Care Unit Of Hospital Research Articles

Determination of Compassion Fatigue and Work Volition of Nurses Working in Intensive Care Units During COVID-19: A Cross-Sectional Survey

Objective: This study aimed to determine the compassion fatigue and work volition of nurses working in the intensive care units during the COVID-19 pandemic. Methods: This descriptive, cross-sectional study was conducted with a sample of 308 nurses working in the COVID-19 intensive care units of the pandemic hospitals affiliated with the Ministry of Health in the Istanbul province, Turkey, between February and May 2021. Data were obtained using the Personal Characteristics Form, the Compassion Fatigue-Short Scale and the Work Volition Scale. The obtained data were asses with the SPSS 22.0 statistical program. Results: It was determined that the mean age of the nurses participating in the study was 30.32±10 years; 80.2% were female, and 23.4% had been working for 1-3 years. The compassion fatigue total mean score was 79.91±25.04, while the work volition total mean score average was 50.28±10.65, which was found to be moderate. In the nurses' compassion fatigue sub-dimensions, the mean for occupational burnout was 49.12±15.61, and the secondary trauma mean was 30.78±10.92. A weak positive correlation was found between the nurses' compassion fatigue and work volition total scores (r= 0.235, p

A multidisciplinary comprehensive nursing Management Approach for Catheter-related bloodstream infections.

Catheter-related bloodstream infection (CR-BSI) stands as one of the leading causes of hospital-acquired infections, often resulting in high healthcare expenditure and mortality rates. Despite efforts, reducing the incidence of CR-BSI remains a significant challenge. This study aimed to assess the impact of a multidisciplinary organizational intervention on reducing intravenous CR-BSI. A quality improvement team was established to implement various interventions, utilizing the FOCUS-PDCA continuous quality improvement model and fishbone diagram for analysis and improvement. After the interventions, operational indicators for catheter insertion, maintenance, and removal improved from 82.50% ± 1.15%, 83.60% ± 1.60%, and 81.60% ± 1.80-95.30% ± 1.00%, 96.20% ± 1.62%, and 97.25% ± 0.50%, respectively. Additionally, catheter dwell time decreased from 7.50 ± 0.85 days to 3.50 ± 0.75 days, and the quarterly infection rate was reduced from 2.328% ± 1.85-0.305% ± 0.95% following the implementation of the intervention. Despite the available evidence, there remains a noticeable gap between the ideal evidence-based practices and their practical implementation. We aim to eradicate CR-BSIs within the surgical intensive care units (ICUs) of hospitals. To achieve this goal, we have introduced a comprehensive quality improvement framework designed not only to benefit our own ICU but also to serve as a model for implementation in other similar healthcare settings.

Neurological Pupil Index and Intracranial Hypertension in Patients With Acute Brain Injury

Invasive intracranial pressure (ICP) is the standard of care in patients with acute brain injury (ABI) with impaired consciousness. The Neurological Pupil Index (NPi) obtained by automated pupillometry is promising for noninvasively estimating ICP. To evaluate the association between repeated NPi and invasive ICP values. This study is a secondary analysis of the Outcome Prognostication of Acute Brain Injury With the Neurological Pupil Index (ORANGE), a multicenter, prospective, observational study of patients with ABI performed from October 1, 2020, to May 31, 2022, with follow-up at 6 months after ABI. The ORANGE study was performed at neurologic intensive care units of tertiary hospitals in Europe and North America. In ORANGE, 514 adult patients receiving mechanical ventilatory support were admitted to the intensive care unit after ABI. Invasive ICP monitoring and automated pupillometry assessment every 4 hours during the first 7 days, considered as a standard of care. Association between ICP and NPi values over time, using bayesian joint models, with linear and logistic mixed-effects longitudinal submodels. The study included 318 adult patients (median [IQR] age, 58 [43-69] years; 187 [58.8%] male) who required intensive care unit admission, intubation, and mechanical ventilatory support due to acute traumatic brain injury (n = 133 [41.8%]), intracerebral hemorrhage (n = 104 [32.7%]), or aneurysmal subarachnoid hemorrhage (n = 81 [25.5%]) and had automatic infrared pupillometry used as part of the standard evaluation practice and ICP monitoring. A total of 8692 ICP measurements were collected, with a median (IQR) of 31 (18-37) evaluations per patient. The median (IQR) NPi and ICP for the study population were 4.1 (3.5-4.5) and 10 (5-14) mm Hg, respectively. In a linear mixed model, the mean change in the NPi value, as a continuous variable, was -0.003 (95% credible interval [CrI], -0.006 to 0.000) for each 1-mm Hg ICP increase. No significant association between ICP and abnormal NPi (<3; odds ratio, 1.01; 95% CrI, 0.99-1.03) or absent NPi (0; odds ratio, 1.03; 95% CrI, 0.99-1.06) was observed. Although an abnormal NPi could indicate brainstem dysfunction, in this large and heterogeneous population of patients, NPi values were not significantly associated overall with ICP values. Repeated NPi measurements may not be a sufficient replacement for invasive monitoring. ClinicalTrials.gov Identifier: NCT04490005.

Influence of HLA mismatch between donors and recipients on postoperative outcomes in cadaveric lung transplantation.

Generally, HLA matching between donors and recipients is not performed in lung transplantation (LTx). Therefore, whether HLA mismatch between donors and recipients (D/R mismatch) influences postoperative outcomes after LTx remains uncertain. In this study, we investigated the influence of D/R mismatch on postoperative outcomes after cadaveric LTx (CLT). A total of 140 CLT procedures were performed between 2012 and 2020. After excluding 5 recipients with preformed DSA and 1 recipient undergoing re-LTx, 134 recipients were enrolled in this retrospective study. The postoperative outcomes were compared between recipients with higher and lower D/R mismatches. The median D/R mismatch (A/B/DR loci) was 4.0 (range, 1-6). When dividing these 134 recipients into two groups (H group [D/R mismatch ≥ 5, n = 57] and L group [D/R mismatch ≤ 4, n = 77]), there were no significant differences in the patient backgrounds. The lengths of hospital and intensive care unit stays were similar (p = 0.215 and p = 0.37, respectively). Although the overall survival was not significantly better in the H group than in the L group (p = 0.062), chronic lung allograft dysfunction-free survival was significantly better in the H group than in the L group (p = 0.027). Conversely, there was no significant difference in the cumulative incidence of de novo donor-specific anti-HLA antibodies(dnDSAs) between the two groups (p = 0.716). No significant difference in dnDSA development was observed between patients with higher and lower D/R HLA mismatches. Given the favorable outcomes in the high HLA mismatch group, CLTs can be performed safely in recipients with high D/R HLA mismatches.

Prevalence, Antibiotic Resistant Pattern and Genotypic Detection of Acinetobacter baumannii Isolated from Different Clinical Specimens of Patients Admitted at a Tertiary Care Hospital in Bangladesh

Background: Acinetobacter baumannii infection treatment has become a clinical challenge due to the increasing resistance of the bacteria to different classes of antimicrobial agents and it needs to be identified before exposure to patients. Objective: This study aimed to determine the prevalence of Acinetobacter baumannii with its antibiotic-resistant patterns. Methodology: The study was a cross-sectional study that was done from 1st January 2019 to 31st December 2019 at the Microbiology Department of Dhaka Medical College. Clinical samples including endotracheal aspirates, blood, urine, sputum, wound swabs, and pus were collected from the patients from the intensive care unit, burn unit, general wards, and outpatient department of Dhaka Medical College and Hospital. Acinetobacter baumannii organisms were identified by biochemical tests and Gram staining, and the resistance pattern was determined by using the disc diffusion method for all antibiotics except for colistin, which was determined by minimum inhibitory concentration. Results: Among 500 clinical samples, 13.31% Acinetobacter baumannii were identified. Most of these showed resistance to fluoroquinolones, carbapenem, amikacin, the extended spectrum of cephalosporin, β-lactam, and β-lactamase inhibitors. However, the least resistant drug was tigecycline (8.88%). About 62.22% MDR, 28.89% A. baumannii were identified. Conclusion: Acinetobacter baumannii is showing increasing resistance to colistin and tigecycline. Bangladesh Journal of Medical Microbiology, January 2024;18(1):37-43

Effect of kangaroo mother care in low-birth-weight babies in reference to breastfeeding in NICU at a tertiary care centre - An observational study

Background: Kangaroo mother care (KMC) is described by the WHO as early, ongoing, and prolonged skin-to-skin contact between a mother and her preterm infants. Aims and Objectives: (1) The aim of the study was to study the effect of KMC in growth of newborn and (2) to study the effect of KMC in prevention of hypothermia, apnea, and requirement of prolonged hospital stay. Materials and Methods: In this prospective, hospital based, observational study, 241 neonates who were hospitalized to the neonatal intensive care unit in Gauhati Medical College and Hospital, Guwahati between April 2023 and March 2024 were assessed. Every potential mother was trained for KMC and given exclusive breastfeeds, and contrasted with a control/(conventional method of care) group of mothers. Results: The KMC babies had better breastfeeding rates as compared to the control group (76% vs. 53.8%). The weight gain (14.9±4.7 vs. 10.5±4.1 g/day), increase in length (0.97±0.67 vs. 0.69±0.63 cm/week), chest circumference (0.73±0.35 vs. 0.49±0.19 G/week), and head circumference (0.74±0.52 vs. 0.50±0.31 g/week), was also better in the KMC group. The incidence of apnea and hypothermia was significantly less in the KMC group, and the duration of stay in hospital was less in the KMC group than the control group (10±5 vs. 16±8 days). Conclusions: KMC improves breastfeeding rates, improves growth, reduces morbidities, and decreases duration of hospital stay.

Recruitment Feasibility for a Randomized Controlled Pilot Study of Animal-Assisted Intervention for Hospitalized Older Adults

This study evaluated the feasibility of recruiting hospitalized older adults into a randomized controlled trial (RCT) comparing an animal-assisted intervention (AAI) involving visits from therapy dogs with an active control (conversation with a volunteer) and treatment as usual (TU) for addressing health and mental health outcomes. Recruitment occurred on acute care hospital units and a long-term physical rehabilitation facility. Feasibility data included the number of recruitment contacts, recruitment rate, and reasons for non-enrollment. The recruitment pool included 1124 patients; the recruitment rate was 4.8% (n = 54). This study explored the difficulties inherent in recruiting medically ill, hospitalized older adults for an RCT of hospital-based therapy dog visits. We believe this is the first RCT of its kind to evaluate the feasibility of recruiting this population for an animal-assisted intervention. Although the intervention was well received, older adults’ illnesses presented significant barriers to study enrollment. Strategies for improving the recruitment of hospitalized older adults for RCTs are discussed.

Neonatal sepsis – etiological study at the Central Park teaching Hospital, Lahore.

Objective: To identify the causative bacteria responsible for early and late onset neonatal sepsis and to determine their antibiotic susceptibilities at Central Park Teaching Hospital. Study Design: Cross-sectional study. Setting: Neonatal Intensive Care Unit (NICU) of Central Park Teaching Hospital, Lahore. Study Period: Jan to June 2024. Methods: Neonates up to 28 days old with clinical features of sepsis were randomly sampled and included in the study. Key maternal and neonatal risk factors were evaluated. Blood cultures were analyzed to identify microbial isolates and assess resistance patterns. Demographic data, clinical features, and blood culture results were collected and analyzed using SPSS version 26.0. Results: Out of the cases studied, 55% were male. Early onset sepsis was slightly more prevalent at 51.5%. Significant maternal risk factors for early sepsis included maternal fever, offensive liquor, and prolonged second stage of labor. Blood cultures were positive in 18.8% of cases, with early onset sepsis accounting for 44.7% of positives and late onset sepsis for 55.3%. Gram-positive bacteria were more common in early sepsis (48.1%), with Acinetobacter baumannii and Candida blankii being notable isolates, while Gram-negative bacteria were more prevalent in late sepsis (63.6%), with Bacillus spp. and Burkholderia cenoc as key pathogens. Coagulase-negative Staphylococcus was the most frequently isolated pathogen in both early and late sepsis. Conclusion: The study underscores the importance of developing tailored antimicrobial strategies based on the timing of sepsis onset to improve neonatal outcomes. Significant differences in microbial distribution between early and late neonatal sepsis were observed (p &lt; 0.001).

A community-based peer-facilitated psychological and social support model to improve retention in care among Cameroonian adolescents perinatally infected with human immunodeficiency virus: A randomized controlled trial

BackgroundPsychological and social support for adolescents living with HIV remains undocumented and unaddressed in Central Africa. This study aimed at assessing effectiveness of a peer-facilitated community-based support model in improving retention in care among adolescents living with HIV and attending care in Chantal Biya Foundation, Yaounde, Cameroon. Materials and methodsWe conducted an analysis of adolescents aged 10–19 years old, perinatally infected with HIV, on follow-up in the Day Care Unit of a reference hospital in Yaounde, Cameroon, and enrolled in the IAS-CIPHER-2021/1214-ATE-SMAVI, a individually randomized controlled trial. While the control arm only received routine care in the health facility, the intervention arm, in addition, was assigned to an HIV association for sustained support model, including support groups, leisure workshops and home visits. Structured questionnaires, including validated French versions of mental health scales, were quarterly administered to the study participants in both study arms by trained healthcare providers. The main outcome was maintaining retention in care beyond the first 15-month period of the study start. Kaplan-Meier and Cox regression models were fitted to assess association between intervention and outcome. Hazard Ratio (HR) across categories of exposure variables were compared using Wald's test. p-value <0.05 was considered significant. ResultsIn total, 305 adolescents were recruited in the study at a median age of 15.2 years old, including 162 (53.1 %) females and 153 individuals in the intervention arm. Mental health troubles were prevalent: severe depression (26.9 %), high or very high anxiety (28.9 %), and low self-esteem (84.9 %). Noteworthy, all of the baseline characteristics were balanced irrelevant to the study arm. Probability of maintaining good retention in care beyond the first 15-month period of study start remained higher in the intervention arm (82.0 % [95 %CI: 73.7 %-88.4 %]) versus the control arm (71.0 % [95 %CI: 63.2 %-78.1 %]), [cHR (95 %CI): 2.0 (1.1–3.3), p=0.044]. ConclusionsCapacity should be built in terms of implementing community-based peer-facilitated support groups in local organizations providing care to adolescents living with HIV.

Nurses’ Knowledge About Bedside Shift Reports In Critical Care Units In Governmental Hospitals– Khartoum State

Nurses’ Knowledge About Bedside Shift Reports In Critical Care Units In Governmental Hospitals– Khartoum State

Clinical Insights and Outcomes in Community-Acquired Acute Bacterial Meningitis versus Postoperative Bacterial Meningitis.

To compare the demographics, clinical characteristics, and in-hospital mortality rates between community-acquired bacterial meningitis cases and postoperative bacterial meningitis. Analytical study. Place and Duration of the Study: Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from 2016 to 2022. A total of 153 patients diagnosed with bacterial meningitis were included and categorised into two groups: 95 (62.1%) with community-acquired bacterial meningitis (CABM) and 58 (37.9%) with postoperative bacterial meningitis (POBM). Demographics, clinical features, laboratory, paraclinical findings, treatments, and outcomes of the cases were compared. Data were retrieved using a standard data collection form from the electronic medical records. A substantial portion (58.8%) of all patients had comorbidities. Fever was the common symptom in all groups. Headache, neck stiffness, nausea, and vomiting were more often observed in the CABM group (p <0.001). Upon admission, the CABM exhibited higher levels of white blood cell count, C-reactive protein, and procalcitonin (p = 0.017, p = 0.004, p = 0.007, respectively). Overall 33.1% had positive cerebrospinal fluid cultures. The overall mortality rate was 26.8%. POBM was associated with longer hospital and intensive care unit (ICU) stays (p <0.001). Shorter treatment durations, lower Glasgow coma scale scores (GCS), higher Charlson Comorbidity Index values, and elevated markers of inflammation were related to mortality. This study illuminates the differences in clinical presentations and outcomes between community-acquired and postoperative bacterial meningitis. It also suggests that factors such as lower GCS scores, comorbidities, and elevated inflammation markers at the last follow-up may be associated with unfavourable clinical outcomes in bacterial meningitis. Postoperative meningitis, Central nervous system infection, Cerebrospinal fluid, Antibiotics.

Translation, psychometric testing and implementation of the perineal assessment tool for assessing incontinence-associated dermatitis risk in semi-intensive care patients

Skin injury is a growing issue among older adults, especially when admitted to an intensive care unit or long-term care facility. Skin prevention is a key point in dealing with this issue, and prompt and effective screening instruments should be used to identify risks and start preventive interventions and care. This descriptive study aimed to translate and examine the psychometric property and implement the Perineal Assessment Tool for incontinence associated dermatitis risk assessment. The English version was translated into Thai following the international guidelines from the World Health Organization by the bilinguals. From May to June 2023, 119 patients from the semi-intensive care unit were included using a consecutive sampling method. The research instruments included the demographic questionnaires, the original English version, and the translated Thai version. The Thai Version had a content validity index, an index of item-objective congruence, a Pearson correlation coefficient of percent agreement, the Pearson correlation coefficient of the interrater reliability, the Kappa coefficient of interrater reliability, the Pearson correlation coefficient of the intra-rater reliability, and the Kappa coefficient of intra-rater reliability ranked from 0.75 to 1.00. The 21.95% had a high risk of developing incontinence-associated dermatitis, which was associated with females, the length of stay in hospital and semi-intensive care unit longer than or equal to four days, receiving antibiotics, disease severity greater than or equal to 20 points, the albumin level less than 3.8 g/dl, and neuropathy and brain disorders. In conclusion, this instrument has high validity and reliability and can assess patients at risk of incontinence-associated dermatitis. This tool will help with early risk detection and guide for planning to manage various risk conditions to prevent dermatitis instead of taking care of them after the skin has already been damaged.

Influence of Trauma Patients Aged ≥55 With PEC in Long Stay in the Hospital and Intensive Care Unit.

Trauma and pre-existing conditions (PECs) can independently impact patient hospital length of stay (H-LOS) or intensive care unit (ICU) ICU-LOS. Pre-existing conditions impact on LOS has rarely been studied in older trauma patients aged ≥55. Our purpose is to examine the relationship between PEC status and ICU-LOS and H-LOS in this population. This is a 3-year retrospective study, for calendar years 2020 through 2022. Multiple linear regression was used for analysis. Confounding factors were controlled for. Statistical significance was defined as P < 0.05. There were 5168 patients (54.9% female) reviewed. The age breakdown was 51.6% were 70-80years old. The injury breakdown showed 49.1% mild injury. The mean H-LOS was 6.00 and mean ICU-LOS was 2.55. Having certain PECs increases H-LOS, including congestive heart failure (CHF) by 2.29days (P < 0.001), chronic obstructive pulmonary disease (COPD) by 1.10days (P < 0.001), and chronic renal failure (CRF) by 0.96days (P = 0.02). Increases in ICU-LOS were associated with having certain PECs, specially CRF by 1.03 days (P < 0.001) and CHF by 1.47days (P < 0.001). Older trauma patients aged ≥55 with certain PECs had an associated increase in ICU and hospital length of stay. Identifying PEC is essential for the care and management of any patient. Identification of PECs on injured patients is essential since this can prolong the LOS. Early involvement of specialists in patient care directed to each PEC may improve these outcomes.

Diagnostic value of tissue plasminogen activator-inhibitor complex in sepsis-induced liver injury: A single-center retrospective case-control study

BACKGROUND Sepsis often causes severe liver injury and leads to poor patient outcomes. Early detection of sepsis-induced liver injury (SILI) and early treatment are key to improving outcomes. AIM To investigate the clinical characteristics of SILI patients and analyze the associated risk factors, to identify potential sensitive biomarkers. METHODS Retrospective analysis of clinical data from 546 patients with sepsis treated in the intensive care unit of the 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force between May 2018 and December 2022. The patients were divided into the sepsis group (n = 373) and SILI group (n = 173) based on the presence of acute liver injury within 2 hours of admission. We used the random forest algorithm to analyze risk factors and assessed potential diagnostic markers of SILI using the area under the receiver operating characteristic curve, Kaplan-Meier survival curves, subgroup analysis and correlation analysis. RESULTS Compared with the sepsis group, tissue plasminogen activator-inhibitor complex (t-PAIC) levels in serum were significantly higher in the SILI group (P &lt; 0.05). Random forest results showed that t-PAIC was an independent risk factor for SILI, with an area under the receiver operating characteristic curve of 0.862 (95% confidence interval: 0.832-0.892). Based on the optimal cut-off value of 11.9 ng/mL, patients at or above this threshold had significantly higher levels of lactate and Acute Physiology and Chronic Health Evaluation II score. The survival rate of these patients was also significantly worse (hazard ratio = 2.2, 95% confidence interval: 1.584-3.119, P &lt; 0.001). Spearman’s correlation coefficients were 0.42 between t-PAIC and lactate, and 0.41 between t-PAIC and aspartate transaminase. Subgroup analysis showed significant differences in t-PAIC levels between patients with different severity of liver dysfunction. CONCLUSION T-PAIC can serve as a diagnostic indicator for SILI, with its elevation correlated with the severity of SILI.

Respiratory Failure Following a Venomous Snakebite: Importance of Ambu Bag Ventilation in a Poor-Resource Setting.

Venomous snakebites are critical medical emergency. Most fatalities resulted from respiratory failure attributable to abrupt neuromuscular paralysis. A 35-year-old male was treated for a snakebite on the dorsum of his right foot, which occurred seven hours prior to hospital admission during sleep. The patient exhibited symptoms of headache, myalgia, extremity weakness, and altered consciousness. No hemorrhagic or myotoxic symptoms were observed. He subsequently had respiratory failure, necessitating emergency bedside intubation with an Ambu bag, followed by treatment initiated in the district hospital and continued in the intensive care unit of a medical college hospital. Timely diagnosis, immediate transport to a medical facility, and rapid bedside intubation can save the lives of individuals experiencing respiratory failure due to venomous snake bites.

The Use of Heated, Humidified, High-flow Nasal Cannulas, and Length of Hospital Stay Among Extremely Preterm Infants

The Use of Heated, Humidified, High-flow Nasal Cannulas, and Length of Hospital Stay Among Extremely Preterm Infants

Assessment of eye care practices and health belief model factors among adult intensive care unit nurses in public hospitals of Amhara Region, Ethiopia

BackgroundEye care is a vital aspect of overall patient health, especially in intensive care units (ICUs) where patients face a heightened risk of ocular complications. Approximately 60% of patients with tracheal tubes and lagophthalmos develop severe ocular surface diseases, such as corneal abrasions, conjunctivitis, and exposure keratopathy, due to insufficient eye protection and lubrication. These complications can adversely affect patient outcomes, including increased mortality rates, extended hospital stays, and reduced satisfaction with care. Despite the importance of effective eye care, practices among intensive care unit nurses can be inconsistent, often influenced by their beliefs and perceptions. The Health Belief Model (HBM) offers a framework to understand these influences, highlighting how nurses’ attitudes toward eye care are shaped by their perceptions of patient severity, susceptibility to complications, perceived benefits and barriers to care, cues to action, and self-efficacy.ObjectiveThis study aims to assess eye care practices among adult intensive care unit nurses in public hospitals in the Amhara Region of Ethiopia and to identify factors influencing these practices based on the Health Belief Model.MethodsA facility-based cross-sectional study was conducted among 213 nurses working in adult ICUs using simple random sampling. Data were collected through a structured, self-administered questionnaire and an observation checklist utilizing Kobo Collect. The data were analyzed using SPSS. Bivariable and multivariable logistic regression models were employed to identify relationships between the constructs of the Health Belief Model and eye care practices.ResultsIn this study, 213 of the 222 respondents participated, resulting in a 96% response rate. Among the participants, 113 nurses (53.1%; 95% CI: 46.5–59.6) demonstrated a high likelihood of providing eye care, while 100 nurses (46.9%; 95% CI: 40.4–53.5) exhibited a lower likelihood based on constructs of the Health Belief Model. Additionally, 125 nurses (58.7%; 95% CI: 52.1–65.3) had inadequate eye care practices, while 133 (62.4%; 95% CI: 55.4–69) possessed adequate knowledge about eye care. Furthermore, 113 participants (53.1%; 95% CI: 46–60.1) held a favorable attitude toward eye care. The multivariable analysis identified several factors associated with eye care practices: monthly salary (AOR = 2.4, 95% CI: 1.1–5.7), educational level (AOR = 0.2, 95% CI: 0.06–0.8), knowledge of eye care (AOR = 2, 95% CI: 1.1–3.4), and availability of eye care equipment (AOR = 0.3, 95% CI: 0.1–0.5).Conclusion and recommendationThe study reveals that fewer than half of the nurses working in adult intensive care units in public hospitals in the Amhara region provide adequate eye care, despite a strong intention to do so. Key factors influencing eye care practices include monthly salary, knowledge level, educational qualifications, and the availability of necessary equipment. To improve eye care delivery, it is essential for relevant authorities to implement targeted training and educational initiatives for nurses, thereby enhancing their skills and knowledge in eye care practices.

Assessment of level and source of stress in mothers of newborns admitted to neonatal intensive care unit in tertiary care hospital

Background: The hospitalization of a neonate is stressful for the mother and all family members Severe stress can affect mother–baby relationship and thus affect newborn development subsequently. The parent-infant bonding process during the newborn period establishes the foundation a lifelong relationship. This process is affected when the newborn spends the first several weeks in NICU. Quantifying stress levels of parents and identifying environmental stressor is useful in assisting the health personnel in improving the quality of medical care. To study the level and source of stress in mothers of Newborns admitted in the Neonatal intensive care unit and to quantify the stress levels by parental stressor scale. Methods: In this cross-sectional study included 400 mothers of newborn babies admitted in NICU of Basaveshwar Hospital and Sangameshwar hospital attached to Mahadevappa Rampure Medical College, Kalaburgi with semi structured validated interview-based questionnaire consisting of parenteral stressor scale: NICU (PSS: NICU) comprising three subscales and questions related to maternal and neonatal characteristics will be used. Results: Among the study population the mean stress score was maximum in parental role domain of PSS: NICU stress scale. The maternal stress was higher among preterm and non-breast-fed babies in looks and behaviour and parental role. Maternal stress was statistically significant among rural, illiterate and home maker participants in all 3 domains. Conclusions: NICU mothers are under significant stress and appropriate counselling targeted towards specific stressors is required and before designing remediation programs for parents, local demography and the predominant NICU stressors need to be kept in mind. maternal stress, neonatal intensive care unit environment, baby looks and behaves.

The impact of enhanced cleaning on bacterial contamination of the hospital environmental surfaces: a clinical trial in critical care unit in an Egyptian hospital.

Contaminated environmental surfaces play an important role in the transmission of pathogens that cause healthcare acquired infection (HAI). The present study aimed to assess the effect of enhanced cleaning techniques on bacterial contamination in high-touch areas compared to routine cleaning at the intensive care units (ICU) of the neurosurgery department of Alexandria Main University Hospital, Egypt. The assessment of the knowledge and practices of healthcare cleaning workers and nurses was conducted through a questionnaire and an observational checklist. An educational program about enhanced cleaning was carried out for healthcare cleaning workers and nurses in one room of the ICU unit. Environmental surface swabs were taken from the two rooms of the ICU before and after cleaning (room A and room B). Room A was selected to apply the enhanced cleaning, and room B was selected for routine cleaning. A significant decrease in bacterial counts in the high-touch areas around the patients after the application of enhanced cleaning compared to routine cleaning (p < 0.001) was observed. Gram-negative bacteria isolated from high-touch areas accounted for 45.6% of the samples collected before enhanced cleaning, and they became 16.3% after enhanced cleaning (p < 0.001), while they accounted for 40% after routine cleaning. The enhanced cleaning intervention in Room A resulted in a significant reduction in total infections, decreasing from 18 cases in the six months prior to the intervention to 11 cases in the six months following its implementation. (p < 0.05). The effect of enhanced cleaning was evident in decreasing bacterial counts in the high-touch areas around the patient and consequently in the records of the HAI rate inside the ICU. PACTR202402531001186, date: 15 February 2024, 'retrospectively registered'.

Xuebijing Injection Alleviates the Inflammatory Response in Patients with Venous-Arterial Extracorporeal Membrane Oxygenation: A Prospective Randomized Controlled Study.

Both acute myocardial infarction (AMI) and its salvage treatment, venoarterial-extracorporeal membrane oxygenation (VA-ECMO), may lead to the production of proinflammatory cytokines and further aggravate tissue damage. Xuebijing (XBJ) may modulate cytokine production involved in the inflammatory response. We aimed to determine the efficacy of XBJ in cardiogenic shock patients on VA-ECMO. This was a prospective, randomized trial carried out in an intensive care unit of a tertiary teaching hospital. Patients with cardiogenic shock after acute myocardial infarction undergoing percutaneous coronary intervention (PCI) with VA-ECMO support were randomly divided into a Xuebijing group and a control group. Cytokines, inflammatory factors and left ventricular ejection fraction (LVEF) were compared between the groups. 41 patients were enrolled in the study, with 21 in the Xuebijing group and 20 in the control group. 28 (68.3%) were male, and the average age was 64.71 ± 8.18 years old. There was no difference in APACHEII (acute physiology and chronic health evaluation II) score, LVEF, or cytokine and inflammatory factors collected before extracorporeal membrane oxygenation (ECMO) between the two groups. The levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in the Xuebijing group were lower than those in the control group in the first 24 hours, 48 hours and 72 hours after ECMO (p < 0.05). The LVEF in the Xuebijing group was higher than that of the control group at 48 hours (31.57 ± 3.43 vs. 28.35 ± 4.42, p = 0.013). This trend persisted at 72 hours. The duration of ECMO support in the Xuebijing group was 5.57 ± 2.11 days, which was shorter than that in the control group (p = 0.033). Xuebijing injection can reduce the inflammatory response and improve cardiac function in patients with acute myocardial infarction treated with VA-ECMO to a certain extent. Chinese Clinical Trial Registry (ChiCTR), ChiCTR2100054069, Registered 8, December 2021, https://www.chictr.org.cn/showproj.html?proj=142869.