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Almazyad A, Alamro M, Almadan N, Almutairi M, AlQuwayz TS. Frequency and Demographic Analysis of Odontogenic Tumors in Three Tertiary Institutions: An 11-Year Retrospective Study. Diagnostics (Basel) 2024; 14:910. [PMID: 38732324 PMCID: PMC11083381 DOI: 10.3390/diagnostics14090910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Odontogenic tumors (OTs) are distinct conditions that develop in the jawbones, exhibiting diverse histopathological features and variable clinical behaviors. Unfortunately, the literature on this subject in Saudi Arabia remains sparse, indicating a pressing need for more comprehensive data concerning the frequency, demographics, treatment modalities, and outcomes of OTs. OBJECTIVES The study aims to evaluate the frequency, demographic features, treatment, and outcomes of OTs across three tertiary medical centers. METHODS AND MATERIAL OT cases were identified in King Abdulaziz Medical City (KAMC), King Fahad Medical City (KFMC), and Prince Sultan Military Medical City (PSMMC) from January 2010 to December 2021. RESULTS Ninety-two OT cases were identified from the anatomical pathology laboratories of three tertiary hospitals. KFMC contributed the highest number of cases (43.5%), followed by KAMC (30.4%) and PSMMC (26.1%). The median age of OT patients was 29 years (range: 5-83), with males representing more than half of the patients (56.5%). The mandible was the most frequent site of OT occurrence (72.5%), with ameloblastoma being the predominant OT (63.0%), followed by odontoma (19.5%). Among the treatment modalities, bone resection was employed the most (51.0%), followed by enucleation (25.6%). Notably, 11.5% of OT cases with available follow-up data exhibited recurrence, with ameloblastoma accounting for eight recurrent cases. CONCLUSIONS Although OTs are relatively common in the jaws, they are rare in anatomical pathology laboratories and the general population. This study contributes valuable insights into the epidemiology characteristics, treatment trends, and recurrence rates of OTs in Saudi Arabia.
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Affiliation(s)
- Asma Almazyad
- Maxillofacial Surgery and Diagnostic Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (M.A.); (M.A.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affair, Riyadh 11426, Saudi Arabia
| | - Mohammed Alamro
- Maxillofacial Surgery and Diagnostic Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (M.A.); (M.A.)
| | - Nasser Almadan
- Prince Sultan Military Medical Center, Riyadh 11159, Saudi Arabia; (N.A.); (T.S.A.)
- Dental Specialist Center, Hafar AlBaten 39953, Saudi Arabia
| | - Marzouq Almutairi
- Maxillofacial Surgery and Diagnostic Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (M.A.); (M.A.)
| | - Turki S. AlQuwayz
- Prince Sultan Military Medical Center, Riyadh 11159, Saudi Arabia; (N.A.); (T.S.A.)
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Kamara RZ, Kamara IF, Moses F, Kanu JS, Kallon C, Kabba M, Moffett DB, Fofanah BD, Margao S, Kamara MN, Moiwo MM, Kpagoi SSTK, Tweya HM, Kumar AMV, Terry RF. Improvement in Infection Prevention and Control Compliance at the Three Tertiary Hospitals of Sierra Leone following an Operational Research Study. Trop Med Infect Dis 2023; 8:378. [PMID: 37505674 PMCID: PMC10385074 DOI: 10.3390/tropicalmed8070378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Abstract
Implementing infection prevention and control (IPC) programmes in line with the World Health Organization's (WHO) eight core components has been challenging in Sierra Leone. In 2021, a baseline study found that IPC compliance in three tertiary hospitals was sub-optimal. We aimed to measure the change in IPC compliance and describe recommended actions at these hospitals in 2023. This was a 'before and after' observational study using two routine cross-sectional assessments of IPC compliance using the WHO IPC Assessment Framework tool. IPC compliance was graded as inadequate (0-200), basic (201-400), intermediate (401-600), and advanced (601-800). The overall compliance scores for each hospital showed an improvement from 'Basic' in 2021 to 'Intermediate' in 2023, with a percentage increase in scores of 16.9%, 18.7%, and 26.9% in these hospitals. There was improved compliance in all core components, with the majority in the 'Intermediate' level for each hospital IPC programme. Recommended actions including the training of healthcare workers and revision of IPC guidelines were undertaken, but a dedicated IPC budget and healthcare-associated infection surveillance remained as gaps in 2023. Operational research is valuable in monitoring and improving IPC programme implementation. To reach the 'Advanced' level, these hospitals should establish a dedicated IPC budget and develop long-term implementation plans.
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Affiliation(s)
- Rugiatu Z. Kamara
- United States Centers for Disease Control and Prevention Country Office, Emergency Operation Centre, Wilkinson Road, Freetown 00232, Sierra Leone;
| | - Ibrahim Franklyn Kamara
- World Health Organization Country Office, 21 A-B Riverside Drive, Off Kingharman Road, Freetown 00232, Sierra Leone; (I.F.K.); (B.D.F.)
| | - Francis Moses
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Joseph Sam Kanu
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
- College of Medicine and Allied Health Science, University of Sierra Leone, Freetown 00232, Sierra Leone
| | - Christiana Kallon
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Mustapha Kabba
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Daphne B. Moffett
- United States Centers for Disease Control and Prevention Country Office, Emergency Operation Centre, Wilkinson Road, Freetown 00232, Sierra Leone;
| | - Bobson Derrick Fofanah
- World Health Organization Country Office, 21 A-B Riverside Drive, Off Kingharman Road, Freetown 00232, Sierra Leone; (I.F.K.); (B.D.F.)
| | - Senesie Margao
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Matilda N. Kamara
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Matilda Mattu Moiwo
- Ministry of Defence, Republic of Sierra Leone Armed Forces, Freetown 00232, Sierra Leone;
| | - Satta S. T. K. Kpagoi
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Hannock M. Tweya
- Department of Global Health, University of Washington, Seattle, WA 98195, USA;
- International Training and Education for Health, Lilongwe P.O. Box 30369, Malawi
| | - Ajay M. V. Kumar
- International Union against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France;
- International Union against Tuberculosis and Lung Disease, South-East Asia Office, C-6, Qutub Institutional Area, New Delhi 110016, India
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to Be University), University Road, Deralakatte 75018, India
| | - Robert F. Terry
- The Special Program for Research and Training in Tropical Diseases (TDR), World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland;
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Zhang J, Yang L, Cao X, Ren Y, Han X, Zang S, Cai F, Xu L, Qin L, Zhang P, Cheng Y. Assessment of disaster preparedness and related impact factors among emergency nurses in tertiary hospitals: descriptive cross-sectional study from Henan Province of China. Front Public Health 2023; 11:1093959. [PMID: 37213610 PMCID: PMC10192630 DOI: 10.3389/fpubh.2023.1093959] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/10/2023] [Indexed: 05/23/2023] Open
Abstract
Background The aim of this study was to investigate the current state of disaster preparedness and to determine associated factors among emergency nurses from tertiary hospitals in Henan Province of China. Methods This multicenter descriptive cross-sectional study was conducted with emergency nurses from 48 tertiary hospitals in Henan Province of China between September 7, 2022-September 27, 2022. Data were collected through a self-designeds online questionnaire using the mainland China version of the Disaster Preparedness Evaluation Tool (DPET-MC). Descriptive analysis and multiple linear regression analysis were used to evaluate disaster preparedness and to determine factors affecting disaster preparedness, respectively. Results A total of 265 emergency nurses in this study displayed a moderate level of disaster preparedness with a mean item score of 4.24 out 6.0 on the DPET-MC questionnaire. Among the five dimensions of the DPET-MC, the mean item score for pre-disaster awareness was highest (5.17 ± 0.77), while that for disaster management (3.68 ± 1.36) was the lowest. Female gender (B = -9.638, p = 0.046) and married status (B = -8.618, p = 0.038) were negatively correlated with the levels of disaster preparedness. Five factors positively correlated with the levels of disaster preparedness included having attended in the theoretical knowledge training of disaster nursing since work (B = 8.937, p = 0.043), having experienced the disaster response (B = 8.280, p = 0.036), having participated in the disaster rescue simulation exercise (B = 8.929, p = 0.039), having participated in the disaster relief training (B = 11.515, p = 0.025), as well as having participated in the training of disaster nursing specialist nurse (B = 16.101, p = 0.002). The explanatory power of these factors was 26.5%. Conclusion Emergency nurses in Henan Province of China need more education in all areas of disaster preparedness, especially disaster management, which needs to be incorporated into nursing education, including formal and ongoing education. Besides, blended learning approach with simulation-based training and disaster nursing specialist nurse training should be considered as novel ways to improve disaster preparedness for emergency nurses in mainland China.
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Affiliation(s)
- Jiange Zhang
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou, China
| | - Lei Yang
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Xue Cao
- Department of Rheumatology and Immunology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Ying Ren
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xu Han
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou, China
| | - Shuting Zang
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou, China
| | - Fangfang Cai
- Henan University School of Nursing and Health, Zhengzhou, China
| | - Lijun Xu
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Lijie Qin
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Peirong Zhang
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
- *Correspondence: Peirong Zhang
| | - Yanwei Cheng
- Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
- Yanwei Cheng
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Yan M, Zhi M, Xu Y, Hu L, Liu Y. Inpatient Satisfaction with Nursing Care and Its Impact Factors in Chinese Tertiary Hospitals: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:16523. [PMID: 36554403 PMCID: PMC9778790 DOI: 10.3390/ijerph192416523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
AIMS To evaluate the level of patient satisfaction with nursing care in China's major tertiary hospitals, and to explore patient and hospital level factors associated with patient satisfaction, in order to provide policy implications for the evaluation and improvement of nursing care, toward a patient-centered healthcare system. BACKGROUND Patient satisfaction with nursing care has been designated as a key measure of the quality of nursing care and is one of the main focuses of the current healthcare improvement campaign in China. METHODS We participated in the 2021 China National Patient Survey and designed and administered a survey instrument with five domains, to evaluate patient satisfaction with nursing care among 24,971 inpatients from 143 tertiary hospitals across 31 provinces in China. Descriptive analysis and binary logistic regressions were utilized to assess the level of satisfaction and identify key factors related to nursing satisfaction. RESULTS The overall satisfaction level is high, but satisfaction with health guidance is relatively low. Patients' sociodemographic characteristics, including age, income, and education, are significantly associated with their satisfaction. Hospital characteristics, such as geographic location, type, and nurse-to-doctor ratio, significantly impact inpatient satisfaction with nursing care. Patients of hospitals in the eastern region, general hospitals, and hospitals with higher nurse-to-doctor ratios are more satisfied with nursing care. CONCLUSION More attention should be paid to equitably allocating healthcare resources among different regions, improving the management and competence of non-general hospitals, and strengthening the recruitment and retention of the nursing workforce. Moreover, patient characteristics should be considered when evaluating patient satisfaction across hospitals. Patient and Public Contribution: These findings will help us better understand patients' satisfaction regarding nursing care in Chinese tertiary hospitals and develop targeted interventions, to establish a patient-centered healthcare system.
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Affiliation(s)
| | | | | | - Linlin Hu
- Correspondence: (L.H.); (Y.L.); Tel.: +86-13661229049 (L.H.); +86-13522592907 (Y.L.)
| | - Yuanli Liu
- Correspondence: (L.H.); (Y.L.); Tel.: +86-13661229049 (L.H.); +86-13522592907 (Y.L.)
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Nassar H, Abu-Farha R, Barakat M, Alefishat E. Antimicrobial Stewardship from Health Professionals' Perspective: Awareness, Barriers, and Level of Implementation of the Program. Antibiotics (Basel) 2022; 11:99. [PMID: 35052979 PMCID: PMC8773352 DOI: 10.3390/antibiotics11010099] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
This study aimed to evaluate health professionals' perceptions regarding the level of implementation of the Antimicrobials Stewardship (AMS) programs in Jordanian tertiary hospitals and to assess the perceived barriers to its implementation. During this cross-sectional study, a total of 157 healthcare providers agreed to participate (response rate 96.3%). Participants were asked to complete an electronic survey after meeting them at their working sites. Only 43.9% of the healthcare providers (n = 69) reported having an AMS committee in their hospital settings. The results suggested that private hospitals have significantly better AMS implementation compared to public hospitals among four areas (p ≤ 0.05). Moreover, the results showed that the most widely available strategies to implement AMS were infectious disease/microbiology advice (n = 112, 71.3%), and treatment guidelines (n = 111, 70.7%). Additionally, the study revealed that the main barrier to AMS implementation was the lack of information technology support (n = 125, 79.6%). These findings could draw managers' attention to the importance of AMS and support the health care provider's practice of AMS in Jordanian tertiary hospitals by making the right decisions and the required modifications regarding the strategies needed for the implementation of AMS programs.
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Affiliation(s)
- Haya Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan; (H.N.); (R.A.-F.); (M.B.)
| | - Rana Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan; (H.N.); (R.A.-F.); (M.B.)
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan; (H.N.); (R.A.-F.); (M.B.)
| | - Eman Alefishat
- Department of Pharmacology, College of Medicine and Health Science, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan
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Boche B, Kebede O, Damessa M, Gudeta T, Wakjira D. Health Professionals' COVID-19 Vaccine Acceptance and Associated Factors in Tertiary Hospitals of South-West Ethiopia: A Multi-Center Cross- Sectional Study. Inquiry 2022; 59:469580221083181. [PMID: 35285341 PMCID: PMC8919101 DOI: 10.1177/00469580221083181] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Acceptance of the COVID-19 vaccine by health professionals highly influences the communities' decision to receive the vaccine, because health professionals are perceived to be a reliable source of health information. Hence, this study aimed at assessing COVID-19 vaccine acceptance and associated factors among health professionals in two tertiary hospitals in southwest Ethiopia. METHODS A cross-sectional study was conducted among 319 health professionals working in Jimma University Medical Center and Mizan-Tepi university teaching hospital, southwest Ethiopia, from June 30, 2021 to July 30, 2021. Data were collected by a structured self-administered questionnaire and analyzed by SPSS version 23. A multivariate logistic regression model was used to identify independent factors associated with health professionals' covid-19 vaccine acceptance. Variables with P-value < .25 on univariate analysis were candidates for multivariate logistic regression. Then, variables with P-value < .05 at 95% CI in multivariate logistics regression were considered statistically significant. RESULTS Of the total participants, 232 (72.73%) received COVID-19 vaccines. Among non-vaccinated health care professionals, 82 (94.3%) of them stated, worries about the safety and side effects of the vaccines, as the reason for non-acceptance. Factors such as, friends or families diagnosed with COVID-19 (AOR = .086; CI: 95%, .041-.18; P = .001), and attitudes and beliefs about COVID-19 and its vaccine (AOR = .129; CI: 95%, .037-.449; P = .001), were significantly associated with the acceptance of COVID-19 vaccine. CONCLUSION More than one-fourth of health professionals who did not accept COVID-19 vaccines require immediate intervention through awareness creation on the safety and adverse effects of the vaccine by the government and other stakeholders. Otherwise, the community may in large reject the vaccine as they trust health professionals.
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Affiliation(s)
- Bekele Boche
- Department of Social and Administrative Pharmacy, School of Pharmacy, Faculty of Health Sciences, 247532Jimma University, Jimma, Oromia, Ethiopia
| | - Oliyad Kebede
- Department of Social Pharmacy and Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, 145052Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Mekonnen Damessa
- Department of Clinical Pharmacy, School of Pharmacy, Faculty of Health Sciences, 247532Jimma University, Jimma, Oromia, Ethiopia
| | - Tadesse Gudeta
- Department of Social and Administrative Pharmacy, School of Pharmacy, Faculty of Health Sciences, 247532Jimma University, Jimma, Oromia, Ethiopia
| | - Diriba Wakjira
- School of Midwifery, Faculty of Health Sciences, 247532Jimma University, Jimma, Oromia, Ethiopia
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Zhu Y, Qiao Y, Dai R, Hu X, Li X. Trends and Patterns of Antibiotics Use in China's Urban Tertiary Hospitals, 2016-19. Front Pharmacol 2021; 12:757309. [PMID: 34803701 PMCID: PMC8595100 DOI: 10.3389/fphar.2021.757309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study aimed to identify the trends in antibiotics utilization and patients costs, evaluating the effect of the policy and exploring factors associated with the irrational use of antibiotics. Methods: Based on the Cooperation Project Database of Hospital Prescriptions, data were collected from 89 tertiary hospitals in nine cities in China during 2016-2019. The study sample consisted of prescription records with antibiotics for 3,422,710 outpatient and emergency visits and 26, 118, 436 inpatient hospitalizations. Results: For outpatients, the proportion of treated with antibiotics declined from 14.72 to 13.92% significantly (p < 0.01). The proportion of antibiotic costs for outpatients decreased from 5.79 to 4.45% significantly (p < 0.01). For emergency patients, the proportion of treated with antibiotics increased from 39.31 to 43.45% significantly (p < 0.01). The proportion of antibiotic costs for emergency patients decreased from 36.44 to 34.69%, with no significant change (p = 0.87). For inpatients, the proportion of treated with antibiotics increased from 23.82 to 27.25% significantly (p < 0.01). The proportion of antibiotic costs for outpatients decreased from 18.09 to 17.19% with no statistical significance (p = 0.89). Other β-lactam antibacterials (1,663.03 ten thousand DDD) far exceeded other antibiotics categories. Stablely ranked first, followed by Macrolides, lincosamide and streptogramins (965.74 ten thousand DDD), Quinolone antibacterials (710.42 ten thousand DDD), and β-lactam antibacterials, penicillins (497.01 ten thousand DDD). Conclusions: The proportion of treated with antibiotics for outpatients and inpatients meet the WHO standards. The antibiotics use varied by different survey areas, clinical departments, patient gender, patient age and antibiotics categories. More efforts should focus on improving the appropriateness of antibiotics use at the individual level.
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Affiliation(s)
- Yulei Zhu
- Office of Scientific Research, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Yang Qiao
- First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Rouli Dai
- Medical Office, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xin Hu
- Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application (Beijing Hospital), Beijing, China
| | - Xin Li
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
- Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Guinemer C, Boeker M, Fürstenau D, Poncette AS, Weiss B, Mörgeli R, Balzer F. Telemedicine in Intensive Care Units: Scoping Review. J Med Internet Res 2021; 23:e32264. [PMID: 34730547 PMCID: PMC8600441 DOI: 10.2196/32264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/03/2021] [Accepted: 09/18/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The role of telemedicine in intensive care has been increasing steadily. Tele-intensive care unit (ICU) interventions are varied and can be used in different levels of treatment, often with direct implications for the intensive care processes. Although a substantial body of primary and secondary literature has been published on the topic, there is a need for broadening the understanding of the organizational factors influencing the effectiveness of telemedical interventions in the ICU. OBJECTIVE This scoping review aims to provide a map of existing evidence on tele-ICU interventions, focusing on the analysis of the implementation context and identifying areas for further technological research. METHODS A research protocol outlining the method has been published in JMIR Research Protocols. This review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A core research team was assembled to provide feedback and discuss findings. RESULTS A total of 3019 results were retrieved. After screening, 25 studies were included in the final analysis. We were able to characterize the context of tele-ICU studies and identify three use cases for tele-ICU interventions. The first use case is extending coverage, which describes interventions aimed at extending the availability of intensive care capabilities. The second use case is improving compliance, which includes interventions targeted at improving patient safety, intensive care best practices, and quality of care. The third use case, facilitating transfer, describes telemedicine interventions targeted toward the management of patient transfers to or from the ICU. CONCLUSIONS The benefits of tele-ICU interventions have been well documented for centralized systems aimed at extending critical care capabilities in a community setting and improving care compliance in tertiary hospitals. No strong evidence has been found on the reduction of patient transfers following tele-ICU intervention. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19695.
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Affiliation(s)
- Camille Guinemer
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martin Boeker
- Intelligence and Informatics in Medicine, Medical Center rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Daniel Fürstenau
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Digitalization, Copenhagen Business School, Copenhagen, Denmark
| | - Akira-Sebastian Poncette
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Björn Weiss
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rudolf Mörgeli
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Felix Balzer
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Qianqian Y, Chunhui L, Xun H, Anhua W, Yuhua C, Yaowang W, Pengcheng Z. Knowledge of occupational exposure to HIV among healthcare workers in college campus clinics and tertiary hospitals. AIDS Care 2021; 34:388-391. [PMID: 34554858 DOI: 10.1080/09540121.2021.1981815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
As the number of college students infected with the human immunodeficiency virus (HIV) has increased significantly in China, the risk of occupational exposure to HIV among healthcare workers (HCW) in college campus clinics has also increased. Our study aimed to evaluate the awareness of HCWs in terms of preventing occupational HIV exposure in college campus clinics compared with HCWs in tertiary hospitals. This cross-sectional study was conducted in nine provinces in China from September to October 2019 (10 college campus clinics, 7 tertiary hospitals). The study's response rate was recorded to be at 87.62% (184 of 210). The knowledge score of HIV among all HCWs was determined to be generally low (67.17 ± 11.17 points), and that of college campus clinics and tertiary hospitals showed no significant difference (66.36 ± 10.36 vs. 67.63 ± 11.61 points, P=0.463). Overall, HCWs in both college campus clinics and tertiary hospitals showed inadequate knowledge regarding occupational HIV exposure. Training for the prevention of occupational HIV exposure should be strengthened in both medical institutions.
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Affiliation(s)
- Ye Qianqian
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Li Chunhui
- Infection Control Center, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Huang Xun
- Infection Control Center, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Wu Anhua
- Infection Control Center, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Chen Yuhua
- Hunan Xiangya Medical Journal Limited Company, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Wang Yaowang
- Infection Control Center, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Zhou Pengcheng
- Infection Control Center, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Department of Infectious Diseases and Infection Control Center, The third Xiangya Hospital, Central South University, Changsha, People's Republic of China
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Seo KD, Kang MJ, Lee JK, Suh SH, Lee KY. Mechanical thrombectomy reduces the gap in treatment outcomes of ischemic stroke between hospital levels of care: analysis of a Korean nationwide data. Ann Transl Med 2021; 9:1227. [PMID: 34532364 PMCID: PMC8421926 DOI: 10.21037/atm-21-2342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/25/2021] [Indexed: 11/06/2022]
Abstract
Background Mechanical thrombectomy (MT) of ischemic stroke was demonstrated to be effective in clinical trials and was reported to have favorable outcomes in real clinical settings since 2015. We aimed to determine the national trends of MT and compare the outcomes between the different levels of treating hospital. Methods We obtained data from the nationwide database from 2008 to 2017. Patients with ischemic stroke who received MT were identified using the International Classification of Disease Codes. Good outcome was defined as discharge to home, and a poor outcome was defined as cerebral hemorrhage, physical disability, or death. The study period was divided into three (off-label MT, transitional, MT period). Hospital groups where MT was performed were divided into tertiary and non-tertiary hospitals. Results In MT period, 47.0% of the MT procedures were performed in non-tertiary hospitals compared with 36.1% in off-label MT period. Comparison of the 3-month mortality between patients who were treated in tertiary vs. non-tertiary hospitals revealed significant lower mortality in tertiary hospital through all period. The incidence of cerebral hemorrhage and physical disability did not differ between hospital groups. However, the percentage of patients discharged home was 41.4% for tertiary hospitals and 42.4% for non-tertiary hospitals, which was not statistically different in MT period (P=0.4671). Conclusions Analysis of the nationwide data confirmed that the extent of increase in MT was higher in non-tertiary hospitals than tertiary hospitals. In addition, no significant difference was revealed in the number of favorable clinical outcome between the hospital groups during MT period.
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Affiliation(s)
- Kwon-Duk Seo
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Min Jin Kang
- Institute of Health Insurance and Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jae Kwang Lee
- Institute of Health Insurance and Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Sang Hyun Suh
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung-Yul Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Ni Z, Jia J, Cui L, Zhou S, Wang X. The Impact of China's Zero Markup Drug Policy on Hospitalization Expenses for Inpatients in Tertiary Public Hospitals: Evidence Based on Quantile Difference-in-Difference Models. Healthcare (Basel) 2021; 9:908. [PMID: 34356286 DOI: 10.3390/healthcare9070908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: The aim of this study was to determine the impact of the Zero Markup drug (ZMD) policy on hospitalization expenses for inpatients in tertiary Chinese hospitals. Methods: Using the administrative data from hospital electronic health records (EHRs) between 2015 and 2017, we implemented the quantile difference-in-differences (QDID) estimators to evaluate the impact of the ZMD policy on hospitalization expenses while controlling for patient-level and hospital-level characteristics. Results: According to the QDID models, the introduction of ZMD policy significantly induced lower drug costs for all inpatients especially at the 50th (-USD 507.84 (SE = USD 90.91), 75th (-USD 844.77 (SE = USD 149.70), and 90th (-USD 1400.00 (SE = USD 209.97)) percentiles of the overall distributions. However, the total hospitalization, diagnostic, treatment, material and services expenses for inpatients were significantly higher for the treated group than the control group. This tendency was more pronounced for inpatients in tertiary hospitals with lower expenses (in the 10th, 25th and 50th percentiles). Conclusion: The implementation of ZMD policy alone may not be enough to change the medical service providers’ profit-driven behavior. The targeted supervision of hospital costs by the Chinese health administration department should be strengthened to avoid unreasonable hospital charges.
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Weir TB, Usmani MF, Camacho J, Sokolow M, Bruckner J, Jazini E, Jauregui JJ, Gopinath R, Sansur C, Davis R, Koh EY, Banagan KE, Gelb DE, Buraimoh K, Ludwig SC. Effect of Surgical Setting on Cost and Hospital Reported Outcomes for Single-Level Anterior Cervical Discectomy and Fusion. Int J Spine Surg 2021; 15:701-709. [PMID: 34266936 DOI: 10.14444/8092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Hospitals seek to reduce costs and improve patient outcomes by decreasing length of stay (LOS), 30-day all-cause readmissions, and preventable complications. We evaluated hospital-reported outcome measures for elective single-level anterior cervical discectomy and fusions (ACDFs) between tertiary (TH) and community hospitals (CH) to determine location-based differences in complications, LOS, and overall costs. METHODS Patients undergoing elective single-level ACDF in a 1-year period were retrospectively reviewed from a physician-driven database from a single medical system consisting of 1 TH and 4 CHs. Adult patients who underwent elective single-level ACDF were included. Patients with trauma, tumor, prior cervical surgery, and infection were excluded. Outcomes measures included all-cause 30-day readmissions, preventable complications, LOS, and hospital costs. RESULTS A total of 301 patients (60 TH, 241 CH) were included. CHs had longer LOS (1.25 ± 0.50 versus 1.08 ± 0.28 days, P = .01). There were no differences in complication and readmission rates between hospital settings. CH, orthopaedic subspecialty, female sex, and myelopathy were predictors for longer LOS. Overall, costs at the TH were significantly higher than at CHs ($17 171 versus $11 737; Δ$ = 5434 ± 3996; P < .0001). For CHs, the total costs of drugs, rooms, supplies, and therapy were significantly higher than at the TH. TH status, orthopaedic subspecialty, and myelopathy were associated with higher costs. CONCLUSION Patients undergoing single-level ACDFs at CHs had longer LOS, but similar complications and readmission rates as those at the TH. However, cost of ACDF was 1.5 times greater in the TH. To improve patient outcomes, optimize value, and reduce hospital costs, modifiable factors for elective ACDFs should be evaluated. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Tristan B Weir
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - M Farooq Usmani
- Department of General Surgery, Eastern Virginia Medical School, Norfolk, Virginia
| | - Jael Camacho
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Michael Sokolow
- Quality Management Division, University of Maryland Medical System, Baltimore, Maryland
| | - Jacob Bruckner
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Julio J Jauregui
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Rohan Gopinath
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Charles Sansur
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland
| | - Randy Davis
- Department of Orthopaedics, University of Maryland Baltimore Washington Medical Center, Baltimore, Maryland
| | - Eugene Y Koh
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Kelley E Banagan
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Daniel E Gelb
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Kendall Buraimoh
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steven C Ludwig
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
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Wang L, Ma X, He H, Su L, Guo Y, Shan G, Wang Y, Zhou X, Liu D, Long Y. Compliance with the Surviving Sepsis Campaign guideline 1-hour bundle for septic shock in China in 2018. Ann Transl Med 2021; 9:278. [PMID: 33708905 PMCID: PMC7944336 DOI: 10.21037/atm-20-5429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Effective implementation of the Surviving Sepsis Campaign (SSC) guidelines has effectively reduced sepsis mortality. The effects of hospital level and ownership on compliance with the SSC guideline 1-hour bundle (Cssc-1h) are unclear. We designed this study to identify the differences in Cssc-1h between secondary and tertiary hospitals, public hospitals, and private hospitals. Methods In this survey, 1,420 hospitals were enrolled, including 864 public tertiary hospitals, 482 public secondary hospitals, 34 private tertiary hospitals, 40 private secondary hospitals. The data were collected between January 1, 2018, and December 31, 2018. The outcomes were adherence to the SSC guidelines (2018 update). Monitoring indicators include 1-hour bundle and its sub-indicators (measure lactate level and remeasure lactate level if initial lactate is >2 mmol/L, obtain blood cultures before administering antibiotics, administer broad-spectrum antibiotics, begin rapid administration of 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L, apply vasopressor if hypotension is present during or after fluid resuscitation to maintain a mean arterial pressure ≥65 mmHg). Every monitoring indicator was stratified by the median, which is defined as 1 if greater than or equal to the median, and 0 if not. Results Cssc-1h in tertiary hospitals was significantly higher than in secondary hospitals (P<0.05). However, there were no statistical differences in Cssc-1h in public hospitals and private hospitals. Conclusions Cssc-1h in tertiary hospitals was significantly better than that in secondary hospitals. There is an urgent need to improve Cssc-1h in secondary hospitals. The increase in private hospitals will not reduce Cssc-1h.
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Affiliation(s)
- Lu Wang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xudong Ma
- Department of Medical Administration, National Health Commission of the People's Republic of China, Beijing, China
| | - Huaiwu He
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Longxiang Su
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yanhong Guo
- Department of Medical Administration, National Health Commission of the People's Republic of China, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences (CAMS) and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ye Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences (CAMS) and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xiang Zhou
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Dawei Liu
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yun Long
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Zhou F, Xu C, Sun Y, Meng X. Influencing Factors of Outpatients' Satisfaction in China a Cross-Sectional Study of 16 Public Tertiary Hospitals. Patient Prefer Adherence 2021; 15:1243-1258. [PMID: 34135576 PMCID: PMC8200138 DOI: 10.2147/ppa.s311786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study aimed to analyze the status of patient satisfaction in outpatients of tertiary hospitals and the factors affecting patient satisfaction, in order to provide a scientific basis for improving patient satisfaction. METHODS A total of 6480 surveys of outpatients were conducted by a cross-sectional study in 16 tertiary hospitals in the Zhejiang province of China. The main contents of the survey were the basic characteristics of patients. Statistical description, single-factor analysis and binary logistic regression analysis were used to screen influencing factors. RESULTS Results of this study showed that the total satisfaction score of outpatients was 87.13±13.47, and higher scored factors in the survey factors were nursing level, the convenience of registration and convenience of appointment diagnosis and treatment. The factors with lower scores were treatment effect, environmental sanitation and comfort and other staffs' attitudes. Hospital managers should pay attention to the improvement of treatment level, environmental sanitation and comfort and other staffs' attitudes. CONCLUSION In the process of serving outpatients, doctors should pay more attention to patients who are male, 31-45 years old or over 60 years old, permanent residents, from public institutions, possessed postgraduate education, without medical insurance, and who visiting paediatrics and Chinese medicine hospitals.
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Affiliation(s)
- Fangwei Zhou
- Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Caiming Xu
- Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Yanxiang Sun
- Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Xuehui Meng
- Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
- Correspondence: Xuehui Meng Humanities and Management School of Zhejiang Chinese Medical University, 548# Binwen Road, Binjiang District, Hangzhou, 310051, People’s Republic of ChinaTel/Fax +86 571-86633056 Email
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Chukwubuike KE, Ozor I, Enyi N. Prevalence and pattern of birth defects in the two tertiary hospitals in Enugu, South East Nigeria: A hospital-based observational study. Afr J Paediatr Surg 2020; 17:85-89. [PMID: 33342840 PMCID: PMC8051625 DOI: 10.4103/ajps.ajps_59_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Birth defects have medical, surgical and aesthetic consequences. The impact of birth defects is particularly severe in low-income countries where health-care resources are limited. AIMS AND OBJECTIVES The aim of this study was to determine the prevalence and types of birth defects in live newborns delivered at the two tertiary hospitals in Enugu, South East Nigeria. MATERIALS AND METHODS This was a hospital-based observational study carried out on neonates delivered in the maternity units of the University of Nigeria Teaching Hospital Ituku/Ozalla and Enugu State University Teaching Hospital Parklane, Enugu during the periods of January 2015 and December 2018. All the live-born babies born in the two hospitals during this period were recruited into the study. The neonates were examined by a paediatrician for the presence of birth defects. The birth defects were classified according to the system involved and also into major and minor. RESULTS During the study period, 9492 babies were born, of which 166 had birth defects, which gave a prevalence of 1.75%. The predominant system affected by birth defects was the musculoskeletal system (45.2%) followed by the central nervous system (34.9%), urogenital system (10.8%) and gastrointestinal tract (9%). 13 (7.8%) patients had their birth defects diagnosed prenatally during the maternal ultrasound scan. Fifteen (9%) and 13 (7.8%) mothers of the neonates who had birth defects were diabetics and hypertensives, respectively. Most of the neonates were delivered vaginally. CONCLUSION Birth defects are not uncommon. This study showed a prevalence of 1.75% in the two tertiary hospitals in Enugu, South East Nigeria. The most commonly affected system was the musculoskeletal system.
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Affiliation(s)
- Kevin Emeka Chukwubuike
- Department of Surgery, Paediatric Surgery Unit, Enugu State University Teaching Hospital, Enugu, Enugu State, Nigeria
| | - Ignatius Ozor
- Department of Surgery, Neurosurgery Unit, Enugu State University Teaching Hospital, Enugu, Enugu State, Nigeria
| | - Nnenna Enyi
- Department of Anatomy, Enugu State University, Enugu, Enugu State, Nigeria
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Hu L, Ding H, Hu G, Wang Z, Liu S, Liu Y. How Perceived Quality of Care Affects Outpatient Satisfaction in China: A Cross-Sectional Study of 136 Tertiary Hospitals. Inquiry 2020; 56:46958019895397. [PMID: 31884866 PMCID: PMC6937535 DOI: 10.1177/0046958019895397] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Public hospitals are integral components of China’s health care system, and improving quality of care and patient satisfaction has become of greater concern for these hospitals. The aim of this study was to assess outpatient satisfaction with tertiary hospitals and to explore the roles played by patient perceptions of specific aspects of care in overall satisfaction. We designed a questionnaire to assess patient satisfaction and perceived quality of care using a 5-point Likert scale. The survey was conducted in 136 hospitals across 31 provinces of China, and a total of 28 822 patients were interviewed. For statistical analysis, we conducted descriptive analysis, nonparameter tests, Spearman’s rank correlation, and multivariate logistic regression. Stepwise logistic regression identified 12 variables of patient perception associated with overall satisfaction. Patients’ perception of physicians’ technical skills had the strongest association with satisfaction, followed by inquiries into medical history/current situation and availability of elevators. Other determinants included a feeling of respect, timely guidance when needed, and explanation of treatments and medications. Waiting times and hospital environment factors, such as cleanliness of bathrooms and drinking water supply, were also associated with patient satisfaction in a slightly less powerful way. This study revealed that Chinese outpatient satisfaction with tertiary hospitals was relatively high. As determinants of satisfaction, patients valued professional medical care and respect from the medical staff more than nonmedical aspects of care. This implied that Chinese hospitals should ensure quality of medical care and sufficient communication with patients, as well as pay more attention to humanism in health care. In the meantime, improvements should be made to nonmedical aspects of care, especially waiting times and physical environment. These findings are also useful for the rest of the low- and middle-income world in improving patient satisfaction.
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Affiliation(s)
- Linlin Hu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | | | - Guangyu Hu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | - Zijuan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | - Shiyang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | - Yuanli Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
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Maphumulo WT, Bhengu BR. Perceptions of professional nurses regarding the National Core Standards tool in tertiary hospitals in KwaZulu-Natal. Curationis 2020; 43:e1-e9. [PMID: 32242424 PMCID: PMC7203207 DOI: 10.4102/curationis.v43i1.1971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/09/2019] [Accepted: 10/29/2019] [Indexed: 11/14/2022] Open
Abstract
Background Internationally, healthcare providers share a common goal of providing safe and high-quality care to every patient. In South Africa, the National Core Standards (NCS) tool was introduced to improve the quality of healthcare delivery. Objectives This article is aimed to determine the perceptions of nurses concerning the use of NCS as a tool to measure quality care delivery in tertiary hospitals in KwaZulu-Natal. Method This was a cross-sectional descriptive survey, where a purposive sampling technique was used to select hospitals. Six strata of departments were selected using simple stratified sampling. In each stratum, every second ward was selected from the provided list of wards using a systematic random sampling. The population of professional nurses in selected departments was 3050, from which 437 participants were selected by systematic random sampling. The collected data were analysed using Statistical Package for the Social Sciences (SPSS®) version 25. Results The study indicated that 53.5% respondents believed that the NCS tool allows them to identify areas of weakness, pointing to risks in basic human rights. However, only 49.7% respondents believed that the NCS tool allows staff inputs to identify relevant innovations. The study recommends improvement in the organisational climate and adoption of strategies that add value to patient care. Conclusion Professional nurses perceived the NCS tool as a good tool for improving quality of healthcare delivery, but there is a need to improve environmental practice and involvement of all healthcare establishments to increase its effectiveness.
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Affiliation(s)
- Winnie T Maphumulo
- Department of Health, Faculty of Nursing, University of KwaZulu-Natal, Durban.
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Ke L, Chen J, Jia J, Ke P, Chen X, Mao Z, Liu B. Outpatients' Satisfaction in the Context of 10 Years of Health-Care Reform: A Cross-Sectional Study of Tertiary Hospitals in Shiyan, China. Patient Prefer Adherence 2020; 14:191-202. [PMID: 32099337 PMCID: PMC6996206 DOI: 10.2147/ppa.s233472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/13/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study aimed to evaluate outpatient satisfaction in tertiary hospitals in Shiyan, China, to predict which items had highest priorities for outpatient satisfaction, and to identify population groups on which the medical institutions should focus. PATIENTS AND METHODS A cross-sectional survey was conducted at three tertiary hospitals in Shiyan city of China, from March to June 2018. An 18-item outpatient satisfaction questionnaire was applied. We conducted matrix analysis to describe the distribution of satisfaction score and the degree of influence of the items. Outpatient satisfaction was classified into the lowest and highest groups according to the 80/20 rule. Logistic regression model was used to identify demographic factors which might influence outpatient satisfaction. RESULTS A total of 2109 valid questionnaires were completed. The "waiting time", "diagnosis and treatment time" and "medical charges" items showed relatively higher degrees of influence but earned lower levels of satisfaction. Outpatients with a college level or above educational background (AOR=1.36, 95% CI=1.03-1.79) and with a family per-capita monthly income (FPMI)>7000 CNY (AOR=3.30, 95% CI=1.60-6.81) were more prevalent in the lowest satisfaction group. Outpatients with college level or above education background (COR=0.77, 95% CI=0.60-0.99), FPMI of 3001-5000 CNY (AOR=0.76, 95% CI=0.60-0.96), non-local residents (AOR=1.48, 95% CI=1.07-2.04), and urban workers with medical insurance (AOR=1.74, 95% CI=1.27-2.39) were more prevalent in the highest satisfaction group. CONCLUSION The survey indicated that "long time to wait for treatment", "short treatment time", and "medical charges too expensive" were the top three aspects that need to be improved with priority by medical institutions. Education level, income level, residence and type of health insurance were the sociodemographic characteristics that significantly affect the outpatient satisfaction in tertiary hospitals. These factors need to be paid more attention by healthcare professionals to improve the patients' satisfaction.
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Affiliation(s)
- Li Ke
- School of Nursing, Hubei University of Medicine, Shiyan, People’s Republic of China
- Global Health Institute, Wuhan University, Wuhan, People’s Republic of China
| | - Jingshu Chen
- School of Public Health and Management, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Jia Jia
- School of Nursing, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Pan Ke
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Xueqin Chen
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Zongfu Mao
- Global Health Institute, Wuhan University, Wuhan, People’s Republic of China
| | - Bing Liu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, People’s Republic of China
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, People’s Republic of China
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Liu H, Liu J, Chen M, Tan X, Zheng T, Kang Z, Gao L, Jiao M, Ning N, Liang L, Wu Q, Hao Y. Sleep problems of healthcare workers in tertiary hospital and influencing factors identified through a multilevel analysis: a cross-sectional study in China. BMJ Open 2019; 9:e032239. [PMID: 31888927 PMCID: PMC6937086 DOI: 10.1136/bmjopen-2019-032239] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 12/02/2019] [Accepted: 12/05/2019] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Sleep problems are common among healthcare workers, especially among those who work in tertiary hospitals; however, studies focusing on healthcare workers in tertiary hospitals in China are limited. Therefore, we aimed to examine the prevalence of sleep problems among tertiary hospital employees in China and identify associated factors. DESIGN Cross-sectional questionnaire survey study. SETTING The study was conducted in 317 departments at 33 tertiary hospitals in the Heilongjiang Province, China. PARTICIPANTS The study included a representative sample of 4007 healthcare workers, including clinicians, medical technicians and office workers, who were selected using a multistage cluster sampling method. Ultimately, 3810 participants completed valid questionnaires, yielding a response rate of 95%. PRIMARY AND SECONDARY OUTCOME MEASURES Participants completed a structured questionnaire which collected data regarding demographics, sleep problems, employment, chronic pain and health-related behaviours. A two-level logistic regression model was constructed to examine determinants of sleep problems. RESULTS We found that nearly half of the respondents reported experiencing sleep problems. The two-level logistic model suggested a positive association of sleep problems with headache (OR=2.64, 95% CI=2.27 to 3.07), working hours (OR=1.41, 95% CI=1.20 to 1.66) and night shifts (OR=1.43, 95% CI=1.21 to 1.69). In contrast, regular diet (OR=0.44, 95% CI=0.36 to 0.53) and exercise (OR=0.65, 95% CI=0.53 to 0.80) protected the study population against sleep problems. CONCLUSIONS We found that sleep problems are prominent among tertiary hospital employees in China. The risk factor most strongly associated with sleep problems was headaches. To alleviate sleep problems in this population, medical institutions and health policy makers should establish reasonable working schedules and night-shift work systems, while the healthcare workers themselves should pay attention to their chronic pain problems and engage in regular diet and exercise.
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Affiliation(s)
- Huan Liu
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Jingjing Liu
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Mingxi Chen
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Xiao Tan
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Tong Zheng
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Zheng Kang
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Lijun Gao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Mingli Jiao
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, China
| | - Ning Ning
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Libo Liang
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Yanhua Hao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
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Bashir A, Garba I, Aliero AA, Kibiya A, Abubakar MH, Ntulume I, Sarkinfada F, Ezera A. Superbugs-related prolonged admissions in three tertiary hospitals, Kano State, Nigeria. Pan Afr Med J 2019; 32:166. [PMID: 31303935 PMCID: PMC6607235 DOI: 10.11604/pamj.2019.32.166.18481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/24/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction Superbugs are pathogenic micro-organism and especially a bacterium that has developed resistance to the medications normally used against it. As the superbug family increases, the need for appropriate diagnostic, treatment, prevention and control strategies cannot be over emphasized. Therefore, this work determined the distribution of superbug bacteria among patients on prolonged hospital admissions in three tertiary hospitals of Kano state, Nigeria. Methods A descriptive cross sectional study was undertaken among 401 patients from medical, surgery, orthopedic and burn centre wards in a three tertiary hospitals in Kano state. A sample collected comprises wound/pus, urine, urine catheter and nasal intubation and were analysed using standard microbiological methods for Acinetobacter spp and other related nosocomial bacterial pathogens. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results One hundred and thirty eight (138) isolates were recovered, from the studied participants. More than 80% of the nosocomial infections (NIs) were caused by Gram-negative bacteria, predominantly Escherichia coli, Klebseilla spp, Proteus spp, Pseudomona spp and Acinetobacter spp. In-vitro antibiotic susceptibility test revealed that acinetobacter were 100% resistant to amoxicillin, co-trimoxazole, perfloxacin and imipenem. Conclusion Superbugs (Acinetobacter species) significantly contributed to delayed hospital admissions through observed 100% resistance to used antibiotics. The healthcare managers of these hospitals and the ministry of health need to take measures against this resistant bacteria (Acinetobacter spp) especially on prescribing antibiotics that showed 100% resistant from these studied hospitals.
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Affiliation(s)
- Alkali Bashir
- Department of Science Laboratory Technology, School of Technology Kano State Polytechnic, Kano, Nigeria.,Department of Microbiology and Immunology, Faculty of Biomedical Sciences Kampala International University Western Campus, Ishaka Bushenyi, Uganda
| | - Iliyasu Garba
- Department of Medicine, Faculty of Clinical Sciences, Bayero University, Kano State, Nigeria
| | - Adamu Almustapha Aliero
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences Kampala International University Western Campus, Ishaka Bushenyi, Uganda.,Department of Microbiology, Faculty of Life Sciences, Kebbi State University of Science and Technology Aliero, Kebbi State, Nigeria
| | - Abdurrazak Kibiya
- Department of Infection Control, Aminu Kano Teaching Hospital, Kano State Nigeria
| | - Muhammad Hassan Abubakar
- Microbiology Unit, Murtala Muhammed Specialist Hospital, Hospital Management Board, Kano State, Nigeria
| | - Ibrahim Ntulume
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences Kampala International University Western Campus, Ishaka Bushenyi, Uganda
| | - Faruk Sarkinfada
- Department of Medical Microbiology, College of Health Sciences, Bayero University, Kano State, Nigeria.,Department of Health and Medical Sciences Khawarizimi International College, Abu Dhabi, United Arab Emirates
| | - Agwu Ezera
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences Kampala International University Western Campus, Ishaka Bushenyi, Uganda.,Medical Microbiology and Immunology Unit, Department of Biomedical Sciences, Kabale University School of Medicine, Kabale, Uganda
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Odumodu IJ, Olufunlayo TF, Ogunnowo BE, Kalu ME. Satisfaction With Services Among Attendees of Physiotherapy Outpatient Clinics in Tertiary Hospitals in Lagos State. J Patient Exp 2019; 7:468-478. [PMID: 33062866 PMCID: PMC7534107 DOI: 10.1177/2374373519847370] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: To determine outpatients’ satisfaction with physiotherapy services in tertiary hospitals in Lagos State, Nigeria. Method: This cross-sectional study utilized a simple random sampling method to recruit 284 participants. Participants responded to a 2-part structured questionnaire with 33-items on a 5-point Likert-type scale. Participants were asked questions about their satisfaction with physiotherapy services, staff attitudes, and the accessibility of outpatient physiotherapy clinics. Data were analyzed using descriptive analysis and χ2. Results: About 28.8% of the participants were satisfied or very satisfied with the location of the outpatient physiotherapy clinics. The majority of the participants were satisfied or very satisfied with these physiotherapy services in maintaining privacy (86.2%), scheduling convenient clinic appointments (78.2%), prompt scheduling of the first physiotherapy clinic appointment (74.6%) and subsequent visits (78.9%), and providing a calm/relaxing atmosphere (90.1%). While 22.5% of the participants were satisfied or very satisfied with the waiting time in these physiotherapy clinics, 86.3% and 97.9% were satisfied or very satisfied with staff attitudes and the cost of the therapy, respectively. Almost all (97.9%) the participants reported being satisfied or very satisfied with their overall experience in the physiotherapy clinics. While there was an association between marital and educational status with overall satisfaction scores, age and gender showed no association. Conclusion: Our findings suggest that patients attending the outpatient physiotherapy clinics in tertiary hospitals in Lagos State, Nigeria, were satisfied or very satisfied with the domain that measured overall satisfaction. Strategies to reduce the waiting time in these physiotherapy clinics and to enhance physical accessibility of the physiotherapy clinics are encouraged.
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Affiliation(s)
| | | | - Babatunde Enitan Ogunnowo
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Michael Ebe Kalu
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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He W, Yao D, Hu Y, Dai H. Analysis of a pharmacist-led adverse drug event management model for pharmacovigilance in an academic medical center hospital in China. Ther Clin Risk Manag 2018; 14:2139-2147. [PMID: 30464487 PMCID: PMC6214595 DOI: 10.2147/tcrm.s178297] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Spontaneous reporting of adverse drug events (ADEs) has long been the cornerstone of pharmacovigilance. Medical institutions in China have been a major source of ADE case reports, but the proportion of reports from tertiary hospitals is low due to the serious underreporting of case reports. The same problem existed in the Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU). Objective In order to increase the number of ADE reports and promote hospital pharmacovigilance, SAHZU’s clinical pharmacists established a pharmacist-led ADE management model. The aim of this paper is to introduce this management model and explore the advantages and disadvantages of the model. Methods Pharmacist-led ADE management model was gradually formed from 2015 to 2017 in the SAHZU. This “pharmacist-led” model is reflected not only in the fact that clinical pharmacists are the main reporters of SAHZU’s ADEs but also in that they are the main groups to analyze and manage ADE and drug errors. The sources of ADEs reported by clinical pharmacists mainly include pharmacy rounds, ADE-related pharmacist consultations, centralized monitoring, ADE warning signal analysis, newly introduced drug evaluations, and drug safety research. Results A total of 533 ADEs were reported by SAHZU to China’s spontaneous reporting system (SRS) in 2017, while the data in 2012 was 177, with an increase by 201%. In 2012, the proportion of “new” and “serious” reports was 16.4%. The proportions during the period from 2015 to 2017 were 41.4%, 60.8%, and 52.2%, respectively, which were statistically significant compared with the proportion in 2012. The proportion of ADEs reported by clinical pharmacists during the period from 2014 to 2017 were 51.5%, 57.3%, 68.8%, and 90.8%, respectively, which were statistically significant compared with the proportion in 2013 (P<0.05). There was a correlation between the proportions of severe ADEs and the proportion of ADEs reported by clinical pharmacists (r=0.873, P=0.023). Four hundred eighty four ADE cases reported by clinical pharmacists to China’s SRS in 2017 were mainly found in rounds of clinical pharmacists (74.17% [359/484]). Conclusion The pharmacist-led pharmacovigilance working model significantly increased the quantity and quality of ADE reporting in SAHZU and promoted pharmacovigilance. This model is worth developing in Chinese tertiary hospitals and the following hospitals, where the physicians working there spend little time and energy on ADE reporting or the cost of physicians is high, while the clinical pharmacist team has strong professional skills.
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Affiliation(s)
- Wei He
- Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China,
| | - Difei Yao
- Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China,
| | - Yangmin Hu
- Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China,
| | - Haibin Dai
- Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China,
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Abstract
BACKGROUND More than a million people a year in the United States experience sepsis or sepsis-related complications, and sepsis remains the leading cause of in-hospital deaths. Unlike many other leading causes of in-hospital mortality, sepsis detection and treatment are not dependent on the presence of any technology or services that differ between tertiary and non-tertiary hospitals. OBJECTIVE To compare sepsis mortality rates between tertiary and non-tertiary hospitals in Washington State. METHODS A retrospective longitudinal, observational cohort study of 73 Washington State hospitals for 2010-2015 using data from a standardized state database of hospital abstracts. Abstract records on adult patients (n = 86,378) admitted through the emergency department (ED) from 2010 through 2015 in all tertiary (n = 7) and non-tertiary (n = 66) hospitals in Washington State. RESULTS The overall mortality rate for all hospitals was 6.5%. In the fully adjusted model, the odds ratio for in-hospital death was higher in non-tertiary hospitals compared with tertiary hospitals (odds ratio 1.25; 95% confidence interval 1.17-1.35; p < 0.001). CONCLUSIONS We observed higher sepsis mortality rates in non-tertiary hospitals, compared with tertiary hospitals. Because most patients who are treated for sepsis are treated outside of tertiary hospitals, and the number of patients treated for sepsis in non-tertiary hospitals seems to be rising, a better understanding of the cause or causes for this differential is crucial.
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Affiliation(s)
- Gail G Salvatierra
- School of Nursing, California State University San Marcos, San Marcos, California
| | - Bernice G Gulek
- College of Nursing, Washington State University, Spokane, Washington
| | - Baran Erdik
- College of Nursing, Washington State University, Spokane, Washington
| | - Deborah Bennett
- School of Nursing, California State University San Marcos, San Marcos, California
| | - Kenn B Daratha
- College of Nursing, Washington State University, Spokane, Washington; Providence Medical Research Center, Providence Sacred Heart Medical Center, Spokane, Washington; Department of Medical Education and Biomedical Informatics, University of Washington, Spokane and Seattle, Washington
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Yu W, Li M, Xue C, Wang J, Liu J, Chen H, Zhang L. Determinants and influencing mechanism of outpatient satisfaction: a survey on tertiary hospitals in the People's Republic of China. Patient Prefer Adherence 2016; 10:601-12. [PMID: 27143865 PMCID: PMC4844439 DOI: 10.2147/ppa.s104453] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Most patients in the People's Republic of China prefer tertiary hospitals when seeking medical services. The aim of this study was to assess outpatient satisfaction with tertiary hospitals in the People's Republic of China, test overall and subscale satisfaction, and explore whether sociodemographic characteristics lead to different degrees of satisfaction and whether subscale outpatient satisfaction contributes to overall satisfaction. METHODS A closed questionnaire was given out to investigate outpatients' sociodemographic characteristics, overall satisfaction, and various subtypes of satisfaction, and a 5-point Likert scale was employed to measure the degree of outpatient satisfaction. Descriptive analysis, Kruskal-Wallis test, Spearman's rank correlation coefficient, and logistic regression analysis were employed for statistical analysis. RESULTS Response rate was 92.48% (971/1,050). Outpatients' sociodemographic characteristics (including sex, age, occupation, monthly income, residence, and marital status) were related to various subtypes of satisfaction to varying degrees. Outpatients who were male, older, married, with low or middle incomes, living in Shanghai or other areas of the People's Republic of China, medical staff, or students were more satisfied with various subtypes of satisfaction than those without these characteristics. In further analyses, satisfaction with their medical needs being met by doctors had the strongest relation to overall satisfaction, followed by satisfaction with doctors' service attitudes, medical costs, waiting time, prescription, and diagnosis and treatment time. Satisfaction with environment had the weakest contribution to overall satisfaction. CONCLUSION This study gave some suggestions for tertiary hospitals in advanced areas of the People's Republic of China. Outpatient sociodemographic characteristics should be paid more attention by medical staff to improve the degree of satisfaction. Tertiary hospitals in the People's Republic of China should provide more support on the management of doctors, medical costs, and time.
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Affiliation(s)
- Wenya Yu
- Institute of Military Health Management, Second Military Medical University, Shanghai, People’s Republic of China
| | - Meina Li
- Institute of Military Health Management, Second Military Medical University, Shanghai, People’s Republic of China
| | - Chen Xue
- Institute of Military Health Management, Second Military Medical University, Shanghai, People’s Republic of China
| | - Jingrui Wang
- Institute of Military Health Management, Second Military Medical University, Shanghai, People’s Republic of China
| | - Jiazhen Liu
- Shanghai Sixth People’s Hospital, Shanghai, People’s Republic of China
| | - Haiping Chen
- Institute of Military Health Management, Second Military Medical University, Shanghai, People’s Republic of China
| | - Lulu Zhang
- Institute of Military Health Management, Second Military Medical University, Shanghai, People’s Republic of China
- Correspondence: Lulu Zhang, Institute of Military Health Management, Second Military Medical University, Shanghai 200433, People’s Republic of China, Tel +86 21 8187 1421, Fax +86 21 8187 1436, Email
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HARB H, HABIL I. Frequency and profile of induced abortions: hospital based study in tertiary hospitals in Egypt. J Prev Med Hyg 2013; 54:159-62. [PMID: 24783894 PMCID: PMC4718373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To determine the frequency and profile of induced abortions among hospitalized cases of abortions in three tertiary hospitals in Egypt. METHODS A total of 517 consecutive cases of abortions with complete records were enrolled from three tertiary hospitals in Egypt: two hospitals in Cairo and one hospital in Alexandria. A data extraction sheet was designed to extract the required information from the records. It included: File No., Age, marital status, occupation, parity, number of children, previous abortion, history of contraception, trial of induction for this abortion and management of abortion in the hospital. The World Health Organization (WHO) criteria of categorizing the abortion as possible, probable or certainly induced abortion was used for classification of abortion cases. RESULTS The proportion of classified induced abortions (certainly, probably and possibly induced abortions) was 30.6% in the total sample, being higher in Alexandria hospital (60.9%) compared to 14 and 19% in the other two hospitals respectively. Using the multiple logistic regression, the following factors were found independently related to induced abortions: Alexandria hospital (as proxy for residence), age > or = 30 years and having more than 2 children. CONCLUSION The current study revealed that about one third of hospitalized cases of abortion can be suspected of being induced. Induced abortion may be linked to elder age, higher number of children in the family and probably have geographical variation in Egypt.
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Affiliation(s)
| | - I. HABIL
- Department of Community, Occupational and Environmental Medicine, Ain-Shams Faculty of Medicine
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