Incidence and Reasons for a Surgical Cancellation at a Hospital in Rwanda

BackgroundSurgery cancellation is a challenging and costly event resulting in operating theatre inefficiency and psychological and financial problems for the patients and their families. This study aimed to find out the incidence and reasons for surgical cancellation at a Rwandan hospital.MethodsA retrospective study was conducted on 736 patients’ files obtained from theatre registry lists of surgical operations done from January to March 2017. The American Association of Perioperative Nurses (AORN) checklist for documenting cancelled surgical cases was used to establish the rate and reasons for cancellation. Data were analyzed using frequency and percentage descriptive statistics.ResultsOut of the 736 surgeries booked, 179 (24.3%) were cancelled as follows: Orthopedic and general surgeries (28.2%) respectively, gynecology and obstetrics (27.4%), urology surgeries (15.5%), maxillofacial surgeries (15.9%), ENT (15.6%) and plastic surgeries (13.3%). Time constrain/long list (19.6%), acute change in medical status (10.6%), non-turn-up of the patient (8.4%), and abnormal lab findings (7.8%) were the most prevalent reasons.ConclusionThe surgical cancellation rate at the study hospital was 24%, increasing with the number of patients booked and the type of surgical procedure. A prospective study is required to gain more insight into the reason for cancellations, mostly amenable to mitigation measures.Rwanda J Med Health Sci 2021;4(3):379-386

Depression and Anxiety among patients suffering from mild to moderate Covid-19 Disease

Aim: To look for the presence of depression and anxiety among patients suffering from mild to moderate COVID-19 disease. Methodology: This cross sectional study was conducted at Department of Medicine, Pakistan Ordinance Factory (POF) Hospital Wah Cantt from 1st April 2020 to 30th September 2020. Patients presenting to Pakistan Ordinance Factory (POF) Hospital Wah Cantt with relevant symptoms and tested positive on polymerase chain reaction for COVID-19 were included in the study. Hospital anxiety and depression scale (HADS) was administered to look for the presence and severity of anxiety and depression among the study participants. Results: Total 101 patients were included in the study, 76.2% were male while 23.8% were female. Mean age of the patients was 53.50 ±13.281years.Out of 101 patients, 33.7% did not show any sign of anxiety and 42.6% showed borderline anxiety while 23.8% had confirmed anxiety. Depression was not found in 72.3%, borderline depressive symptoms were present in 25.7%, while 2% had confirmed depression. Conclusion: Depression and anxiety were common findings among patients admitted in hospital with COVID 19. Anxiety was more common than depression in these patients. Borderline anxiety and depression were found in most of the patients which may need formal psychiatric consultation for exact diagnosis. Keywords: Anxiety; covid-19; depression, Pakistan

Conflict Management, a New Challenge in Workplace Case Study Hospital in North Lebanon

Nevertheless, whether managing organizational conflicts improves or degrades employee performance is a point of contention. The purpose of this study was to see how managing organizational conflict approaches, such as negotiation, mediation, cooperation, and denial, affected performance of employees in a private hospital in Lebanon. Human capital, human relations, and contingency theories were used in the research. On a daily basis, every organization faces conflicts. Conflicts are inevitable but they can be managed and detected early. It is vital to keep track of the organizational signals that indicate their presence on a constant basis. There are many ways to manage conflicts, relying on the reasons of conflicts, this study concentrates on communications role in managing conflict because it is considered to be a key element in solving conflicts. Conflicts are regional in the whole society. The research followed a positivist quantitative methodology, which is “a methodological process” that aims to record the results and generalize conclusions from different studies employing statistical means. The research embraced the research of descriptive design. The employees of this research were chosen from hospitals in Lebanon. Stratified and random sampling technique procedures were used to choose an 80-person sample.

Description of the Characteristics of Solid Medical Waste in the Environment During the COVID - 19 Pandemic: Case Study Hospital X Covid-19 Referral in Semarang City

Characteristics of Solid Medical Waste As long as the hospital as a health service provider is a source of solid medical waste generation. The current COVID-19 pandemic can potentially increase the number of medical waste generation in health care facilities. The COVID-19 pandemic has had an impact on changing the characteristics of the medical waste produced. This study describes the characteristics of hospital solid medical waste during the COVID-19 pandemic at the X Referral Covid Hospital in Semarang City. The study results show that the ratio of increasing solid medical waste during the 2020 pandemic ranges from 1.39 to 2.08 kg/bed/day. Handling medical waste in this condition is a challenge that needs to be appropriately managed.

Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: an observational study

ObjectiveTo evaluate variation in Illinois hospital nurse staffing ratios and to determine whether higher nurse workloads are associated with mortality and length of stay for patients, and cost outcomes for hospitals.DesignCross-sectional analysis of multiple data sources including a 2020 survey of nurses linked to patient outcomes data.Setting: 87 acute care hospitals in Illinois.Participants210 493 Medicare patients, 65 years and older, who were hospitalised in a study hospital. 1391 registered nurses employed in direct patient care on a medical–surgical unit in a study hospital.Main outcome measuresPrimary outcomes were 30-day mortality and length of stay. Deaths avoided and cost savings to hospitals were predicted based on results from regression estimates if hospitals were to have staffed at a 4:1 ratio during the study period. Cost savings were computed from reductions in lengths of stay using cost-to-charge ratios.ResultsPatient-to-nurse staffing ratios on medical-surgical units ranged from 4.2 to 7.6 (mean=5.4; SD=0.7). After adjusting for hospital and patient characteristics, the odds of 30-day mortality for each patient increased by 16% for each additional patient in the average nurse’s workload (95% CI 1.04 to 1.28; p=0.006). The odds of staying in the hospital a day longer at all intervals increased by 5% for each additional patient in the nurse’s workload (95% CI 1.00 to 1.09, p=0.041). If study hospitals staffed at a 4:1 ratio during the 1-year study period, more than 1595 deaths would have been avoided and hospitals would have collectively saved over $117 million.ConclusionsPatient-to-nurse staffing ratios vary considerably across Illinois hospitals. If nurses in Illinois hospital medical–surgical units cared for no more than four patients each, thousands of deaths could be avoided, and patients would experience shorter lengths of stay, resulting in cost-savings for hospitals.

Fungal Urinary Tract Infection; A Study Conducted On Patients With Liver Cirrhosis

Objective: To determine frequency of fungal infection of urinary tract in patients with liver cirrhosis Design & duration: This is a cross sectional study. This study was completed in duration of six months. Setting: Study was conducted in Margalla Hospital Gulshan Colony PMO, Taxila. Patients & Methods: Patients admitted in study hospital with liver cirrhosis having child class A, B and C were evaluated for fungal urinary tract infection, belonging to any gender, having age above 40 years. All data was documented and analyzed using SPSS software version-20 and means, frequencies, standard deviation and p-value were calculated. Results presented in the form of tables and graphs. Results: Total 400 cases were evaluated for fungal urinary tract infection having liver cirrhosis admitted in study hospital in given duration of study. Fungal cause of UTI was found in 260 cases including 29.3% male and 70.7% female cases. While other causes were found in 140 cases. According to child classification out of 260 cases with fungal UTI, 11 cases were in class B and 249 cases were in class-C while no case belonged to class-A. Most of the cases (42%) with UTI were in age interval of 40-50 years. Duration of CLD was 2-4 years in most of the cases (30%). Conclusion: Fungal cause of urinary tract infection is very common among patients with liver cirrhosis and older age as these cases have week immunity Key words: Liver cirrhosis, chronic liver disease, urinary tract infection, fungal infection, immunocompromised

EPIDEMIOLOGY AND TREATMENT OF FUNGAL INFECTIONS IN ONCO-PEDIATRIC PATIENTS AT A REFERRAL HOSPITAL

Aim: to identify the epidemiology of fungal infections in the pediatric service of a reference hospital for the treatment of cancer for 2016 to 2019, through the dispensing of antifungal drugs by the hospital pharmacy. Methods: Retrospective cohort analysis of 1.211 antifungal requests. Results and Discussion: 1.211 treatments with antifungal agents were performed in the period, with 71.9% of cases treated with empirical therapy, 64.1% of cases of mucocutaneous candidiasis and with the use of nystatin in 48.6% of cases. There were 114 episodes of IFIs, in which probable fungal pneumonia represented 40.4% of the therapeuticindications, based on suggestive tomographic images and clinical and epidemiological criteria in 40.3% of cases. Conclusions: There was an agreement between the epidemiology of fungal infections and the worldwide epidemiology, but there was disagreement between the therapies applied in the study hospital and the recent guidelines.

Evaluation of immune response to hepatitis B vaccine among health care workers at a tertiary care hospital in south India: a retrospective record based study

Seroprevalence of hepatitis B virus (HBV) among healthcare workers (HCWs) is two to four times higher than that of the general population due to repeated exposure. To determine the hepatitis B (hep B) vaccination status, non-response rate to (hep B) and its determinants among HCWs at a tertiary care teaching hospital in south India. A secondary analysis of the medical records of a group of HCWs who joined the hospital from 1st January 2015 to 31st December 2016 was done. A total of 451 HCWs received the vaccine at the study hospital. Mean age of the HCWs was 25.3±6.1 years, majority 374 (82.1%) of them were females and joined as staff nurses 213 (47.2%). Only 164 (36.3%) had received all 3 doses of hep B vaccination. Complete vaccination with (hep B) among HCWs was poor. Health education and suitable administrative controls must be instituted to ensure protection.