scholarly journals Routine Replacement versus Clinically Indicated Replacement of Peripheral Venous Catheters through Assessment of Incidences and Grades of Phlebitis in Patients with IV Cannula at a Tertiary Care Hospital, Mumbai

2021 ◽  
pp. 116-120
Author(s):  
Bhavnani Namrata ◽  
Ahire Neha ◽  
Prakash Kalke ◽  
Shrikrishna Dhale
Keyword(s):  
Private Hospital ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Cost Effective ◽  
Routine Practice ◽  
Care Hospital ◽  
Improve Patient Satisfaction ◽  
Infusion Phlebitis ◽  
Improve Patient ◽  
Intravenous Catheters

Background: The current study assesses the incidences and grades of phlebitis among patients with IV cannula to determine the association of grades of phlebitis. The purpose of the study was to study the feasibility of Routine replacement versus Clinically indicated replacement of peripheral venous catheters. The study observes the incidences of  removing peripheral intravenous catheters when clinically indicated compared with removing and re‐siting the catheter routinely. Methods: An observational study was conducted in the tertiary care private hospital of Mumbai, India. The study was conducted over 5 weeks from May -June 2020. Purposive sampling was considered during the collection of data. The sample size of the study was 117 patients admitted having peripheral venous catheters. The standard visual infusion phlebitis (VIP) score was used as a tool for data collection. Descriptive analysis was done.  Results: Out of 117 patients (VIP score 0 -56, Score 1- 49, Score -12 no cases with score 3, 4, and 5). Routine replacement of IV cannula after every 5 days is judiciously followed, 45 healthy lines were replaced at score 0; which is the major concern (Rs. 633/- the total cost of replacing 1 PVC line).  Conclusion: Following the routine practice of IV cannula replacement based on VIP score to avoid phlebitis is equally good but simultaneously clinically indicated replacement of IV cannula is advisable to make it cost-effective and reduced number of a prick to the patients; this will help to improve patient satisfaction.

scholarly journals Post-injection thrombophlebitis in patients undergoing peripheral IV catheterization in a tertiary care hospital: incidence and risk factors

2020 ◽  
Vol 6 (4) ◽  
pp. 154
Author(s):  
Pranjal Rai ◽  
Vinaykumar Thati ◽  
Geeta Ghag ◽  
Vipul Nandu
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Endothelial Damage ◽  
Economic Consequences ◽  
Care Hospital ◽  
Nursing Time ◽  
Potential Risk Factors ◽  
Level 3 ◽  
Infusion Phlebitis ◽  
Intravenous Catheters

<p class="abstract"><strong>Background:</strong> Intravenous catheters cause endothelial damage and trauma, which can predispose to venous thrombosis. Peripheral vein infusion thrombophlebitis occurs in 25- 35% of hospitalized patients with intravenous catheters and has both patient-related implications (e.g., sepsis) and economic consequences (e.g., extra nursing time). This study is designed to address this issue, by assessing the potential risk factors in those who have developed phlebitis, and deriving conclusions based on the same.</p><p class="abstract"><strong>Methods:</strong> A total of 830 patients were observed over a period of 2 months. All details of the patient were collected. Thrombophlebitis was graded using Visual Infusion Phlebitis Score. Each case was compared with a matching control.  </p><p class="abstract"><strong>Results:</strong> 53 of 830 patients observed, developed thrombophlebitis giving an incidence of 6.4%. 92.5% had IV cannulation flushed after insertion. IV cannula had to be changed at least 2 times during the hospital stay. All had an average IV cannulation for 5 days. All had insertion of same size cannula (20G). Level 1 Phlebitis was identified in 64.15% patients, level 2 Phlebitis in 33.96% patients and Level 3 Phlebitis was seen 1.88% patients.</p><p class="abstract"><strong>Conclusions:</strong> Significant association was noted between the number of times the catheter was changed since admission and administration of Potassium chloride and Certain Medications such as Piperacillin through the cannula.</p>

Telemedicine During A Crisis: Challenges, Opportunities & Way Forward At A Tertiary Care Hospital (Preprint)

2021 ◽  
Author(s):  
Sadia Masood ◽  
Zanaib Samad ◽  
Sarah Nadeem ◽  
Unzela Ghulam
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Successful Implementation ◽  
Care Hospital ◽  
Quality Health Care ◽  
Cross Sectional ◽  
Innovative Strategy

BACKGROUND Telemedicine is utilized to deliver health care services remotely. Recently, it is well established due to pandemics because it can help the patients get required supportive care while minimizing their hospital exposure. In the future, it will continue to be used as a convenient, cost-effective patient care modality. OBJECTIVE The objectives were to identify physicians' challenges during teleconsultations and recognize the opportunities and strengths of this modality during the pandemic in a lower-income country. METHODS This cross-sectional study was conducted in a tertiary care hospital. The self-made questionnaire was filled through an online medium and responses were recorded on a five-point Likert scale. RESULTS A total of 83 participants were enrolled in this study. Most of them were Associate professors (29.8%), Assistant professors (26.2%), the ratio of the females was (52.4%) greater than males (,47.6%). 46 (54.8%) have laid between the age group 30-40 years. Pediatricians and senior instructors faced more difficulty in using telemedicine. The ones having clinical experience of fewer than 15 years or categorized in the age of 50-60 years faced challenges while using this modality. CONCLUSIONS During the current pandemic, situation telemedicine is the only glimmer of light to provide better quality health care. Telemedicine is an innovative strategy and it is important to understand the perception of physicians about it. Incomplete and inadequate infrastructure and attitude of the physicians is the main obstacle toward successful implementation of telemedicine. Successful installation and deployment of this technology require a complete grasp of the process among physicians.

scholarly journals Knowledge in palliative care of nursing professionals at a Spanish hospital

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Elena Chover-Sierra ◽  
Antonio Martínez-Sabater ◽  
Yolanda Lapeña-Moñux
Keyword(s):  
Palliative Care ◽  
Basic Education ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Study Data ◽  
Care Hospital ◽  
Cross Sectional

Resume Objective: to determine the level of knowledge in palliative care of nursing staff at a Spanish tertiary care hospital. Method: descriptive, cross-sectional study. Data were collected about the results of the Spanish version of the Palliative Care Quiz for Nurses (PCQN), sociodemographic aspects, education level and experience in the field of palliative care. Univariate and bivariate descriptive analysis was applied. Statistical significance was set at p < 0.05 in all cases. Results: 159 professionals participated (mean age 39.51 years ± 10.25, with 13.96 years ± 10.79 of professional experience) 54.7% possessed experience in palliative care and 64.2% educational background (mainly basic education). The mean percentage of hits on the quiz was 54%, with statistically significant differences in function of the participants’ education and experience in palliative care. Conclusions: although the participants show sufficient knowledge on palliative care, they would benefit from a specific training program, in function of the mistaken concepts identified through the quiz, which showed to be a useful tool to diagnose professionals’ educational needs in palliative care.

scholarly journals Adverse events following immunization with pentavalent vaccine in a tertiary care hospital

2017 ◽  
Vol 5 (1) ◽  
pp. 82
Author(s):  
Sharad Bansal
Keyword(s):  
Adverse Events ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Care Hospital ◽  
Immunization Programs ◽  
Global Alliance ◽  
Immunization Program ◽  
Pentavalent Vaccine ◽  
Mild Fever

Background: Immunizations currently save 3 million lives per year throughout the world and is one of the most cost-effective health interventions. The Global Alliance for Vaccines and Immunizations (GAVI) and WHO recommended the use of pentavalent to replace the DPT vaccine in developing countries. Vaccines related most side effects are mild and non-serious. Surveillance of adverse events following immunization will enable us to monitor the safety of immunization programs and thereby contribute to validating the immunization program. The main aim of this study is to analyze all suspected adverse events in children reported for pentavalent vaccination.Methods:A prospective, observational epidemiological study was conducted in the department of Paediatrics OPD at tertiary care teaching institute during October 2016 to December 2016. The study was conducted amongst 190 children attending the department of Paediatrics OPD for the second or third dose of pentavalent vaccine.Results: The study shows the following adverse effects after pentavalent injection  127 (66.8%) children had pain at the site of injection, 103(54.2%) mild fever, Swelling at injection site 84(44.2%) and 55(28.9%) children held their leg back due to pain. In majority 85 (44.7%) of children antipyretic and in 65 (34.2%) children analgesic was given was given to relieve the symptoms. The parents were very positive for completing their children’s immunization schedule even though they have faced few symptoms.Conclusions:It can be concluded that all the adverse events reported were mild and could be managed easily without any complications. 

scholarly journals Supervision and monitoring to assess quality of outreach immunization sessions in a rural area using a checklist

2020 ◽  
Vol 7 (5) ◽  
pp. 1950
Author(s):  
Ambika R. Bhaskar ◽  
Mridula Solanki
Keyword(s):  
Tertiary Care ◽  
Immunization Coverage ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Immunization Services ◽  
Timely Fashion ◽  
Assess Quality

Background: Immunization is one of the most cost-effective interventions to prevent the suffering that comes from avoidable sickness, disability and death. Outreach immunization services ensure that immunization is available to children who are unable to access a general practice in a timely fashion for their immunization events. Effective supervision and monitoring will help in improving quality and coverage of immunization.Methods: This was an observational cross-sectional study conducted in the rural field practice area of a tertiary care hospital. 50 outreach sessions held in various outdoor places including Anganwadi were supervised and monitored using checklist. 110 mothers and 20 stakeholders were interviewed. Immunization records were assessed.Results: Outreach immunization sessions were found to be of good quality. 89% children were fully immunized. ANMs and ASHAs were of the opinion that outreach session has significantly raised immunization coverage. 75.4% mothers had knowledge about services provided by outreach sessions.Conclusions: There was increase in immunization coverage due to outreach sessions. There is need for adequate supervision on safety injection practices and regular timely incentive to ASHA.

scholarly journals Susceptibility of Clinical Isolates of Staphylococcus aureus to Ceftaroline

2021 ◽  
Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
The United States ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital

Introduction: Methicillin-Resistant Staphylococcus aureus(MRSA) infection is a major global healthcare problem, the prevalence of which varies from 25-50% in India. It is known to cause Skin and Soft tissue Infections (SSI), endovascular infections, endocarditis, pneumonia, septic arthritis, osteomyelitis, and sepsis. Vancomycin is the drug of choice for treating severe MRSA infections. Ceftaroline, a fifth-generation cephalosporin has been approved by the United States Food and Drug Administration (US FDA) for treating acute bacterial SSI caused by susceptible micro-organisms including MRSA, Community acquired respiratory tract infection, MRSA bacteremia and endocarditis. Aim: To assess the susceptibility of clinical isolates of S. aureusto ceftaroline, in a Tertiary Care Hospital. Materials and Methods: This prospective study was conducted in the Department of Microbiology of a Tertiary Care Hospital over a period of two months from June 2019 to July 2019. S.aureus isolates from various clinical samples were screened for methicillin resistance by disc diffusion method using cefoxitin disc and ceftaroline susceptibility of these isolates was assessed by E-strip method. The isolates were classified as ceftaroline susceptible, Susceptibility Dose Dependent (SDD) and ceftaroline resistant respectively as per CLSI guidelines. A descriptive analysis of the data was done and the results were presented as frequencies and percentages. Results: All the S.aureus isolates were found to be susceptible to ceftaroline. Methicillin Sensitive Staphylococcus aureus(MSSA) isolates had lower Minimum Inhibitory Concentration (MIC) when compared to MRSA. The highest MIC among MRSA was 0.5 μg/mL. Conclusion: Ceftaroline can be considered as an effective alternative for treatment of infections caused by MRSA.

scholarly journals Assessment of Factors Associated with Dropout for Pentavalent Vaccine in Tertiary Care Hospital of Kathmandu, Nepal

2020 ◽  
Vol 22 (3) ◽  
pp. 106-110
Author(s):  
Supri Raj Shrestha ◽  
B Shakya ◽  
R Oli
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Sampling Technique ◽  
Cost Effective ◽  
Dropout Rate ◽  
Care Hospital ◽  
Vaccine Preventable Diseases ◽  
Factors Associated ◽  
Pentavalent Vaccine

Immunization is one of the most cost-effective public health measures as it has helped in huge reduction of disease, disability and death from different infectious diseases in children by protecting them from vaccine preventable diseases. The current study aimed to study factors associated with dropout for pentavalent vaccine in tertiary care hospital of Kathmandu. A longitudinal observational study using purposive sampling technique was conducted among 196 infants. The information was obtained using self-constructed structured questionnaire from parents visiting Community Medicine OPD of Nepal Medical College Teaching Hospital. The information regarding socioeconomic characteristics of mother, gender of the infant, place of delivery of child, birth order and reasons for dropout of pentavalent third dose were taken. The dropout of third dose pentavalent vaccine was mainly seen in infant of parents living in rented house and according to gender wise, dropout was high among male infants. The different reasons for dropout of vaccine were busy parents, forgotten date, visit to other immunization centres and sick infants. Among these, the main reason for dropout of vaccine was due to infants getting sick during the time of immunization. The dropout rates between first and third dose of pentavalent vaccine were 26.3% and 30.4% respectively for two consecutive months and the overall dropout rate was 28.35%. Also, literacy level of the mother was directly associated with the immunization visit of the infant as, maximum number of infants of illiterate mother were absent for third dose of pentavalent vaccine as opposed to no absentee among master degree holding mothers. Thus, the present study provides valuable information regarding the factors associated with dropout for pentavalent vaccine.

scholarly journals Clinical profile of hemodialysis patients attending a tertiary care hospital in Delhi, India

2021 ◽  
Vol 8 (12) ◽  
pp. 6000
Author(s):  
Mithilesh Kumar ◽  
Shipra Saini ◽  
Lokesh Parashar ◽  
Rajesh Chetiwal ◽  
Tanisha Kalra ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Kidney Diseases ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Age Group ◽  
Av Fistula ◽  
Demographic Profiles ◽  
Viral Marker

Background: CKD (chronic kidney disease) is one of the major complications of diabetes and hypertension. With increase in prevalence of non-communicable diseases, the patients presenting with the symptoms of CKD are also rising. Most of the patients suffering from CKD eventually land up on renal replacement therapy, putting extra burden economically as well as psychologically to the self and their family. The aim of the study is to find out the socio demographic and clinical profile of the patients suffering from CKD attending a tertiary care hospital in Delhi.Methods: It was a record based descriptive analysis, conducted between January 2019 and June 2019 in one of the ESIC (Employee State Insurance Corporation) hospital of Delhi. Medical Records of the only those patients were considered whose complete data were present in the record file. Data about Socio demographic profiles , clinical data, duration of CKD, duration of haemodialysis, viral markers, number of blood transfusions, vascular access, number of failed AV fistula etc. were entered in MS Excel and analysed through SPSS 11.Results: Hospital records of 473 CKD patients undergoing hemodialysis were analyzed. It was found that 315 (67%) were males and 158 (33%) were females. Majority of the patients i.e. 245 were in the age group of 41-60 years followed by 166 who were in the age group of 21 to 40. Out of total patients, 195 (41.2%) participants were undergoing hemodialysis twice a week, 276 (58.4%) thrice a week, 2 (0.4) patients were undergoing hemodialysis session four times a week. Majority of the participants i.e. 414 (88%) were Hindu. Out of total 473 participants, 439 (93%) participants had sero negative for viral marker (i.e. HbsAg, HCV, HIV I and II) and 33 (7%) participants were sero positive for viral marker. Most common etiology of CKD was found to be hypertension in our study followed by diabetes.Conclusions: Patients suffering from chronic kidney diseases are increasing day by day with increasing prevalence of hypertension. Most of the patients of CKD patients were middle aged males. Most of the patients have to visit 3 times a week to any health care institution for hemodialysis.  Many of the patients are getting infected with viral hepatitis during course of the illness.

scholarly journals Phenotypic Pattern of Vibrio choleraeIsolates from a Tertiary Care Hospital in Vadodara, Gujarat, India

2020 ◽  
Author(s):  
Sonia Sandeep Barve ◽  
Srujana Prabhala ◽  
Tanuja Bakul Javadekar ◽  
Sandeep Om Nanda
Keyword(s):  
Vibrio Cholerae ◽  
Monsoon Season ◽  
Descriptive Analysis ◽  
Phage Type ◽  
Tertiary Care ◽  
Diarrhoeal Disease ◽  
Phage Typing ◽  
Resistance Pattern ◽  
Care Hospital ◽  
El Tor

Introduction: Cholera is an acute diarrhoeal disease caused by Vibrio cholerae (V.cholerae). Based on antigenic differences of O antigen, O1 serogroup can be divided into three serotypes. In addition, by performing various biochemical reactions, O1 Serogroup can be differentiated into two biotypes. Outbreaks of Cholera occur seasonally. It is associated with monsoon season, warm temperature, heavy rainfall and increased plankton population. Aim: The aim was to determine the trends in resistance pattern and phenotypic Pattern of Vibrio cholerae. Materials and Methods: A retrospective study was conducted during the period from June 2019-December 2019. Culture of Stool specimens were done on different agar media. Biotyping was done by conventional methods. Serotyping and phage typing was also done along with the Antibiotic susceptibility testing. Descriptive analysis was used and presented in terms of percentage. Results:V.cholerae was isolated in 72 patients and they belonged to serogroup O1 and biotype El Tor. The most common serotype was Ogawa. The predominant phage type were T2 by old scheme and T27 by new scheme of phage typing. The maximum number of V. cholerae isolates was seen in the month of November, 2019 followed by October, 2019. Conclusion: The phenotypic pattern and fluctuating seasonal trend of V. cholerae and antimicrobial resistance encourage the continued epidemiological and microbiological surveillance of the disease.

scholarly journals A clinical study of trends of ectopic pregnancy and its management in a tertiary care hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4834
Author(s):  
Chandana M. Puttaraju ◽  
Nagothi Nagendra Prasad ◽  
M. P. A. Sailakshmi
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Sex Education ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Diagnostic Tools ◽  
Care Hospital ◽  
Care Teaching ◽  
Β Hcg ◽  
Ectopic Pregnancies

Background: Ectopic gestation is a gynaecological emergency which culminates in pregnancy loss and causes significant maternal morbidity, mortality besides jeopardizing future conception. The study discusses the incidence, risk factors, symptomatology and management of ectopic pregnancy in a tertiary care teaching hospital.Methods: This was a prospective study of 45 cases of ectopic pregnancies at a tertiary care teaching hospital from January 2012 to December 2013. Information was collected in a structured proforma, tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 1.17%. Majority of the patients (80%) belonged to 20-30 yrs age group. Second gravidas predominated (42.2%). Fallopian tube was the most common site (95.5%). Rudimentary horn ectopic accounted for 4.65%. Previous abdominopelvic surgery (31.1%), IUCD usage (22.2%), PID (20%), abortions (20%), tubectomy (15.5%) were the principal risk factors. 42% of the patients had no risk factor. The triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 51.1% of cases. Ultrasound, UPT, β-hCG estimation were the diagnostic tools. Ruptured ectopic pregnancy accounted for 64.4%. Nearly 95.5% of patients underwent surgery; salpingectomy (76%). Methotrexate was successful in 4.44%. There was no maternal mortality.Conclusions: Mostly diagnosis, prompt surgical or medical management is cornerstone of treatment. Primary prevention such as improved access to family planning services, sex education, treatment of STI, PID, surgical asepsis  and haemostasis, implementing legislation for dispensing MTP drugs ameliorate risk factors and hence reduce ectopic pregnancy.

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