Hospital Topics最新文献

Introduction: Telemedicine has been a growing trend. Its use in the field of orthopedic surgery has its own unique facets. To determine the perception and assess the utilization of telemedicine the current study was conducted.

Materials and methods: This is a cross-sectional exploratory study conducted from January to April 2022 among 142 orthopedic surgeons across India who had previous experience of using telemedicine and were willing to participate in this study. The data was collected using a validated semi-structured questionnaire consisting of 44 multiple Choice questions, divided into 7 sections: experience in using telemedicine, technical aspects, patient selection, problems faced, benefits, current use, and opinions designed in English language. The data obtained from the responses were tabulated, analyzed and expressed in proportions.

Results: We found that nearly 80% of orthopedic surgeons believed that teleconsultation was most appropriate for follow up visits. The two most common issues faced were technical issues relating to poor video/audio/connectivity, and difficulty with regard to viewing of radiographs, MRI films etc. The major advantage was perceived to be easier access for patients, especially bed ridden/old patients.

Conclusion: Our survey showed a significantly positive response toward telemedicine. Technical issues and lack of clinical examination were cited as the most common hindrances faced. Saving the time of the patient, and easier access to healthcare for old aged individuals, bed ridden patients and individuals in remote areas were the major perceived benefits.

Objective: To assess the perceived risks and impact of the COVID-19 outbreak on radiation therapists in Saudi Arabia. Methods: A questionnaire was distributed to all radiation therapists in the country. The questionnaire contained questions about demographic characteristics, the extent of the pandemic's impact on hospital resources, risk perception, work-life, leadership, and immediate supervision. The questionnaire's reliability was assessed using Cronbach's alpha; >0.7 was considered adequate. Results: Out of the 127 registered radiation therapists, 77 (60.6%) responded; 49 (63.6%) females; and 28 (36.4%) males. The mean age was 36.8 ± 12.5 years. Nine (12%) of the participants had a past experience with pandemics or epidemics. Further, 46 (59.7%) respondents correctly identified the mode of transmission of COVID-19. Approximately, 69% of the respondents perceived COVID-19 as more than a minor risk to their families and 63% to themselves. COVID-19 had an overall negative impact on work at the personal and organizational levels. However, there was a positive attitude toward organizational management during the pandemic in general; positive responses ranged from 66.2% to 82.4%. Ninety-two percent considered protective resources and 70% considered the availability of supportive staff to be adequate. Demographic characteristics were not significantly associated with the perceived risk. Conclusions: Despite the high perception of risk and negative impact on their work, radiation therapists conveyed a positive overall perception regarding resource availability, supervision, and leadership. Efforts should be made to improve their knowledge and appreciate their efforts.

The lean approach is a value-added system that reduces cost and waste to continuously improve the quality performance of the healthcare organization. The present study investigates the relationships of the lean approach with top management team and employee engagement toward quality improvement of the public hospitals in Malaysia. This study used stratified random sampling to collect data from the public hospitals' staff who were directly involved with patient services. In this study, PLS-SEM 3.3.4 was applied to measure the research constructs and hypotheses. The research findings indicate that the lean approach has a significant relationship with the top management team and employee engagement to positively impact the quality improvement of the public hospital. However, research findings also indicate that the top management team has no significant influence on quality improvement in public hospitals, but it has an indirect effect through the lean approach and employee engagement. The findings of the study will provide guidelines on how the lean approach contributes to the body of knowledge and practical implications to continuously improve the quality performance of public healthcare system.

Background: Rural hospitals in the United States face staffing and financial challenges, low patient volumes, and aging infrastructures among others. In addition, they deal with such crises as the opioid epidemic, natural disasters, and the coronavirus.

Methods: The analyses presented in this study are based on two databases: (1) the 2019 annual survey data published by the American Hospital Association (AHA) and (2) US Department of Health and Human Services (HHS) database of US hospitals containing information related to COVID-19 for the week of November 27, 2020. Using a subset of the 2019 AHA annual survey data to which the authors acquired access, this study develops a profile of rural hospitals in America. The data are proprietary property of AHA. The authors are permitted to use the data in published research but only in aggregate form. No individual hospital metrics can be used in this report. The HHS database is public data and as such is available to all. HHS recognizes the importance of providing high-quality, accessible, and timely information for entrepreneurs, researchers, and policy makers to help drive insights and better health outcomes for all. Employing this HHS database, a cross-sectional view of the impact of COVID on small, rural hospitals in the United States is undertaken. In this study, data found in the HHS database are presented only in the aggregate form.

Results and discussion: The average small, rural hospital has 20.8 beds, 10 weekly admissions, a daily census of 6.6 patients, 145 full-time personnel, 67 part-time personnel, and a total facility expense of $27 million of which payroll expense was 41%. Due to COVID, there was an increase in admissions and outpatient visits.

The significant and apparent variance in hospital charges and inpatient care in the U.S. has perplexed the general public including many stakeholders such as the healthcare regulators and insurers. While the clinical side of inpatient care has been undergoing tremendous progress and standardization, the overall cost of healthcare has been ballooning. The purpose of this research is to conduct statistical analyses that reveal the sources of variance in hospital charges and inpatient care using the annual data from the AHRQ's (Agency for Healthcare Research and Quality) HCUP's (Hospital Cost and Utilization Project) NIS (National Inpatient Sample) database. Our focus is on non-clinical factors such as patient age, gender, income and race and hospital location data as independent variables to investigate their impact on hospital charges and inpatient care. Our research sample is the liver transplant cases in 2019 sampled in the NIS 2019 database. Our regression results show patient age and gender as well as payer affect the number of diagnoses; and hospital charges are affected by age, payer and hospital location. Number of procedures was not affected by any of these non-clinical factors except the hospital location. Implications suggest that there is more room for standardization of the number of diagnoses and procedures across regions in the US. Results also reveal that race and income do not have any effect on hospital charges and inpatient care. Our study contributes to an empirical understanding of non-clinical factors in the explanation of variance in hospital charges and inpatient care.

This study purposed to determine the levels of nursing informatics competency and self-efficacy in clinical practice and influencing factors on self-efficacy among Palestinian nurses in hospitals. A descriptive-correlational design was adopted. The nurses who worked in the North West Bank of Palestine (N = 331) were recruited. The data were collected using the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) which consists of 30 items rated on a 5-point Likert scale, ranging from 1(not competent) to 5 (expert), and scored by calculating the mean as follows: novice/low (1.00-2.59), beginner/moderate (2.60-3.39), and competent/high (3.40-5.00); and the New General Self-Efficacy Scale (NGSE) that consists of eight items rated on a 5-point Likert scale, ranging from 1(strongly disagree) to 5(strongly agree) and scored according to the average of the scale, whereas the average of > 3 indicated high self-efficacy, and ≤ 3 reflected low self-efficacy. The data were collected during the period from September to November 2020. Findings showed that the total mean score for the nursing informatics competency scale was 2.9 (SD = 0.7), which indicated that the nurses had a moderate level of nursing informatics competency. The average score for the self-efficacy scale was 3.5 (SD = 0.8), which reflected that nurses had high self-efficacy. Self-efficacy in clinical practice increased with age and with nursing informatics competency. Thus, it is necessary to enhance nurses' informatics competency by developing continuous educational programs about this technology for nurses and engaging nurses in such programs to enhance their competencies in this system.

This cross-sectional study aimed to explore the perceptions and performances of hospital pharmacists in providing services for people with visual impairment. This study surveyed 150 hospital pharmacists at all levels in public hospitals in Bangkok, Thailand. The results demonstrate that hospitals faced challenges in translating the principles of the Convention Rights of People with Disabilities into hospital policy guidelines and service plans. Due to lack of policy endorsement, pharmacists were left unsupported for critical resources, such as facilities, budgets, staff, and materials to provide services quality. The hospital management and disability cultural competency were facilitating factors that promoted equitable care for vulnerable groups.

This was an observational study of hospitalized patients with dementia who developed COVID-19. The disease course, dietary intake, and disease severity (mild/severe) were evaluated. Twenty-nine patients with a median age of 84 years, with both mild (18) and severe conditions, (11) were evaluated. Mild group had decreased food intake from the day of symptom onset. In the severe group, the decline began the day before symptom onset. On day 30 of the disease, the median food intake of the mild group returned to levels observed prior to symptom onset, in contrast to those in the severe group.

Medication administration is a complex multistep process with a role of clinician in prescribing and transcribing, and nurse in administering drugs and monitoring patient's response. Error in any step can be a major threat to the safety of patients. Thus, the present study was trying to assess the level of knowledge and attitude of nurses regarding medication administration, pharmacology applied to nursing and barriers in reporting medication error. Also, its correlations with demographic variables. After obtaining the ethical clearance, a cross-sectional study with 141 nurses was conducted using a set of self-administered questionnaires. The questionnaire included demographic details, multiple choice question and five points of Likert scale related to nursing pharmacology, medication administration, reasons for committing medication error, and the barriers in reporting medication errors. Data was analyzed using both descriptive and inferential statistics (Pearson correlation). The findings of the study showed that only 38% nurses had an adequate knowledge regarding drug calculation and pharmacology applied to nursing, scoring more than 80%. A significant correlation (0.184) was found between knowledge and education level of nursing staffs (p = 0.05). But at the same time nurses follow proper medication administration process and had a favorable attitude toward medication error in real practice. Fear of getting blamed was found to be the highest perceived barrier in reporting medication error. The study concluded that a regular update in knowledge regarding medication administration of nurses is required and trust building by the organization among their staff is required to overcome the fear of getting blamed.

In Canada, hospitals designate patients as Alternate Level of Care (ALC) after they have completed all the necessary treatments and are ready for discharge, but remain in the hospitals and await transfer to an appropriate destination, such as a facility-based long-term care bed, home with care services, or palliative care bed. Provincial governments fund acute care in hospitals. However, hospitals have to divert funds to serve ALC patients. In 2019-20, ALC accounted for 19.31% of total bed-days. Yet, there is no comprehensive estimate of the cost of ALC. Therefore, the objective is to estimate the ALC cost, which is challenging, as the cost data for ALC days is lacking. However, the hospitalization cost (acute care plus ALC costs) and the number of acute and ALC days are available. Applying the log-log regression model with interaction terms between provinces and the natural logarithm of ALC length-of-stay to the hospital discharge data, supplemented by hospitalization cost data, the cost elasticity of ALC length-of-stay was estimated for each province. Then, the estimated cost elasticity, average hospitalization cost, average ALC length-of-stay, and total ALC bed-days for each province were utilized to estimate the province-specific cost of ALC in Canada. Summing these costs across provinces, the total expenditure for ALC services in Canadian provinces was estimated at $2.48 billion in 2019-20. This funding could potentially be redirected to improve value for money and enable timely acute care. Additionally, the study identified key diagnoses driving ALC costs.