Healthcare Professionals In India Research Articles

Development and Evaluation of a Mobile App for Guiding Rabies Prophylaxis among Health-Care Professionals in India.

Background:The majority of dog-mediated human rabies as well as rabies-related human deaths are reported from low-income countries of Asia and Africa where access to appropriate postexposure prophylaxis is limited or nonexistent. At present, India is second in position after China in terms of having the highest number of mobile phone users surpassing the United States.Objective:In this context, we decided to develop a user-friendly, technically less demanding, mobile App for health-care professionals, which is accessible even without Internet facility.Methodology:The current study was conducted in four phases, namely assemblage of informational contents on rabies, development of the software, assessment of the reliability of the questionnaire tool and evaluation of the mobile App. The evaluation of App was conducted among physicians and nursing staffs in a tertiary care referral hospital.Results:The information content was prepared referring national and international guidelines. The App was designed with Hypertext Markup Language 5 for presentation on the World Wide Web and was coined the name of “RabiApp.” This is a hybrid App of the native App and web App, allowing the information to be stored in the local server. The mobile App was assessed using a validated and reliable questionnaire after confirming the internal consistency by means of Cronbach's alpha. The overall Cronbach's alpha for the main scale was 0.788, which was a respectable score.Conclusion:The developed App is a user-friendly, easily accessible platform, which can help health-care professionals in making decisions regarding rabies wound management, treatment, and prophylaxis.

Assessment and evaluation of drug information services provided by department of pharmacy practice based on enquirerandrsquo;s perspective at tertiary care hospital, Kalburgi

Background: Drug-information service (DIS), is still in a nascent stage, and might be due to late introduction of such tradition in India. It is an undervalued course of department of pharmacy practice that is barely used to their full potential in providing information about drug to the health-care professionals in India. This study has been conducted to expound and explore the information regarding drug needed to enquirer mainly patient specific. The service comprises of collecting, reviewing, evaluating, indexing, and distributing information requested by enquirer. Rational drug use demands access to unbiased drug-information. Aim: To assess and evaluate the DIS provided by department of pharmacy practice based on enquirer’s perspective. Materials and methods: A hospital based prospective study for six months was conducted. Results: A total of 113 queries were received with an average of 18.83 queries per month. Majority of queries were received from interns (39.82%) and general medicine physicians (21.23%). Predominantly asked for the purpose of education or academic 51(37.50%), update of knowledge 31(31.61%) and better patient care 36(26.47%). The feedbacks of the response were rated as ‟good and satisfactory”. Conclusion: The quality of the services provided by the center suggests providing more awareness regarding DIS.

COVID-19 and Management of Severe Acute Respiratory Infection (SARI): A Questionnaire-Based Study Among Indian Healthcare Professionals.

Background: COVID-19 presenting as SARI (severe acute respiratory syndrome) mandates the need for ICU (intensive care unit) hospitalization, increasing healthcare burden. This study aims to determine knowledge of healthcare professionals towards management of SARI in COVID-19 suspected cases. Methods: A total of 313 healthcare professionals from the state of Maharashtra, India completed a questionnaire-based survey study adapted from the WHO interim guidance for management of SARI in COVID-19 suspected cases. Convenience sampling method was used and the distribution of responses was presented as frequencies and percentages. Sub-groups were classified on the basis of gender, age, profession and ICU vs. Non-ICU setting. Descriptive statistics were performed for all groups based on percentage of correct responses and individual pairwise comparisons were done using the Chi-Square test. Results: The median and mean percentage of correct responses for all sub groups was only 66.80% and 58.62% respectively. A higher percentage of total correct responses were those from the ICU setting with a higher overall performance from medical postgraduates. The nursing and allied healthcare professionals had a poor overall performance. Conclusions: The findings indicate lacunae in several aspects of SARI management which calls for nationwide studies and implementation of comprehensive training programmes. A uniform structured training program with team-oriented crisis resource management suitable for all healthcare professionals irrespective of prior training in COVID-19 management must be implemented. Furthermore, the findings of this study can serve as a baseline to develop training resources for healthcare professionals for COVID-19 management.

Historical Look at Indian Healthcare Professionals in the NHS

Doctors and nurses from the Indian subcontinent have been working in the UK healthcare sector for over a 100 years. Initially only open to Europeans, Indians were allowed to enter the Indian Medical Service (IMS) in 1855, although the requisite was that they had to sit exams based in London and had to be registered with the General Medical Council (GMC). At the time there were many schools training Indian doctors, but only as licentiates. In relation to medical education, through pressure applied by the IMS, indigenous courses for the training of Indian doctors were abolished and several medical colleges, modelled along western pedagogic styles, were established. The staff of all these colleges were appointed from the IMS and their methods of instruction were virtually indistinguishable from those practised in England and Scotland. Indian degrees were recognised in 1892 by the GMC and this recognition persisted until 1975, with a short interlude in the mid-1930s when there was a dispute between the GMC and the Government of India about the quality of Indian medical education. 1

Treatment and re/habilitation of children with cerebral palsy in India: a scoping review.

To describe the nature and extent of the literature addressing the medical and its re/habilitative management of cerebral palsy (CP) in India. Online worldwide scholarly databases, research hosting directories, Indian publishing houses, and grey literature were used to identify papers published between 2005 and 2016. We retrieved 144 English language papers that described the medical and rehabilitative management of Indian children with CP. Quantitative, qualitative, and mixed research designs are published by a variety of health care professionals in India. Intervention (45%) and observational studies (30%) predominate. Outcomes were categorized using the World Health Organization's International Classification of Functioning, Disability and Health framework, with body structure and function most reported and activity/participation least reported; 57% described its re/habilitation interventions and 43% were medical interventions. There is a substantial body of CP research in India that focuses on interventions to reduce impairments, with minimal attention given to activities and participation, environmental, and personal factors. Twenty-six per cent of studies are published in what appear to be 'predatory journals'. This paper serves as an alert about the presence of 'predatory journals' in medicine that may introduce publication bias, which can distort results reported in those studies individually, or from conclusions drawn in reviews that contain those studies. Cerebral palsy research in India focuses on interventions to reduce impairment. Activities, participation, and environmental factors are minimally addressed. Quantitative studies are more common than qualitative studies. Many Indian studies are published in journals that are not indexed in worldwide databases of scholarly journals.

Area postrema syndrome: A lesser known variant of neuromyelitis optica spectrum disorder

One of the most specific presentations of neuromyelitis optica spectrum disorders (NMOSDs) is area postrema syndrome (APS). Although NMOSDs are now being increasingly encountered, APS is rarely reported in literature. With the emergence of the ever-expanding spectrum of neuromyelitis optica (NMO) comes various challenges in the prompt recognition, confirmation, and swift initiation of the therapy. Although with the new consensus criteria of the International Panel of NMO Diagnosis 2015, the earlier challenges of diagnosis have been removed to a great extent, still there is a long road ahead in the widespread dissemination of the current knowledge of NMOSD among health-care professionals in India. We hereby report a case of APS in a young female with endeavor to increase the awareness of this peculiar kind of presentation from India.

Emotional intelligence as a moderator in abusive supervision-intention to quit relationship among Indian healthcare professionals

PurposeDespite knowledge of the destructive effect of abusive supervision on several individual and organizational outcomes, the construct remains scarcely investigated, especially in Indian organizations. Drawing upon the conservation of resources theory, the purpose of this paper is to explore the linkage between abusive supervision (an interpersonal stressor) and subordinate’s intention to quit and to focuss on the moderating role of subordinate’s emotional intelligence as a neutralizer in curbing the pernicious effect of abusive supervision on subordinate’s intention to quit.Design/methodology/approachThe participants of this study were 353 healthcare professionals working in a large Indian hospital chain having all India presence. The authors have collected data on our predictor and criterion variables at two time points with a separation of three to four weeks for reducing common method bias (Podsakoff et al., 2012). At Time 1, participants rated the perception of their supervisor’s abusiveness and answered few demographic questions. At Time 2, participants completed measures of intention to quit and their emotional intelligence.FindingsThe finding of this study corroborates the assertion that subordinates who perceive their supervisors to be abusive have higher intension to quit organization. But surprisingly, this study reports that the moderating effect of emotional intelligence showed stronger relationship between abusive supervision and intention to quit when emotional intelligence is high than low.Practical implicationsOrganization should take serious note of supervisors or managers that are abusive or are perceived to be abusive by their subordinates. As it is impossible to completely eradicate abusive and deviant supervisory behaviors at workplace, these toxic behaviors can be checked at several levels like hiring people high on emotional intelligence and through imparting emotional intelligence training and counseling to both the accused and the victim.Originality/valueThe study finds support to the relationship between abusive supervision and intention to quit in Indian context. The finding of this study fails to empirically corroborate the assumption that emotional intelligence will act as a neutralizer in mitigating the pernicious effect of abusive supervision on subordinates’ intention to quit.

Prevalence of reproductive tract infection symptoms and treatment-seeking behavior among women: A community-based study.

Introduction:Reproductive tract infection (RTI) is a public health problem affecting women's health, especially in developing country like India. The associated stigma with this reproductive morbidity is often a deterrent in seeking health care.Aims and Objectives:The aim was to study the prevalence of RTI symptoms and treatment-seeking behavior among married women of reproductive age group.Methodology:It was a community-based cross-sectional study. A total of 276 women were interviewed in the community by trained medical social workers. RTI symptoms were defined according to the syndromic case management guideline developed by the World Health Organization. Statistical analysis was performed using the Epi Info software for Windows (CDC Atlanta).Results:About one-third (98/276; 35.5%) of women reported symptoms suggestive of RTI. The most commonly experienced symptoms were foul-smelling vaginal discharge (68/98; 69.4%) followed by lower abdominal pain not associated with menstruation (51/98; 52.0%). Around half of those having RTI symptoms sought treatment for their problem (57.1%).Conclusion:Health-care professionals in India should focus on strengthening women knowledge of RTI symptoms and encouraging them to seek health care.

Lack of Awareness of Pharmacovigilance among Young Health-care Professionals in India: An Issue Requiring Urgent Intervention.

Background:Young healthcare professionals (HCPs) are the pillar of healthcare system. The objective of the present study was to assess the knowledge, attitude, and practices of young HCPs regarding adverse drug reactions (ADRs) reporting.Methods:This cross-sectional questionnaire-based study was conducted on young HCPs in a tertiary care teaching hospital of North India. The study instrument was semi-structured, prevalidated questionnaire. The responses obtained were compared among doctors and nursing professionals.Results:We obtained response from 84 HCPs (61 doctors and 23 nurses). The mean age of the doctors and nurses was 25.0 ± 2.4 versus 26.3 ± 3.4 years, respectively. No significant difference was observed in questions related to definition of ADR, components of pharmacovigilance (PV), who can report ADRs and medications for which ADRs are to be reported. Only 9.8% doctors and 26.1% nurses were aware of ADR reporting system in India, of which 6 (26%) nurses and none of the doctors were aware of its name. About 16.4% doctors as compared to 61% nurses admitted to have reported an ADR (P < 0.001). The main discouraging factor in ADR reporting was time constraint while lack of knowledge was also highlighted by the HCPs. More nurses as compared to doctors (78.3% vs. 49.2%, P = 0.01) were of the opinion that holding continuing medical education/workshop could encourage reporting.Conclusion:There is an urgent need to increase awareness about PV among young HCPs, and adequate interventions should be instituted to encourage PV practices.

P 4 Diagnosis, management and care of hypertensive disorders of pregnancy (HDP) in India – An Indian expert opinion

Introduction Hypertension is the second most common direct cause of maternal mortality worldwide with greater prevalence in developing world. Studies on HDP in India are limited and there is no uniformity for screening, diagnosis, care and management of HDP in India. Objective To review the available evidence and prepare a treatment consensus for screening, diagnosis, care and management of HDP in India. Method Major databases were searched for literature on HDP. A committee of 14 Obstetrics and Gynecology experts were formed in scientific collaboration with Wockhardt Ltd., Mumbai, India. The discussions and consensus from the expert discussions were drafted and refined as Expert Opinion on screening, diagnosis, care and management of HDP in India. Results The Expert Panel recommended NICE guidelines to classify hypertension. The panel also advised to follow guidelines on antenatal care and perform thorough clinical examination of the patient on first visit preferably in first trimester and then subsequent visits during the pregnancy. Dietary counselling should be provided to pregnant women. Panel emphasized use of standard mercury sphygmomanometer for accurate measurement of B.P in the sitting position. Minimum of four antenatal care visits and initial screening (BP and proteinuria) at 8 to 12 weeks of gestation for early diagnosis of hypertension was advised. Choosing a safe antihypertensive is important. Panel recommended either labetalol or methyldopa as the first line treatment during third trimester of pregnancy. However, during second trimester methyldopa should be used as first line treatment. Conclusion This Expert opinion document is a comprehensive guide on HDP for Health Care Professionals in India. Types of HDP, major complications associated with it and their management during pregnancy, at the time of delivery and postpartum care has been elucidated. Awareness among pregnant women, family members and proper training of health care professionals forms the basis for effective management of HDP in India. Download : Download high-res image (800KB) Download : Download full-size image Download : Download high-res image (460KB) Download : Download full-size image

Ethical Off-label Drug use: Need for a Rethink?

Off-label drug use is unavoidable, especially in children. Legal justice originates from ethical justice; therefore, ethical off-label drug use can be considered legal. We share our successful experiences with this issue in China, which may provide a reference to Indian healthcare professionals, to develop a common executable standard to be applied to evaluate the off-label drug use in clinical practice.

Quit Tobacco: Are We Prepared?

Background: The pattern of tobacco consumption survey among the students in a private dental college in Mangalore helps us to assess the awareness and pattern of tobacco consumption among the dental students and also to assess the preparedness for tobacco control among the future health care professionals in India. Aim: To study the awareness and pattern of tobacco use among undergraduate dental students of a private dental College, at Dakshina Kannada, Karnataka. Materials and Methods: A Cross-sectional study was conducted among 100 dental students using a predesigned and pretested, semi-structured self-administered anonymous questionnaire. Data was analyzed by Microsoft excel and SPSS v 16.Statistical analysis comprised calculating proportion and the chi-square (χ2) test with Yates correction. Results: Among 100 participants, of which 52 students were males and 48 females, out of which 49% believed that the minimum number of cigarettes a person can smoke without causing harm to one’s health. About 89% of the students believe that it is the doctor’s duty to advice patients not to smoke or chew tobacco. 81% believe that health professional intervention would help the patient quit the habit. Conclusion: Awareness about harmful effects of tobacco abuse was good and the students feel that tobacco cessation modules should be incorporated in the dental curriculum. Given their important future role as exemplars, more effective measures to help reduce tobacco smoking among dental students are clearly needed worldwide.

Evidence-based medicine: A survey among perioperative health care professionals in India.

Background and Aims:Evidence-based medicine (EBM) is defined as the use of scientifically proven evidence for delivering best possible health care to patients. Despite growing emphasis on the need for EBM-based practice, acceptability, and perceptions toward EBM might differ among health professionals. The objective of this study was to assess the attitude, knowledge, and current practices of EBM among perioperative care health professionals in India.Material and Methods:This was a single point paper-based questionnaire survey carried out in February 2014 among delegates registered for an EBM conference on “perioperative care” held at a Tertiary referral Cancer Centre in India. Participation was voluntary and respondents were given the option of remaining anonymous.Results:Out of 190 questionnaires, 123 (65%) were returned. Most respondents (98%) agreed that practicing EBM improved patient care. The need to follow departmental protocols (22%) worries about the cost of implementing new treatments (20%) and inadequate skills to critically appraise articles (16%) accounted for major barriers in implementing EBM in clinical practice, with only 15% of respondents stating reluctance to change set practice. “Randomized controlled trial” and “number needed to treat” were the best and least understood EBM terms. Regarding awareness of 10 commonly used EBM-based guidelines in perioperative medicine, the percentage of correct responses ranged from 20% to 88%.Conclusion:Although most respondents agreed that practicing EBM improved patient care, many of them showed a low level of awareness regarding fundamental aspects of EBM. In addition to encouraging implementation of EBM, there should be increased focus on training in EBM methods.

Forum for Injection Technique and Therapy Expert Recommendations, India: The Indian Recommendations for Best Practice in Insulin Injection Technique, 2017.

Health-care professionals in India frequently manage injection or infusion therapies in persons with diabetes (PWD). Patients taking insulin should know the importance of proper needle size, correct injection process, complication avoidance, and all other aspects of injection technique from the first visit onward. To assist health-care practitioners in their clinical practice, Forum for Injection Technique and Therapy Expert Recommendations, India, has updated the practical advice and made it more comprehensive evidence-based best practice information. Adherence to these updated recommendations, learning, and translating them into clinical practice should lead to effective therapies, improved outcomes, and lower costs for PWD.

Trends in Students’ Outlook for Annual Health Checkup at an Indian University

The annual health checkup programme is important for primary care and important concern for the healthcare professional to promote health. Health promotion professionals in higher education practice a process of prevention. To engage students in health promotion is the challenge for healthcare professionals in India. Formal evaluation of patient satisfaction should be a part of college health services as it is unclear whether the issue is being addressed in college health clinics. Hence, we conducted the study to understand students’ perception from last three academic (2014–2017) years towards annual health check-up program and its aspects of conduct.

Current trends in highly active anti-retroviral therapy in an anti-retroviral therapy centre attached to a remote government medical college of Maharashtra, India: a retrospective study

Background: Highly active anti-retroviral therapy (HAART) became the keystone of national AIDS program. There is lack of awareness and inadequate training about drug safety monitoring among health care professionals in India. Hence, the present study was carried out to study current trends in HAART and pattern of associated adverse drug reactions. Methods: A retrospective observational study was conducted at an anti-retroviral therapy (ART) Centre. A total of 151 HIV/AIDS Patients (old and new cases) receiving HAART during July 2015 to December 2015 were randomly included in the study. Causality and severity assessment of adverse drug reactions (ADRs) was done by using Naranjo’s ADR causality scale and modified Hartwig and Siegel scale respectively. The data was computed using MS Excel and descriptive results were expressed as counts and percentages. The study was approved by institutional ethics committee. Results: The prevalence of HIV/AIDS infection was higher in adult males (51.66%). Zidovudine+lamivudine+nevirapine (ZLN) was the most commonly prescribed HAART combination. Out of 132 ADRs reported, 76.52% of the ADRs were related to haematological system and ZLN was the commonest combination causing ADRs. 90.91% ADRs belong to possible category on causality assessment and 68.94% of the ADRs were of moderate severity. Tuberculosis (28.47%) was the commonest diagnosed opportunistic infection among the HIV/AIDS patients. Conclusions: The prescribing pattern of HAART regimens was in accordance with national guidelines for antiretroviral therapy. We recommend a pharmacovigilance system for sustainable management of ADRs in HIV/AIDS patients as we found under reporting of ADRs.

Pharmacovigilance study in medicine department in a tertiary care hospital

Background: Adverse drug reactions (ADRs) are major worldwide public health problem. Proper reporting of an ADR is very important as it reduces number of deaths due to ADR and extra financial burden on patients. The aim of the study was to assess the pattern of ADR reporting in outpatients and inpatients of medicine department and to assess their causality, severity and preventability. Methods: This was a prospective observational study done from April 2013 to June 2014 or in 100 consecutive study subjects (which ever happen first) with ADRs in department of medicine. The clinical pattern, spectrum of ADRs reported and assessment of ADRs in terms of causality, severity and preventability .The causality, severity and preventability assessment was done on the basis of applying various scales for each of them. Results: A total of 153 suspected ADRs were reported and evaluated from 100 patients. Dermatological system (28%) was most commonly involved. Drug class most commonly associated was Antimicrobials (51%). 68% ADRs were classified as “Probable” in view of causality, while 68% were found to be “Moderate” in case of severity. In 65% of the cases the ADRs was “Probably Preventable”. In majority of the cases the suspected drug was withdrawn and alternate therapy was instituted. Most patients recovered from the ADR.70% of these ADR was Type A. Conclusions: Awareness about ADR reporting is still poor amongst healthcare professionals in India. Conducting regular training programmes can improve the number of ADR reporting.

Indo-Canadian Collaboration for Suicide Prevention: Training Needs Assessment for Healthcare Professionals in India.

The main purpose of the study was to conduct a comprehensive needs assessment of primary healthcare professionals in order to develop a training program aimed at enhancing competencies in suicide risk assessment and management. A total of 144 primary healthcare professionals (physicians=46; primary care workers=98) completed the needs assessment questionnaire. The majority of healthcare professionals rated their level of comfort and competence in assessing, treating, and referring suicidal patients as medium or high. However, their knowledge about suicide, risk factors for suicide, asking about suicidal behaviour, and helping a suicidal patient was rated low or medium. Overall, the scarcity of qualified healthcare professionals and the existing gaps in core competencies for suicide risk assessment and management was identified. Development of innovative and effective competencies-based suicide specific training for primary care providers in India is urgently required.

Assessment of hand hygiene levels among healthcare professionals in India

Introduction: Hand hygiene, either by hand disinfection or hand washing remains to be most pivotal in controlling infection in healthcare settings. Simple preventive measures have been proven effective to contain infections. The exiguity on studies done in healthcare settings in India has galvanized us to undertake this study on hand hygiene assessment among nurses in a healthcare setting in India Materials and methods: A cross sectional study was done in one of leading organization in preventive and promotive healthcare in India. . Hand Hygiene Self-Assessment Framework 2010 by World Health Organization was the tool used for the study. The tool had 5 components envisaging education and training, system change, institutional safety, reminders and evaluation and feedback for hand hygiene. Data was entered in Microsoft Excel and percentages were derived. Results: Among 120 medical rooms, 57% of the medical rooms had basic hygiene, while 32% had intermediate hygiene levels and 11% of the medical rooms had advanced hygiene levels. Conclusion: An advanced level of hand hygiene program with elements of infection control should be offered to the all the professionals working in healthcare setting. Cultural and behavioural issues would play in role in low compliance despite of the efforts to improve quality of healthcare.

Knowledge, attitude, and practice of healthcare professionals about adverse drug reaction in major tertiary care teaching hospital in Punjab

Background: Adverse drug reaction (ADR) has a severe morbidity and mortality associated with it. The safe use of medicines is a critical issue for all healthcare professionals, including physicians, pharmacists, and nurses as well as the public. The main objective of this study was to evaluate the knowledge, attitude, and practice (KAP) of healthcare professionals about ADRs in a tertiary care teaching hospital. Methods: A cross-sectional survey was carried out among the health care professionals in India using a pre-tested questionnaire with 30 questions (18 questions on knowledge, 6 on attitude, 5 on practice, and 1 on training about reporting of ADR). The study was conducted, over a period of 6 months. Results: The questionnaire was distributed to the respondents (n=200). The response rate of 85% was recorded. Among these, only 82 questionnaires were filled in pre-test and 88 questionnaires were filled in post-test after improving awareness through pamphlets. Of the total completed questionnaire (88), 34.88% were filled by physicians, 8.53% by pharmacists, 27.9% by nurses, and 31.3% by medical and paramedical interns. Conclusions: The health care professionals have little KAP toward ADR reporting. Healthcare professionals with higher experience such as (>10 years experience) have better KAP. With additional training on pharmacovigilance, the Indian healthcare professionals working in different sectors can become part of ADR reporting system.