Hospital Topics最新文献

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.

Background: Professional self-concept and problem-solving abilities could differ over career stages, thereby enabling graduate nurses to plan appropriate care.

Aim: This study aimed to assess professional self-concept and problem-solving abilities over career stages and examine the association between professional self-concept and problem-solving ability among Jordanian registered nurses (RNs).

Methods: A descriptive cross-sectional correlational design was performed. A self-administered questionnaire was used to collect demographic data, the Nurses Self-Concept Questionnaire (NSCQ), and the Problem-Solving Inventory (PSI).

Results: Female was 162 (58.4%) of 277 RNs, with a mean age of 29.55 (SD 5.97). Professional self-concept and problem-solving abilities were moderate. Moreover, professional self-concept and problem-solving ability differed based on marital status, the educational track at university, monthly income, working area, shift system, and career stages. The results showed a negative relationship between the professional self-concept and problem-solving ability (r = -0.29, P < 0.001).

Conclusion: Jordanian RNs have a high general perception level of professional self-concept and moderate problem-solving ability. Nurses with a higher professional self-concept would promote their ability to solve problems.

The implementation of Standard Inpatient Classes (SIC) in hospitals presents a significant challenge for Indonesia in its efforts to achieve Universal Health Coverage (UHC). This study aims to strengthen the strategy of public hospitals in Indonesia to face the SIC policy. The study design is qualitative with a case study approach. Data were collected through in-depth interviews and observations were conducted in the 1^st, 2^nd, and 3^rd inpatient rooms. Data analysis was carried out by using the Atlas-TI software and Strength, Weakness, Opportunity, and Threat (SWOT) analysis. Based on the results of this study, it was found that general hospitals are ready for the implementation of SIC. Public hospital is ready for SIC implementation. Hospitals must also consider a work plan for managing and observing the current condition of hospital infrastructure, a compatible hospital infrastructure management system, and an adequate budget for procuring hospital infrastructure. This study concluded that the main effort to deal with the SIC implementation is to strengthen the infrastructure of hospital inpatient rooms by optimizing funding from the Government.

Basic life support and advanced cardiovascular life support training are required every two years; however, these skills often deteriorate due to lack of routine practice which can increase anxiety in healthcare workers. The purpose of this project is to determine the effect of interdisciplinary simulation training on self-efficacy and anxiety levels of healthcare professionals in managing a medical emergency. Sessions simulating emergent situations were held every two weeks for eight weeks. Surveys (GAD-7) were completed two weeks pre- and postintervention, and an effectiveness questionnaire (SET) was completed immediately post-intervention. Participants agreed that the simulation sessions were an effective means of increasing confidence in responding to a medical emergency. Overall anxiety was decreased post-intervention.

Hospitals are required to provide a social safety-net through charity care to indigent populations. This study aims to build upon previous research by examining the provision of charity care by hospitals using national, longitudinal data. We found no significant difference in the provision of charity care. However, we did find that hospital charity care ratio may be influenced by type of care, location, and market conditions. Policymakers need to determine the appropriate level of charity care to be provided by non-profit hospitals. Managers need to determine the appropriate cost management strategy to support their hospitals' financial sustainability.

Introduction: Provider continuity can improve many aspects of an inpatient stay however, there is little data on whether it could affect mechanical ventilation weaning and tracheostomy decannulation. This study evaluated whether provider continuity could increase mechanical ventilation weaning and decannulation rates in the inpatient setting. Methods: Data was collected retrospectively from April 2020 to May 2022 for patients admitted to a pulmonary stepdown unit (SDU). A new staffing model was started in February 2021, in which a small group of physicians and advanced practice providers (APPs) continuously rotated through the unit. Ventilator weaning and decannulation protocols were used before and after initiating the new staffing model. Results: A total of 185 patients were reviewed and included in the study. During the 2‑year timeframe, 46% of the patients were weaned off the ventilator (n = 86), with 26% of the patients weaned occurring before the staffing model (n = 22) and 74% of patients weaned after (n = 64). Of the patients weaned from the ventilator, 56% were decannulated (n = 48), with 10% occurring before the staffing model started (n = 5) and 90% occurring afterward (n = 43). The increase in patients weaned from the ventilator and decannulated after the staffing model was statistically significant (P = 0.01 and P = 0.001, respectively). Conclusion: There was a significant increase in both mechanical ventilator weaning and decannulation rates after initiating the new staffing model. This study shows how continuity of care can have a positive effect on mechanical ventilation weaning and decannulation rates in the inpatient setting.

Prolonged lengths of stay (PLOS) impact patient outcomes, healthcare spending, and bed availability. Many patients stay beyond medical necessity due to complex barriers to discharge, including conservatorship applications and insurance coverage, shifting the provision of care from acute to chronic on medicine wards. We aim to understand the impact of this shift on healthcare staff workflow, interactions, and wellbeing through 23 key informant interviews analyzed using grounded theory. Our findings highlight PLOS as a contributor to burnout, with implications for patient care and staff job satisfaction that necessitate additional support for caring for this vulnerable patient population.

Perimenopause is a transitional state which occurs in women in their mid-life. These women may experience climacteric symptoms that affect their day-to-day life. The aim of the study was to assess and compare climacteric symptoms and their impact on daily lives among employed and unemployed perimenopausal women. A cross-sectional survey was done on 160 rural south Indian women aged 40 to 55 years who were identified as symptomatic of perimenopause as per the Stages of Reproductive Aging Workshop 10+ (STRAW) staging criteria. The study participants were grouped as employed and unemployed. Climacteric symptoms were assessed using Greene Climacteric Scale and climacteric symptoms' impact on daily lives was measured using a structured self-administered questionnaire. Both descriptive and inferential statistics were used to compare the variables between the two groups. The total Greene Climacteric score for unemployed perimenopausal women were found to be significantly higher than the employed group of perimenopausal women (14.5 ± 7.23 versus 12.52 ± 4.9, p < 0.05). The majority (58.8%) of the employed group had minimum impact whereas; the majority (51.2%) of the unemployed group had an average impact score. There was a strong positive correlation between climacteric symptoms and their impact on the daily lives of perimenopausal women. Employment status is a significant factor in causing variation in the climacteric symptoms. Unemployed perimenopausal women suffered more climacteric symptoms than their employed counterparts.