Examination Room Research Articles

A Syringe in an Emergency Saves Time: An Audit on the Utility of Syringe Provision in Eye Emergency.

Background Patient satisfaction is the top priority of health care facilities in addition to the quality of health care delivery services. The convenience of health care receivers, be it temporal or monetary, fall in this domain. Hospitals should be equipped with dealing with all kinds of emergencies no matter how trivial or catastrophic. Aim To improve the provision of emergency care equipment (1 c.c. syringes) in the examination room of our ophthalmology department by 50% in two months' time. Materials and methods This quality improvement project (QIP) was conducted in the ophthalmology department of a teaching hospital in Khyber Pakhtunkhwa. This QIP was conducted over a period of two months in the form of three cycles. All cooperative patients with embedded and superficial corneal foreign bodies who presented to the eye emergency were included in the project. The provision of 1 c.c. syringes in the emergency eye care trolley of the eye examination roomwas ensured at all times after the first cycle survey. A record was maintained of the percentage of patients receiving syringes from the department as well as the percentage of patients purchasing them from the pharmacy. The progress was measured every 20 days, following the approval of this QI project. Results A total of 49 patients were included in this QIP. This QIP shows that the provision of syringes was improved to 92.8% and 88.2% in cycles 2 and 3from the previous statistics of 16.6% in the first cycle. Conclusions It is concluded that this QIP achieved its target. The provision of emergency equipment, such as a 1 cc syringe costing less than 1/20thof a dollar, is a simple act that saves resources and improves patient satisfaction.

Increasing cultural awareness in emergency departments with simulation scenarios created through a survey

Introduction: There are various difficulties in treating foreign patients; however, the existing educational programs are still insufficient for addressing this issue. The purpose of this study is to investigate what difficulties are encountered in the treatment of foreigners in emergency departments, and to create scenarios for simulation-based education using real-life cases. Methods: A cross-sectional anonymous survey to 457 emergency departments was conducted in 2018. Additionally, we conducted a survey of 46 foreign residents who had visited hospitals for treatment in Japan. The data was analysed quantitatively, and the narrative responses were thematically analysed. Results: Of the 141 hospitals that responded (response rate: 30.9%), 136 (96.5%) answered that they had treated foreign patients. There were 51 and 66 cases with cultural and linguistic difficulties, respectively. In the qualitative analysis, different ideas/beliefs towards treatments or examinations (51.0%) and communication with non-English speaking patients (65.2%) were most common categories in the cases with cultural and linguistic difficulties, respectively. The survey of 46 foreign residents on the surprising aspects of Japanese healthcare showed, 14% mentioned difference in treatment plans between own country and Japan, 12% each mentioned a lack of explanation by medical staff, and a lack of privacy in the examination room. Based on the survey results, we created 2 scenarios of simulation. Conclusions: Scenarios of simulation-based education using real-life cases may be effective materials for cultivating cultural awareness of medical staff.

The Examination Room- Gateway to Sexual Wellness in Women

Following a surprising discovery at a women’s hospital in Ahmedabad, Gujarat, it was decided to put forth this discussion. It was noticed that if the topic of sexual health was broached by a female doctor, while the pelvic examination was being conducted, the patients were comfortably open about their sex lives. It was during this period of time that the examiner could discuss various techniques or methods to ease any discomfort during sexual intercourse, and most importantly, discover whether the patient might be having a sexual dysfunction. If amenable, the patient was welcome to further counseling or referral.

Knowledge and attitudes of medical staff on infection control at Bac Ninh Obstetric and Pediatric Hospital 2022

Objective: To evaluate the knowledge and attitudes of healthcare workers toward standard precautions, prevention of Central Line-Associated Bloodstream Infections (CLABSI), and ventilator Associated Pneumonia (VAP) at Bac Ninh Obstetrics and Children’s Hospital in 2022. Methods: A descriptive cross-sectional study was conducted between November and December 2022 at Bac Ninh Obstetrics and Children’s Hospital. The survey on standard prevention was participated by 120 health workers, who were from 6 pediatric clinical departments. On the other hand, the prevention of hospital-acquired infections related to pulmonary health care survey had the participation of 47 health workers from 2 intensive care units. Results: The study revealed that the medical staff had good knowledge regarding the examination room content, ranging from 70.8% to 97.5%, however, they exhibited negative attitudes towards some infection control measures. The healthcare workers’ knowledge regarding the prevention of Central Line-Associated Bloodstream Infections (CLABSI) was inadequate, and they lacked knowledge about ventilator Associated Pneumonia. Nevertheless, the healthcare workers had a positive attitude toward implementing measures to prevent pneumonia in ventilator-supported patients, with 100%. Conclusion: The study showed that the knowledge and attitudes of healthcare workers regarding infection control were limited. Therefore, appropriate training programs must be planned and organized to improve their knowledge and attitudes toward infection control.

A Comparative Study of Acoustic Regulations for Hospital Bedrooms in Selected Countries in Europe

Regulatory acoustic requirements for hospitals exist in several countries in Europe, but many countries have either no or few regulatory limits or only recommendations. The purpose of limit values is to ensure optimal acoustic conditions for the patients under treatment and for the personnel for the various tasks taking place in many different rooms, e.g., bedrooms, examination and treatment rooms, corridors, stairwells, waiting and reception areas, canteens, offices, all with different acoustic needs. In addition, some rooms require special considerations such as psychiatric rooms and noisy MR-scanning rooms. The extent of limit values varies considerably between countries. Some specify few, others specify several criteria. The findings from a comparative study carried out by the authors in selected countries in various geographical parts of Europe show a diversity of acoustic descriptors and limit values. This paper includes updated criteria for reverberation time, airborne and impact sound insulation, noise from traffic and from service equipment for hospital bedrooms. The discrepancies between countries are discussed, aiming at potential learning and implementation of improved limits. In addition to regulations or guidelines, some countries have hospitals included in national acoustic classification schemes with different acoustic quality levels. Indications of such class criteria are included in the paper.

Spatial Scattering Radiation to the Radiological Technologist during Medical Mobile Radiography.

Mobile radiography allows for the diagnostic imaging of patients who cannot move to the X-ray examination room. Therefore, mobile X-ray equipment is useful for patients who have difficulty with movement. However, staff are exposed to scattered radiation from the patient, and they can receive potentially harmful radiation doses during radiography. We estimated occupational exposure during mobile radiography using phantom measurements. Scattered radiation distribution during mobile radiography was investigated using a radiation survey meter. The efficacy of radiation-reducing methods for mobile radiography was also evaluated. The dose decreased as the distance from the X-ray center increased. When the distance was more than 150 cm, the dose decreased to less than 1 μSv. It is extremely important for radiological technologists (RTs) to maintain a sufficient distance from the patient to reduce radiation exposure. The spatial dose at eye-lens height increases when the bed height is high, and when the RT is short in stature and abdominal imaging is performed. Maintaining sufficient distance from the patient is also particularly effective in limiting radiation exposure of the eye lens. Our results suggest that the doses of radiation received by staff during mobile radiography are not significant when appropriate radiation protection is used. To reduce exposure, it is important to maintain a sufficient distance from the patient. Therefore, RTs should bear this is mind during mobile radiography.

Pediatric Chemotherapy Infusions in Outpatient Examination Rooms: A Novel Patient Care Approach.

Background: Many health care organizations offer pediatric infusions in outpatient infusion centers or, as in our organization, in a hospital-based outpatient Pediatric Infusion Therapy Center (PITC). When restrictions related to the COVID-19 pandemic decreased our PITC appointment capacity by 40%, other patient and family satisfaction issues were exacerbated. We implemented a new approach to pediatric infusions with the aim of improving patient and family satisfaction and reducing the amount of time in an appointment itinerary without negatively affecting patient safety. Methods: Our team used a phased approach to pilot the administration of short chemotherapy infusions in the same outpatient clinic examination rooms where consultation and routine office visits were conducted. Patients saw their specialist for an examination and, if clinically indicated, their infusion was administered in the same room. Appointment itineraries were then completed. The team tracked efficiency, satisfaction, and safety metrics related to the new process. Results: All efficiency metrics improved. No harm came to the 49 unique patients who received a total of 184 infusions. Patient appointment itineraries were shortened by an average of 1.03 hr. Satisfaction survey responses indicated a clear preference (93%) for the new process. Discussion: The novel approach of offering short infusions in outpatient clinic examination rooms provides an opportunity to ease capacity constraints and further increase patient and family satisfaction. This method may be especially helpful for health care organizations when external influences (e.g., lack of physical space, challenging patient volumes, and pandemics) necessitate a change.

Influence of Students’-Staff Interactions on Academic Delinquency amongst Undergraduate Students in Public Universities in Kiambu and Nairobi Counties-Kenya

Academic delinquency has manifested itself in practices through practices such as: ‘sex for grades,’ sneaking unacceptable materials into examination rooms popularly known as ‘mwakenya’, plagiarism of assignments among other delinquent practices which have greatly affected the quality of university education in Kenya. So, this study sought to answer the research question: what is the influence of students’-staff interactions on academic delinquency amongst undergraduate students in public universities in Kiambu and Nairobi Counties in Kenya? The study adopted both quantitative and qualitative approaches targeting 40 Deans, 12 heads of departments, 120,000 undergraduate students, 2 counsellors, 2 registrars and 2 examination coordinators from Kenyatta University and Jomo Kenyatta University of Agriculture and Technology. Using stratified, multistage and purposive sampling criteria, a total of 414 respondents were sampled to participate in the study. For ethical purposes, the two universities were coded as X and Y in the analysis of data. Questionnaires and structured interview guide with open-ended test items were used to collect data from the students and deans, heads of departments, counselors, registrars and exam coordinators respectively. The study found that students’ interactions with members of staff during lecturers, Class work, sport and social functions was found to influence engagement in academic delinquency amongst students, as supported by more than 60% of respondents from both university X and Y. The study recommends a collaborative teaching and learning practice, where parents, staff and other stakeholder are engaged in ensuring proper ethics are instilled to all earners in universities.

Postnatal care services in rural Zambia: a qualitative exploration of user, provider, and community perspectives on quality of care

BackgroundPostnatal care (PNC) is an important set of services offered to the mother and her newborn baby immediately after birth for the first six weeks to prevent maternal and neonatal complications and death. This qualitative study explored user and provider perspectives on quality of PNC services in the selected health facilities within the context of the Maternity Homes Access in Zambia project in the Saving Mothers Giving Life districts in rural Zambia.MethodsBetween October 2018 and February 2019, forty focus group discussions (FGDs) (n = 160 participants) and twelve in-depth interviews (IDIs) were conducted in four districts in Southern and Eastern provinces. FGDs comprised women who delivered within the last year, fathers, community elders, and volunteers. IDIs comprised health workers at facility, district, and provincial levels. Data were analysed using content analysis guided by the international quality of care domains derived from the World Health Organization quality of care framework. Findings were triangulated to understand perceptions.ResultsOverall, study participants perceived PNC services to be beneficial. Nevertheless, respondents had mixed feelings on the quality of PNC services and expressed a stark difference in their perception of factors affecting service quality. Service users described challenges arising from ineffective communication about the new PNC guidelines, and non-adherence of service providers to quality standards regarding respect, preservation of dignity and emotional support. Other factors were long waiting hours, small examination rooms providing inadequate privacy, and low levels of confidentiality. In contrast, service providers attributed poor service quality to various health system-related factors including low staffing levels, dysfunctional referral services, low supply of essential medicines, supplies, vaccines and equipment for optimal routine emergency obstetric and newborn care and management of complications.ConclusionThese findings highlight important intervention opportunities to improve quality of PNC services in Zambia through better communication and raising awareness on PNC guidelines, respect, preservation of dignity and emotional support to mothers. Interventions should also focus on addressing contextual health system challenges including staffing levels, supply chain for essential medicines and commodities, shortening waiting time, and ensuring functional referral system.

Myopia and its associated factors among pregnant women at health institutions in Gondar District, Northwest Ethiopia: A multi-center cross-sectional study.

Myopia is the most common form of uncorrected refractive error with a growing burden worldwide. It is the principal complaint of most women during pregnancy. Although myopia has led to several consequences across the standard life of pregnant women, there is no previous study in Ethiopia regarding this topic. Thus, this study determined the prevalence of myopia and identifies its associated factors among pregnant women attending antenatal care units at governmental health institutions in Gondar City District, Northwest Ethiopia. An institution-based cross-sectional study design was conducted from 08February to 08 April 2021. From the selected health centres, study participants were recruited by systematic random sampling technique. A pre-tested, structured-interviewer-administered questionnaire consisting of socio-demographic variables, obstetric and clinical-related variables was used to collect the required data. Non-cycloplegic refraction was performed using trial lenses, trial frames, and retinoscopy in a semi-dark examination room. EpiData 3 and STATA 14 were used for data entry and statistical analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of myopia. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with myopia. Model fitness was checked by Hosmer and Lemeshow goodness of test (at p > 0.05). A total of four-hundred and twenty-three pregnant women participated with a 100% response rate in this study. The overall prevalence of myopia among pregnant women was 26.48% (95% CI: 22.48-30.91). Eighty-Eight (20.81%) and Eighty-Four (19.85%) of the study participants had myopia in their right and left eyes respectively. The prevalence of myopia was significantly associated with age (AOR = 1.17; 95% CI: 1.09-1.28), the third trimester of gestation (AOR = 2.05, 95% CI: 1.08-3.90), multi & grand multipara (AOR = 3.15; 95% CI: 1.59-6.25), and history of contraceptive use (AOR = 3.30; 95% CI: 1. 50-7.28). The finding of our study shows that there is a higher prevalence of myopia among pregnant women in our study area. Further prospective analytical studies regarding visual systems among pregnant women, particularly as a result of pregnancy, are strongly recommended.

The database for extracting numerical and visual properties of numerosity processing in the Chinese population

The ability to handle non-symbolic numerosity has been recurrently linked to mathematical abilities. The accumulated data provide a rich resource that can reflect the underlying properties (i.e., dot ratio, area, convex hull, perimeters, distance, and hash) of numerosity processing. This article reports a database of numerosity processing in the Chinese population. The database contains five independent datasets with 7459, 4902, 415, 671, 414 participants respectively. For each dataset, all data were collected in the same online computerized test, examination room, professorial tester, and using the same protocols. Computational modeling method could be used to extract the dot ratio and visual properties of numerosity from five types of dot stimuli. This database enables researchers to test the theoretical hypotheses regarding numerosity processing using a large sample population. The database can also indicate the individual difference of non-symbolic numerosity in mathematical abilities.

Measures against Infection in Facilities Using Air Catalysts

Background: The global outbreak of COVID-19 has affected the operations of healthcare field and various infection control measures are being carried out at each hospital and clinic.
 Aim: We have administered infection control measures using air catalysts which is a new antiviral and antibacterial technology being employed at our healthcare center.
 Methodology: We used a product called Health Bright® and this liquid substance was sprayed to coat every part of the facility. After that, we measured the amount of adenosine triphosphate (ATP) in coated places, including the waiting room, examination room and endoscopy room.
 Results: The amount of ATP decreased the day after the treatment in each room, and of note is that the amount of ATP was still low after 6 months and 12 months.
 Conclusion: Our current data showed the possible efficacy of air catalysts against bacteria and virus in the healthcare facility.

Evaluation of Detectability in Clinical Practice of Metal Detectors, etc. for Magnetic Resonance Imaging

In order to prevent magnetic materials from being brought into the magnetic resonance imaging (MRI) examination room, many facilities have metal detectors, etc., but there are various types of equipment with different performance and characteristics. The purpose of this study was to evaluate each detector in actual clinical practice. At multiple facilities, gate-type magnetic detectors, pole-type magnetic detectors, handy-type magnetic detectors, and handy-type metal detectors were used to identify 9 types of objects that may be brought into the MRI examination room. We performed evaluation of detection distance measurement assuming actual operation. The gate type was only able to detect objects with strong magnetism. With the pole type, the closer the measurement distance was to the pole, the more objects could be detected, and the lower the pole, the shorter the detection distance. With the handy type, there were many objects that could be detected when the device and the object were brought into close contact. The detectability of the instruments varied depending on the size and type of the object. It is important to understand the characteristics of each device and use it according to the purpose in carrying-in confirmation before the examination.

CHARACTERISTICS OF THE VOLUME AND OUTCOMES OF MEDICAL CARE FOR PATIENTS WITH SKIN CANCER IN UKRAINE IN 2010-2020.

The aim: To investigate the dynamics of the volumes and outcomes of medical care for patients with skin cancer in Ukraine during 2010-2020. Materials and methods: Official statistical data from the reports of the Center for Medical Statistics of the Center for public health of the Ministry of Health of Ukraine and the National Cancer Registry for 2010-2020. Statistical and bibliosemantic methods were used in the work. Results: A decrease in the capacity to provide medical care to patients with skin cancer was identified, as evidenced by a decrease in the number of oncological dispensaries, oncological and examination rooms in outpatient clinics, oncological and radiological beds, with a relatively unchanged level of staffing. An analysis of the main indicators of the organization and activities of medical care for patients with cancer skin revealed problems with early detection of tumors, in particular during preventive examinations, and incomplete coverage of patients with stages I-II of the disease with special treatment. The positive dynamics of melanoma treatment outcome indicators were revealed (increase in accumulation index, 5-year patient survival rate, decrease in lethality and mortality). Conclusions: the organization of medical care for patients with skin tumors, especially non-melanoma ones, needs further improvement in the context of preventive interventions, ensuring the coverage of patients with special treatment.

ISHD: Intelligent Standing Human Detection of Video Surveillance for the Smart Examination Environment

In the environment of smart examination rooms, it is important to quickly and accurately detect abnormal behavior (human standing) for the construction of a smart campus. Based on deep learning, we propose an intelligent standing human detection (ISHD) method based on an improved single shot multibox detector to detect the target of standing human posture in the scene frame of exam room video surveillance at a specific examination stage. ISHD combines the MobileNet network in a single shot multibox detector network, improves the posture feature extractor of a standing person, merges prior knowledge, and introduces transfer learning in the training strategy, which greatly reduces the computation amount, improves the detection accuracy, and reduces the training difficulty. The experiment proves that the model proposed in this paper has a better detection ability for the small and medium-sized standing human body posture in video test scenes on the EMV-2 dataset.

The Optimization Model of Final Project Examination Scheduling in Two Different Locations: A Case Study

The Nursing Undergraduate Study Program of the Vocational Faculty of Universitas Airlangga has two classes in two different cities: Gresik and Lamongan. The final project examination scheduling in the study program should be scheduled simultaneously to minimize the round-trip of the examiner. Currently, the scheduling process is done manually without a certain systematic method or approach. In this paper, an optimization model is developed to solve the scheduling problem. Several factors are considered in the model, namely the number of examiners, examination room availability, and the home campus of eachexaminer. The model employed an integer programming approach with the objective function of maximizing the totalassignment of the examiners in the time slot. The model cansolve the scheduling problem more efficiently than manual scheduling.

Hybrid emergency room: Installation, establishment, and innovation in the emergency department.

A novel trauma workflow system called the hybrid emergency room (Hybrid ER) that combines a sliding computed tomography (CT) scanning system with interventional radiology features was first installed in Osaka General Medical Center in 2011. The Hybrid ER enables CT diagnosis and emergency therapeutic interventions without transferring the patient to another examination room. In this article, the history of CT in trauma care, the world's first installation of the Hybrid ER, clinical experiences, and evidence for the Hybrid ER in trauma workflow and nontrauma fields are summarized, and the future and innovation of the Hybrid ER are reviewed.

Assessment of the prevention of healthcare-associated infections in the dental practice in Rabat

in dentistry, many treatments are invasive and can lead to infections. The purpose of this study was to evaluate the prevention of healthcare-associated infections in the dental practice in Rabat. a survey on the prevention of healthcare-associated infections in Rabat dental practices was conducted among 324 practitioners. A self-administered questionnaire was used to assess their training, hygiene, protection, organization of premises, asepsis, antisepsis and use of medical devices. Data were collected using JAMOVI version 1.8.4, the χ2 and Fisher tests were used to compare the variables, the significance level was set at P<0.05. only 80 subjects took part in the study. All the dentists had protective equipment, but 68 (85%) did not have instructions on what to do in case of accidental exposure to blood; 41 (62.1%) operators had qualified assistants, 36.4% had a team vaccinated against hepatitis B and 61.3% of operators and assistants had been trained to handle reusable medical devices. Seventy-six studies had isolated examination rooms, 41 had a steam steriliser and a sorting area with sharps collector. However, 35.1% had a contract for the collection of waste generated by health-care activities, posing a significant risk of infection. the results of this study show that most practitioners in Rabat comply with the majority of the aseptic and hygienic standards in dentistry. However, more needs to be done to ensure that staff are vaccinated.

The urgent need for physician-led abortion advocacy

When the Supreme Court of the United States decided Dobbs v. Jackson, it overruled Roe v. Wade and the decades of legal protections that physicians and patients have relied upon in making pregnancy decisions, including but not limited to abortion care. Abortion access has been limited before Dobbs, but the new legal landscape substantially limits patient access to abortion care by greatly curtailing legal provision of these services in many states, restricting physicians' ability to provide legal abortion care through confusing, inconsistent, and burdensome legal requirements, and by upending decades of reliable standards and leaving physicians and lawyers guessing about possible future court decision. Medical societies and healthcare organizations over the last 50 years since Roe have largely been silent in the face of attacks to abortion rights. Their silence left a void in which politicians and legislators without an understanding of abortion care promoted their own ideology and political interest at the expense of patient access to abortion care, patient autonomy, the physician-patient relationship, and physician autonomy. Physicians have an ethical duty to organize and advocate. Abortion legislation exemplifies the impact of unjust policies limiting our ability to provide patients with autonomy over their medical decision-making and interfering in the provision of evidence-based care, and in some cases preventing us from upholding our oath to do no harm. We must regain control of the examination room from political ideologies so that we can provide equitable, patient-centered, evidence-based, autonomous healthcare to our patients.

Ecological Study of Sick Building Syndrome among Healthcare Workers at Johor Primary Care Facilities.

Persistent exposure to indoor hazards in a healthcare setting poses a risk of SBS. This study determines the prevalence of and risk factors for SBS among healthcare workers in health clinics. A cross-sectional study was conducted across four health clinics from February 2022 to May 2022. As part of the study, self-administered questionnaires were completed to determine symptoms related to SBS. An indoor air quality (IAQ) assessment was conducted four times daily for fifteen minutes at five areas in each clinic (laboratory, lobby, emergency room, pharmacy, and examination room). Most of the areas illustrated poor air movement (&lt;0.15 m/s), except for the laboratory. The total bacterial count (TBC) was above the standard limit in both the lobby and emergency room (&gt;500 CFU/m3). The prevalence of SBS was 24.84% (77) among the healthcare workers at the health clinics. A significant association with SBS was noted for those working in the examination room (COR = 2.86; 95% CI = 1.31; 6.27) and those experiencing high temperature sometimes (COR = 0.25; 95% CI = 0.11; 0.55), varying temperature sometimes (COR = 0.31; 95% CI = 0.003), stuffy air sometimes (COR = 0.17; 95% CI = 0.005; 0.64), dry air sometimes (COR = 0.20; 95% CI = 0.007; 0.64), and dust sometimes (COR = 0.25; 95% CI = 0.11; 0.60) and everyday (COR = 0.34; 95% CI = 0.14; 0.81). Only healthcare workers in the examination room (AOR = 3.17; 95% CI = 1.35; 7.41) were found to have a significant risk of SBS when controlling for other variables. SBS is prevalent among healthcare workers at health clinics.