Etiology and Epidemiology of Neonatal Septicemia in Hospital Units

Sensing, distributed computation and wireless communication are the essential building components of a Cyber-Physical System (CPS). Having many advantages such as mobility, low power, multi-hop routing, low latency, self-administration, utonomous data acquisition, and fault tolerance, Wireless Sensor Networks (WSNs) have gone beyond the scope of monitoring the environment and can be a way to support CPS. This paper presents the design, deployment, and empirical study of an eHealth system, which can remotely monitor vital signs from patients such as body temperature, blood pressure, SPO2, and heart rate. The primary contribution of this paper is the measurements of the proposed eHealth device that assesses the feasibility of WSNs for patient monitoring in hospitals in two aspects of communication and clinical sensing. Moreover, both simulation and experiment are used to investigate the performance of the design in many aspects such as networking reliability, sensing reliability, or end-to-end delay. The results show that the network achieved high reliability - nearly 97% while the sensing reliability of the vital signs can be obtained at approximately 98%. This indicates the feasibility and promise of using WSNs for continuous patient monitoring and clinical worsening detection in general hospital units.

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CANADIAN UNIVERSITY HOSPITAL UNITS

BMJ ◽

10.1136/bmj.2.2959.373-b ◽

1917 ◽

Vol 2 (2959) ◽

pp. 373-373

Author(s):

R. Mitchell

Keyword(s):

University Hospital ◽

Hospital Units

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Reserved Bed Program Reduces Neurosciences Intensive Care Unit Capacity Strain: An Implementation Study

Neurosurgery ◽

10.1093/neuros/nyz024 ◽

2019 ◽

Vol 86 (1) ◽

pp. 132-138

Author(s):

Christopher D Shank ◽

Nicholas J Erickson ◽

David W Miller ◽

Brittany F Lindsey ◽

Beverly C Walters

Keyword(s):

Intensive Care ◽

Economies Of Scale ◽

Negative Impact ◽

The United States ◽

Fiscal Year ◽

Implementation Study ◽

Service Line ◽

Hospital Units ◽

Significant Negative Impact ◽

Operational Issues

Abstract BACKGROUND Neurosciences intensive care units (NICUs) provide institutional centers for specialized care. Despite a demonstrable reduction in morbidity and mortality, NICUs may experience significant capacity strain with resulting supraoptimal utilization and diseconomies of scale. We present an implementation study in the recognition and management of capacity strain within a large NICU in the United States. Excessive resource demand in an NICU creates significant operational issues. OBJECTIVE To evaluate the efficacy of a Reserved Bed Pilot Program (RBPP), implemented to maximize economies of scale, to reduce transfer declines due to lack of capacity, and to increase transfer volume for the neurosciences service-line. METHODS Key performance indicators (KPIs) were created to evaluate RBPP efficacy with respect to primary (strategic) objectives. Operational KPIs were established to evaluate changes in operational throughput for the neurosciences and other service-lines. For each KPI, pilot-period data were compared to the previous fiscal year. RESULTS RBPP implementation resulted in a significant increase in accepted transfer volume to the neurosciences service-line (P = .02). Transfer declines due to capacity decreased significantly (P = .01). Unit utilization significantly improved across service-line units relative to theoretical optima (P < .03). Care regionalization was achieved through a significant reduction in “off-service” patient placement (P = .01). Negative externalities were minimized, with no significant negative impact in the operational KPIs of other evaluated service-lines (P = .11). CONCLUSION Capacity strain is a significant issue for hospital units. Reducing capacity strain can increase unit efficiency, improve resource utilization, and augment service-line throughput. RBPP implementation resulted in a significant improvement in service-line operations, regional access to care, and resource efficiency, with minimal externalities at the institutional level.

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Clinical Team Distribution and Antibiotic Use Patterns at a Tertiary-Care Academic Medical Center

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.695 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s168-s169

Author(s):

Rebecca Choudhury ◽

Ronald Beaulieu ◽

Thomas Talbot ◽

George Nelson

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Tertiary Care ◽

Antibiotic Use ◽

Care Hospital ◽

Hospital Units ◽

Antibiotic Utilization ◽

Academic Medical ◽

Level Data ◽

Utilization Data

Background: As more US hospitals report antibiotic utilization to the CDC, standardized antimicrobial administration ratios (SAARs) derived from patient care unit-based antibiotic utilization data will increasingly be used to guide local antibiotic stewardship interventions. Location-based antibiotic utilization surveillance data are often utilized given the relative ease of ascertainment. However, aggregating antibiotic use data on a unit basis may have variable effects depending on the number of clinical teams providing care. In this study, we examined antibiotic utilization from units at a tertiary-care hospital to illustrate the potential challenges of using unit-based antibiotic utilization to change individual prescribing. Methods: We used inpatient pharmacy antibiotic use administration records at an adult tertiary-care academic medical center over a 6-month period from January 2019 through June 2019 to describe the geographic footprints and AU of medical, surgical, and critical care teams. All teams accounting for at least 1 patient day present on each unit during the study period were included in the analysis, as were all teams prescribing at least 1 antibiotic day of therapy (DOT). Results: The study population consisted of 24 units: 6 ICUs (25%) and 18 non-ICUs (75%). Over the study period, the average numbers of teams caring for patients in ICU and non-ICU wards were 10.2 (range, 3.2–16.9) and 13.7 (range, 10.4–18.9), respectively. Units were divided into 3 categories by the number of teams, accounting for ≥70% of total patient days present (Fig. 1): “homogenous” (≤3), “pauciteam” (4–7 teams), and “heterogeneous” (>7 teams). In total, 12 (50%) units were “pauciteam”; 7 (29%) were “homogeneous”; and 5 (21%) were “heterogeneous.” Units could also be classified as “homogenous,” “pauciteam,” or “heterogeneous” based on team-level antibiotic utilization or DOT for specific antibiotics. Different patterns emerged based on antibiotic restriction status. Classifying units based on vancomycin DOT (unrestricted) exhibited fewer “heterogeneous” units, whereas using meropenem DOT (restricted) revealed no “heterogeneous” units. Furthermore, the average number of units where individual clinical teams prescribed an antibiotic varied widely (range, 1.4–12.3 units per team). Conclusions: Unit-based antibiotic utilization data may encounter limitations in affecting prescriber behavior, particularly on units where a large number of clinical teams contribute to antibiotic utilization. Additionally, some services prescribing antibiotics across many hospital units may be minimally influenced by unit-level data. Team-based antibiotic utilization may allow for a more targeted metric to drive individual team prescribing.Funding: NoneDisclosures: None

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Facing COVID-19 Pandemic in a Tertiary Hospital in Milan: Prevalence of Burnout in Nursing Staff Working in Sub-Intensive Care Units

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136684 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6684

Author(s):

Alberto Bisesti ◽

Andrea Mallardo ◽

Simone Gambazza ◽

Filippo Binda ◽

Alessandro Galazzi ◽

...

Keyword(s):

Intensive Care ◽

Respiratory Failure ◽

Intensive Care Units ◽

Healthcare Workers ◽

Maslach Burnout Inventory ◽

Tertiary Hospital ◽

Personal Accomplishment ◽

Preventive Strategies ◽

Common Condition ◽

Hospital Units

In early March 2020, Italy became the epicenter of the Coronavirus Disease 2019 (COVID-19) pandemic in Europe. A different organization of hospital units was required to take care of patients affected by acute respiratory failure caused by COVID-19. This study aimed to evaluate the prevalence of burnout in two sub-intensive care units (SICUs) of the COVID-19 hub center of the Lombardia region in Milan (Italy). All nurses and healthcare assistants working in the SICUs during June 2020 were included in the study. Burnout was assessed via the Maslach Burnout Inventory questionnaire. One hundred and five (84%) SICU staff participated in the study. The prevalence of high burnout for nurses and healthcare assistants was 61.9% for emotional exhaustion, 47.6% for depersonalization and 34.3% for personal accomplishment. Depersonalization was significantly more frequent in younger nurses (p = 0.009). Nurses were 4.5 times more likely to have burnout than healthcare assistants. Burnout was a common condition among healthcare workers operating in SICUs during the pandemic. Urgent actions are needed, especially for nurses, as well as preventive strategies for future pandemic scenarios.

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Food Safety and Food Waste in One Portuguese Public Hospital

Proceedings ◽

10.3390/foods_2020-07673 ◽

2020 ◽

Vol 70 (1) ◽

pp. 36

Author(s):

Carla Gonçalves ◽

Ana Gomes ◽

Alexandra Esteves ◽

José António Silva ◽

Cristina Maria Saraiva

Keyword(s):

Staphylococcus Aureus ◽

Food Safety ◽

Bacillus Cereus ◽

Food Waste ◽

Estimation Method ◽

Physical Method ◽

Salmonella Spp ◽

Hospital Units ◽

Development Goals ◽

And Staphylococcus Aureus

The present study aims to contribute to sustainable development goals by increasing knowledge of food safety and food waste of meals produced by the cook–chill system in hospital units. The food waste (FW) of meals served at lunch was evaluated for all new hospitalized patients with light diet (n = 17) and soft texture diet (n = 10), during their hospital stay, using the physical method by weighing for dish and the visual estimation method for the soup. Samples of each diet (light, n = 3; soft texture, n = 3) were also collected in four different moments (after cooked, after cold transportation, after refrigerated storage and after hot regeneration) for detection and enumeration of Listeria monocytogenes, Salmonella spp. and Staphylococcus aureus and enumeration of Escherichia coli, Clostridium spp., Bacillus cereus, Enterobacteriaceae, total viable counts (TVC) at 30 °C, as well as pH, water activity, moisture, ashes and protein. The FW (%) of the light diet (n = 64) was 39.8 ± 6.3 in dish and 14.9 ± 5.4 in soup, and of the soft texture diet (n = 51) was 65.1 ± 9.0 in dish and 39.0 ± 5.8 in soup. Regarding the percentage of protein per meal, both light (8.73%) and soft (3.33%) diets presented on average values lower than those recommended by the WHO (10–15% protein). The value of different microorganisms varied along the production moments; however, the final products in the light diet (after hot regeneration) presented 1.34–1.73 log cfu/g of TVC. Counts of Bacillus cereus and Staphylococcus aureus were also obtained at low levels (less than 1 log cfu/g). Besides these results, the risk of foodborne diseases should be considered. The implementation of effective measures to increase food safety and reduce FW in hospital is crucial.

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Health promotion for migrants in Morocco: Progress, challenges et prospects

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.494 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Maaroufi

Keyword(s):

Civil Society ◽

Health Information System ◽

Migrant Health ◽

Civil Society Organizations ◽

Free Access ◽

Health Coverage ◽

Stimulate Action ◽

Migrant Populations ◽

Hospital Units ◽

Building Program

Abstract Morocco has become a land of permanent settlement for migrants. In promoting their health, we have made a significant progress with persistence of challenges Progress: Development and implementation of a National Strategy to promote the health of migrantsFree access to primary care and emergency care and screening services;Free access to health coverage program for regular migrants. Challenges: Development of a health surveillance system for the migrant populationStrengthening the skills of healthcare professionals to take care of the specific health needs of the migrant population (tropical diseases);Strengthening of medical, psycho-social assistance for migrants, protection of particularly vulnerable categories (women and children) and intersectoral coordination;Stimulate action by civil society and the community in promoting the health of migrants. Prospects for action: Integrate migrant health data into the health information system of health facilities and health programs;Develop and implement a health education plan adapted to the specificities of migrant populations;Establish a network of hospital units specializing in tropical pathology, acting as national reference teams;Define and implement a capacity building program for health professionals (doctors, nurses and social workers);Support civil society organizations to improve their intervention capacity in the area of migrant health.

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