Gaza Hospital Research Articles

Logics of War

As manifested in Jean Baudrillard’s notoriously provoking claim that “the Gulf War did not take place,” mediatization of war has long been associated with illusion. Today, war images that circulate online are increasingly judged by their proximity to ‘truth,’ eliciting a skepticism towards their ‘evidentiary’ value. By juxtaposing Baudrillard’s reading of the mediatization of the Gulf War with the contemporary image theories of e.g. Cecilia Sjöholm and Matthew Fuller and Eyal Weizman, the article explores how this skepticism is expressed in a contemporary context. Through visual analysis of a YouTube video of a press conference held at the bombed Al-Ahli Baptist Hospital in Gaza, it examines the relationship between the f orm through which the war is perceived (the images) and their cont ent (the ‘realities’ of war). Through a lens oered by Georges Didi-Huberman, the article concludes by suggesting that by expanding what I term the snapshot logic of war images to embrace a scenography of war, the press conference video gives form to the condition of desperation and suering in Gaza.

The Baptist Hospital in Gaza. Current ruins for future archaeologists?

Abstract As a Palestinian archaeologist whose work is focused on the geopolitics of Palestinian archaeology practice and theory, I reflect in this provocation article on the current devastation of the Gaza Strip by Israel and how archaeology can be incorporated into Gaza’s current situation. Pertinent questions include the following: How should archaeologists treat the ruins of the Baptist Hospital or any ruins in Gaza? What should be done with all these ruins? When does democide become genocide? Is an ex situ analysis possible? Is there such a thing as archaeology without a place? What kind of ‘regime of truth’ does it establish? What ethical implications does this form of analysis have? What kind of accountability does it possess? In what ways does it shape our memories of events?

First report of carbapenems encoding multidrug-resistant gram-negative bacteria from a pediatric hospital in Gaza Strip, Palestine

BackgroundThe worldwide prevalence of multi-drug resistance (MDR) in Gram-negative bacteria (GNB), particularly related to extended-spectrum beta-lactamases (ESBLs) and carbapenemases, poses significant global public health and clinical challenges.ObjectivesTo characterize ESBL-producing Gram-negative bacilli, within a pediatric hospital in Gaza using whole genome sequencing (WGS).MethodsA total of 158 clinical isolates of Gram-negative bacilli were collected from Al-Nasser Pediatric Hospital. These isolates were tested for ESBL production using the double disk synergy test. The antibiotic susceptibility profile was determined using the Kirby Bauer method following the Clinical and Laboratory Standard Institute guidelines. Selected 15 phenotypically MDR isolates were whole-genome sequenced and characterized for their genome-based species identity and antibiotic resistance gene profile.ResultsOf the 158 isolates, 93 (58.9%) were positive for ESBL production. The frequency of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Proteus mirabilis, and Serratia marcescens was 50%, 22.7%, 22.7%, 1.8%, 1.2%, and 1.2% respectively. The prevalence of ESBL among urine, pus, blood, and sputum was 64%, 44%, 23%, and 63.6%, respectively. Chloramphenicol, Imipenem, and Meropenem were the most effective antibiotics against ESBL producers.In sequenced isolates, an average of six anti-microbial resistance (AMR) genes were noted per isolate, where one of them carried up to 13 antibiotic resistance genes. Carbapenem resistance genes such as blaKPC-2(6.6%), blaPDC-36/12 (6.6%), and blaPOM-1 (6.6%) were detected. All the sequenced E. coli isolates (n = 8) showed multiple resistance genes, mainly against β-lactamase (25.0%), aminoglycosides (37.5%), sulfonamides (37.5%), and genes conferring resistance to tetracyclines (25.0).ConclusionOur results showed a high prevalence of ESBL-producing GNB isolated from a pediatric hospital in the Gaza Strip. Various antibiotic resistance genes were identified, including those encoding ESBL and carbapenems. The results highlight the significant challenge posed by MDR in GNB and emphasize the need for effective antibiotic strategies. Given the high endemicity observed in various studies from Palestine, it is important to conduct clinical and molecular epidemiology research to identify risk factors, transmission patterns, and clinical outcomes associated with GNB strains that carry ESBL and carbapenem resistance genes.

Effectiveness of Coping Strategies-Based Counseling Program on Quality of Life among Nurses at European Gaza Hospital

Context: Nurses are the backbone of healthcare systems. They often work in high-stress environments that can significantly impact their quality of life. Addressing their well-being is crucial for maintaining effective healthcare services. Aim: This study investigates the effectiveness of a counseling program based on coping strategies to enhance the quality of life among nurses at European Gaza Hospital. Methods: The researchers used this quasi-experimental design, utilizing a single-group pretest-posttest design. Thirty-three nurses, comprising 20 males and 13 females, participated in the study. The researchers developed and implemented quality-of-life scales and a counseling program that applied to the nurses at European Gaza Hospital. Results: The results showed statistically significant differences between the pre-test and post-test scores of the experimental group across the quality-of-life subscales. The following changes were observed at the significance level (p≤0.05): Physical Health Subscale: Pre-test mean rank is 29.45±5.50, compared to post-test mean rank of 18.81±4.12, p-value = 0.000. Psychological Health Subscale: Pre-test mean rank is 36.81±5.35, compared to the post-test mean rank of 28.36±6.39, p-value = 0.000. Social Relationships Subscale: The pre-test mean rank is 20.39±3.30, compared to the post-test, the mean rank of 15.27±3.07, p-value = 0.000. Environmental Subscale: The pre-test mean rank is 19.18±3.30, compared to the post-test mean rank of 14.18±2.83, p-value = 0.000. Professional domain: The pre-test mean rank is 37.30±6.21, compared to post-test mean rank of 27.96±5.15, p-value = 0.000. Conclusion: These findings suggest the importance of prioritizing nurses' well-being through tailored counseling interventions. Recommendations include implementing psychological support programs, providing ongoing professional development, fostering a collaborative work environment, promoting self-care practices, and conducting regular program evaluations.

Trauma care supported through a global telemedicine initiative during the 2023–24 military assault on the Gaza Strip, occupied Palestinian territory: a case series

Hospitals, patients, and health-care workers are legally protected by international humanitarian law and the Geneva Convention. However, since Oct 7, 2023, the health-care system in the Gaza Strip, occupied Palestinian territory, has been under unprecedented direct military attacks by Israel, with support for patients proving to be challenging for the remaining health-care workers. Peer-to-peer telemedicine holds promise for assisting surgeons in high-risk, low-resource environments, but might be of reduced utility in extremely austere settings. We present a patient case series of traumatic injuries shared in an international telemedicine group by the surgical team at Nasser Medical Complex, also known as Nasser Hospital, the largest remaining partially functioning hospital in Gaza. WhatsApp (Meta; Menlo Park, CA, USA), a widely available and user-friendly end-to-end encrypted smartphone application, was used to facilitate consultations for weapon-inflicted injuries. All the presented patient cases were shared after obtaining verbal consent from the patients and discussed through a multidisciplinary team approach. The group was developed into a community with more than 15 specialty and injury-oriented subgroups and over 1000 members who joined through non-targeted social media outreach followed by snowball recruitment. Prospective registration and formal ethics approval in Gaza was impossible because the Ministry of Health, including the local Helsinki Committee, had suspended all operations. In June, 2024, we obtained ethics approval from the local Helsinki committee in Gaza. We present 12 select patient case studies from a pool of hundreds of patients admitted to Nasser Hospital between Jan 28 and Feb 12, 2024. Four (33%) of the 12 patients were female and eight (67%) were male, with four patients (33%) being children (younger than 18 years). The age range was between 3 years and 70 years, with a median age of 25 years. Most patients presented with penetrating injuries (11 [92%] of 12), with six patients presenting with wounds secondary to fragment injury, and five patients presenting with wounds due to gunshots. One patient presented with a direct blast injury. The site of reported injuries included head and neck areas (four [33%] of 12), abdomen (four [33%] of 12), chest (three [25%] of 12), pelvis (two [17%] of 12), and limbs (one [8%] of 12). Most patients were lost to follow-up (11 [92%] of 12) and were affected by the invasion of the hospital by the Israeli Defense Forces, which subsequently rendered the hospital non-functional. One patient died following their injury. The health-care team at the now non-functioning Nasser Hospital in southern Gaza adapted their allocation and distribution of extremely low resources and relied on smartphones for specialised telemedicine outreach purposes. This enhanced the capability of the medical teams in management of mass casualties of military assaults that few are trained to work in. Nonetheless, the options available to a health-care system that is under-staffed, under-served, and under siege, are extremely constrained, regardless of such telemedicine initiatives. None.

The Impact of Emotional Intelligence on Job Burnout through the Mediating Effect of Job Satisfaction of Nurses in Private Hospitals in Gaza Strip

The Impact of Emotional Intelligence on Job Burnout through the Mediating Effect of Job Satisfaction of Nurses in Private Hospitals in Gaza Strip

THE ATTACK OF AL-SYIFA HOSPITAL IN THE REPORT OF ONLINE MEDIA REPUBLIKA, ALJAZEERA, AND BBC NEWS

This article aims to reveal the exclusion and inclusion strategies and the differences in the use of reporting strategies onthe news of the Al-Syifa Hospital attack on Republika, Aljazeera, and BBC News online media using Van Luwen's critical discourse analysis theory. The type of research used is a qualitative method. Data sources are taken from Republika online news media entitled Pasukan Israel Kepung 3 Rumah Sakit di Gaza dan Mengebom kembali RS Al-Shifa, Aljazeera net entitled Al-Jazirah Nit Tarshadu Awdhaa'uhu, Hakadza Yabdu al-Mustasyfa al-Indunisiya bi Gazzah tahta al-Qashfi, and BBC News entitled “Israeli Militarry Looking into Reports of Gaza Hospital Blast”. The data were analyzed using descriptive analysis techniques, namely data presentation, data analysis, and conclusion drawing. The results showed that the news strategy used on Republika online media is an exclusion strategy with passivization and nominalization, and an inclusion strategy with differentiation, abstraction, nomination categorization, and nomination identification. Aljazeera uses exclusion strategies with passivization and nominalization techniques, as well as inclusion strategies with abstraction, nomination categorization and dissociation techniques. BBC News only uses exclusionary strategies with, passivization nominalization, and clause replacement techniques. The use of news strategies on Republika and Aljazeera media contrasts sharply with the use of strategies in the BBC News media, which only uses exclusion strategy. The use of these strategies shows that Republika and Aljazeera online media support Palestine, while BBC News online media support Israel.

The Gaza-Israel War Terminology: Implications for Translation Pedagogy

Student translators at my college take a Media Translation course in which they translate the latest news stories. This study proposes a model for integrating Gaza-Israeli war terminology and texts in translation instruction to familiarize the students with such terminology such as (names of weapons (grenades, mortar, drones, missiles, Merkava, Cornet anti-armor, mortar shells), toponyms (Khan Younis, Maghazi, Sderot, Ashkelon), crossings (Rafah, Erez), Jihadist groups and brigades (Islamic Jihad, Golani), military actions (incursion, bombing, shelling, genocide, displacement) war metaphors (target bank, carpet bombing, scorched earth, fire belt, Philadelphia Axis, Hannibal's plan), (UNRWA, Gaza hospitals, starvation, humanitarian aid) and others. English and Arabic texts can be collected from mainstream media as RT, BBC, CNN, Al-Jazeera and Al-Ghad. A class blog can be created for posting translations, corrections, discussions, and feedback. The students can practice full, summary, and conceptual translation and avoid word-for-word translation. They can watch news stories about the Gaza-Israel war, write a summary translation of it and receive comments and feedback. Beginners can translate short news excerpts (few lines). Students make sure their translations are cohesive, make sense and are easy to read. Students should use Google Translate and artificial intelligence (AI) with caution and should read the same news story in both English and Arabic to get used to the terminology and their equivalents. The instructor serves as a facilitator. Further instructional guidelines and recommendations are given.

Analyzing the Capacity of the Healthcare System in Gaza to Address Gaza Residents Needs

The present humanitarian crisis in Gaza has resulted in the devastation of medical facilities and health infrastructure. As of January 2024, the World Health Organization reports that 78% of primary care clinics funded by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA, 2024) have ceased operations, and hospitals’ bed capacity throughout Gaza has decreased by more than 59% (World Health Organization, 2024). Direct military attacks on medical facilities as well as the blockade of medical supplies and humanitarian aid pose the largest obstacles to greater healthcare attainment in Gaza (IRC, 2024). Over the course of the conflict, there has been a surge in the number of people suffering from war injuries, which now totals 71,377 (Shurafa, 2024). The rise in the number of patients who require access to medical services in combination with the limited hospital functionality in the Gaza Strip is putting a massive strain on their already limited healthcare system; before the over 6 month long duration of direct military attacks by the Israeli Defence Forces (IDF) on hospitals in Gaza, data indicated a maximum ratio of 1.55 hospital beds per 1000 individuals across the entire region of the Gaza Strip, while the ratio in the US is around 2.35 hospital beds per 1000 individuals (Taylor, 2024). The already poor living conditions of the demographic–most of whom are housed in temporary structures in severe weather conditions with a lack of access to food and water for sustenance or hygiene–signify a need for a more robust healthcare system. However, triage conditions prioritize treatment of the most severe war injuries, which has forced hospitals to abandon previously established vaccination projects and disease surveillance programs, leaving the remaining population to suffer from preventable diseases such as chickenpox, upper respiratory infections, scabies, and Hepatitis A (Soni, 2024). Individuals who do receive medical care face higher levels of infection due to a lack of adequate sanitation, waste management measures, and basic hygiene supplies (The Economist, 2024).

Polarization and Radicalization as Identity Dynamics in a Fluid Environment

Playing with parallel mirrors is one of the most famous tricks in magic. Cropping the image seen by viewers, and playing with the lights and spots is also part of the business. But these tactics are also used extensively in informational warfare as a cynical tool of trompe-oeil. Turning upside down the mirror means projecting on your adversary the wrongs and legal breaches that one actor is doing himself. Cropping scenes means making people ignore parts of reality and focusing on the sequences of the picture where the actor would like to channel the attention of the public, where lights are also playing their part in the make-up of the show.The magnitude of the distance between reality and created perception could become equal to that between a victim and an aggressor. Good sense and logic would plead for the impossibility of such a change between the perception and the reality of one’s public. However, things do happen in such a way, and an obvious lie could become credible for a specific public when emotions and beliefs are taking the place of rational behavior and factual reality. We’ve seen that emotions and beliefs can alter the perception of reality or make alternative realities admissible. The research question is if polarization and radicalization are instruments able to create such a space where belonging to a special community and assuming a common identity becomes far more important than reality and absolute truth themselves. Complacency or active need to prove to belong to the group leads to dynamics of identity able to forge a self-trumping behavior that perceives alternative needed realities according to the beliefs of the group. Our case study is the bombardment of the Al Ahli Hospital in Gaza, on the 17th of October 2023, able to erase the perceived memory of the horrible Hamas attack on the 7th of October in southern Israel.

Rosuvastatin plus N Acetylcysteine to Prevention of Contrast Induced Acute Kidney Injury in Patients with Low Mehran Risk Score

Objective: Contrast induced acute renal injury is the third leading cause of hospital-acquired acute kidney injury, several protective treatments options have been developed among patients undergoing percutaneous coronary intervention (PCI). Our trial aimed to comparison between high dose rosuvastatin versus rosuvastatin plus N acetylcysteine to prevention of contrast induced acute kidney injury in patients undergoing elective PCI at Alshifa hospital in Gaza. Methods: Randomize control trial included 100 patients who undergoing elective PCI at Alshifa hospital in Gaza, Group A: (N:50) patients received 40 mg rosuvastatin orally once daily for 3 days, on dose before undergoing PCI and two dose after PCI. Group B (N: 50) patients received 40 mg rosuvastatin orally once daily for 3 days, on dose before PCI and two dose after PCI plus N-acetylcysteine 1200 mg orally twice daily every 12 hours for two days, the first dose before PCI and other 3 doses after PCI. All patients were measuring serum creatinine level, creatinine clearance and blood urea nitrogen (BUN) before PCI and (2-3) days after procedure. Result: In Group A: nonsignificant reduction of serum creatinine level (P: 0.90), creatinine clearance (P: 40) but significant reduction of BUN was seen after treatment (P: 0.017). In Group B: Significant reduction of serum creatinine level, and BUN (P; 0.001). But creatinine clearance not significant changes were seen after treatment (P:0.72). On other hand comparison between two group was significant reduction of serum creatinine level (P: 0.046) in group B, but not significant changes in creatinine clearance and BUN were not significant (0.41, 0.34) respectively. Conclusion: High dose rosuvastatin plus N-acetylcysteine compared rosuvastatin had significant reduction of creatinine level among patients undergoing PCI.

Missile Attacks on Al-Ahli Hospital in Gaza and Silence of Reference International Authorities

The Article Abstract is not available.

Effectiveness of Training Programme on the Quality of Cardiopulmonary Resuscitation among Health Care Providers in Critical Care Units at Governmental Hospitals in Gaza Strip

Rescuers' ability to properly administer cardiopulmonary resuscitation (CPR) depends on their ability to learn, remember, and apply the necessary cognitive, behavioural, and psychomotor abilities. In order to provide HCPs with the knowledge and abilities needed to do CPR in circumstances where life is at risk, such as cardiac or respiratory arrest, the researcher used CPR training classes. The training sessions will also include lectures on the theories underlying as well as skill teaching sessions, and a final exam. This study used baseline data to show the improvement in effective training program quality and comprehension. Given guidelines on how to make it better and general guidelines for applying them across all hospitals in GS. The purpose of this study was to evaluate the effectiveness of a training program for healthcare professionals working in critical care units at governmental hospitals in the Gaza Strip. In order to assess the quality and knowledge of CPR among HCPs in these institutions, researchers employed a pre-post quasi-experimental design before and after education intervention studies (Al-Shifa). The training program's efficacy effect size was calculated using partial eta squared; the average score in the pre- and post-tests, paired t-test, P value, and MD with 95% CI were as follows: total score (0.360.10 vs 0.880.06, t = 43.05, P0.001, MD = 0.519, 95% CI =0.495-0.543), and effect size by Partial eta squared were 0.980. Specialists from all over the world who advice stakeholders on how to improve the standard of HCPs (Doctors and Nurses) offered in the ICU, ER, and CCU in the Gaza Strip are in a heated debate on CRP. Governmental hospitals with continuing education committees implement rigorous strategies to improve the knowledge and clinical proficiency of nurses and doctors, Urging HCPs to put in more effort and carry out more research in order to enhance the standard of their profession, save patients, and strengthen their areas of weakness in order to become more proficient and effective from a scientific and practical perspective (HCPs). Guidelines and suggestions were made to stakeholders that might improve the standard of CPR provided for critical care in ERs, ICUs, and CCUs.

Nurse's Knowledge Regarding Pressure Ulcer Prevention among Critical Patients in Intensive Care Unit at Governmental Hospitals in Gaza Strip

This study aimed to assess nurse's knowledge of pressure ulcer prevention in governmental hospitals in the Gaza Strip. This study utilized a descriptive, cross-sectional, analytical design. The sample of the study consisted of 116 ICU nurses from five governmental hospitals. For data collection, the researcher used a self-administrated questionnaire and Observation Checklist. Results showed that the study population were males (73.3%) and 26.7% were females. Moreover, (62.1%) of the study population had less than 5 years of experience in the ICU. There were no statistical significant differences between means in knowledge related to gender, age, educational level, and hospitals. The study concluded that intensive care nurses' knowledge of pressure ulcer prevention was above moderate. The study recommended the need to provide sufficient numbers of qualified nurses in intensive care departments and urged nurses to attend training courses on safety standards for the prevention of pressure ulcers among patients.

Impact of Liver Cirrhosis on the Occurrence of Diabetes Mellitus and Glucose Intolerance among Liver Cirrhosis Patients in European Gaza Hospital: A Retroactive Study

Background: Third of liver cirrhosis patients have diabetes mellitus. In addition, most of patients with cirrhosis may be glucose intolerant. This study aimed to shed light on the impact of liver cirrhosis on the occurrence of diabetes mellitus among liver cirrhosis patients. Materials and Methods: This study is a retrospective analytical study design. The study was a descriptive study. The study was conducted at the gastroenterology outpatient clinic in European Gaza Hospital. Data were collected retrospectively from patients records and from patients themselves when attending at the clinic. The study was conducted during the period from September 2022 to February 2023. The study tool is a self-designed questionnaire based on most recent published literature. The questionnaire included basic information about the patients, data related to liver cirrhosis and some laboratory work done for the patients. Results: A total of 70 patients were included in the study, with more than half being male (60%). The mean age of participants was 61.97 ± 11.54 years. The most frequent cause of liver cirrhosis among participants was cryptogenic (54.3%), and two-thirds of the participants had comorbid conditions besides liver cirrhosis, with diabetes mellitus being the most frequent (54.3%). The majority of participants were overweight or obese, with a mean body mass index of 31.15 kg/m2. Ultrasound imaging showed that most participants had severe steatosis (88.6%) and a shrunken liver (72.9%). The laboratory findings showed raised mean alanine transaminase (ALT) and aspartate aminotransferase (AST) levels, with high levels of triglycerides and cholesterol. Conclusion: Most participants were overweight or obese. More than half of the participants had comorbidities, including diabetes mellitus, and cryptogenic liver cirrhosis was the most prevalent etiology. Most liver ultrasounds indicated significant steatosis. Participants had increased alanine transaminase, aspartate aminotransferase, triglycerides, and total bilirubin.

Prevalence of mecA and Panton-Valentine Leukocidin Genes in Staphylococcus aureus Clinical Isolates from Gaza Strip Hospitals.

Methicillin-resistant Staphylococcus aureus (MRSA) are spreading worldwide in hospital and community settings, thus posing a serious public health problem. Panton-Valentine Leukocidin (PVL), an important virulence factor of S. aureus, is a marker of community-acquired MRSA. Here we determined the prevalence of pvl genes among S. aureus isolates from different hospitals in the Gaza Strip, Palestine. A total of 285 S. aureus isolates were collected from five different hospitals in the Gaza Strip. All isolates were characterized for their susceptibility patterns to available antimicrobial agents and by using multiplex PCR for the detection of mecA and pvl genes. The overall prevalence of MRSA in Gaza hospitals was 70.2% (range: 76.3% to 65.5%) and that of pvl among S. aureus isolates was 29.8% (range: 32.9% to 26.2%). The pvl gene was equally prevalent among MRSA isolates (30.5%) and MSSA isolates (28.2%). The most effective antibiotics were rifampicin, vancomycin, and clindamycin, with susceptibility rates of 91.2%, 88.7%, and 84.6%, respectively. The highest percentage of strains were observed to be resistant to penicillin and amoxicillin with clavulanic acid-96.1% and 73.6%, respectively. Our results showed a high prevalence of MRSA and pvl-positive isolates in Gaza Strip hospitals, which likely reflects the situation in the community. It is mandatory to implement systematic surveillance of both hospital and community isolates, together with interventions (such as increased hand hygiene, use of hydroalcoholic solutions, and isolation of carriers) to limit their spread.

Knowledge and practice towards status epilepticus among emergency room physicians in the Gaza Strip: a cross-sectional study (P9-1.006)

<h3>Objective:</h3> To determine the level of knowledge and practice of Palestinian ER physicians towards status epilepticus (SE). <h3>Background:</h3> SE is a medical and neurologic emergency with many serious complications. Management is both time and knowledge-dependent. <h3>Design/Methods:</h3> This cross-sectional study recruited all ER physicians working in the six main governmental hospitals in Gaza Strip during June 2022. A questionnaire was used to assess the knowledge and practice toward SE. <h3>Results:</h3> Overall, 137 physicians participated (response rate 81%), including 100 males and 37 females. Mean age was 28.36 years (SD 3.4). Most participants were fresh graduates (107 had graduated in 2018 or later). The mean number of status epilepticus cases per participant during the past 12 months was 4.42 (SD 6.33). Out of 22 knowledge questions, the mean score was 13.24 (SD 3.13). A weak negative correlation (−0.20) existed between age and knowledge. Also, graduates of local medical schools scored significantly higher compared to graduates of foreign medical schools (mean score 14.3 vs. 12.17, p=0.000). Only 63.5% of participants recognized the correct, updated definition of status epilepticus. On the other hand, 85.4 and 83.9% recognized that it might cause permanent brain damage or death, respectively. In terms of practice, only 51 (37.2%) participants correctly answered whether an EEG monitoring device was available at their facility or not, while 17 (12.4%) did not correctly answer if their hospital had a neurologist among the staff. Self-revision of Status epilepticus guidelines was associated significantly with higher knowledge scores. <h3>Conclusions:</h3> Palestinian ER physicians in this survey demonstrated low levels of knowledge and practice towards SE. This should be addressed by the local health authorities to avoid potentially preventable SE-related mortality and morbidity. <b>Disclosure:</b> Dr. Aldabbour has nothing to disclose. Dr. AbuNemer has nothing to disclose. Mr. Alfarra has nothing to disclose. Dr. Aldabbour has nothing to disclose. Dr. Abu Zaydah has nothing to disclose. Dr. Abuzaid has nothing to disclose.

Assessment of leadership styles at hospitals in Gaza strip of Palestine

Assessment of leadership styles at hospitals in Gaza strip of Palestine

Prevalence of extended spectrum beta lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram negative bacilli isolates from pediatric patient population in Gaza strip

BackgroundExtended-spectrum β lactamases (ESBLs), have the ability to hydrolyze and cause resistance to various types of the β-lactam antibiotics, including the extended-spectrum (or third-generation) cephalosporins (e.g., cefotaxime, ceftriaxone, ceftazidime) and monobactams (e.g., aztreonam). ESBL-producing Gram negative bacteria is still posing significant therapeutic challenges.ObjectivesTo assess the prevalence and molecular characteristics of ESBL producing Gram negative bacilli, isolated from a cohort of pediatric patients in Gaza hospitals.MethodsA total of 322 isolates of Gram-negative bacilli were collected from four referral pediatric hospitals in Gaza, namely: Al-Nasr, Al-Rantisi, Al-Durra and Beit Hanoun hospitals. These isolates were tested for ESBL production using the double disk synergy and CHROMagar phenotypic methods. Molecular characterization of the ESBL producing strains was performed using PCR targeting the CTX-M, TEM and SHV genes. Antibiotic profile was done using Kirby Bauer method according to Clinical and Laboratory Standard Institute.ResultsOut of 322 isolates tested by phenotypic methods, 166 (51.6%) were ESBL positive. The prevalence of ESBL production in Al-Nasr, Al-Rantisi, Al-Durra and Beit Hanoun hospitals was 54%, 52.5%, 45.5% and 52.8% respectively. The prevalence of ESBL production among Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp., Proteus mirabilis, Enterobacter spp., Citrobacter spp., and Serratia marcescens is 55.3%, 63.4%, 17.8%, 57.1%, 33.3%, 28.5%, 38.4%, and 4% respectively.ESBL production among urine, pus, blood, CSF and sputum was 53.3%, 55.2%, 47.4%, 33.3%, and 25% respectively. Out of the 322 isolates, 144 were screened for CTX-M, TEM and SHV production. Using PCR, 85 (59%) had at least one gene. The prevalence rate of CTX-M, TEM and SHV genes was 60%, 57.6%, and 38.3% respectively.Meropenem and amikacin were highest rates of susceptibility antibiotics against ESBLs producers (83.1% and 82.5% respectively), while the least effective antibiotics were amoxicillin (3.1%) and cephalexin (13.9%). Moreover, ESBLs producers showed high resistance rate to cefotaxime, ceftriaxone and ceftazidime (79.5%, 78.9% and 79.5% respectively).ConclusionOur results show high prevalence of ESBL production among Gram negative bacilli isolated from children in different pediatric hospitals in Gaza strip. A substantial level of resistance to first and second generation cephalosporins was also observed. This ascertains the need for a rational antibiotic prescription and consumption policy.

Critical Care Nurse’s Practice Regarding Medication Administration Safety in Intensive Care Units at Governmental Hospitals in Gaza Strip

Background: Administration of medications is primarily the nurse’s responsibility. This study aimed to assess intensive care nurses’ practice of safe medication administration in governmental hospitals in the Gaza Strip. Methods: This study utilized descriptive, cross-sectional, analytical design. The sample of the study consisted of 116 ICU nurses from five governmental hospitals (Al Shifa Hospital, Indonesy Hospital, Shohada Al Aqsa hospital, European Gaza Hospital, and Nasser Hospital). For data collection, the researcher used Patient Safety Assessment in Medication Administration Questionnaire and Observation Checklist. A pilot study was conducted on 20 nurses, and reliability of the Patient Safety Assessment in the Medication Administration Questionnaire was 0.908. Results: The results showed that 66.4% of study participants were male nurses and 33.6% were female nurses, mean age was 28.97 years, 85.4% have bachelor degree, mean experience was 4.18 years, mean income was 1431.64 New Shekel, and 67.2% are working mixed shifts (morning, evening, and night). The practice of safety medication administration indicated that the highest score was in right route (93.8%), the right time (91.8%), right patient (90.7%), right way (89.5%), right recording of administered medication (88.9%), right answer (86.7%), right guidance (86.5%), right dose (86%), right medication (85.3%), and the overall score was 88.6%. Also, observation of nurses indicated high practice of safe medication administration with an average score of 83.6%. There were statistically insignificant differences in the practice of safe medication administration related to the hospital, gender, qualification, age, experience, and income. Conclusion: The study concluded that intensive care nurses handling medication safely at a moderate level and more. The authors demonstrated the need to provide adequate number of qualified nurses in Intensive Care Units, and encouraged nurses to participate in training programs about safe medication preparation and administration.