Changes in the Number of Newly Diagnosed Lung Cancer Patients Before and During the COVID-19 Pandemic: A single-Center Experience

This study was conducted to determine whether there was an effect on the hospital admissions of newly diagnosed lung cancer (NDLC) patients in Turkey during the COVID-19 pandemic. In this retrospective study, NDLC patients were recorded from the Hospital Information Management System between January,1 2015-December, 31, 2020, at our tertiary hospital. The number of NDLC patients diagnosed in 2020 was compared with each year of 2017-2019. Between 2017 and 2020, 15,150 NDLC cases were analyzed. The number of NDLC patients by year were; 4,030 patients in 2017, 4,004 patients in 2018, 4,391 patients in 2019, and 2,725 in 2020, respectively. In 2020, NDLC patients decreased by 38%, 32%, 32% compared to 2019, 2018, and 2017, respectively. The late admission of lung cancer patients might result in the advanced stage, missing the chance for surgery, and decreased survival. Precautions should be considered to diagnose and treat lung cancer patients in specialized centers during a pandemic due to epidemic diseases such as COVID-19.

Epidemiological study of motorcycle accidents in Gonabad in 2018-2019

Introduction: Motorcycle accidents are among the deadliest road traffic accidents, and the prevention of road traffic injury is a daunting challenge in numerous countries, including Iran. The present study aimed to investigate the motorcycle accidents that occurred in Gonabad, Iran. Methods: This cross-sectional descriptive study was conducted using all standard pre-hospital emergency reporting forms related to motorcycle accidents registered in a software-based pre-hospital information management system (called ASAYAR in Persian) between March 2018 and 2019. The motorcycle accidents were assessed in terms of urban and rural settings, time and mission results of accidents, and demographic characteristics of injured people. Descriptive statistics (mean, standard deviation, frequency, and frequency percentage) were used for data analysis. Results: A total of 1,555 traffic accidents were recorded in the ASAYAR system, out of which 746(48%) accidents were related to motorcycle accidents, and out of 746 cases in the county, 431 cases had occurred in Gonabad. The majority of motorcycle accidents (49%) took place in the age group of 15-25 years. The time analysis of accidents demonstrated that the majority of accidents had happened in the spring with 34% (n=147) and in June with 11.86% (n=51). Moreover, 77% of the injured were motorcycle riders, and 82% of all the injured have been taken to hospital. Conclusion: As evidenced by the obtained results, nearly half of all road accidents are caused by motorcycles. Given that most of the injured in motorcycle accidents are adolescents and young people, it is necessary to take practical measures to control and manage this major health threat.

ANALYSIS OF HOSPITAL INFORMATION MANAGEMENT SYSTEM USING HUMAN ORGANIZATION FIT MODEL

Background: Hospital is a health care institution that provides public services for patients. It needs computerized information technology, for example, a hospital information management system.Aims: This study was aimed at analyzing the implementation of hospital management information system using the human organization fit model at the Outpatient Department of Sabang General Hospital.Methods: This study was conducted from March-June 2020 using a cross sectional design. The study’s population was the hospital managers, administration staff and health workers at the hospital. The study’s sample size was 106 respondents selected using a purposive sampling. This study used a quantitative design in which the data analysis was done using a spearman correlation test with P-value of =<0.05. The independent variables were the quality of system, quality of information, and quality of care. While the dependent variables included system user, user satisfaction and organization. The data were collected through questionnaire distributed to the respondents.Results: The quality of system did not have a relationship with the system user (P=0.585), user satisfaction (P=0.541), and organization (P=0.256). The quality of information had a relationship with the system user(P=0.004) and user satisfaction (P=0.000), but it did not have a relationship with organization (P=0.132). The quality of care had a relationship with the system user(P=0.000), user satisfaction (P=0.000) and organization (P=0.000).Conclusion: The Sabang General Hospital, Aceh, needs to improve the hospital management information system with the HOT-fit model, especially the quality of system. They can conduct training for users and provide applicable and attractive manuals.Keywords: hospital, information management system, quality of care, quality of information, quality of system.

Autonomous wheelchair for patient’s transportation on healthcare institutions

The transport of patients from the inpatient service to the operating room is a recurrent task in a hospital routine. This task is repetitive, non-ergonomic, time consuming, and requires the labor of patient transporters. In this paper is presented a system, named Connected Driverless Wheelchair, that can receive transportation requests directly from the hospital information management system, pick up patients at their beds, navigate autonomously through different floors, avoid obstacles, communicate with elevators, and drop patients off at the designated operating room. As a result, a prototype capable of transporting patients autonomously in hospital environments was obtained. Although it was impossible to test the final developed system at the hospital as planned, due to the COVID-19 pandemic, the extensive tests conducted at the robotics laboratory facilities, and our previous experience in integrating mobile robots in hospitals, allowed to conclude that it is perfectly prepared for this integration to be carried out. The achieved results are relevant since this is a system that may be applied to support these types of tasks in the future, making the transport of patients more efficient (both from a cost and time perspective), without unpredictable delays and, in some cases, safer.

Should We Perform Laboratory and Radiographic Evaluations for All Children with COVID-19?: A Single-Center Experience

Background The diagnostic and treatment strategies for children are limited because of the small number of children with COVID-19. A large proportion of infected children are asymptomatic or have mild symptoms. We report our experience regarding clinical characteristics, laboratory, radiologic findings, and outcomes of children with COVID-19. Materials and Methods This retrospective single-center study was conducted on children with COVID-19. The data on epidemiologic characteristics, clinical features, laboratory, and radiologic findings of patients were extracted from the hospital information management system records, and patients' forms filled upon admission. Results The median age of children was 121 months, 46.8% of the patients were females and 53.2% were males. Of the 581 children assessed, a total of 222 (38.2%) had positive test results; 69 of them (31.1%) were asymptomatic. The median absolute lymphocyte and eosinophil counts were statistically significantly lower in symptomatic children (p = 0.001; p = 0.02). Neutrophil lymphocyte ratio was statistically significantly higher in the symptomatic children (p = 0.001). Of 72 computed tomography scans, 35 (48.6%) were normal, and only 29 (40%) were consistent with classic/probable/indeterminate COVID-19 predominant pattern. Conclusion Our results showed a few laboratory abnormalities in asymptomatic polymerase chain reaction positive children; therefore, unnecessary investigation might be avoided and clinicians should consider clinical symptoms.

Acute respiratory effect of transpyloric feeding for respiratory exacerbation in preterm infants

ObjectivesGastroesophageal reflux may exacerbate chronic lung disease in preterm infants. We evaluated the short-term effects of transpyloric feeding on respiratory status in preterm infants during mechanical ventilation.MethodsWe retrospectively collected data from the hospital information management system. To evaluate the effect of transpyloric feeding on oxygenation, we compared changes in SpO2/FiO2 ratios before and after commencing transpyloric feeding by a piecewise linear regression model.ResultsWe examined 33 infants (median gestational age, 25.4 weeks; median birth weight, 656 g) who underwent transpyloric feeding. All tubes were placed at the bedside without fluoroscopy. No cases of unsuccessful placement, gastroduodenal perforation, or tracheal misinsertion occurred. Transpyloric feeding began at a median age of 18 (interquartile range, 15–23) days. Mean SpO2/FiO2 (±SD) ratios were 391 (±49), 371 (±51), 365 (±56), and 366 (±53) 72–96 h before, 0–24 h before, 48–72 h after, and 96–120 h after starting transpyloric feeding, respectively. The rate of change per hour of SpO2/FiO2 ratios increased 48–120 h after compared with 0–96 h before transpyloric feeding (0.03 [95% confidence interval, −0.10 to 0.17] vs. −0.29 [−0.47 to −0.12]) (p=0.007). No apparent changes occurred in the mean airway pressure, amplitude pressure, or pCO2.ConclusionsTranspyloric feeding during mechanical ventilation can prevent the deterioration of oxygenation without major complications at the stage of respiratory exacerbation in preterm infants.

EVALUATION OF THE CHARACTERISTICS OF REVISITS TO AN ADULT EMERGENCY DEPARTMENT WITHIN 72 HOURS

The objective of this study was to determine revisits of the patients discharged from the adult emergency department of our hospital in the early period (72 hours) between January 2016 and December 2016, and to evaluate characteristics of these revisits. In this study, records of the patients discharged from the adult emergency department in 2016 were retrospectively screened from the hospital information management system. Of the 361,413 patients, 7,800 (2.1%) met the inclusion criteria. The most common cause of the initial presentation was unexplained pain with 890 (11.4%) patients, while the most common diagnosis in revisits was acute upper respiratory tract infection with 642 (8.2%) patients. It was found that 18 patients (2.23%) died in the emergency department. No significant difference was found between triage scores of the emergency department presentations, while 161 patients with green area triage in the initial presentation presented to the red area and 134 of these patients were discharged. In our study, the revisit rate was similar with the studies in the literature. It was observed that the majority of the patients who revisited were discharged after the initial visit and they presented to the emergency department again upon their complaints continued. It was thought that revisits can be largely prevented with correct prescription and providing better information to patients.

Emergency Service Experience following the Terrorist Attack in Mogadishu, 14 October 2017

Background: To evaluate the trauma patients presenting at the Emergency Department (ED) of Mogadishu Somalia Turkish Training and Research Hospital following the explosion caused by a suicide bomber with a truck loaded with explosives in the Somalian capital, Mogadishu.Methods: The data of patients presenting at the hospital following the severe explosion on 14 October 2017 were accessed from the hospital information management system, patient examination forms and patient records and were retrospectively examined. Results: The patients comprised 188 (74.6%) males and mean age of 30.94±12.23 years (range, 1-80 years). 86 (34.1%) patients were marked with red code, 138 (54.8%) patients had superficial injuries. 173 (68.7%) patients were managed in the ED and 7 (2.8%) patients died on first admission in the ED. Multiple trauma injuries were detected in 43 (17.1%) patients, and 31 (12.3%) patients were admitted to Orthopedics departmentConclusion: Disaster management in a terrorist event requires rapid transport, appropriate triage, effective surgical approaches and specific postoperative care. Such a form of disaster management can be effective in reducing mortality of the injured who can be saved.

Investigation of Resistance, Perception and Attitudes of Employees against Change in Information Systems Using Change Management Approach: A Study in a University Hospital

The need for change in the rapidly developing health sector is essential for the provision of quality health care services. In this study, the technological change experienced in the process of transition from the old hospital information management system used in a university hospital to the new hospital information management system was discussed and employees’ resistance, perceptions and attitudes to change have been examined through a change management approach. In this study, we aimed to examine the level of usage of the change management tools and change management phases in a university hospital through a change management approach in the transition phase to the new HIS. We also aim to discuss faced problems encountered in the change process, help to create consciousness for management of change, examine behavioural reasons of resistance of healthcare professionals and present our experiences and propose solutions in the view of adoption and acceptance management tools against change in Hospital Information Systems (HIS) for healthcare managers. In the research, it has been observed that in the transition to the new information system, the change management tools are applied partially whereas change management phases have been implemented to a large extent. University hospital employees are resistant to Hospital Information Management System replacement. The most resistant groups are doctors and nurses and the least resistant employees are administrative staff. The rise in hospital revenues following the change is noteworthy.