Pamela Youde Nethersole Eastern Hospital Research Articles

Evidence of clonal dissemination of multidrug-resistant Streptococcus pneumoniae in Hong Kong.

The relationship between the phenotypic and genotypic characteristics of 105 penicillin-intermediate or -resistant Streptococcus pneumoniae isolates saved during 1994 to 1997 at the Prince of Wales Hospital and Pamela Youde Nethersole Eastern Hospital, Hong Kong, was studied. The pbp genes for penicillin-binding proteins 1a, 2b, and 2x for each isolate were amplified by PCR, and the products were digested with restriction enzymes HinfI and AluI. A combination of the pulsed-field gel electrophoresis (PFGE) profiles, pbp fingerprints, and phenotypic characteristics of capsular types and antibiograms enabled these isolates to be divided into four major groups. Seventy-four percent (78 of 105) of the strains, belonging to serotypes 23F, 19F, and 14, showed indistinguishable pbp fingerprint patterns (group A1, 1-1-1, 1-1-1), with PFGE patterns belonging to group A and its subtypes, suggesting that these strains were closely related. Eighty-three percent (65 of 78) of these isolates were also resistant to tetracycline, erythromycin, chloramphenicol, and trimethoprim. The type 23F isolates were indistinguishable from representative strains of the Spanish 23F clone by these molecular methods, indicating that these strains may be variants of the Spanish 23F clone. Serotype 6B accounted for 19% (20 of 105) of the isolates with reduced penicillin susceptibility and was made up of variants belonging to four different pbp fingerprint groups with the PFGE pattern group B, the predominant group being indistinguishable from that of the Spanish 6B clone. Other PFGE and fingerprint groups were mainly obtained from penicillin-susceptible strains of various serotypes. The results suggest that the rapid emergence of drug-resistant S. pneumoniae in Hong Kong has been due to the rapid dissemination of several successful clones.

Managing change: facilities management at the Pamela Youde Nethersole Eastern Hospital

Increasing budget constraints, the introduction of new clinical protocols and technologies, and changing community needs and expectations are changing Hong Kong’s health care system. These unprecedented changes are creating powerful and urgent needs for many of Hong Kong’s hospitals to explore alternative approaches to designing and managing their hospital environments. The paper starts by reviewing these changing conditions and then suggests that hospital facilities management professionals must think and act anew. The paper concludes that hospital administrators at the Pamela Youde Nethersole Eastern Hospital in Hong Kong are responding to these corporate challenges by developing a facilities management support response.

A disaster drill in Hong Kong

This case report relates the course of a disaster drill held on 19 August 1994 in a regional acute hospital (Pamela Youde Nethersole Eastern Hospital) in Hong Kong. The Hospital Civil Disaster Contingency Plan (the Plan) was put to trial on that day. Volunteers were invited to become simulated casualties in the exercise. Briefing seminars had been conducted with clinicians of the Accident and Emergency department (A & E) and other departments of the hospital. The scenario was a man-made type disaster. A double-decker bus turned over and injured 19 people in that afternoon. All the victims were sent to A & E by ambulance. The Plan was activated and relevant units were mobilized according to the Plan. It took 45 minutes to complete the disaster exercise. Debriefing sessions reviewed difficulties encountered throughout the drill and possible remedies.

Accuracy and efficiency of X-ray requests initiated by triage nurses in an accident and emergency department

A study was carried out from 1 March 1995 to 31 May 1995 in the Accident & Emergency department, Pamela Youde Nethersole Eastern Hospital, Hong Kong. The aim was to assess the feasibility of requesting X-rays by triage nurses based on a pre-set protocol prior to patients being seen by a doctor. Judgement of the attending physician was used as the gold standard by which to judge the need for radiographs requested by the triage nurse. In addition, the senior medical officer or consultant would judge whether the triage nurse had applied the protocol correctly. A total of 934 patients were included in the study and 883 (94.54%) patients had X-ray requested by the triage nurse. Only 5.44% of the radiographs requested by nurses were considered to have been unnecessary by the doctor. There was no statistically significant difference in agreement for the child and adult groups. In 917 (98%) of cases, nurses had adhered to the protocol. A saving of an average of 18.59 minutes of total service time was obtained during the study. Requesting of X-ray by triage nurses was feasible and could decrease total service time.