scholarly journals Compliance with Recommended Practices for Management of Controlled Substances in a Health Care Facility and Corrective Actions

2019 ◽  
Vol 72 (3) ◽  
Author(s):  
Manon Videau ◽  
Suzanne Atkinson ◽  
Maxime Thibault ◽  
Denis Lebel ◽  
Jean-François Bussières
Keyword(s):  
Failure Modes ◽  
Care Facility ◽  
Health Care Facility ◽  
Medium Term ◽  
Cross Sectional ◽  
Controlled Substances ◽  
Corrective Actions ◽  
Recommended Practices ◽  
Study Hospital ◽  
California Hospital

<p><strong>ABSTRACT</strong><br /><strong></strong></p><p><strong>Background:</strong> Pharmacists are required to maintain a secure inventory of medications and to ensure proper, safe, and diversion-free dispensing practices. <br /><strong></strong></p><p><strong>Objectives:</strong> The primary objectives of this study were to determine compliance with recommended practices for the management of controlled substances in a mother–child teaching hospital and to identify actions to improve compliance. The secondary objective was to identify steps in the drug pathway for controlled substances and associated failure modes in the study hospital.<br /><strong></strong></p><p><strong>Methods:</strong> This descriptive cross-sectional study used a framework devel-oped by the California Hospital Association (CHA) to assess compliance with recommended practices for the management of controlled substances in hospitals. For each criterion, a research assistant observed practices within the pharmacy, on patient care units, at outpatient care clinics, and in operating and delivery rooms. The level of compliance was recorded as compliant, partially compliant, or noncompliant. An Ishikawa diagram was developed to illustrate steps in the drug pathway and associated failure modes related to the use of controlled substances in the study hospital. <br /><strong></strong></p><p><strong>Results:</strong> The pathway for controlled substances at the study hospital was compliant for 56 (49.6%) of the 113 CHA criteria, partially compliant for 27 (23.9%) of the criteria, and noncompliant for 24 (21.2%) of the criteria; the remaining 6 (5.3%) criteria were not applicable. This practice evaluation highlighted 22 corrective actions, 12 (55%) that could be implemented in the short term, 8 (36%) suitable for implementation in the medium term, and 2 (9%) suitable for both the short and medium term. A total of 57 potential failure modes related to the use of controlled substances were identified.<br /><strong></strong></p><p><strong>Conclusions:</strong> The pathway for controlled substances at the study hospital was compliant with almost half of the CHA criteria, and 22 corrective actions were identified. Pharmacists, physicians, and nurses should be mobilized to optimize the use of controlled substances throughout the drug-use process.</p><p><strong>RÉSUMÉ</strong><br /><strong></strong></p><p><strong>Contexte:</strong> Les pharmaciens sont responsables de maintenir à jour les réserves de médicaments et doivent faire en sorte que les pratiques de distribution soient adéquates, sûres et exemptes de détournement. <br /><strong></strong></p><p><strong>Objectifs :</strong> Les objectifs principaux de la présente étude consistaient à déterminer le degré de conformité aux pratiques de gestion des substances contrôlées, recommandées dans un hôpital universitaire mère-enfant, et de trouver des mesures pour améliorer leur degré de conformité. L’objectif secondaire visait à recenser les étapes que suivent les substances contrôlées dans le circuit des médicaments et les modes de défaillance qui y sont associés dans l’hôpital à l’étude.<br /><strong></strong></p><p><strong>Méthodes :</strong> La présente étude descriptive et transversale s’appuyait sur un cadre mis au point par la California Hospital Association (CHA), qui sert à évaluer le degré de conformité aux recommandations relatives aux pratiques de gestion des substances contrôlées dans les hôpitaux. Pour chaque critère, un assistant de recherche observait les pratiques dans le service de pharmacie, les unités de soins, les cliniques de consultation ex-terne et les salles d’opération ou les salles d’accouchement. Il évaluait le degré de conformité à l’aide d’un des qualificatifs suivants : conforme, partiellement conforme ou non conforme. Un diagramme d’Ishikawa a été conçu pour illustrer les étapes du circuit des médicaments et les modes de défaillance associés à l’utilisation de substances contrôlées dans l’hôpital à l’étude. <br /><strong></strong></p><p><strong>Résultats :</strong> Le circuit des substances contrôlées à l’hôpital où se déroulait l’étude était conforme à 56 (49,6 %) des 113 critères de la CHA, partiellement conforme à 27 (23,9 %) critères et non conforme à 24 (21,2 %) critères; les 6 (5,3 %) critères restants n’étaient pas applicables. Cette évaluation des pratiques a mis en évidence 22 actions correctives, dont 12 (55 %) pouvaient être mises en place à court terme, 8 (36 %) à moyen terme et 2 (9 %) à court ou à moyen terme. Les investigateurs ont repéré 57 modes de défaillance potentiels liés à l’utilisation de substances contrôlées.<br /><strong></strong></p><p><strong>Conclusions :</strong> L’analyse du circuit des substances contrôlées à l’hôpital où se déroulait l’étude a révélé que près de la moitié des critères de la CHA étaient conformes, et 22 actions correctives ont été proposées. Les pharmaciens, médecins et infirmières devraient participer à l’optimisation de l’utilisation des substances contrôlées dans l’ensemble du processus de distribution des médicaments.</p>

scholarly journals Knowledge and perception about the ongoing COVID-19 pandemic among patients attending a rural primary health care facility in Delhi

2021 ◽  
Vol 8 (3) ◽  
pp. 1494
Author(s):  
Ekta Arora ◽  
Nidhi Budh ◽  
Rohit Katre ◽  
Bratati Banerjee
Keyword(s):  
Public Perception ◽  
Statistical Tests ◽  
Care Facility ◽  
Health Care Facility ◽  
Primary Health Care Facility ◽  
Preventive Strategies ◽  
Cross Sectional ◽  
Modes Of Transmission ◽  
Correct Knowledge ◽  
Novel Coronavirus

Another decade is suffering from the wrath of another coronavirus. Currently, this pandemic has spread to almost all countries of the world taking lives of millions of people globally. This study has uncovered the perceived facts about COVID-19 by general population as well as the effect of IEC in modulating their perception and presenting right amount of information in a scientific manner. A cross-sectional, descriptive study was carried out at rural health training center, Barwala on patients attending out-patient department at RHTC, for a duration of 2 months. Pre-tested questionnaire for assessing public perception and awareness were used to collect data. Appropriate statistical tests were applied to find out association between different variables. Majority of study subjects (98.5%) were aware about the ongoing pandemic of COVID-19. Out of the total study subjects, 90% of them had correct knowledge about various preventive strategies undertaken to break the chain of transmission. However, only about half of the study subjects (53.1%) had correct knowledge regarding various modes of transmission of novel coronavirus. Motivating the people to report any possible infection and to follow the preventive strategies being recommended by experts on timely basis is an important aspect to curb the ongoing menace of COVID-19.

scholarly journals Serum retinol in 1–6-year-old children from a low socio-economic South African community with a high intake of liver: implications for blanket vitamin A supplementation

2011 ◽  
Vol 15 (4) ◽  
pp. 716-724 ◽  
Author(s):  
Martha E van Stuijvenberg ◽  
Serina E Schoeman ◽  
Carl J Lombard ◽  
Muhammad A Dhansay
Keyword(s):  
Vitamin A ◽  
Economic Status ◽  
Care Facility ◽  
Health Care Facility ◽  
Significant Negative Correlation ◽  
Primary Health Care Facility ◽  
Serum Retinol ◽  
Cross Sectional ◽  
Vitamin A Supplementation ◽  
Breast Fed

AbstractObjectiveTo assess serum retinol, liver intake patterns, breast-feeding history and anthropometric status in pre-school children of a low socio-economic community where liver is regularly consumed.DesignCross-sectional study.SettingNorthern Cape Province, South Africa.SubjectsChildren aged 1–6 years (n243) who attended the local primary health-care facility and had not received a vitamin A supplement in the 6 months preceding the study. Non-pregnant female caregivers (n225), below 50 years of age, were also assessed.ResultsDespite stunting, underweight and wasting being prevalent in 40·5 %, 23·1 % and 8·4 % of the children, only 5·8 % had serum retinol concentrations < 20 μg/dl, which is in sharp contrast to the national prevalence of 63·6 %. None of the caregivers were vitamin A deficient. Liver was eaten by 89·2 % of children, with 87 % of households eating liver at least once monthly and 30 % eating it at least once weekly; liver was introduced into the diet of the children at a median age of 18 months. Ninety-three per cent of the children were being breast-fed or had been breast-fed in the past; children were breast-fed to a median age of 18 months. A significant negative correlation was found between educational level of the caregiver and frequency of liver intake (r= −0·143,P=0·032). There was no correlation between serum retinol and indicators of anthropometric or socio-economic status.ConclusionsThe blanket approach in applying the national vitamin A supplementation programme may not be appropriate for all areas in the country, even though the community may be poor and undernourished.

scholarly journals Bundle Prevention Form Filling Completeness of Surgical Site Infection (SSI) on Sectio Caesarea Patients in 2016

2017 ◽  
Vol 5 (1) ◽  
pp. 13
Author(s):  
Adita Puspitasari Swastya Putri ◽  
Kurnia Dwi Artanti ◽  
Dwiono Mudjianto
Keyword(s):  
Health Care ◽  
Surgical Site Infection ◽  
Care Facility ◽  
Health Care Facility ◽  
Simple Random Sampling ◽  
Total Sample ◽  
Health Care Facilities ◽  
Sectio Caesarea ◽  
Site Infection ◽  
Cross Sectional

Hospital Acquired Infections (HAIs) is an infection acquired during a patient undergoing treatment proedur and medical measures in health care facilities within ≥ 48 hours or within ≤ 30 days and infection was observed after the patients leaving the health care facility. The one of Hais what often happens is Surgical Site Infection (SSI) so that SSI surveillance is needed for prevention and control of infection. Bundle prevention is an instrument used for data collection the incidence of SSI in Hospital X Surabaya. This study aims to look at the picture of existence, charging and completeness of bundle SSI prevention on patients sectio caesarea in Hospital X Surabaya. The study design used is cross sectional with a total sample of 47 patients were taken by simple random sampling on patients sectio caesarea in January-June 2016. The result showed that 64% of patient records status is not accompanied by SSI prevention bundle with charging and completeness of the data that is still below the predetermined standard that is equal to 80%. Although SSI surveillance is in conformity with the guidelines infection surveillance but there are still some shortcomings in terms of the accuracy of the data so that the information obtained is still not able to be reported as well.Keywords: surveillance, SSI, hospital

scholarly journals Highway Emergency Response and Accident Mitigation Service (HERAM) – A Field Report

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Balaji Utla ◽  
Shailendra Kumar B. Hegde ◽  
Sri Ranga Prasad Saride ◽  
Ramanuja Chary Kandaala ◽  
Sridhar Upadhya ◽  
...  
Keyword(s):  
Emergency Response ◽  
Care Service ◽  
National Level ◽  
Care Facility ◽  
Health Care Facility ◽  
Cross Sectional ◽  
Emergency Ambulance ◽  
One Year ◽  
Field Report ◽  
Sectional Analysis

This paper describes a cross-sectional analysis of data pertaining to accidents that occurred on the National Highway between Hyderabad and Vijaywada, over a period of one year. A fully equipped trauma ambulance was despatched to the site as soon as a call comes on 1033. The victim was attended to by well-trained paramedics in the ambulance and transported to the nearest health care facility. This service attended to 60% of the accidents in the service area. Incidence of fatalities was 5.63%. This service can be established at the national level to provide emergency ambulance care service to accident victims on National Highways.

scholarly journals COVID-19 Vaccine Acceptability Among Pregnant Women at a Primary Health Care Facility in Durban, South Africa

2020 ◽  
Vol 2 (5) ◽  
Author(s):  
A. M. Hoque ◽  
S. Buckus ◽  
M. Hoque ◽  
M. E. Hoque ◽  
G. Van Hal
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Community Health Center ◽  
Care Facility ◽  
Health Care Facility ◽  
Primary Health Care Facility ◽  
Vaccine Acceptability ◽  
Cross Sectional ◽  
Vaccine Acceptance ◽  
Public Health Officials

A vaccine represents the most promising strategy for combatting the COVID-19 pandemic through primary prevention. No study has been reported on the acceptability of the COVID-19 vaccine in South Africa (SA) and in the region. The objective of this study was to determine the acceptance of a COVID-19 vaccine among pregnant women. A cross-sectional, descriptive study was conducted at the Kwadabeka Community Health Center (KCHC), Durban. Logistic regression analysis was performed to determine the factors for vaccine acceptability among pregnant women. About two-thirds of pregnant women (63.3%) may accept COVID-19 vaccination once it becomes available in SA. Participants who were <22 years of age were 72% less likely (OR=0.28, CI: 0.13 -0.62) to accept the vaccine, compared to those who were >39 years old. Women with 0-1 parity were 4.3 times more likely (OR=4.3, CI: 1.98-9.48) to accept the vaccine than those with four or more parity. Single pregnant women were less likely (OR=0.23, CI: 0.10- 0.51) to accept the vaccine than those living with their partners. Employed pregnant women had four times more chances of accepting the vaccine (OR= 4.2, CI: 2.28-7.75) than unemployed pregnant women. It was also found that having a positive attitude towards vaccination increased the chance of accepting the vaccine by four times (OR=4.05, CI: 1.89-8.69). Our study found a 63.3% acceptance of a COVID-19 vaccine, but there were noticeable demographic, knowledge, attitude and practice disparities observed in vaccine acceptance among pregnant women. Before a COVID-19 vaccine is introduced to SA, public health officials and policymakers must prioritize effective COVID-19 vaccine-acceptance messages and mass education for all South Africans, especially for the most vulnerable.

scholarly journals Epidemiology of preoperative hyperglycaemia among patients undergoing surgery at a tertiary health care facility of Eastern India

2019 ◽  
Vol 6 (7) ◽  
pp. 2838
Author(s):  
Souvik Banerjee ◽  
Rakesh Kumar ◽  
Debasis Basu
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Overweight And Obesity ◽  
World Health ◽  
Surgical Patients ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Health Organization

Background: With about 425 million patients globally and 72.9 million patients in India, diabetes mellitus (DM) is one of the global health emergency of 21st century. Perioperative hyperglycaemia is reported in 20-40% of patients undergoing general surgery. A substantial body of literature demonstrates a clear association between perioperative hyperglycaemia and adverse clinical outcomes. This study aims to find out the frequency of preoperative hyperglycaemia and factors influencing it among patients undergoing surgery at a tertiary health care hospital of Eastern India.Methods: This Institution based, cross-sectional, observational study was conducted among study subjects who were operated at IQ City Medical College and Multispecialty Hospital, Durgapur, India during January-February 2019. Relevant medical records were reviewed to collect data regarding clinic-social data. Estimation of fasting plasma glucose (FPG) has been done as per World Health Organization (WHO) guidelines. Hyperglycaemia was defined and classified as per American Diabetes Association (ADA). Anthropometric measurements were taken as per standard WHO protocols.Results: A total 158 study subjects participated in study. The mean age and mean FPG of the study subjects was 42.63±12.95 years and 103.3±17.37 mg/dl respectively. As per the ADA criteria, 58.9% had normal FPG, 24.0% had impaired fasting glucose (IFG) and 17.1% had diabetes. Out of total 27 T2DM patients, 22 (13.9%) were known cases of T2DM and 5 (3.2%) were undiagnosed. The frequency of preoperative hyperglycaemia i.e. sums of IFG and diabetes was found to be 41.1%. Increasing age, male gender and overweight and obesity significantly influenced the occurrence of preoperative hyperglycaemia.Conclusions: The prevalence of preoperative hyperglycaemia among patients undergoing surgery is higher than the prevalence of hyperglycaemia among non surgical patients. Routine HbA1C should be done in all surgical patients to differentiate between chronic undiagnosed hyperglycaemia and stress hyperglycaemia.

scholarly journals Profile of unnatural deaths in a teaching hospital of West Bengal, India

2020 ◽  
Vol 7 (3) ◽  
pp. 971
Author(s):  
Satabdi Mitra ◽  
Saumabrata Panja
Keyword(s):  
Traffic Accidents ◽  
Burn Injury ◽  
Road Traffic ◽  
Care Facility ◽  
Health Care Facility ◽  
Binary Logistic Regression ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Fall From Height

Background: Enquiry into unnatural deaths with all its manners being, suicidal, accidental or homicidal depends on circumstantial evidences for acceptable judgment in court of law. Objectives were to study socio-demographic characteristics of the study and to find out influencing factors, if any, behind these sudden, suspicious, undesirable deaths.Methods: A record-based, descriptive study with cross-sectional design was conducted for first six months of 2017 in NRS medical college hospital among 1603 unnatural deaths undergone police inquest. Besides the records obtained from medical record section, findings were corroborated from mortuary. Data were analyzed in SPSS 22.0 and Epi Info 7.0.Results: Mean age of the deceased was 37.18±17.42 years. Regarding cause of injury, more than 1/3rd (36.6%) was attributed to poisoning, followed by burn injury (24.8%), road traffic accidents (22.8%), fall from height (6.9%) and others the rest. Majority (68.3%) died within twenty hours of reaching the health care facility. More than half of the deceased committed suicide followed by accident and suicide the least. Binary logistic regression revealed, unnatural deaths inflicted by selves or others, i.e. suicide or homicide respectively, had statistically significant (p<0.05) association to productive age, urban residence, burn and RTA, longer survival and conservative nature of management.Conclusions: As suicide was found to comprise lion share of unnatural deaths, development and implementation of addressing the issue at all the levels, starting from individual to community is the need of the hour.

scholarly journals Mid upper arm circumference in pregnant women and its relationship with birth weight

2021 ◽  
Vol 11 (2) ◽  
pp. 331-335
Author(s):  
Surendra Nath Soren ◽  
Partha Sarathi Sahu
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Linear Regression Analysis ◽  
Care Facility ◽  
Health Care Facility ◽  
Cross Sectional Study ◽  
Upper Arm ◽  
Cross Sectional ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

: Mid upper arm circumference (MUAC) is considered as a good indicator of maternal nutritional status in pregnant women. Very few studies have been done to establish a relationship between MUAC and birth weight of newborn. This study was carried out to analyze the relationship between MUAC and birth weight of newborn in a tertiary health care facility.This cross sectional study was conducted in 240term pregnant women. MUAC was measured to the nearest millimeters using a non-stretchable tape at the midpoint between acromian process and olecranon process. Newborn baby weight was measured within 24 hrs of birth. The association between MUAC and birth weight was established by linear regression analysis.The mean of MUAC among pregnant women delivering LBW was 21.68±2.27 cm which was significantly low (p&#60;0.001) compared to women delivering normal babies (23.47±2.56 cm). There wasa positive correlation(r=0.32;p&#60;0.05)between MUAC and birth weight of newborn.The cut off value of MUAC for the prediction of LBW in our study was found to be 22.59 cm with 62.77% sensitivity and 71.55% specificity.Among the various maternal factors for the prediction of LBW, mid-upper arm circumference (MUAC) can be correlated with birth weight outcome effectively.

scholarly journals Prevalence of acute morbidities and their health seeking behaviour among under-five children of urban slums in a city in Karnataka

2017 ◽  
Vol 4 (7) ◽  
pp. 2449
Author(s):  
Yamuna B. N. ◽  
Ratnaprabha G. K. ◽  
Prakash Kengnal
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Sampling Technique ◽  
Cluster Sampling ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Cross Sectional ◽  
Under Five ◽  
The Past

Background: Morbidity and lack of health facility especially in the first five years of life would cause irreparable damage. Therefore it is important to assess the magnitude of morbidities, and their health seeking behaviour. The objectives of the study were to assess the prevalence of acute morbidities and their associated factors among Under-five (U5) children residing in slums of Davanagere city, Karnataka, and to assess the health-seeking behaviour of their mothers/caregiversMethods: It was a cross sectional study done in the slums of Davanagere city during August-September 2016. Using 30 cluster sampling technique, the estimated sample size was 656. A total of 22 children were included in each cluster. Questionnaire consisting of demographic details, history of acute morbidities in the past two weeks and their treatment details was administered to the mother/caregiver. Data was entered in Microsoft Excel sheet and analyzed using SPSS Version 20.Results: Totally 656 mothers/caregivers of U5 children were contacted, majority of the children were in the age group of 13 to 60 months. Total of 348 (53%) children suffered from some acute morbidity in the past 2 weeks, of whom 282 (81%) children were taken to some health care facility, and majority preferred private practitioner (73.4%). Most common reason for poor health seeking behaviour was “following the medicines which were prescribed for previous illness”.Conclusions: More than half of the children suffered from some acute morbidity in the past 2 weeks and 81% of them were taken to health care facility. 

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