Hospital Experience Research Articles

Factors that influence young people’s experiences of emergency suicide care in Australia: a qualitative study

Young people in Australia are increasingly presenting to the emergency department in suicide crisis, where their experiences influence present and future treatment outcomes. Previous research on emergency suicide care has predominantly focused on adults’ experiences. This qualitative study aims to identify the factors that influence perceived positive and negative experiences of emergency suicide care for young people. Semi-structured interviews were conducted with 17 young people aged 16-24 years old (mean age = 18.4 years) who presented to an Australian hospital in the past 12 months for a suicide crisis. Young people reflected on the care they received in the emergency department, and the factors that influenced the quality of care. Data underwent reflexive thematic analysis. Most young people reported a negative hospital experience, attributed to resource constraints and invalidating staff responses, reflecting underlying stigma around suicide. Conversely, when young people reported positive experiences, this was largely attributed to empathetic connections with staff. Our findings highlight the importance of compassionate care from hospital staff for young people’s experience of emergency suicide care. Future research with young people is needed to co-design and trial interventions that promote compassionate care and address the barriers with resource constraints in hospitals.

Prevalence of Para-Pneumonic Effusion and the Associated Factors among Children: A 3-Year Experience in a Single Tertiary Hospital

Background: Previous studies have highlighted the significant morbidity associated with para-pneumonic effusions in pediatric populations. However, comprehensive data on the prevalence and associated factors in children remain limited, particularly in tertiary care settings. Methods: A retrospective cohort study was conducted over a three-year period at a single tertiary hospital. Medical records of pediatric patients diagnosed with pneumonia were reviewed to identify cases of para-pneumonic effusion. The study analyzed demographic data, clinical presentations, laboratory findings, and management approaches to determine factors associated with the development of para-pneumonic effusions. Results: 150 patients were identified with para-pneumonic effusions. The majority of patients with effusions were male (60%) and under five years of age (70%). Factors significantly associated with the development of effusions included the presence of comorbidities (p<0.01), higher CRP levels (p<0.05), and hospital-acquired pneumonia (p<0.001). The length of hospital stay was notably longer in patients with effusions than those without (p<0.001). Conclusion: The study found a considerable prevalence of para-pneumonic effusions among children with pneumonia in a tertiary hospital setting. Notably, associated factors were underlying comorbidities, elevated inflammatory markers, and hospital-acquired infections. These findings underscore the need for heightened surveillance and tailored management strategies in high-risk pediatric populations to mitigate the impact of effusions.

Active Tuberculosis Risk Associated with Malignancies: A 4-Year Retrospective Study in a Tertiary Care Hospital

Background Tuberculosis (TB) remains an important public health problem worldwide. Risk of acquiring TB in patients diagnosed with cancers remains high and can result due to reactivation or reinfection. We share the experience in a large tertiary care hospital. Materials and Methods Clinical samples from presumptive TB patients while on cancer therapy were tested by smear Ziehl–Neelsen (ZN) staining, GeneXpert MTB/RIF (Gx), TB polymerase chain reaction (PCR), and liquid culture (MGIT 960) from January 1, 2019, to December 31, 2022. Statistical Analysis Stata 14.0 software was used for statistical analysis. The p-value calculation was done by Pearson's chi-square test. Results Of 906 patients investigated, 42 (4.64%) tested positive for TB. Seven (1.37%) tested positive by ZN staining, 10 patients (6%) had culture positive by MGIT, 20 (10.53%) and 5 (13.51%) samples were positive by Gx and PCR, respectively. Maximum number of TB-positive patients were found to be suffering from carcinoma lung (28%) followed by leukemia (25%), gastrointestinal cancer (13%), and genitourinary cancer (13%), respectively. Seven of the 42 patients succumbed to the disease; the cases belonged to Hodgkin's lymphoma (75% mortality), leukemia (30% mortality), and genitourinary cancer (20% mortality). Conclusion The incidence of active TB is high in cancer patients, especially lung cancer, leukemia, gastrointestinal, and genitourinary cancers. Mortality was high in Hodgkin's lymphoma patients who developed TB. Screening for TB at the time of diagnosis of a high TB risk cancer would help initiate early treatment. We recommend targeted screening for TB in patients with these high-risk cancers, at the time of diagnosis and periodically through cancer treatment.

Analysing the patient experience of COVID-19: Exploring patients' experiences of hospitalisation and their quality of life post discharge.

We sought to gain an understanding of the patient experience during their hospital stay for COVID-19, and the impact of COVID-19 on quality of life post discharge. Symptoms of COVID-19 include a persistent cough, dyspnoea and fatigue. Individuals with comorbidities such as cardiovascular disease have a higher risk of contracting COVID-19 and approximately 20% of those diagnosed with COVID-19 are admitted to hospital. Following discharge from hospital, 40% of patients report a worsened quality of life and up to 87% of those discharged from hospital have experienced 'long COVID'. A qualitative design was used to understand patient experience of hospitalisation following a diagnosis of COVID-19, and their experiences following discharge from hospital. Ten patients with a previous diagnosis of COVID-19 took part in semi-structured interviews regarding their experiences of hospitalisation and the impact on quality of life post-discharge. The results identified three key themes from the interviews: communication and the inpatient experience, symptoms following discharge and regaining independence. Patients discussed their experience of hospitalisation and how this continued to impact their emotional well-being post-discharge. However, patients appeared to push themselves physically to improve their health, despite continued COVID-19 symptoms. Patients hospitalised following a diagnosis of COVID-19 experienced psychological distress during their hospital stay, as well as 3-months post-discharge. We suggest the use of psychosocial interventions to support patients post-discharge. The results of this study provide a greater understanding of the patient experience during their hospital stay, which can support nursing staff practice. Additionally, the study provides in depth knowledge of personal experiences of patients diagnosed with COVID-19 and the impact following hospital discharge. Patient's took part in semi-structured interviews via telephone to support the aims and objectives of this study.

Nurse Manager Practice Environment and Its Influencing Factors: A Multicenter Cross-Sectional Study

Objective. This study aimed to evaluate the current status and related factors of practice environments of nurse managers in China. Background. Insufficient nurse staffing and poor working environment directly increase the burnout and turnover of nurse leaders. Nurse managers play a pivotal role in healthcare organizations, and their performance has been inextricably linked to achieving optimal patient, staff, and healthcare organizational outcomes. However, there are few studies exploring the influencing factors of nurse manager practice environment. Methods. A cross-sectional study was undertaken to examine a sample of 405 nursing managers who were selected from 10 hospitals located across three provinces in China. The general characteristics questionnaire, the Nurse Manager Practice Environment Scale, the Perceived Stress Scale, and the Career Growth Scale were used. Data were analyzed by descriptive statistics, univariate analysis, and multiple stepwise linear regression. Results. The total scores of the nurse manager practice environments were 236.71 ± 27.635 (with 270 being the highest possible score), which was at a generally high level. The three lowest scores were adequate budgeted resources, fair and manageable workload, and nurse manager-physician relationships. Nurse manager practice environment was predicted by hospital geographic location, having (or not) training experience in higher ranked hospitals, levels of perceived stress, and career growth scores. Conclusion. Chinese nursing managers reported a relatively favorable nursing practice environment. Policymakers should pay more attention to the practice environment of nursing managers in small city hospitals, and they could regularly evaluate, monitor, and promote practice environment determinants that are sensitive to disparities between different hospitals. In addition, hospital managers can take action by implementing diversity training programs, developing stress-reduction initiatives, and creating robust career development programs for nurse managers to support nurse managers better. Implications for nursing management: a better understanding of the current practice environment of nursing managers is beneficial for improving nursing managers’ work environment, which in turn will promote the quality of care delivered and nursing management work. For nurse managers, the characteristics of the management and work environment of the small city hospitals should be benchmarked and learned against the district capital hospitals. Also, hospital administrators were required to adopt strategies to foster psychological support of nurse managers and create pathways and opportunities for professional growth to create a supportive working environment.

Barriers and Solutions to Comprehensive Care for Mental Health Patients in Hospital Emergency Departments

Hospital emergency departments in Ontario, have become a common place for patients with mental health problems to seek treatment. Studies report healthcare providers have limited knowledge and competency to provide optimal care for patients with mental health problems. As a result, these patients are at risk of poor hospital experiences and treatment outcomes. In addition, emergency staff report considering patients with mental health problems lower priority to other patients. This paper reviews the existing literature and examines the challenges surrounding patients with mental health problems seeking treatment in emergency rooms and how it leads to sub-optimal care. Strategies are then shared to overcome these challenges by changing emergency department experiences for mental health patients seeking treatment.

A visit to David’s World: exploring the impact of a passive art intervention on hospitalized children’s wellbeing, engagement, and joy

ABSTRACT Background A gap exists in research regarding the impact of passive art on hospitalized children. This descriptive study explored the ability of an intervention using original paintings and the same paintings altered with personalized content to capture the attention of hospitalized children, engage them, and bring them joy. Methods This grounded theory mixed-method exploratory pilot study included interview, observation, Leuven Scales for Involvement and Well-being, and the VAS-Joy Scale. Ten hospitalized children, ages four to 12 years, viewed a painting and later the painting with personalized content. Results Leuven scores pre- (M = 4) and post-intervention (M = 4.5) suggested high levels of well-being and involvement, with post scores higher. Joy scores (M = 6.3) obtained post-intervention indicated high levels of joy when viewing the personalized altered painting. Five response themes emerged: (1) Felt special; (2) Brightened mood; (3) Reinforced positive identity; (4) Stimulated imagination; and (5) Revealed homesickness. Conclusions Findings support the emergent theory that passive art interventions using “organic art” can contribute to improving the hospital experience for children.

Australian Hospital Experiences of People Living with Deafblindness or Dual Sensory Impairment: The Report Card.

Gaps abound in the literature about what happens when people living with deafblindness or dual sensory impairment (DBDSI) go to the hospital. Anecdotally, from my lived experiences and professional work, as well as from within communities, stories are told about how hazardous it is to be a patient in an Australian hospital for those living with DBDSI. This paper outlines a quantitative component of a mixed-methods study examining the intricacies of these experiences. The research objective was to discover what hospital interactions looked like for patients living with DBDSI. A constrained question set was used, namely, the Australian hospital experience question set (AHPEQS 2017). It asked patients about key factors in their hospital interactions. The results form a distressing snapshot of care and communication interactions. Experiences of flouting protective conventions, dehumanisation, neglect, discrimination, disparate care, inaccessible consent forms, and a lack of communication predominate. The participants reported experiences from multiple different hospitals, so these findings suggest a broad culture of failing to provide patient-centred care and accessible-to-the-patient communication. The findings showcase the urgency for more research and remedial actions to be undertaken by both professionals and institutions.

Impact of Social Media Marketing on Brand Loyalty, through the mediating role of customer experience: An Applied Study in the Egyptian Private Hospitals

Social media marketing has developed rapidly in the world's contemporary highly competitive business environment in order to gain patient loyalty and competitive advantage by providing prompt services. For research scholars and practitioners, the marketing strategy that incorporates technological advancements has taken center stage. Effective communication and interaction between stakeholders are crucial to the success of a business, and social media platforms provide the venue for such communication and interaction. Thus, the benefits and risks of scientific communication on social media during COVID-19 are understood, and social media may be employed in such emergency scenarios. The purpose of this research is to empirically investigate the impact of social media marketing on brand loyalty with mediation role of customer experience in the Egyptian private hospitals. A questionnaire tool was employed to gather required data from a convienacne sample of 416 Customer of Egyptian private hospitals and structural equation modelling technique (SEM) was utilized for analysis using Spss 28 & AMOS26 software. The main conclusions drawn from this study are the direct effect between social media marketing and Brand Loyalty is statistically significant, the direct effect between Social Media Marketing and customer experience is statistically significant. The direct effect between customer experience and brand loyalty is statistically significant. Finally, the study found that there is partial mediation effect of the customer experience between the relationship of social media marketing and brand loyalty in the Egyptian private hospitals.

Lesional Magnetic Resonance Imaging Is Associated with Better Outcomes in the Loma Linda University Children’s Hospital Experience (P5-1.009)

Lesional Magnetic Resonance Imaging Is Associated with Better Outcomes in the Loma Linda University Children’s Hospital Experience (P5-1.009)

‘A voice of children: I would like a hospital just for children’ - Children's perspectives on hospitalization: A phenomenological study

PurposeThis study aimed to explore children's perception of hospital experience and interpretations of hospitalization. Design and methodsPhenomenological qualitative study design was used. The sample consisted of 18 participants (seven-18 years old) from a general paediatric ward in a university hospital recruited using criterion sampling, a purposive sampling method. Individual semi-structured interviews were conducted face-to-face and were audio recorded. Inductive thematic analysis was used to analyze the data. ResultsThe participants talked about the symptoms, limitations and treatments of their diseases, as well as the team communication, lack of activity and physical conditions regarding the hospital. It was seen that the children reported each expression with positive or negative emotions. Finally, they did not neglect to mention their desires regarding the hospital and their daily life. Four main themes emerged “hospital, disease, mood, and desires”. ConclusionsHealth professionals should care about the needs of children during hospitalization and children should be allowed to express themselves. Practice implicationsKnowing and understanding the needs of hospitalized children can guide the planning and implementation of quality nursing care processes.

Approach to intrapartum fever during the COVID-19 pandemic: A New York City Hospital experience

The yield of repeat severe acute respiratory syndrome coronovirus 2 (SARS-CoV-2) testing for intrapartum fever in patients admitted to labor and delivery negative for SARS-CoV-2 on admission testing is unknown. From October 2020 to June 2022, we performed a retrospective study of 151/3,168 (4.8%) patients who had repeat testing for intrapartum fever. One (0.7%) patient was SARS-CoV-2-positive suggesting repeat SARS-CoV-2 testing for intrapartum fever is generally not warranted nor is separating birthing dyads while awaiting test results.

Bacterial etiology and antimicrobial resistance pattern of pediatric bloodstream infections: a 5-year experience in an Iranian referral hospital

BackgroundBloodstream infections (BSI) are the major cause of morbidity and mortality in children in developing countries. The purpose of the current study was to establish the antimicrobial susceptibility pattern of bacterial isolates from bloodstream infections at Children’s Medical Center Hospital (CMC), Tehran, Iran.MethodsWe retrospectively recorded all positive blood cultures and antimicrobial susceptibility of all bloodstream isolates among children admitted to CMC, during 5 years. Specimen culture, bacterial identification, and antimicrobial susceptibility testing were performed according to standard laboratory methods.ResultsFrom 3,179 pathogens isolated from the blood cultures 2,824 bacteria were cultured, with 1,312 cases being identified as Gram-positive bacteria (46%) and 1,512 cases as Gram-negative bacteria (54%). The most common Gram-negative bacteria isolated were as follows: Pseudomonas spp. (n = 266, 17.6%), Klebsiella pneumoniae (n = 242, 16%), Stenotrophomonas maltophilia (n = 204, 13.5%), Enterobacter spp. (n = 164, 10.8%), Escherichia coli (n = 159, 10.5%), Pseudomonas aeruginosa (n = 126, 8.3%), Serratia marcescens (n = 121, 8%), and Acinetobacter baumannii (n = 73, 4.8%). The most common Gram-positive bacteria isolated were coagulase-negative staphylococci (CONS) (n = 697, 53%), Streptococcus spp. (n = 237, 18%), Staphylococcus aureus (n = 202, 15%) and Enterococcus spp. (n = 167, 12.7%). 34% of bacterial strains were isolated from ICUs. The rates of methicillin resistance in S. aureus and CONS were 34% and 91%, respectively. E. coli isolates showed high resistance to cefotaxime (84%). All isolates of K. pneumoniae were susceptible to colistin and 56% were susceptible to imipenem. P. aeruginosa isolates showed high susceptibility to all antibiotics.ConclusionsOur findings emphasize the need of clinicians having access to up-to-date bacterial susceptibility data for routinely prescribed drugs. Continuous monitoring of changes in bacterial resistance will aid in the establishment of national priorities for local intervention initiatives in Iran. The increased risk of BSI caused by antibiotic-resistant organisms, emphasizes the significance of implementing appropriate antibiotic prescribing regulations and developing innovative vaccination techniques in Iran.

(1075) - Medium to Long-Term Ventricular Assist Device Support in Adults with Congenital Heart Disease: The Baylor St. Luke’s Medical Center / Texas Children’s Hospital Experience

(1075) - Medium to Long-Term Ventricular Assist Device Support in Adults with Congenital Heart Disease: The Baylor St. Luke’s Medical Center / Texas Children’s Hospital Experience

Insights from Seoul National University Hospital's experience: a systematic review of pure laparoscopic donor hepatectomy progression.

Following its initial execution in November 2015, pure laparoscopic donor hepatectomy (PLDH) has gained acceptance as a conventional practice at Seoul National University Hospital (SNUH). It is noteworthy that a significant proportion of cases entail full right hepatectomies, which are acknowledged to be technically demanding. As expertise and knowledge have been accrued, the pure laparoscopic technique has been extended to encompass liver recipients as a viable option in SNUH. The aim of this review is to present the developmental progression of PLDH, with a focus on pure laparoscopic donor right hepatectomy (PLDRH), at SNUH. This includes the standardization process, which can be achieved by sharing the hospital's accumulated experience and previous reports. Various types of graft, including full right, left, left lateral section, and monosegment, were procured by pure laparoscopic technique. The criteria for selection were expanded to include donors with variations in the anatomy of the portal vein and bile duct. Additionally, the procedure of PLDRH was determined to be safe and viable for donors with high body mass index and larger graft weight. In conclusion, this review demonstrates the alterations implemented throughout our evolution from restricted to inclusive criteria for donor selection, leading to a complete shift from open surgery to pure laparoscopic procedures in donor hepatectomy and eventually pure laparoscopic living donor liver transplantation (LDLT) in recipient.

Using quality improvement to address social determinants of health needs in perinatal care

There are unacceptable racial inequities in perinatal outcomes in the United States. Social determinants of health (SDOH) are associated with health outcomes and contribute to disparities in maternal and newborn health. In this article, we (1) review the literature on SDOH improvement in the perinatal space, (2) describe the SDOH work facilitated by the Illinois Perinatal Quality Collaborative (ILPQC) in the Birth Equity quality improvement initiative, (3) detail a hospital's experience with implementing strategies to improve SDOH screening and linkage to needed resources and services and (4) outline a framework for success for addressing SDOH locally. A state-based quality improvement initiative can facilitate implementation of strategies to increase screening for SDOH. Engaging patients and communities with specific actionable strategies is key to increase linkage to needed SDOH resources and services.

Predicting outcomes in patients with acute kidney injury: Our experience in a district general hospital

Predicting outcomes in patients with acute kidney injury: Our experience in a district general hospital

Epidemiological characteristics of Klebsiella ozaenae infection and its antibiotic susceptibility: Experience of a tertiary care hospital in the Eastern Province of Saudi Arabia.

Klebsiella ozaenae (K. ozaenae), a forgotten pathogen that normally colonizes the upper respiratory mucosa, can be associated with severe and invasive infections. The objectives of this study were to determine the frequency of isolation of K. ozaenae at the microbiology laboratory in a tertiary hospital and the scope of diseases associated with it and to characterize its antimicrobial susceptibility pattern. This cross-sectional study analyzed the retrospective data, from 2002 to 2021, on cases with laboratory-confirmed isolation of K. ozaenae at a tertiary care hospital. The primary outcome was to identify the scope of K. ozaenae infections and their antimicrobial susceptibility patterns. K. ozaenae isolation was done by cultivation on microbiological culture media, whereas its identification and antimicrobial susceptibility pattern were performed using either Microscan or Vitek automated systems. Data was gathered and analyzed in Excel. The percentage of resistance was calculated as the number of resistant isolates from the total isolates multiplied by 100. Similarly, the percentage of sensitivity was calculated as the number of sensitive isolates from total isolates multiplied by 100. K. ozaenae was detected in 59 cases during the study period. K. ozaenae was associated with urinary tract infections (39%), nasal infections (18.6%), other respiratory tract infections including sinusitis, bronchiectasis, and pneumonia (16.9%), and wound infections (15.3%). It was also associated with invasive infections such as bacteremia (3.4%) and abscesses (3.4%). K. ozaenae showed susceptibility to multiple antibiotic classes, but was resistant to ampicillin, piperacillin, nalidixic acid, and nitrofurantoin. K. ozaenae isolates from urinary tract infections had higher antibiotic resistance percentage than isolates from other infections, particularly to amoxicillin/clavulanic acid (P = 0.007, 95% confidence interval [CI]: 1.84-375), ciprofloxacin (P < 0.0001, 95% CI: 4.6-111.2), and trimethoprim/sulfamethoxazole (P < 0.001, 95% CI: 3.1-63.6). Our data show that K. ozaenae is a pathogen with a spectrum of diseases wider than expected and a unique antibiotic susceptibility pattern in urinary tract infections.

Post-traumatic stress disorder in parents of schizophrenic patients at the Arrazi Psychiatric Hospital in Salé following familial violence

IntroductionParents whose adult child has a serious mental illness are at risk of serious violence from their child. One of the reasons for the high risk of PTSD is violence in the home [1,2]. The high risk of PTSD in parents of patients with schizophrenia is an issue of great concern because parents are likely to fear repeated violence and, therefore, to object to patients being discharged from hospital.Objectives To assess the existence of post-traumatic stress disorder in relatives of patients with schizophrenia treated at the Arrazi University Psychiatric Hospital in Salé following familial violence.MethodsThis was a descriptive cross-sectional study using a questionnaire including sociodemographic criteria, clinical criteria, questions about domestic violence and an “IES-R” post-traumatic stress symptom assessment questionnaire to investigate the existence of post-traumatic stress disorder in relatives of patients with schizophrenia followed up at Arrazi University Psychiatric Hospital in Salé following familial violence.ResultsThe response of 72 relatives of schizophrenic patients was collected. About 70% of the participants were mothers. The average age of the participants was 58. All lived with children who had been treated for schizophrenia for more than 18 years (57% of participants). Around 20% of these children were in hospital at the time of completing this questionnaire. About 80% of the children with schizophrenia spent all their time at home, and about 89% of the participants had already been victims of violence from their sick children. 90% had been sworn at and insulted, the majority blamed themselves for the illness, about 56% had already been kicked or punched, and 36% had already received death threats and 12% serious injuries/. For all items, parents with a high IES-R score had significantly more experiences of violence than parents with a low IES-R score. The percentage of parents with a high IES-R score was 45%.Conclusions The experience of severe violence and hospitalisation of a patient was related to a high risk of post-traumatic stress disorder in parents. These two factors can be considered as traumatic events arising from crisis situations and can have harmful consequences for parents and their schizophrenic children, who are sometimes rejected. There seems to be a need to create crisis intervention programmes that offer a multidisciplinary approach capable of rapidly detecting the exacerbation of a serious mental illness and providing rapid and intensive treatment as quickly as possible. Finally, the provision of support, education or treatment for parents during their child’s hospitalisation is essential.Disclosure of InterestNone Declared

Etiologies and Seizure Outcome of Neonatal Seizures: A Tertiary University Hospital Experience

Context: Despite the vast developments in medical sciences in recent decades, seizures remain a common occurrence among neonates, associated with high rates of morbidity and mortality. Aims: The aim of this study was to assess and analyze the presentation and outcome of neonates who were previously exposed to seizures. Subjects and Methods: Following a retrospective research design, this study included 50 cases of neonatal seizures (29 males and 21 females), who were admitted to the neonatal intensive care unit at King Abdulaziz University Hospital, Jeddah City, Saudi Arabia. Data were collected from the hospital records and included all visits between January 2022 and December 2022. Results: The most common types of neonatal seizures were clonic and myoclonic seizures (44% and 28%, respectively). Apgar score at 5 min was &lt;7 in 30% of cases. The main diagnosis was hypoxic-ischemic encephalopathy (HIE) in 28 children (56%), and central nervous system (CNS) infection in 18 children (36%). Children with neonatal seizures mainly received phenobarbital, benzodiazepines, or levetiracetam (48%, 46%, and 36%, respectively). Mechanical ventilation was applied to 20 children (40%). A total of 15 children (30%) had developmental delays, being global delay in 7 children (14%), or motor in 8 children (16%), while 6 children died (12%). Seizures could be controlled in 37 children (74%). Children who presented early (during the 1st week of life) and those who had Apgar scores &lt;7 at 5 min had significantly worse outcomes, with higher case fatality and less seizure control than those who had Apgar scores of 7–10 (P &lt; 0.001). Conclusions: Seizures are a common occurrence among neonates, especially males during the 1st week of their lives. HIE and CNS infections are the main diagnoses. The most administered medications are phenobarbital, benzodiazepines, and levetiracetam. Children who present during their 1st week of life and those who have 5-min Apgar scores &lt;7 have significantly higher case fatality and less seizure control.