Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Sahara...Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.展开更多
Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little ...Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little known in Africa. The purpose of this study is to list all cases of hyperprolactinemia over the past four years and to make an inventory of the various etiologies found and their management. Methodology. This is a cross-sectional descriptive study on the files of patients who came for consultation in the internal medicine and endocrinology department with hyperprolactinemia retrospectively collected from January 2017 to December 2020. Included were patients followed or whose the diagnosis of hyperprolactinemia was established in endocrinological consultation during the study period. Results. This study recorded 26 cases of hyperprolactinemia. The female sex represented 73.08% (sex ratio M/F 0.37) and the average age was 33.92 years. The 40 - 50 age group was the most represented with 30.77%. In women, galactorrhea accounted for 73.07%, amenorrhea 57.69% of clinical pictures and infertility 23.08%. In men, infertility accounted for 7.69% of presentations, gynecomastia 11.54% and erectile dysfunction 15.38%. The duration of evolution of the signs was 4 months in 23.08% of the patients. The mean prolactinemia was 702.58 ng/ml. CT was performed in 80.85% of patients. The main etiologies were pituitary adenomas (77%). All our patients were treated with dopaminergic agonists. Cabergoline was prescribed in 77% of patients. The evolution was favorable in 96.25% of patients. Conclusion. Hyperprolactinemia is a pathology that exists in our regions. The main etiology remains pituitary adenomas and treatment with cabergoline.展开更多
Purpose: The number of retracted papers from Chinese university-affiliated hospitals is increasing, which has raised much concern. The aim of this study is to analyze the retracted papers from university-affiliated ho...Purpose: The number of retracted papers from Chinese university-affiliated hospitals is increasing, which has raised much concern. The aim of this study is to analyze the retracted papers from university-affiliated hospitals in China’s mainland from 2000 to 2021. Design/methodology/approach: Data for 1,031 retracted papers were identified from the Web of Science Core collection database. The information of the hospitals involved was obtained from their official websites. We analyzed the chronological changes, journal distribution, discipline distribution and retraction reasons for the retracted papers. The grade and geographic locations of the hospitals involved were explored as well.Findings: We found a rapid increase in the number of retracted papers, while the retraction time interval is decreasing. The main reasons for retraction are plagiarism/self-plagiarism(n=255), invalid data/images/conclusions(n=212), fake peer review(n=175) and honesty error(n=163). The disciplines are mainly distributed in oncology(n=320), pharmacology & pharmacy(n=198) and research & experimental medicine(n=166). About 43.8% of the retracted papers were from hospitals affiliated with prestigious universities. Research limitations: This study fails to differentiate between retractions due to honest error and retractions due to research misconduct. We believe that there is a fundamental difference between honest error retractions and misconduct retractions. Another limitation is that authors of the retracted papers have not been analyzed in this study.Practical implications: This study provides a reference for addressing research misconduct in Chinese university-affiliated hospitals. It is our recommendation that universities and hospitals should educate all their staff about the basic norms of research integrity, punish authors of scientific misconduct retracted papers, and reform the unreasonable evaluation system.Originality/value: Based on the analysis of retracted papers, this study further analyzes the characteristics of institutions of retracted papers, which may deepen the research on retracted papers and provide a new perspective to understand the retraction phenomenon.展开更多
Introduction: Given its effects, hospital waste is an environmental concern and a threat to health personnel, users of health services and neighboring populations. Our objective was to assess the perception of health ...Introduction: Given its effects, hospital waste is an environmental concern and a threat to health personnel, users of health services and neighboring populations. Our objective was to assess the perception of health care stakeholders on the environmental effects related to biomedical waste produced in Teaching Hospitals (CHU) in Togo in 2021. Methods: This was a cross-sectional study held from June 24 to August 28, 2021. It targeted three university hospitals, 340 health care providers and services selected by a probabilistic method with a simple random technique in 25 services, 72 directors, deputy directors, supervisors and heads of services, 27 collection and incineration agents selected by a non-probabilistic method with a reasoned choice technique, 44 patients and attendants and 36 householders of neighboring residents selected by a non-probabilistic method with an accidental choice technique. Variables such as the spreading of disease vectors, soil, air and water contamination, the presence of unpleasant odors and unsightly living conditions were assessed. Results: According to the respondents, biomedical waste causes the proliferation of vectors (55.3%), an unsightly environment inside the hospital (47.1%), and unpleasant odors (61.2%). Incineration operations disturb hospital residents (52.8%), according to the householders of the residents. During observation, we note deposits of waste that have not been destroyed and wastewater flowing in some places. Conclusion: Biomedical waste in Togo’s university hospitals generates environmental effects and therefore potentially high risks for human health. Improving their management should be a concern for all hospital actors.展开更多
Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (...Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.展开更多
Objective The prevalence and related factors of serum anti-HCV in different regions and hospitals have not been studied extensively in China. We used routine screening data to determine the prevalence of HCV antibody ...Objective The prevalence and related factors of serum anti-HCV in different regions and hospitals have not been studied extensively in China. We used routine screening data to determine the prevalence of HCV antibody in hospital patients, evaluate the epidemic trend of hepatitis C and formulate screening strategies.Methods Patient information and HCV antibody testing results were collected from January 2017 to December 2019 in 77 HCV sentinel hospitals in China. Univariate and multivariate logistic regression was used to determine the characteristics and associations.Results HCV antibody prevalence rates were distinct among patients in different departments, with a range of 0.33%–6.93%. Patients who were admitted to the liver disease-related departments(aOR =10.76;95% CI, 10.27–11.28), Internal Medicine(aOR = 2.87;95% CI, 2.75–3.00), and Department of Surgery(aOR = 1.95;95% CI, 1.87–2.04), were more likely to be tested for HCV antibody positive. HCV antibody prevalence was associated with patients aged 45 years and older(aOR = 2.74;95% CI,2.69–2.80), testing in infetious disease hospitals(aOR = 2.33;95% CI, 2.26–2.40) and secondary hospitals(aOR = 1.72;95% CI, 1.69–1.75). Patients in sentinel hospitals of the Northeast(aOR = 12.75;95% CI,12.40–13.11), the Central(aOR = 1.65;95% CI, 1.61–1.70), and the West(aOR = 1.78;95% CI, 1.73–1.83)China had higher HCV prevalence than those who were in the Eastern coastal area. Conclusion Those who were over 45 years old and saw doctors for liver diseases, and invasive diagnosis and treatment should be referred to HCV antibody testing.展开更多
Objective:Nurses,due to the nature of their job,are subjected to various forms of stress and physical and psychological injuries.Self-compassion and a sense of coherence have attracted much attention in research in re...Objective:Nurses,due to the nature of their job,are subjected to various forms of stress and physical and psychological injuries.Self-compassion and a sense of coherence have attracted much attention in research in recent years as having high potential for improving the health and performance of people in the workplace.The present study aimed to compare self-compassion and the sense of coherence in nurses working in psychiatric hospitals and other hospitals of Kerman University of Medical Sciences.Methods:The present study was a descriptive-comparative study of applied type conducted on 100 nurses of Shahid Beheshti Psychiatric Hospital in Kerman by the census method and 100 nurses of other hospitals of Kerman University of Medical Sciences by the stratified random sampling method.The instruments included the self-compassion questionnaire and the sense of coherence questionnaire.Data were analyzed using the Statistical Package for Social Sciences software.Results:The results of the present study showed that self-compassion and sense of coherence were higher in psychiatric nurses(39.35±7.7 and 53.02±8.01)than among other nurses(36.03±5.81 and 49.76±6.30).There was a direct and moderate relationship between a sense of coherence and self-compassion(P-value<0.005).The higher the score of compassion for oneself,the higher was the score of sense of coherence.Furthermore,the sense of coherence had a direct and weak relationship with all dimensions of self-compassion,except for the extreme imitation dimension,which showed a direct and moderate relationship to other dimensions(P-value<0.001).Conclusions:Self-compassion and a sense of coherence,as a form of self-communication,increase nurses’satisfaction and reduce nurses’job stress and,as a result,job performance is improved.展开更多
Haematuria is the presence of red blood cells in urine. It is most often caused by urinary tract infections of which Escherichia coli is frequently implicated. Impairment of kidney functions could occur as a result of...Haematuria is the presence of red blood cells in urine. It is most often caused by urinary tract infections of which Escherichia coli is frequently implicated. Impairment of kidney functions could occur as a result of infection or other complications of the kidney. The aim of the study was to determine the prevalence of uropathogenic Escherichia coli among adult male patients with haematuria and impaired kidneys attending a general hospital in Benue state. Three hundred and sixty-eight (368) samples of urine were collected from 368 male patients (≥ 40 years) attending the 23 general hospitals in Benue state. Each of the urine samples was divided into two parts for haematuria and isolation and identification of Escherichia coli. Blood samples (368) were also collected from the patients and used for quantitative determination of creatinine and estimation of glomerular filtration rate. The presence of haematuria was 45.1% and ranges from 12.5% to 100%. Prevalence of haematuria with respect to age shows that patients within the age group of 90 - 99 years had the highest rate (100%) and the least were those within the ages of 40 - 49 years (20.0%). Isolation rate of uropathogenic Escherichia coli was 16.3% and ranged from 6.3 to 37.5%. Patients within the age group of 90 - 99 years had the highest elevated impaired renal function of 4 (80%), followed by patients within the ages of 80 - 89 years [17 (77.3%)] and the lowest were those within the ages of 40 - 49 [6 (10.0%)]. The overall presence of haematuria in the patients was high (45.1%) with similar high Escherichia coli isolation rate and impaired renal function which could mean that acute or chronic kidney disease may set in.展开更多
INTRODUCTION Occupational safety and health (OSH) is generally the anticipation, recognition, evaluation, and control of hazards arising in or from the workplace. The study sought to assess and evaluate occupational h...INTRODUCTION Occupational safety and health (OSH) is generally the anticipation, recognition, evaluation, and control of hazards arising in or from the workplace. The study sought to assess and evaluate occupational health and safety hazards experienced among health workers in the Bono region of Ghana. METHODOLOGY The study was descriptive cross-sectional quantitative study. Data was from two hundred (200) health workers and was analyzed using the binary logistic regression analysis. RESULTS The findings from the study show that risk factors associated with biological hazards were clinical staff [OR = 2.487 (1.146 - 5.397), p = 0.021], poor maintenance of hospital items [OR = 0.446 (0.240 - 0.831), p = 0.011], assault (verbal) abuse [OR = 2.581 (1.317 - 5.059), p = 0.006] and extreme pressure from work [OR = 2.975 (1.519 - 5.829), p = 0.001]. Non-biological hazards were associated with being single [OR = 0.499 (0.263 - 0.947), p = 0.034], being verbally assaulted [OR = 3.581 (1.865 - 6.876), p CONCLUSION Risk factors related with biological hazards include poor maintenance of hospital items and extreme pressure from work whereas non-biological hazards were associated with being single, being verbally assaulted. Clinical healthcare providers are more vulnerable to occupational health and safety hazards. The study recommends the provision of strategic policies to promote and protect the workers’ health based on the development of the epidemiological profile of health, needs to be readjusted and strengthened.展开更多
Background:Conflict among nurses often has an undesirable effect on their work.Thus,understanding the predictable causes of conflict helps in dealing with it at an early stage,preventing negative consequences that may...Background:Conflict among nurses often has an undesirable effect on their work.Thus,understanding the predictable causes of conflict helps in dealing with it at an early stage,preventing negative consequences that may impact nurses’performance,ultimately affecting the quality of care and patient safety.This study aimed to explore the sources of conflict and how Saudi nurses in Taif deal with conflicts in hospitals.Method:A descriptive qualitative approach was employed,using the semi-structured interview method to collect data from 17 Saudi nurses working in 3 hospitals in the city of Taif from September 2022 to January 2023.Ethical approval was obtained from the Research and Studies Department at the Directorate of Health Affairs in Taif(IRB registration number with King Abdulaziz City for Science and Technology,KSA:HAP-02-T-067,approval number:720 on 10/08/2022).Results:The data revealed two main themes:firstly,conflicts arising among nurses,which can be categorized into two sub-themes:lack of awareness in work policies and procedures,and lack of communication;secondly,preemptive strategies for dealing with conflicts.Three sub-themes emerged in this regard:identifying conflict sources in advance,conducting regular meetings to enhance communication,and increasing awareness of policies and regulations while adhering to them.Conclusion:Conflict negatively impacts the quality of nursing care.Therefore,it is crucial to implement preventive and early measures,such as improving communication among nurses and enhancing awareness of policies and procedures,to address the ambiguities that lead to workplace conflict.展开更多
In South Africa,nurses and doctors are emigrating in significant numbers. Job satisfaction,safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). ...In South Africa,nurses and doctors are emigrating in significant numbers. Job satisfaction,safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to become registered and 15 years for subspecialists. Career progression,creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India,which has a population of more than 1 billion people,is struggling with similar problems. For the past 10-15 years,private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows. A national task force for specialist training in RSA should be instituted. It should discuss,based on the current status and projected specialist and subspecialist personnel requirements,thefuture structure and logistics of training needs. This is required in all subspecialities including gastroenterology,as has been done in India. It is hoped that as a consequence well-trained doctors,similar to those in India,might move to provincial hospitals in rural areas,upgrading the medical services and keeping medical power in South Africa. South Africa should become a model for Sub-Saharan Africa,as India already is for South-East Asia.展开更多
The Balanced Budget Act of 1997 created a designation for critical access hospitals(CAHs)to sustain care for people living in rural communities who lacked access to care due to hospital closures over the preceding dec...The Balanced Budget Act of 1997 created a designation for critical access hospitals(CAHs)to sustain care for people living in rural communities who lacked access to care due to hospital closures over the preceding decade.Twenty-five years later,1350 CAHs serve approximately 18% of the US population and a systematic policy evaluation has yet to be performed.This policy analysis serves to define challenges faced by CAHs through a literature review addressing the four major categories of payment,quality,access to capital,and workforce.Additionally,this analysis describes how current challenges to maintain sustainability of CAHs over time are accentuated by gaps in public health infrastructure and variability in individual health care plans exhibited during the COVID-19 pandemic.展开更多
Introduction: Hospital infections prolong patient hospitalization, necessitate additional treatment, increase mortality rate, raise hospital expenses, and even reduce the level of health in the society. The purpose of...Introduction: Hospital infections prolong patient hospitalization, necessitate additional treatment, increase mortality rate, raise hospital expenses, and even reduce the level of health in the society. The purpose of this research was to study hospital infections in selected hospitals of Qazvin. Methods and Materials: This was an analytic-cross-sectional study. The research population consisted of 25,628 hospitalized patients in the first eight months of 2012 in three selected hospitals of the Qazvin Province. The algorithm of reporting hospital infections, the National Program of Controlling Hospital Infections, and 223 patient files hospitalized due to hospital-acquired infections were used to collect information. The collected information was analyzed using the SPSS V. 17 software;the descriptive statistics was used to analyze the qualitative variables;and the descriptive statistics together with chi-square and t-test were employed for the quantitative variables. Results: The ICU units had the most cases of hospital infections. Respiratory pneumonia and urinary infections topped the list of hospital infections. The most invasive treatments carried out on patients with hospital infections were surgery, urinary catheter, and venous catheter, respectively. More than 50 percent of patients with hospital infections were hospitalized for 2 to 21 days. Results and Conclusions: Because of the high rate of hospital infections, especially in the ICU ward, authorities must give top priority in their plans to designing suitable educational programs to inform hospital staff and patients of hospital infections and to provide suitable resources for dealing with this problem.展开更多
Objective:To assess healthcare workers' involvement in healthcare waste management in public and private hospitals.Methods:Validated questionnaires(n = 660) were administered to randomly selected healthcare worker...Objective:To assess healthcare workers' involvement in healthcare waste management in public and private hospitals.Methods:Validated questionnaires(n = 660) were administered to randomly selected healthcare workers from selected private hospitals between April and July 2013.Results:Among the healthcare workers that participated in the study,187(28.33%) were medical doctors,44(6.67%) were pharmacists,77(11.67%) were medical laboratory scientist,35(5.30%) were waste handlers and 317(48.03%) were nurses.Generally,the number of workers that have heard about healthcare waste disposal system was above average 424(69.5%).More health-workers in the government(81.5%) than in private(57.3%) hospitals were aware of healthcare waste disposal system and more in government hospitals attended training on it.The level of waste generated by the two hospitals differed significantly(P=0.0086) with the generation level higher in government than private hospitals.The materials for healthcare waste disposal were significantly more available(P=0.001) in government than private hospitals.There was no significant difference(P = 0.285) in syringes and needles disposal practices in the two hospitals and they were exposed to equal risks(P =0.8510).Fifty-six(18.5%) and 140(45.5%) of the study participants in private and government hospitals respectively were aware of the existence of healthcare waste management committee with 134(44.4%) and 19(6.2%) workers confirming that it did not exist in their institutions.The existence of the committee was very low in the private hospitals.Conclusions:The availability of material for waste segregation at point of generation,compliance of healthcare workers to healthcare waste management guidelines and the existence of infection control committee in both hospitals is generally low and unsatisfactory.展开更多
ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hos...ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hospitals(maternal and child health care hospitals)in Hubei province from 2012 to 2019 were collected.The indicators related to antimicrobial drug use included the utilization rate of different grades of antimicrobial drugs,the intensity of antimicrobial agent use,the rational use of prophylactic antimicrobial agents before class I surgical incision,and pathogenic detection and consultation rates before antimicrobial drug use.ResultsSince the implementation,the purchase of antimicrobial agents in hospitals has been maintained within the prescribed range,and the defined daily dose system(DDDs)of antimicrobial agents has been reduced,prophylactic use and accurate treatment of antimicrobial agents related to class I surgical incision have been more reasonable.With the implementation of ASPs,the detection rate of imipenem-resistant Acinetobacter baumannii,cefotaxime-resistant Escherichia coli,and methicillin-resistant Staphylococcus aureus has been decreased in China from national bacterial resistance surveillance data.ConclusionASPs have positive effects on antibiotic use and drug resistance in 85 maternity hospitals(maternal and child health care hospitals).展开更多
In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to p...In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to patients by hospitals.After the program was recognised,hospitals were identified as magnet hospitals[1].Some studies show that magnet hospitals provide a healthier working environment for nurses,accompanied by higher nurse satisfaction and better patient prognosis than non-magnet hospitals[2e5].The nursing work environment is the sum of various elements that directly or indirectly affect the patient care system[6].Improving the nursing work environment is a focal point and challenge for nursing administrators.Therefore,administrators in magnet hospitals usually apply a variety of assessment tools for effective evaluation of the nursing work environment to maintain and improve the health of the environment.展开更多
Clinical engineering(CE) has evolved rapidly over the last 25 years in China. Among the 34 provincial-level administrative units within China, the Zhejiang Province is one of the most advanced in terms of healthcare t...Clinical engineering(CE) has evolved rapidly over the last 25 years in China. Among the 34 provincial-level administrative units within China, the Zhejiang Province is one of the most advanced in terms of healthcare technology maintenance and management. In order to determine Zhejiang's current stage of development and opportunities for further improvement, a comparison of the performance of its CE departments was made against hospitals in the USA. Data were collected from 21 Zhejiang hospitals and compared to those from 270 acute-care hospitals in USA collected by Truven Health Analytics. The benchmarking comparison was made in three categories: operational, financial, and productivity. Within the operational category, the following metrics were compared: equipment inventory size/operating beds, annual repairs/inventory size, and annual scheduled maintenance/inventory size. Within the Financial category, the following metrics were compared: total CE expense/operating beds and total CE expense/total hospital expense. Within the Productivity category, the following metrics were compared: total CE full-time equivalent(FTE)/inventory size and total CE FTE/total hospital expense. These comparisons showed that:(1) While the equipment inventory in Zhejiang tends to be much smaller than USA for hospitals of comparable amount of operating beds, the numbers of repairs and scheduled maintenance per inventory size are similar;(2) The total CE expense/total hospital expense ratio is around 1% in both Zhejiang and USA; however, the total CE expense/operating beds and total CE expense/cost of equipment inventory are significantly lower in Zhejiang than USA;(3) The FTE amount in Zhejiang is significantly higher than in USA relative to both inventory size and total hospital operating expense, but significantly lower relative to the number of operating beds. The fact that repairs and scheduled maintenance are similar in Zhejiang and USA shows that CE leaders are managing equipment in comparable manner. Most of the differences found in the comparisons were traced to a few factors. First, the average length of stay in China is substantially higher than USA, which explains why hospitals in Zhejiang tend to have more operating beds but fewer pieces of equipment. Second, labor cost is significantly lower in China than USA, thus allowing Zhejiang hospitals to employ more workers than their American counterparts. Third, there is significantly difference in the cost of living between China and USA; Finally, being public entities Chinese hospitals are managed and operated in a different manner than American hospitals, which are mostly private, albeit nonprofit organizations. Nonetheless, it is interesting to note that hospitals in both areas spend roughly 1% of their total expenditure for CE. The results suggest that CE in Zhejiang is comparable to USA in terms of managerial excellence but there could be some room for improvement in financial management and productivity.展开更多
This study described the evolution of programs to improve the efficiency of patient movement between hospitals and nursing homes in the metropolitan area of Syracuse, New York. These programs were needed in order to i...This study described the evolution of programs to improve the efficiency of patient movement between hospitals and nursing homes in the metropolitan area of Syracuse, New York. These programs were needed in order to improve coordination among providers in the absence of networks that included both acute and long term care providers. The mechanisms included the exchange of data and monitoring the movement of Difficult to Place patients from hospitals to nursing homes. Between 2006 and 2014, the annual number of Difficult to Place patients increased from 983 to 1836. During this period, annual hospital medical/surgical discharges increased by 7.5 percent, severity of illness increased by 13.7 percent, and the population aged 65 years and over increased by 9.8 percent. Most of the Difficult to Place patients were admitted by the four largest facilities in the community, which accounted for 60 percent of the nursing home beds. The initiatives also included Subacute and Complex Care Programs that provided financial incentives for admission of certain types of patients, such as intravenous therapy and extensive wound care. The programs described how these programs were implemented using minimal financial resources and without adding positions to the participating provider organizations.展开更多
The purpose of the study sought to assess and evaluate the contents and records of the emergency trolley in the maternity section of the state hospitals in Windhoek, Namibia. A quantitative and descriptive research de...The purpose of the study sought to assess and evaluate the contents and records of the emergency trolley in the maternity section of the state hospitals in Windhoek, Namibia. A quantitative and descriptive research design was used for the study to investigate emergency equipment, essential drugs and emergency trolleys. A convenient sample of 10 emergency trolleys in the Windhoek Central Hospital (Hospital A) and Katutura Intermediate Hospital (Hospital B) in Windhoek, Namibia were used. Data was collected using a checklist adapted and edited from the EMSSA. Data were analysed using Microsoft excel 2013. Essential paediatric equipment including bag valve mask devices, Magill’s forceps, oxygen masks were absent in many of the units and wards. Data described that checking of defibrillators, monitors and suction devices still remained a major problem in the units/wards that were fortunate enough to have the aforementioned equipment. A conclusion was that generally the units/wards performed well during the assessments and evaluations. There were still units without emergency trolleys, trolleys that were poorly assessed, and those that were obstructed and registered nurses that had a negative perception to the audit of the emergency trolley. Specialized units such as NICU and Hi-Care Hospital A and Prem Unit Hospital B performed very well in their assessments. Development of policy with regards to assessing, restocking and maintenance of emergency supplies can be used to guide the nurses on what to do. Resuscitation morbidity and mortality meetings in order to identify issues and outcomes surround resuscitation incidences within the unit or ward.展开更多
Introduction: Occupational stress has negative effects on employee’s health and organizational productivity. Nurses in emergency department are more exposed to stress than nurses in other departments. Aim: To explore...Introduction: Occupational stress has negative effects on employee’s health and organizational productivity. Nurses in emergency department are more exposed to stress than nurses in other departments. Aim: To explore nurses’ experiences of occupational stress in emergency departments in private hospitals in Bangkok, Thailand. Design: A descriptive qualitative design, with a deductive approach based on the Job Demand-Control-Support model was used. Methods: Fifteen emergency department nurses at two different hospitals were interviewed and the data were analyzed using a manifest content analysis. Results: Three main categories: “work context is an issue”, “consequences of reactions to stress”, and “coping with work stress”, including seven sub-categories emerged from the data analysis. Conclusion: The patients’ and their relatives’ behaviors were experienced as the primary stressor at the private hospital, in addition to excessive work tasks. Other important stressors were misunderstanding and conflicts between emergency department nurses and the other health care professionals, presumably related to hierarchy and power relations between health care professions. Creating a better working environment and a balance between the number of patients and nurses would reduce workload and stress, encourage ED nurses to stay in the profession and ultimately maintain patient safety.展开更多
文摘Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.
文摘Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little known in Africa. The purpose of this study is to list all cases of hyperprolactinemia over the past four years and to make an inventory of the various etiologies found and their management. Methodology. This is a cross-sectional descriptive study on the files of patients who came for consultation in the internal medicine and endocrinology department with hyperprolactinemia retrospectively collected from January 2017 to December 2020. Included were patients followed or whose the diagnosis of hyperprolactinemia was established in endocrinological consultation during the study period. Results. This study recorded 26 cases of hyperprolactinemia. The female sex represented 73.08% (sex ratio M/F 0.37) and the average age was 33.92 years. The 40 - 50 age group was the most represented with 30.77%. In women, galactorrhea accounted for 73.07%, amenorrhea 57.69% of clinical pictures and infertility 23.08%. In men, infertility accounted for 7.69% of presentations, gynecomastia 11.54% and erectile dysfunction 15.38%. The duration of evolution of the signs was 4 months in 23.08% of the patients. The mean prolactinemia was 702.58 ng/ml. CT was performed in 80.85% of patients. The main etiologies were pituitary adenomas (77%). All our patients were treated with dopaminergic agonists. Cabergoline was prescribed in 77% of patients. The evolution was favorable in 96.25% of patients. Conclusion. Hyperprolactinemia is a pathology that exists in our regions. The main etiology remains pituitary adenomas and treatment with cabergoline.
基金supported by grants from Humanity and Social Science Youth Foundation of Ministry of Education of China (21YJC870016).
文摘Purpose: The number of retracted papers from Chinese university-affiliated hospitals is increasing, which has raised much concern. The aim of this study is to analyze the retracted papers from university-affiliated hospitals in China’s mainland from 2000 to 2021. Design/methodology/approach: Data for 1,031 retracted papers were identified from the Web of Science Core collection database. The information of the hospitals involved was obtained from their official websites. We analyzed the chronological changes, journal distribution, discipline distribution and retraction reasons for the retracted papers. The grade and geographic locations of the hospitals involved were explored as well.Findings: We found a rapid increase in the number of retracted papers, while the retraction time interval is decreasing. The main reasons for retraction are plagiarism/self-plagiarism(n=255), invalid data/images/conclusions(n=212), fake peer review(n=175) and honesty error(n=163). The disciplines are mainly distributed in oncology(n=320), pharmacology & pharmacy(n=198) and research & experimental medicine(n=166). About 43.8% of the retracted papers were from hospitals affiliated with prestigious universities. Research limitations: This study fails to differentiate between retractions due to honest error and retractions due to research misconduct. We believe that there is a fundamental difference between honest error retractions and misconduct retractions. Another limitation is that authors of the retracted papers have not been analyzed in this study.Practical implications: This study provides a reference for addressing research misconduct in Chinese university-affiliated hospitals. It is our recommendation that universities and hospitals should educate all their staff about the basic norms of research integrity, punish authors of scientific misconduct retracted papers, and reform the unreasonable evaluation system.Originality/value: Based on the analysis of retracted papers, this study further analyzes the characteristics of institutions of retracted papers, which may deepen the research on retracted papers and provide a new perspective to understand the retraction phenomenon.
文摘Introduction: Given its effects, hospital waste is an environmental concern and a threat to health personnel, users of health services and neighboring populations. Our objective was to assess the perception of health care stakeholders on the environmental effects related to biomedical waste produced in Teaching Hospitals (CHU) in Togo in 2021. Methods: This was a cross-sectional study held from June 24 to August 28, 2021. It targeted three university hospitals, 340 health care providers and services selected by a probabilistic method with a simple random technique in 25 services, 72 directors, deputy directors, supervisors and heads of services, 27 collection and incineration agents selected by a non-probabilistic method with a reasoned choice technique, 44 patients and attendants and 36 householders of neighboring residents selected by a non-probabilistic method with an accidental choice technique. Variables such as the spreading of disease vectors, soil, air and water contamination, the presence of unpleasant odors and unsightly living conditions were assessed. Results: According to the respondents, biomedical waste causes the proliferation of vectors (55.3%), an unsightly environment inside the hospital (47.1%), and unpleasant odors (61.2%). Incineration operations disturb hospital residents (52.8%), according to the householders of the residents. During observation, we note deposits of waste that have not been destroyed and wastewater flowing in some places. Conclusion: Biomedical waste in Togo’s university hospitals generates environmental effects and therefore potentially high risks for human health. Improving their management should be a concern for all hospital actors.
文摘Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.
文摘Objective The prevalence and related factors of serum anti-HCV in different regions and hospitals have not been studied extensively in China. We used routine screening data to determine the prevalence of HCV antibody in hospital patients, evaluate the epidemic trend of hepatitis C and formulate screening strategies.Methods Patient information and HCV antibody testing results were collected from January 2017 to December 2019 in 77 HCV sentinel hospitals in China. Univariate and multivariate logistic regression was used to determine the characteristics and associations.Results HCV antibody prevalence rates were distinct among patients in different departments, with a range of 0.33%–6.93%. Patients who were admitted to the liver disease-related departments(aOR =10.76;95% CI, 10.27–11.28), Internal Medicine(aOR = 2.87;95% CI, 2.75–3.00), and Department of Surgery(aOR = 1.95;95% CI, 1.87–2.04), were more likely to be tested for HCV antibody positive. HCV antibody prevalence was associated with patients aged 45 years and older(aOR = 2.74;95% CI,2.69–2.80), testing in infetious disease hospitals(aOR = 2.33;95% CI, 2.26–2.40) and secondary hospitals(aOR = 1.72;95% CI, 1.69–1.75). Patients in sentinel hospitals of the Northeast(aOR = 12.75;95% CI,12.40–13.11), the Central(aOR = 1.65;95% CI, 1.61–1.70), and the West(aOR = 1.78;95% CI, 1.73–1.83)China had higher HCV prevalence than those who were in the Eastern coastal area. Conclusion Those who were over 45 years old and saw doctors for liver diseases, and invasive diagnosis and treatment should be referred to HCV antibody testing.
文摘Objective:Nurses,due to the nature of their job,are subjected to various forms of stress and physical and psychological injuries.Self-compassion and a sense of coherence have attracted much attention in research in recent years as having high potential for improving the health and performance of people in the workplace.The present study aimed to compare self-compassion and the sense of coherence in nurses working in psychiatric hospitals and other hospitals of Kerman University of Medical Sciences.Methods:The present study was a descriptive-comparative study of applied type conducted on 100 nurses of Shahid Beheshti Psychiatric Hospital in Kerman by the census method and 100 nurses of other hospitals of Kerman University of Medical Sciences by the stratified random sampling method.The instruments included the self-compassion questionnaire and the sense of coherence questionnaire.Data were analyzed using the Statistical Package for Social Sciences software.Results:The results of the present study showed that self-compassion and sense of coherence were higher in psychiatric nurses(39.35±7.7 and 53.02±8.01)than among other nurses(36.03±5.81 and 49.76±6.30).There was a direct and moderate relationship between a sense of coherence and self-compassion(P-value<0.005).The higher the score of compassion for oneself,the higher was the score of sense of coherence.Furthermore,the sense of coherence had a direct and weak relationship with all dimensions of self-compassion,except for the extreme imitation dimension,which showed a direct and moderate relationship to other dimensions(P-value<0.001).Conclusions:Self-compassion and a sense of coherence,as a form of self-communication,increase nurses’satisfaction and reduce nurses’job stress and,as a result,job performance is improved.
文摘Haematuria is the presence of red blood cells in urine. It is most often caused by urinary tract infections of which Escherichia coli is frequently implicated. Impairment of kidney functions could occur as a result of infection or other complications of the kidney. The aim of the study was to determine the prevalence of uropathogenic Escherichia coli among adult male patients with haematuria and impaired kidneys attending a general hospital in Benue state. Three hundred and sixty-eight (368) samples of urine were collected from 368 male patients (≥ 40 years) attending the 23 general hospitals in Benue state. Each of the urine samples was divided into two parts for haematuria and isolation and identification of Escherichia coli. Blood samples (368) were also collected from the patients and used for quantitative determination of creatinine and estimation of glomerular filtration rate. The presence of haematuria was 45.1% and ranges from 12.5% to 100%. Prevalence of haematuria with respect to age shows that patients within the age group of 90 - 99 years had the highest rate (100%) and the least were those within the ages of 40 - 49 years (20.0%). Isolation rate of uropathogenic Escherichia coli was 16.3% and ranged from 6.3 to 37.5%. Patients within the age group of 90 - 99 years had the highest elevated impaired renal function of 4 (80%), followed by patients within the ages of 80 - 89 years [17 (77.3%)] and the lowest were those within the ages of 40 - 49 [6 (10.0%)]. The overall presence of haematuria in the patients was high (45.1%) with similar high Escherichia coli isolation rate and impaired renal function which could mean that acute or chronic kidney disease may set in.
文摘INTRODUCTION Occupational safety and health (OSH) is generally the anticipation, recognition, evaluation, and control of hazards arising in or from the workplace. The study sought to assess and evaluate occupational health and safety hazards experienced among health workers in the Bono region of Ghana. METHODOLOGY The study was descriptive cross-sectional quantitative study. Data was from two hundred (200) health workers and was analyzed using the binary logistic regression analysis. RESULTS The findings from the study show that risk factors associated with biological hazards were clinical staff [OR = 2.487 (1.146 - 5.397), p = 0.021], poor maintenance of hospital items [OR = 0.446 (0.240 - 0.831), p = 0.011], assault (verbal) abuse [OR = 2.581 (1.317 - 5.059), p = 0.006] and extreme pressure from work [OR = 2.975 (1.519 - 5.829), p = 0.001]. Non-biological hazards were associated with being single [OR = 0.499 (0.263 - 0.947), p = 0.034], being verbally assaulted [OR = 3.581 (1.865 - 6.876), p CONCLUSION Risk factors related with biological hazards include poor maintenance of hospital items and extreme pressure from work whereas non-biological hazards were associated with being single, being verbally assaulted. Clinical healthcare providers are more vulnerable to occupational health and safety hazards. The study recommends the provision of strategic policies to promote and protect the workers’ health based on the development of the epidemiological profile of health, needs to be readjusted and strengthened.
文摘Background:Conflict among nurses often has an undesirable effect on their work.Thus,understanding the predictable causes of conflict helps in dealing with it at an early stage,preventing negative consequences that may impact nurses’performance,ultimately affecting the quality of care and patient safety.This study aimed to explore the sources of conflict and how Saudi nurses in Taif deal with conflicts in hospitals.Method:A descriptive qualitative approach was employed,using the semi-structured interview method to collect data from 17 Saudi nurses working in 3 hospitals in the city of Taif from September 2022 to January 2023.Ethical approval was obtained from the Research and Studies Department at the Directorate of Health Affairs in Taif(IRB registration number with King Abdulaziz City for Science and Technology,KSA:HAP-02-T-067,approval number:720 on 10/08/2022).Results:The data revealed two main themes:firstly,conflicts arising among nurses,which can be categorized into two sub-themes:lack of awareness in work policies and procedures,and lack of communication;secondly,preemptive strategies for dealing with conflicts.Three sub-themes emerged in this regard:identifying conflict sources in advance,conducting regular meetings to enhance communication,and increasing awareness of policies and regulations while adhering to them.Conclusion:Conflict negatively impacts the quality of nursing care.Therefore,it is crucial to implement preventive and early measures,such as improving communication among nurses and enhancing awareness of policies and procedures,to address the ambiguities that lead to workplace conflict.
文摘In South Africa,nurses and doctors are emigrating in significant numbers. Job satisfaction,safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to become registered and 15 years for subspecialists. Career progression,creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India,which has a population of more than 1 billion people,is struggling with similar problems. For the past 10-15 years,private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows. A national task force for specialist training in RSA should be instituted. It should discuss,based on the current status and projected specialist and subspecialist personnel requirements,thefuture structure and logistics of training needs. This is required in all subspecialities including gastroenterology,as has been done in India. It is hoped that as a consequence well-trained doctors,similar to those in India,might move to provincial hospitals in rural areas,upgrading the medical services and keeping medical power in South Africa. South Africa should become a model for Sub-Saharan Africa,as India already is for South-East Asia.
文摘The Balanced Budget Act of 1997 created a designation for critical access hospitals(CAHs)to sustain care for people living in rural communities who lacked access to care due to hospital closures over the preceding decade.Twenty-five years later,1350 CAHs serve approximately 18% of the US population and a systematic policy evaluation has yet to be performed.This policy analysis serves to define challenges faced by CAHs through a literature review addressing the four major categories of payment,quality,access to capital,and workforce.Additionally,this analysis describes how current challenges to maintain sustainability of CAHs over time are accentuated by gaps in public health infrastructure and variability in individual health care plans exhibited during the COVID-19 pandemic.
文摘Introduction: Hospital infections prolong patient hospitalization, necessitate additional treatment, increase mortality rate, raise hospital expenses, and even reduce the level of health in the society. The purpose of this research was to study hospital infections in selected hospitals of Qazvin. Methods and Materials: This was an analytic-cross-sectional study. The research population consisted of 25,628 hospitalized patients in the first eight months of 2012 in three selected hospitals of the Qazvin Province. The algorithm of reporting hospital infections, the National Program of Controlling Hospital Infections, and 223 patient files hospitalized due to hospital-acquired infections were used to collect information. The collected information was analyzed using the SPSS V. 17 software;the descriptive statistics was used to analyze the qualitative variables;and the descriptive statistics together with chi-square and t-test were employed for the quantitative variables. Results: The ICU units had the most cases of hospital infections. Respiratory pneumonia and urinary infections topped the list of hospital infections. The most invasive treatments carried out on patients with hospital infections were surgery, urinary catheter, and venous catheter, respectively. More than 50 percent of patients with hospital infections were hospitalized for 2 to 21 days. Results and Conclusions: Because of the high rate of hospital infections, especially in the ICU ward, authorities must give top priority in their plans to designing suitable educational programs to inform hospital staff and patients of hospital infections and to provide suitable resources for dealing with this problem.
文摘Objective:To assess healthcare workers' involvement in healthcare waste management in public and private hospitals.Methods:Validated questionnaires(n = 660) were administered to randomly selected healthcare workers from selected private hospitals between April and July 2013.Results:Among the healthcare workers that participated in the study,187(28.33%) were medical doctors,44(6.67%) were pharmacists,77(11.67%) were medical laboratory scientist,35(5.30%) were waste handlers and 317(48.03%) were nurses.Generally,the number of workers that have heard about healthcare waste disposal system was above average 424(69.5%).More health-workers in the government(81.5%) than in private(57.3%) hospitals were aware of healthcare waste disposal system and more in government hospitals attended training on it.The level of waste generated by the two hospitals differed significantly(P=0.0086) with the generation level higher in government than private hospitals.The materials for healthcare waste disposal were significantly more available(P=0.001) in government than private hospitals.There was no significant difference(P = 0.285) in syringes and needles disposal practices in the two hospitals and they were exposed to equal risks(P =0.8510).Fifty-six(18.5%) and 140(45.5%) of the study participants in private and government hospitals respectively were aware of the existence of healthcare waste management committee with 134(44.4%) and 19(6.2%) workers confirming that it did not exist in their institutions.The existence of the committee was very low in the private hospitals.Conclusions:The availability of material for waste segregation at point of generation,compliance of healthcare workers to healthcare waste management guidelines and the existence of infection control committee in both hospitals is generally low and unsatisfactory.
基金supported by the Natural Science Foundation of Hubei Province(No.2021CFB348).
文摘ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hospitals(maternal and child health care hospitals)in Hubei province from 2012 to 2019 were collected.The indicators related to antimicrobial drug use included the utilization rate of different grades of antimicrobial drugs,the intensity of antimicrobial agent use,the rational use of prophylactic antimicrobial agents before class I surgical incision,and pathogenic detection and consultation rates before antimicrobial drug use.ResultsSince the implementation,the purchase of antimicrobial agents in hospitals has been maintained within the prescribed range,and the defined daily dose system(DDDs)of antimicrobial agents has been reduced,prophylactic use and accurate treatment of antimicrobial agents related to class I surgical incision have been more reasonable.With the implementation of ASPs,the detection rate of imipenem-resistant Acinetobacter baumannii,cefotaxime-resistant Escherichia coli,and methicillin-resistant Staphylococcus aureus has been decreased in China from national bacterial resistance surveillance data.ConclusionASPs have positive effects on antibiotic use and drug resistance in 85 maternity hospitals(maternal and child health care hospitals).
文摘In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to patients by hospitals.After the program was recognised,hospitals were identified as magnet hospitals[1].Some studies show that magnet hospitals provide a healthier working environment for nurses,accompanied by higher nurse satisfaction and better patient prognosis than non-magnet hospitals[2e5].The nursing work environment is the sum of various elements that directly or indirectly affect the patient care system[6].Improving the nursing work environment is a focal point and challenge for nursing administrators.Therefore,administrators in magnet hospitals usually apply a variety of assessment tools for effective evaluation of the nursing work environment to maintain and improve the health of the environment.
文摘Clinical engineering(CE) has evolved rapidly over the last 25 years in China. Among the 34 provincial-level administrative units within China, the Zhejiang Province is one of the most advanced in terms of healthcare technology maintenance and management. In order to determine Zhejiang's current stage of development and opportunities for further improvement, a comparison of the performance of its CE departments was made against hospitals in the USA. Data were collected from 21 Zhejiang hospitals and compared to those from 270 acute-care hospitals in USA collected by Truven Health Analytics. The benchmarking comparison was made in three categories: operational, financial, and productivity. Within the operational category, the following metrics were compared: equipment inventory size/operating beds, annual repairs/inventory size, and annual scheduled maintenance/inventory size. Within the Financial category, the following metrics were compared: total CE expense/operating beds and total CE expense/total hospital expense. Within the Productivity category, the following metrics were compared: total CE full-time equivalent(FTE)/inventory size and total CE FTE/total hospital expense. These comparisons showed that:(1) While the equipment inventory in Zhejiang tends to be much smaller than USA for hospitals of comparable amount of operating beds, the numbers of repairs and scheduled maintenance per inventory size are similar;(2) The total CE expense/total hospital expense ratio is around 1% in both Zhejiang and USA; however, the total CE expense/operating beds and total CE expense/cost of equipment inventory are significantly lower in Zhejiang than USA;(3) The FTE amount in Zhejiang is significantly higher than in USA relative to both inventory size and total hospital operating expense, but significantly lower relative to the number of operating beds. The fact that repairs and scheduled maintenance are similar in Zhejiang and USA shows that CE leaders are managing equipment in comparable manner. Most of the differences found in the comparisons were traced to a few factors. First, the average length of stay in China is substantially higher than USA, which explains why hospitals in Zhejiang tend to have more operating beds but fewer pieces of equipment. Second, labor cost is significantly lower in China than USA, thus allowing Zhejiang hospitals to employ more workers than their American counterparts. Third, there is significantly difference in the cost of living between China and USA; Finally, being public entities Chinese hospitals are managed and operated in a different manner than American hospitals, which are mostly private, albeit nonprofit organizations. Nonetheless, it is interesting to note that hospitals in both areas spend roughly 1% of their total expenditure for CE. The results suggest that CE in Zhejiang is comparable to USA in terms of managerial excellence but there could be some room for improvement in financial management and productivity.
文摘This study described the evolution of programs to improve the efficiency of patient movement between hospitals and nursing homes in the metropolitan area of Syracuse, New York. These programs were needed in order to improve coordination among providers in the absence of networks that included both acute and long term care providers. The mechanisms included the exchange of data and monitoring the movement of Difficult to Place patients from hospitals to nursing homes. Between 2006 and 2014, the annual number of Difficult to Place patients increased from 983 to 1836. During this period, annual hospital medical/surgical discharges increased by 7.5 percent, severity of illness increased by 13.7 percent, and the population aged 65 years and over increased by 9.8 percent. Most of the Difficult to Place patients were admitted by the four largest facilities in the community, which accounted for 60 percent of the nursing home beds. The initiatives also included Subacute and Complex Care Programs that provided financial incentives for admission of certain types of patients, such as intravenous therapy and extensive wound care. The programs described how these programs were implemented using minimal financial resources and without adding positions to the participating provider organizations.
文摘The purpose of the study sought to assess and evaluate the contents and records of the emergency trolley in the maternity section of the state hospitals in Windhoek, Namibia. A quantitative and descriptive research design was used for the study to investigate emergency equipment, essential drugs and emergency trolleys. A convenient sample of 10 emergency trolleys in the Windhoek Central Hospital (Hospital A) and Katutura Intermediate Hospital (Hospital B) in Windhoek, Namibia were used. Data was collected using a checklist adapted and edited from the EMSSA. Data were analysed using Microsoft excel 2013. Essential paediatric equipment including bag valve mask devices, Magill’s forceps, oxygen masks were absent in many of the units and wards. Data described that checking of defibrillators, monitors and suction devices still remained a major problem in the units/wards that were fortunate enough to have the aforementioned equipment. A conclusion was that generally the units/wards performed well during the assessments and evaluations. There were still units without emergency trolleys, trolleys that were poorly assessed, and those that were obstructed and registered nurses that had a negative perception to the audit of the emergency trolley. Specialized units such as NICU and Hi-Care Hospital A and Prem Unit Hospital B performed very well in their assessments. Development of policy with regards to assessing, restocking and maintenance of emergency supplies can be used to guide the nurses on what to do. Resuscitation morbidity and mortality meetings in order to identify issues and outcomes surround resuscitation incidences within the unit or ward.
文摘Introduction: Occupational stress has negative effects on employee’s health and organizational productivity. Nurses in emergency department are more exposed to stress than nurses in other departments. Aim: To explore nurses’ experiences of occupational stress in emergency departments in private hospitals in Bangkok, Thailand. Design: A descriptive qualitative design, with a deductive approach based on the Job Demand-Control-Support model was used. Methods: Fifteen emergency department nurses at two different hospitals were interviewed and the data were analyzed using a manifest content analysis. Results: Three main categories: “work context is an issue”, “consequences of reactions to stress”, and “coping with work stress”, including seven sub-categories emerged from the data analysis. Conclusion: The patients’ and their relatives’ behaviors were experienced as the primary stressor at the private hospital, in addition to excessive work tasks. Other important stressors were misunderstanding and conflicts between emergency department nurses and the other health care professionals, presumably related to hierarchy and power relations between health care professions. Creating a better working environment and a balance between the number of patients and nurses would reduce workload and stress, encourage ED nurses to stay in the profession and ultimately maintain patient safety.
