERME scale had a maximum score of 16 and a minimum of one point, respectively. The present study identified that neurocritical patients have little functionality within the ICU, but identifies that perhaps this scale is not the most suitable for assessing neurocritical patients.

scholarly journals Young doctors’ perspectives on antibiotic use and resistance: a multinational and inter-specialty cross-sectional European Society of Clinical Microbiology and Infectious Diseases (ESCMID) survey

2019 ◽  
Vol 74 (12) ◽  
pp. 3611-3618 ◽  
Author(s):  
Bojana Beović ◽  
May Doušak ◽  
Céline Pulcini ◽  
Guillaume Béraud ◽  
Jose Ramon Paño Pardo ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Principal Component ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Self Assessment ◽  
Cross Sectional ◽  
Web Based ◽  
Five Dimensions ◽  
And Gender

Abstract Background Postgraduate training has the potential to shape the prescribing practices of young doctors. Objectives To investigate the practices, attitudes and beliefs on antibiotic use and resistance in young doctors of different specialties. Methods We performed an international web-based exploratory survey. Principal component analysis (PCA) and bivariate and multivariate [analysis of variance (ANOVA)] analyses were used to investigate differences between young doctors according to their country of specialization, specialty, year of training and gender. Results Of the 2366 participants from France, Greece, Italy, Portugal, Slovenia and Spain, 54.2% of young doctors prescribed antibiotics predominantly as instructed by a mentor. Associations between the variability of answers and the country of training were observed across most questions, followed by variability according to the specialty. Very few differences were associated with the year of training and gender. PCA revealed five dimensions of antibiotic prescribing culture: self-assessment of knowledge, consideration of side effects, perception of prescription patterns, consideration of patient sickness and perception of antibiotic resistance. Only the country of specialization (partial η2 0.010–0.111) and the type of specialization (0.013–0.032) had a significant effect on all five identified dimensions (P < 0.01). The strongest effects were observed on self-assessed knowledge and in the perception of antibiotic resistance. Conclusions The country of specialization followed by the type of specialization are the most important determinants of young doctors’ perspectives on antibiotic use and resistance. The inclusion of competencies in antibiotic use in all specialty curricula and international harmonization of training should be considered.

scholarly journals Do we need to enlarge emergency services or new emergency hospitals?

2021 ◽  
Vol 8 (5) ◽  
pp. 329-333
Author(s):  
Ensar Durmuş ◽  
Fatih Güneysu
Keyword(s):  
Intensive Care ◽  
Emergency Room ◽  
Emergency Services ◽  
Cross Sectional ◽  
Average Hospital ◽  
Emergency Admissions ◽  
Prolonged Length ◽  
Intensive Care Patients ◽  
Number Of Patients ◽  
Bed Capacity

Objective: It was aimed to obtain a notion about the needed hospital bed capacity by analyzing the number of hospitalizations and referrals from the ER in this study. Material and Method: This study is a retrospective, analytical cross-sectional research. Patients admitted to a tertiary hospital’s adult emergency service in 2018-2019, hospitalized, or referred to another hospital were analyzed. Results: Of the patients, 28036 were hospitalized; furthermore, this number corresponded to 38.4 patients per day. Of these cases, 15303 (54.6%) were male, and the mean age was 57.89 (±19.5); 8438 cases (30.1%) were admitted to the intensive care unit. The department with the most hospitalizations was internal medicine with 6105 patients (21.78%) and cardiology, with 4822 hospitalized, the most intensive care patients; moreover, psychiatry had the most prolonged length of stay service average of 28 days. The number of patients required to be hospitalized from the emergency room was an average of 48.5 patients per day. The average hospital stay was seven days. Conclusion: Mainly in regions with several emergency admissions, it can be considered to establish emergency hospitals that serve particularly emergency cases to engage the number of patients to be hospitalized from the emergency room.

scholarly journals Hubungan Beban Kerja Dengan Tingkat Stres Perawat Ruang Intensive Care Unit dan Instalasi Gawat Darurat

2019 ◽  
Vol 2 (1) ◽  
pp. 9
Author(s):  
Nonik Eka Martyastuti ◽  
Isrofah Isrofah ◽  
Khalilatun Janah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
General Hospital ◽  
Emergency Departments ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
Stress Scale ◽  
Number Of Patients ◽  
Stress Levels ◽  
Intensive Care Unit Nurses

The workload in the room is not always a cause of stress on nurses, the workload will be a source of stress if the number of workloads is not proportional to the ability of both the physical or expertise and the time available to nurses. Besides, nurses are faced with patients who trigger an increasing stress on nurses. This research was conducted at Siaga Medika General Hospital in Pemalang. The research design used quantitative associative analytic through cross-sectional approach. The sample of this study was 45 nurses who served in the Intensive Care Unit and Emergency Departments because the nurses' stress levels were higher than the nurses’ stress levels in the other treatment rooms (ward) obtained through total sampling because the population was less than 100, so that all population used as research samples. The Work Stress research instrument used the standard Depression Anxiety Stress Scale questionnaire, while the workload questionnaire adopted the previous research and was modified. The results showed that there was a correlation between workload and stress level of Intensive Care Unit nurses and stress of Emergency Departments nurses. This showed that nurses who have a heavy workload that is not comparable to the duties of nurses with the average number of patients, the number of types of work that must be done. If this is not managed properly, it will cause increased stress.H This is what becomes the workload of Intensive Care Unit and Emergency Departments nurses in Siaga Medika General Hospital in Pemalang which can cause an increase of stress.

scholarly journals Admission Profile and Outcome of Patients in a Level III Intensive Care Unit: A Two-Year Comparative Study

2020 ◽  
Vol 42 (3) ◽  
pp. 52-56
Author(s):  
Sunil Pathak ◽  
Subhash P Acharya ◽  
Pragya Acharya ◽  
Binita Bhattarai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Stable Condition ◽  
Severity Of Illness ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Female Ratio ◽  
Number Of Patients ◽  
Male Preponderance

Introduction An Intensive Care Unit (ICU) is an area where critically ill patients are admitted and the highest level of care is provided with close intensive monitoring and management. Clinical audit is a must to measure indicators of the quality of care in ICU and benchmarking outcome. The main aim of the study was to evaluate the profile of patients admitted to ICU and assess their outcome of two consecutive years. MethodsA single-institutional, descriptive cross-sectional study was conducted on all adult patients admitted to the ICU of Tribhuvan University Teaching Hospital, Kathmandu, between April 2018 and April 2020 (Baisakh 2075 to Chaitra 2076). ResultsWith an average of 1.98 admissions per day, a total of 1447 patients were admitted to TUTH ICU over the period of two years. A male preponderance was noted with a male to female ratio of 1.19:1. Most of the patients admitted were neurosurgical cases 429 (29.6%). A total of 884 (61%) were shifted out of ICU in stable condition while the overall mortality was 458 (31.6%). ConclusionThis study shows that there is a higher severity of illness at admission as well as a comparatively high mortality rate. More number of patients were male, of age group of 15-65 years, with medical and neurosurgical conditions. This study of profile and outcome of patients admitted in ICU can serve as a quality indicator as well as evidence on which planning and policymaking can be based upon in the future.

scholarly journals Infection Control Measures in Pakistani Dental Practices During COVID-19 Outbreak

2021 ◽  
Vol 30 (03) ◽  
pp. 152-156
Author(s):  
Yashfika Abdul Bari ◽  
◽  
Syeda Maliha Waqar ◽  
Saqif Nasir ◽  
Kamil Zafar ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Cross Sectional ◽  
Web Based ◽  
Infection Control Measures ◽  
Number Of Patients ◽  
Dental Practitioners ◽  
Dental Practices ◽  
Single Use ◽  
Study Participants

OBJECTIVE: The objective of this study is to assess infection control measures in dental practices during COVID-19 outbreak in Pakistan. METHODOLOGY: It was a cross-sectional web based survey conducted during COVID-19 outbreak from the period of June 2020 to August 2020. The study participants were the dental surgeons who were either working in hospital setup or running their own private practice or working in private dental setup. The survey consisted of sets of questions to assess whether dental practitioners have implemented strategies to combat novel corona virus infection in their practice. It also consists of questions that assess aerosol generating procedures are commencing with or without out any COVID-19 symptoms. RESULTS: About 39.1% participants reported that 75% of the number of patients in their clinic had been reduced and 52.2% of the participants reported that >50% of the patients came for endodontic procedures with pain. Eighty one percent of the participants were maintaining hand hygiene before touching all patients, 71.7% before any cleaning, 78.3% before any aseptic procedure, 81% after exposure to patient’s fluid and 80.4% after touching. There was low compliance regarding the use of personal protective equipment and almost 62.6% were using eye wear for all patients, 58.7% were disinfecting whole clinical room before new patient and 43.9% were using single use (disposable) examination set during COVID-19 outbreak. CONCLUSION: Majority of dentist in Pakistan were following the recommendations and guidelines of infection control practices related to COVID-19 pandemic. KEYWORDS: COVID-19, coronavirus, infection control measures, practices, dentistry

scholarly journals Knowledge, Attitude, and Associated Factors towards Physical Assessment among Nurses Working in Intensive Care Units: A Multicenter Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Bikis Liyew ◽  
Ambaye Dejen Tilahun ◽  
Tilahun Kassew
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Cross Sectional ◽  
Physical Assessment ◽  
Referral Hospitals ◽  
The Mean ◽  
Knowledge And Attitude

Introduction. Nurses working in the intensive care unit play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Objectives. To assess knowledge, attitude, and associated factors towards physical assessment on critically ill patients among nurses working in the intensive care unit at Amhara regional state referral hospitals, Northwest Ethiopia, 2019. The research hypothesis: there is poor physical assessment knowledge, poor physical assessment attitude, and there are factors that are likely to affect nurses’ knowledge and attitude towards physical assessment providing this care to critically ill patients at Amhara regional state referral hospitals, Northwest Ethiopia, 2019. Methods. Institution-based cross-sectional study was conducted among 299 nurses from March to September 2019. A convenience sampling method was used. Data were entered by using Epi Info 7.2.2 and analyzed by using STATA 14. The result was computed by descriptive statistics and to explore predictors of knowledge, and attitude linear regression analysis models were fitted, and the adjusted unstandardized beta (β) coefficient at 95% CI was used. A p-value <0.05 was considered significant. Result and conclusion: the knowledge mean scores were 9.93 ± 2.99 [95% CI (9.59, 10.31)]. The proportion of nurse’s knowledge who score above the mean was 167 (55.9%) [95% CI (50.2, 61.5)] and below the mean 132 (44.1%) [95% CI (38.5, 49.8)]. Attitude means scores were 36.85 ± 6.21 [(36.16, 37.51)]. The proportions of nurse’s attitudes who score above the mean were 158 (52.8%) [95% CI (47.5, 58.5)] and below the mean 141 (47.2) [95% CI (41.5, 52.5)]. Regarding predictor variables, being male [β = 0.84, 95% CI (0.16, 1.52)] and taken training [β = 1.85, 95% CI (1.14, 2.56)] were factors positively associated with knowledge, whereas has taken training [β = 4.13, 95% CI (2.82, 5.44)], total years of experience [β = 0.59, 95% CI (0.25, 0.93)], and knowledge [β = 0.92, 95% CI (0.0.72, 1.12)] were factors positively associated with attitude towards physical assessment. Conclusion. Based on the result of this study, the knowledge and attitude towards physical assessment regarding critically ill patients among nurses working in intensive care units were good. Hence, training, educational support services, and awareness are recommended to encourage nurse’s knowledge and attitude towards physical assessment.

Efficacy of Methylprednisolone With DexamethasoneiIn patients With Severe Covid Pneumonia

2021 ◽  
Vol 15 (10) ◽  
pp. 2635-2636
Author(s):  
Javaria Aslam ◽  
Momina Masroor ◽  
Sami Ahmad ◽  
Wajahat Hussain ◽  
Hurria Mansoor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Analytical Study ◽  
Primary Outcome ◽  
Oxygen Demand ◽  
Cross Sectional ◽  
Methyl Prednisolone ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Aim: Efficacy of Methylprednisolone with Dexamethasone in patients with severe COVID pneumonia in term of clinical and biochemical improvement. Methodology: Cross Sectional analytical study conducted among COVID-19 patients admitted in HDU of Sir Sadiq Hospital, Bahawalpur from May, 2021 to June 2021 after taking approval from institutional ethical committee. 82 patients were included in this study after taking informed consent. Patients were divided into two groups A and B i.e. I/V methyl prednisolone and I/V dexamethasone respectively. Each group was containing 41 patients. Primary outcome was measured in terms of decrease or increase in oxygen demand leading to discharge or shifting to Intensive Care Unit. CRP levels were also measured to assess biochemical improvement. Results: 31 (75.6%) patients from group A and 22(53.7%) from group B were improved and discharged and difference was statistically significant (p<0.05). Number of patients shifted to ICU were 10(24.4%) and 19(46.3%) from A and B groups respectively. Conclusion: In terms of clinical and biochemical response methylprednisolone outperforms dexamethasone. Keywords: Methylprednisolone, Dexamethasone, COVID pneumonia,

scholarly journals What Is Preparedness and Capacity of Intensive Care Service in Indonesia to Response to COVID-19? A Mixed-method Study

2021 ◽  
Vol 9 (B) ◽  
pp. 1686-1694
Author(s):  
Mochamat Helmi ◽  
Djayanti Sari ◽  
Andreasta Meliala ◽  
Laksono Trisnantoro
Keyword(s):  
Intensive Care ◽  
Mixed Method ◽  
Online Survey ◽  
Care Service ◽  
Protective Equipment ◽  
Medical Team ◽  
Isolation Room ◽  
Care Services ◽  
Initial Stage ◽  
Medical Teams

BACKGROUND: Pandemics can increase disease spread, as well as unpredictable and highly in patient demand, which can have a negative impact on hospital capacity and the overall functioning of the health-care system. The preparedness and capacity of intensive care services to respond to COVID-19 in Indonesia are remain unknown. AIM: This study aimed to investigate the preparedness and capacity of intensive care services in Indonesia to respond to the initial stage of the COVID-19 pandemic. METHODS: A mixed-method research design was used in this study using in-depth interviews and an online survey. An in-depth interview was conducted with the medical team (intensive care consultant and an anesthesiologist) who is actively involved in the provision of COVID-19 services in 15 national referral hospitals. The online survey was conducted to all medical teams that provide direct care to the COVID-19 patients. A total of 459 (response rate was 95.2%) agreed to join the survey. The content analysis technique was used to analyze qualitative data and a descriptive analysis was used to describe issues encountered in providing health services to COVID-19 patients. RESULTS: The analysis preparedness and capacity of intensive care service in Indonesia to respond to the initial stage of the COVID-19 pandemic resulting in 4 themes with 12 sub-themes. The four themes were limited quality and quantity of standardized intensive care unit (ICU) isolation room (inadequate zoning systems, adequacy of the standardized ICU isolation room, the readiness of the hospital infrastructure, and telemedicine facilities are not yet widely used, including in the COVID-19 isolation room), limited medical service support (lack of personal protective equipment (personal protective equipment [PPE], re-used PPE, lack of availability of medical devices), limitations in the medical team’s quality and quantity management (lack of number and distribution of expert doctors and medical team screening for ICU), and command systems (task shifting, effective communication, and leadership). CONCLUSION: Medical team encounters several difficulties, particularly related to the quality of facilities, staff preparedness, and systems for the provision of services to COVID-19 patients with critical conditions. There is a critical need for well-defined pathways, legal protection, and occupational health for medical teams providing services in the aftermath of a pandemic.

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