A Retrospective Evaluation of Morbidity Pattern and Outcome of Patients Admitted in Paediatric Intensive Care Unit in a Tertiary Care Rural Teaching Hospital

Background: Antibiotic resistance is rising to alarming levels that necessitates the evaluation of prescription patterns for the rational use of antibiotics. Hence this study was conducted to evaluate antibiotic use in a government run general hospital.Methods: A prospective observational study was conducted to evaluate the rationality of antimicrobial prescription in a paediatric intensive care unit (PICU) of a government run tertiary care teaching hospital using the USAID indicators for rational use of antibiotics. Case records of 104 patients were documented and analysed.Results: The most common antimicrobials prescribed were 3rd generation Cephalosporins namely Ceftriaxone, followed by Aminoglycosides (Amikacin), Imipenams (Meropenam), Anti-Influenza Antiviral (Oseltamivir) and Oxazolidinones (Linezolid). A common trend of antibiotic overuse emerged due to paucity of resources to support decision making and choice of antibiotic. This led to patients being exposed to a high number of antibiotics with an associated increase in morbidity.Conclusions: Antibiotic resistance would remain a challenge until systems for rapid, precise and low cost detection of the causative micro-organisms and antibiotic sensitivity are developed, surveillance systems are increased and antibiotic stewardship programs are enforced.

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Quality of Care in a Paediatric Intensive Care Unit of a Tertiary Care Teaching Hospital in New Delhi

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v37i2.18133 ◽

2018 ◽

Vol 37 (2) ◽

pp. 168-173

Author(s):

Vijaydeep Siddharth ◽

Shakti Kumar Gupta ◽

Rakesh Lodha ◽

Sidhartha Satpathy

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Teaching Hospital ◽

Paediatric Intensive Care Unit ◽

Tertiary Care ◽

Pulmonary Haemorrhage ◽

Paediatric Intensive Care ◽

New Delhi ◽

Number Of Patients

Introduction: This research aimed to study the outcome of patient care being rendered in Paediatric Intensive Care Unit (PICU) of an apex public sector teaching hospital of North India.Material and methods: A descriptive and observational study was carried out in PICU. Medical records of all admitted patients from January to June 2011 were analysed. Demographic, morbidity and mortality parameters were studied. PIM II score was calculated to assess the severity of illness.Results: In PICU, from January to June 2011, 110 patients were admitted. Almost equal number of patients got admitted in PICU through emergency ward/casualty and other inpatient areas. Of the total patients, 66% (62) were male. Mean age of the patients admitted to PICU was 4.56 years. Three fourth patients admitted in PICU required mechanical ventilation and 652 days of mechanical ventilation was given. Patient’s required mechanical ventilation on an average of 7.01 days. Almost one third, [36.61% (21)] patients were reintubated. Majority (78.7%) of the patients required oxygen support, while 72.3% (68) required vasopressor support. Prevalence of bed sore rate was 2.1%. Only 2.1% patients required readmission within 72 hours. Mean hospital and PICU length of stay was 16.82 and 8.7 days respectively. Mean PIM 2 score of patients was 14.13% (range 0.2% to 86.9%).Conclusion: 43.6% of patients died in PICU, while hospital mortality in PICU admitted patients was 47.2%. Sepsis with septic shock was the major cause of mortality followed by pulmonary haemorrhage, disseminated intravascular coagulation. Standardised mortality was calculated to be 3.09.

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Study of morbidity pattern and outcome of patients admitted in paediatric intensive care unit in a tertiary care rural teaching hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193725 ◽

2019 ◽

Vol 6 (5) ◽

pp. 2064

Author(s):

Vijay L. Bhavari ◽

Deepali A. Ambike ◽

Neil D. Pawar

Keyword(s):

Intensive Care Unit ◽

Critical Care ◽

Intensive Care ◽

Medical Record ◽

Critically Ill ◽

Teaching Hospital ◽

Paediatric Intensive Care Unit ◽

Paediatric Intensive Care ◽

Critically Ill Children ◽

Rural Teaching

Background: The care of the critically ill children remains one of the most demanding and challenging aspects in the field of paediatrics. The main purpose of Paediatric Intensive care unit is to prevent mortality by intensively monitoring and treating critically ill children who are considered at high risk of mortality. In the developing countries, there is a scarce data on paediatric critical care. Evaluation of the outcome of medical interventions can assess the efficacy of treatment. This helps in better decision making, improving the quality of care and modifying the future of management if required. This study will also help to study the causes of morbidity and mortality among paediatric age group in our hospital. Aims and Objectives of the study is to evaluate the morbidity pattern and outcome of admissions in the PICU of a rural teaching hospital, and to take measures to prevent morbidity and mortality by improving critical care facilities.Methods: This was a retrospective study, the cases admitted in paediatric ICU in our teaching hospital in last two and a half considering the estimated sample size. Data will be collected from PICU and Medical record Department. Details will be studied with the help of medical record and will be analysed and interpreted according to the medical record details.Results: During a period of 30 months of the study, total of 417 patients were admitted in our PICU. Of the total cases studied, Maximum i.e. 180(43.2%) had age below 1 year. The minimum – maximum range of age was between 1 day to 18 years. About 228(54.7%) cases were males and 189(45.3%) were females. The most common diagnosis was LRTI which was observed in 61(14.7%) of cases. The most common system involved was respiratory system which was observed in 101(21.8%) cases. Of total cases studied, 357(85.6%) were discharged, 36(8.6%) had DAMA (discharge against medical advice) and 24(5.8%) expired.Conclusions: Mortality was low in our PICU. We conclude based on the present study that in our rural set up PICU, with better treatment protocols, skilled expertise/ Paediatric Intensivist we have chances to facilitate the care of critically ill patients giving desirable outcome.

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Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs

The Indian Journal of Medical Research ◽

10.4103/0971-5916.184306 ◽

2016 ◽

Vol 143 (4) ◽

pp. 502 ◽

Cited By ~ 2

Author(s):

Sidhartha Satpathy ◽

Jitender Sodhi ◽

DK Sharma ◽

Rakesh Lodha ◽

Arti Kapil ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hospital Stay ◽

Paediatric Intensive Care Unit ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Paediatric Intensive Care ◽

Healthcare Associated Infections ◽

Care Hospital ◽

Healthcare Associated

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Iatrogenic illness in the paediatric intensive care unit at Gharian teaching hospital, Libya

Eastern Mediterranean Health Journal ◽

10.26719/2012.18.2.143 ◽

2012 ◽

Vol 18 (2) ◽

pp. 143-150 ◽

Cited By ~ 1

Author(s):

A.M. Ismail ◽

S.A. Shedeed

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Teaching Hospital ◽

Paediatric Intensive Care Unit ◽

Paediatric Intensive Care ◽

Iatrogenic Illness

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Study of Morbidity and Mortality Pattern of Children Admitted in Paediatric Intensive Care Unit of Tertiary Care Children’s Hospital

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v40i3.29108 ◽

2020 ◽

Vol 40 (3) ◽

pp. 232-240

Author(s):

Prakash Joshi ◽

Sumit Agrawal ◽

Umesh Prasad Sah

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Infectious Diseases ◽

Paediatric Intensive Care Unit ◽

Tertiary Care ◽

Paediatric Intensive Care ◽

Morbidity And Mortality ◽

Female Ratio ◽

Children's Hospital ◽

Children’S Hospital

Introduction: Intensive care is predominantly concerned with the management of patients with acute life threatening conditions in a specialised unit. The objective of this study was to describe the morbidity and mortality patterns as well as outcome of patients admitted in the Paediatric Intensive Care Unit (PICU) of a tertiary care government paediatric hospital in Nepal. Methods: A cross-sectional study of 652 children admitted to the PICU of Kanti Children’s Hospital was undertaken from 1st January 2018 to 31st December 2018. The data were retrieved retrospectively from the record files of PICU regarding patient’s age, sex, inhabitant, admitting and final diagnosis, length of stay in the ICU and final outcome. Data were entered into MS Excel and analysed using Pearson’s Chi Square Test. Results: Among 652 admitted children between 1 month to 14 years of age, 397 (61%) were males and 255 (39%) females with male to female ratio 1.55:1. Majority 352 (54%) of them were in the age group of one month to 12 months of age. Pneumonia (216, 33.1%) was the major disease seen followed by septicemia (123, 18.9%), bronchiolitis (44, 6.7%), Other infectious diseases (38, 5.8%) and so on. Out of total admission, 484 (74.23%) cases improved, 46 (7.05%) left against medical advice (LAMA) and 120 cases died with mortality rate of 18.46%. More than half of the deaths (n = 87/120, 72.5%) were due to infections (Septicemia, acute gastroenteritis, pneumonia and meningitis and other infectious diseases). Conclusions: Pneumonia with respiratory distress was the major cause of PICU admission while fatality was highest for acute leukemia. Therefore it seems justifiable to improve primary and secondary health care facilities for timely and reliable delivery of current standardised therapeutic practice as well as to increase ICU facilities in those areas.

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Knowledge of Hand Hygiene Practices among Healthcare workers in Neonatal and Paediatric Intensive Care Unit of a tertiary care hospital of Odisha

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i4.16716 ◽

2017 ◽

Vol 10 (4) ◽

pp. 272

Author(s):

Jasashree Choudhury ◽

Anuspandana Mahapatra

Keyword(s):

Health Care ◽

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Paediatric Intensive Care Unit ◽

Healthcare Workers ◽

Tertiary Care ◽

Paediatric Intensive Care ◽

Care Hospital ◽

Hygiene Practices

BackgroundThe objective of this study was to assess the knowledge of hand hygiene of healthcare workers in the neonatal and paediatric intensive care unit in a tertiary care hospital.Methods : Study was conducted to assess the knowledge of hand hygiene for the five moments of hand hygiene of WHO. Healthcare workers were given a questionnaire during routine patient care on random basis and the data was collected. Data analysis was performed using SPSS software version 13.Results : A total of 50 health care workers were questioned during the observation period. Answers differed by role: nurses (25) and doctors (10).15 nurses have no knowledge of moments of hand hygiene and were excluded from study. Nurses were more likely to use soap and water compared to waterless-alcohol-based hand hygiene practices. Doctors were most likely to use alcoholic hand rub.Conclusion : Though knowledge of hand hygiene practice is high ,use of alcohol-based disinfectant was found to be very low compared to soap and water. Keywords: Hand hygiene, Health care, Soap and water, Alcohol hand rub.

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