scholarly journals Barriers and Facilitators to Guideline-Adherent Pulse Oximetry Use in Bronchiolitis

2020 ◽  
Vol 16 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Courtney Benjamin Wolk ◽  
Amanda C Schondelmeyer ◽  
Frances K Barg ◽  
Rinad Beidas ◽  
Amanda Betterncourt ◽  
...  
Keyword(s):  
Hospital Medicine ◽  
Integrated Approach ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Barriers And Facilitators ◽  
Cross Sectional ◽  
Hospital Administrators ◽  
Respiratory Therapists ◽  
Semistructured Interviews ◽  
Visual Reminders

METHODS: This multicenter qualitative study took place in the context of the Eliminating Monitor Overuse (EMO) SpO2 study, a cross-sectional study to establish rates of cSpO2 in bronchiolitis. We conducted semistructured interviews, informed by the Consolidated Framework for Implementation Research, with a purposive sample of stakeholders at sites with high and low cSpO2 use rates to identify barriers and facilitators to addressing cSpO2 overuse. Interviews were audio recorded and transcribed. Analyses were conducted using an integrated approach. RESULTS: Participants (n = 56) included EMO study site principal investigators (n = 12), hospital administrators (n = 8), physicians (n = 15), nurses (n = 12), and respiratory therapists (n = 9) from 12 hospitals. Results suggest that leadership buy-in, clear authoritative guidelines for SpO2 use incorporated into electronic order sets, regular education about cSpO2 in bronchiolitis, and visual reminders may be needed to reduce cSpO2 utilization. Parental perceptions and individual clinician comfort affect cSpO2 practice. CONCLUSION: We identified barriers and facilitators to deimplementation of cSpO2 for stable patients with bronchiolitis across children’s hospitals with high- and low-cSpO2 use. Based on these data, future deimplementation efforts should focus on clear protocols for cSpO2, EHR changes, and education for hospital staff on bronchiolitis features and rationale for reducing cSpO2. Journal of Hospital Medicine 2020;15:XXX-XXX. © 2020 Society of Hospital Medicine

scholarly journals Infection control practices and challenges in Pakistan during the COVID-19 pandemic: a multicentre cross-sectional study

2021 ◽  
pp. 175717742110127
Author(s):  
Salma Abbas ◽  
Faisal Sultan
Keyword(s):  
Personal Protective Equipment ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
And Control

Background: Patient and staff safety at healthcare facilities during outbreaks hinges on a prompt infection prevention and control response. Physicians leading these programmes have encountered numerous obstacles during the pandemic. Aim/objective: The aim of this study was to evaluate infection prevention and control practices and explore the challenges in Pakistan during the coronavirus disease 2019 pandemic. Methods: We conducted a cross-sectional study and administered a survey to physicians leading infection prevention and control programmes at 18 hospitals in Pakistan. Results: All participants implemented universal masking, limited the intake of patients and designated separate triage areas, wards and intensive care units for coronavirus disease 2019 patients at their hospitals. Eleven (61%) physicians reported personal protective equipment shortages. Staff at three (17%) hospitals worked without the appropriate personal protective equipment due to limited supplies. All participants felt overworked and 17 (94%) reported stress. Physicians identified the lack of negative pressure rooms, fear and anxiety among hospital staff, rapidly evolving guidelines, personal protective equipment shortages and opposition from hospital staff regarding the choice of recommended personal protective equipment as major challenges during the pandemic. Discussion: The results of this study highlight the challenges faced by physicians leading infection prevention and control programmes in Pakistan. It is essential to support infection prevention and control personnel and bridge the identified gaps to ensure patient and staff safety at healthcare facilities.

scholarly journals Assessment of Knowledge, Practice and Attitude about Biomedical Waste Management among Healthcare Professionals during COVID-19 Crises in Al-Ahsa

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 747
Author(s):  
Sahbanathul Missiriya Jalal ◽  
Fahima Akhter ◽  
Amal Ismael Abdelhafez ◽  
Ahmed Mansour Alrajeh
Keyword(s):  
Work Experience ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Cross Sectional ◽  
Biomedical Waste ◽  
Respiratory Therapists ◽  
Global Pandemic ◽  
Before And After ◽  
Knowledge Practice

Biomedical waste (BMW) management is an essential practice of healthcare professionals (HCPs) for preventing health and also environmental hazards. Coronavirus disease (COVID-19) has become a global pandemic, posing significant challenges for healthcare sectors. A cross-sectional study was performed to assess the knowledge, practice, and attitude on BMW management among HCPs when taking care of patients with COVID-19 and associated with demographic variables. From Al-Ahsa healthcare sectors, 256 HCPs were selected randomly, of which 105 (41%) had excellent knowledge, 87 (34%) had good knowledge, and 64 (25%) had poor knowledge with a mean score of 13.1 ± 3.6. A higher mean score was (14.4 ± 3.2) obtained by physicians, and (13.6 ± 3.8) nurses than the other HCPs. Regarding practice, 72 (28.1%) HCPs used and discarded PPE while handling biomedical wastes. Additionally, 88 (34.4%) followed proper hand hygiene before and after each procedure and whenever needed. Physicians, nurses, and respiratory therapists had a more favorable attitude than other HCPs. There was a statistically significant association found among knowledge level and educational qualification (p < 0.0001), gender (p < 0.001), and work experience (p < 0.05). Emphasis is needed to train all HCPs regarding proper BMW management during this pandemic to prevent infection transmission.

Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

2021 ◽  
pp. 1-4
Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Endotracheal Tube Cuff ◽  
Cross Sectional ◽  
Tube Cuff ◽  
Respiratory Therapists ◽  
Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

scholarly journals Socioeconomic and Behavioral Correlates of COVID-19 Infections among Hospital Workers in the Greater Jakarta Area, Indonesia: A Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5048
Author(s):  
Adrianna Bella ◽  
Mochamad Thoriq Akbar ◽  
Gita Kusnadi ◽  
Olivia Herlinda ◽  
Putri Aprilia Regita ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Healthcare Workers ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Household Size ◽  
Risk Of Infection ◽  
Sectional Study ◽  
Hospital Workers ◽  
Behavioral Correlates ◽  
Cross Sectional

(1) Background: because of close contacts with COVID-19 patients, hospital workers are among the highest risk groups for infection. This study examined the socioeconomic and behavioral correlates of COVID-19 infection among hospital workers in Indonesia, the country hardest-hit by the disease in the Southeast Asia region. (2) Methods: we conducted a cross-sectional study, which collected data from 1397 hospital staff from eight hospitals in the Greater Jakarta area during April–July 2020. The data was collected using an online self-administered questionnaire and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) tests. We employed descriptive statistics and adjusted and unadjusted logistic regressions to analyze the data of hospital workers as well as the subgroups of healthcare and non-healthcare workers. (3) Results: from a total of 1397 hospital staff in the study, 22 (1.6%) were infected. In terms of correlates, being a healthcare worker (adjusted odds ratio (AOR) = 8.31, 95% CI 1.27–54.54) and having a household size of more than five (AOR = 4.09, 1.02–16.43) were significantly associated with a higher risk of infection. On the other hand, those with middle- and upper-expenditure levels were shown to have a lower risk of infection (AOR = 0.06, 0.01–0.66). Behavioral factors associated with COVID-19 infection among healthcare and non-healthcare workers included knowledge of standard personal protective equipment (PPE) (AOR = 0.08, 0.01–0.54) and application of the six-step handwashing technique (AOR = 0.32, 0.12–0.83). (4) Conclusion: among hospital staff, correlates of COVID-19 infection included being a healthcare worker, household size, expenditure level, knowledge and use of PPE, and application of appropriate hand washing techniques.

scholarly journals A Cross-sectional Study on Challenges Faced and Strategies Adopted in Responding to Corona Virus Disease (COVID-19) by Hospital Administrators in Kaski District

2021 ◽  
Vol 2 (4) ◽  
pp. 256-260
Author(s):  
KC Deepti ◽  
S Poudel ◽  
SB Hamal Thakuri ◽  
S Shrestha
Keyword(s):  
Virus Disease ◽  
Health Care Systems ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Hospital Administrators ◽  
Corona Virus ◽  
Care Systems ◽  
Private And Public

Background: Following the outbreak of Coronavirus disease in 2019, the year 2020/21 has been an incredibly challenging one for all global health-care systems. Methods: A cross sectional descriptive research design was used to conduct the study. The study was carried out in all general private and public hospitals of Kaski district of Nepal. Data were collected from 25th October to 5th December, 2020 from the Hospital administrators using a semi structured interview schedule. Descriptive statistics were used for data analysis. Results: Most (96.3%) of the hospitals reported that increased cost or expenses of the hospitals creating financial threat is the most challenging situation that hospitals are facing in this pandemic. In addition shortages of ventilators creating ethical dilemma for patient allocation and changing guidelines from authorities have been reported as a challenge by 88.9 percent of the hospitals respectively. All of the surveyed hospitals had developed the use of thermometers for screening at the hospital entrances to minimize the risk. Conclusion: Hospitals in this pandemic are facing a lot of challenges with regard to staff management, PPE management and so on. Hence they need to adopt best strategies in responding to the corona virus.

scholarly journals Evaluation of facemask associated acne/ “Maskne” among health care workers and non-health care workers of India during COVID-19 pandemic-A cross-sectional study

2021 ◽  
Vol 7 (3) ◽  
pp. 243-248
Author(s):  
Krina B Patel ◽  
Savfeena M. Nagani ◽  
Aanal T. Patel ◽  
Nirav Bapat
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Demographic Data ◽  
Face Mask ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Workers ◽  
Front Line Workers

“MASK-NE”-Mask associated Acne, is a common form of acne during COVID-19 pandemic. It is type of acne mechanica seen when external factor occludes the skin, leads to irritation, inflammation and starts/aggravates all grades of acne.We conducted a cross-sectional study among 773 participants, using a Self-administered, aim oriented, questionnaire which includes demographic data, acne related history, type and duration of wearing mask & other mask related skin problems in COVID-19 pandemic during 15 October to 15December,2020.: Among 773 participants, age ranged 18-45 years with mean 30.69 (SD: 61.30) and M:F was 1:1.78. After starting of Pandemic, occurrence of new development of mask associated Acne/ Maskne was higher among Health Care Workers (HCW) (34.98%) as compared to non- Health Care Workers (non-HCWs) (17.36%). Moreover, more number of HCWs had aggravation of their pre-existing acne and/or development of new of acne during pandemic (81.2%) than non-HCWs (61%). Wearing N95 type of mask showed the highest aggravation (82%) of Maskne as compare to wearing Surgical mask (75.5%) and wearing cloth (cotton) mask (65.6%).Wearing a face mask for 4 to 8 hours/day and &#62;8 hours/day showed increase in the aggravation of Maskne as compared to wearing a facemask &#60;4 hrs/day.Though wearing face masks can be the best strategy against COVID-19 infection, HAZARD OF THIS SAFETY is not negligible especially in front-line workers-doctors, nurses, pharmacist, policemen, hospital staff who are at higher risk due to several factors including type of mask use, duration of mask use etc.

scholarly journals Socio-economic Analysis and the Study of Prevalence, Awareness, Treatment, Control and Risk Factors of Hypertension in Hospital Staff

2013 ◽  
Vol 7 (1) ◽  
pp. 15-19
Author(s):  
Samjhana Shakya ◽  
J Bhattarai ◽  
K Rawal ◽  
AR Kunwar ◽  
YR Shakya ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Economic Status ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Cluster Sampling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public Health Challenge

Hypertension is an important public health challenge in the developing and the developed world alike. This worksite based descriptive cross-sectional study was undertaken in Sahid Gangalal National Heart Centre in 2010 with 50 subjects were recruited by multistage purposive cluster sampling. The primary aim of this descriptive cross-sectional study was to assess the socioeco­nomic status and to measure the prevalence, awareness, treatment, and correlates of hypertension. The prevalence of pre-hypertension is 38% and hypertension is 34%. Among the hypertensive 53% are aware of their condition and 66.66% of them are under treatment and 16.66% have con­trol over the condition. The prevalence of overweight and obesity were 22% and 4% respectively. The prevalence of central obesity was 29.72% among male and 69% among female. Knowledge, Attitude and Practice on hypertension was satisfactory. Fourteen percent understood hypertension as a raised blood pressure during blood flow in the arteries. Majority of them (72%) have posi­tive attitude towards use of medicine in hypertension. Majority of them (86%) had checked their blood pressure in last 2 years. Difference in prevalence of hypertension was found among the tobacco users and non- users (65% vs 40%), who do regular exercise and those who do not (28% vs. 38%) and sleep disturbance was higher among hypertensive than non-hypertensive (48% vs. 10%). Patients with Dislipidemia (32%) had higher prevalence of hypertension than those without Dislipidemia (44% vs 30 %) Similar finding were found between overweight participants (26%) and normal weight participants (46% vs 34%). The prevalence of hypertension is higher with the higher socio-economic status. Nepalese Heart Journal | Volume 7 | No.1 | November 2010 (special issue) | Page 15-19 DOI: http://dx.doi.org/10.3126/njh.v7i1.8496

The Validity of ‘Recognition-Based’ Headache Diagnoses in Adolescents. Data from the Nord-TrØndelag Health Study 1995-97, Head-Hunt-Youth

Cephalalgia ◽  
2003 ◽  
Vol 23 (3) ◽  
pp. 223-229 ◽  
Author(s):  
J-A Zwart ◽  
G Dyb ◽  
LJ Stovner ◽  
T Sand ◽  
TL Holmen
Keyword(s):  
High Schools ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
Health Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Semistructured Interviews ◽  
Health Related ◽  
Type Headache ◽  
Good Agreement

The aim of this study was to evaluate the validity of the headache diagnoses (migraine and tension-type headache) obtained from short interviews by nurses, where the subjects were asked to identify their headache(s) based on recognition of typical headache descriptions. All students in junior high schools and high schools aged 12-19 years in Nord-Tr⊘ndelag county, Norway, were invited to participate in the youth part of the Nord-Tr⊘ndelag Health Study ('Helseunders⊘kelsen i Nord-Tr⊘ndelag'-HUNT), 1995-1997. In this cross-sectional study a total of 8984 students (88%) completed a comprehensive questionnaire with different health-related items. Of these, 6149 were also interviewed by nurses about their headache complaints by giving them two alternative headache descriptions accordant with either migraine or tension-type headache (Head-HUNT-Youth). The headache diagnoses obtained from nurse interviews were validated in a stratified random sample enriched with headache subjects from the interviewed population. Out of 159 invited individuals, 112 (70%) participated in extensive semistructured interviews by neurologists. The overall chance-corrected agreement (K) was 0.76 (confidence interval (CI) 0.66-0.86), which is considered good. For migraine, the positive and negative predictive values were 89% and 90%, respectively, and the chance-corrected agreement (K) was 0.72 (CI 0.58-0.87). For tension-type headache, positive and negative predictive values were 83% and 91%, respectively, and chance-corrected agreement (K) was 0.74 (CI 0.62-0.87). There was good agreement between the headache diagnoses obtained from the short interviews by nurses and the extensive interviews by neurologists. Short interviews based on recognition of typical headache descriptions seem to be an alternative and efficient way to identify migraine and tension-type headache sufferers among adolescents. The method can be useful in epidemiological research, e.g. in estimation of headache prevalence.

Sign in / Sign up

Export Citation Format

Share Document