Artykuły w czasopismach: „Hospital literature index”

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O, Yancy, i Ayuningtyas D. "Assessing Lean Thinking in Hospital: A Conceptual Framework". Community Medicine and Education Journal 5, nr 1 (1.11.2023): 373–80. http://dx.doi.org/10.37275/cmej.v5i1.411.

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Currently, the lean thinking system has not been implemented in all hospitals in Indonesia, where there is a lot of waste that affects the low quality of service and patient safety. The aims of this study is to develop a conceptual framework as a basis for quantitative assessment of lean thinking systems in Indonesian Hospitals to improve services, increase patient satisfaction and improve hospital quality. In preparing the conceptual framework for the quantitative assessment model of the lean thinking system index, a literature study was carried out through a literature search for journals from several countries and textbooks using the keywords "lean thinking" and "hospital". Literature review was conducted through several data sources, including ProQuest, Taylor & Francis, SpringerLink, and ScienceDirect. The types of literature were research articles with range of years 2012–2022. In total, 86 articles were obtained. The next stage includes screening, checking for duplication of articles and filtering articles based on inclusion criteria, so that there are 8 articles remaining. The 8 articles were reviewed to create a new conceptual framework. The result of the study is lean thinking model designed based on current conditions, expected future conditions, implements lean thinking, and maintains it with continuous improvement. This model is still in the early stages of research and forms the basis for the preparation of subsequent instruments. Currently the model is used in the hospital where the author works. The proposed conceptual framework can become the necessary basis for index development, which can then be used as a basis for further policy interventions to improve services in hospitals. In the end, this model can also improve quality and patient satisfaction.

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Shi, Jingyu, Xinyue Sun i Kai Meng. "Identifying organisational capability of hospitals amid the new healthcare reform in China: a Delphi study". BMJ Open 11, nr 1 (styczeń 2021): e042447. http://dx.doi.org/10.1136/bmjopen-2020-042447.

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ObjectiveSince China launched its nationwide systemic healthcare reform in 2009, policies such as the elimination of drug markups and the reform of medical insurance payments have forced some hospitals into a crisis threatening their survival. Both public and private hospitals have been building and strengthening their capacity to achieve sustainable development. However, the existing research has not provided a comprehensive evaluation tool required to support this effort. Therefore, this study develops an organisational capability evaluation index system to help public and private hospitals assess their current conditions.DesignThe Delphi method was used to construct a hospital organisational capability evaluation index system in conjunction with the boundary value method and an analytic hierarchical process. Then, a questionnaire survey was administered in 55 hospitals (32 non-profit and 23 for-profit hospitals), and Cronbach’s α and a factor analysis were used to verify the index system’s reliability and validity.Setting and participantsA literature review and semistructured interviews with 23 hospital managers and scholars clarified the definition of hospital organisational capability and formed an indicator pool. Additionally, 20 hospital directors were selected from public and private hospitals to participate in two rounds of the Delphi consultation.ResultsThe Delphi consultation resulted in an index system including 12 primary and 40 secondary indicators demonstrated to be reliable and valid. The three indicators with the largest weights were ‘regulation capability’ (0.251), ‘decision-making capability’ (0.121) and ‘executive capability’ (0.105).ConclusionThis study constructed an index system based on theoretical and practical considerations, and is expected to be applied to quantitatively evaluate the organisational capability of both public and private hospitals in China, and support their adaptation to external environmental changes.

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Subagja, Bayu, i Rosyidah Rosyidah. "Analysis of Patient Satisfaction at Outpatient Installation in the Hospitals: A Systematic Literature Review". Disease Prevention and Public Health Journal 17, nr 1 (19.02.2023): 109–15. http://dx.doi.org/10.12928/dpphj.v17i1.7394.

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Background: A hospital is a public facility that offers services to improve individual health status. One of the services offered by the hospital is an outpatient installation. As healthcare institutions, hospitals need to optimize their quality to ensure patient satisfaction with outpatient services. Method: This research is a systematic literature review that contains reviews of several studies using the PRISMA method. Related articles carry out by https://sinta.kemdikbud.go.id/journals/index/page. Inclusion criteria are the research articles must be published between the years 2018-2023, journals indexed by SINTA 1 or 2, and research subjects who were undergoing outpatient care at hospitals in Indonesia. There were 6 research articles that were close to the inclusion criteria and were determined to be the study material in this study. Results: The results of studies found that the quality of hospital services significantly influences the level of patient satisfaction. The dimensions of satisfaction including tangible, reliability, assurance, responsiveness, and empathy have a significant influence on patient satisfaction, so hospital management should be able to fulfill the five dimensions of satisfaction. Efforts can be made to improve quality by identifying indicators of patient expectations and needs regarding comfort when accessing outpatient services at hospitals Conclusion: Assessment of patient needs can be evaluated by satisfaction surveys or by providing compliant services centers. Thus, the patient's expectations can be used as an improvisational study in optimizing available facilities, the reliability, and responsiveness of officers, as well as the attitude shown by officers toward outpatients at the hospital.

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Lamine, Hamdi, Alessandro Lamberti-Castronuovo, Prinka Singh, Naoufel Chebili, Chekib Zedini, Nebil Achour, Martina Valente i Luca Ragazzoni. "A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations". International Journal of Environmental Research and Public Health 20, nr 6 (12.03.2023): 4985. http://dx.doi.org/10.3390/ijerph20064985.

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The Hospital Safety Index is a tool developed by the World Health Organization and the Pan American Health Organization in 2008 and updated in 2015. Although it is the most widely used instrument of its kind to assess the level of hospital preparedness, scientific literature on its application in real life is scarce. This study aimed to investigate the use of the Hospital Safety Index to assess disaster preparedness in healthcare facilities. A retrospective, qualitative study employing semi-structured online interviews was conducted to gather the opinions and perspectives of professionals who have experience in applying the Hospital Safety Index. Authors of scientific publications using the Hospital Safety Index were recruited. A semi-structured interview guide was developed. It addressed different phases of data collection with the Hospital Safety Index, the challenges and facilitators of using it, and recommendations for future adaptations. Data were analysed using inductive thematic analysis. Nine participants who were from three countries (Serbia, Sri Lanka, and Indonesia) and had different professional backgrounds (medical doctors, engineers, spatial planners, etc.) participated in this study. A total of 5 themes and 15 subthemes emerged during data analysis. Most of the participants reported their reasons for choosing the Hospital Safety Index as being its comprehensiveness and the fact that it was issued by the World Health Organization. The tool appears to be very specific and allows investigators to spot details in hospitals; however, it is not easy to use, and training is highly encouraged to learn how to navigate the different components of the tool. Governmental support is a crucial facilitator for investigators to be able to enter hospitals and conduct their evaluations. Overall, the tool has a lot of potential, and it should be used to reach a broader audience, such as community members, and assess the preparedness of other facilities that can take part in the response to disasters (hotels, stadiums, schools, etc.). Nevertheless, it still needs more adaptations to be tailored to different contexts and settings.

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Cruz, Isabel Cristina Fonseca da. "OBJN index 2004". Online Brazilian Journal of Nursing 3, nr 3 (20.12.2004): 86–87. http://dx.doi.org/10.17665/1676-4285.20044944.

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EDITORIAL A scientific evidence: the OBJN has more quantitative and qualitative links. (text in English) Aurora de Afonso Costa School of Nursing - from 1944 to 2004: 60 years preparing nurses to care people´s responses to health and illness and to leader the health system. (text in English) The OBJN upgrade: now it is the official journal of the Professional Master in Nursing Program at the Fluminense Federal University Nursing School. (text in English)ORIGINAL ARTICLESClowns doctors: the child talk. (text in Portuguese) Interfaces of geriatric nursing and dental care.(text in Portuguese)Mortality for Accidents of Traffic in Rio Branco – Acre - Brazil, 2001 to 2003.(text in Portuguese)Nursing diagnosis of patients with myocardial infarction, according to the conceptual model of Florence Nightingale. (text in Portuguese)Nursing process: application to the professional practice. (text in Portuguese)Participation of nursing students in the network for the prevention of occupational accidents - REPAT. (text in Portuguese)The american tegumentary leishmaniasis in the perspective of who lives it. (text in Portuguese)The nurse’s leadership: challenges of the practice. (text in Portuguese)Understanding functional health literacy in experiences with prostate cancer: older men as consumers of health information. (text in English)Vancomycin administration in an universitary hospital at general surgical units inpatients (text in Portuguese)We have needs, too: parental needs during a child’s hospitalisation.(text in English)Work accidents with needles and other sharp medical devices in the nursing team at public hospitals - Rio Branco, Acre - Brazil.(text in Portuguese)REVIEW ARTICL ESGender, health and nursing: The male inclusion in the nursing care. (text in Portuguese)Influence of psychosociais needs in the mental health of the children.(text in Portuguese)Literature review on ineffective thermoregulation – OBNJ Club Journal.(text in Portuguese)Literature review on Neonatal Pain – OBJN Club Journal. (text in Portuguese)Literature review on newbons care – OBJN Club Journal.(text in Portuguese)Literature review on risk for impaired parenting – OBJN Club Journal. (text in Portuguese)Literature review on risk of infection in intravenous catheter related to the dialysis treatment – OBJN Club Journal. (text in Portuguese)Public policies regarding family, institutional requirement from the politics philosophy of Hegel and Marx.(text in Portuguese)Review of research about parish nursing practice (text in English)The civil responsibility of nurse as a public agent. (text in Portuguese)The contribution of philosophy, ethics, and bioethics in the Ribeirão Preto School of Nursing – USP(text in Portuguese)The importance of the insert of the thematic " violence against the woman " in the curriculum of nursing. (text in Portuguese)Work of nursing in the family health program of and its relation with the non-institucionalization.(text in Portuguese)ABSTRACTSConstruction and validation of an instrument of collection of data of the aged one in the Program of Health of the Family.Construction and validation of data collection instrument for children from 0 - 5 years.Interaction among teachers and students in the construction of the nurses professional identityKnowledge and practice of beginner and veteran (men and women) nurses in the hospital scenarioNursing in field from training: “ Natural Lab” a professional learningPsycossocial Necessities of the Client at the Unit of Chest Pain: issues for caring in the Emergency Room.The social representation of family: expectation and meaning of cardiac surgery.(text in English)PROFESSIONAL ISSUES2004 Brazilian Women Year: Visual reflections related to the female sexuality in a feminine (sexy) Brazil focusing the female nurse.(pps in Portuguese) 5th European Conference of ACENDIO: Association for Common European Nursing Diagnoses, Interventions and Outcomes (text in English)NURSES: Working with the Poor; Against Poverty. Message from ICN (text in English)OBJN 2004 thanks to the Editorial and Peer-Review Board (text in English)The Professional Master in Nursing Website (EEAAC/UFF): linking knowledge to nursing practice (text in Portuguese)Thirteen National Brazilian Nursing Research Congress (SENPE) June 2005, São Luiz, Maranhão.World Health Organization: Forum 8 + World Summit on Health Research Mexico City, November 6-10, 2004 (text in English)

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Dang, You-Ting, Qiang Wang, Yun-Ping Zho, Deng-Ke We i Fei Xi. "Fibrolipomatous hamartoma of the median nerve: a case report and literature review." Investigación Clínica 63, nr 4 (11.11.2022): 400–413. http://dx.doi.org/10.54817/ic.v63n4a07.

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Fibrolipomatous hamartoma (FLH) of the nerve, also known as lipomatosis of the nerve, neurofibrillary lipomatous lesion, or intraneural li-poma, is a rare benign soft tissue tumor which mainly occurs in the nerves of the upper limb, especially in the median nerve.In April 2021, a 30-year-old male patient was secondly admitted to our hospital and underwent his third surgery, due to the recurrence of a mass and pain in the right palm, noticeable swelling and numbness of the right index and ring fingers, and limited flexion and extension activities of the right ring finger. He first visited our hospital in December 2017 due to a mass and pain in the right palm and swelling and numbness of the right index and ring fingers. When the clinician asked for the patient medical history, his parents stated that his right middle finger was swol-len after birth. When the patient was ten years old; he was diagnosed with “mac-rodactyly” at the local county hospital, not in our hospital, and subsequently, the middle finger was amputated at the metacarpophalangeal joint level at the local county hospital. The postoperative pathological examination was not per-formed at that time, which was the first surgery the patient received.FLH is clinically rare, and its exact epidemiology and etiology are poorly understood. FLH is highly suspected in cases where a painless mass is present in the wrist, combined with macrodactyly. Magnetic resonance imaging and pathological examination are helpful in clarifying the diagnosis. Although FLH is a benign tumor, an individual treatment plan is the best choice according to the severity of the patient’s symptoms. Therefore, further exploration and understanding of this disease by clinicians radiologists, and pathologists is necessary.

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Jones, Daniel, Srishti Kumar, Caitlin Anstee, Molly Gingrich, Alexander Simone, Zubair Ahmadzai, Kednapa Thavorn i Andrew Seely. "Index hospital cost of adverse events following thoracic surgery: a systematic review of economic literature". BMJ Open 13, nr 9 (wrzesień 2023): e069382. http://dx.doi.org/10.1136/bmjopen-2022-069382.

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ObjectivesAdverse events (AEs) following thoracic surgery place considerable strain on healthcare systems. A rigorous evaluation of the economic impact of thoracic surgical AEs remains lacking and is required to understand the value of money of formal quality improvement initiatives. Our objective was to conduct a systematic review of all available literature focused on specific cost of postoperative AEs following thoracic surgery.DesignSystematic review of the economic literature was performed, following recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Data sourcesAn economic search filter developed by the Canadian Agency for Drugs and Technologies in Health was applied, and MEDLINE, Embase and The Cochrane Library were searched from inception to January 2022.Eligibility criteriaWe included English articles involving adult patients who underwent a thoracic surgical procedure with estimated costs of postoperative complications. Eligible study designs included comparative observational studies, randomised control trials, decision analytic or cost-prediction models, cost analyses, cost or burden of illness studies, economic evaluation studies and systematic reviews and/or meta-analyses of cost analyses and cost of illness studies.Data extraction and synthesisTwo reviewers independently screened titles and abstracts in the first stage and full-text articles of included studies in the second stage. Disagreements during abstract and full-text screening stages were resolved via discussion until a consensus was reached. Studies were appraised for methodological quality using the Critical Appraisal Skills Program checklist.Results3349 studies were identified: 20 met inclusion criteria. Most were conducted in the USA (12/20), evaluating AE impact on hospital expenditures (18/20). 68 procedure-specific AE mean costs were characterised (USD$). The most commonly described were anastomotic leak (mean:range) (USD$49 278:$6 176–$133 002) and pneumonia ($12 258:$2608–$34 591) following esophagectomy, and prolonged air leak ($2556:$571–$3573), respiratory failure ($19 062:$11 841–$37 812), empyema ($30 189:$23 784–$36 595), pneumonia ($15 362:$2542–$28 183), recurrent laryngeal nerve injury ($16 420:$4224–$28 616) and arrhythmia ($6835:$5833–$8659) following lobectomy.ConclusionsHospital costs associated with AEs following thoracic surgery are substantial and varied. Quantifying costs of AEs enable future economic evaluation studies, which could help prioritising value-directed quality improvement to optimally improve outcomes and reduce costs.

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Heyam, Dalky F., Gharaibeh Besher i Al-Khateeb Nesreen. "Work Ability Index of Shift Working Hospital Nurses in Jordan". Open Nursing Journal 12, nr 1 (29.06.2018): 116–24. http://dx.doi.org/10.2174/1874434601812010116.

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Background:Despite the extensive literature on work ability, few studies have looked at variables associated with work ability of nurses working fixed versus rotating shifts.Objective:The study aims were to explore variables contributing to work ability and to examine the association of demographic, job satisfaction, and work shift to work ability.Method:A cross-sectional design was utilized to assess work ability level and job satisfaction among nurses working 8 or 12 hour rotating or fixed shifts in Jordanian hospitals. The data collection tools were the Work Ability Index and the Mueller/McCloskey Satisfaction Scale. Data were analyzed to determine the extent to which job satisfaction, shift work, and demographic variables were associated with work ability.Results:Work ability level was “moderate”, while job satisfaction level was “moderately dissatisfied”. A positive significant relationship was found between work ability and job satisfaction (r = 0.347, n = 349, p < 0.000). This relationship was higher for fixed-shift workers (r =.507) compared to rotating-shift workers (r = .299). Standard linear multiple regression analysis indicated that job satisfaction level predicted work ability level (β =.347, p = .000).Conclusion:The study confirmed that promoting job satisfaction leads to higher work ability, and thus, enhances the quality of care provided. The finding that job satisfaction is predictive of work ability has implications for training intervention.

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Lopez, Greta L., Kathryn Hoehn Anderson i Johanna Feutchinger. "Transition of Premature Infants From Hospital to Home Life". Neonatal Network 31, nr 4 (2012): 207–14. http://dx.doi.org/10.1891/0730-0832.31.4.207.

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Purpose: To conduct an integrative literature review to studies that focus on the transition of premature infants from neonatal intensive care unit (NICU) to home.Method: A literature search was performed in Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and MEDLINE to identify studies consisting on the transition of premature infants from hospital to home life.Results: The search yielded seven articles that emphasized the need for home visits, child and family assessment methods, methods of keeping contact with health care providers, educational and support groups, and described the nurse’s role in the transition program. The strategy to ease the transition differed in each article.Conclusion: Home visits by a nurse were a key component by providing education, support, and nursing care. A program therefore should consist of providing parents of premature infants with home visits implemented by a nurse or staying in contact with a nurse (e.g., via videoconference).

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Silva, Leonor Coelho da, Célia Pereira Caldas, Cintia Silva Fassarella i Patricia Simas de Souza. "Effect of the organizational culture for patient safety in the hospital setting: A systematic review". Aquichan 21, nr 2 (25.06.2021): 1–16. http://dx.doi.org/10.5294/aqui.2021.21.2.3.

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Objective: To identify the effect of the organizational culture on patient safety in the hospital context. Materials and methods: A systematic review, without meta-analysis, registered in PROSPERO with number CRD42020162981. Cross-sectional and observational studies were selected that assessed the safety environment and safety culture published between 2014 and 2020 in journals indexed in the EMBASE, Latin American and Caribbean Literature in Health Sciences (Literatura Latinoamericana e do Caribe em Ciências da Saúde, LILACS) via the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), Medline (International Literature in Health Sciences) via PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Results: The findings show that a positive safety environment exerts a beneficial effect on the safety culture, favors the notification of events, and enables improvements in the quality of health care. Conclusions: The effective interaction between safety culture and organizational culture is still scarce in the literature. Most of the studies carried out investigate the situational diagnosis and little progress is made in terms of deepening the implications for the professional practice and the repercussions for the safety of hospitalized patients.

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Sahamir, Shaza Rina, Rozana Zakaria, Raja Rafidah Raja Muhd Rooshdi, Noor Akmal Adillah Ismail i Zainab Mohmad Zainordin. "Key influencing factors for green public hospital building development in Malaysia". MATEC Web of Conferences 266 (2019): 01025. http://dx.doi.org/10.1051/matecconf/201926601025.

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The green hospital movement began years ago, following by several countries release their green rating system for the hospital buildings. In the past few years, a few newly constructed private hospital buildings in Malaysia have strived for the green building index certification. Paucity studies demonstrate that public hospital buildings have established for certifying the index. Despite the recognition of the importance of green building in achieving sustainability goal and the existence of many studies on issues associated with green innovations adoption in general, few have specifically examined factors influencing the development of green public hospital building. As a result, with the intent to enhance green building promotion efforts, the primary objective of this study is to investigate the key factors influencing the development of green public hospital building. A review of literature has been conducted and a set of factors were identified. A questionnaire survey was carried out based on the literature review to solicit experts’ opinions. The experts were requested to evaluate the degree to which factor was an important in the implementation of green public hospital buildings. Feedbacks from 82 design experts were collected and analysed using descriptive analysis. The findings indicate that several factors were identified as key factors for the development of green public hospital buildings. The identified factors have incorporated with the accomplishment of environmental stewardship, social responsibility and economic prosperity.

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Fatima, Iram, Muhammad Shafiq i Ayesha Humayun. "Development and Validation of Survey Instrument for Measurement of Hospital Functional Service Quality". Journal of Shalamar Medical & Dental College - JSHMDC 5, nr 1 (29.06.2024): 34–41. http://dx.doi.org/10.53685/jshmdc.v5i1.188.

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Background: Emergency, diagnostics, and surgical services are critical areas of hospitals both in terms of technicalities and resource creation. The literature review reflects that there is a need to develop a survey instrument-based measurement model that can identify areas of functional service quality within hospital facilities based on patients’ perspectives as hospital quality improvement initiatives. Objective: To design and validate an instrument that helps to evaluate the functional service quality of hospitals using structural equation modeling. Methods: It was a mixed-method research having a cross-sectional study design. A total of 817 responses were purposively collected from consumers of surgical, emergency, and diagnostic departments of tertiary care hospitals. Simple descriptive, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was performed to identify the factors to formulate the instrument using SPSS Amos 20.0 Results: The study validated seven constructs for the development of Func.Qual (Survey instrument named to measure hospital functional service quality). Amongst these constructs’ assurance, responsiveness communication, and reliability are critical contributing factors reported earlier. Whereas promptness, food and aesthetics are new constructs extracted in local settings. The values of goodness of model fit indices found statistically valid with Comparative Fit Index (CFI=0.96), Root Mean Square Error of Approximation (RMSEA=0.055) and Standardized Root Mean Square Residual (SRMR=0.05). Conclusion: Func.Qual is a powerful survey instrument to measure hospital functional service quality. The current study is an effort to enrich the literature associated with the body of knowledge for hospital functional service quality.

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Lin, John C., Allison J. Chen, Ingrid U. Scott i Paul B. Greenberg. "U.S. News & World Report Ophthalmology Hospital Rankings and Research Productivity". Journal of Academic Ophthalmology 13, nr 01 (styczeń 2021): e46-e50. http://dx.doi.org/10.1055/s-0040-1722743.

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Abstract Introduction Despite the wide usage of U.S. News & World Report (U.S. News) rankings of ophthalmology hospitals among the public, residency applicants, and ophthalmologists, there is disagreement in the literature on the role of quality of care, research productivity, and other factors in the ranking system. This study investigated the association of U.S. News ranking of ophthalmology hospitals and objective measures of research productivity. Methods The 2020 U.S. News “Best Hospitals for Ophthalmology” ranking lists 38 hospitals by reputation score and numerically ranks the top 12 institutions. For our analysis, top 12 hospitals were classified as group A and the remaining 26 as group B. The Clinicaltrials.gov, National Institutes of Health (NIH) Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER), and NIH Research Portfolio Online Reporting Tools (RePORT) were systematically searched for total clinical trials, NIH funding, and the National Eye Institute (NEI) funding for fiscal years 2017, 2018, and 2019. Faculty size and the number of publications by ophthalmology faculty per hospital were recorded from a previous study in 2016. Results Independent measures of research productivity significantly associated with group A status after multivariate logistic regression analysis were mean faculty Hirsch's index (h-index) over 15 (odds ratio [OR]: 6.13, 95% confidence interval [CI]: [1.14–32.94]) and conducting five or more total clinical trials (OR: 8.77, 95% CI: [1.39–55.16]). Conclusion This study suggests that the reputation-based U.S. News ranking may serve as a proxy for an ophthalmology department's contribution to research measured by mean faculty h-index and number of clinical trials.

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M. Kadhim, Esraa, i Meervat R. Altaie. "Factors Affecting Maintenance Practises in Iraq’s Hospital Buildings". Jordan Journal of Civil Engineering 17, nr 3 (10.07.2023): 408–18. http://dx.doi.org/10.14525/jjce.v17i3.04.

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A lack of adequate building maintenance is a significant obstacle faced by governmental hospitals. This paper evaluates factors that negatively impact building-maintenance practices in Iraq. A literature review was conducted to identify factors affecting maintenance. A list of 42 factors affecting hospital-buildings was collected from previous studies and tested using a structured questionnaire distributed to hospital-maintenance experts. During the data analysis, 76 valid questionnaires were used. Based on the respondents’ ratings, the relative-importance index (RII) was used to determine the level of importance of each factor. From the results, it was concluded that twelve factors affect maintenance practices in hospital buildings: faulty design (0.889), lack of funding (0.874), inadequate training (0.871), misuse of building facilities (0.866), construction errors (0.863), lack of work experience (0.858), building age (0.826), individual modifications carried out by the hospital staff (0.826), shortage of maintenance staff (0.824), administrative corruption (0.821), selection of unqualified maintenance contractors (0.816) and unavailability of skilled appointed maintenance personnel (0.808). Understanding these factors’ effects is essential for maintenance-department managers to develop strategies for maintaining hospital buildings in Iraq by controlling them, as well as identifying problems and finding appropriate solutions to avoid them. KEYWORDS: Governmental hospitals, Maintenance, Iraq, Building maintenance, Maintenance practices, Factors affecting maintenance

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Warneke, Lorne B. "The Dexamethasone Suppression Test in a General Hospital Psychiatric Setting". Canadian Journal of Psychiatry 30, nr 8 (grudzień 1985): 614–18. http://dx.doi.org/10.1177/070674378503000812.

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The use of the dexamethasone suppression test in a general hospital setting is discussed with a review of some of the literature pertaining to the test. The test was performed on a series of 47 patients where there was a high index of suspicion that depression was present. Of the patients with a final diagnosis of depression, 77% had a nonsuppressive DST. There were no false positives. Bipolar depressed patients were more likely to be nonsuppressors than unipolar patients.

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Heng, Hazel, Dana Jazayeri, Louise Shaw, Debra Kiegaldie, Anne-Marie Hill i Meg E. Morris. "Educating hospital patients to prevent falls: protocol for a scoping review". BMJ Open 9, nr 9 (wrzesień 2019): e030952. http://dx.doi.org/10.1136/bmjopen-2019-030952.

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IntroductionFalls prevention in hospitals is an ongoing challenge worldwide. Despite a wide variety of recommended falls mitigation strategies, few have strong evidence for effectiveness in reducing falls and accompanying injuries. Patient education programmes that promote engagement and enable people to understand their heightened falls risk while hospitalised are one approach. The aim of this scoping review is to examine the content, design and outcomes of patient education approaches to hospital falls prevention. As well as critiquing the role of patient education in hospital falls prevention, strategies that can be used in clinical practice shall be recommended.Methods and analysisThe analysis will apply the methodological framework developed by Arksey and O’Malley and refined by the Joanna Briggs Institute. An initial limited search of Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed will be completed to identify keywords and index terms. A developed search strategy of Medical Subject Headings and text words will be conducted of PubMed, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, PsychINFO, Education Resources Information Center and grey literature databases from January 2008 to current. The reference lists of included articles will be hand searched for additional studies. Two reviewers will screen the titles and abstracts independently and analyse the full text of potential articles based on the inclusion and exclusion criteria. The data will be extracted using a structured data form. Thematic analysis and numerical synthesis of the data will be conducted, and key themes will be identified.Ethics and disseminationResults of this scoping review will illuminate the designs and outcomes of patient education research for hospital falls prevention in the current literature. It is anticipated that the findings will highlight best-practice educational design to inform the development of future patient-focused education for falls prevention. Study findings will be presented at relevant conferences and public forums, and published in peer-reviewed journals. Ethics approval is not required.

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ALAHMADI, Bader, i Manal Alharbi. "Work-Related Fatigue Factors among Hospital Nurses: An Integrative Literature Review". Nurse Media Journal of Nursing 8, nr 2 (4.03.2019): 113. http://dx.doi.org/10.14710/nmjn.v8i2.19554.

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Background: Due to the demanding nature of nurses’ work and the current shortage of nurses, hospital nurses often find themselves working extra shifts, extended hours, and taking on more responsibilities. However, this added pressure on the body and mind results in fatigue which adversely affects nurses' health status as well as their ability to provide optimal health care procedures. Preventing fatigue and reducing its adverse consequences requires comprehensive awareness about its diverse contributing factors.Purpose: Examine factors that influence fatigue among nurses employed in a hospital setting.Methods: An integrative review to assess the quality of the research evidence, to find minor and major gaps in current research and the main issues in the area of the research and finally to bridge the research gaps. This integrative review identified a total of 12 relevant research studies from Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase, PsycINFO, and a manual search were used in this review. Data were reviewed in May 2017, using an integrative review then interpreted, analyzed and synthesized to identify key contributing factors that influence fatigue among hospital nurses.Results: The 12 studies in this review revealed that significant factors such as organizational factors, nursing work characteristics, psychosocial factors as well as individual characteristics and demand influence nurse fatigue. Work shifts, specifically night- shifts and extended work shifts without sufficient inter-shift recovery were linked to higher levels of fatigue.Conclusion: This review identified the significant associations between work schedules, work environments, demographics and fatigue among nurses in hospital settings located in various countries all around the world.Impact: Increased physical and psychological job demands combined with the lack of social support at work leads to a heightened degree of job dissatisfaction, which results in acute and chronic fatigue. Findings from this study may help healthcare organizations and policymaker to introduce strategies that mitigate fatigue among nurses in hospital settings.

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Rój, Justyna. "Competition measurement of hospitals in Poland: the Herfindahl-Hirschman index approach". Ekonomika 95, nr 1 (12.04.2016): 166–81. http://dx.doi.org/10.15388/ekon.2016.1.9912.

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The purpose of this study was to measure the competition level of general hospitals in Poland. The Herfindahl-Hirschman Index (HHI) was used to investigate the concentration level of the general hospital sector in Poland, which is treated in the literature as a proxy of competition. To understand how general hospitals’ market has been structured and thus competitive, the data for general hospitals spanning all Poland for the period of 2005-2013 were collected. The concentration of hospitals was measured in each of the 16 provinces in Poland based on the aggregated data at the counties level. Data are collected from the public statistical system. The HHI indices support the assertion that in the period of analysis the entire general hospitals’ sector in Poland has been on average moderately concentrated and thus, moderately competitive with the growing tendency to higher concentration and less competition. Moreover, the concentration of hospitals’ services is diversified across the provinces and regions of Poland and it is quite uneven. The analysis also shows that changes in the health care market, which took place in the analysed period, especially statutory changes regarding hospitals in 2011, affected the level of concentration and thus competition. Including this introduction, this paper is organized into six sections. Section 2 outlines the Polish health care reforms especially those applying to hospitals. Section 3 and 4 presents the concept of empirical research, such as data and method. Section 5 provides results of empirical research and section 6 concludes.

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Амантай, Н., Д. Айтмуханбетов, М. Аханбаева, О. Даутакын, Г. Махай, Г. Мустапа, Л. Б. Сейдуанова i А. К. Сайлыбекова. "TOPICAL MARKERS OF INFLAMMATION IN A SURGICAL HOSPITAL (LITERATURE REVIEW)". Vestnik, nr 4 (25.02.2022): 110–18. http://dx.doi.org/10.53065/kaznmu.2021.97.55.021.

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В настоящее время очень важна ранняя диагностика заболевания, оценка эффективности хирургического или консервативного лечения, раннее прогнозирование послеоперационных осложнений и знание того, какие воспалительные маркеры назначать при ранней профилактике осложнений, врачам-хирургам, работающим в стационарах, обслуживающих хирургическое направление. Наиболее информативным и точным методом исследования, характерным для начала воспалительного процесса, является определение острофазных белков. К острофазным белкам относятся около 30 белков, обнаруженных в плазме человеческого организма. Каждый белок, помимо ответа на воспаление, имеет и другие функции, например, белки участвуют в свертывании крови, переносе иммуномодуляторы функция, но характерная для всех функция они выполняет процессы репарации в области поражения . Цель работы выявление маркеров воспаления в стационаре хирургического профиля, наиболее подходящих для работы, и знание методов их получения и использования. В качестве материалов и методов исследования в ходе данной работы нами был проведен анализ зарубежной и отечественной литературы, посвященной различным маркерам. В нашем исследовании маркеры воспаления, которые часто использовались в практиде и те которые только сейчас набирают оборот: С-реактивный белок, прокальцитонин, пресепсин, лактат и IgG. Конечно, на сегодняшний день актуальными тестами на выявление неспецифического воспалительного процесса являются скорость оседания эритроцитов и расчет индекса лейкоцитов, которые широко используются за простоту и дешевизну исполнения, а не за самые информативные показатели. Currently, early diagnosis of the disease, evaluation of the effectiveness of surgical or conservative treatment, early prediction of postoperative complications and knowledge of which inflammatory markers to prescribe for early prevention of complications, surgeons working in hospitals serving the surgical direction are very important. The most informative and accurate method of investigation, characteristic of the onset of the inflammatory process, is the determination of acute-phase proteins. Acute-phase proteins include about 30 proteins found in the plasma of the human body. Each protein, in addition to responding to inflammation, has other functions, for example, proteins are involved in blood clotting, the transfer of immunomodulators function, but they perform a characteristic function of all repair processes in the affected area. The purpose of the work is to identify the markers of inflammation in a surgical hospital that are most suitable for work, and to know the methods of obtaining and using them. As materials and research methods in the course of this work, we analyzed foreign and domestic literature on various markers. In our study, markers of inflammation that were often used in practice and those that are only now gaining momentum: C-reactive protein, procalcitonin, presepsin, lactate and IgG. Of course, today the relevant tests for the detection of a nonspecific inflammatory process are the rate of erythrocyte sedimentation and the calculation of the leukocyte index, which are widely used for simplicity and cheapness of execution, and not for the most informative indicators.

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Arko, Leopold, Jordan W. Swanson, Tamara M. Fierst, Rosemary E. Henn, Daniel Chang, Phillip B. Storm, Scott P. Bartlett, Jesse A. Taylor i Gregory G. Heuer. "Spring-mediated sagittal craniosynostosis treatment at the Children’s Hospital of Philadelphia: technical notes and literature review". Neurosurgical Focus 38, nr 5 (maj 2015): E7. http://dx.doi.org/10.3171/2015.3.focus153.

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OBJECT Sagittal craniosynostosis has been treated using both cranial remodeling techniques and modification of the sagittal strip craniectomy. A more recent technique is to implant springs in conjunction with a suturectomy to transversely expand the parietal bones to accommodate the growing brain. In this paper the authors describe and evaluate several modifications to the spring-mediated cranioplasty (SMC) technique, most notably use of an ultrasonic scalpel to limit dural dissection and maximize opening of the stenosed suture by placement of multiple spring devices. In addition, the literature is reviewed comparing SMC to other surgical treatments of sagittal synostosis. METHODS The authors retrospectively reviewed patients who presented to the Children’s Hospital of Philadelphia with a diagnosis of sagittal synostosis from August 2011 to November 2014. A pooled data set was created to compare our institutional data to previously published work. A comprehensive literature review was performed of all previous studies describing the SMC technique, as well as other techniques for sagittal synostosis correction. RESULTS Twenty-two patients underwent SMC at our institution during the study period. Patients were 4.2 months of age on average, had a mean blood loss of 56.3 ml, and average intensive care unit and total hospital stays of 29.5 hours and 2.2 days, respectively. The cranial index was corrected to an average of 73.7 (SD 5.2) for patients who received long-term radiological follow-up. When comparing the authors’ institutional data to pooled SMC data, blood loss and length of stay were both significantly less (p = 0.005 and p < 0.001, respectively), but the preoperative cranial index was significantly larger (p = 0.01). A review of the SMC technique compared with other techniques to actively expand the skull of patients with sagittal synostosis demonstrated that SMC can be performed at a significantly earlier age compared with cranial vault reconstruction (CVR). CONCLUSIONS The authors found that their institutional modifications of the SMC technique were safe and effective in correcting the cranial index. In addition, this technique can be performed at a younger age than CVRs. SMC, therefore, has the potential to maximize the cognitive benefits of early intervention, with lower morbidity than the traditional CVR.

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A, Agegnehu. "Computerized Tomographic Study of Normal Evans Index in Adults at University of Gondar Comprehensive Specialized Hospital, North West Ethiopia, Gondar 2019". Journal of Human Anatomy 4, nr 1 (7.01.2020): 1–5. http://dx.doi.org/10.23880/jhua-16000150.

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Introduction: Evans indexis one of the most important parameter in diagnosis of hydrocephalus, follow up cases of ventriculoperitoneal shunt, dementia and numerous other pathologies. In this situation, having a standard reference value of the Evan’s index will be supportive in a wide extent of clinical pathologies. The main objective of this study was to establish normal values for Evans index in a population of North West Ethiopia as there is no study found in Ethiopian medical literature. Methods: Computerized tomographic brain scans of 169 normal subjects were reviewed. Evan’s index was measured as the direct proportion of the most extensive frontal horn tips diameter of the cerebral lateral ventricles to the most extensive internal distance across the cranium. Results: In this study, 123(72.78) of the patients were males and 46 (27.22%) were females; their ages ranged from 18 to 79 years with a mean age of 40 years. The mean value for Evans index for the studied population was 0.262 ± 0.03. The Evan’s index increased with age and it was slightly higher among males. The difference in Evans value in males and females was not statistically significant. People over 60 years old had the highest Evans values in both genders. Conclusion: This study found the ranges of normal value for Evans index in north west Ethiopian population. It agrees with the diagnostic cut-off value of > 0.3 for hydrocephalus.

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Liu, Yang, Ning-Ning Yang, Yong-Song Guan i Qing He. "Anastomotic leakage with abscess after laparoscopic sleeve gastrectomy for obesity: report of a series and review of literature". Therapeutic Advances in Gastrointestinal Endoscopy 13 (styczeń 2020): 263177452092596. http://dx.doi.org/10.1177/2631774520925963.

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Anastomotic leakage with abscess is a rare but severe complication of bariatric surgery. However, there is currently a lack of attention regarding this complication. This study aimed to investigate the risk factors for this complication and relevant treatment strategies to call attention to this severe complication. We retrospectively reviewed the patients who were rehospitalized for anastomotic leakage with abscess after bariatric surgeries in West China Hospital of Sichuan University from November 2017 to November 2018. The clinical profiles analyzed included body mass index, body weight before and after surgery, postoperative hospital stay, diet prescriptions, treatment strategies, and outcomes. A total of six patients (two men and four women) were included. The mean baseline body mass index was 37.52 (29.84–43.37), and the mean weight was 104.95 kg (74.5–127.5). The chief complaints leading to rehospitalization were fever and dull abdominal pain. The average postoperative hospital stay was 3.3 (3–4) days, and the onset time ranged from 7 to 15 days. Finally, revision surgeries were performed in two of the six patients (33%), and they were all cured by percutaneous drainage-based treatments. The postoperative fever and abdominal pain were the signs of leakage and abscess. Similar patients should be followed up once a week for 3 weeks after bariatric surgery to facilitate the early recognition of this complication. A longer hospital stay and sufficient parenteral nutrition plus a later implementation of diet should be helpful to minimize this severe complication. Percutaneous drainage played a significant role in the treatment of these patients.

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Kgakge, Kagiso, Paul Kiprono Chelule, Morris Kahere i Themba Geoffrey Ginindza. "Investigating the Risk of Patient Manual Handling Using the Movement and Assistance of Hospital Patients Method among Hospital Nurses in Botswana". International Journal of Environmental Research and Public Health 21, nr 4 (26.03.2024): 399. http://dx.doi.org/10.3390/ijerph21040399.

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Background: Evidence on the prevalence of lower back pain (LBP) among nurses is widespread in the literature, with several risk factors being reported. These include manual handling of patients, repetitive bending and twisting movements, and long working hours. It is reported that LBP has negative health outcomes and causes poor work performance among healthcare workers (HCWs). The magnitude of ergonomic risks associated with these healthcare activities has not been adequately investigated in Botswana. Thus, this study aimed to investigate the ergonomic risk levels associated with the manual handling of patients and its association with the prevalence of LBP among nurses in Botswana. Methods: This was an observational cross-sectional hospital-based study conducted in a Botswana public tertiary hospital from March to April 2023. The Movement and Assistance of Hospital Patients (MAPO) tool was used to collect data on ergonomic risk levels. Data on the demographic characteristics of participants were collected using a tool adapted from the Nordic Musculoskeletal Questionnaire (NMQ). Odds ratios and 95% confidence intervals were estimated to determine the association between ergonomic risk levels and the prevalence of LBP. Results: A total of 256 nurses participated and completed the study. The self-reported prevalence of LBP in this study was 76.6%. The risk of acquiring LBP was high (90.5%) based on the MAPO index. Although the frequencies of self-reported LBP were high among nurses, these did not show any significant association with the MAPO index data. This could be partly due to the small sample size. Conclusions: There was a high prevalence of LBP in this study, which was corroborated by the MAPO index data. This has demonstrated the value of the MAPO index in forecasting the risk of patient manual handling. The findings might help Botswana formulate policies intended to address ergonomic preventive measures, directed towards reducing the MAPO index score by addressing the single risk determinants.

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Chua, Felicia H. Z., Tien Meng Cheong, Ramez W. Kirollos, Lee Ping Ng, Wan Tew Seow i Sharon Y. Y. Low. "Pediatric Intracranial Aneurysms: Experience from a Singapore Children’s Hospital". Surgeries 5, nr 2 (12.06.2024): 434–48. http://dx.doi.org/10.3390/surgeries5020036.

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(1) Background: Pediatric intracranial aneurysms (PIA) are rare and clinicopathologically distinct neurovascular entities. The aims of this study are to evaluate our institution’s experience and corroborate our results with updated literature. (2) Methods: This is a single-institution, retrospective study. Patients with a confirmed diagnosis of PIA are included. Variables of interest include patient demographics, clinical presentation, treatment outcomes and features specific to each patient’s PIA. A literature review on PIA-centric clinical studies was conducted. (3) Results: A total of 14 PIAs in 11 patients were treated from 2000 to 2022. The mean age was 5.8 years old, and most were males (90.1%). Anterior circulation PIAs constituted 78.6% of the cohort. Half of the PIAs were of the dissecting type, and 14.3% were giant aneurysms. Of interest, 14.3% of patients had subsequent de novo aneurysms after treatment of their index aneurysm. For treatment, 57.1% underwent surgery, 35.7% had endovascular intervention and the remaining 7.1% were managed conservatively. Based on the literature review, this study had congruent findings to other existing publications. (4) Conclusions: PIAs are unique neurovascular lesions that have good outcomes if managed in a timely fashion by an experienced multidisciplinary team. We recommend longer surveillance periods due to the risk of developing de novo aneurysms.

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Braveman, Paula, Susan Egerter, Michelle Pearl, Kristen Marchi i Carol Miller. "Early Discharge of Newborns and Mothers: A Critical Review of the Literature". Pediatrics 96, nr 4 (1.10.1995): 716–26. http://dx.doi.org/10.1542/peds.96.4.716.

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Objective. To determine whether research supports the advisability of early discharge of healthy newborns and mothers. Methods. Critical review of English-language literature cited in the Index Medicus or the International Nursing Index. Findings. No adequately designed studies have examined discharge before 48 hours after delivery without additional postdischarge services. Few studies have examined the consequences of recommending a clinic visit within the first days after discharge; studies of this practice among low-income populations found high no-show rates. Some small studies suggest that early discharge is likely to be safe for selected populations at low psychosocial, socioeconomic, and medical risk, with careful antenatal screening and preparation and multiple postpartum home visits. Some studies suggested adverse outcomes associated with early discharge even with early follow-up. Conclusions. Published research provides little knowledge of the consequences of short maternal/newborn hospital stays or varying postdischarge practices for the general population. The studies that have concluded that early discharge was safe were applied under restricted circumstances or were too small to detect clinically significant effects on important outcomes. Further research is needed to inform clinical and reimbursement policy on health services in the first days of life and parenting. Rigorous studies of sufficient size are needed to examine the impact of different hospital stays and different postdischarge practices on a range of outcomes for mothers and newborns in diverse populations and settings. Given a priori concerns, decisions on neonatal/obstetric discharge planning should be made cautiously.

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Zhan, Zhaoxi, Wenna Xu, Lin Xu, Xinyue Qi, Wenjie Song, Chen Wang i Ziye Huang. "BIM-Based Green Hospital Building Performance Pre-Evaluation: A Case Study". Sustainability 14, nr 4 (11.02.2022): 2066. http://dx.doi.org/10.3390/su14042066.

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With ecological problems and energy crises intensifying today, greening is essential to sustainable development. Compared with other types of buildings, hospital buildings account for a relatively larger proportion of building energy consumption. In order to realize the rapid cycle optimization of a green hospital project in the design stage and improve the green grade of the building, a pre-evaluation Building Information Model (BIM) of green hospital building performance was established in this study. Firstly, the literature review and expert consultation established the building performance pre-evaluation index system for green hospitals. Then, BIM technology is taken to extract data needed for building a performance pre-evaluation system, and the Cloud Model and the Matter–Element Extension Theory are used to build models. The final green grade calculation is realized in MATLAB. Finally, the Maluan Bay Hospital is taken as an example to test the applicability and effectiveness of the proposed model. The results show that the green hospital building performance pre-evaluation model has advantages of simulation, cyclic optimization and fuzzy quantification, which can effectively guide the design and construction of a green hospital.

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Brondfield, Sam, Daniel H. Kwon, Andrew H. Ko, Robert M. Wachter i Eric J. Small. "Impact of staffing an inpatient oncology consult service with dedicated hospital-based oncologists." Journal of Clinical Oncology 42, nr 16_suppl (1.06.2024): e13538-e13538. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.e13538.

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e13538 Background: No standard care model for hospitalized patients with cancer currently exists. The majority of oncology care is provided in the outpatient setting. Consequently, for many oncologists, inpatient care is a secondary responsibility. To address this issue, several U.S. institutions have changed their inpatient oncology models to include dedicated inpatient oncology-trained attendings (hospital-based oncologists). In this study, we investigate outcomes following such a change on an inpatient solid oncology consult service. Methods: This is a single-institution retrospective study of the University of California, San Francisco (UCSF)’s inpatient solid oncology consult service, which switched from a rotating outpatient oncologist attending model to a dedicated inpatient oncologist model in 2018. Since data prior to the switch were not available, we compared all inpatients who received an oncology consult (n=3974) with a comparison group (CG) of all inpatients with a solid tumor diagnosis who did not receive an oncology consult (n=3200) between fiscal years 2018 and 2023. We analyzed trends in case mix index (case complexity), in-hospital mortality index (observed/expected), 30-day unplanned readmission rate, length of stay index, and direct cost index using the Pearson correlation coefficient. In 2022, we conducted an anonymous retrospective pre/post-switch survey of hospitalists who had worked on the hospital medicine service both before and after the switch and compared mean satisfaction with oncology consultation (5-point scale) using Student’s t test. Results: Following the switch, the number of weeks per year covered by dedicated inpatient oncologists increased from seven (2018) to 39 (2023) out of 52. From 2018 to 2023, we found a significant increase in annual consults (495 to 919, r=0.95, p<0.01) and case mix index (2.30 to 3.30, r=0.90, p=0.01; CG 1.60 to 1.70, r=0.60, p=0.20), and a significant decrease in mortality index (1.59 to 0.70, r=-0.98, p<0.01; CG 0.90 to 0.48, r=-0.66, p=0.15). There were non-significant decreases in 30-day unplanned readmission rate (35.8% to 30.5%, r=-0.77, p=0.07), length of stay index (1.45 to 1.32, r=-0.75, p=0.08), and direct cost index (2.2 to 1.8, r=-0.61, p=0.20), similar to the CG. Mean (standard deviation) satisfaction increased from 3.27 (1.22) pre-switch to 4.53 (0.92) post-switch ( p=0.02, response rate 15/51, 29%). Conclusions: Switching to a dedicated inpatient oncologist model on a consult service was associated with decreased in-hospital mortality and increased satisfaction with oncology consultation despite growing case volume and complexity, while readmission rate, length of stay, and cost remained unchanged. This study adds to growing literature supporting dedicated inpatient oncologist attending models of care and is in line with recent literature from other specialties supporting similar inpatient care models.

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Silveira, Felipe, Maíra Leite Basile, Fábio Seiji Kuga, José Donato Próspero, Roberto Antonio Pinto Paes i Fabíola Del Carlo Bernardi. "Neuroendocrine tumors: An epidemiological study of 250 cases at a tertiary hospital". Revista da Associação Médica Brasileira 63, nr 10 (październik 2017): 856–61. http://dx.doi.org/10.1590/1806-9282.63.10.856.

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Summary Objective: To compare the frequency of neuroendocrine tumors in our service with that reported in the literature considering age, gender, location, degree of differentiation and increase in incidence by means of a retrospective study. Method: Search of variables from a database of neuroendocrine tumor cases diagnosed at the Department of Pathological Sciences, Hospital da Santa Casa de São Paulo over the past 10 years, relating them to epidemiological data such as gender, age, distribution across organs, most-used immunohistochemical markers and presence or absence of either lymph node or distant metastases. Results: In all, 250 cases were reviewed, 133 involving females, predominantly in the 61-70 age range. The lung was the most frequent site, followed by the stomach. CD56, synaptophysin and chromogranin were the immunohistochemical markers used most often and to a lesser extent Ki67, a marker of cell proliferation that indicates a higher or lower degree of histological malignancy. Metastases, either in lymph nodes and/or distant sites, were found in 44 cases (17.6%). Conclusion: The results were largely consistent with those in the literature, including age group, gender and location. Most metastases originated from high-grade tumors, with high Ki67 levels and greater impairment of the liver. However, only 36.4% of the cases had Ki67 index. Reevaluation of the Ki67 proliferative index using image analysis in doubtful cases will allow for a correlation between progression and prognosis.

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Du, Juan, Shuhong Cui i Hong Gao. "Assessing Productivity Development of Public Hospitals: A Case Study of Shanghai, China". International Journal of Environmental Research and Public Health 17, nr 18 (16.09.2020): 6763. http://dx.doi.org/10.3390/ijerph17186763.

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As the main provider of medical services for the general public, the productivity changes of public hospitals directly reflect the development of the healthcare system and the implementation effect of medical reform policies. Using the dataset of 126 public hospitals in China from 2013 to 2018, this paper improves the existing literature in both index selection and model formulation, and examines public hospitals’ total factor productivity (TFP) growth. Empirical results not only demonstrate the trend of productivity development but also point out the directions in how to improve the current running status. Our study demonstrates that there were no obvious productivity fluctuations in public hospitals during the recent observing years, indicating that the performance of China’s public health system was generally acceptable in coping with fast-growing medical demand. However, the effect of public hospital reform has not been remarkably shown; thus, no significant productivity improvement was observed in most hospitals. Tertiary hospitals witnessed a slight declining trend in TFP, while secondary hospitals showed signs of rising TFP. To effectively enhance the overall performance of public hospitals in China, practical suggestions are proposed from the government and hospital levels to further promote the graded medical treatment system.

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Wilkes, Fiona A., Harith Akram, Jonathan A. Hyam, Neil D. Kitchen, Marwan I. Hariz i Ludvic Zrinzo. "Publication productivity of neurosurgeons in Great Britain and Ireland". Journal of Neurosurgery 122, nr 4 (kwiecień 2015): 948–54. http://dx.doi.org/10.3171/2014.11.jns14856.

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OBJECT Bibliometrics are the methods used to quantitatively analyze scientific literature. In this study, bibliometrics were used to quantify the scientific output of neurosurgical departments throughout Great Britain and Ireland. METHODS A list of neurosurgical departments was obtained from the Society of British Neurological Surgeons website. Individual departments were contacted for an up-to-date list of consultant (attending) neurosurgeons practicing in these departments. Scopus was used to determine the h-index and m-quotient for each neurosurgeon. Indices were measured by surgeon and by departmental mean and total. Additional information was collected about the surgeon's sex, title, listed superspecialties, higher research degrees, and year of medical qualification. RESULTS Data were analyzed for 315 neurosurgeons (25 female). The median h-index and m-quotient were 6.00 and 0.41, respectively. These were significantly higher for professors (h-index 21.50; m-quotient 0.71) and for those with an additional MD or PhD (11.0; 0.57). There was no significant difference in h-index, m-quotient, or higher research degrees between the sexes. However, none of the 16 British neurosurgery professors were female. Neurosurgeons who specialized in functional/epilepsy surgery ranked highest in terms of publication productivity. The 5 top-scoring departments were those in Addenbrooke's Hospital, Cambridge; St. George's Hospital, London; Great Ormond Street Hospital, London; National Hospital for Neurology and Neurosurgery, Queen Square, London; and John Radcliffe Hospital, Oxford. CONCLUSIONS The h-index is a useful bibliometric marker, particularly when comparing between studies and individuals. The m-quotient reduces bias toward established researchers. British academic neurosurgeons face considerable challenges, and women remain underrepresented in both clinical and academic neurosurgery in Britain and Ireland.

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Luo, Liyan, i Min Wang. "Pre-albumin is a strong prognostic marker in elderly intensive care unit patients". Journal of Laboratory Medicine 45, nr 4-5 (19.08.2021): 225–28. http://dx.doi.org/10.1515/labmed-2021-0009.

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Abstract Objectives Pre-albumin (PAB) can be used to evaluate the association between nutrition status and in-hospital mortality. However, there is no literature to compare if PAB is the best indicator to predict in-hospital mortality among the nutrition indexes in a study. Methods We operated a retrospective study including 145 patients admitted to our institution’s elderly intensive care unit (ICU) from January, 2017 to December, 2019. Admission laboratory results were collected. Regression analysis and receiver operating curve (ROC) were analyzed to explore the performance of different nutrition indexes. Results The levels of PAB were significantly different between the survivor and non-survivor group (p=0.001). Univariate analysis showed nutrition indexes (lymphocytes, albumin, body mass index [BMI], geriatric nutritional risk index (GNRI), prognostic nutritional index [PNI] and PAB) were associated with in-hospital mortality (all p<0.1). Following adjustment for age, platelets and creatinine (CREA), only BMI and PAB remained statistically significant (BMI: HR 2.799, 95% CI 1.167–6.715, p=0.021; PAB: HR 6.329, 95% CI 2.660–15.151, p<0.001). In addition, PAB had the highest area under the curve (AUC) for predicting in-hospital mortality (AUC = 0.696) followed by BMI (AUC = 0.561) and other factors. Conclusions PAB is a better predictor of in-hospital mortality than other nutrition indexes in elderly ICU patients.

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Luo, Liyan, i Min Wang. "Pre-albumin is a strong prognostic marker in elderly intensive care unit patients". Journal of Laboratory Medicine 45, nr 4-5 (19.08.2021): 225–28. http://dx.doi.org/10.1515/labmed-2021-0009.

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Abstract Objectives Pre-albumin (PAB) can be used to evaluate the association between nutrition status and in-hospital mortality. However, there is no literature to compare if PAB is the best indicator to predict in-hospital mortality among the nutrition indexes in a study. Methods We operated a retrospective study including 145 patients admitted to our institution’s elderly intensive care unit (ICU) from January, 2017 to December, 2019. Admission laboratory results were collected. Regression analysis and receiver operating curve (ROC) were analyzed to explore the performance of different nutrition indexes. Results The levels of PAB were significantly different between the survivor and non-survivor group (p=0.001). Univariate analysis showed nutrition indexes (lymphocytes, albumin, body mass index [BMI], geriatric nutritional risk index (GNRI), prognostic nutritional index [PNI] and PAB) were associated with in-hospital mortality (all p<0.1). Following adjustment for age, platelets and creatinine (CREA), only BMI and PAB remained statistically significant (BMI: HR 2.799, 95% CI 1.167–6.715, p=0.021; PAB: HR 6.329, 95% CI 2.660–15.151, p<0.001). In addition, PAB had the highest area under the curve (AUC) for predicting in-hospital mortality (AUC = 0.696) followed by BMI (AUC = 0.561) and other factors. Conclusions PAB is a better predictor of in-hospital mortality than other nutrition indexes in elderly ICU patients.

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Doğramacı, Esma J., i Farhad B. Naini. "Impacted maxillary canines: contemporary management and review of the literature". Faculty Dental Journal 3, nr 4 (październik 2012): 210–17. http://dx.doi.org/10.1308/204268512x13466824724715.

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Management of impacted maxillary canines forms a sizeable proportion of orthodontic treatment provided in dental school and district general hospital settings. Patients presenting with impacted canines fall into the highest category on the Index of Orthodontic Treatment Need (IOTN). Patients who agree to have surgical exposure and subsequent orthodontic alignment of an impacted canine are committing themselves to a course of treatment that could take up to three years, towards the end of which the patient's enthusiasm may be waning. Prevention, or at least early interception of the impacted canine, could save a protracted course of treatment and avert not only the surgical morbidity associated with exposure of the impacted tooth but also the general risks associated with orthodontic treatment.

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Middleton, Smith, Bedford, Neilly i Myint. "Shock Index Predicts Outcome in Patients with Suspected Sepsis or Community-Acquired Pneumonia: A Systematic Review". Journal of Clinical Medicine 8, nr 8 (31.07.2019): 1144. http://dx.doi.org/10.3390/jcm8081144.

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Background: To improve outcomes for patients who present to hospital with suspected sepsis, it is necessary to accurately identify those at high risk of adverse outcomes as early and swiftly as possible. To assess the prognostic accuracy of shock index (heart rate divided by systolic blood pressure) and its modifications in patients with sepsis or community-acquired pneumonia. Methods: An electronic search of MEDLINE, EMBASE, Allie and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Open Grey, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (WHO ITRP) was conducted from conception to 26th March 2019. Eligible studies were required to assess the prognostic accuracy of shock index or its modifications for outcomes of death or requirement for organ support either in sepsis or pneumonia. The methodological appraisal was carried out using the Downs and Black checklist. Evidence was synthesised using a narrative approach due to heterogeneity. Results: Of 759 records screened, 15 studies (8697 patients) were included in this review. Shock index ≥ 1 at time of hospital presentation was a moderately accurate predictor of mortality in patients with sepsis or community-acquired pneumonia, with high specificity and low sensitivity. Only one study reported outcomes related to organ support. Conclusions: Elevated shock index at time of hospital presentation predicts mortality in sepsis with high specificity. Shock index may offer benefits over existing sepsis scoring systems due to its simplicity.

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Husaini, Brury A., Sugiarto Sugiarto, Safrizal Rahman i Rina S. Oktari. "Assessing hospital disaster preparedness: A scoping review of available tools". Narra J 3, nr 2 (29.08.2023): e210. http://dx.doi.org/10.52225/narra.v3i2.210.

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One of the problems faced after a disaster is health service for victims and hospitals play a critical role in handling disaster victims. Therefore, hospitals must enhance their preparedness and establish a disaster-safe environment to effectively fulfill their role as a provider of health services during a crisis. The aim of this scoping review was to identify hospital disaster preparedness tools used around the globe and to identify the critical aspects that need to be included in hospital disaster preparedness. This study used the five stages of Arksey and O'Malley's scoping review framework to determine what disaster preparedness tools can be used in a hospital setting. The electronic literature searches of English articles published between 2018 and 2023 were conducted using PubMed, Elsevier, ProQuest, ISI Web Science, and Google Scholar databases. The searched keywords were combined into several search terms such as sub-discipline, subtitle, year, language, and content type. The keywords of sub-title searching were “preparedness”, “hospital” and “disaster”. After applying some inclusion criteria, ten articles out of 1,221 identified records were included in the final analysis. The World Health Organization (WHO) Hospital Safety Index, WHO Hospital Emergency Checklist or their modified versions, and modified Public Health Emergency Preparedness were tools used in assessing hospital disaster preparedness. These tools evaluate some aspects such as structural safety, non-structural safety, and functional capacity. The studies indicated that each tool used to measure hospital disaster preparedness has strengths and weaknesses in each assessed aspect. Although some tools have been recommended to assess hospital disaster preparedness, assessing each tool validity and reliability are critical and needs to be conducted.

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Irvin, Laura, Annemarie De Leo i Clare Davison. "Stand and deliver: an integrative review of the evidence around birthing upright". British Journal of Midwifery 30, nr 3 (2.03.2022): 172–77. http://dx.doi.org/10.12968/bjom.2022.30.3.172.

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Background The benefits of upright birth positions are well-established in the literature, yet women are persistently challenged to assume the lithotomy or supine birth positions. This study aimed to explore what is known about women's capacity to assume upright birth positions in hospital environments, and its effect on physiological birth. Methods A structured five-step approach was employed to conduct an integrative review of the literature. The Cumulative Index to Nursing and Allied Health Literature and MEDLINE were searched for articles on women's position during labour and birth in hospital settings. Four articles were selected for inclusion and subjected to thematic analysis to elicit themes and subthemes. Results Three core themes emerged from this review: ‘the biomedical model of care and workplace culture impact the positions women adopt during labour and birth’, ‘midwives' philosophy and views support physiological birth’ and ‘clinical settings are not conducive to physiological birth’. Conclusions Midwives are losing the skills and confidence to support women into upright birth positions. Improved education and training around upright birthing may see a rise in women adopting these positions in hospital environments.

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Zhang, Baozhi, Xiao Ling Wu i Ruiping Li. "A Meta-Analysis on Evaluation of Nosocomial Infections Amongst Patients in a Tertiary Care Hospital". Journal of Healthcare Engineering 2021 (29.09.2021): 1–6. http://dx.doi.org/10.1155/2021/4386423.

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Background. Hospital-acquired infections, also known as nosocomial infections, are one of the many severe outcomes amongst patients in tertiary care hospitals. Hospital-acquired influenza is amongst the most common infection which has affected huge population. Objective. We have performed a meta-analysis in order to summarize the effects of epidemiology and clinical characteristics in HAI. Methods. We performed literature review with help of PubMed, Cochrane Library, Embase, Scopus, Web of Science, China National Knowledge Infrastructure (CNKI), The Global Index Medicus (GIM), and other clinical databases till 2021. Many random models were used in order to obtain pooled proportions, mean difference, odds ratio, and CI. Results. A total of six studies were analyzed, where a total of 491 nosocomial and 4030 nonnosocomial infection cases were reported. The odds ratio of mortality was 0.02 with 95% CI and the risk ration for males was 1.08 with 95% CI. Conclusion. The proportion of nosocomial infections in cases of influenza was higher in patients admitted in tertiary care hospitals. Thus, a surveillance system for vaccination for all the high-risk patients must be made mandatory.

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Kapanadze, George, Johanna Berg, Yue Sun i Martin Gerdin Wärnberg. "Facilitators and barriers impacting in-hospital Trauma Quality Improvement Program (TQIP) implementation across country income levels: a scoping review". BMJ Open 13, nr 2 (luty 2023): e068219. http://dx.doi.org/10.1136/bmjopen-2022-068219.

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ObjectiveTrauma is a leading cause of mortality and morbidity globally, disproportionately affecting low/middle-income countries (LMICs). Understanding the factors determining implementation success for in-hospital Trauma Quality Improvement Programs (TQIPs) is critical to reducing the global trauma burden. We synthesised topical literature to identify key facilitators and barriers to in-hospital TQIP implementation across country income levels.DesignScoping review.Data sourcesPubMed, Web of Science and Global Index Medicus databases were searched from June 2009 to January 2022.Eligibility criteriaPublished literature involving any study design, written in English and evaluating any implemented in-hospital quality improvement programme in trauma populations worldwide. Literature that was non-English, unpublished and involved non-hospital TQIPs was excluded.Data extraction and synthesisTwo reviewers completed a three-stage screening process using Covidence, with any discrepancies resolved through a third reviewer. Content analysis using the Consolidated Framework for Implementation Research identified facilitator and barrier themes for in-hospital TQIP implementation.ResultsTwenty-eight studies met the eligibility criteria from 3923 studies identified. The most discussed in-hospital TQIPs in included literature were trauma registries. Facilitators and barriers were similar across all country income levels. The main facilitator themes identified were the prioritisation of staff education and training, strengthening stakeholder dialogue and providing standardised best-practice guidelines. The key barrier theme identified in LMICs was poor data quality, while high-income countries (HICs) had reduced communication across professional hierarchies.ConclusionsStakeholder prioritisation of in-hospital TQIPs, along with increased knowledge and consensus of trauma care best practices, are essential efforts to reduce the global trauma burden. The primary focus of future studies on in-hospital TQIPs in LMICs should target improving registry data quality, while interventions in HICs should target strengthening communication channels between healthcare professionals.

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Conway, Francine, Priyam Talreja, James McCarthy i Fiona Conway. "Thought and Language Disorder among Sexually Abused Children in a Psychiatric Hospital". Psychological Reports 112, nr 2 (kwiecień 2013): 340–52. http://dx.doi.org/10.2466/16.02.pr0.112.2.340-352.

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The empirical literature offers evidence that childhood sexual abuse is a predictor of psychopathology in adults. However, the literature examining the relations between thought disorder and psychotic symptoms in children is sparse. Children with a history of childhood sexual abuse are expected to demonstrate more disturbances in thought relative to their peers with no childhood sexual abuse. Using the Thought and Language Index, Thematic Apperception Test (TAT) narratives for four commonly used TAT cards obtained from 39 closed charts of hospitalized children were analyzed. Narratives were assessed on seven dimensions including weakening of goals, perseveration, looseness, peculiar word usage, peculiar sentence construction, non-logical reasoning, and distractibility. Good inter-rater reliability was obtained. Sexually abused children had higher aberrant scores on card number four compared to non-abused children. Sexual abuse history was a predictive factor for non-logical reasoning, with small effect size. Implications and suggestions for future research are discussed.

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Usoro, Agnes, Mercy Dickson, Valerie Osula i Angelica K. Ezeigwe. "52739 Trauma Care in Nigeria and Recommendations for Sustainable Improvement to Nigeria’s Trauma Care System: A Systematic Literature Review". Journal of Clinical and Translational Science 5, s1 (marzec 2021): 67. http://dx.doi.org/10.1017/cts.2021.574.

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ABSTRACT IMPACT: This work highlighs the significant burden of Trauma in Nigeria and will help inform policy decisions on improving Nigeri’s current Trauma care system OBJECTIVES/GOALS: To evaluate trauma care delivery at the pre-hospital, hospital and health systems level in Nigeria in order to identify the burden of trauma, gaps in the delivery of trauma care, and interventions, implemented or recommended, to improve upon the limitations to trauma care delivery. METHODS/STUDY POPULATION: A two-concept search - one being trauma and the other being Nigeria - of the Pubmed (Medline) and Embase databases, in addition to Global Index Medicus and grey literature was performed between September 2018 and September 2019. The search yielded 3,970 articles that underwent title screening and 331 articles that underwent abstract screening. 101 articles were identified for full text screening and the majority were extracted for inclusion into the review. The extracted literature was grouped into 4 categories - articles outlining the burden of trauma in Nigeria, and articles outlining the delivery of trauma care at the pre-hospital, hospital and health systems level. RESULTS/ANTICIPATED RESULTS: Results were classified as an identified challenge or an intervention, recommended or implemented, to address Nigeria’s trauma care system. There was a highlighted need for pre-hospital infrastructure, training of frontline providers, continued competency assessments of frontline providers, in-hospital diagnostic resources, and trauma care surveillance systems to guide health policy. DISCUSSION/SIGNIFICANCE OF FINDINGS: There is a significant burden of trauma in Nigeria. Coordinated interventions and policies at the pre-hospital level, the hospital level, as well as the health systems level are needed in order to address the gaps in Nigeria’s current trauma care system.

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Gorgemans, Sophie, Micaela Comendeiro-Maaløe, Manuel Ridao-López i Enrique Bernal-Delgado. "Comparing Hospital Efficiency: An Illustrative Study of Knee and Hip Replacement Surgeries in Spain". International Journal of Environmental Research and Public Health 20, nr 4 (15.02.2023): 3389. http://dx.doi.org/10.3390/ijerph20043389.

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WHO’s Health Systems Performance Assessment framework suggests monitoring a set of dimensions. This study aims to jointly assess productivity and quality using a treatment-based approach, specifically analyzing knee and hip replacement, two prevalent surgical procedures performed with consolidated technology and run in most acute-care hospitals. Focusing on the analysis of these procedures sets out a novel approach providing clues for hospital management improvements, covering an existing gap in the literature. The Malmquist index under the metafrontier context was used to estimate the productivity in both procedures and its decomposition in terms of efficiency, technical and quality change. A multilevel logistic regression was specified to obtain the in-hospital mortality as a quality factor. All Spanish public acute-care hospitals were classified according to their average severity attended, dividing them into three groups. Our study revealed a decrease in productivity mainly due to a decrease in the technological change. Quality change remained constant during the period with highest variations observed between one period to the next according to the hospital classification. The improvement in the technological gap between different levels was due to an improvement in quality. These results provide new insights of operational efficiency after incorporating the quality dimension, specifically highlighting a decreasing operational performance, confirming that the technological heterogeneity is a critical question when measuring hospital performance.

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Rana, Sweta Rajya Laxmi, i Arun Sharma. "Periodontal Status of Patients Undergoing Hemodialysis Therapy in a Tertiary Level Hospital of Nepal". Medical Journal of Shree Birendra Hospital 15, nr 2 (23.04.2017): 2–7. http://dx.doi.org/10.3126/mjsbh.v15i2.15266.

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Introduction: Periodontitis is a chronic inflammation of the supporting structures of the teeth. It has been shown to be associated with systemic diseases including cardiovascular and respiratory diseases, diabetes mellitus and preterm birth. Conflicting reports on the relationship of chronic renal failure patients and periodontal diseases are present in the literature. No previous study has been reported in renal patients in Nepalese population. Hence this study was done to assess the oral hygiene and periodontal conditions in hemodialysis patients in a Tertiary level hospital in Nepal.Methods: Descriptive observational study in which hemodialysis cases were assessed for periodontal parameters including Oral Hygiene- Simplified Index (OHI-S), Plaque Index (PI), Gingival Index (GI), Probing pocket depth (PPD) and clinical attachment level (CAL).Results: A total of 30 patients (20 male, 10 female; mean age 51.06±14.37 years) were assessed. Mean OHI-S, PI, GI, PPD and CAL were 4.02±0.89, 1.93±0.27, 1.57±0.28, 2.09±0.19 and 2.18±0.42, respectively. The distribution of periodontitis was 10% severe, 46.66% moderate and 43.33% mild periodontitis.Conclusions: Hemodialysis patients showed poor oral hygiene and moderate and periodontitis. Hence periodic assessment and periodontal treatment may prevent further complications in these patients.

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Shen, Chan, Dian Gu, Roger Klein, Shouhao Zhou, Ya-Chen T. Shih, Thomas Tracy, David Soybel i Peter Dillon. "Factors Associated With Hospital Decisions to Purchase Robotic Surgical Systems". MDM Policy & Practice 5, nr 1 (styczeń 2020): 238146832090436. http://dx.doi.org/10.1177/2381468320904364.

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Background. Robotic surgical systems are expensive to own and operate, and the purchase of such technology is an important decision for hospital administrators. Most prior literature focuses on the comparison of clinical outcomes between robotic surgery and other laparoscopic or open surgery. There is a knowledge gap about what drives hospitals’ decisions to purchase robotic systems. Objective. To identify factors associated with a hospital’s acquisition of advanced surgical systems. Method. We used 2002 to 2011 data from the State of California Office of Statewide Health Planning and Development to examine robotic surgical system purchase decisions of 476 hospitals. We used a probit estimation allowing heteroscedasticity in the error term including a set of two equations: one binary response equation and one heteroscedasticity equation. Results. During the study timeframe, there were 78 robotic surgical systems purchased by hospitals in the sample. Controlling for hospital characteristics such as number of available beds, teaching status, nonprofit status, and patient mix, the probit estimation showed that market-level directly relevant surgery volume in the previous year (excluding the hospital’s own volume) had the largest impact. More specifically, hospitals in high volume (>50,000 surgeries v. 0) markets were 12 percentage points more likely to purchase robotic systems. We also found that hospitals in less competitive markets (i.e., Herfindahl index above 2500) were 2 percentage points more likely to purchase robotic systems. Limitations. This study has limitations common to observational database studies. Certain characteristics such as cultural factors cannot be accurately quantified. Conclusions. Our findings imply that potential market demand is a strong driver for hospital purchase of robotic surgical systems. Market competition does not significantly increase the adoption of new expensive surgical technologies.

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Santos, Alana Sousa dos, Arlete Rodrigues Chagas da Costa, Lara Mabelle Milfont Boeckmann, Ana Ligia da Silva Sousa, Solange de Paiva Pinto i Domitília Bonfim de Macêdo Mihaliuc. "Adaptation and validation of the safe birth checklist for a public maternal and child reference hospital". Concilium 23, nr 17 (27.10.2023): 617–29. http://dx.doi.org/10.53660/clm-2196-23q26.

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Objective: to adapt and validate the World Health Organization's safe birth checklist for the Brazilian reality using a public maternal and child reference unit as a model. Method: this is a methodological study. In the first stage, the instrument was adapted based on the literature review and the guidelines of the safe birth checklist protocol. In the second stage corresponding to validation through content analysis, the adapted instrument was sent to the judges using Likert scales, consisting of 41 items. To analyze the data, the Content Validity Index was used. Results: Validity and content analysis were carried out by 17 judges working in assistance, teaching and research. Items with a Content Validity Index greater than or equal to 0.8 were maintained in full or underwent revisions as suggested by the judges. The instrument achieved an overall Content Validity Index of 0.96. Conclusion: the instrument was valid in the five dimensions studied and can be used in similar birth care services in Brazil and around the world and used in future research.

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Hsia, Renee Y., Amy J. Markowitz, Feng Lin, Joanna Guo, Debbie Y. Madhok i Geoffrey T. Manley. "Ten-year trends in traumatic brain injury: a retrospective cohort study of California emergency department and hospital revisits and readmissions". BMJ Open 8, nr 12 (grudzień 2018): e022297. http://dx.doi.org/10.1136/bmjopen-2018-022297.

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ObjectiveTo describe visits and visit rates of adults presenting to emergency departments (EDs) with a diagnosis of traumatic brain injury (TBI). TBI is a major cause of death and disability in the USA; yet, current literature is limited because few studies examine longer-term ED revisits and hospital readmission patterns of TBI patients across a broad spectrum of injury severity, which can help inform potential unmet healthcare needs.DesignWe performed a retrospective cohort study.SettingWe analysed non-public patient-level data from California’s Office of Statewide Health Planning and Development for years 2005 to 2014.ParticipantsWe identified 1.2 million adult patients aged ≥18 years presenting to California EDs and hospitals with an index diagnosis of TBI.Primary and secondary outcome measuresOur main outcomes included revisits, readmissions and mortality over time. We also examined demographics, mechanism and severity of injury and disposition at discharge.ResultsWe found a 57.7% increase in the number of TBI ED visits, representing a 40.5% increase in TBI visit rates over the 10-year period (346–487 per 100 000 residents). During this time, there was also a 33.8% decrease in the proportion of patients admitted to the hospital. Older, publicly insured and black populations had the highest visit rates, and falls were the most common mechanism of injury (45.5% of visits). Of all patients with an index TBI visit, 40.5% of them had a revisit during the first year, with 46.7% of them seeking care at a different hospital from their initial hospital or ED visit. Additionally, of revisits within the first year, 13.4% of them resulted in hospital readmission.ConclusionsThe large proportion of patients with TBI who are discharged directly from the ED, along with the high rates of revisits and readmissions, suggest a role for an established system for follow-up, treatment and care of TBI.

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Einarson, Thomas R. "Drug-Related Hospital Admissions". Annals of Pharmacotherapy 27, nr 7-8 (lipiec 1993): 832–40. http://dx.doi.org/10.1177/106002809302700702.

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OBJECTIVE: To review and summarize studies reporting rates of drug-related hospital admissions. DATA SOURCES: Manual and computerized literature searches using MEDLINE, Index Medicus, and International Pharmaceutical Abstracts as databases (key words: Drug, drug-related, or iatrogenic; admission, hospital admission, or hospitalization; and ADR or adverse drug reaction). References from retrieved articles were searched to locate further studies. STUDY SELECTION: Included were English-language studies of humans admitted to the hospital because of medications. Problems investigated were admissions prompted by adverse drug reactions (ADRs) when drugs were used by the patient and admissions resulting from a patient's noncompliant or unintentionally inappropriate drug use. Excluded were cases involving drug abuse, alcoholism, suicide attempts, intoxication, or inadequate prescribing. DATA SYNTHESIS: Between 1966 and 1989, ADR rates from 49 hospitals or groups of hospitals in a variety of international settings were published in 36 articles. Sample sizes ranged from 41 to 11 891 patients, with a median of 714 (interquartile range [IQR] 275-1245) and a mean of 1412 (SD 2233). The prevalence of reported admissions resulting from ADRs ranged from 0.2 to 21.7 percent; the median was 4.9 percent (IQR 2.9–6.7 percent) and the mean was 5.5 percent (SD 4.1 percent). The weighted meta-analytic estimate was 5.1 percent (95 percent confidence interval 4.4–5.8). Of those ADR admissions, 71.5 percent were side effects, 16.8 percent excessive effects, 11.3 percent hypersensitivity reactions, and 0.4 percent idiosyncratic; 3.7 percent of patients admitted for ADRs died. Eleven reports indicated that 22.7 percent of ADR hospitalizations were induced by noncompliance. CONCLUSIONS: Drug-induced hospitalizations account for approximately five percent of all admissions. Results apply only to people from highly developed industrialized countries. Economic analyses have not been performed. Future research should include the Third World and nonindustrialized nations as well as specific cultural groups.

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Linh Pham, Thuy. "Efficiency and productivity of hospitals in Vietnam". Journal of Health Organization and Management 25, nr 2 (24.05.2011): 195–213. http://dx.doi.org/10.1108/14777261111134428.

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PurposeThe purpose of this paper is to examine the relative efficiency and productivity of hospitals during the health reform process.Design/methodology/approachData envelopment analyses method (DEA) with the input‐oriented variable‐returns‐to‐scale model was used to calculate efficiency scores. Malmquist total factor productivity index approach was then employed to calculate productivity of hospitals. Data of 101 hospitals was extracted from databases of the Ministry of Health, Vietnam from the years 1998 to 2006.FindingsThere was evidence of improvement in overall technical efficiency from 65 per cent in 1998 to 76 per cent in 2006. Hospitals' productivity progressed around 1.4 per cent per year, which was mainly due to the technical efficiency improvement. Furthermore, provincial hospitals were more technically efficient than their central counterparts and hospitals located in different regions performed differently.Originality/valueThe paper provides an insight in the performance of Vietnamese public hospitals that has been rarely examined before and contributes to the existing literature of hospital performance in developing countries

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Lamine, Hamdi, Alessandro Lamberti-Castronuovo, Prinka Singh, Naoufel Chebili, Chekib Zedini, Nebil Achour, Luca Ragazzoni i Martina Valente. "A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations." Prehospital and Disaster Medicine 38, S1 (maj 2023): s135—s136. http://dx.doi.org/10.1017/s1049023x23003576.

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Introduction:Hospitals around the world need to be safe and prepared to face disasters, being these man-made or caused by natural hazards. The Hospital Safety Index (HSI) is a tool developed by the World Health Organization (WHO) that allows access to the level of preparedness of hospitals; it is the most widely used instrument of its kind. Although the HSI is frequently used by hospitals and healthcare facilities around the world, scientific literature on its application in real life is scarce and qualitative studies are absent. By adopting a qualitative methodology, this study aims to investigate the use of the HSI to assess disaster preparedness in hospitals and healthcare facilities, identify challenges and facilitators of the HSI use, and devise recommendations for future adaptations of the tool.Method:A retrospective qualitative study employing semi-structured online interviews was conducted to gather opinions and perspectives of professionals using the HSI to assess disaster preparedness. Participants were recruited by contacting via email the authors of scientific publications on the use of the HSI.Results:In total, nine people from three different countries (Serbia, Sri Lanka, and Indonesia) and having different professional backgrounds agreed to participate in this study. They shared the reasons for their choice of using the HSI, against other tools, as well as the steps taken before and during data collection. Strengths and weaknesses of the HSI were identified and authors reported the challenges they encountered in the preparatory phase and during data collection. Modifications of the tool and recommendations for the future were proposed targeting both researchers and hospital managers.Conclusion:As far as the authors know, this is the first qualitative study examining the methodological implications of using the HSI and providing practical recommendations that can advance the HSI tool and foster its use for disaster preparedness assessments worldwide.

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Perazzoli, Camila, Rogério S. Parra, Marley R. Feitosa, Enrico Sfoggia, Belinda Pinto Simões, José J. R. Rocha i Omar Féres. "A Novel Severity Score Index for Febrile Neutropenic Patients with Colorectal Diseases". Gastroenterology Research and Practice 2019 (24.03.2019): 1–6. http://dx.doi.org/10.1155/2019/4175960.

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Introduction. Abdominal and anorectal disorders may be the cause of clinical decompensation in neutropenic febrile patients, particularly those with hematologic diseases. Infection is a cause for concern for the colorectal surgeon. Some conditions have few manifestations and can lead to death within a short period of time. This study presents the novel colorectal disorder severity score for febrile neutropenic patients. Materials and Methods. This was a case series study analyzing the medical records of 897 patients admitted to the Hematology and Hematopoietic Stem Cell Transplant Unit in a university hospital between the years 2008 and 2013. Seventy-four episodes of febrile neutropenia in 69 patients diagnosed with an abdominal or anorectal infection site were eligible for the study. The new scoring system proposed here is based on the author’s clinical experience and an extensive literature review. In addition to the extensive literature review, effect measures were calculated, and a statistical analysis was performed. Based on an evaluation of common biological plausibility criteria, five factors were selected as the main predictors of hospital mortality in febrile neutropenic patients with colorectal disease. Results. The proposed score demonstrated increased mortality as the condition worsened as reflected by an increasing score (Fisher’s exact test: 0.001). When considering the logistic model for the probability of death by score level, the AUC value was 0.82 (0.72-0.925), and the Hosmer-Lemeshow statistic value was 2.3, p=0.806. Conclusion. The proposed scoring system allows prediction of the likelihood of death during hospitalization for febrile neutropenic patients with an abdominal and anorectal focus. New studies on the subject are required, and the proposed scoring scale must be validated on a larger and different sample of patients.

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Ananta, Mishra, Pandit Vinay, Jhasketan Jhasketan i Abhishek Abhishek. "Subacute thyroiditis-an unusual endocrine cause of pyrexia of unknown origin: Case report with review of literature". Global Journal of Infectious Diseases and Clinical Research 9, nr 1 (15.03.2023): 009–11. http://dx.doi.org/10.17352/2455-5363.000055.

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We report a case of a 58-year-old male who presented with high grade fever of 45 days duration. He had presented with a dry cough and right ear pain. His initial clinical evaluation and diagnostic tests were unremarkable. During the hospital stay, he developed palpitation for which tests for thyroid functions were done which revealed subacute thyroiditis. He recovered fully with the treatment. Subacute thyroiditis is one of the rarely mentioned causes of Pyrexia of Unknown origin. A high index of suspicion and appropriate imaging is required for early diagnosis and management.

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