scholarly journals Implementing Delirium Prevention in the Era of COVID-19

2021 ◽  
Vol 79 (1) ◽  
pp. 31-36
Author(s):  
Nila S. Radhakrishnan ◽  
Mariam Mufti ◽  
Daniel Ortiz ◽  
Suzanne T. Maye ◽  
Jennifer Melara ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Quality Care ◽  
Tertiary Care ◽  
Cognitive Stimulation ◽  
Evidence Based ◽  
Care Hospital ◽  
Future Studies ◽  
Delirium Prevention ◽  
Prevention Model ◽  
Prevention Methods

Patients admitted with COVID-19 can develop delirium due to predisposing factors, isolation, and the illness itself. Standard delirium prevention methods focus on interaction and stimulation. It can be challenging to deliver these methods of care in COVID settings where it is necessary to increase patient isolation. This paper presents a typical clinical vignette of representative patients in a tertiary care hospital and how a medical team modified an evidence-based delirium prevention model to deliver high-quality care to COVID-19 patients. The implemented model focuses on four areas of delirium-prevention: Mobility, Sleep, Cognitive Stimulation, and Nutrition. Future studies will be needed to track quantitative outcome measures.

scholarly journals Lack of bundled care intervention training program will trip up rates of ventilator associated pneumonia: the contemporary trend

2019 ◽  
Vol 6 (6) ◽  
pp. 2623
Author(s):  
Rituja Kaushal ◽  
Sanjeev Gupta ◽  
Aashish Saraogi ◽  
Sandhya Singh
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Secondary Data ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Hospital Acquired Infection ◽  
Intervention Training ◽  
Care Intervention ◽  
Hospital Acquired

Background: Ventilator associated pneumonia (VAP) is the deadliest hospital acquired infection in many low resource settings of developing countries. For VAP prevention, the concept of bundle of care was defined. Evidence based resources showed it enabled great successes in VAP prevention. It has been observed in clinical practice due to insufficient compliance, there is a need to address related issues in order to define easier-to-apply procedures.Methods: It is a retrospective analytical secondary data based study. It was conducted in a tertiary care hospital of Bhopal city.Results: T value of Mann Whitney/U test was found to be statistically significant and is indicating need of “Bundle Care Intervention” training for the prevention of increase in ventilator associated pneumonia rates in any health care setting.Conclusions: Expanded bevy of options related to infect

scholarly journals Confronting hidden COVID-19 burden: a telemedical solution for elective urological outpatient clinics

Infection ◽  
2020 ◽  
Vol 48 (6) ◽  
pp. 935-939
Author(s):  
Thilo Westhofen ◽  
Giuseppe Magistro ◽  
Simon Lennartz ◽  
Jozefina Casuscelli ◽  
Christian Stief ◽  
...  
Keyword(s):  
High Risk ◽  
Tertiary Care Hospital ◽  
Quality Care ◽  
Tertiary Care ◽  
Outpatient Clinics ◽  
Care Hospital ◽  
Outpatient Services ◽  
High Quality ◽  
Symptom Monitoring ◽  
Risk Patients

AbstractMaintaining high-quality care for urological patients is a challenge during and after the Coronavirus disease 2019 (COVID-19) pandemic. We observe an increasing volume of postponed elective visits at our tertiary care hospital, holding the risk for deterioration of non-emergency disease conditions. As it is unclear for how long the pandemic will last, we propose to implement telehealth as a solution to provide regular symptom monitoring compatible with social distancing guidelines during the pandemic and beyond. Telemedical assessment and prioritizing of high-risk patients for individual consults at outpatient services will have to be aligned with available outpatient capacity and local outbreak severity.

P2– Electronic evidence-based evaluation of thromboprophylaxis in a tertiary care hospital in Brazil

2010 ◽  
Vol 143 (1_suppl) ◽  
pp. 79-80
Author(s):  
Airton Tetelbom Stein ◽  
André Wajner ◽  
Fernando Waldemar ◽  
Fernanda Fuzinatto ◽  
Grasiele Bess ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Evidence Based ◽  
Care Hospital ◽  
Electronic Evidence

scholarly journals Evaluation of prescribing pattern of drugs use in patients of coronary artery disease at a tertiary care hospital

2018 ◽  
Vol 7 (9) ◽  
pp. 1792
Author(s):  
Mahesh N. Belhekar ◽  
Tejal C. Patel ◽  
Mohit Kumar Singh ◽  
Prasad R. Pandit ◽  
Kiran A. Bhave ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ace Inhibitors ◽  
Tertiary Care Hospital ◽  
Beta Blockers ◽  
Tertiary Care ◽  
Evidence Based ◽  
Care Hospital ◽  
Artery Disease

Background: Coronary artery disease (CAD) is a major cause responsible for mortality more in younger age group than in elderly. Studies have reported underuse of four evidence based medicines namely aspirin, β-blockers, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB), and statins in patients with CAD, particularly in developing countries. Therefore, this study was planned to analyse the prescriptions of patients with CAD to determine the appropriateness of the prescriptions.Methods: After obtaining the Institutional ethics committee permission, a cross sectional observational study was conducted at a tertiary care hospital. Total 150 patients were enrolled from the outpatient department, wards and intensive care unit of medicine department. Total 150 patients’ prescriptions presenting with varied category of CAD were screened and analysed.Results: The most common categories of CAD encountered was ST segment elevated myocardial infarction (N=50, 33%) followed by chronic stable angina (N=29, 20%). Among the drugs prescribed, antiplatelet drugs were prescribed to 135 (90%), hypolipidemics to 134 (89%), nitrates to 114 (76%), beta blockers to 97 (65%), ACE inhibitors to 94 (64%), anticoagulants to 60 (40%) and miscellaneous drugs to 52 (35%), patients. Of 68 (45%) patients with type 2 diabetes mellitus, 15 (22%) were prescribed only metoprolol and others were given ACE-I or ARBs.Conclusions: Among four evidence based drugs, use of 3 drugs, antiplatelets, beta blockers and hypolipidemics was apparent in 90% of prescriptions. Use of ACE inhibitors and ARBs was observed in type 2 diabetic patients with CAD, reflecting rational prescribing behavior of clinicians.

scholarly journals Predicting intervention in renal colic patients after emergency department evaluation

CJEM ◽  
2005 ◽  
Vol 7 (02) ◽  
pp. 78-86 ◽  
Author(s):  
Linda Papa ◽  
Ian G. Stiell ◽  
George A. Wells ◽  
Ian Ball ◽  
Erica Battram ◽  
...  
Keyword(s):  
Emergency Department ◽  
Operating Characteristic ◽  
Renal Colic ◽  
Tertiary Care Hospital ◽  
Characteristic Curve ◽  
Tertiary Care ◽  
Percutaneous Nephrostomy ◽  
Care Hospital ◽  
Future Studies ◽  
Department Evaluation

ABSTRACTObjectives:There is no set of prospectively validated criteria to identify the emergency department (ED) patients with renal colic who are most likely to eventually have to undergo an intervention. This study prospectively assessed predictors of intervention in this patient population.Methods:This prospective cohort study included adult patients with renal colic who presented to 2 tertiary care hospital EDs. Patients had an 18-variable data form completed by an emergency physician and a radiological study to confirm urolithiasis. After discharge, patients were followed at 1 and 4 weeks to assess for intervention. The outcome criteria included the patient having had at least 1 of the following procedures performed: extracorporeal shockwave lithotripsy (ESWL), ureteroscopy, percutaneous nephrostomy or open surgery. Data were analyzed using appropriate univariate techniques, and those variables associated with intervention were combined using logistic regression analysis.Results:Over an 8-month period, 245 patients with confirmed urolithiasis were followed; 20% (95% confidence interval [CI] 15%–25%) eventually had a procedure to remove their calculi. Three variables were significantly correlated with having a procedure: i) size of calculus ≥ 6 mm (odds ratio [OR] 10.7, 95% CI 4.6–24.8), ii) location of calculus above mid-ureter (OR 6.9, 95% CI 3.0–15.9), and iii) Visual Analogue Scale score for pain at discharge from the ED ≥ 2 cm (OR 2.6, 95% CI 1.0–6.8). The area under receiver operating characteristic curve was 0.77 (95% C I 0.70–0.84) (p< 0.001). If all variables were present there was a 90% probability of the patient having an intervention performed within 4 weeks of discharge from the ED. Conversely, if none of the variables were present there was only a 4% probability of an intervention. Overall, the model had a sensitivity of 92% (95% CI 89%–96%) and a specificity of 63% (95% CI 57%–69%).Conclusions:This study has identified variables that could potentially be used to identify those renal colic patients who require an intervention after ED evaluation. Future studies will prospectively validate this model.

scholarly journals A study of work-related stress among nurses in a tertiary care hospital in Goa

2018 ◽  
Vol 5 (2) ◽  
pp. 657 ◽  
Author(s):  
Shefalee Pai Vernekar ◽  
Hemangini Shah
Keyword(s):  
Tertiary Care Hospital ◽  
Quality Care ◽  
Tertiary Care ◽  
Death And Dying ◽  
Care Hospital ◽  
Cross Sectional ◽  
Work Related Stress ◽  
Work Related ◽  
Services Delivery ◽  
Related Stress

Background: Nursing is, by its very nature, a stressful occupation. The role of nursing is associated with multiple and conflicting demands imposed by nurse supervisors and managers, and by medical and administrative staff. Such a situation appears to lead to work overload and possible to role conflict. This seriously impairs the provision of quality care and the efficacy of health services delivery. The objectives of the study were to determine the levels of work-related stress in nurses; to identify various sources of stress among nurses; to develop suitable recommendations based on the findings of the study.Methods: A cross-sectional study was conducted among registered nurses working in wards of a tertiary care hospital, Goa wherein Expanded Nursing Stress Scale was used to assess level and sources of stress among them.Results: 59.3% of nurses experienced moderate. 36.8% severe, 2.4% experienced very severe stress. Highest mean score was in the area of death and dying subscale (2.35±0.61) and workload subscale (2.11±0.53). Nurses working in casualty and general wards were more stressed. Also, younger nurses were more stressed in dealing with death of a patient.Conclusions: Death of a patient and excessive workload were major contributors of stress. Stress reduction activities and measures to decrease workload will help in decreasing the stress at workplace. 

Confidence toward vaccination as reported by parents of children admitted to a tertiary care hospital in Riyadh, Saudi Arabia: A cross sectional study

Vacunas ◽  
2020 ◽  
Vol 21 (2) ◽  
pp. 95-104 ◽  
Author(s):  
Y.M. AlGoraini ◽  
N.N. AlDujayn ◽  
M.A. AlRasheed ◽  
Y.E. Bashawri ◽  
S.S. Alsubaie ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional
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