Hospital In Qatar Research Articles

Parental attitudes and perceptions towards the recruitment of children to clinical trials: a cross-sectional survey

BackgroundClinical trials (CTs) in children are critical for understanding and treating childhood diseases. However, there trials require prior permission from parents. We evaluated parental attitudes and perceptions regarding the recruitment of their children in CTs.MethodsWe used a cross-sectional survey questionnaire targeting parents of children admitted to the neonatal and pediatric departments in two tertiary hospitals in Qatar. The survey was administered by investigators and was composed of two domains to assess the knowledge and attitude of parents regarding children's enrollment in CTs, in addition to the participant's demographics domain.ResultsOf the 167 questionnaires offered to parents, we received a total of 138 responses, resulting in a response rate of 82.6%, with the majority being women (72%). Many parents (75%) expressed willingness to enroll their children in CTs. However, 66% opposed new experimental treatments for their child, while 41% agreed to new treatments if they had previously been used in the medical field. Logistic regression analysis revealed key predictors influencing parents’ decisions to include their children in CTs, including having a newborn (aOR = 17.651, p < 0.001), families with five or more members (aOR = 3.293, p = 0.012), collecting blood samples (aOR = 8.602, p = 0.003), performing additional tests on collected samples (aOR = 4.115, p = 0.046), belief in helping others (aOR = 8.744, p = 0.002), and the option of home therapy (aOR = 7.090, p = 0.004).ConclusionMany parents are open to enrolling their children in CTs, particularly when treatments have been previously used. Factors like having a newborn, large family size, blood collection, additional tests, and home therapy influence their decisions. Clear communication can enhance recruitment in pediatric trials.

Risk factors for surgical site infection: An observational study in appendectomies performed in a community hospital in Qatar

Background: Surgical site infections (SSIs) after appendectomies constituted a significant patient safety issue and impacted the efficiency of healthcare. Various risk factors had been linked to SSI after appendectomies, including risk to patients and procedures, and compliance with infection control practices. This study aimed at identifying the risk factors for SSI in appendectomies due to acute appendicitis in a single facility in Qatar. Methods: A historical observational study of appendectomies performed from January 2013 to February 2023 at a single facility in Qatar was conducted. Demographics, surgical procedure data, compliance with antibiotic prophylaxis, and histopathological findings were recorded from the patient’s electronic medical records. Results: A total of 2377 appendectomies and 52 SSIs were described, mainly in male patients (93.3%) with a mean age of 32.4 years and non-complicated appendicitis (66.7%). SSI risk was 3.86 times higher when appendicitis was perforated in comparison to other appendicitis types [odds ratio (OR) = 3.86; 95% confidence interval (95% CI) OR 1.93–7.70]. Procedures longer than 81 minutes had 4.84 times more SSI risk (OR = 4.84; 95% CI 2.25–10.42), the improper timing of antibiotic prophylaxis had 5.97 times higher SSI risk (OR = 5.97; 95% CI 1.10–32.56), and the improper antibiotic selection had 9.08 times higher SSI risk (OR = 9.08; 95% CI 1.81–45.42). Conclusion: This study identifies the risk factors linked to SSI risk, including perforated appendectomies, longer surgical procedures, and improper timing and selection of antibiotic prophylaxis. The infection control program should focus on interventions to improve compliance with antibiotic prophylaxis and evaluate additional strategies to minimize the SSI risk in complicated appendicitis.

Gram-Negative Bacteremia: Epidemiology and Antimicrobial Resistance in Qatar

One of the major causes of morbidity and mortality in hospitalised patients is the presence of gram-negative bacteremia (GNB) in blood. The developed resistance among the bacteria poses a significant challenge for treatment. The study aimed to identify the gram-negative patient’s epidemiological risk factors, antimicrobial susceptibility patterns, and clinical outcomes. A retrospective observational study of adult in-patients with gram-negative bacteremia was conducted between January 2019 and December 2020 in the 320-bed general hospital in Qatar. Data on demographics, antimicrobial resistance, source of infection, and treatment were collected. The primary outcomes were patients’ cure, death, or relapse. Total of 357 patients were identified with bacteremia, the most common sources being urinary tract infections (39.6%), intra-abdominal infections (28%), and lower respiratory tract infections (9%). The mean duration of the intravenous and oral antibiotics administration was 14 days. Surgical source control was performed in 35.7% of patients. Common pathogens were Escherichia-coli (47.2%), Klebsiella pneumoniae (16.4%), Salmonella enterica serotype Typhi (10.6%), and Pseudomonas aeruginosa (7.8%). 67.32% fully susceptible strains, 31.56% extended-spectrum beta-lactamase (ESBL) producing bacteria, and 1.11% multidrug-resistant organisms (MDROs) were among the isolates. Most infections (68%) were cured, but 5% had recurrence within 90 days of admission. Infection-related mortality was 8%, and death due to non-infectious causes was 2%. In conclusion, Gram-negative BSIs are severe infections with increasing antimicrobial resistance, primarily caused by ESBL-producing bacteria. High mortality rates are linked to diabetes, age, and hospitalisation, necessitating antibiotic treatment optimisation.

Job satisfaction of multidisciplinary staff working in intensive care units: a cross-sectional study in Qatar

Background/Aims Job satisfaction is an important contributor to the efficacy and success of organisations. An intensive care unit is a highly skilled area of healthcare that can be a physically and mentally challenging environment for staff, potentially impacting job satisfaction. This study aimed to assess job satisfaction levels among multidisciplinary staff members working in the intensive care units of a hospital in Qatar and evaluate how this is affected by sociodemographic and employment factors. Methods This was a cross-sectional, quantitative study that used a survey method. A total of 142 intensive care unit nurses, physicians and allied health professionals were recruited via random sampling from a tertiary hospital in Qatar. The Minnesota Satisfaction Questionnaire (short form) was used to collect data on respondents' intrinsic, extrinsic and overall job satisfaction levels, using statements scored with 5-point Likert scales. The survey also collected data on respondents' gender, age, job category and years of experience working in intensive care. Data were analysed using Shapiro-Wilk tests, Mann-Whitney U tests, Kruskal–Wallis tests and analysis of variance. Mean overall job satisfaction scores were classified as low (<3.00), moderate (3.00–3.99) or high (>4.00). A P value of <0.05 indicated statistical significance. Results The mean overall job satisfaction score was 3.82 out of 5.00, indicating moderate satisfaction. There were strong correlations between job satisfaction and both intrinsic (0.940) and extrinsic (0.894) satisfaction. There was a significant difference in job satisfaction levels depending on respondents' years of experience working in intensive care units (P=0.0477), with those who had less than 10 years of experience having the highest job satisfaction levels and those with 20–24 years' experience having the lowest job satisfaction levels. There were no significant differences between the job satisfaction levels of participants in different gender, age and job categories. Conclusions This study suggests that intensive care unit staff with more years of experience may have lower job satisfaction than those with fewer years of experience. Healthcare organisations should consider implementing targeted interventions to enhance job satisfaction, such as opportunities for professional development, recognition programmes, mentorship programmes, stress management workshops and efforts to improve work-life balance.

Rehabilitation and functional outcomes of COVID-19 patients in a rehabilitation hospital in Qatar.

Patients recovering from severe COVID-19 infections have experienced prolonged cognitive, physical, and psychological sequelae, including cardiorespiratory and motor deconditioning, neurological deterioration, anxiety, and depression. The impact of rehabilitation post-acute COVID-19 infection was recognized in the literature, but studies assessing and quantifying specific functional outcomes were lacking. This study aims to describe the characteristics and quantify the changes in functional outcomes of patients admitted to Qatar Rehabilitation Institute (QRI) for inpatient rehabilitation (IPR) post-COVID-19 infection during a 10-month period in 2021. This is a retrospective observational cohort study, which included individuals over 18 years of age with a documented COVID-19-positive diagnosis who were admitted to QRI for IPR due to COVID-19 complications. Data was collected by the investigators from January 1, 2021, until October 30, 2021. A total of 243 patients were included in this study. The changes in functional rehabilitation outcomes were assessed and quantified at both the patient's baseline (on admission to QRI) and after completion of IPR (on discharge). The duration of the IPR program varied based on each patient's baseline assessment. Patients were given a total of 8-12 weeks to achieve their rehabilitation goals and were discharged once those goals were met. Several validated tools were utilized in this study including Functional Independence Measure (FIM), Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Modified Medical Research Council (mMRC) Dyspnea Scale, Mini-Mental State Examination (MMSE), and Right- and left-Hand Grip Strength. In addition, patients' diet, the need for respiratory support, and the presence of a tracheostomy tube before and after IPR were also recorded. In total, 84.4% of the included patients were males (n = 205); with a mean age of 52.44 ± 12.99 years. The most commonly reported comorbidities were type 2 diabetes (62.1%) and hypertension (49.8%) with 83.5% of patients experiencing critical illness neuromyopathy. The average patients' length of stay in QRI was 33.92 ± 27.72 days. A statistically significant improvement in all functional outcome scales was noted following the completion of the IPR program (p = 0.001). The number of patients requiring modification to their diet or feeding via nasogastric tube (NGT) significantly decreased by 35% and 93%, respectively (p = 0.001). Patients requiring respiratory support decreased by 98% (p = 0.001) and the need for a tracheostomy tube among patients was reduced by 95% (p = 0.001). IPR following COVID-19 infection was associated with significant functional, motor, and cardiorespiratory improvement. Dedicating clinics for post-COVID-19 rehabilitation would ensure improved patient outcomes and enhanced recovery.

Clinical features and management approaches for Urinary Incontinence in Older Adults: Evidence from Three Hospitals in Qatar.

Urinary incontinence (UI) is a common medical problem that seriously affects patients' physical, psychological, social, and financial well-being. To identify the most effective drug management techniques, this retrospective study aimed to describe the demographics, etiology, and medical traits of people with UI. This retrospective study was conducted at Rumailah Hospital, Ambulatory Care Centre, and Hamad General Hospital to investigate UI risk factors, causes, and management practices in people aged ≥ 65 years within the Hamad Medical Corporation (HMC) in Qatar. The 272 patients enrolled in the study had a marked male preponderance, and a larger percentage of non-Qatari residents than Qataris residents. Solifenacin (24.9%), Tolterodine (4.1%), and Oxybutynin (1.1%) were the most commonly administered anticholinergic drugs, while Tamsulosin (82.9%), Alfuzosin (14.5%), and Doxazosin (1.7%) were the most frequently prescribed alpha-blockers. This study underscores the importance of investigating UI in institutionalized older adult populations considering the limited research available in Qatar. The identified preventable risk factors can be proactively addressed to mitigate UI. This study also highlights the need for thorough documentation of the diagnosis and reasons for improving the standards of patient care. The findings of this study provide important information that can be used to design medication management methods for enhancing patient outcomes.

Prevalence of polypharmacy and factors impacting psychotropic prescribing patterns in women of childbearing potential at inpatient mental health services in Qatar.

Women may experience unique mental disorders due to hormone shifts. Rates of schizophrenia and bipolar disorder are similar between genders, but onset and symptoms may differ. Women tend to use more psychotropic drugs due to limited therapeutic options. This study was aimed to estimate the prevalence of psychotropic polypharmacy among females of childbearing potential and factors impacting prescribing patterns. This was a quantitative retrospective chart review for patients admitted to inpatient units at the Mental Health Hospital in Qatar. SPSS® Statistics was used for data analysis. In addition to descriptive statistics applied, linear regression and binary logistic regression models were used to examine the clinical and sociodemographic factors associated with polypharmacy and full therapeutic response upon discharge, respectively. An alpha value of 0.05 was used. Of the 347 patients, 52.7% of the patients received a prescription of at least two psychotropic drugs upon discharge. Around two-thirds (63.1%) were prescribed at least one antipsychotic. Potential predictors of polypharmacy were age (p = 0.027), longer hospital stay (p = 0.003), family history (p < 0.001), absence of suicidal history (p = 0.005), and a diagnosis of a mood disorder (p = 0.009), or a diagnosis of a psychotic disorder (p = 0.015). A full response upon discharge was less likely to occur in patients with a longer stay (OR = 0.940; p = 0.029) and in those with a substance use disorder (OR = 0.166; p = 0.035). There is a notably high prevalence of total polypharmacy upon discharge. Some identified factors are modifiable. Evidence-based prescription practices through hospital guidelines and education should be emphasized to avoid unreasonable polypharmacy.

Spectrum of infection and outcomes in individuals with Candida auris infection in Qatar.

We investigated the spectrum of infection and risk factors for invasive fungal disease due to Candida auris (CA) in Qatar. We performed structured chart reviews on individuals with any positive CA culture between May 2019 and December 2022 at three tertiary care hospitals in Qatar. Invasive CA disease (ICAD) was defined as a positive sterile site culture, or any positive culture for CA with appropriate antifungal prescription. Main outcomes included proportion of individuals who developed ICAD among those with positive cultures, and 30-day/in-hospital mortality. Among 331 eligible individuals, median age was 56 years, 83.1% were male, 70.7% were non-Qataris, and 37.5% had ≥ 3 comorbidities at baseline. Overall, 86.4% were deemed to have colonization and 13.6% developed ICAD. Those with ICAD were more likely to have invasive central venous or urinary catheterization and mechanical ventilation. Individuals with ICAD had longer prior ICU stay (16 vs 26 days, P = 0.002), and longer hospital length of stay (63 vs. 43 days; P = 0.003), and higher 30-day mortality (38% vs. 14%; P<0.001). In multivariable regression analysis, only mechanical ventilation was associated with a higher risk of ICAD (OR 3.33, 95% CI 1.09-10.17). Invasive Candida auris Disease is associated with longer hospital stay and higher mortality. Severely ill persons on mechanical ventilation should be especially monitored for development of ICAD.

Assessing child satisfaction and expectations for developing a child-friendly environment at the pediatric department in a general hospital in Qatar.

"Patient-centered" care positions the patient at the core and emphasizes fulfilling their unique needs, preferences, and values. This approach is particularly significant in the context of children. Although widely recognized as necessary, this approach is not universally implemented. The children find themselves in hospital wards where they are required to follow protocols and systems designed primarily for adults. In the appropriate atmosphere, children often express themselves more effectively through words, body language, and play, leading to a richer understanding of their needs. There is growing recognition of the importance of addressing children's concerns regarding hospital environments. This study investigates children's satisfaction with the physical aspect of the hospital environment. Insights from this exploration could provide valuable input for creating hospital environments centered around children's needs and preferences. This mixed-methods study involves children aged 6-14 years with parental consent from a premiere healthcare provider in the state of Qatar. The survey used nine items to gauge satisfaction with the existing hospital environment as a "child-friendly hospital" and another nine items to explore their expectations for such environments. The Mann-Whitney U and Kruskal-Wallis tests as well as thematic analyses were employed to assess the statistical significance of differences in satisfaction levels and children's expectations of the hospital's physical environment. A total of 398 children participated in the study. Of them, 40.3% were aged 6-8 years; 60.3% had experienced two to five hospital visits; 55.8% of children participated during their outpatient service visit; and 31.7% were Asian. Children's satisfaction levels with various aspects of the hospital environment-including its physical appearance, signage, lounge, consultant rooms, corridors, bedrooms, TV content, toys, and staff uniforms-were in the range of 42.9%-59%. The children expressed a desire for a hospital environment that is spacious, colorful, attractive, and filled with cartoon characters and toys in the children's hospital from the front lounge to the inpatient units. The findings underline the importance of considering the perspectives of children in evidence-based healthcare design. The study reveals that children's satisfaction with the hospital environment is generally average or below average. Ultimately, a "child-friendly hospital environment" integrates children's rights into healthcare to significantly improve outcomes.

Magnet ingestion in growing children: a multi-center observational study on single and multiple magnet incidents

Over the past 15 years, there has been a noticeable uptick in incidents involving children ingesting multiple magnetic foreign bodies which can cause injuries and gastrointestinal complications including death. The current study aimed to identify the prevalence, clinical presentation, and management of single or multiple magnet ingestions. A retrospective multi-central cross-sectional study was conducted to include all pediatric patients < 18 years presented to the emergency department with ingestion of single or multiple magnets and admitted across hospitals in Qatar, UAE, KSA, Tunisia, and Turkey between January 2011 and December 2021. Demographics, symptoms, management, and outcomes were analyzed. There were 189 magnet ingestions, of which 88 (46.6%) were multiple magnet ingestions. Most patients (55.6%) were male, and the median age was 3.9 (IQR 2–7) years. An abdominal X-ray was obtained in all cases. 119 (62%) patients were conservatively treated, 53 (28%) required surgical intervention and 17 (8.9%) underwent gastroscopy. None of the patients with single magnet ingestions experienced morbidity or severe outcomes. Multiple magnet ingestions led to significant morbidity including hospitalizations, perforations (44.3%), severe intestinal necrosis (19.3%), peritonitis (13.6%), severe abdominal infection (10.2%), and septic shock (4.5%). The rate of surgical intervention (59.1% vs. 1.0%) and gastroscopy (15.9% vs. 3.0%) was significantly higher in the multiple ingestion group compared to the single magnet ingestion group. No deaths were identified. A high risk of serious complications, including the need for surgery to remove the magnets and substantial morbidity may result from swallowing more than one magnet. Magnet safety requirements, public education, and improved legislation are urgently required.

Real world evidence of epidemiological trends, clinical presentation, and prognostic outcomes of multiple myeloma (2007-2021).

Multiple myeloma (MM) is one of the most common hematological malignancies globally, and it is projected to increase in the coming years. It occurs more frequently in males and affects older individuals. Presenting symptoms can range from being asymptomatic to severely debilitating. The objective of this study was to determine the epidemiology, clinical features, and prognostic outcomes of patients with MM in the only tertiary cancer hospital in Qatar. Patients with symptomatic myeloma diagnosed at the National Center for Cancer Care and Research in Qatar between 2007 and 2021 were included. Data on demographics, laboratory work, bone marrow analysis, radiology, and given treatment were collected. Descriptive statistics, survival curves, and multivariable cox regression were used to identify independent mortality risk factors. During the study period of 15 years, a total of 192 patients were diagnosed with MM. The incident rate of myeloma cases in 2021 was 8 patients per million. The median age of patients was 57 years [range 22-88], with 68% being above the age of 50 years at diagnosis. The majority of patients were male (71%) and (85%) were expats. At the time of diagnosis, most patients [n = 169 (88%)] had bone lesions, and 27% had extramedullary plasmacytoma. Anemia, hypercalcemia, and spinal cord compression were reported in 53%, 28%, and 7% of patients, respectively, at presentation. The monoclonal immunoglobulin subtypes were IgG, IgA, and free light chain in 52%, 16%, and 26% of patients, respectively. The overall median survival was 103 months (95% CI 71-135 months). In a multivariate cox-regression analysis for risk factors, only high serum calcium (≥ 2.7 mmol/L) was associated with increased mortality (HR: 2.54, 95% C.I.: 1.40-4.63, p = 0.002). Patients who received an autologous stem cell transplant (ASCT) had significantly better overall survival. In this comprehensive study of patients with MM treated in a country with a small and young general population, centralized hematology care, and free cancer care, we found a low but increasing incidence of MM and a good overall survival. Hypercalcemia was confirmed as a negative risk factor. ASCT had a significant positive impact on survival and should be provided to all patients eligible for this treatment, even in the era of novel agents.

Population genomic analyses reveal high diversity, recombination and nosocomial transmission among Candida glabrata (Nakaseomyces glabrata) isolates causing invasive infections.

Candida glabrata is a commensal yeast of the gastrointestinal tract and skin of humans. However, it causes opportunistic infections in immunocompromised patients, and is the second most common Candida pathogen causing bloodstream infections. Although there are many studies on the epidemiology of C. glabrata infections, the fine- and large-scale geographical nature of C. glabrata remain incompletely understood. Here we investigated both the fine- and large-scale population structure of C. glabrata through genome sequencing of 80 clinical isolates obtained from six tertiary hospitals in Qatar and by comparing with global collections. Our fine-scale analyses revealed high genetic diversity within the Qatari population of C. glabrata and identified signatures of recombination, inbreeding and clonal expansion within and between hospitals, including evidence for nosocomial transmission among coronavirus disease 2019 (COVID-19) patients. In addition to signatures of recombination at the population level, both MATa and MATα alleles were detected in most hospitals, indicating the potential for sexual reproduction in clinical environments. Comparisons with global samples showed that the Qatari C. glabrata population was very similar to those from other parts of the world, consistent with the significant role of recent anthropogenic activities in shaping its population structure. Genome-wide association studies identified both known and novel genomic variants associated with reduced susceptibilities to fluconazole, 5-flucytosine and echinocandins. Together, our genomic analyses revealed the diversity, transmission patterns and antifungal drug resistance mechanisms of C. glabrata in Qatar as well as the relationships between Qatari isolates and those from other parts of the world.

Characteristics of the clinical pharmacists' interventions at the main general tertiary care hospital in Qatar.

Medication-related problems (MRPs) are prevalent throughout healthcare systems, whereby pharmacy-based interventions are pivotal to reducing occurrence. In the Middle East, including Qatar, the professional roles of pharmacists have been expanding to improve patient safety. This study aimed to characterize and analyze pharmacist-led interventions among hospitalized patients in the leading general hospital in Qatar. A retrospective analysis of pharmacist interventions in the internal medicine ward, critical care unit, and emergency department (ED) was conducted. Data were extracted from three periods of 1 month (March 1-31, 2018, July 15-August 15, 2018, and January 1-31, 2019). A descriptive type of analysis was undertaken. A total of 340 patients with 858 interventions were analyzed. The average age of the study participants was 51 years (SD ± 17.7). The study population was predominantly male (65%). The prevailing pharmacist intervention was adding drug therapy (27%), followed by medication discontinuation (18%) and dosage adjustments (16%). This pattern was maintained across all subpopulations, e.g., gender, age, and ward, except for the ED, where cessation of medication was the most frequent intervention (4%). The two pharmacological classes associated with most interventions were anti-infective and cardiovascular agents. Pharmacist interventions effectively identify, prevent, and resolve MRPs in general inpatient settings in Qatar.

Exploring determinants of antimicrobial prescribing behaviour using the Theoretical Domains Framework

BackgroundFew theoretically-based, qualitative studies have explored determinants of antimicrobial prescribing behaviour in hospitals. Understanding these can promote successful development and implementation of behaviour change interventions (BCIs). Objective(s): To use the Theoretical Domains Framework (TDF) to explore determinants of clinicians’ antimicrobial prescribing behaviour, identifying barriers (i.e., impediments) and facilitators to appropriate antimicrobial practice. MethodsSemi-structured interviews with purposively-sampled doctors and pharmacists with a wide range of specialties and expertise in Hamad Medical Corporation hospitals in Qatar. Interviews based on previous quantitative research and the TDF were audio-recorded, transcribed and independently analysed by two researchers using the TDF as an initial coding framework. ResultsData saturation was achieved after interviewing eight doctors and eight pharmacists. Inter-related determinants of antimicrobial prescribing behaviour linked to ten TDF domains were identified as barriers and facilitators that may contribute to inappropriate or appropriate antimicrobial prescribing. The main barriers identified were around hospital guidelines and electronic system deficiencies (environmental context and resources); knowledge gaps relating to guidelines and appropriate prescribing (knowledge); restricted roles/responsibilities of microbiologists and pharmacists (professional role and identity); challenging antimicrobial prescribing decisions (memory, attention and decision processes); and professional hierarchies and poor multidisciplinary teamworking (social influences). Key facilitators included guidelines compliance (goals and intentions), and participants’ beliefs about the consequences of appropriate or inappropriate prescribing. Further education and training, and some changes to guidelines including their accessibility were also considered essential. ConclusionsAntimicrobial prescribing behaviour in hospitals is a complex process influenced by a broad range of determinants including specific barriers and facilitators. The in-depth understanding of this complexity provided by this work may support the development of an effective BCI to promote appropriate antimicrobial stewardship.

Appropriateness of gentamicin therapeutic drug monitoring at a Middle Eastern tertiary hospital setting: a retrospective evaluation and quality audit.

The use of gentamicin in the treatment of infectious diseases requires frequent monitoring to attain the best treatment outcomes. This study aimed to evaluate the appropriateness of gentamicin therapeutic drug monitoring (TDM) at a tertiary care hospital in Qatar. A one-year quantitative retrospective chart review of all gentamicin TDM records was conducted. Evidence-based criteria were applied to evaluate the appropriateness of gentamicin TDM in terms of indication, sampling times, and post-analytical actions. Out of 59 captured gentamicin TDM records, 58 gentamicin samples were eligible for evaluation. Overall, gentamicin TDM appropriateness was achieved in 50% (n = 29) of the evaluated records. However, 12% (n = 7) of gentamicin drug concentrations were below the assay quantification limits or were not sampled appropriately. Inappropriate post-analytical actions (22.4%, n = 13) and inappropriate sampling times (44.8%, n = 26) were recorded. Most of the gentamicin blood samples (n = 43; 74.2%) were taken appropriately at steady-state. Inappropriate sampling time relative to the last dose was captured in 31% (n = 18) of the cases. Although 27.6% (n = 16) of gentamicin concentrations were non-therapeutic, continuing gentamicin dosing without adjustment was the most frequent post-analytical action (69.8%, n = 37). Gentamicin dose regimen continuations, dose regimen decreases and dose regimen discontinuations were inappropriately applied in 27% (n = 10), 25% (n = 2) and 14% (n = 1) of the times, respectively. Suboptimal gentamicin TDM practices exist in relation to sampling time and post-analytical actions. Studies exploring setting-specific reasons behind inappropriate TDM practices and methods of its optimisation are needed.

Effect of pioglitazone on inflammatory response and clinical outcome in T2DM patients with COVID-19: a randomized multicenter double-blind clinical trial.

Coronavirus disease 2019 (COVID-19) caused by the coronavirus SARS-CoV-2, has emerged as a rapidly spreading contagious disease across the globe. Recent studies showed that people with diabetes mellitus, severe obesity, and cardiovascular disease are at higher risk of mortality from COVID-19. It has been suggested that the increased risk is due to the chronic inflammatory state associated with type 2 diabetes. This study aimed to evaluate the efficacy of pioglitazone, a strong insulin sensitizer with anti-inflammatory properties, in improving the clinical outcomes of patients with type 2 diabetes admitted with moderate-severe COVID-19. We enrolled 350 patients with type 2 diabetes who were admitted to hospitals in Qatar and Kuwait with COVID-19. Patients were randomized to receive, in a double-blind fashion, pioglitazone (n = 189) or a matching placebo (n = 161) for 28 days. The study had two primary outcomes: (1) the incidence of a composite outcome composed of (a) the requirement for mechanical ventilation, (b) death, and (c) myocardial damage; and (2) an increase in C-reactive protein (CRP) levels. The first primary outcome occurred in 28 participants (8%), and the secondary outcome occurred in 17. Treatment with pioglitazone showed a significant reduction in interleukin (IL)-3 levels compared with placebo treatment (mean (SD) 2.73 (± 2.14) [95% CI: 0.02, 1.1], p = 0.043 vs. 2.28 (± 1.67) [95% CI: - 0.23, 0.86], p = 0.3, respectively), with no effect seen in the levels of other inflammatory markers. Even though not significant, a few of the patients on pioglitazone exhibited serum troponin levels > 3 times higher than the normal range seen in patients on placebo. On the other hand, more patients on pioglitazone were admitted to the ICU than those with placebo, and no significant difference in the CRP reduction was observed between the two groups. The results of the present study demonstrate that pioglitazone treatment did not independently provide any additional clinical benefit to patients with type 2 diabetes admitted with a COVID-19 infection. https://clinicaltrials.gov, identifier NCT04604223.

Abstract #1603090: Real World Use, Effectiveness, and Safety of SGLT2 inhibitors in Patients With Type 2 Diabetes: Experience in A Tertiary Care Hospital in Qatar

Abstract #1603090: Real World Use, Effectiveness, and Safety of SGLT2 inhibitors in Patients With Type 2 Diabetes: Experience in A Tertiary Care Hospital in Qatar

Analytical study to assess the impact of health service quality on patient satisfaction in Hamad Medical Corporation Hospitals in Qatar: using SERVQUAL

Abstract Objective The study aims to assess the impact of the five dimensions of service quality on patient satisfaction and determine which dimension has the greatest impact on patient satisfaction. We can judge service quality through the delivery of excellent services concerning patients’ expectations. Consequently, we can define it as the difference between the patient’s expectations and experiences (patient views, subjectively). Methods A total of 400 patients were randomly selected in this study. This study was conducted in Hamad Medical Corporation Hospital, Qatar, in the first half of 2019. We utilized the cross-sectional method using a modified Assessment of Service Quality Questionnaire. The response was recorded on a 5-point Likert scale, wherein ‘one’ indicates ‘strongly disagree’ and ‘five’ indicates ‘strongly agree.’ In addition to these items, global satisfaction was measured by a single item asking participants how they felt after the delivery of health services. Results Univariable and multivariable linear regressions were made to test the predefined hypotheses. The study findings showed a statistically significant impact of health service quality on patient satisfaction (P = 0.00). The Standardized Beta proved that the empathy dimension had the greatest impact on patient satisfaction, while assurance had the lowest (β = 0.23 and 0.05, respectively). Also, socio-demographic data have a significant impact on patient satisfaction. The study sample showed that 81% were single, 55.5% were males, and 79.8% were non-Qatari. All hospitals have significant values (P &amp;lt; 0.05). There is variation in patient satisfaction between the newly opened hospitals and the old ones. Conclusion Hospital management and policymakers must improve and maintain patient confidentiality, encouraging staff to build confidence and trust in the patient. The management must consider contemporary managerial orientation’s crucial role in delivering quality services and patient satisfaction.

Assessment of nurse’s perceived just culture: a cross-sectional study

BackgroundThe non-punitive approach to error investigation in most safety culture surveys have been relatively low. Most of the current patient safety culture measurement tools also lack the ability to directly gauge concepts important to a just culture (i.e. perceptions of fairness and trust). The purpose of this study is to assess nurses’ perceptions of the six just culture dimensions using the validated Just Culture Assessment Tool (JCAT).MethodsThis descriptive, cross-sectional study was conducted between November and December 2020. Data from 212 staff nurses in a large referral hospital in Qatar were collected. A validated, self-reported survey called the JCAT was used to assess the perception of the just culture dimensions including feedback and communication, openness of communication, balance, quality of event reporting process, continuous improvement, and trust.ResultsThe study revealed that the overall positive perception score of just culture was (75.44%). The strength areas of the just culture were “continuous improvement” dimension (88.44%), “quality of events reporting process” (86.04%), followed by “feedback and communication” (80.19%), and “openness of communication” (77.55%) The dimensions such as “trust” (68.30%) and “balance” (52.55%) had a lower positive perception rates.ConclusionA strong and effective just culture is a cornerstone of any organization, particularly when it comes to ensuring safety. It places paramount importance on encouraging voluntary error reporting and establishing a robust feedback system to address safety-related events promptly. It also recognizes that errors present valuable opportunities for continuous improvement. Just culture is more than just a no-blame practice. By prioritizing accountability and responsibility among front-line workers, a just culture fosters a sense of ownership and a commitment to improve safety, rather than assigning blame.

Wastewater-based epidemiology for tracking bacterial diversity and antibiotic resistance in COVID-19 isolation hospitals in Qatar

Hospitals are hotspots for antimicrobial resistance genes (ARGs), and play a significant role in their emergence and spread. Large numbers of ARGs will be ejected from hospitals via wastewater systems. Wastewater-based epidemiology has been consolidated as a tool to provide real-time information, and represents a promising approach to understanding the prevalence of bacteria and ARGs at community level. To determine bacterial diversity and identify ARG profiles in hospital wastewater pathogens obtained from coronavirus disease 2019 (COVID-19) isolation hospitals compared with non-COVID-19 facilities during the pandemic. Wastewater samples were obtained from four hospitals: three assigned to patients with COVID-19 patients and one assigned to non-COVID-19 patients. A microbial DNA quantitative polymerase chain reaction was used to determine bacterial diversity and ARGs. The assay recorded 27 different bacterial species in the samples, belonging to the following phyla: Firmicutes (44.4%), Proteobacteria (33.3%), Actinobacteria (11%), Bacteroidetes (7.4%) and Verrucomicrobiota (3.7%). In addition, 61 ARGs were detected in total. The highest number of ARGs was observed for the Hazem Mebaireek General Hospital (HMGH) COVID-19 patient site (88.5%), and the lowest number of ARGs was found for the HMGH non-patient site (24.1%). The emergence of contaminants in sewage water, such as ARGs and high pathogen levels, poses a potential risk to public health and the aquatic ecosystem.