scholarly journals High Frequency of Non-Compliance with Quality Indicators of Enteral and Parenteral Nutritional Therapy in Hospitalized Patients

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2408
Author(s):  
Daiane Aparecida Nogueira ◽  
Lara Princia Ferreira ◽  
Renata Paniago Andrade de Lúcia ◽  
Geórgia das Graças Pena
Keyword(s):  
Quality Indicators ◽  
Health Professionals ◽  
High Frequency ◽  
Real Life ◽  
Nutritional Therapy ◽  
Feeding Tube ◽  
Hospitalized Patients ◽  
Nutrition Support ◽  
Real Life Situation ◽  
A Prospective Study

Quality indicators in nutritional therapy (QINT) are measures of the effectiveness and quality of nutrition support. The purpose of this study was to evaluate the frequency of the QINT adequacy of Enteral Nutritional Therapy (EN) and/or Parenteral (PN) in hospitalized patients and identify the best indicators according to health professionals. A prospective study was performed, including data from patients aged 18 years or over admitted to clinical or surgical wards. The patients who had received EN and/or PN were followed from the first day of nutritional prescription until discharge. Twelve indicators were calculated, as recommended by the literature. Regarding professional opinion, the QINT adequacy was evaluated by observing its utility, simplicity, objectivity, and cost. Of the 727 hospitalized patients, 101 were on EN and/or PN. Regarding the 12 QINT evaluated, only 25% (3) achieved the goals: involuntary withdrawal of enteral feeding tube (0.01%); feeding tube occlusion or withdrawal per occlusion (0%); the measurement of energy and protein requirements (92%). A high frequency of non-compliance (75% of QINT) was observed in clinical and surgical patients on EN and/or PN. With knowledge of the six best indicators chosen by health professionals in this service, it will be possible to elaborate protocols according to the real-life situation in the institution.

High frequency of non-compliance with quality indicators during oral nutrition support in hospitalized patients

2020 ◽  
Vol 40 ◽  
pp. 363-368
Author(s):  
Daiane Aparecida Nogueira ◽  
Lara Princia Ferreira ◽  
Renata Paniago Andrade de Lúcia ◽  
Geórgia das Graças Pena
Keyword(s):  
Quality Indicators ◽  
High Frequency ◽  
Hospitalized Patients ◽  
Nutrition Support ◽  
Oral Nutrition

scholarly journals Assessment of Automatically Monitored Water Levels and Water Quality Indicators in Rivers with Different Hydromorphological Conditions and Pollution Levels in Greece

Hydrology ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 86
Author(s):  
Angeliki Mentzafou ◽  
George Varlas ◽  
Anastasios Papadopoulos ◽  
Georgios Poulis ◽  
Elias Dimitriou
Keyword(s):  
Water Quality ◽  
Time Series ◽  
Quality Indicators ◽  
High Frequency ◽  
Automatic Monitoring ◽  
Water Levels ◽  
High Temporal Resolution ◽  
Water Quality Indicators ◽  
Pollution Levels ◽  
Riverine Ecosystems

Water resources, especially riverine ecosystems, are globally under qualitative and quantitative degradation due to human-imposed pressures. High-temporal-resolution data obtained from automatic stations can provide insights into the processes that link catchment hydrology and streamwater chemistry. The scope of this paper was to investigate the statistical behavior of high-frequency measurements at sites with known hydromorphological and pollution pressures. For this purpose, hourly time series of water levels and key water quality indicators (temperature, electric conductivity, and dissolved oxygen concentrations) collected from four automatic monitoring stations under different hydromorphological conditions and pollution pressures were statistically elaborated. Based on the results, the hydromorphological conditions and pollution pressures of each station were confirmed to be reflected in the results of the statistical analysis performed. It was proven that the comparative use of the statistics and patterns of the water level and quality high-frequency time series could be used in the interpretation of the current site status as well as allowing the detection of possible changes. This approach can be used as a tool for the definition of thresholds, and will contribute to the design of management and restoration measures for the most impacted areas.

scholarly journals Medication Experience and Adherence to Oral Chemotherapy: A Qualitative Study of Patients’ and Health Professionals’ Perspectives

2021 ◽  
Vol 18 (8) ◽  
pp. 4266
Author(s):  
Amparo Talens ◽  
Mercedes Guilabert ◽  
Blanca Lumbreras ◽  
María Teresa Aznar ◽  
Elsa López-Pintor
Keyword(s):  
Qualitative Study ◽  
Health Professionals ◽  
Real Life ◽  
Positive Influence ◽  
Barriers And Facilitators ◽  
University Hospital ◽  
Nominal Group ◽  
Care Plans ◽  
Individualized Care ◽  
Medication Experience

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients’ experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in treatment with ANEO, to describe the barriers and facilitators related to the disease and its treatment and to compare them with the healthcare professionals’ perspectives. We carried out an exploratory qualitative study in the University Hospital of San Juan de Alicante, Spain. Three focus groups and two nominal group discussions were conducted with 23 onco-hematological patients treated with ANEO and 18 health professionals, respectively. The data were analyzed using content analyses and were eventually triangulated. The most impactful aspects in patients’ ME were the presence of adverse effects; lack of information about treatment; beliefs, needs and expectations regarding medications; social and family support; and the relationship with the health professionals. Both patients and professionals agreed on considering the negative side effects and the information about treatment as the main barriers and facilitators of adherence, respectively, although the approaches differed between both profiles. The professionals offered a more technical vision while patients prioritized the emotional burden and motivation associated with the disease and medication. This study allowed us to understand the real-life experiences of patients being treated with ANEO and explore the factors which had an impact on adherence to treatment. This understanding enables professionals to have a positive influence on patients’ behavior and provide individualized care plans. Pharmacists’ assistance is relevant to support patients’ adherence and self-management.

scholarly journals Anemia predicts poor outcomes of COVID-19 in hospitalized patients: a prospective study in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masood Faghih Dinevari ◽  
Mohammad Hossein Somi ◽  
Elham Sadeghi Majd ◽  
Mahdieh Abbasalizad Farhangi ◽  
Zeinab Nikniaz
Keyword(s):  
Prospective Study ◽  
High Sensitivity ◽  
Hospitalized Patients ◽  
Icu Admission ◽  
Reactive Protein ◽  
Hs Crp ◽  
Prospective Association ◽  
Poor Outcomes ◽  
A Prospective Study ◽  
Ventilator Requirement

Abstract Background There are limited number of studies with controversial findings regarding the association between anemia at admission and coronavirus disease 2019 (COVID-19) outcomes. Therefore, in this research, we aimed to investigate the prospective association between anemia and COVID-19 outcomes in hospitalized patients in Iran. Methods In this prospective study, the data of 1274 consecutive patients hospitalized due to COVID-19 were statistically analyzed. All biomarkers, including hemoglobin and high-sensitivity C-reactive protein (hs-CRP) levels were measured using standard methods. Anemia was defined as a hemoglobin (Hb) concentration of less than 13 g/dL and 12 g/dL in males and females, respectively. Assessing the association between anemia and COVID-19 survival in hospitalized patients was our primary endpoint. Results The mean age of the participants was 64.43 ± 17.16 years, out of whom 615 (48.27%) were anemic subjects. Patients with anemia were significantly older (P = 0.02) and had a higher frequency of cardiovascular diseases, hypertension, kidney disease, diabetes, and cancer (P < 0.05). The frequency of death (anemic: 23.9% vs. nonanemic: 13.8%), ICU admission (anemic: 27.8% vs. nonanemic:14.71%), and ventilator requirement (anemic: 35.93% vs. nonanemic: 20.63%) were significantly higher in anemic patients than in nonanemic patients (P < 0.001). According to the results of regression analysis, after adjusting for significant covariate in the univariable model, anemia was independently associated with mortality (OR: 1.68, 95% CI: 1.10, 2.57, P = 0.01), ventilator requirement (OR: 1.74, 95% CI: 1.19, 2.54, P = 0.004), and the risk of ICU admission (OR: 2.06, 95% CI: 1.46, 2.90, P < 0.001). Conclusion The prevalence of anemia in hospitalized patients with COVID-19 was high and was associated with poor outcomes of COVID-19.

scholarly journals How hospitalized patients evaluate and report their pain together with nurses: A scoping review

2021 ◽  
pp. 205715852110134
Author(s):  
Bente Dale Malones ◽  
Sindre Sylte Kallmyr ◽  
Vera Hage ◽  
Trude Fløystad Eines
Keyword(s):  
Scoping Review ◽  
Pain Assessment ◽  
Health Professionals ◽  
Clinical Care ◽  
Hospitalized Patients ◽  
Assessment Tools ◽  
Post Surgery ◽  
Reliable Assessment ◽  
Scoping Reviews ◽  
The Relationship

Pain assessment tools are often used by patients to report their pain and by health professionals to assess patients’ reported pain. Although valid and reliable assessment of pain is essential for high-quality clinical care, there are still many patients who experience inappropriate pain management. The aim of this scoping review is to examine an overview of how hospitalized patients evaluate and report their pain in collaboration with nurses. Systematic searches were conducted, and ten research articles were included using the PRISMA guidelines for scoping reviews. Content analysis revealed four main themes: 1) the relationship between the patient and nurse is an important factor of how hospitalized patients evaluate and report their post-surgery pain, 2) the patient’s feelings of inconsistency in how pain assessments are administered by nurses, 3) the challenge of hospitalized patients reporting post-surgery pain numerically, and 4) previous experiences and attitudes affect how hospitalized patients report their pain. Pain assessment tools are suitable for nurses to observe and assess pain in patients. Nevertheless, just using pain assessment tools is not sufficient for nurses to obtain a comprehensive clinical picture of each individual patient with pain.

scholarly journals Use of the ReSVinet Scale for parents and healthcare workers in a paediatric emergency service: a prospective study

2021 ◽  
Vol 5 (1) ◽  
pp. e000966
Author(s):  
Jhon Camacho-Cruz ◽  
Shirley Briñez ◽  
Jorge Alvarez ◽  
Victoria Leal ◽  
Licet Villamizar Gómez ◽  
...  
Keyword(s):  
Prospective Study ◽  
Emergency Room ◽  
Health Professionals ◽  
Emergency Service ◽  
Weighted Kappa ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Paediatric Emergency ◽  
A Prospective Study ◽  
Spearman’S Correlation

IntroductionMost scales for acute respiratory infection (ARI) are limited to healthcare worker (HCW) use for clinical decision-making. The Respiratory Syncytial Virus network (ReSVinet) Scale offers a version for parents that could potentially help as an early warning system.ObjectiveTo determine whether or not the ReSVinet Scale for ARI in infants can be reliably used by HCWs and parents in an emergency service.MethodsA prospective study was done of infants with ARI who were admitted to a paediatric emergency room to assess the ReSVinet Scale when used by faculty (paediatric doctor-professors), residents (doctors doing their first specialty in paediatrics) and parents. Spearman’s correlation and a weighted kappa coefficient were used to measure interobserver agreement. Internal consistency was also tested by Cronbach’s alpha test.ResultsOverall, 188 patients, 58% male, were enrolled. A Spearman’s correlation of 0.92 for faculty and resident scoring and 0.64 for faculty or resident and parent scoring was found. The weighted kappa coefficients were 0.78 for faculty versus residents, 0.41 for faculty versus parents, and 0.41 for residents versus parents. Cronbach’s alpha test was 0.67 for faculty, 0.62 for residents and 0.69 for parents.ConclusionThere was good correlation in the ReSVinet scores between health professionals when used in the paediatric emergency area. Agreement between parents and health professionals was found to be more variable. Future studies should focus on finding ways to improve its reliability when used by parents before the scale is used in the emergency room.

scholarly journals Advancing the Population Needs-Based Health Workforce Planning Methodology: A Simulation Tool for Country Application

2021 ◽  
Vol 18 (4) ◽  
pp. 2113
Author(s):  
James Asamani ◽  
Christmal Christmals ◽  
Gerda Reitsma
Keyword(s):  
Open Access ◽  
Population Health ◽  
Health Workforce ◽  
Health Professionals ◽  
Real Life ◽  
Workforce Planning ◽  
Health Needs ◽  
Simulation Tool ◽  
Flow Process ◽  
Health Workforce Planning

Although the conceptual underpinnings of needs-based health workforce planning have developed over the last two decades, lingering gaps in empirical models and lack of open access tools have partly constrained its uptake in health workforce planning processes in countries. This paper presents an advanced empirical framework for the need-based approach to health workforce planning with an open-access simulation tool in Microsoft® Excel to facilitate real-life health workforce planning in countries. Two fundamental mathematical models are used to quantify the supply of, and need for, health professionals, respectively. The supply-side model is based on a stock-and-flow process, and the need-side model extents a previously published analytical frameworks using the population health needs-based approach. We integrate the supply and need analyses by comparing them to establish the gaps in both absolute and relative terms, and then explore their cost implications for health workforce policy and strategy. To illustrate its use, the model was used to simulate a real-life example using midwives and obstetricians/gynaecologists in the context of maternal and new-born care in Ghana. Sensitivity analysis showed that if a constant level of health was assumed (as in previous works), the need for health professionals could have been underestimated in the long-term. Towards universal health coverage, the findings reveal a need to adopt the need-based approach for HWF planning and to adjust HWF supply in line with population health needs.

Nutrition Support After Cardiac Surgery: Lessons Learned From a Prospective Study

2020 ◽  
Author(s):  
Chin Siang Ong ◽  
Pooja Yesantharao ◽  
Patricia M. Brown ◽  
Joseph K. Canner ◽  
T. Andrew Brown ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Prospective Study ◽  
Lessons Learned ◽  
Nutrition Support ◽  
A Prospective Study
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