Hospital Facilities Research Articles

Time-course assessment of oral intake function and its impact on end-of-life in older individuals over 90 years with frailty.

The study investigates end-of-life trajectories, focusing on the degree of oral intake function in older individuals with frailty aged over 90 years. This retrospective observational study examined individuals aged 90 years and older who passed away at a long-term chronic care hospital and related facilities in Japan. We assessed their Clinical Frailty Scale (CFS) and Function Oral Intake Scale (FOIS), categorizing them into two groups-"preserved CFS" (CFS score ≤7) and "poor CFS" (CFS score ≥8)-considering evaluations conducted 6 months before death. We examined the transitional progression of their CFS and FOIS scores, along with a time-course assessment of low FOIS scores (≤3) in each group at various intervals. Among 66 cases, 38 were in the preserved CFS group, and 28 were in the poor CFS group. The CFS and FOIS scores of the preserved CFS group declined rapidly towards the end-of-life, with approximately half experiencing significant declines within 3 months. In contrast, both the CFS and the FOIS scores of the poor CFS group declined gradually within 6 months. The percentage of low FOIS score (≤3) was lower at 12 and 6 months than at 1 month prior to death in the preserved CFS group. The end-of-life trajectories in older individuals with frailty aged over 90 years were heterogeneous. Clinicians should carefully monitor the degree of frailty and changes in food intake as crucial indications of the end-of-life phase, providing optimal support to manage potential vicious cycles. Geriatr Gerontol Int 2024; ••: ••-••.

Conditioned fully convolutional denoising autoencoder for multi-target NILM

AbstractEnergy management requires reliable tools to support decisions aimed at optimising consumption. Advances in data-driven models provide techniques like Non-Intrusive Load Monitoring (NILM), which estimates the energy demand of appliances from total consumption. Common single-target NILM approaches perform energy disaggregation by using separate learned models for each device. However, the use of single-target systems in real scenarios is computationally expensive and can obscure the interpretation of the resulting feedback. This study assesses a conditioned deep neural network built upon a Fully Convolutional Denoising AutoEncoder (FCNdAE) as multi-target NILM model. The network performs multiple disaggregations using a conditioning input that allows the specification of the target appliance. Experiments compare this approach with several single-target and multi-target models using public residential data from households and non-residential data from a hospital facility. Results show that the multi-target FCNdAE model enhances the disaggregation accuracy compared to previous models, particularly in non-residential data, and improves computational efficiency by reducing the number of trainable weights below 2 million and inference time below 0.25 s for several sequence lengths. Furthermore, the conditioning input helps the user to interpret the model and gain insight into its internal behaviour when predicting the energy demand of different appliances.

Two-phase analysis of blood in microchannel architecture on plasma separation ability with dimensional variance

Purpose This paper aims to study the effects of varying inlet channel angle in a novel microfluidic architecture blood plasma separation ability over range of hematocrit values (5–45%) at multiple flowrates. Design/methodology/approach CAD designs for both micro architectures were designed in SOILWORKS. In the second step, these designs were imported into ANSYS to perform where meshing, model selection, defining blood as two-phase material and boundary conditions are performed. Findings Separation efficiency values close to 100% with diluted blood and 65.2% with whole blood were observed. Straight channel inlet design has significantly better performance at high hematocrit levels, whereas at lower hematocrit levels, both designs had almost same outcome. Furthermore, lower flowrates have shown the highest separation efficiency for lower hematocrit levels, whereas at higher hematocrit percentages, higher flowrates have shown better separation effects for both designs. Furthermore, trends obtained for flow ratio and flowrates against separation efficiency are demonstrated. Research limitations/implications This study is based on blood modeled as two-phase flow, with the phases consisting of blood plasma as primary phase and red blood cells as secondary particulate phase. Practical implications Implications of this study are far reaching for point-of-care health-care systems. A practical system of this numerical study can provide a microchannel device which take very small amount of blood sample to separate it into constituents which can be coupled with detection module to detect a particular disease for which it is designed for. This microsystem can be very beneficial for remote areas where a large hospital facility is far away. Originality/value This study has carried out a detailed analysis on the ability of a novel microchannel architecture to separate blood plasma from other blood constituents. Inlet channel angle variation effects are observed over a range of hematocrit percentages. These trends are further investigated for three different flowrates to assess the microchannel design behavior.

Obstacles of Patient Education in Medical Imaging; Radiographers’ Perspective in West of Iran in 2021

Background: Teaching patients is one of the essential duties of radiographers. Proper implementation of patient education leads to improved efficiency of medical imaging processes, faster patient recovery, reduced costs and anxiety, and ultimately, greater patient satisfaction. Understanding barriers to patient education is crucial for managing these factors effectively. Methods: This cross-sectional descriptive study was conducted on 548 radiographers employed in hospitals in western Iran. Participants were selected using a convenience sampling method and provided informed consent to identify barriers to patient education in medical imaging from the radiographers' perspective. Data were collected using an online questionnaire addressing obstacles to patient education, which had confirmed validity and reliability (ɑ = 0.78). Statistical analysis was performed using SPSS software version 22, with P < 0.05 considered statistically significant. Results: Among the participants, 77.2% held a bachelor's degree. The most significant barriers to patient education in medical imaging from the radiographers' perspective included a large number of patients (56.4%), lack of time (48.9%), insufficient hospital facilities (42.9%), shortage of manpower (41.8%), unfavorable physical and mental condition of patients (40.7%), and lack of responsibility among radiographers (33%). Conclusions: The barriers to patient education can be addressed by reducing radiographers' workload, enhancing their training skills, and equipping medical imaging centers with patient education facilities. Implementing these measures would improve the efficiency of imaging centers and promote better patient outcomes.

Digital Twin Types and Applications in Healthcare.

Digital Twins, represents an innovative approach consisting of real-time digital replicas of physical entities. This innovative concept has already many applications in Industry, automotive, business environment and is also transforming the healthcare industry. Digital Twins have the potential to provide comprehensive models of individual patients, hospital facilities, and medical processes, integrating data from various sources such as electronic health records, wearable devices, and imaging systems. This paper discusses Digital Twin models and their application in healthcare, focusing on care coordination, treatment planning and hospital management development.

Important features of hospitals, intensive care unit waiting rooms, and patient care rooms: perspectives of intensive care unit visitors.

Family members of critically ill patients spend significant periods of time in the intensive care unit (ICU) and hospital environment. We aimed to identify what services, resources, and conveniences are important to adult ICU visitors. We conducted a cross-sectional study including visitors in four adult ICUs in the province of Ontario, Canada. In the survey, we asked visitors to rate the importance of 58 items relating to the environment of patient rooms, the waiting room, and hospital facilities. For each item, we gave respondents five categorical response options, from "not at all important" to "extremely important." We used descriptive statistics to analyze the survey results. We analyzed 224 surveys completed by ICU visitors (60% female, ages 14-87yr). Respondents were predominantly children (41%) or the spouse/partner (23%) of adult ICU patients. Nearly half (51%) lived more than 30km from the hospital, and 30% spent at least one night in the ICU waiting room, with a median of 2 nights (range, 1-20) spent in hospital. Within the hospital environment, the top four items rated as "extremely important" or "very important" were directional signage (82%), convenient parking (80%), discounted parking (80%), and healthy and affordable food (78%). Regarding ICU waiting rooms, 24/7 visitation (92%), convenient restrooms (87%), a water dispenser (83%), and Wi-Fi (80%) were priorities. Features of ICU patient rooms identified as most important included seating for visitors (92%), access to natural light (78%), and access to fresh air (74%). Intensive care unit visitors prioritized pragmatic environmental elements. Many of these modifications are simple and inexpensive but may significantly improve visitors' comfort and experience.

Abstract 4137823: Influence of Hospital and Cardiac Rehabilitation Facility Proximity on Enrollment Rates Among Medicare Beneficiaries

Background: Participation in cardiac rehabilitation (CR) is enhanced by proximity to CR facilities and communication between inpatient and outpatient settings but may become fragmented when patients are distant from their discharging hospital and nearest CR facility. Research Question: This study investigates how patient distance to both hospitals and CR facilities impacts the rates of CR participation. Methods: This study included 100% Medicare fee-for-service claims for beneficiaries with 12 months of continuous Part A/B coverage who had coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or surgical or transcatheter aortic valve replacements (SAVR or TAVR) between 07/2016-12/2018, excluding patients discharged to hospice or died within 30 days. Google Maps defined travel distances from the patient to hospital and CR facility locations using geographic centroids of ZIP codes, which were then categorized into quartiles. CR enrollment was defined as attending at least one session within one year of discharge. Logistic regression models estimated marginal CR enrollment rates across both hospital and CR facility distance categories adjusting for patient, hospital, and regional factors. Results: The study included a total sample of 501,049 beneficiaries undergoing PCI (62%), CABG (19%), SAVR (7%), and/or TAVR (15%). The median travel distance to the hospital was 18.6 miles (IQR 8.2-43.3 miles) and to the CR facility was 7.7 miles (IQR 2-15.3 miles). A total of 188,963 (37.7%) beneficiaries attended at least one CR session, which varied across categories of distance to hospital (Q1: 36.8% to Q4: 37.5%) and CR facility (Q1: 44.7% to Q4: 30.0%, p<0.01). Adjusted CR enrollment rates improved when beneficiaries lived farther from their admitting hospitals but closer to CR facilities (Figure 1), with the highest enrollment for those located farthest from their admitting hospital but closest to the CR facility (47.5%) and lowest enrollment among those closest to the hospital but farthest from the CR facility (20.6%). Conclusions: Greater distance to the admitting hospital was associated with higher CR enrollment, while greater distance to the CR facility was associated with lower enrollment among eligible Medicare beneficiaries. Addressing geographic barriers to CR participation may require tailored solutions based on patient proximity to hospitals and CR facilities.

Current situation and capacity of cancer diagnosis and treatment in county hospitals in China: a multicenter cross-sectional survey

PurposeCounty-level hospitals in China constitute a vital component of the healthcare system, delivering essential medical services, emergency care, and specialized treatments, particularly in oncology. This study aimed to comprehensively evaluate the current status of cancer diagnosis and treatment in county hospitals and assess their overall capacity.MethodsA nationwide cross-sectional survey by the China Anti-cancer Association (CACA) from February to May 2023 assessed cancer diagnosis and treatment in mainland China's county hospitals. Using a multi-center approach, a fifty-five-question questionnaire was administered to oncology professionals and management staffs, focusing on hospital facilities, oncology specialists, cancer cases, treatment capabilities, and healthcare collaboration. Questionnaire reliability and validity were established in a 2022 national survey. Participants, aged 18 or older, were recruited through purposive sampling, receiving self-administered questionnaires for confidentiality. SAS 9.4 software facilitated statistical analysis.ResultsThe study encompassed 76 county-level medical institutions, with 82.9% of them featuring established oncology departments providing comprehensive cancer care, including early screening, diagnosis, treatment, and long-term follow-up. Notably, a total of 56.6% of the institutions surveyed implemented programs for cancer screening and early diagnosis. A significant proportion of advanced cancer patients received treatment and follow-up at the county level. Persistent disparities in medical insurance policies at the county level were identified as a continuing challenge. Furthermore, 82.9% of hospitals had cultivated collaborative relationships with higher-level institutions to enhance patient care quality and treatment capacity. The study revealed a 56.6% shortage of remote collaboration platforms in these hospitals. The need for a patient-centered approach in county hospitals was underscored.ConclusionWhile county-level hospitals face challenges, such as a shortage of specialized oncologists and advanced resources, they exhibit progress in standardizing cancer care to enhance diagnosis and treatment in rural areas.

SURGICAL SITE INFECTION IN HIV-POSITIVE PATIENTS WITH CHRONIC SPONDYLITIS

Introduction. The epidemic process of medical care-related infections complies to the general laws for development of epidemic process, although it has specific features. The probability for development of surgical site infection becomes precipitated by risk factors, which contribute to emergence of surgical site infection based on traits of pathology, patient populations and the specifics of hospital facility. The aim of the study was to evaluate HIV-related effect on developing surgical site infection in patients with chronic spondylitis. Materials and methods. A retrospective cohort epidemiological study was conducted. The inclusion criteria were met by 809 examined patients including 119 HIV-positive patients who underwent 192 surgical interventions. At admission, a patient provided a discharge summary describing the disease profile as well as HIV-positive status verified by infectious disease specialist through a comprehensive data assessment, no more than a month prior to admission. HIV-infected and HIV-free patients comprised exposed and unexposed cohort, respectively. Results. Tuberculous spinal lesions prevailed in HIV patients (p≤0.001; RR=4.864; 95% CI [3.070- 7.707]). Almost all patients were at stage 4 HIV, and one patient – stage 3. The incidence of surgical site infection in patients with chronic infectious spondylitis was 5.01 per 100 operations (49 cases per 978 operations), in HIV patients it developed only in 2 cases of tuberculous spondylitis (the incidence was 1.04 per 100 operations). HIV-infection did not increase the risk of surgical site infection (p=0.009; RR=0.174; 95% CI [0.043 - 0.711]. surprisingly, it turned out to observe higher risk of revision interventions in HIV-free patients (p=0.007; RR = 1.783; 95% CI [1.149 - 2.768]). Conclusions. HIV-positive patients had higher risk of developing a tuberculous than a nonspecific lesion. The HIV status of patients with chronic infectious spondylitis did not significantly affect development of surgical site infection and increased incidence of revision operations. A potential reason for the final result is the long-term use of anti-tuberculosis drugs acting, in this case, as a preventive measure against developing surgical site infection.

THE EFFECT OF RADIATION PROTECTION TRAINING ON RADIATION SAFETY CULTURE

Radiology examination in Indonesia is bound by radiation protection policy. Radiographers, as radiation workers, must ensure radiation safety during radiology examinations. A strong safety culture needs to be implemented, considering that radiology installations use radiation that can adversely affect health. Radiation protection training is one of the most critical factors contributing to forming a radiation safety culture. This study aims to analyze the effect of radiation protection training on radiation officers on improving radiation safety culture, identifying radiation safety culture before and after radiation protection training on radiation officers. This study uses a quasi-experiment with a pre-test-post-test group design, which will observe and then measure the radiation safety culture of the experimental group before and after radiation protection training by providing a pre-test and post-test. The data obtained are then processed and interpreted as a results report. From 32 respondents, it was shown that elements of safety culture such as awareness and concern, knowledge and competence, commitment, motivation, supervision, and responsibility increased after participating in training. By this study, an increase in aspects of safety culture was obtained from before training to after training with a sig. (2-tailed) value of 0.000 is lower than the alpha level of 5% (0.05). Radiation protection training has become an effective means to improve and grow the radiation safety culture in hospital facilities. Keywords: radiation protection training, radiation safety culture, radiation officers, radiation examination.

Implementation of a High-Reliability Organization Framework in a Large Integrated Health Care System: A Pre-Post Quasi-Experimental Quality Improvement Project.

The purpose of this quality improvement (QI) project was to evaluate outcomes across Veterans Health Administration (VHA) hospital facilities engaged in an enterprise-wide implementation of a high-reliability organization (HRO) framework. This QI project relied on primary data drawn from 139 facilities nationwide from 2019 to 2023. Data sources included the All Employee Survey Patient Safety Culture (PSC) Module and patient safety reporting data derived from the Joint Patient Safety Reporting system. The project design applied a pre-post quasi-experimental design that examined within-cohort changes at pre-intervention, intervention, and 2 post-intervention follow-up timepoints. HRO interventions included a combination of training, leadership coaching, site assessments, and experiential learning. HRO interventions were initiated at 18 facilities beginning in 2019 (Cohort 1), 54 facilities in 2020 (Cohort 2), and 67 facilities in 2021 (Cohort 3). For between-cohort analyses, the relative degree of change within Cohort 1 sites was compared with all other sites. There were broad positive within-group trends for PSC scores across all sites, and domain-specific between-group differences in PSC Dimension 2-Risk Identification and Just Culture-and Dimension 4-Error Transparency and Risk Mitigation. For patient safety reporting, total events reported, and close calls increased for Cohort 1. The ratio of close calls to adverse events also increased for both Cohort 1 and all other VHA sites at post-intervention year 2. The results of this QI project will inform further refinements to VHA's efforts to implement HRO principles and practices in the nation's largest integrated health system. In addition, the implementation practices may inform other large-scale, multi-level efforts to improve quality and patient safety.

Global Research Trends on Factors Affecting Patient Satisfaction Levels in Hospital Inpatient Wards: A Bibliometric Analysis

ABSTRACT Research on patient satisfaction in hospital inpatient rooms is one of the main focuses in efforts to improve the quality of health services. Understanding the factors that influence patient satisfaction is crucial for policy makers and healthcare practitioners. Although various studies have been conducted, the global map of this research trend is still not clearly depicted. This study aims to fill this gap by conducting a bibliometric analysis of the literature related to patient satisfaction in hospitals, using a visualization approach to provide deeper insights into the dynamics of research in this area. The method used involved data collection of scholarly articles from 2014 to 2024 using Google Scholar's Publish or Perish application. A total of 50 articles were selected based on relevance to keywords such as Patient Satisfaction, Inpatient Room, Satisfaction Factors, Hospital, and Health Services. This data was then analyzed using VOSviewer to visualize the relationship between various elements in the literature through network visualization, overlay visualization, and density visualization. This approach mapped research trends, identified key clusters, and showed collaboration patterns and dominant topics. The results show that service quality and patient satisfaction are the main focus in the literature. Research clusters showed significant attention to basic aspects of healthcare such as hospital care and facilities, while demographic aspects and specific determinants were less explored. Citation analysis showed that articles providing comprehensive reviews or practical models received more attention. In addition, the density visualization revealed the dominance of quality of care aspects, but also showed the potential for further research on topics such as technological innovation and the impact of health policy. The conclusions of this study show that although much research has been conducted, there are still significant research gaps that can be further explored. This study maps global trends in patient satisfaction studies, and provides guidance for researchers to focus on less explored areas, thereby contributing to the improvement of healthcare quality in hospitals. Keywords: Patient Satisfaction, Service Quality, Hospital, Bibliometric Analysis.

Causes of Coronary Angioplasty Denial in Patients Diagnosed with Significant Coronary Artery Disease in East Afghanistan

Coronary Artery Disease (CAD) is a leading cause of mortality worldwide, with coronary angioplasty being a crucial intervention for patients with significant disease. This study aimed to identify and analyze the causes of coronary angioplasty denial in patients with significant coronary artery disease in Afghanistan, focusing on demographic, socioeconomic, and clinical factors. A case-control study was conducted with a sample size of 213 patients diagnosed with significant CAD at tertiary care center in Afghanistan. The case group consisted of 106 patients who were denied angioplasty, and the control group included 107 patients who underwent the procedure. Data were collected on demographic characteristics, comorbidities, education, residence, functional status, income, and the reasons for angioplasty denial. Descriptive statistics and comparative analyses were performed to assess the factors associated with denial. The primary reasons for angioplasty denial were financial constraints (45.3%, p < 0.001), limited hospital facilities (15.1%, p = 0.045), patient refusal (23.6%, p < 0.001), and physician preference for conservative management (12.3%, p = 0.091). Denial rates were higher among patients who were older, had multiple comorbidities, were from rural areas, and had lower education and income levels. Illiteracy and cultural beliefs contributed significantly to patient refusal, while inadequate healthcare infrastructure disproportionately affected rural populations. Financial and infrastructural barriers are the leading causes of coronary angioplasty denial in Afghanistan, exacerbating disparities in healthcare access, particularly among low-income and rural patients. Addressing these issues through policy reforms, improved healthcare infrastructure, and targeted public health education is essential to reducing CAD-related morbidity and mortality in the country.

Enhancing healthcare operations: a systematic literature review onapproaches for hospital facility layout planning.

The appropriate physical layout of hospital services can help resolve management problems by streamlining the work of medical teams, improving the flow of patients between specific areas and the medical support environment. Nevertheless, the academic literature lacks structured research into how the physical layout of hospitals might be improved. Our study aims to fill this research gap, providing information for researchers and professionals who intend to guide the hospital facility layout planning (HFLP) from the steps and prescribed approaches found in the literature. This study analyzes the current literature status and concerning approaches that support HFLP and identifies their strengths and weaknesses. The literature was classified using the following criteria: approaches for layout generation, approaches for layout evaluation and healthcare facility layout outcomes. The hospital facility layout outcomes achieved for each phase served as a basis for identifying a list of strengths and weaknesses for the hospital layout facility generation and evaluation approaches. Readers can refer to this paper to identify the approach that best fits the desired goal and the HFLP step. This is a contribution to current studies into HFLP, and it provides guidelines for selecting the approach to be utilized based on the desired outcome. The paper describes how to conduct an HFLP and lists the strengths and weaknesses of each approach. The research may be used as a strategy for determining which tool is most suited based on the practitioner's target purpose.

Reducing Emergency Room’s overcrowding

Abstract Introduction The ageing of the population and the consequent increase in the epidemiology of chronic diseases pose numerous challenges at both hospital and territorial levels. In this context, one phenomenon that deserves particular attention is the frequent use of emergency services by ‘frail’ people. The aim of our study was to identify the most frequent users of the University Hospital’s Emergency Room (ER) of Siena, based on their care at territorial level. Materials and methods A retrospective study was carried out on the data of accesses to the ER of the University Hospital’s of Siena from June to September 2023. Patients were stratified according to the number of admissions, excluding those with only one admission during the study period. After identifying those with four or more accesses, the USL-TSE management system ‘Astercloud’ was used to check whether they were in integrated home care (ADI) or planned home care (ADP). Descriptive analysis was performed using STATA software. Results During the study period, 2347 patients were admitted to the ER, 78.95% had two admissions, 14.96% had three, 4.26% had four, 1.24% had five, 0.34% had six, 0.13% had seven, 0.09% had eight and, finally, 0.04% had eleven admissions. 93.1% of the sample had fewer than four admissions (2,204 patients), while 6.1% had four or more admissions (143 patients). Of the 143 patients studied, 16.1% were in home care, 13.3% in ADI and 2.8% in ADP. 36.8% of patients in ADI died within 4 months of the last admission during the period studied. Conclusions Our results suggest that the identification of people at risk of frequent use of the ER seems essential. Equally important is the existence of effective coordination and cooperation between hospitals and the community, with special attention to certain categories of patients. All of this is aimed to achieve overall appropriateness and therapeutic effectiveness, thus avoiding inappropriate admissions to the ER. Key messages • Significance of identifying individuals prone to frequent use of emergency services to underscore the need for proactive management strategies to address their healthcare needs. • Coordination and cooperation between hospital facilities and community-based services to enhance appropriateness of care and reduce inappropriate Emergency Room admissions.

Do the prevention procedures work in reducing infections?

Abstract Introduction Healthcare-associated infections (HCAIs) pose significant challenges in healthcare settings. Poor environmental hygiene contributes to HCAI. This study aims to evaluate and to assess the effectiveness of HCAI containment practices in nursing homes (NH). Methods The study examined infection prevention procedures in eight NHs supervised by the Multidisciplinary Commission of the Tuscany South-East Local Health Authority of Italy. Infection frequencies were obtained from NHs management and compliance with preventive procedures was assessed by inspection reports. Infection prevention protocols, including cleaning and disinfection procedures, were referenced from ministerial guidelines for hospital and territorial facilities. Comparisons was done whit Mann-Whitney test, using STATA. Results In 2023 more frequent infections were SARS-CoV-2 (19.5%), urinary tract infections (17%), pharyngitis (15.7%), influenza-like syndromes (ILI) (15%), and pneumonia (9%). Compared to 2022, significant improvements were observed in legionellosis surveillance, laundry, sanitary procedures, instrument disinfection, and hairdressing services. Non-compliance to specific procedures revealed differences in infectious onset like cleaning process verification with fungal infections (P = 0.01; M = 2,5), gastrointestinal infections (P = 0.04; M = 1.5); cleaning sanitary pans with Clostridium Difficile gastrointestinal infections (P = 0.04; M = 2); instrument disinfection with gastrointestinal infections (P = 0.04; M = 1.5) conjunctivitis (P = 0.01; M = 8); laundry procedures with pneumonia (P = 0.04; M = 18) and ILI (P = 0.04; M = 35). Conclusions These findings emphasize the importance of well-defined procedures in reducing HCAIs. While preventive measures demonstrate efficacy, continuous efforts are necessary for their consistent implementation. Continuous monitoring and stakeholder engagement are essential for developing sustainable strategies in preventing healthcare-associated infections. Key messages • Healthcare-associated infections are a significant complication in the healthcare sector and require effective practices in nursing homes. • Prevention measures are effective, but continuous and collaborative effort is needed to ensure their uniform implementation and develop more effective strategies in preventing HCAI.

Status of infection prevention and control in Cameroon healthcare facilities: lessons learned from the WHO COVID-19 scorecard tool under the hierarchy of control model

BackgroundInfection prevention and control (IPC) helps prevent disease transmission in healthcare facilities. There is a dearth of information on the implementation of IPC during the COVID-19 outbreak in Cameroon using the recommended WHO COVID-19 IPC scorecard tool. The present study assessed healthcare facilities’ compliance to IPC by continuous assessments, with an evaluation of the tool using the hierarchy of control theory. MethodsThis cross-sectional study was conducted in the 10 administrative regions of Cameroon by evaluating healthcare facilities prioritized by the Ministry of Public Health as high-risk facilities between March 2020 and November 2023. Comparisons were made regarding the facilities’ ownership, level and status. Results2,188 assessments from 1,358 healthcare facilities were collected. The median IPC scores at each evaluation were between the intermediate and advanced level, with a bias linked with decreasing selection of facilities. However, only 172 (13%) healthcare facilities achieved advanced IPC score (≥75%). Higher IPC scores were found in hospitals (p<0.001) and in private facilities (p=0.02). Predictors of good IPC compliance were hospital (OR=3.7, CI: 1.4-9.8) and private facility (OR=2.3, CI: 1.6-3.3). The tool met the five domains of the hierarchy of control model. ConclusionRepeated IPC assessments using recommended tools contribute to a better compliance of IPC by healthcare facilities in resources constrained settings.

Physical and psychological impact of HIV/AIDS toward youths in Southwest Ethiopia: a phenomenological study

BackgroundYouths with HIV/AIDS encounter a variety of unique challenges that impact their physical, mental, emotional, and social well-being. These challenges and experiences differ across settings, populations, cultures, and the broader socio-economic and political contexts. This study focuses on exploring the life challenges, experiences, and coping mechanisms of youths living with HIV/AIDS in public hospital facilities in southwest Ethiopia.Methods and study approachThe study was conducted in two regional states of Ethiopia. Using a phenomenological study approach, researchers focused on purposefully selected youths living with HIV/AIDS in public hospital facilities. Data were gathered through life history and in-depth interview techniques, delving deeply into the participants’ lived experiences and feelings about the challenges of living with HIV/AIDS. The study population consisted of youths with HIV/AIDS who were currently using antiretroviral medication in two selected public hospitals. A total of 12 participants were employed and completed the study.ResultsThe findings indicated that youths with HIV/AIDS face complex life challenges, influenced by psychological, emotional, and social factors. These intertwined challenges impact their self-management, treatment adherence, and ability to create and maintain healthy social relationships and roles. Many youths avoid social interactions and do not seek the necessary social support, believing they are unworthy of respect and care. Consequently, they may live in despair and constant fear of rejection, lacking the social support they desperately need. Substance abuse is prevalent among these youths due to the psychosocial, biological, emotional, and material aspects of their experiences.

VirtualPharm: Bridging healthcare through telepharmacy

The word "telepharmacy" refers to a type of pharmaceutical care in which patients and pharmacists communicate by information and communication technology (ICT) even though they are not in the same location. Telepharmacy has been used to solve the scarcity of pharmacists and offer pharmaceutical services to underprivileged communities. Due to geographic and demographic constraints, however, rural inhabitants and towns frequently may not have easy access to healthcare services. A more recent term for pharmaceutical service delivery is telepharmacy, which allows patients who live far from a hospital, pharmacy, or other healthcare facility to receive healthcare services from a qualified pharmacist, including medication review, patient counseling, and prescription verification. Increased comfort with the medication-use system, patient safety, and job satisfaction were shown by nurses' survey results.Actually, after a pharmacist's intervention, there has been evidence of better control over hypertension, dyslipidemia or diabetes, successful smoking cessation, and a decrease in hospitalization among heart failure patients. Telepharmacy services are developed and offered using a range of technology, care models, and interventions, catering to a diverse range of individuals with various clinical conditions. Video conferencing is used in pharmacy for management, instruction, and training needs. The telephone has evolved from a device for dialing and speaking to a multimodal communication tool. Refill authorization, prior authorization, prescription counseling, and formulary compliance monitoring are all provided by call centers, while medical equipment are being connected to phone lines to provide remote monitoring and therapy. Telepharmacy is a useful tool for community pharmacies to improve drug dispensing safety and lessen the strain on the healthcare system.

From data silos to seamless integration and coordination: a data-asset centric approach to smart hospital facility management

PurposeExisting hospital building operations involve numerous information technology applications and complex building systems; therefore, an intelligent facility management (FM) platform is required to ensure their continuous operation. To address the persistent issues of data silos, inefficient data interoperability, and workflow incoordination that have been identified in the current body of FM practice and literature, the present study develops a data-asset (DA) centric FM platform specifically designed for hospital buildings.Design/methodology/approachThis study proposes a semi-customized approach to develop the DA-centric FM platform for hospital buildings. To elucidate the precise function requirements of the hospital FM platform, focus group interviews are employed. By seamlessly integrating the as-built BIM model, IoT sensor data and FM workflow data, the BIM-based DA model with a data transfer mechanism is developed. The development of the FM platform with function modules in a case study is guided by a five-tier architecture and the coordination theory (CT). The case study provides an in-depth introduction to the applications of DA management, space management and maintenance management modules.FindingsThe capabilities of the developed DA-centric hospital FM platform are validated through the case application and user satisfaction survey, which assess data quality, automation level, operation efficiency, flexibility and functionality. For hospital FM activities, this DA-centric FM platform realizes data integration and seamless transformation, optimizes workflow coordination and enhances operation performance.Originality/valueThe initial scholarly contribution is the establishment of the BIM-based DA model, which serves as the data middle platform for continuous data integration, transmission and sharing within the FM platform. Subsequently, under the guidance of the CT, the business process of function modules is designed, improving the intra-module and inter-module workflow coordination. The developed DA-centric FM system along with its performance benchmarking application, assists facility managers and decision-makers in implementing smart operations for hospital buildings and achieving the management goals of safety, efficiency, energy savings and convenience.