scholarly journals ROLE OF OBSTETRIC TRIAGE IN IMPROVING PATIENT HEALTH CARE AT CMH KHARIAN-A COMPARITIVE STUDY

2020 ◽  
Vol 70 (6) ◽  
pp. 1792-98
Author(s):  
Asma Ansari ◽  
Umbreen Akram ◽  
Hafsa Khalil ◽  
Ayesha Imran

Objective: To evaluate the up gradation of obstetric patient care by using obstetrics-specific triage acuity tool. Study design: Comparative prospective study Place and duration of study: This study was conducted at obstetrics unit of combined military hospital Kharian from June 2018 to Dec 2018. Methodology: Pregnant patients were triaged and prioritized according to Maternal fetal triage index (MFTI) into five levels. Primary outcome was time to triage and management plan documentation. Patient and health care provider satisfaction was evaluated using Likert’s scale before and after implementation of MFTI. Data was collected and expressed in frequencies and percentage. Chi square test was applied for association between before and after triage intervention variables, and a P value of 0.05 was considered significant. Results: A total of 1000 pregnant patients referred to OPD were enrolled, 500 patients before and 500 after implementation of MFTI. Patients were prioritized using MFTI system,10(2%) patients category 1 while category 2,3,4,and 5 were 28(5.6%),68(13.6%),150(30%) and 244(48.8%) respectively. There was significant reduction in waiting time from 35.4±8.2 minutes to18.2±6.5 p=<0.002. Hospital complaints reduced significantly from 25(5%) in before group to 4(0.8%) P=<0.001 after application of obstetric triage. Conclusion: Obstetric triage by MFTI focuses on the urgency and symptoms at presentation to decide further disposal. The usage of a systematic and properly developed triage system produces improvement in patient care. The results of study not only highlight the importance of usage of a triage system but also explore its usefulness and improvement in outcomes in a developing country like Pakistan.

Author(s):  
Dhaval Dalal ◽  
Kamalpriya Thiyagarajan ◽  
Humeshwari Nipane ◽  
Vijaykumar Gawali

Background: COVID-19 has brought psychological disorders that affect health care workers and the general public. Hence it is important to have necessary counselling to address the psychological, social aspects of the pandemic to ensure psychological well-being of especially Health-care Workers and preserve their innate and acquired immunity.Methods: The study was planned as single centre retrospective study and conducted between April and June 2020 at dedicated COVID-19 hospital in India. Front-line HCWs more than 18 years, of any gender working in COVID-19 hospital and willing to participate for the study were enrolled in the study. Study included two questionnaires, generalized anxiety disorder scale, and socio-demographics and COVID-19 related awareness questionnaire. Measurements were taken pre and post the psychological counselling intervention.Results: As per generalized anxiety disorder (GAD) scale people suffering from moderate anxiety disorder dropped from 19% (pre counselling) to 5% (post counselling) and severe cases dropped from 14% (pre counseling) to 2% (post counseling), there was statistically significant difference observed due to psychological intervention in GAD scale (Chi square test-10.794, p value=3.67E-27). Socio demographics and COVID-19 related awareness questionnaire results were statistically significant (Chi square test-11.945, p value=6.91E-33).Conclusions: Counselling interventions based on scientific data offered in groups by investigator with an accurate knowledge of the COVID-19 and its manifestation increased the confidence of health care workers (HCWs) and reduced anxiety level. This was translated into the full availability of HCWs on the clinical study site, although medical services were disrupted while other hospitals were starving due to lack of staff.


2021 ◽  
Vol 5 (11) ◽  
pp. 1030-1036
Author(s):  
Galih Aktama ◽  
Henky Agung Nugroho ◽  
Muhammad David Perdana Putra

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.


2021 ◽  
Vol 5 (4) ◽  
pp. 940-946
Author(s):  
Galih Aktama ◽  
Hengky Agung Nugroho ◽  
Muhammad David Perdana Putra

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.


2020 ◽  
Vol 8 (3) ◽  
pp. 396
Author(s):  
Nurasih Nurasih ◽  
Endang Nurrochmi

In Indonesia, Yoga is currently one of the most popular sports, not only for the general public but also for pregnant women. Many benefits can be obtained from prenatal yoga including the mother feeling comfortable and relaxed throughout pregnancy and during childbirth, training the pelvic floor muscles and perineum, keeping the body's muscles relaxed, balanced during childbirth, reducing stress, increasing and improving oxygen circulation to the body and fetus. . This study aims to determine the effect of prenatal yoga on optimizing fetal position on third trimester Primigravida maternal delivery output at Puskesmas Cirebon City. This research is a quasi-experimental research pre post control group design and only post control group design with T test and Chi Square test. Paired T Test results of the intervention group (mean difference = 3.111, P value = 0.000, control group (mean difference = 0.833, P value = 0.318). Independent T Test results obtained (average difference = -1.944, P value = 0.024), Chi Square test obtained a value of P = 0.73. There is a difference in the average anxiety before and after the intervention in the intervention group, there is no difference in average anxiety before and after the intervention in the control group. There is a difference in the average anxiety between the intervention and control groups. There is a difference in mean Long I stage between the intervention and control groups There was no effect of prenatal yoga on the type of labor.


2020 ◽  
Vol 16 (1) ◽  
pp. 93-100
Author(s):  
Viranda Nedine Putri Watulinggas ◽  
Mona Lestari ◽  
Novrikasari Novrikasari ◽  
Desheila Andarini ◽  
Anita Camelia

The port has a fairly dense loading/unloading activity according to the total flow of goods it manages. In addition to high work activities, environment factors such as noise and work climate can also affect the occurrence of work fatigue.  Therefore, this study aims to determine factors associated with work fatigue in loading/unloading workers at the port.  This study uses cross sectional study design with simple random sampling.  Data analysis used the Paired Sample T-Test and Chi-Square test.  The results showed that there was a difference of fatigue before and after work and as many as 71.2% of workers experienced moderate fatigue.  It is known that age (p-value = 0,000), breakfast habits (p-value = 0,000), and years of service (p-value = 0,000) have a significant correlation with work fatigue, while nutritional status (p-value = 0.203), workload (p-value = 0.140), hot work climate (p-value = 0.362), and noise (p-value = 0.880) have no correlation with work fatigue.  It was concluded that age, breakfast habits and work duration were related to work fatigue in loading/unloading labor.  Therefore, workers are advised to be used to have breakfast with the right menu and time and workers should wear hats while working to reduce sun exposure.


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Faisal Nadeem ◽  
Muhammad Khan ◽  
Faheem Ullah Naz

Objective: The sub hepatic drain is often placed after laparoscopic cholecystectomy is considered to affect post operative infection, pain and sub hepatic collections. The objective of this study was to compare the degree of postoperative pain in patients with routine drainage with those without it after elective, uncomplicated laparoscopic cholecystectomy. Methods: This randomized control trial (RCT) was done over six months from 9th June 2015 to 8th December 2015 at Military Hospital Rawalpindi. Sample calculated with WHO calculator and consecutive non probability random sampling used to divide 170 patients undergoing laparoscopic cholecystectomy in two groups. One group had routine sub hepatic drain and other didn’t. Degree of postoperative pain was assessed according to VISUAL ANALOGUE SCALE by duty doctor at 24 hours. Data was collected and analyzed applying chi square test and p value was <0.05 considered statistically significant. Results: Our results demonstrated that intensity of post operative pain in routine drainage group is higher as compared to non drainage group after elective, uncomplicated laparoscopic cholecystectomy. Conclusion: Routine placement of sub hepatic drain in elective uncomplicated laparoscopic cholecystectomy should be avoided to reduce post-operative pain. How to cite this:Nadeem F, Khan MR, Naz FU. Comparison of mean pain scores for the patients with sub hepatic drainage to those without it after elective uncomplicated laparoscopic cholecystectomy. Pak J Med Sci. 2019;35(1):226-229. doi: https://doi.org/10.12669/pjms.35.1.224 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Sity Kunarisasi ◽  
Imran Pambudi ◽  
Asri Mutiara Putri ◽  
Nurhanifah Hamdah

Tuberculosis is a public health issue. Prevalence of tuberculosis in 2017 is estimated 824.000 cases in which making Indonesia the third country in the world with biggest burden TB and the seventh country with biggest burden in HIV-TB. PITC in primary health care is a Health Ministry program. PITC is the only test and counseling to motivated TB patient to get HIV test. The aim of this study is to analyze relationship between age and gender with the success of PITC in TB patients to know the HIV status at Medan in 2017. Method This research is a descriptive-analytic study with cross-sectional approach. the population in this study is TB patients with age 15-49 years old wo had TB diagnosed either with bacteriologic or clinical in primary health care at Medan in 2017. Medan is chosen because Medan is one of eight cities with the highest burden of TB and HIV in Indonesia, also it has complete recording of TB patients. The sample of this study is all TB patients in primary health care at Medan in 2017 who had PITC in total 2.228 from all TB patients in total 5.039 patients. Data analysis using SPSS to search for p value and Odds Ratio (OR). Result 250 of 2.228 (11,22%) patients is positive in HIV test. Statistics analysis using chi-square test shows p value 0.000 (p<0.05) and OR = 1.905 for relationship between gender and HIV test positive. Also, p value of 0,006 (p<0,05) and OR = 1.459 for relationship between age and HIV test positive. In this study with the implementation of PITC in TB patients in primary health care at Medan there is a relationship between sex and age with HIV infection.


2021 ◽  
Vol 104 (2) ◽  
pp. 247-251

Objective: To compare the efficacy of organizational measures on helmet use rate of the motorcycle driver and rider in Trang Hospital. Materials and Methods: The present study was a prospective study comparing the helmet use rate before and after the measures including helmet policy, supportive and incentive organizational measure, and penalizing organizational measure. The personnel of Trang Hospital included 1,441 people. There were 637 drive-only personnel, 143 ride-only personnel and 443 drive-ride personnel. The helmet use rate was collected at the front gate of the hospital by closed circuit video camera monitoring during 07:00 am to 08:30 am every day for one week before and after the various measures. The mean helmet use rates were compared by the chi-square test was considered significant at the p value of less than 0.05. Results: The increased rate of helmet use in driver after the supportive and incentive organizational measure and the penalizing organizational measure compared to the helmet use rate before the policy measures were statistically significant (p<0.001). Unlike the increased rate of helmet use in driver and rider after the policy measure compared to the helmet use rate before the policy measure were not statistically significant (p=0.220, 0.470, consecutively). The increased helmet use of the rider after the penalizing organizational measure was statistically significant when compared to the helmet use rate before the policy (p<0.001), and the supportive and incentive measure (p=0.019). However, the increased rate of helmet use in driver after the penalizing organizational measure compared to the helmet use rate after the supportive and incentive organizational measure were not statistically significant (p=0.990). Conclusion: Only the policy measure has not significantly increased the rate of helmet use in both drivers and riders. The supportive and incentive organizational measure have significantly increased the helmet use rate in the drivers, but not significantly increased the rate of helmet use in the riders. However, the penalizing organizational measure has significantly increased the rate of helmet use in the riders, but not significantly increased the rate of helmet use in the drivers. Keywords: Helmet implementation, Organizational measure, Head injury prevention, Motorcycle accident, Helmet use rate


2016 ◽  
Vol 2 (3) ◽  
pp. 99
Author(s):  
Habibur Rochman ◽  
Edi Sampurno Ridwan ◽  
Effatul Afifah

<p>Nursing service is the key of health care service in hospitals. Therefore, it is necessary to restuctre the health service quality related to the adequacy of nurse-patient ratio. The improvement of health services quality is a form of strategy to enhance patient safety. The performance of a nurse is the key of health care service and is very important to address in order to maintain and improve the quality of health services. The award system is one of motivation methods used to increase nurse performance. The purpose of this study was to know the relationship between awards system and nurse-patients ratio with nurse performance at RSUD Panembahan Senopati Bantul. The study design was observational analytic with cross sectional approach. Samples were selected by stratified random sampling, then simple random sampling resulting on 65 nurses. Data analysis was done by using chi-square test. The results showed that there was relationship between award system and the nurse performance with p-value 0.02 (p&gt;0.05). Conversely there was no relationship between award system and nurse patients ratio and the nurse performance with p-value 1.000 (p&gt;0.05). In conclusion, there was a significant relationship between award system and nurse performance, and there was no relationship between the nurse patients ratio and nurse performance.</p>


2021 ◽  
Vol 8 ◽  
Author(s):  
Yu Ling ◽  
Ye Mingxia ◽  
Zhang Xiaoyan ◽  
Fan Yifan ◽  
Liu Peipei ◽  
...  

Background: The coronavirus disease 2019 (COVID-19) had become a health care event endangering humans globally. It takes up a large number of healthcare resources. We studied the impact of COVID-19 on patients with ovarian cancer by comprehensively analyzing their admissions before and after the epidemic, and made reasonable suggestions to improve their current situation.Methods: We randomly divided the enrolled patients into three groups, PreCOVID-19 Group (PCG) (2019.8.20–2020.1.20), COVID-19 Group (CG) (2020.1.21–2020.6.14), and Secondary Outbreak COVID-19 Group (SOCG) (2020.6.15–2020.10.10). One-way ANOVA and chi-square test were used for analysis.Results: The number of patients from other provinces decreased significantly (p &lt; 0.05). The total hospital stay during the epidemic was substantially more extended (p &lt; 0.05). Before the epidemic, our department performed more open surgery while during the epidemic outbreak, we tended to choose laparoscopy (p &lt; 0.01). We took a longer surgery time (P &lt; 0.05). Patients had significantly less post-operative fever during the epidemic (p &lt; 0.001).Conclusion: During the COVID-19 epidemic, no patient was infected with COVID-19, and no patient experienced severe post-operative complications. We recommend maintaining the admissions of patients with ovarian cancer during the epidemic following the rules: 1. The outpatients must complete a nucleic acid test and chest CT in the outpatient clinic; 2. Maintain full daily disinfection of the ward and insist that health care workers disinfect their hands after contact with patients; 3. Increase the use of minimally invasive procedures, including laparoscopy and robotics; 4. Disinfect the ward twice a day with UV light and sodium hypochlorite disinfectant; 5. Patients need to undergo at least three nucleic acid tests before entering the operating room.


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