Hospital Unit Research Articles

Impact of care bundle audit on compliance to device care bundles and device associated infections in the Critical Care Unit of a tertiary care hospital, Southern India – A before-after interventional study

BackgroundA care bundle comprises a set of evidence-based practices in patient care that are grouped together with the assumption that these practices when performed together will result in better clinical outcomes than when these practices are performed separately. Care bundles for devices when implemented effectively can bring about a reduction in device associated infection rates. MethodsThe study was conducted in three phases, 1 month pre-interventional and interventional phases and 11 months of post-interventional phase in a critical care unit. Compliance to care bundles were recorded by direct observation during daily audit rounds. An educational intervention addressing the healthcare workers regarding bundle care approach was conducted and supplemented with bedside “audit and feedback” during the interventional phase. Audit was conducted in the post-interventional period to study the trend of device associated infections and compliance rates. ResultsAn increasing trend of month-wise compliance rates to the device care bundles were observed. The month-wise Ventilator Associated Events rates showed a decreasing trend. In the post-interventional phase, the average Catheter-associated Urinary Tract Infection, Central Line Associated Bloodstream Infection and Ventilator Associated Events rates showed a reduction from their respective baseline rates for the study setting. ConclusionsAn educational intervention targeted at the healthcare workers along with daily audit of care bundle practices in the critical care setting led to an increase in the compliance to device care bundles and a reduction in the incidence of Catheter-associated Urinary Tract Infection, Central Line Associated Bloodstream Infection and Ventilator Associated Events rates in the critical care setting.

Tixagevimab/cilgavimab prophylaxis against COVID-19 in solid organ transplant recipients: a systematic review and meta-analysis.

Tixagevimab/cilgavimab (Tix/Cil) shows promise as a prophylactic treatment against coronavirus disease 2019 (COVID-19) in solid organ transplant recipients (SOTRs). This study was performed to assess the effectiveness of Tix/Cil for preexposure prophylaxis against COVID-19 in this population. We systematically searched the Cochrane Library, Web of Science, PubMed, and Embase databases to identify articles relevant to our study up to December 15, 2023. Comprehensive Meta-Analysis (ver. 3.0) was used for data analysis. The meta-analysis included seven eligible retrospective studies, encompassing a total of 4,026 SOTRs. The analysis revealed significant differences in SOTRs who received Tix/Cil preexposure prophylaxis relative to those who did not. Specifically, these differences were observed in the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.15-0.60), hospitalization (OR, 0.24; 95% CI, 0.08-0.70), and intensive care unit admission (OR, 0.07; 95% CI, 0.02-0.22). However, mortality rate did not differ significantly between the two groups (P=0.06). The evidence supporting the effectiveness of Tix/Cil as preexposure prophylaxis against SARS-CoV-2 in SOTRs is of a low to moderate level. Further high-quality research is necessary to understand its effects on this population.

Empowerment Analysis in Patients with Acute Coronary Syndrome and Heart Failure in Hospitalization Units: A Cross-Sectional Study

Empowerment Analysis in Patients with Acute Coronary Syndrome and Heart Failure in Hospitalization Units: A Cross-Sectional Study

Independent Risk Factors of Failed Extubation among Adult Critically Ill Patients: A Prospective Observational Study from Saudi Arabia.

Mechanical ventilation provides essential support for critically ill patients in several diagnoses; however, extubation failure can affect patient outcomes. From Saudi Arabia, no study has assessed the factors associated with extubation failure in adults. This prospective observational study was conducted in the intensive care unit of a tertiary care hospital in Riyadh, Saudi Arabia. Adult patients who had been mechanically ventilated via the endotracheal tube for a minimum of 24 hours and then extubated according to the weaning protocol were included. Failed extubation was defined as reintubation within 48 hours of extubation. A total of 505 patients were included, of which 72 patients had failed extubation (14.3%, 95% CI: 11.4%-17.7%). Compared with the failed extubation group, the successfully extubated group had significantly shorter duration of mechanical ventilation (mean difference: -2.6 days, 95% CI: -4.3 to -1; P = 0.001), a slower respiratory rate at the time of extubation (mean difference: -2.3 breath/min, 95% CI: -3.8 to -1; P = 0.0005), higher pH (mean difference: 0.02, 95% CI: 0.001-0.04; P = 0.03), and more patients with strong cough (percent difference: 17.7%, 95% CI: 4.8%-30.5%; P = 0.02). Independent risk factors of failed extubation were age (aOR = 1.02; 95% CI: 1.002-1.03; P = 0.03), respiratory rate (aOR = 1.06, 95% CI: 1.01-1.1; P = 0.008), duration of mechanical ventilation (aOR = 1.08, 95% CI: 1.03 - 1.1; P < 0.001), and pH (aOR = 0.02, 95% CI: 0.0006-0.5; P = 0.02). Older age, longer duration of mechanical ventilation, faster respiratory rate, and lower pH were found to be independent risk factors that significantly increased the odds of extubation failure among adults.

The Usefulness of the C2HEST Score in Predicting the Clinical Outcomes of COVID-19 in COPD and Non-COPD Cohorts.

Patients with chronic obstructive pulmonary disease (COPD) infected with SARS-CoV-2 indicate a higher risk of severe COVID-19 course, which is defined as the need for hospitalization in the intensive care unit, mechanical ventilation, or death. However, simple tools to stratify the risk in patients with COPD suffering from COVID-19 are lacking. The current study aimed to evaluate the predictive value of the C2HEST score in patients with COPD. A retrospective analysis of medical records from 2184 patients hospitalized with COVID-19 at the University Hospital in Wroclaw from February 2020 to June 2021, which was previously used in earlier studies, assessed outcomes such as mortality during hospitalization, all-cause mortality at 3 and 6 months, non-fatal discharge, as well as adverse clinical incidents. This re-analysis specifically examines the outcomes using a COPD split. In the COPD group, 42 deaths were recorded, including 18 in-hospital deaths. In-hospital mortality rates at 3 and 6 months did not significantly differ among C2HEST strata, nor did their impact on subsequent treatment. However, a notable association between the C2HEST score and prognosis was observed in the non-COPD cohort comprising 2109 patients. The C2HEST score's predictive ability is notably lower in COPD patients compared to non-COPD subjects, with COPD itself indicating a high mortality risk. However, C2HEST effectively identifies patients at high risk of cardiac complications during COVID-19, especially in non-COPD cases.

Clinical Characteristics and Prognosis of Older Adult Patients With Necrotizing Pancreatitis: A single center retrospective study

Background: Acute pancreatitis (AP) is a common condition encountered during clinical practice; 20% of patients have pancreatic necrosis, and the mortality is high. This study aimed to explore the clinical characteristics and prognosis of older adult patients with necrotizing pancreatitis (NP). Methods: We searched for 1159 patients with AP admitted to the General Surgery Department of Xuanwu Hospital from January 2014 to December 2021. After screening medical history and imaging examinations, a total of 109 patients were divided into a death group (n=31) and a survival group (n=78), and their clinical characteristics and prognosis were further analyzed. Results: In the death group, the scope of pancreatic necrosis was more extensive, the evidence of infection was apparent, the nutritional status and the clinical outcome were worse; In addition, patients in the death group have a higher proportion of organ failure and infection, and longer intensive care unit (ICU) hospitalization time. Conclusion: Preoperative persistent organ failure (POF) and prolonged hospitalization in ICU are independent risk factors leading to increased mortality in elderly patients with NP. Early identification of risk factors ,timely drug treatment and surgical intervention are essential to improve the prognosis of older adult patients and reduce mortality.

COVID-19 induced changes to news gathering and news production: Practical experiences from five Ghanaian newsrooms

This study, grounded in Kurt Lewin’s theory of change management, investigates how the COVID-19 pandemic influenced change in the news gathering and news production process in five newsrooms in Ghana. Through semi-structured in-depth interviews, our study proves that the social restrictions that were introduced due to the COVID-19 pandemic forced Ghanaian newsrooms to introduce certain measures, including work-from-home policies, a strategy that had never been explored prior to the pandemic. Our study further reveals that, whereas male journalists were usually given tasks that were considered dangerous, such as reporting from the morgue and intensive care units of hospitals, female journalists were usually assigned news conferences and tasked to conduct interviews with various stakeholders, a gender perspective to news gathering during the pandemic which has never been reported. Based on these and other findings, we argue that the COVID-19 pandemic did indeed drive change in how journalists gather and produce news.

Impact on Patient Communication and Information after the Incorporation of white Boards in the Rooms of the Cardiology Hospitalization Units of four Hospitals

Impact on Patient Communication and Information after the Incorporation of white Boards in the Rooms of the Cardiology Hospitalization Units of four Hospitals

Humor Styles in Healthcare Professionals: A Correlational Study.

Using humor as a caregiving strategy can help professionals perceive daily and work-related events from a more optimistic and light-hearted perspective. The main objective of this study was to analyze humor styles among health care professionals. A cross-sectional and correlational design was employed. Data were collected using the Humor Styles Questionnaire, which measures four humor styles: affiliative, self-enhancing, aggressive, and self-defeating humor. Health care professionals scored higher in positive humor than negative humor. Age exhibited a negative correlation with positive humor. Significant differences were observed between marital status and affiliative and self-enhancing humor, professional category and hospital unit with aggressive humor, shift work and self-enhancing humor, and type of contract and experience with affiliative humor. Health care professionals employ various humor styles based on their social and work contexts. It is crucial for health care professionals to receive training in the use of positive humor to consciously avoid humor styles that can hinder well-being.

Factors associated with the readiness for oral intake in post-extubated critically ill adult patients: A prospective observational study.

Post-extubation dysphagia (PED) is a common post-extubation complication that may lead to serious problems, such as malnutrition and longer hospital and intensive care unit (ICU) stays. To explore factors associated with the readiness for oral intake in post-extubated critically ill adult patients. This prospective observational study involved 125 extubated patients. Readiness for oral intake was assessed using the Gugging Swallowing Screen (GUSS), and regression analysis was used to determine its predictors. The median age of the participants was 40.0 years, and 51.2% were female. The median GUSS score was 12.0 (possible range, 0-20), and 35.2% of the studied patients had severe dysphagia (scored 0-9). Bivariate regression analysis showed that older age, male, higher APACHE II score, body mass index (BMI) ≥30, smoking history, longer ICU stay, muscle relaxants use, large-bore endotracheal and orogastric tubes and frequent intubation attempts were associated with lower GUSS score (p-value <.05). Multivariate regression analysis showed that age, BMI and smoking history predicted 37.2% of the variability in the GUSS score (F = 23.865, p-value <.001). Adding the ICU length of stay, muscle relaxants use, size of the endotracheal tube, size of the orogastric tube and frequency of intubation attempts to the regression model raised the predictability to 86.0% (F = 88.809, p-value <.001). More than one-third of extubated patients have severe PED with a high risk of aspiration. Several modifiable factors, such as muscle relaxant use and endotracheal and orogastric tube size, predict post-extubation readiness for oral intake. Using endotracheal and orogastric tubes of appropriate sizes, careful assessment of patients with a high risk for difficult intubation, and minimal use of muscle relaxants may help increase patients' readiness for post-extubation oral intake.

Post-traumatic stress disorder in individuals who required hospitalization for COVID-19: A cross-sectional study

Introduction: Currently, the physical and functional consequences on individuals who have recovered from the severe form of the Covid-19 and are experiencing traumatic stress remain unknown. Objective: To assess post-traumatic stress disorder (PTSD) in individuals post-hospital discharge following COVID-19 and investigate its relationship with sociodemographic variables, quality of life, muscle strength and functional capacity. Methods: A cross-sectional study was conducted, including individuals of both genders aged between 31 and 79 years, who had recovered from COVID-19 and required hospitalization. Participants underwent evaluations for PTSD, physical activity level, mobility and balance (Timed Up and Go test – TUG), the distance covered in the 6-minute walk test (6MWT) and quality of life (Short Form-36 Health Srvey -SF-36). Results: Out of 153 eligible individuals, 60 successfully completed the assessments. The age range was 31 to 77 years, and 63.3% were female. PTSD was identified in 48.3%, with 38.7% exhibiting partial symptoms. Furthermore, 65.5% of individuals with PTSD were obese, and 62.1% were hypertensive. This group demonstrated a higher degree of sedentary behavior (p=0.009), increased frequency of intensive care unit hospitalization, and a greater number of days hospitalized, respectively (p&lt;0.001 and p=0.010). They exhibited longer times in the TUG (p=0.014), shorter distances than predicted in the 6MWT (p=0.001), and a reduction in all domains of the SF-36. Conclusion: Given the findings of this study, the follow-up of these individuals needs to be continued in order to verify the permanence of these symptoms and functional manifestations.

A comparative analysis of sivelestat sodium hydrate and ulinastatin combination therapy in the treatment of sepsis with acute respiratory distress syndrome

ObjectiveThis comparative analysis aimed to investigate the efficacy of Sivelestat Sodium Hydrate (SSH) combined with Ulinastatin (UTI) in the treatment of sepsis with acute respiratory distress syndrome (ARDS).MethodsA control group and an observation group were formed with eighty-four cases of patients with sepsis with ARDS, with 42 cases in each group. The control group was intravenously injected with UTI based on conventional treatment, and the observation group was injected with SSH based on the control group. Both groups were treated continuously for 7 days, and the treatment outcomes and efficacy of both groups were observed. The Murray Lung Injury Score (MLIS), Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE II) were compared. Changes in respiratory function, inflammatory factors, and oxidative stress indicators were assessed. The occurrence of adverse drug reactions was recorded.ResultsThe total effective rate in the observation group (95.24%) was higher than that in the control group (80.95%) (P < 0.05). The mechanical ventilation time, intensive care unit (ICU) hospitalization time, and duration of antimicrobial medication in the observation group were shorter and multiple organ dysfunction syndrome incidence was lower than those in the control group (P < 0.05). The mortality rate of patients in the observation group (35.71%) was lower than that in the control group (52.38%), but there was no statistically significant difference between the two groups (P > 0.05). MLIS, SOFA, and APACHE II scores in the observation group were lower than the control group (P < 0.05). After treatment, respiratory function, inflammation, and oxidative stress were improved in the observation group (P < 0.05). Adverse reactions were not significantly different between the two groups (P > 0.05).ConclusionThe combination of SSH plus UTI improves lung injury and pulmonary ventilation function, and reduces inflammation and oxidative stress in patients with sepsis and ARDS.

Development of a Clinical Pathway for Acute Coronary Syndrome at Philippine General Hospital

BACKGROUND: Acute coronary syndrome (ACS) is a leading cause of admission and mortality in a tertiary care hospital in the Philippines. The significant burden of the disease necessitates that evidence-based care set by international and local guidelines be met to improve service delivery and quality of care (QOC). Institution-specific QOC studies showed gaps between guideline recommendations and compliance. Development and utilization of a clinical pathway are among the identified strategies to improve compliance. It is also crucial for implementation of standard-of-care set specific to a hospital setting based on its needs and resources. METHODS: This is a descriptive research on the development of a clinical pathway for ACS appropriate for the emergency room setting of a tertiary care hospital from March 2021 to August 2022. Local QOC studies and evidence behind the latest international guideline recommendations on the management of ACS were reviewed to create the interim ACS Pathway. Two-level content validation of the interim pathway was done: internal validation with the consultants and fellows of the Division of Cardiovascular Medicine and external validation through focused group discussions with different hospital units and stakeholders to assess applicability and feasibility based on the resources of the setting, identify hindrances, and propose solutions in its implementation. RESULTS: An evidence-based clinical pathway for ACS that encompasses identification and management of ST-segment elevation myocardial infarction and non–ST-segment elevation acute coronary syndrome with judicious use of locally available and feasible resources applicable for local emergency room hospital setting was created. CONCLUSION: Review of local QOC studies and interdepartmental collaboration are necessary components in developing institution-specific clinical pathway for ACS. KEYWORDS: acute coronary syndrome, clinical pathway, quality of care

The effect of hand-foot exercises on chemotherapy-induced peripheral neuropathy-related pain, falls, and quality of life in colorectal cancer: A randomized controlled trial

PurposeThe aim of this study is to determine the effect of hand-foot exercises on chemotherapy-induced peripheral neuropathy-related pain severity, falls, and quality of life in patients with colorectal cancer. MethodsThe study was conducted in the outpatient chemotherapy unit of a public hospital between 25 April-31 December 2022. The enrolled 39 patients were randomly assigned to the intervention (n:19) and control (n:20) groups. The hand-foot exercises program was applied to the intervention group in three sessions a day and three days a week fashion for 8 weeks at home. No intervention was applied to the control group other than routine treatment and care. Data were collected through face-to-face interviews in the first interview and the 2nd, 4th, 6th, 8th weeks. The exercise program adherence of the intervention group was followed up through telephone/face-to-face interviews in weeks 1–8. Data were collected using the Numerical Pain Rating Scale, Fall Follow-Up Form, the CIPNAT scale, EORTC QLQ-C30 and EORTC QLQ-CR29 scales. Mann-Whitney U Test, Chi-square test, Wilcoxon signed test, and Friedman test were used to analyze the data. ResultsThe study found that as of week 4th, the intervention group experienced less pain severity than the control group (p < 0.001); at week 8th, the peripheral neuropathy symptoms of the intervention group decreased compared to the control group (p < 0.05); at weeks 2nd,4th,6th,8th, there was no statistically significant difference in falls (p > 0.05); at week 8th, while there was no significant difference between the groups regarding colorectal cancer quality of life (p > 0.05), the overall cancer quality of life improved in the intervention group (p < 0.05). ConclusionsThe hand-foot exercises program is effective in chemotherapy-induced peripheral neuropathy-related symptoms, pain severity, and overall cancer quality of life. Trial registrationwww.clinicaltrials.gov, NCT05873829.

The Effect of Deferoxamine and Vitamin C Supplementation on Ferritin and CRP Levels in COVID-19 Patients

Background: Today, the COVID19 pandemic is one of the most important health system challenges in the world, which doesn’t have specific treatment yet. It includes a wide range of respiratory and non-respiratory signs and symptoms, that lead to hospitalization and intensive care units. Methods: In this study, 78 patients in two groups of 39 patients were included. The case group included 39 COVID19 patients who had specified sign in CT scans and factors of viral infection, high serum ferritin, increased inflammatory factor in the blood. There were two intervention groups (receiving deferoxamine and vitamin C) and the control group (receiving only official protocol drugs of the country). All patients were admitted to the ICU of Shohada-e-Tajrish Hospital and underwent complete cardiorespiratory monitoring. All changes in Spo2, hemodynamics, serum ferritin and CRP were recorded before the study. Results: This study presented that improved patient had lower ferritin levels than those who were still ill. In addition, prescribing deferoxamine as an adjunct to vitamin C can prevent cytokine storms that was effective for improving the patients with COVID19. Conclusion: In conclusion. According to the role of deferoxamine and vitamin C in significantly reducing inflammatory factors of ferritin and CRP, they can be used as an adjunctive therapy in patients with COVID19.

Nursing care for maintenance and prevention of enteral probe loss

Objective: To understand the perception and practice of nursing professionals about care related to the maintenance and prevention of enteral probe loss in hospitalization units. Methods: Quanti-qualitative and descriptive study carried out in a large general hospital in Belo Horizonte, Minas Gerais, Brazil. It was attended by 40 professionals, 19 nurses and 21 nursing technicians, interviewed in September and October 2018. Secondary data were collected from the medical records of 114 patients who were using an enteral probe from 01/01/2017 to 01 /01/2018. Results: It was observed that the majority (68.4%) of patients undergoing enteral nutritional therapy were over 60 years of age. Nutritional causes were the main indication for the use of probes, occurring in 51.7% of patients. Most (90.0%) of professionals recognize that washing the probe is the main care in terms of preventing loss of this device and recognize that the biggest complication of its use is bronchoaspiration. Conclusion: It was found that nursing professionals have knowledge about care related to maintenance and prevention of probe loss, but the perception of these professionals is different from the information introduced in the medical records, which may highlight a disarticulation between knowledge and care practice.

Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway

BackgroundHealthcare organizations worldwide face persistent challenges relating to turnover and intention to leave the nursing profession among registered nurses. Factors contributing to their retention and well-being at work include high job satisfaction, professional competence, and self-efficacy. Few multicenter studies have investigated these factors in relation to work experience in a Nordic context. Therefore, this study aimed to investigate job satisfaction, professional competence, and self-efficacy among registered nurses.MethodsThis multicenter cross-sectional study survey was part of a larger overarching Swedish-Norwegian project, and was conducted among registered nurses (n = 1137) in September 2021. The participants worked in a variety of health care units, e.g., hospital units, primary health care, and home care. Data was subjected to descriptive and comparative statistical analysis; chi-square test, one-way between-groups analysis of variance (ANOVA) and Kruskal-Wallis test.ResultsThe findings show that job satisfaction is reported as lowest in registered nurses with medium-term work experience as compared to newly qualified and long-term work-experienced registered nurses. Professional competence and self-efficacy are reported as higher among registered nurses with long-term work experience as compared to those with medium-term work experience and newly qualified registered nurses. However, the participants reported their professional competence as highest in relation to the same factor – “Value-based nursing care” – regardless of their work experience.Conclusions and implicationsThis study underscores the need for continuous support and professional development for registered nurses throughout their careers. Proactive support for newly qualified nurses may improve job satisfaction as they progress to being registered nurses with medium-term work experience. Tailored interventions to address the distinct needs of both newly qualified and medium-term work-experienced registered nurses are crucial for nurturing a sustainable nursing workforce.

The impact of gender differences on the clinical characteristics of critically ill patients with venous thromboembolism: A retrospective, observational study.

The aim of this study is to describe the general information, disease and treatment of venous thromboembolism (VTE) in critically ill patients, to explore the characteristics of severe patients with deep venous VTE and provide clinical reference data for the prevention and treatment of VTE in critically ill patients. This study carried out a retrospective study on the medical records of patients who were treated in the intensive care unit of Affiliated Hospital of Jining Medical College from 2020 to 2022. The general data, general conditions, drug use, past history, VTE prevention measures, post-VTE conditions, and Padua risk score of 297 patients with VTE during the period of hospitalization in intensive care unit (ICU) were classified and statistically analyzed. A total of 297 including 171 male and 126 male patient medical records were included in the analysis, we compared multiple clinical indicators between male and female patients. Compared to women, male patients have a higher acute physiology and chronic health evaluation II score(APACHE-II score) (P = .027), a higher state of consciousness (P = .003), a higher rate of smoking and drinking history (P < .001), a lower rate of heart failure (P = .003) and chronic depression (P = .013), and a higher rate of recommended operations for male patients after VTE (P = .031). The prothrombin time (PT) (P = .041) and activated partial thromboplastin time (APTT) (P = .040) of male patients were significantly higher than those of female patients, while triglyceride (P = .009) and total cholesterol (TC) (P = .001) were significantly lower than those of female patients. The difference in D-dimer (P = .739) was not significant. This study shows that male and female patients with VTE in the ICU have significant differences in general characteristics, general clinical conditions, history of past illness, thrombosis character, and examination items, this may be the reason for the different rates of VTE between male and female patients in the ICU.

A case of varicose necrotic phlegmon of the orbit in a child

AIM: This study aimed to analyze the peculiarities of a clinical case of orbital cellulitis in a child with varicella-zoster virus infection. MATERIAL AND METHODS: In this report of a rare case, necrotizing orbital cellulitis developed on day 6 from the onset of varicella-zoster disease in a 5-year-old child. The child was hospitalized in a serious condition at the intensive care unit of an infectious disease hospital and was subsequently transferred to an ophthalmology department of another hospital. The patient was subjected to comprehensive laboratory examinations and received conservative and surgical treatments. Computed tomography was performed to detect changes in the status of the orbits. RESULTS: The disease manifested with a pronounced pain syndrome in the right orbit, intoxication, and hyperthermia. Exophthalmos, purulent discharge, and necrosis of the conjunctiva of the affected eye were also observed. Computed tomography revealed infiltration of the right orbit without changes in the sinuses. The clinical blood analysis demonstrated leukocytosis, left shift in neutrophils, eosinophilia, and high levels of C-reactive protein and lactate dehydrogenase. The coagulogram demonstrated a proclivity toward hypercoagulation, as evidenced by diminished prothrombin activity according to Quick’s test, increased active partial thromboplastin time, and high D-dimer levels. Urinalysis revealed leukocyturia. Cultures from the conjunctival cavity yielded Streptococcus pyogenes, and a polymerase chain reaction tested positive for S. pyogenes. Antiviral, antibacterial, and symptomatic treatments were initiated. Necrotic masses were obtained during the drainage of the orbital cavity. The child was hospitalized for 21 days. The symptoms were controlled, and the patient’s condition was satisfactory at discharge. Visual functions remained fully preserved. At the examination 1.5 months later, a slight residual exophthalmos was detected. CONCLUSION: Employing a complex multidisciplinary approach, timely prescription of antibacterial and antiviral therapy, and surgical assistance (drainage of the orbit) ensures a successful disease outcome.

Preventive Measures of Ventilator-Associated Pneumonia among Intensive Care Unit Nurses

General Background: Ventilator-associated pneumonia (VAP) significantly prolongs intensive care unit (ICU) hospitalizations, elevating healthcare costs and increasing mortality risk. Specific Background: Despite existing knowledge of VAP's impact, there is limited research on the preventative practices of ICU nurses, a critical factor in mitigating this condition. Knowledge Gap: This study explores ICU nurses' preventive measures for VAP and their correlation with demographic characteristics, highlighting a gap in literature. Results: Conducted from November 1, 2023, to April 10, 2024, at Basrah hospitals, the study involved 93 purposively sampled ICU nurses. The findings revealed that 48.4% of participants exhibited moderate preventive behavior, while 39.8% displayed poor preventive behavior. Notably, a significant relationship was found between the preventative behavior scores and the education level, as well as years of service in the ICU. Novelty: The study provides valuable insights into the current VAP prevention practices among ICU nurses, highlighting demographic factors that influence these behaviors. Implications: The study highlights the need for educational interventions to improve ICU nurses' preventative practices, potentially reducing VAP incidence and improving patient outcomes in intensive care settings. Higlights: Moderate Preventive Behavior: 48.4% of ICU nurses showed moderate VAP prevention practices. Demographic Relationships: Education level and service years influence preventive behavior scores. Training Necessity: Targeted education needed to improve VAP prevention among ICU nurses. Keywords: Ventilator-associated pneumonia, ICU nurses, preventive practices, demographic characteristics, patient outcomes.