Crisis In Health System Research Articles

Swiss cohort of healthcare professionals & informal caregivers (SCOHPICA): baseline survey's results

Abstract Background Worldwide, health systems face workforce problems such as personnel shortages, low job satisfaction and burnout. In Switzerland, data is insufficient to address this health system crisis. Hence, the Swiss COhort of Healthcare Professionals and Informal Caregivers (SCOHPICA) aims to study healthcare professionals (HCPs) and informal caregivers’ experiences, well-being, and career/personal trajectories. Results of the baseline survey on HCPs (completed in January 2023) are reported. Methods SCOHPICA is an open prospective cohort. Any HCP working with patients in any healthcare setting in Switzerland was eligible. The data was collected with a self-reported electronic questionnaire. Outcome variables are intents to stay in the job/profession/health sector and well-being; we also explored organizational, psychosocial, psychological and occupational factors, as well as sociodemographic and socioprofessional variables. Results The baseline sample included 1707 HCPs, with 32% registered nurses, 12% physicians and 9% physiotherapists among others. In the next few months, 20% of HCPs “not really/not at all intended to stay in their job”, 13% “in their profession” and 11% “in the health sector”; “not intending to stay in the profession” was highest among healthcare assistants (HCAs), nurses and pharmacists. Well-being was also low for these HCPs. Across other factors, pharmacists, physicians, and nurses showed worse scores than other HCPs, especially for workload and work-life balance. HCAs, pharmacists, and nurses reported more burnout and worse self-rated health. Conclusions Results revealed that some categories of HCPs had a lower intent to stay in their profession, and worse working conditions and experiences, such as nurses and pharmacists, compared to other HCPs. Future data collections, findings and data dissemination through a data repository will support decision-makers and public health policies with first-hand evidence. Key messages • SCOHPICA is the first cohort study to examine the working conditions, intents to leave/stay in the profession, well-being and trajectories of all types of healthcare professional across Switzerland. • At baseline, 13% of healthcare professionals did not intend to stay in their profession; pharmacists and nurses reported worse working conditions and experiences than other healthcare professionals.

COVID-19 crisis management of German ICU clinicians in leadership - a metaphor analysis.

The COVID-19 pandemic coincided with an already long-standing crisis in health systems around the world characterized by economic pressure and increasing staff shortage. "Crisis" became a global metaphor to convey collective experiences of the COVID-19 threat. Little is known on how crisis metaphors influence thought and speech on crisis management and the challenging staff situation of intensive care unit (ICU) clinicians in leadership positions and how they act. Therefore, we were interested in (1) which metaphorical concepts ICU clinicians in leadership use to express experiences and strategies in dealing with coinciding crises, (2) how these change over time, and (3) how metaphors in speech reveal self-images of crisis management. We conducted a systematic metaphor analysis focusing on data from three participants of a qualitative interview study with twenty-four healthcare professionals in ICUs in Germany. The participants were interviewed at two time points between April 2020 and March 2021. We identified and reconstructed metaphorical concepts of three interviewees (ICU clinicians in leadership) with regard to the pandemic management, and developed a typology based on the dimensions of mood, modus operandi, location, and scope. The typology consists of eight self-images (protagonists) for the crisis management of ICU clinicians in leadership, such as the figure of the soldier ("to unite everyone behind this flag"), the distributor ("sometimes it is a crazy patchwork [wahnsinniges Gestückel]") or the critic ("we are the fool for everything"). They embody different qualities of a leader and refer to intra- and inter-role conflicts within multiple crisis conditions. Metaphor analysis reveals different self-images of ICU leadership clinicians in relation to crisis management. This illustrates that thinking and perceptions of crisis management may strongly differ between and within leaders and may change over the course of crises. Our findings highlight the need both to improve knowledge on challenges associated with leadership in crises and preparedness, and to support clinicians in their leadership by recognizing and addressing differences and changes in leaders' self-image.

Interprofessional collaboration: A public policy healthcare transformation call for action

The United States faces a health system crisis from evolving and lingering social, economic, and political issues complicated by a global pandemic. However, it is the same crisis that presents opportunities for transformation as the nation evaluates how best to address the vulnerabilities, inequities, and inefficiencies of fragmented healthcare exposed during a period of extreme systemic strain on the healthcare system. The National Academies of Practice (NAP) is well positioned as the oldest interprofessional health sciences organization, to lead advocacy efforts in a comprehensive approach for inclusive care that is modeled on interprofessional collaborative practice. NAP recognizes that the scope of healthcare extends traditional hospital boundaries into communities and homes. Further, NAP advocates for intentional interprofessional education of pre-licensure and post-licensure health professionals as a requirement to foster a paradigm shift in healthcare where the patient and family are central and active members of decision making. The purpose of this paper is to provide an explanation of the ongoing strategic goals, initiatives, and core tenets of NAP that are focused on Interprofessional Collaborative Practice (IPCP), Interprofessional Education (IPE), and now Interprofessional Education for Collaborative Practice (IPECP). Further, NAP examines current healthcare system issues in a defining manner and offers viable action plans for NAP and others to support a paradigm shift in the framework for health system transformation.

The Impact of the COVID-19 Pandemic and Socioeconomic Deprivation on Admissions to the Emergency Department for Psychiatric Illness: An Observational Study in a Province of Southern Italy.

The restriction measures adopted to limit population movement in order to contain the COVID-19 pandemic contributed to a global public health system crisis. This retrospective study aimed at identifying changes in psychiatric admissions to Accident and Emergency Departments (A&Es) in a province in southern Italy during the first two years of the pandemic and was characterized by two different restriction levels (phases 2 and 3) compared to the pre-pandemic period (phase 1). We also investigated the role of socioeconomic deprivation (DI) on psychiatric admissions. The total number of patients admitted to the A&Es was 291,310. The incidence of admission for a psychiatric disorder (IPd) was 4.9 per 1000 admissions, with a significant younger median age of 42 [IQR 33-56] compared to non-psychiatric patients (54 [35-73]). The type of admission and type of discharge were factors related to the psychiatric admission to A&E, and their relationship was modified by the pandemic. In the first year of the pandemic, patients with psychomotor agitation increased compared to the pre-pandemic period (72.5% vs. 62.3%). In the period preceding the spread of SARS-CoV-2, the IPd was equal to 3.33 ± 0.19; after the pandemic started, there was an increase in the IPd: 4.74 ± 0.32 for phase 2 and 3.68 ± 0.25 for phase 3. The IPd was higher for psychiatric admissions from areas with a very low DI compared to areas with a low DI; however, during phase 2, this difference was reduced. In conclusion, an increase in admissions for psychiatric disease was observed during the initial spread of SARS-CoV-2. Patients who lived in the most deprived municipalities generally came to the A&Es less than others, probably because the patients and their families had less awareness of their mental health. Therefore, public health policies to address these issues are needed to reduce the pandemic's impact on these conditions.

Reasons for choosing and completing nursing studies among incoming and outgoing students: A qualitative study

BackgroundThe shortage of nurses is causing instability and crisis in health systems and will continue. The WHO reinforced the importance of recruiting and retaining new students. Authors of various studies recommend the need to identify and understand the reasons for pursuing a nursing degree. ObjectivesTo determine students' preference for nursing studies and to identify the reasons for choosing, continuing, and completing a bachelor's degree in nursing. DesignQualitative, descriptive study. Participants106 nursing students at the University of Huelva (Spain) participated during their first year (2017) and final year (2021) of the nursing degree. MethodsThis study was conducted with the same group of students in two phases. Data were collected in writing in a document with open-ended questions and no maximum wordcount. The responses were analysed using content analysis. ResultsA total of 76.4 % of participants stated that nursing had been their first choice. The main reasons for choosing a nursing degree were associated with fulfilment, and a desire to help others and interact with them. The reasons for completing their studies were primarily related to an interest in providing professional care, showing a deeper and more concrete knowledge of nursing care work. ConclusionFor most participants, nursing was their first choice due to a strong intrinsic motivation related to self-satisfaction in helping others. The reasons for completing this degree had extrinsic motivations linked to nursing activity in hospital. Areas such as management, teaching, or research were not interesting to our students. Knowing the causes of this lack of interest could help us attract them to these areas.

Facing the COVID-19 pandemic with science and practice

The COVID-19 pandemic has led to a health system crisis, deaths and socioeconomic hardship. In order to minimize the consequences of the COVID-19 pandemic in the municipality of Lavras, a partnership was developed between the Lavras City Hall and the Universidade Federal de Lavras (UFLA). The present study aimed to describe the main prevention measures proposed in Lavras and to evaluate the community's perception of the management model towards COVID-19. A public online questionnaire, with 20 multiple-choice questions, about the measures to confront covid was submitted to the Google Forms platform from April 22nd to April 30th, 2020. The data regarding the strategies carried out to deal with COVID-19 was obtained from the published municipal ordinances. During the eight days that the questionnaire was applied, a total of 8,874 respondents from Lavras were obtained. Among these respondents, 31.64% (2,808) were men, 68.15% (6,047) were women, and 0.21% (19) declared "another option". When the participants were asked whether they are respecting the social distance measures, 7,452 (84.1%) of them answered "yes."Also, a total of 57.4% of the participants reported that the social distancing measures compromised their family income. However, despite the impact of this economic compromise on these families, 93.82% of the respondents believe that the measures applied are important. When analyzing the questionnaire responses, it was noticeable that despite residents suffering negative economic consequences, there was great popular approval of preventive measures, such as social distancing and the use of masks. In addition, it was possible to notice the population's trust in the measures recommended by professionals at UFLA and the city hall, highlighting the importance of establishing contact between authorities and the population during decision making.

In silico approaches and in vitro assays identify a coumarin derivative as antiviral potential against SARS-CoV-2

COVID-19, a disease caused by SARS-CoV-2, was declared a pandemic in 2020 and created a global crisis in health systems, with more than 545 million confirmed cases and 6.33 million deaths. In this sense, this work aims to identify possible inhibitors of the SARS-CoV-2 RdRp enzyme using in silico approaches. RdRp is a crucial enzyme in the replication and assembly cycle of new viral particles and a critical pharmacological target in the treatment of COVID-19. We performed a virtual screening based on molecular docking from our in-house chemical library, which contains a diversity of 313 structures from different chemical classes. Nine compounds were selected since they showed important interactions with the active site from RdRp. Next, the ADME-Tox in silico predictions served as a filter and selected the three most promising compounds: a coumarin LMed-052, a hydantoin LMed-087, and a guanidine LMed-250. Molecular dynamics simulations revealed details such as changes in the positions of ligands and catalytic residues during the simulations compared to the complex from molecular docking studies. Binding free energy analysis was performed using the MMGBSA method, demonstrating that LMed-052 and LMed-087 have better affinities for the RdRp by energetic contributions to the stability of the complexes when compared to LMed-250. Furthermore, LMed-052 showed significant in vitro inhibition against MHV-3, decreasing 99% of viral titers. Finally, these findings are useful to guide structural modifications aiming to improve the potential of these compounds to act as inhibitors of SARS-CoV-2. Communicated by Ramaswamy H. Sarma

Application of Statistical Modelling to Interpret a Health System Crisis in Sri Lanka due to COVID-19

G.H.S. Fernando, B.A.H.M Gunasena, A.S. Yapa Bandara, Lal Panapitiyahttps://orcid.org/0000-0001-7356-6257 AbstractAccording to the World Health Organization, the critically ill patients of SARS-CoV-2 require mechanical ventilation as [...]

Application of Statistical Modelling to Interpret a Health System Crisis in Sri Lanka due to COVID-19

This paper will discuss the application of statistical modeling to interpret a health system crisis in Sri Lanka caused by Covid-19. A strong focus on the preventive approach and contact tracing, with the utilization of available resources in a rational manner, describes Sri Lanka’s response to the prevention and mitigation of Covid-19. The early contact tracing, pre-emptive quarantining, isolation, and treatment were implemented as a concerted effort. This approach, proven efficient during the early phase of the pandemic, was sustainable until the rapid increase in Covid-19 patients in July 2021, exceeding the health system’s capacity. The country’s Covid-19 situation during the period from 01st of August 2021 to 31st of October 2021 was taken into consideration. Variables used for analysis were: the total number of cases, recovered cases, comorbid and O2 dependent patients, ICU patients, and deaths. The regression model was applied to analyze the data using the EViews 12 (x64) software application. The correlation coefficients of all the independent variables under consideration imply that they have a strong positive relationship with the number of deaths that occurred during the said period.

Impact of the COVID pandemic on vascular access creation for haemodialysis in 16 Spanish haemodialysis centres.

ABSTRACTBackgroundThe coronavirus disease (COVID) pandemic has resulted in a major disruption in healthcare that has affected several medical and surgical specialties. European and American Vascular Societies have proposed deferring the creation of an elective vascular access (VA) [autologous or prosthetic arteriovenous fistula (AVF) or arteriovenous graft (AVG)] in incident patients on haemodialysis (HD) in the era of the COVID pandemic. The aim of this study is to examine the impact of the COVID pandemic on VA creation and the central venous catheter (CVC)-related hospitalizations and complications in HD patients dialyzed in 16 Spanish HD units of three different regions.MethodsWe compared retrospectively two periods of time: the pre-COVID (1 January 2019–11 March 2020) and the COVID era (12 March 2020–30 June 2021) in all HD patients (prevalent and incident) dialyzed in our 16 HD centres. The variables analysed were type of VA (CVC, AVF and AVG) created, percentage of CVC in incident and prevalent HD patients, CVC-related hospitalizations and complications (infection, extrusion, disfunction, catheter removal) and percentage of CVC HD sessions that did not reach the goal of Kt (>45) as a marker of HD adequacy.ResultsA total of 1791 VAs for HD were created and 905 patients started HD during the study period. Patients who underwent vascular access surgery during the COVID period compared with pre-COVID period were significantly younger, with a significant decrease in surgical activity to create AVFs and AVGs in older HD patients (>75 and >85 years of age). There was a significant increase in CVC placement (from 59.7% to 69.5%; P < 0.001) from the pre-COVID to the COVID period. During the COVID pandemic, a significantly higher number of patients started HD through a CVC (80.3% versus 69.1%; P < 0.001). The percentage of CVC in prevalent HD patients has not decreased in the 19 months since the start of the pandemic [414 CVC/1058 prevalent patients (39.4%)]. No significant changes were detected in CVC-related hospitalizations between the pre-COVID and COVID periods. In the COVID period, a significant increase in catheter replacement and the percentage of HD session that did not reach the HD dose objective (Kt > 45) was observed.ConclusionsCOVID has presented a public health system crisis that has influenced VA for HD, with an increase in CVCs relative to AVFs. A decrease in HD sessions that did not reach the HD dose objective was observed in the COVID period compared with a pre-COVID period.

A machine learning algorithm to analyse the effects of vaccination on COVID-19 mortality.

The coronavirus disease 2019 (COVID-19), with new variants, continues to be a constant pandemic threat that is generating socio-economic and health issues in manifold countries. The principal goal of this study is to develop a machine learning experiment to assess the effects of vaccination on the fatality rate of the COVID-19 pandemic. Data from 192 countries are analysed to explain the phenomena under study. This new algorithm selected two targets: the number of deaths and the fatality rate. Results suggest that, based on the respective vaccination plan, the turnout in the participation in the vaccination campaign, and the doses administered, countries under study suddenly have a reduction in the fatality rate of COVID-19 precisely at the point where the cut effect is generated in the neural network. This result is significant for the international scientific community. It would demonstrate the effective impact of the vaccination campaign on the fatality rate of COVID-19, whatever the country considered. In fact, once the vaccination has started (for vaccines that require a booster, we refer to at least the first dose), the antibody response of people seems to prevent the probability of death related to COVID-19. In short, at a certain point, the fatality rate collapses with increasing doses administered. All these results here can help decisions of policymakers to prepare optimal strategies, based on effective vaccination plans, to lessen the negative effects of the COVID-19 pandemic crisis in socioeconomic and health systems.

Training Medical Students as COVID-19 First Contact Responders: Integrating Telemedicine and Medical Education during a Health System Crisis in Sri Lanka

No abstract available

Forced migration and reproductive rights: Pregnant women fleeing Venezuela

Numerous pregnant Venezuelan women have fled Venezuela, given the health system crisis that has increased risk to their lives and their children. Thousands of them have arrived in Colombia in search of reproductive health care. Notwithstanding Colombia’s government efforts to provide some relief measures to the massive influx of Venezuelan migrants, pregnant women are not receiving the prenatal and postnatal care they need. One of the primary barriers to health care access is their immigration status and the health system structure regarding migrants. Therefore, this paper studies Colombia’s international human rights obligations concerning their immigration status and the right to reproductive health to conclude that government measures have been insufficient to meet these obligations.

The prevalence of common mental disorders among healthcare professionals during the COVID-19 pandemic at a tertiary Hospital in Addis Ababa, Ethiopia.

BackgroundCoronavirus disease 2019 (COVID-19) has resulted in unprecedented morbidity, mortality, and health system crisis leading to a significant psychological destress on healthcare workers (HCWs). The study aimed to determine the prevalence of symptoms of common mental disorders among HCWs during the COVID-19 pandemic at St. Paul's Hospital, Ethiopia.MethodsA self-administered cross-sectional study was conducted to collect socio-demographic information and symptoms of mental disorders using validated measurement tools. Accordingly, PHQ-9, GAD-7, ISI, and IES-R were used to assess the presence of symptoms of depression, anxiety, insomnia, and distress, respectively. Chi-square test, non-parametric, and logistic regression analysis were used to detect risk factors for common mental disorders.ResultsA total of 420 healthcare workers participated in the survey. The prevalence of symptoms of depression, anxiety, insomnia, and psychological distress was 20.2%, 21.9%, 12.4%, and 15.5% respectively. Frontline HCWs had higher scores of mental health symptoms than non-frontline healthcare workers. Binary logistic regression analysis showed that being married was associated with a high level of depression. Furthermore, working in a frontline position was an independent risk factor associated with a high-level of symptoms of depression, anxiety, and psychological distress.LimitationsIt is a single-center cross-sectional study and the findings may not be nationally representative or reveal causality.ConclusionsA significant proportion of healthcare workers are suffering from symptoms of mental disorders. Frontline HCWs were at a greater risk of severe symptoms. Therefore, psychological interventions should be implemented to support health professionals, especially frontline workers.

Cyclic and Acyclic Amine Oxide Alkyl Derivatives as Potential Adjuvants in Antimicrobial Chemotherapy against Methicillin-Resistant Staphylococcus aureus with an MDR Profile

The dramatic intensification of antimicrobial resistance occurrence in pathogenic bacteria concerns the global community. The revitalisation of inactive antibiotics is, at present, the only way to go through this health system crisis and the use of antimicrobial adjuvants is turning out the most promising approach. Due to their low toxicity, eco-friendly characteristics and antimicrobial activity, amphoteric surfactants are good candidates. This study investigated the adjuvant potentialities of commercial acyclic and newly cyclic N-oxide surfactants combined with therapeutically available antibiotics against MDR methicillin-resistant Staphylococcus aureus (MRSA). The safety profile of the new cyclic compounds, compared to commercial surfactants, was preliminarily assessed, evaluating the cytotoxicity on human peripheral mononuclear blood cells and the haemolysis in human red blood cells. The compounds show an efficacious antimicrobial activity strongly related to the length of the carbon atom chain. In drug–drug interaction assays, all surfactants act synergistically, restoring sensitivity to oxacillin in MRSA, with dodecyl acyclic and cyclic derivatives being the most effective. After evaluating the cytotoxicity and considering the antimicrobial action, the most promising compound is the L-prolinol amine-oxide C12NOX. These findings suggest that the combination of antibiotics with amphoteric surfactants is a valuable therapeutic option for topical infections sustained by multidrug-resistant S. aureus.

Toward understanding the complexity of the COVID-19 crisis: a grounded theory approach

Abstract The purpose of this paper is to investigate the complexity of the COVID-19 crisis by using the grounded theory approach. It is a new approach based on a data set constituted from published papers, reports delivered by official organizations or research institutes, working papers, and public information in media. Each of these documents presents data, information, knowledge, and ideas, usually from a single perspective. The present research uses the method of grounded theory and constructs an integrated model of analysis that explores the complexity of the global crisis induced by COVID-19. For the present research, the data were extracted from published papers focused on different aspects of the COVID-19 pandemic induced economic crisis. That means a meta-analysis of the initial quantitative data but performed from a semantic perspective. The findings show that COVID-19 induced economic crisis is a complex phenomenon that is influenced directly and indirectly by the health system crisis, governmental policies, and behavior of people. The integrated model we got can be used as a tool in a further investigation for a deeper understanding of the complexity of COVID-19. The originality of this paper comes from creating a meta-analysis with the grounded theory of different aspects investigated in a series of papers and constructing a dynamic model capable of approaching the complexity of this Black Swan phenomenon.

Spatial distribution and temporal trend of National Health System and Supplemental Health Sector human resources, Brazil, 2005-2016.

to analyze the spatial distribution and temporal trend of human resources for the Brazilian National Health System (SUS) and the Supplemental Health sector. an ecological study was conducted in the country's 27 Federative Units (FUs); SUS Information Technology Department (DATASUS) data were used relating to the doctor, dental surgeon, nurse and nursing technician personnel categories for the period 2005-2016; Prais-Winsten regression was used to assess the time trend. there was an rising trend of Supplemental Health Sector human resources in all personnel categories, with an mean annual increase of 0.054 (95%CI: 0.031;0.076); with regard to SUS, there was an increase in dental surgeons and nursing technicians, with annual increases of 0.008 (95%CI: 0.003;0.011), and 0.066 (95%CI 0.022; 0.087), respectively, while in most FU, nurses showed a stationary trend and doctors showed a stationary or falling trend. inequalities were found in human resource distribution, reflecting the health system crisis.

Epidemiology of COVID-19 Outbreak in Oromia Region of Ethiopia: The First Six Months Surveillance – 13 March 2020 to 13 September 2020

Background: Despite unrelenting global efforts to contain its spread, Coronavirus disease 2019 (COVID-19) is still causing unprecedented crises globally with no proven vaccine or cure so far. Ethiopia reported its first case on 13 March 2020 but has an accelerated increase in caseload and geographic distribution since recently. We now describe the epidemiology of COVID-19 in Oromia Regional State, the largest and most populous region in Ethiopia, during the early months of the outbreak.Methods: We analyzed data from the COVID-19 surveillance database of the Oromia Regional Health Bureau. We included RT-PCR confirmed COVID-19 cases diagnosed at healthcare facilities across the region during the period of 13 March to 13 September 2020.Findings: COVID-19 was confirmed in 8955 (5·5%) of 164206 individuals tested during the surveillance period. The test positivity rate increased from an average of 1·0% in the first three months to 6·3% in August and September. About 70% (6230) of the cases were male; the mean age was 30·0 years (SD=13·3) and 87·8% were between 10 and 49 years of age. Only 64 (0·7%) of the cases had symptoms at diagnosis. Among symptomatic cases, cough was the most common, reported in 48 (75·0%) and fever the least common, reported in 11 (17·2%) of cases. Moreover, only 6 (0·1%) cases presented with severe disease. Overall, 4346 (48·5%) have recovered from the virus and a total of 52 deaths were reported with a case fatality rate of 1·2%. However, the reported case fatality rate should be interpreted cautiously since in 44 (84·6%) of those reported as COVID-19 death, the virus was detected from a dead body.Interpretation: The COVID-19 infection rate in the Oromia Region of Ethiopia is surging six months after the onset of the pandemic in the country. So far, the proportion of symptomatic cases and severe diseases besides the fatality rate are lower than reports from most other developing and developed countries. This epidemiologic profile might have prevented the anticipated health system crisis to date, but it can hinder efforts to contain the outbreak.Funding: NoneDeclaration of Interests: The authors declare no competing interests.Ethics Approval Statement: The authors have obtained authorization to use the surveillance data from Oromia Regional Health Bureau Public Health Emergency Management and Health Research Directorate

Psychiatric Mental Health Nurse Practitioners Meeting Rural Mental Health Challenges.

OBJECTIVE: To describe the current rural mental health system crisis in the United States and how psychiatric mental health nurse practitioners (PMHNPs) can holistically mitigate this systemic issue. METHOD: Respective to the objective, relevant literature is reviewed. RESULTS: PMHNPs have successfully increased access to care in underserved rural communities by practicing at the fullest extent of their scope without mandated supervision, utilizing telepsychiatry practice, while expanding PMHNP rural mental health education and research to meet and absolve pressing rural mental health challenges. CONCLUSIONS: Current evidence supports that rural mental health care improves when PMHNPs have full scope of practice, utilize telepsychiatry, engage in related scholarly activity, and have formalized education and training for rural health care delivery, which collectively answer the professional and moral call serving the underserved rural population with mental illness.

National Heart Failure Registry, India: Design and methods

ObjectiveHeart failure (HF) has emerged as a global public health problem that affects both low and high-income countries. The high HF burden and the need for resource-intensive treatments often lead to health system crisis in resource-poor settings. Data on prevailing practice patterns and long-term clinical outcomes of HF are scarce from the low and middle-income countries. Nationally representative HF data from India are not available. MethodsThe National Heart Failure Registry (NHFR) is a multicentric, hospital-based registry of HF patients from 53 centers across India. Consecutive patients admitted with the diagnosis of acute decompensated HF satisfying the European Society of Cardiology (ESC) 2016 criteria will be enrolled into the registry from January 2019 to December 2019. Each participating center is expected to contribute 200 patients into the registry (i.e., more than 10,000 HF patients from India). We are collecting demographics, clinical, laboratory, imaging, and other diagnostic data at baseline from all registered patients in the registry by using a structured document. Additionally, we are collecting the details of treatment practices and the usage of guideline-directed therapy from all participants. We intend to obtain the in-hospital, 3-months, 6-months and one-year outcome data on mortality, cause of death, and repeated hospitalization events. ConclusionsIn summary, NFHR will be the first nationally representative HF registry aimed at providing crucial information on prevailing etiology, distribution and current practices in the management of HF.