scholarly journals Improvement of Young and Elderly Patient's Knowledge of Heart Failure after an Educational Session

2009 ◽  
Vol 3 ◽  
pp. CMC.S2357 ◽  
Author(s):  
Jérôme Roncalli ◽  
Laurence Perez ◽  
Atul Pathak ◽  
Laure Spinazze ◽  
Sandrine Mazon ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
University Hospital ◽  
Knowledge Test ◽  
Educational Session ◽  
Good Level ◽  
Number Of Patients ◽  
Before And After ◽  
Final Score ◽  
Level Of Knowledge

Background Interest in the role of patient education sessions for optimizing the management of heart failure (HF) is increasing. We determined whether improvements in young and elderly patients' knowledge of HF and self-care behavior could be analyzed by administering a knowledge test before and after an educational session. Methods Stable heart failure patients (n = 115) were enrolled in a prospective cohort study from our Heart Failure educational centre in a university hospital. Patient knowledge of six major HF-related topics was assessed via a questionnaire distributed once before an educational session and twice afterward. Each answer was assigned a numerical value and the final score for each topic could range from 0 to 20. Scores ≥ 15/20 were considered representative of a good level of knowledge. Results The level of knowledge was low (9.7/20) before the educational session but was significantly higher (16.3/20) during the 1st quarter after the session, and this benefit was maintained for up to 12 months (16.6/20). Knowledge levels increased in both younger and elderly patients, and the number of patients who had a good level of knowledge also increased after the educational session. Conclusion This study confirms that an HF knowledge test is feasible and that educational sessions improve the knowledge and self-management of both younger and elderly patients.

scholarly journals A Single-Center Retrospective Study on the Initiation of Peritoneal Dialysis in Patients With Cardiorenal Syndrome and Subsequent Hospitalizations

2020 ◽  
Vol 7 ◽  
pp. 205435812097923
Author(s):  
Bourne L. Auguste ◽  
Arnav Agarwal ◽  
Ali Z. Ibrahim ◽  
Michael Y. Girsberger ◽  
Zita Abreu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Peritoneal Dialysis ◽  
Length Of Stay ◽  
American Literature ◽  
Diuretic Therapy ◽  
Cardiorenal Syndrome ◽  
Catheter Insertion ◽  
Health Network ◽  
Number Of Patients ◽  
Before And After

Background: Inotropic dependence and diuretic resistance in patients with cardiorenal syndrome (CRS) lead to frequent hospitalizations and are associated with high mortality. Starting peritoneal dialysis (PD) acutely (within 2 weeks of a heart failure hospitalization) offers effective volume removal without hemodynamic compromise in this population. There is little data on this approach in the North American literature. Objective: To determine whether volume-overloaded patients with CRS on maximal doses of diuretic therapy had reduced hospitalization for heart failure following PD initiation. Design: Retrospective cohort study. Setting: Academic hospital network (University Health Network, Toronto, Ontario). Patients: Patients with CRS receiving a bedside catheter and starting PD within 2 weeks of insertion at the University Health Network from January 1, 2013, to December 31, 2018. Methods and measurements: Data for heart failure–related hospitalizations and length of stay 6 months before and after PD initiation were collected. Patients who died, switched to hemodialysis, or were transferred to another facility within 6 months of starting PD were excluded from the analysis. Results: We identified 31 patients with CRS who had a bedside PD catheter inserted. The average age of patients was 66.0 ± 13.0 years. There were 7 (22.6%) deaths and 4 (12.9%) transfers to other programs or hemodialysis within 6 months of catheter insertion. After exclusion, we analyzed hospitalization and length of stay data for 20 patients. The hospitalization rate 6 months before PD initiation was 6.9 admissions per 1000 patient-days. This decreased to 2.5 admissions per 1000 patient-days after PD initiation. In addition, there was also a significant reduction in the average length of stay per hospitalization (24.1-3.9 days; P = .001). Limitations: Our study did not assess the severity of heart failure symptoms using a standardized functional classification system. We did not assess quality of life and illness intrusiveness scores before and after starting dialysis, nor did we capture non–heart-failure-related hospitalizations or external admissions at other hospital sites. We limited eligibility to clinically stable patients with no prior major abdominal surgical history in a single Canadian PD program using bedside ultrasound approach for catheter insertions by experienced nephrologists and included a small number of patients. Conclusions: Volume-overloaded patients with CRS receiving maximal diuretic therapy have lower hospitalization rates and shorter stays after initiation of PD. The development of a bedside PD catheter insertion program and close collaboration between nephrology and cardiology services may facilitate acute start dialysis in this population.

scholarly journals CLINICAL AND PATHOLOGICAL FEATURES OF COLONIC ILEUS FROM OBSTRUCTIVE COLORECTAL CANCER. ACTUAL CHARACTERISTICS

2021 ◽  
Vol 27 (1) ◽  
pp. 3582-3584
Author(s):  
Konstantin Kostov ◽  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Emergency Surgery ◽  
Good Condition ◽  
Tumor Stage ◽  
University Hospital ◽  
Obstructive Colorectal Cancer ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group B

Purpose: The purpose of this study is to analyze the possible change in the characteristics of patients with colonic ileus from obstructive colorectal cancer in UMHATEM "N. Pirogov ". Material and Methods: For two separate periods of 2 years in the Department of General, Visceral and Emergency Surgery in University Hospital "N. I. Pirogov" from ileus caused by colorectal carcinoma were operated respectively: Group A (1.1.2010-31.12.2011) - 187 patients (average 71.2 years, women were 88, men 99) Group B (1.1.2014-31.12.2015) - 141 patients (average 73.5 years, women were 69, men 72). Results: In group B there was an increase in the infected patients at an earlier stage. There was no significant difference in the localization of the tumor process in the two groups. In contrast to the increased number of patients hospitalized at an earlier ileus stage, there was no difference in the two groups according to the tumor stage. Conclusions: Emergency surgery is indicated for cases with full bowel obstruction and significant prediction of rupture. Surgery procedure like proximal colostomy is reccomended for elderly patients and complicated comorbidity. Primary procedure like segmental and subtotal colectomy is appropriate for patients in good condition. Segmental resection is favorable in elderly patients and those with shock who may not tolerate lengthy surgery.

Atrial fibrillation and concerns in some groups of patients: elderly patients, pregnant women, co-existing hypertrophic cardiomyopathy and WPW syndrome

2018 ◽  
Vol 4 (49) ◽  
pp. 7-11
Author(s):  
Karolina Adamczyk ◽  
Radosław Lenarczyk ◽  
Michał Mazurek ◽  
Ewa Jędrzejczyk-Patej
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Hypertrophic Cardiomyopathy ◽  
General Population ◽  
Elderly Patients ◽  
Special Treatment ◽  
Number Of Patients ◽  
The World ◽  
The One ◽  
Clinical Problems

Atrial fibrillation (AF) is the one of the most frequent arrhythmia in general population. In 2010 all over the world there was 20,9 mln male and 12,6 mln female with this arrhythmia [1-3]. Atrial fibrillation could be totally asymptomatic, thus the number of patients is probably underestimated. AF increases cardiovascular morbidity, and is one of the cause of stroke or heart failure. Due to the fact that AF concerns an increasing number of patients with various comorbidities in some groups of patients, it may pose many clinical problems and require special treatment.

scholarly journals The Rational Drug Use of Dentists in a University Hospital

2018 ◽  
Author(s):  
Özlem Terzi ◽  
Fikret Yılmaz
Keyword(s):  
Drug Use ◽  
University Hospital ◽  
Drug Selection ◽  
Rational Drug Use ◽  
Rational Drug ◽  
Before And After ◽  
The Status ◽  
Level Of Knowledge ◽  
The Mean ◽  
Medical Drug

Objective: To evaluate the status of receiving education on rational drug use, the criteria in medical drug selection, and level of knowledge of dentists working in a dentistry faculty in Turkey. Material and Methods: This was a descriptive study based on a questionnaire. One hundred seventeen (74%) dentists volunteered to participate in the study. The questionnaire consisted of 20 questions investigating sociodemographic features and rational drug use. Results: The mean age of the dentists was 30.8 ± 7.2 years, and 62.4% were men. The mean period of professional experience was 8.9±7.1 years. The most frequently used resources of references while prescribing medicine were Vademecum (medical drug guide) (61.5%), the internet (59.0%), and colleagues (49.6%). The most frequently reported condition described as ‘good’ was drug indications (43.6%). The dentists had a moderate level of information about posology, and administration route (48.7%), pharmacologic features (48.7%), and contraindications (46.2%). The number of dentists who stated that they considered cost while prescribing was low [always (6%), and frequently (15.4%)]. Rational drug use education had been received by 23.9% of the dentists. Conclusions: The dentists were found to have a lack of adequate and effective education on rational use of drugs. Regular and continuous education before and after graduation is a necessity for dentists and for their patients.

scholarly journals Knowledge of Midwives as a Healthcare Provider About Hypertensive Disorders During Pregnancy

2019 ◽  
pp. 9
Author(s):  
Junita Indarti ◽  
Sandy Prasetyo
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Basic Science ◽  
Knowledge Level ◽  
Cross Sectional ◽  
Good Level ◽  
Hypertensive Disorders ◽  
Number Of Patients ◽  
Level Of Knowledge ◽  
In Pregnancy

Objective: To investigate the knowledge of midwives about hypertensive disorders during pregnancy.   Methods: The study design is cross-sectional by evaluating the knowledge of midwives regarding hypertensive disorders during pregnancy by using questionnaire. This study was conducted in Jakarta during the period between September and October 2017. The subject is a midwife member of Indonesian Midwives Association (IBI) practicing in DKI Jakarta, Indonesia.   Results: Total respondents were 639 practicing midwives in Central, South, West and North Jakarta. A total of 323 (50.5%) of the respondents had a sufficient level of knowledge about the basic science of high blood pressure in pregnancy, 372 (58.2%) of respondents had a good level of knowledge related to clinical examination and early diagnosis of high blood pressure in pregnancy, and 385 (60.3%) of respondents had a good level of knowledge about the management of high blood pressure in pregnancy. The location of the clinic, physician attendance, the number of patients treated by the midwives, and the number of midwives attending the clinic had significant association with the knowledge level of the subjects (all P values < 0,05)   Conclusion: The lowest knowledge level was about the basic science of hypertensive disorders during pregnancy. Factors affecting the knowledge levels of the midwives were location of the clinic, physician attendance, the number of patients treated by the midwives, and the number of midwives attending the clinic   Keywords: knowledge, midwive, hypertensive disorders, pregnancy, preeclampsia

scholarly journals Evaluation of the French National Program on Home Return of Patients with Chronic Heart Failure (PRADO-IC): Pilot Study of 91 Patients During Its Deployment in the Bas Rhin Area

2020 ◽  
Vol 9 (4) ◽  
pp. 1222
Author(s):  
Mylène Radreau ◽  
Noel Lorenzo-Villalba ◽  
Samy Talha ◽  
Jean-Jacques Von Hunolstein ◽  
Michel Hanssen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Controlled Study ◽  
National Program ◽  
Number Of Patients ◽  
Before And After ◽  
The Mean

Objective: The main objective of this study was to evaluate the impact of the French national program on home return of chronic heart failure patients (PRADO-IC) in terms of re-hospitalizations for heart failure (HF) during its deployment in the Bas-Rhin (France). Patients and methods: This was a pilot, descriptive, quantitative, retrospective, and bi-centric study (University Hospitals of Strasbourg and Haguenau Hospital Center, France). It included all patients included in the PRADO-IC program from these centers between January 1, 2015 and December 31, 2015. The primary endpoint of our study was the evaluation of the number of 1-year, 6-month, and 30-day re-admissions to the hospital in relation to an acute HF episode, before and after the inclusion of patients in the PRADO-IC program. The secondary endpoints were the number of overall re-hospitalizations (all-cause); the number of days of hospitalization for HF; the time to first re-hospitalization and the average length of hospital stay, before and after inclusion in PRADO-IC; and the overall and cardiovascular mortality rates. Results: 91 patients out of 271 (33,6%) with a mean age of 79.2 years (67–94) were included. They all had chronic HF, essentially class II-III NYHA (90.1%), mostly of ischemic origin (41.9%), with altered left ventricular ejection fraction in 71.4% of cases. A reduction in the mean number of hospitalizations for HF per patient at 30 days, 6 months and 1 year was observed, respectively, from 0.18 ± 0.42 per patient before inclusion to 0.15 ± 0.36 after inclusion (p = 0.56); 0.98 ± 1.04 hospitalizations to 0.53 ± 0.81 at 6 months (p < 0.01); and 1.64 ± 1.14 hospitalizations 1.04 ± 1.05 at 1 year (p < 0.001). Patients were hospitalized less overall after inclusion in the PRADO-IC program. The number of days of hospitalization for HF was reduced after inclusion of patients from 18.02 ± 7.78 days before inclusion to 14.28 ± 11.57 days for the 6 month follow-up (p = 0.006), and from 22.07 ± 10.33 days before inclusion to 16.39 ± 15.94 days for the 1 year follow-up (p < 0.001). In contrast, inclusion in PRADO-IC statistically increased the mean time to first re-hospitalization for HF from mean 99.36 ± 72.39 days before inclusion to 148.11 ± 112.77 days after inclusion (p < 0.001). Conclusion: This study seems to demonstrate that the PRADO-IC program could improve the management of chronic HF patients in ambulatory care, particularly regarding HF re-hospitalization. However, due to the limitations of the methodology used and the small number of patients, it is advisable to consolidate its initial results with a randomized controlled study on a larger number of patients. In our opinion, its results need to be communicated because, to our knowledge, no equivalent study exists.

The effect of educating the clients of rehab centers on the frequency of methadone poisoning among children: a study from Iran

2018 ◽  
Vol 32 (4) ◽  
Author(s):  
Hakimeh Abdoli ◽  
Tabandeh Sadeghi ◽  
Majid Kazemi
Keyword(s):  
Educational Program ◽  
Data Gathering ◽  
Study Data ◽  
Educational Session ◽  
Exact Test ◽  
Face To Face ◽  
Significant Difference ◽  
Before And After ◽  
Study Population ◽  
Level Of Knowledge

AbstractBackgroundPoisoning with methadone is considered dangerous and fatal, which can lead to decreased consciousness, coma, apnea and eventually death.AimsThe present study was conducted to evaluate the effect of educating the clients of rehabilitation (rehab) centers on the frequency of methadone poisoning among children.MethodsIn the present semi-experimental study, the study population included all of the clients referred to the rehab centers in an urban area of Iran who received treatment with methadone. Samples were selected using the census method. The data gathering tool was a researcher-made questionnaire of which the content validity has been approved. To perform the educational program, educational brochures were distributed among all the rehab centers (33 centers) and one face-to-face educational session was conducted at each center. Six months after the intervention, the number of under 12 year-old children who were referred to hospital with methadone poisoning was calculated and compared to the same number from the 6 months prior to the study. Data were analyzed using SPSS 18.ResultsAccording to the results, the number of methadone poisonings during the 6-month period prior to the study was 29, while the same number during the 6-month period after the intervention was 9. Fisher’s exact test showed a significant difference between the number of methadone poisonings before and after the intervention (p < 0.001).ConclusionThe increased level of knowledge among the parents referred to rehab centers could decrease the rate of poisoning among their children. Therefore, performing this educational program is recommended for all the rehab centers.

scholarly journals Use of an indicator to evaluate physician adherence to prescription guidelines for the treatment of heart failure

2013 ◽  
Vol 49 (4) ◽  
pp. 831-836 ◽  
Author(s):  
Márcio Galvão Oliveira ◽  
Luiz Carlos Passos ◽  
Edval Gomes Santos Júnior ◽  
Andrea Cristina Barbosa ◽  
Djanilson Barbosa Santos
Keyword(s):  
Heart Failure ◽  
Beta Blockers ◽  
Patient Admission ◽  
University Hospital ◽  
Angiotensin Receptor ◽  
Heart Failure Treatment ◽  
Failure Treatment ◽  
Number Of Patients ◽  
Physician Adherence ◽  
To Receive

The aim of this study was to use indicators to evaluate physician adherence to prescription guidelines for heart failure treatment in a university hospital. This was a prospective cohort study conducted in a university hospital. The information collected at the time of patient admission, including therapeutic indication, absolute contra indications and intolerance, was utilised for the formulation of a guideline adherence indicator (GAI). This indicator was calculated as follows: (the number of patients who used the medication/the number of eligible patients) x 100. The percentage of eligible patients was calculated using the following formula: (the number of eligible patients/the total number patients) x 100. The GAI was applied to a population of 53 patients. Inhibitors of angiotensin-converting enzyme/angiotensin receptor blocker (ACE-I/ARB) combination therapy were used in the greatest percentage of eligible patients (92.4%) and demonstrated the largest GAI value (73.5%). The percentages of patients who were eligible for beta-blockers, spironolactone and digitalis treatments were 81.1%, 52.8% and 60.4%, respectively. The GAI values for the use of beta-blockers, spironolactone and digitalis were 60.4%, 57.1% and 56.2%, respectively. For the studied patient population, the GAI was consistent with the proportion of patients who were eligible to receive digitalis and spironolactone.

scholarly journals Are nurses updated on the proper management of patients with sepsis?

2019 ◽  
Vol 23 (4) ◽  
Author(s):  
Layala de Souza Goulart ◽  
Marcos Antonio Ferreira Júnior ◽  
Elaine Cristina Fernandes Baez Sarti ◽  
Álvaro Francisco Lopes de Sousa ◽  
Adriano Menis Ferreira ◽  
...  
Keyword(s):  
University Hospital ◽  
Test Results ◽  
Surviving Sepsis Campaign ◽  
Knowledge Test ◽  
Practice Nurses ◽  
Political Incentives ◽  
Service Training ◽  
Level Of Knowledge ◽  
The Subject ◽  
Definition Of

Abstract Objective: To evaluate nurses' knowledge about the definitions of Sepsis-3 and updates to the Surviving Sepsis Campaign. Methods: This descriptive study was carried out from July to August 2018, with 30 nurses from four wards of a large university hospital. For data collection, we created, structured, and validated a questionnaire composed of socio-demographic/occupational data and knowledge test. Results: Only 16.6% of the professionals received in-service training on the subject. There was no implementation of sepsis protocols in the institution, although 96.6% of the participants considered their implementation necessary. Professionals aged ≥35 years old had a higher level of knowledge about the new definition of sepsis (p=0.042). The knowledge about volume resuscitation (p=0.001) and use of vasopressors (p=0.025) was greater in those with ≥10.5 years of experience in the profession. Nurses from the clinical units presented a higher level of knowledge about the organic dysfunctions caused by sepsis (p=0.025). Conclusion and implications for the practice: Nurses do not have satisfactory knowledge for the proper identification, treatment, and clinical management of sepsis. There is a need for greater professional, institutional, and political incentives to implement a permanent education and the sepsis protocol.

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