Hospital Care Services Research Articles

Conducting clinical research and embedding person‐centred care into the hospital setting during a global pandemic: Challenges and solutions

AbstractConducting scientific research in the healthcare context is an ongoing challenge. Immediate clinical care and related tasks take priority out of necessity, often in difficult circumstances including unplanned staff absenteeism and turnover, and resource limitations. These challenges are further exacerbated in times of crisis, such as the current worldwide pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). The pandemic disproportionately affects vulnerable populations, such as people living with dementia who rely on aged and healthcare services. Concurrently research studies aiming to improve health and aged care for these people are also being negatively impacted by the pandemic. There is a need for the development of guidelines that will support researchers to implement and maintain quality studies during pandemics, to prevent unnecessary delay in the dissemination of research findings, that have the potential to improve healthcare delivery quality and outcomes.This presentation first highlights the main challenges and solutions that have emerged in a study aiming to improve healthcare for people living with dementia in hospital settings, using evidence‐based person‐centred care. In addition to evaluating health outcomes for people living with dementia and cost‐effectiveness, we are using a knowledge translation framework (Goodenough et al., 2017; Damschroder et al., 2009) to evaluate the implementation of the intervention (process and outcomes) and determine nationwide scalability for hospital ward and care services. Evidence on how to adapt research processes to enable research programs to continue throughout the pandemic will be presented, followed by a set of guidelines to support researchers to engage successfully in clinical research during a pandemic. The guidelines aim to be generalisable to all clinical research projects that have been impacted by the current SARS‐CoV‐2 pandemic, as well as projects that may face future similar crises.ReferencesDamschroder LJ, Aron DC, Keith RE, et al. 2009. Fostering implementation of health research findings into practice: A consolidated framework for advancing implementation science. Implement Sci. 4(50):15 ‐20.Goodenough B, Young M. (2017). Innovation to Implementation for Dementia (i2i4dementia): A Practical Guide to Knowledge Translation in Health Care (with examples from aged care and dementia). Dementia Collaborative Research Centres, Australia. Access: DementiaKT.com.au

To study the perception of the Indian population towards health care services in government hospitals of India

To study the perception of the Indian population towards health care services in government hospitals of India

When a home is no longer the best place – older adults’ use of health and care services in the context of a major healthcare reform

Abstract This study investigates the association between insufficient home care and the use of health and social care services among older adults. Data was collected from the Resident Assessment Instrument (RAI) home care register linked to registers for health care and primary health care (N = 33,493). The results show that one in six respondents felt that they would be better off living elsewhere than at home with home care, and these respondents used more hospital, emergency, and home care services than those who preferred living at home. The findings suggest that when older adults perceive their home care to be insufficient, they are more likely to utilize a range of health and social care services. Improved service integration could potentially mitigate the increased use of health and social care services by older adults who perceive their home care as inadequate. Furthermore, the ongoing healthcare reform in Finland aims to promote the integration of health and social services, which could lead to improved care outcomes for older adults. The study's findings can inform policymakers and healthcare providers on the importance of identifying and addressing the needs of older home care clients, particularly in the context of the ongoing healthcare reform in Finland.

Impact of the workforce allocation on the technical performance of mental health services: the collective case of Helsinki-Uusimaa (Finland)

BackgroundLong-term mental health (MH) policies in Finland aimed at investing in community care and promoting reforms have led to a reduction in the number of psychiatric hospital beds. However, most resources are still allocated to hospital and community residential services due to various social, economic and political factors. Despite previous research focussing on the number and cost of these services, no study has evaluated the emerging patterns of use, their technical performance and the relationship with the workforce structure.ObjectiveThe purpose of this study was to observe the patterns of use and their technical performance (efficiency) of the main types of care of MH services in the Helsinki-Uusimaa region (Finland), and to analyse the potential relationship between technical performance and the corresponding workforce structure.MethodsThe sample included acute hospital residential care, non-hospital residential care and outpatient care services. The analysis was conducted using regression analysis, Monte Carlo simulation, fuzzy inference and data envelopment analysis.ResultsThe analysis showed a statistically significant linear relationship between the number of service users and the length of stay, number of beds in non-hospital residential care and number of contacts in outpatient care services. The three service types displayed a similar pattern of technical performance, with high relative technical efficiency on average and a low probability of being efficient. The most efficient acute hospital and outpatient care services integrated multidisciplinary teams, while psychiatrists and nurses characterized non-hospital residential care.ConclusionsThe results indicated that the number of resources and utilization variables were linearly related to the number of users and that the relative technical efficiency of the services was similar across all types. This suggests homogenous MH management with small variations based on workforce allocation. Therefore, the distribution of workforce capacity should be considered in the development of effective policies and interventions in the southern Finnish MH system.

Documentation Completeness Workshop For Clients With Endocrine Disorders As An Effort To Improve The Quality Of Health Care Services In Hospital "X" In 2023

Pada klien dengan gangguan Sistem Endokrin terjadi beberapa gangguan sehingga menyebabkan kedaruratan medis dan berakhir pada kematian sehingga diperlukan pencegahan dan perawatan yang cepat dan akurat. Perawat, mempunyai peran memberikan kontribusi besar terhadap keberhasilan pemberian pelayanan kesehatan paripurna kepada klien. (Potter dan Perry, 2013). Pelayanan kesehatan yang bermutu dipengaruhi oleh beberapa faktor seperti tingkat pengetahuan, keterampilan, kompetensi, dan kinerja perawat. Dokumentasi lengkap dan akurat adalah pondasi dari asuhan pelayanan kesehatan yang berkualitas. Peserta kegiatan dengan Jenis kelamin yang mengisi pre test dan post test terbanyak ialah perempuan sebanyak 26 perawat (78,8%), usia terbanyak 26 -35 tahun sebanyak 18 perawat (54,5%), masa kerja perawat yang terbanyak ialah perawat pelaksana lanjutan 12 perawat (36,4%), pendidikan terbanyak ialah Ners (S1 Profesi) sebanyak 18 perawat (54,5%). Didapatkan hasil setelah pelaksanaan kegiatan didapatkan bahwa terjadi peningkatan dalam tingkat pemahaman kelengkapan dokumentasi pada klien dari pemahaman kelengkapan dokumen secara optimal pada saat Pre Test sebesar 21 responden (63,6%) meningkat menjadi 33 responden (100%). Diketahui juga faktor yang menyebabkan ketidaklengkapan dalam melakukan dokumentasi keperawatan yang mempunyai nilai yang paling tinggi ialah kesibukan di ruangan sebanyak 25 perawat (62,5%). Hal yang dapat mendukung dalam melengkapi dokumentasi secara optimal dengan jumlah terbanyak yaitu; kebijakan dan panduan yang jelas dalam mendukung kelengkapan dokumentasi sebanyak 11 perawat (27,5%). Peserta memiliki komitmen 100% untuk mendukung kelengkapan dokumentasi secara optimal. Oleh karena pentingnya untuk fokus pada kelengkapan dokumentasi pasien dengan gangguan endokrin sebagai salah satu langkah untuk meningkatkan kualitas pelayanan kesehatan di Rumah Sakit dan menjawab tantangan-tantangan yang ada dalam industri perawatan kesehatan

Outpatients satisfaction and perceptions toward pharmaceutical services in public and private hospitals in Palestine: a cross-sectional study

BackgroundPharmaceutical care is an essential component of healthcare services, and patient satisfaction with these services is crucial for improving overall health outcomes. We aimed to evaluate patient satisfaction and perception with pharmaceutical care services provided at public and private hospitals for outpatient pharmacies. This study can provide insights into the quality of pharmaceutical services provided in both settings and identify areas for improvement.Materials and methodsA cross-sectional 1-month study was conducted in three hospitals in Nablus city in the Northern District of West Bank, Palestine. Participants were a convenience sample of outpatients who attended the study-selected hospitals (two public and one private). A sample of 30 patients from each hospital was selected with a total of 90 patients. A self-administered questionnaire was used to assess socio-demographics pharmacist-related issues, waiting and working time, and medication availability.ResultsA total of 90 patients were recruited. The overall level of patient satisfaction with pharmaceutical health services was moderate with a mean of 3.24 out of 5. Females represented 58.9%. The most prevalent age was (30–39) years (30%). There was a statistically significant difference in patient satisfaction with pharmaceutical services regarding working time between the morning and evening shifts (p value = 0.009) in favor of morning shift. No statistically significant differences in satisfaction with pharmaceutical treatments based on socio-demographics (age, gender, marital status, education level, family income, employment status, and living place), were found. Nearly, 70% of patients indicated having problems getting the medicine on their last visit to the hospital pharmacy. Only 66.7% of patients expressed satisfaction with the pharmacies’ operating (working) hours.ConclusionsPatient satisfaction with pharmaceutical care services could be enhanced by involving pharmacists in patient-oriented training and informing patients about the role of pharmacists. Patient satisfaction in the evening shift might be improved by establishing a system for continuous evaluation and improvement of pharmaceutical care services in hospitals to ensure the highest quality of care for patients in addition to implementing technology such as electronic prescribing and medication management systems that can improve the accuracy and efficiency of pharmaceutical services in hospitals.

Quality outcomes for end-of-life care among people with haematological malignancies at a New Zealand cancer centre.

Little is known about the end-of-life (EOL) experience and specialist palliative care use patterns of patients with haematological malignancies (HMs) in New Zealand. This retrospective analysis sought to examine the quality of EOL care received by people with HMs under the care of Auckland District Health Board Cancer Centre's haematology service and compare it to international data where available. One hundred consecutive adult patients with HMs who died on or before 31 December 2019 were identified. We collected information on EOL care quality indicators, including anticancer treatment use and acute healthcare utilisation in the last 30 days of life, place of death and rate and timing of specialist palliative care input. During the final 14 and 30 days of life, 15% and 27% of the patients received anticancer therapy respectively. Within 30 days of death, 22% had multiple hospitalisations and 25% had an intensive care unit admission. Death occurred in an acute setting for 42% of the patients. Prior contact with hospital and/or community (hospice) specialist palliative care service was noted in 80% of the patients, and 67% had a history of hospice enrolment. Among them, 15% and 28% started their enrolment in their last 3 and 7 days of life respectively. The findings highlight the intensity of acute healthcare utilisation at the EOL and high rates of death in the acute setting in this population. The rate of specialist palliative care access was relatively high when compared with international experiences, with relatively fewer late referrals.

Telemedicine Breastfeeding Consultation: The Saudi Experience.

Background Telemedicine is widely used in health specialties. Yet, the experience of telemedicine use and its effectiveness in breastfeeding support is a research gap. The purpose of this study was to describe the pattern of telemedicine use for breastfeeding support in Saudi Arabia and to explore patients' satisfaction with the service. Methods A cross-sectional survey was conducted in outpatient settings at Ministry of Health facilities in several Saudi regions. The number of breastfeeding consultations over one year (2021) was analyzed in terms of region, month, method of consultation, and women's maternity status. Data on patient satisfaction and telemedicine techniques were gathered during 2022. Results Across the 16 regions enrolled in the project, 51,571 remote breastfeeding consultations were conducted, representing 28.2% of the total consultations. The eastern region reported the highest percentage (40.7%), and the southern region reported the lowest (2.4%). Almost two-thirds of the consultations were provided to lactating mothers (62.91%). Most data (90%) were collected from breastfeeding clinics in hospitals, and nurses were the main primary health care providers. The mean was 4,255 consultations per month. In terms of technology, telemedicine consultations were mostly conducted by phone (50%) and WhatsApp (38%). Satisfaction with telemedicine was reported by 80% of the participants, with a statistical difference found in those favoring telemedicine over in-person care (p=0.032), particularly for those using phone consultations and Telegram (p<0.001). WhatsApp respondents had the commonest neutral responses (p<0.001). Conclusion Telemedicine breastfeeding care has been widely established with high patient satisfaction. A national protocol outpatient lactation services with an intergrated hospital and primary care services and involvement of different health care professionals are recommended. Although breastfeeding counselling is proven to have a positive change on breastfeeding indicators, telemedicine tool per se needs further work on its role in breastfeeding indicators. Triage of cases to be evaluated face-to-face or referral to a specialist after telemedicine lactation care is an area for future work.

Prevalence and factors associated with unsafe abortion among females below 25 years in Fort Portal regional referral hospital, Fort Portal City, Western Uganda

Unsafe abortion is defined by the World Health Organization as a method of terminating an unplanned pregnancy that is either performed by someone who doesn't have the necessary skills or in a setting that does not meet the bare minimum of medical requirements, or both. While the concept appears to be related to the procedure, the criteria of an unsafe abortion refer to unsuitable conditions that may exist prior to, during, or following an abortion. An unsafe abortion often has the following characteristics, however occasionally only a few or even all of them apply: Abortion is self-induced by ingesting traditional medications or dangerous substances, abortion is provoked by insertion of an object into the uterus by the woman herself or by a traditional practitioner, or by a violent abdominal massage, abortion is induced by an unskilled provider, frequently in unhygienic conditions, or by a health practitioner outside official/adequate health facilities, no pre-abortion counseling and advice, the wrong drug is provided for a medical abortion, or a pharmacist gives out the wrong medication with no instructions and no follow-up. A cross-sectional study design was deployed to generate the data for this study. Quantitative and qualitative methods of data collection were utilized and the study population was women aged below 25years attending post abortion care services in Fort portal Regional Referral Hospital. According to this study, the prevalence of Unsafe Abortion was 15.7% and the socio demographic factors that was commonly associated with unsafe abortions were; age 17-20 years (52.0%), single marital status (55.2%), unemployment (58.6%), No formal education (53.6%), Residing in the rural area (55.2%), age of first sexual intercourse at 17-20 years (48.5%), Having at least one child (61.2%) and having a monthly income lesser than 100,000/=(56.7%). Unsafe abortion continues to be a major public health problem. The risk factors associated with unsafe abortion were; age, marital status, unemployment, Level of education, Place of residence, age of first sexual intercourse, Number of children and financial status. The recommendation of this study is to encourage the people who provide information about Unsafe abortion to package a right full information to the young women. And to add on these young women should obtain extensive knowledge about contraception methods and safe methods of abortion. Parents are recommended to practice family planning methods as it would increase the care of parents to their girl child and this will decrease on the number of unwanted pregnancies thus prevention of un safe abortion. Keywords: Unsafe abortion, WHO and pregnancy.

Does a Community Care programme reach a high health need population and high users of acute care hospital services in Melbourne, Australia? An observational cohort study

ObjectiveThe Community Care programme is an initiative aimed at reducing hospitalisations and emergency department (ED) presentations among patients with complex needs. We aimed to describe the characteristics of the programme...

Hastane Etik İkliminin Onkoloji Hemşirelerinin Seslilik Davranışlarına Etkisi: Cesaretin Aracılık Rolü

Aim: Ethical climate is an important organizational characteristic that affects employees' thoughts, attitudes, and behaviors. The voice of the nurses, one of the fundamental employees of the hospitals, is very valuable both in terms of the organizations they work in and the safety of their patients. However, the relationship between hospital ethical climate and voice behavior remains unclear. The aim of this study was to investigate the effects of the ethical climate on oncology nurses’ voice behaviors, considering courage as a mediator.&#x0D; Material and Methods: This study was designed as a predictive cross-sectional study. The sample of this study consisted of 71 registered nurses who were employed as staff nurses in inpatient care services in Hacettepe University Oncology Hospital between October and December 2018. &#x0D; Results: There is a positive and significant relation between the hospital’s ethical climate and oncology nurses’ voice behaviors, and that courage has a positive partial mediating effect.&#x0D; Conclusion: Since the relationship between a hospital’s ethical climate and nurses’ voice behavior contains many different variables, courage can be deemed a mediator in this relationship, but courage is not may directly be effective on its own.

The organisation of paediatric hospital-at-home care: a multi-country comparative study

PurposeMany countries have developed hospital-at-home (HAH) models to bring hospital services closer to home. Although some countries already have a long tradition of HAH for adults, paediatric HAH has been developed more recently. Specificities of paediatric care make it difficult to directly extend an adult HAH model to the paediatric population. The objective of this study is to compare the organisation of paediatric HAH in four countries: France, Australia (states of Victoria and New South Wales), the Netherlands and Belgium. Ultimately, lessons can be drawn for further development in the countries analysed and/or for implementation in other countries.Design/methodology/approachLegal documents and other grey literature were analysed to describe the legal context for the provision of paediatric HAH in the selected countries. In addition, semi-structured in-depth interviews were conducted with key informants from paediatric HAH organisations in these countries, addressing the following topics: historical background, legal framework, functioning of HAH models, workforce, number of services, profile of children, type of care activities, funding, coordination with other providers and quality of care. Results were reviewed by a content expert from the respective country.FindingsOrganisational differences were highlighted in terms of coordinating actor (hospital or home nursing care services), decision-making process, range of clinical conditions treated, territorial organisation, qualifications and expertise of the team members, medical expertise, financing, responsibilities, etc.Originality/valueThere is no single preferred model for the provision of HAH care for children. There is a large variety in almost all aspects of organisation. There are, however, also some common characteristics across the different models. Notably, paediatric expertise of nurses within the HAH team was considered indispensable in all programmes.

COVID-19 infection and mortality among non-pregnant indigenous adults in Mexico 2020-2022: Impact of marginalisation.

Indigenous individuals have higher rates of mortality and poverty in Mexico and more than half are marginalised, and COVID-19 pandemic aggravated the existing burden of health disparities. We aimed to analyse the effects of being indigenous and marginalised on coronavirus (COVID-19) infection fatality in Mexico. We identified 3 424 690 non-pregnant, COVID-19 positive adults ≥19 years in the Mexico national COVID-19 database with known date of symptom. We used demographic information, indigenous status, marginalisation status, and co-morbidities in binary logistic regression to predict mortality, adjusting for covariates, including hospitalisation, admission to the intensive care unit (ICU), and mechanical ventilation use. We also assessed the interaction between indigenous status and marginalisation. Marginalisation was much higher among indigenous (53.7%) compared to non-indigenous individuals (4.8%). COVID-19 fatalities were approximately 20 years older (64.4 and 63.0 years) than survivors (44.7 and 41.2 years) among indigenous vs non-indigenous individuals, respectively. The unadjusted risk of COVID-19 fatality among indigenous individuals was nearly two-fold (odds ratio (OR) = 1.92)) compared to non-indigenous individuals (OR = 1.05). COVID-19 fatality was higher among highly marginalised individuals (upper quartile) (OR = 1.51; 95% confidence interval (CI) = 1.49-1.54). Marginalised indigenous individuals had a significantly lower likelihood of ICU admission compared to non-indigenous non-marginalised individuals. The likelihood of mechanical ventilation for indigenous individuals was 4% higher compared to non-indigenous individuals. Indigenous marginalised individuals had a significantly lower probability of mechanical ventilation compared to non-indigenous non-marginalised individuals. COVID-19 comorbidity risks of fatality significantly differed between the two groups in the Cox survival analysis. In the fully adjusted model, indigenous individuals were 4% more likely to die from COVID-19 compared to non-indigenous. Indigenous, marginalised individuals with COVID-19 had higher risk of hospitalisation and ICU admission than non-indigenous patients. Marginalised, indigenous individuals were less likely to receive mechanical ventilation compared to non-indigenous, but had a higher risk of COVID-19. Indigenous individuals had a 4% higher COVID-19 mortality risk COVID-19 compared to non-indigenous individuals. Improved community medical care and augmented health services in rural hospitals could mitigate barriers to health care access in indigenous, marginalised populations.

Assessment of Patients' Satisfaction with Pharmaceutical Care Services in a Nigerian Teaching Hospital: A Cross Sectional Study

Objective: Pharmaceutical Care (PC) services have come to be the cornerstone of pharmacy practice all over the world. PC has been linked to better clinical and humanistic outcomes for patients. In Nigeria, only a few studies have analyzed pharmacists' pharmaceutical care services in hospitals. This study aims to ascertain patients' satisfaction with pharmaceutical care services and evaluate pharmacists' practices in Nigerian hospitals.&#x0D; Methods: This was a cross-sectional study using a semi-structured questionnaire among inpatients and outpatients visiting five clinics in the hospital. The questionnaire was interviewer-administered. Descriptive statistics were used to summarize the findings. The chi-square test was used to determine the association between respondents' sociodemographic variables and their satisfaction towards pharmacists' medication counselling.&#x0D; Results: Five hundred and three patients participated in the study. Females that participated in the study formed 58.6% of the total population. Approximately 71.4% of the respondents were satisfied with the pharmaceutical care services provided by pharmacists in the hospital. Most participants (70.8%) completed tertiary education, and the majority (63.4%) of the visits were follow-ups. There was no statistically significant correlation between the sociodemographic factors and patients' satisfaction, except for age and patronage, which showed a positive association.&#x0D; Conclusion: Patients at the University of Nigeria teaching hospital were satisfied with the pharmaceutical care services offered by the pharmacists. However, some of the respondents noted some level of dissatisfaction with the willingness of pharmacists to re-counsel patients upon request. An effective policy and strategy would address the issue and raise satisfaction.

Association between medically diagnosed postnatal infection and childhood cancers: A matched case-control study in Denmark, 1978 to 2016.

Although the association between infection and childhood cancer has been long investigated, there is limited information on rarer cancers. This article aimed to explore the association between postnatal infection and childhood cancers in the Danish population. A matched case-control study was conducted using Danish nationwide registries from 1978 to 2016. Each childhood cancer case was matched 1:25 with controls by birth date within a week and sex. Postnatal infections were identified from the Danish National Patient Registry, which lists diagnoses seen in hospital, specialist or emergency care services. Multivariable conditional logistic regression was used to estimate adjusted odds ratios (adj.OR) and 95% confidence intervals (CI). Specific types of infections and the number of infection episodes were also considered. The study included 4125 childhood cancer cases and 103 526 matched controls with ages ranging from 0 to 19 years. Medically diagnosed postnatal infections were positively associated with many types of childhood cancer including acute lymphoblastic leukemia (adj.OR = 1.42; 95% CI: 1.23-1.63), acute myeloid leukemia (adj.OR = 1.80; 95% CI: 1.28-2.52), non-Hodgkin lymphoma (adj.OR = 1.53; 95% CI: 1.19-1.97) and central nervous system tumors (adj.OR = 1.57; 95% CI: 1.39-1.77). A higher number of infection episodes were also associated with an increased risk of these cancers. Specific infections such as viral, enteric and urinary tract infections were also strongly associated with specific types of cancer. In conclusion, children who later develop cancer appear to have adverse reactions to infections necessitating referral to specialized health care services, perhaps indicating dysregulated immune function.

Using Mean Anesthesia Workload to Plan Anesthesia Workforce Allocations: The “Flaw of Averages”

(Anesth Analg. 2022;135:1138–1141) Workforce planning within acute care hospital services is especially important, though especially complicated due to inherently unpredictable, unstable, and frequently emergent needs. This editorial comments on the Im et al article “Obstetric Anesthesia Procedure-Based Workload and Facility Utilization of Society of Obstetric Anesthesia and Perinatology Centers of Excellence Designated Institutions,” which studies procedure-based obstetric anesthesia workload and staff utilization using self-reported data collected from the Society of Obstetric Anesthesia and Perinatology Centers of Excellence.

The Effects of Monitoring and Evaluation on Delivery of Quality HIV Care Services in County Hospitals

Developing countries face significant difficulties that are identified with the arrangement of low-quality medical care administrations which have been ascribed to insufficient information and abilities compounded with low staff individuals. M&amp;E in Kenya is feeble with helpless data and information sharing. Nonetheless, the current M&amp;E frameworks actually have disconnected exercises, various program-explicit M&amp;E structures and the current M&amp;E frameworks fulfilling the revealing necessities of benefactors. These difficulties have made a powerless culture of data use and request and provision of quality HIV care services. The purpose of the study; toascertain the effects of monitoring and evaluation on delivery of quality HIV care services in county hospitals. The study was guided by the following research objectives; To establish the effect of processes analysis on delivery of quality HIV care services, to examine the effect of continuous monitoring on delivery of quality HIV care services, to understand the effect of proper documentation and data reporting on delivery of quality HIV care services and to examine the effect of quality technology on delivery of quality HIV care services. The study was guided by the theory of change and program theory. The study targets 25 respondents, health care workers providing the HIV care services. The data collection tools used included; questionnaire-guided guided interview. Descriptive research design was used in the study. Qualitative data was used and analyzed using descriptive statistic while qualitative data using content analysis, the content of the open finished inquiries is considered and partitioned into topics guided by the destinations of the examination. However, Qualitative data will likewise be changed into quantitative data and broke down by the assistance of SPSS as per the main objectives of the research. The data will be utilizing frequency tables, bar graphs and pie charts.

Patients’ Satisfaction regarding Eye Care Services in a Multi-specialty Eye Hospital of Northern Bangladesh

Aims: Patients’ satisfaction is an important health outcome, which is regarded as a determinant measure for quality of health care services. The aim of the study is to evaluate patients’ satisfaction regarding eye care services in a multi-specialty eye hospital of northern Bangladesh.&#x0D; Methods: This cross sectional descriptive study was conducted among the patients who took the eye care services in OPD and admitted as in-patients in the hospital. Randomly selected patients were interviewed by trained staff. A semi-structured questionnaire was used to conduct these interviews. Their responses were grouped into one of five categories and evaluated to determine satisfaction for different components of eye care services. There were also open-ended questions regarding feedback from participants’ view and recommendations for the improvement of the quality of services.&#x0D; Results: Four hundred and forty nine participants were interviewed. Among these, 71 (15.81%) were very satisfied and 358 (79.73%) were satisfied, constituting 95.54% satisfaction with overall services received at the hospital. 99.55% of respondents were satisfied with the doctors and 98.66% of respondents were satisfied with other hospital staff regarding patient care services. 86.1% patient had satisfaction with the cost of services, while 28.57% expressed that the surgery cost was high. Though the participants expressed dissatisfaction for the long waiting time in front of refraction and doctors’ consultation room during pick hours, 442 (98.4%) patients expressed their willingness to utilize the services again.&#x0D; Conclusion: Although eye care services both in OPD and in the IPD were satisfactory according to the respondents, there are scopes for improvement. Patient satisfaction surveys should be encouraged in hospitals for better accountability and also for strengthening the quality of eye care services.

Impacts of the COVID-19 pandemic on antimicrobial use in companion animals in an academic veterinary hospital in NorthCarolina.

Antimicrobial resistance (AMR) in bacterial pathogens reduces the effectiveness of these drugs in both human and veterinary medicine, making judicious antimicrobial use (AMU) an important strategy for its control. The COVID-19 pandemic modified operations in both human and veterinary healthcare delivery, potentially impacting AMU. The goal of this research is to quantify how antimicrobial drug prescribing practices for companion animals in an academic veterinary hospital changed during the pandemic. A retrospective study was performed using prescribing data for dogs and cats collected from the NC State College of Veterinary Medicine (NCSU-CVM) pharmacy, which included prescriptions from both the specialty referral hospital and primary care services. Records (n = 31,769) for 34 antimicrobial drugs from 2019-2020-before and during the pandemic-related measures at the NCSU-CVM-were compared. The prescribed antimicrobials' importance was categorized using the FDA's Guidance for Industry (GFI #152), classifying drugs according to medical importance in humans. A proportional odds model was used to estimate the probability of more important antimicrobials being administered in patients seen during the pandemic versus before (i.e., critically important vs. highly important vs. important). Rates of AMU per week and per patient visit were also compared. During the pandemic, cumulative antimicrobials prescribed per week were significantly decreased in most services for dogs. Weekly rates for Highly Important antimicrobials were also significantly lower in dogs. For important and critically important antimicrobials, rates per week were significantly decreased in various services overall. Rates of antimicrobial administration per patient visit were significantly increased for Highly Important drugs. Patients in the internal medicine, dermatology, and surgery services received significantly more important antimicrobials during the pandemic than before, while cardiology patients received significantly less. These results suggest that the pandemic significantly impacted prescribing practices of antimicrobials for companion animals in this study.

Exploring areas of improvement in postnatal care services in a tertiary care hospital in Lahore.

Poor postnatal care can increase morbidity and mortality. This study assessed the current deficiencies in quality of postnatal care provided to mothers in Lady Aitchison hospital, Lahore when compared to WHO standards and identifies the areas for quality improvement. It is a descriptive cross-sectional study which employs quantitative method to collect and analyze the data. It was conducted to include ninety-six maternities attending the wards of Lady Aitchison Hospital, Lahore during January 2022 to February 2022. Consenting post-partum mothers were selected by random sampling and interviewed by using a structured proforma. Among 96 mothers, 56% were below 25 years of age, 39% had secondary education, with more than one child (71%) and 57% visited for the first time. Majority of mothers, were given medicine timely (82%) and found the attitude (85%) and information (83%) provided by the healthcare workers helpful. Their subjective satisfaction rate with staff was 90%. The main areas of concern were lack of proper examination guidelines and facilities, limited information to mothers regarding neonatal care and substandard interior of hospitals. The statistics on the detailed maternal and neonatal examination showed that it was left out in 30% to 50% patients. Information regarding the danger signs of mothers and neonates was not given in 69% and information on family planning was provided to only 28%. Contentment with the infrastructure of the hospital was subpar and it was suggested that the sanitary conditions of washrooms and the paraphernalia of the wards i.e., ACs and beds needed improvement. This study suggests that in developing countries like Pakistan, majority of the patients were satisfied by the services of healthcare workers. The prime improvement area is the infra-structure of the hospital which can be upgraded to provide better quality facilities in terms of air-conditioning, washrooms and well-designed areas for extensive examination of breast, pelvis, abdomen and neonates. There is also need for introduction of standard guidelines for postnatal care.