scholarly journals Antibiotic Prescribing Patterns by Health Care Providers in Pediatric Outpatients: A Prospective Observational Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Siva Kumar Ramasamy ◽  
Prachi Goyal ◽  
Nirbhay Mehta
Keyword(s):  
Health Care Providers ◽  
Prospective Observational Study ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Reference Value ◽  
Prescribing Patterns ◽  
Outpatient Department ◽  
Antibiotic Prescribing ◽  
Care Providers

Objectives: To audit the patterns and quality of antibiotic prescription for children in the outpatient department (OPD). Methods: This prospective observational study was conducted on the tertiary care outpatient department of a teaching hospital. One thousand prescriptions for children between 1 month and 15 years of age, who attended the outpatient department of a tertiary care teaching hospital between April 2018 and May 2019, were included. The quality of prescriptions was assessed based on 12 pretest parameters. One score was given to each correctly written parameter, and total scores were categorized as poor (0 - 4), average (5 - 8), and good (9 - 12). The core prescribing indicators presented by the world health organization (WHO) were used to analyze antibiotic prescribing patterns. The data were analyzed using open-source Epidata software. Results: Out of 1000 prescriptions, quality was average in 490 (49%) and poor in 46 (4.6%) prescriptions. The average number of medicines prescribed per encounter was 3.5 (reference value < 2). The medicines were prescribed by their generic names in 27.3% of the prescriptions (reference value 100%). Antibiotics and injections appeared in 65% (reference value < 30%) and 6% (reference value < 20%) of the prescriptions. The ratio of prescription from a list of essential medicines was 15% (reference value 100%). According to the prescriber profile, the rate of prescribing an antibiotic was 63% by postgraduates in pediatrics, 70% by MBBS, and 90% by AYUSH doctors (reference value < 30%). Conclusions: More than half of the prescriptions could not attain a good score. There is room for improving prescription writing practice. Antibiotic prescription by health care providers, especially AYUSH doctors, needs to be restricted given the high number of antibiotics per prescription. This will limit the indiscriminate use of antibiotics and may be a big step towards achieving the antibiotic stewardship goal.

scholarly journals One for Everyone: A Study of User Satisfaction Among Health-Care Providers Regarding Extended Use of N95 Masks During the COVID-19 Pandemic

2020 ◽  
pp. 1-8
Author(s):  
Nishant Sharma ◽  
Anant Gupta ◽  
Makhdoom Killedar ◽  
Ashish Bindra ◽  
Asmita Patil ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
User Satisfaction ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Northern India ◽  
Large Tertiary Care

ABSTRACT Objective: This study was conducted to assess the feasibility of extended use of N95 masks in our hospital during the coronavirus disease 2019 (COVID-19) pandemic. We also studied the use pattern, user satisfaction, and issues faced during extended use of the mask. Methods: This cross-sectional study was conducted among health-care providers in a large tertiary care teaching hospital in northern India from April 1 to May 31, 2020. A list was prepared from the institute’s register, and participants were chosen by random sampling. The data collected from the physical forms were transferred to excel sheets. Results: A total of 1121 responses were received. The most common problem stated with reuse of N95 masks was loss of fit followed by damage to the slings, highlighted by 44.6% and 44.4% of the participants, respectively. A total of 476 (42.5%) participants responded that they would prefer “cup-shaped N95 mask with respirator”. The median scores regarding the satisfaction with the quality of masks and their fit was also 4 each. Conclusions: It was concluded that the extended use of N95 masks was acceptable, with more than 96% of the participants using these masks.

scholarly journals Antibiotic utilization pattern in the department of surgery in a tertiary care centre in eastern India

2019 ◽  
Vol 6 (11) ◽  
pp. 4080
Author(s):  
Archana Dipa Sangita Kujur ◽  
Nishith M. Paul Ekka ◽  
Satish Chandra
Keyword(s):  
Bacterial Resistance ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Study Data ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Prevalence Survey ◽  
Cross Sectional

Background: The overuse and volume of antibiotic prescription has been found to correlate to the incidence of bacterial resistance. Clinical audit and education can favourably change antibiotic prescribing patterns among practitioners.Methods: Prospective cross-sectional prevalence survey carried out in inpatient department (IPD) and outpatient department (OPD) of department of Surgery, Rajendra Institute of Medical Sciences, Ranchi. 200 prescriptions from OPD and 200 case sheets from IPD were randomly selected. Data was analyzed as per WHO outpatient prescribing indicators. ICU patients and patients on anti-tubercular treatment, antifungals etc. were excluded from this study. Data were computed and analyzed using MS Excel.Results: In the OPD, the average no of drugs per patient was 3.445 of which 17% were injections. 33% of drugs prescribed were antibiotics. Beta-lactams followed by nitroimidazoles were the most common antibiotic class. In the IPD, an average of 2.26 antibiotics per patients was prescribed. 21% of antibiotics were prescribed by a generic name and 196 patients received antibiotic prophylaxis. β-lactams again were the most commonly prescribed antibiotic class with 42.7% (n=193) of total antibiotics prescriptions, Metronidazole (n=101, 22.37%) was the most prescribed antimicrobial agent.Conclusions: The practice of polypharmacy and high antibiotic prescription rate is a concern in our part of the country. Prescriptions writing in generic name needs to be encouraged. There is an acute need for the development of antibiotics prescribing guidelines in India.

scholarly journals Analysis of prescribing pattern of antimicrobial agents and its rationality in tertiary care rural setup of Central India

2017 ◽  
Vol 6 (9) ◽  
pp. 2289
Author(s):  
Nitin D. Pise ◽  
Swapnil B. Kaikade
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Antimicrobial Agents ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Care Providers ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Resistant Strains

Background: Antimicrobial agents are most commonly prescribed drug and share major cost of the treatment. Excessive and inappropriate use of antimicrobial has become a global problem, resulting not only in substantial economic burden on healthcare system but also in contributing to the selective pressure favoring the emergence of antibiotic-resistant microorganisms. Antimicrobial agents which one uses for prophylactic, empiric and therapeutic purposes, depends upon the local epidemiology of infectious diseases, microbiology and resistance pattern as well as local clinical experience. Rational use of antibiotics is one of the most important way of preventing development of resistant strains to these drugs. However, for this, the health care providers should be aware of the available antibiotic prescription guidelines and should strictly adhere to it. Also, they should be updated of emerging resistant strains. Though the strict guidelines are available for the use of antibiotics, there are differences in level of knowledge and approach to antibiotic prescription among professional health care providers.Methods: The present cross sectional study was carried out in A.V.B.R. Teaching Hospital by collecting data from admitted patient’s case paper, tabulated in seven groups of diseases and different groups of antimicrobial agents prescribed.Results: Penicillin and quinolone group of antimicrobials show maximum use whereas sensitivity found more in cephalosporins and quinolone group of antimicrobials.Conclusions: It was found that Cephalosporins (3rd Gen.) are the most commonly prescribed antimicrobial agents followed by aminoglycosides (Gentamicin) and Fluroquinolones (Ciprofloxacin).

scholarly journals Medical Auditing of Outdoor Health Services of A Tertiary Care Hospital

2020 ◽  
Vol 19 (1) ◽  
pp. 47-50
Author(s):  
Chinmoy Baidya ◽  
M Jalal Uddin ◽  
Saraj Uddin ◽  
Faheem Ul Hasan
Keyword(s):  
Health Services ◽  
Health Care Providers ◽  
Action Plan ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Care Hospital ◽  
Care Providers ◽  
Specialized Service ◽  
Almost All

Background: Medical auditing is a must to identify the short comings of healthservices provided by the health care providers and experienced by patients. Thepurpose of this study is to detect the supposing and opposing factors regardingoutdoor health services to improve the quality of outdoor health services. Materials and methods: This observational study was conducted among thepatients visiting different outdoors of Chattogram Maa-O-Shishu Hospital from Julyto December 2017 by purposive sampling technique. Total 384 respondents wereinterviewed to fill out a pretested semi structured questionnaire. The data werecollected and analyzed using the SPSS version 20. Results: Among the patients, 86.72% resided within Chattogram City Corporation.Mean age was 24.14 (±13.18) years, most (62.24%) aged from 15 and 60 years andfemales (55.46%) were predominant. Monthly income of the most (60.41%)respondents was from 11000 to 20000 taka. Specialized service was the leadingreason (40.62%) followed by cost effectiveness (33.07%) to select this hospital.Majority (47.14%) came by themselves while 38.28% were referred by the relatives.Maximum (89.58%) patients requiredless than 10 minutes time to collect ticket. Alsomost (92.19%) required less than 10 minutes time to meet doctor. In addition,60.68% of respondents availed lab facilities and 73.44% patients purchasedmedicine from hospital pharmacy. From non-buyers, unfamiliar location was themain reason in (23.18%) most patients. Treatment cost was inexpensive for 95.31%respondents. Regarding behavior, 92.19% were satisfied with doctors and 96.88%were satisfied with staffs. Almost all (98.69%) understood doctors’ advice. However,the opposing factors stated by respondents were less waiting space (5.47%), poorgeneral cleanliness (2 .605%), long queue in pharmacy (2.605%), bad toilet service(1.82%), unclean water supply (1.30%). Only 3 (0.78%) experienced misbehavior.Majority (98.69%) did not pay without receipt, but 1.04% paid to security guardwhich is not acceptable. Conclusion: By providing more emphasis on the deficiencies the service could beimproved. Certain action plan with participation of all authorized people, it wouldbe helpful to improve the quality of outdoor health services. Chatt Maa Shi Hosp Med Coll J; Vol.19 (1); January 2020; Page 47-50

scholarly journals A Prospective Observational Study to Find out Prevalence of Polypharmacy, Co-Morbidities and Drug-Related Problems among Type 2 Diabetes Patients at a Tertiary Care Teaching Hospital

2021 ◽  
pp. 132-140
Author(s):  
Rajesh Hadia ◽  
Mihir Thakkar ◽  
Shivani Shah ◽  
Prati Patel ◽  
Kushalkumar Gohel ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Observational Study ◽  
Health Care Providers ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Care Providers ◽  
Drug Related Problems ◽  
Type 2 Dm ◽  
Multiple Drugs

Background: Presently India, depicts 49% of the world’s diabetes burden, with an approximated 72 million cases in 2017. Comorbidities make type 2 Diabetes Mellitus (DM) management complicated for health care providers. Therefore, patients have been prescribed multiple drugs. As a result of polypharmacy, the chances of the occurrence of drug-related problems (DRPs) increase. Objective: The present study aimed to find out the prevalence of comorbidities, polypharmacy, and drug-related problems among type 2 DM patients. Methodology: A prospective observational study was conducted for six months among 110 patients having type 2 DM. Based on inclusion and exclusion criteria data were collected. All collected cases were analysed for the number of medications prescribed and comorbidities present. Prescriptions were further assessed to find out the drug-related problem. Results: Comparing the gender proportionality, male represents 59% (n=65) and female represents 41% (n=45) of the study population. The present study evaluated that 91% (n=100) of patients were having at least one comorbid condition or complication along with diabetes, the most common being cardiovascular disorders. The average number of drugs prescribed is 7.86±7.83 per patient. Polypharmacy was observed in 84.54% (n=93) of the patients. A total of 180 DRPs were found among 110 patients. Conclusion: The present study concluded that the increase in the number of co-morbidities significantly increases the burden of polypharmacy which can further lead to DRPs. Reducing the number of pills and the presence of a clinical pharmacist in prescription monitoring can help to alleviate the problems of polypharmacy and its consequences.

scholarly journals 2065. Reducing Inappropriate Antibiotic Prescriptions in the Primary Care Setting

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S696-S696
Author(s):  
Marlena Klein ◽  
Diana Zackey ◽  
Niharika Sathe ◽  
Ayobamidele S Balogun ◽  
Mona Domadia ◽  
...  
Keyword(s):  
Primary Care ◽  
Antibiotic Prescription ◽  
Average Rate ◽  
Primary Care Providers ◽  
Prescribing Patterns ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Care Providers ◽  
Office Visits ◽  
Post Intervention

Abstract Background In 2015, the CDC established the National Action Plan for Combating Antibiotic-Resistant Bacteria, with the goal of reducing inappropriate outpatient antibiotic use by 50% by 2020. Upper respiratory infections, (URIs) account for one of the top three diagnoses prompting outpatient visits, and despite viral pathogens being the etiology of most URIs, many patients are treated with antibiotics. This study aimed to reduce inappropriate antibiotics prescribing for URIs at Cooper Primary Care offices. Methods Using the electronic medical record, we analyzed office visits (OVs) of 63 primary care providers during the influenza season (November 1, 2017–February 28, 2018) that were associated with a URI diagnosis code and resulted in an antibiotic prescription. The intervention was a personalized digital URI score card (Figure 1) emailed to each primary care physician. It included (1) Cooper Hospitals’ Primary Care Department Average Rate of Antibiotic Prescribing for URI OVs and (2) each physician’s average rate of antibiotic prescribing for URI office visits. Data were collected post-intervention (November 1, 2018–February 28, 2019) to evaluate for changes in antibiotic prescribing patterns. Results Using Fischer’s Exact test we analyzed the pre vs. post-intervention rate of antibiotic prescribing for URI OVs. There were 7,295 total pre-intervention office visits. Of these, 41.03% resulted in an antibiotic prescription. There were 6,642 total post-intervention office visits. Of these, 35.85% resulted in an antibiotic prescription. There was a 5.18% overall decrease in antibiotics prescribed for all URI office visits (P < 0.001) (see Figure 2). Conclusion Increasing providers’ awareness of their own prescribing patterns compared with their department’s prescribing patterns utilizing a single report card decreased the rate of antibiotics prescribed for URIs by 5.18% for all URI-related office visits. Specifically, there was 10.19% decrease in antibiotics prescribed for bronchitis, which is by definition, of viral etiology. This is significant given the potential side-effects of unnecessary antibiotics, and the emergence of antibiotic resistance. Limitations include a lack of certainty in “true” inappropriate prescriptions and diagnosis coding. Disclosures All authors: No reported disclosures.

Client characteristics and satisfaction with the quality of primary health-care services in Calabar, Nigeria

2020 ◽  
Vol 3 ◽  
pp. 1-8
Author(s):  
H. C. Okeke ◽  
P. Bassey ◽  
O. A. Oduwole ◽  
A. Adindu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Client Satisfaction ◽  
Demographic Characteristics ◽  
Care Providers ◽  
Client Characteristics ◽  
Study Objective ◽  
Primary Health

Different mix of clients visit primary health care (PHC) facilities, and the quality of services is critical even in rural communities. The study objective was to determine the relationship between socio-demographic characteristics and client satisfaction with the quality of PHC services in Calabar Municipality, Cross River State, Nigeria. Specifically to describe aspects of the health facilities that affect client satisfaction; determine the health-care providers’ attitude that influences client satisfaction; and determine the socio-demographic characteristics that influence client satisfaction with PHC services. A cross-sectional survey was adopted. Ten PHCs and 500 clients utilizing services in PHC centers in Calabar Municipality were randomly selected. Clients overall satisfaction with PHC services was high (80.8%). Divorced clients were less (75.0%) satisfied than the singles and the married counterparts (81%), respectively. Clients that were more literate as well as those with higher income were less satisfied, 68.0% and 50.0%, respectively, compared to the less educated and lower-income clients, 92.0% and 85.0% respectively. These differences in satisfaction were statistically significant (P = 0.001). Hence, it was shown that client characteristics such as income and literacy level show a significant negative relationship with the clients satisfaction with the quality of PHC services in Calabar Municipality.

Medical Informatics and the Quality of Health: New Approaches to Support Patient Care

2003 ◽  
Vol 42 (02) ◽  
pp. 185-189 ◽  
Author(s):  
R. Haux ◽  
C. Kulikowski ◽  
A. Bohne ◽  
R. Brandner ◽  
B. Brigl ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Informatics ◽  
Health Care Providers ◽  
Medical Knowledge ◽  
Lessons Learned ◽  
Care Providers ◽  
Access To Health Services ◽  
Leading Role ◽  
Future Challenges

Summary Objectives: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of excellent papers on medical informatics research which have been recently published (www.yearbook.uni-hd.de). The 2003 Yearbook of Medical Informatics took as its theme the role of medical informatics for the quality of health care. In this paper, we will discuss challenges for health care, and the lessons learned from editing IMIA Yearbook 2003. Results and Conclusions: Modern information processing methodology and information and communication technology have strongly influenced our societies and health care. As a consequence of this, medical informatics as a discipline has taken a leading role in the further development of health care. This involves developing information systems that enhance opportunities for global access to health services and medical knowledge. Informatics methodology and technology will facilitate high quality of care in aging societies, and will decrease the possibilities of health care errors. It will also enable the dissemination of the latest medical and health information on the web to consumers and health care providers alike. The selected papers of the IMIA Yearbook 2003 present clear examples and future challenges, and they highlight how various sub-disciplines of medical informatics can contribute to this.

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