Evaluation of an Emergency Treatment Unit – in a District General Hospital – Sri Lanka – A case Study

Emergency Treatment Unit of a hospital is the place where, acutely unwell patients admitted to the hospital, are given the immediate treatment in the critical stage. DGH – Gampaha – Sri Lanka is a tertiary care hospital with a bed strength of 795 with a well - recognized Emergency Treatment Unit. Objective of this study was to evaluate the Emergency Treatment Unit of District General Hospital, Gampaha, Sri Lanka. Data was collected through oobservations, key informant interviews and reviewing registers and records. Findings were subjected to SWOT analysis. 1) Identified strengths included accessibility, Infrastructure, ETU concept, 24 hour service, competent staff, availability of equipment and investigation facilities and Information management. 2) Some weaknesses identified were; shortage of staff, absenteeism, gaps in competency, shortage of equipment and inadequate quality management system. 3) Receiving priority attention by the provincial, regional and the hospital management, Administration Support Team, Hospital Management Committee, Hospital Clinical Society, Hospital Development Committee, Hospital Development Foundation and regular donations were recognized as opportunities. 4) Finally, Unnecessary transfers from peripheral hospitals, by pass of peripheral hospitals by patients, frequently changing of the management and delay in procurement, repairing and condemning processes were noted as threats. TOWS analysis using a TOWS matrix was performed and strategies were developed for further improvement.

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The High Burden of In-Hospital Diabetes Mellitus at A Tertiary Care Hospital in Sri Lanka; A Case Control Study

Journal of Diabetes & Metabolism ◽

10.4172/2155-6156.1000502 ◽

2015 ◽

Vol 06 (03) ◽

Author(s):

Arjuna B Medagama

Keyword(s):

Diabetes Mellitus ◽

Sri Lanka ◽

Case Control Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Control ◽

Care Hospital ◽

High Burden ◽

Control Study

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Teleradiological implementation as a decision support system at an accident service unit in a tertiary care hospital in Sri Lanka

Sri Lanka Journal of Bio-Medical Informatics ◽

10.4038/sljbmi.v10i3.8082 ◽

2019 ◽

Vol 10 (3) ◽

pp. 18

Author(s):

D. H. Jayakody ◽

R. B. Marasinghe

Keyword(s):

Decision Support ◽

Sri Lanka ◽

Decision Support System ◽

Support System ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Service Unit

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Pattern of psychiatric morbidity among referred inpatients in a tertiary care hospital of Bangladesh

Bangladesh Journal of Psychiatry ◽

10.3329/bjpsy.v31i2.45373 ◽

2020 ◽

Vol 31 (2) ◽

pp. 38-42

Author(s):

Nasim Jahan ◽

Mohammad Muntasir Maruf ◽

Sharmin Kauser ◽

Mekhala Sarkar ◽

Md Masud Rana Sarker ◽

...

Keyword(s):

General Hospital ◽

Tertiary Care ◽

Psychiatric Morbidity ◽

Care Hospital ◽

Psychiatric Consultation ◽

Liaison Psychiatry ◽

Major Depressive ◽

Consultation Liaison Psychiatry ◽

The Mean ◽

Inpatient Units

There is a dearth of studies related to consultation-liaison psychiatry in Bangladesh. The psychiatric referral rates in this country are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. This was a descriptive study consisting of all the cases referred for psychiatric consultation from inpatient units of various departments of BIRDEM General Hospital, Dhaka from July 2017 to June 2018. Patients of any age and of either gender were included. A total of 673 patients (1.97% of total admission) were referred from different departments of the hospital for psychiatric consultation within the study period. Majority of the respondents were female. The mean age of the respondents was 59.47 (±1.98) years. Among the referred, Generalized anxiety disorder (GAD) was the diagnosis in 24.96%, followed by Major depressive disorder (MDD) in 9.95% cases. Referral from the department of Medicine and allied was 92.86 %, followed by department of Surgery and allied (6.38%) & department of Obstetrics and Gynaecology (0.74%). Frequency of referral was the lowest in the months of November to January. There is a need to encourage multi-disciplinary interaction in the management of patients who attend general hospitals, so as to better identify the psychiatric morbidity. Bang J Psychiatry December 2017; 31(2): 38-42

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Endoscopic evaluation of patients with dyspepsia in a tertiary care hospital in Sri Lanka

Sri Lanka Journal of Surgery ◽

10.4038/sljs.v33i4.8201 ◽

2016 ◽

Vol 33 (4) ◽

pp. 23

Author(s):

R. T. Gamage ◽

J. R. Wijesekera ◽

A. L. A. M. C. Ambegoda ◽

D. T. Wijesinghe ◽

K. I. Panditharathne

Keyword(s):

Sri Lanka ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Endoscopic Evaluation

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Prevalence and associations of psychoactive substance use among male supportive staff members in a tertiary care hospital of Sri Lanka

BJPsych Open ◽

10.1192/bjo.2021.778 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S293-S293

Author(s):

Chathurie Suraweera ◽

Iresha Perera ◽

Priyanka Rupasinghe ◽

Janith Galhenage

Keyword(s):

Substance Use ◽

Sri Lanka ◽

Alcohol Use ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Psychoactive Substance ◽

Staff Members ◽

History Of ◽

Psychoactive Substance Use

AimsThe study describes the prevalence and associated socio-demographic variables of psychoactive substance use among male supportive staff members at a tertiary care hospital in Sri Lanka.MethodA cross-sectional descriptive study was carried out among male supportive staff members of a tertiary care hospital in Colombo District, Sri Lanka by using a self-administered anonymous questionnaire. Participants were recruited using stratified cluster sampling in thirteen overseer divisions of the hospital. Anonymous questionnaires were collected into a sealed box and analysed using Statistical Package for Social Sciences 20.ResultThe mean age of the 404 male staff members who participated in the study was 38.78(SD = 10.90) years and 71.5% were married. Among them 202 (49.1%) were educated up to grade 6-11 and 30 of them has had encounters with law in the past. Thirty of participants had history of psychoactive substance use in the family. Alcohol was used more than once a month by 127(30.9%) and more than once a week by 19(4.6%) individuals. Among other substances, tobacco, beetle and beedi were used by 104(25.3%), 78(19.0%) and 18(4.4%) respectively at least once a month. Further, 22(5.3%), 20(4.8%), 7(1.7%) and 7(1.7%) participants used Mava, Cannabis, Methamphetamine and Thool respectively at least less than once a month. Heroin, Tramadol and Morphine were used by two individuals at least less than once a month. Among substance using participants, 132 wished to cut down their habit. Most commonly identified (14.1%) adverse consequence was financial issues secondary to psychoactive substance use. Eleven (4.5%) staff members used the substance at hospital. Alcohol use was associated with age more than 35 years (p = 0.039) and history of forensic involvement (p = 0.038). Tobacco(p = 0.000), beetle (p = 0.056), Cannabis (p = 0.000) and mava (p = 0.015) use were significantly associated with positive forensic history. Supportive staff members’ alcohol and cannabis use was associated with tobacco (p = 0.000, p = 0.000) and beetle use (p = 0.001, p = 0.049). Mava use was associated with alcohol (p = 0.060) use in addition to tobacco (p = 0.020) and beetle use (p = 0.008).Binomial logistic regression revealed alcohol use and beetle use were associated with the number of children in family and above associations.ConclusionCommonest psychoactive substance consumed by supportive staff members were alcohol, tobacco, beetle, Cannabis and Mava in descending order of frequency. Forensic history was significantly associated with substance use. True prevalence of substance use can be higher than these values.

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A Descriptive Study on Sepsis: Causes, Outcomes, and Adherence to Guidelines on Patients with Sepsis at a Tertiary Care Hospital in Sri Lanka

BioMed Research International ◽

10.1155/2020/7971387 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Anne Thushara Matthias ◽

J. Indrakumar ◽

Tharushi Ranasinghe ◽

Shalini Wijekoon ◽

Charuni Yashodara

Keyword(s):

Sri Lanka ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Bundle ◽

Common Source ◽

Care Hospital ◽

Poor Countries ◽

Arterial Blood ◽

Resource Poor ◽

Sepsis Care

The global incidence of sepsis is increasing, and mortality remains high. The mortality is even higher in resource-poor countries where facilities and equipment are limited. The Surviving Sepsis Campaign (SSC) recommends an updated hour-1 bundle based on the evidence from the International Guidelines for Management of Sepsis and Septic Shock 2018. To reduce mortality from sepsis, compliance with the “bundle” is essential. Data from developing countries like Sri Lanka on the management of sepsis according to the SSC guidelines are not available. Hence, this study looks at the patient characteristics and management of septic patients at a tertiary care hospital in Sri Lanka. Patients admitted to the University Medical Unit of Colombo South Teaching Hospital from January to August 2019 fulfilling the inclusion criteria were included. The hour-1 sepsis bundle adherence, demographic data, and management were recorded. There were 387 patients: 163 males and 224 females. The age range was 15-95 with a mean age of 63. 83.7% were direct admissions while 16.3% were transfers from a peripheral hospital. The most common source of infection was urine (82 (21.2%)) followed by blood stream (105 (27.1%)) and skin and soft tissue (114 (29.5%)). One-hour SSC bundle compliance is as follows: administration of intravenous fluids: 42 (10.9%), blood cultures before antibiotics: 225 (58.1%), first dose antibiotic: 15 (3.9%), and arterial blood gas: 60 (15.5%). Staffing capacity did not make a difference to adherence to the bundle. The study mortality rate was 37 (9.6%). Binary logistic regression indicates that quick sequential organ failure assessment (qSOFA) score is a significant predictor of mortality (chi‐square=35.08, df=3, and p=0.001 (<0.05)) with an odds ratio (OR) of 7.529 (95% CI 3.597-14.323). The other predictors, age, sex, adherence to sepsis care bundle, and comorbidities, were not significant. In conclusion, mortality of sepsis is high and adherence to sepsis care bundle is poor in Sri Lanka even at a tertiary care hospital. Education and training of staff are needed to boost adherence. This will in turn improve quality of care and outcomes of septic patients in resource-poor countries.

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