scholarly journals Prescription audit a tool to determine the effects of antibiotics in the pediatric inpatient department of a tertiary teaching care hospital in Punjab

2021 ◽  
Vol 2 (1) ◽  
pp. 27-32
Author(s):  
Monika Kapoor ◽  
Jagminder Kaur Bajaj ◽  
Shalini Salwan

Introduction: Health care professionals dealing with pediatric patients face a lot of challenges and pass through hurdles during their daily practice of medicines owing to the scarcity of suitable drugs and other facilities. A fundamental part of the antibiotic prescription is inappropriate due to errors in the selection of appropriate antibiotics, dose, duration, route of administration, and frequency for treatment. Medication use evaluation and audits are an integral part of evaluating whether the drugs are being utilized appropriately considering the social, economic, and medical points. Objectives: The main objective of this study was to do an antibiotic audit to analyze the prescribing pattern in the in-patient department of pediatrics of the hospital. Methods: A prospective observational study was conducted in the inpatient pediatrics department of Punjab Institute of Medical Science and Hospital, Jalandhar. The study was conducted on a total of 150 hospitalized children and infants for a period of two months from February 1, 2020, to March 30, 2020. Results: The analysis of 150 prescriptions was done using IBM SPSS software version 24 and statistical analysis was done. Antibiotic usage was expressed in percentile and the duration of treatment was expressed. Aminoglycosides (Amikacin) were the top most used class of antibiotics followed by cephalosporin. Among cephalosporins, the third generation ceftriaxone, and cefoperazone were found to be mostly used. Conclusions: Accordingly, health care professionals must keep a clear understanding of the need for microbiological diagnosis, antibiotics usage, and make good judgment in clinical situations. Regular antibiotic audits and staff education must be implemented.

2009 ◽  
Vol 1 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Michel Tousignant ◽  
Patrick Boissy ◽  
Hélène Corriveau ◽  
Hélène Moffet ◽  
François Cabana

The purpose of this study was to investigate the efficacy of in-home telerehabilitation as an alternative to conventional rehabilitation services following knee arthroplasty. Five community-living elders who had knee arthroplasty were recruited prior to discharge from an acute care hospital. A pre/post-test design without a control group was used for this pilot study. Telerehabilitation sessions (16) were conducted by two trained physiotherapists from a service center to the patient’s home using H264 videoconference CODECs (Tandberg 550 MXP) connected at 512 Kb\s. Disability (range of motion, balance and lower body strength) and function (locomotor performance in walking and functional autonomy) were measured in face-to-face evaluations prior to and at the end of the treatments by a neutral evaluator. The satisfaction of the health care professional and patient was measured by questionnaire. Results are as follows. One participant was lost during follow-up. Clinical outcomes improved for all subjects and improvements were sustained two months post-discharge from in-home telerehabilitation. The satisfaction of the participants with in-home telerehabilitation services was very high. The satisfaction of the health care professionals with the technology and the communication experience during the therapy sessions was similar or slightly lower. In conclusion, telerehabilitation for post-knee arthroplasty is a realistic alternative for dispensing rehabilitation services for patients discharged from an acute care hospital.Keywords: Telerehabilitation, Physical Therapy, Total Knee Arthroplasty, Videoconferencing


2020 ◽  
Author(s):  
Cynthia Lamper ◽  
Ivan PJ Huijnen ◽  
Mariëlle EAL Kroese ◽  
Albère J Köke ◽  
Gijs Brouwer ◽  
...  

Abstract Background and aims: Integration of care is lacking for chronic musculoskeletal pain (CMP) patients. Network Pain Rehabilitation Limburg (NPRL), a transmural health care network, has been designed to provide integrated rehabilitation care from a biopsychosocial perspective to improve patients’ levels of functioning. This feasibility study aims to provide insight into barriers and facilitators for the development, implementation, and transferability of NPRL.Methods: This study was conducted with a three-phase iterative and incremental design from October 2017 to October 2018. NPRL comprises two rehabilitation practices, and three local primary care networks, with a general practitioner together with, a mental health practice nurse, and a physiotherapist or exercise therapist. These stakeholders with a random sample of participating patients took part in evaluations, consisting of interviews, focus groups, and observations. Field notes and observations were recorded during meetings. The Consolidated Framework for Implementation Research guided data collection and analysis. Results were used to refine the next phase.Results: According to health care professionals (HCPs), guidelines and treatment protocols facilitate consistency and transparency in collaboration, biopsychosocial language, and treatment. One barrier is stigmatization of CMP in society. Non-participating HCPs’ treatment approaches are often more biomedical than biopsychosocial, causing patients to resist participating in NPRL. The current organization of health care, with cultural, structural, and financial aspects, acts as a barrier, complicating implementation between and within practices. HCPs preferred the iterative, bottom-up strategy. A critical mass of participating organizations is needed for proper implementation.Conclusion: NPRL is feasible in daily practice if barriers are overcome and facilitators of development, implementation, and transferability are promoted. These findings will be used to refine NPRL. A large-scale process and effect evaluation will be performed. Our implementation strategies and results may assist other health care organizations aspiring to implement a transmural network using a similar model.


Author(s):  
Kaksha J. Patel ◽  
Ashwin K. Panchasara ◽  
Manish J. Barvaliya ◽  
C. B. Tripathi

Background: The objective of the study was to study the clinical patterns, causality and severity of adverse drug reactions in a tertiary care hospital.Methods: Total 131 ADR forms were collected from January 2012 to December 2012 and evaluated. Patient’s characteristics, ADR and drug characteristics, causality, severity and preventability of collected ADR were analyzed.Results: Total 131 ADR forms were evaluated. Male patient experiencing ADR were more (73, 55.7%) than female (58, 44.2%). Adult patients (12-60 years) experienced 110 (84%) ADR followed by pediatric patients (< 12 years) 11 (8.4%) and geriatric patients (>60 years) 10 (7.63%). Antimicrobial were the most common group of drugs responsible for ADR followed by NSAIDs and antipsychotic group.Conclusions: Present study shows lack of awareness among health care professionals for reporting of an ADR. Training and collaboration of health care professionals are needed for improvement in ADR reporting. Appropriate feedback from ADR reporting will help in selection of drug and promotes safer use of drugs.


Author(s):  
Shobha P. ◽  
Messaline Sunitha

Background: ICU patients are exposed to more number of life saving drugs and face drug related problems like therapeutic failure, drug interactions and frequent adverse drug reactions. The cost of ICU hospitalisation and money spent on medicines is also a huge burden on these patients. A study of prescribing pattern in an ICU set up will serve as a medical audit to monitor and evaluate the prescribing practices to make it more rational and cost effective.Methods: A prospective observational study was carried out in a medical ICU of a tertiary care hospital. All the inpatients admitted in the medical ICU during the study period of 2 months were included in the study. The data obtained from the case sheets were used to assess the prescribing pattern and rationality of drug use.Results: A total of 101 patients were admitted in 2 months. The most common illness for which the patients (22) were admitted was respiratory problems. Average number of drugs per prescription was 6.9. Cardiovascular system (23.9%) drugs were the most frequently prescribed. Pantoprazole (77) was the single most commonly prescribed drug. 40% of the drugs were prescribed from the essential drug list. The average cost of medicines incurred per person in our study was 5126.33 in INR.Conclusions: Polypharmacy and unwanted prescription of proton pump inhibitors can be avoided by prescribing more generics and drugs from essential drug list.


2020 ◽  
Vol 27 (05) ◽  
pp. 1032-1037
Author(s):  
Khadija Mumtaz ◽  
Nadia Aslam ◽  
Naima Mehdi ◽  
Nazma Kiran ◽  
Sadaf Farzand ◽  
...  

Objectives: This study was performed to access the knowledge of health care professionals regarding health care associated infections, nosocomial pathogens, fomites and their role in transmission of nosocomial pathogens. Study Design: Descriptive, questionnaire based, cross-sectional study. Setting: Tertiary care hospital of Lahore, Punjab. Period: From October 2017 to January 2018. Material & Methods: Questionnaires were carefully formulated to access basic knowledge of physicians, surgeons and nurses. Responses given were analyzed and recorded as frequency and percentage. Results: Regarding health care associated infections, respiratory tract infections were identified by 72% surgeons, 65% physicians and 59% nurses. Surgical wound infections were identified by 76% of surgeons and 81% nurses. 45.7% physician identified bacteraemia as nosocomial infection. Rate of identification for rest of nosocomial infections was sub optimum (<50%) by health care workers. Regarding identification of nosocomial pathogens, Methicillin Resistant Staphylococcus aureus was marked by 65% of physicians, 83.8% of nurses, 76% of surgeons. Pseudomonas nosocomial pathogen was identified by 40%, 46% and 64% of physicians, nurses and surgeons respectively. The rate of identification for rest of the nosocomial organisms was again sub optimum (<40%) by health care workers. Regarding fomites, mattresses and pillows, thermometer, stethoscopes were identified by 75.7%, 59.2 and 50% of Health care professionals respectively. Conclusion: This survey identified positive attitude among Health care workers towards infection control but low level of knowledge regarding health care associated infections and nosocomial pathogens. Therefore, to prevent nosocomial infections, there is strong need to develop strategies for improving knowledge of Health care professionals.


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