Hospital Patients Research Articles

Incidence of head and neck cancer among Baquba Teaching Hospital Patients

Background: Squamous cells lining the tissues of the head and neck region, such as the nasal cavity, paranasal sinuses, oral cavity, lip, salivary glands, and hypopharynx, give growth to a group of malignancies together recognized as squamous cell carcinoma of the head and neck, which is the seventh utmost communal cancer diagnosis around the world. Objective: Determine the prevalence of head and neck cancer in Diyala province during 2022-2023 and their distribution according to age and gender of patients. In addition, this study aimed to identify the numbers of each type of head and neck cancer. Patients and Methods: A retrospective study achieved on the prevalence of head and neck cancer in the region accomplished in oncology center of Baquba teaching hospital in Diyala province, Iraq. Head and neck cancer patients recorded from 2022 to 2023. During this dated, a total of 172 patients were recorded. A search was accomplished on numerous databases, moreover, the information evaluated by age, gender and cancer type. Results: Regarding patients during 2022 (first group) which is contained of (94) patients with different head and neck cancer, 38(40.4%) were males and 56(59.6%) were females with statistically significant relationship. The patients during 2023 (second group) comprises of (78) patients with different head and neck cancer, 43(50.1%) were men and 35(44.9%) were women with statistically no significant correlation. Conclusion: Oral and pharyngeal cancer is more common in men than in women. The most common age group is 4th and 5th decade for head and neck cancer.

Contextual Factors Influencing Intensive Care Patients' Discharge Processes: A Multicentre Prospective Observational Study.

To compare contextual factors influencing discharge practices in three intensive care units (ICUs). A prospective observational study. Data were collected using a discharge process report form (DPRF) between May and September 2023. Descriptive statistics were performed to analyse demographic and clinical data. One-way analysis of variance (ANOVA) was used to test the time interval differences among the three sites. Overall, 69 patients' discharge processes were observed. Among them, 41 (59%) experienced discharge delay, and 1 in 5 patients experienced after-hours discharge. There were statistically significant differences in mean hours in various time intervals during the discharge processes among the three sites. Patients in Hospital C waited the longest time (mean = 31.9 h) for the ward bed to be ready after the bed was requested and for being eventually discharged after ICU nurses to get them ready for discharge (mean = 26.7 h) compared to Hospital A and Hospital B. We found that discharge delay and after-hours discharge were common and there were significant differences in mean hours of various time intervals during the discharge processes occurred among the three sites. The influence of contextual factors in different hospitals/ICU needs to be considered to improve the ICU discharge process. Researchers and clinicians should consider targeted context-specific interventions and strategies to optimise patient discharge process from ICUs. The study findings will inform the development of tailored interventions to reduce the discharge delay and after-hours discharge and, in turn, improve the quality and safety of patient care and health service efficiency. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Patients' discharge processes were observed, and consumer representatives were involved in the study design.

The impact of chemotherapy on the memory and quality of life of oncology patients in a referral hospital in Recife

The impact of chemotherapy on the memory and quality of life of oncology patients in a referral hospital in Recife

Psychometric properties of the Chinese version of the nurses’ attitudes towards communication with the patient scale among Chinese nurses

BackgroundNurses’ attitudes towards communication with patients influence the effectiveness of communication, which could reduce patients’ negative emotions and improve their adherence to medication and treatment. The aim of this study was to develop a Chinese version of the nurses’ attitudes towards communication with the patient (ACO) scale and examined its validity and reliability.MethodsThe Chinese version ACO scale was generated using the translation-backward translation method and cross-cultural adaption.The psychometric properties of the scale, including item-to-total correlations, discriminative validity, content validity, structural validity, convergent validity, internal consistency reliability and test-retest reliability, were evaluated. Data were collected from a convenience sample of 610 clinical nurses from four hospitals and were analyzed using both exploratory factor analysis and second-order confirmatory factor analysis.ResultThe reliability was demonstrated with item-to-total correlations of greater than 0.40, Cronbach’s alpha of 0.946 and intraclass correlation coefficients of 0.879. Content validity was acceptable and discriminative validity showed a significant discriminative ability. Exploratory and confirmatory factor analyses revealed a three-factor model. Convergent validity was confirmed by a moderate relation with a measure for nurses’ empathy (r = 0.375, P<0.01).The test-retest reliability was satisfactory within a 2-week interval.ConclusionThe ACO is a reliable and valid instrument to assess nurses’ attitudes towards communication with patient in Chinese hospitals.

Determinants of unsuccessful tuberculosis treatment outcome in Southwest Ethiopia regional state public hospitals, 2022: a multi-center case control study.

Tuberculosis is the major cause of morbidity, and it is one of the top ten causes of death globally. In Africa, the overall pooled estimate of unsuccessful tuberculosis treatment outcome was reported to be 21.1%, which is above the World Health Organization defined threshold of 15%. Unsuccessful treatment outcomes result in drug resistance, prolonged periods of infection, and increased morbidity and mortality. Therefore, this study aimed to assess determinants of unsuccessful treatment outcomes among tuberculosis patients in Southwest Ethiopia regional state public hospitals, in 2022. A retrospective unmatched case-control study was employed by recruiting 570 study units (190 cases and 380 controls) in three randomly selected public hospitals from 1 August 2022 to 21 August 2022. Data were collected by using a data extraction checklist adapted from tuberculosis registration logbook. Bivariate and multivariate logistic regression models were employed. A predictor variable with a p-value of less than 0.05 in the multivariate logistic regression model was taken as statistically significant. The odds ratio and 95% confidence level were used to measure the strength of the association. A total of 561 records (187 cases and 374 controls) were included from tuberculosis registers. In this study, the factors independently associated with unsuccessful tuberculosis treatment outcome were older age (AOR = 1.68, 95% CI: 1.142, 2.472), rural residence (AOR = 1.548, 95% CI: 1.055, 2.272), retreatment category (AOR = 2.12, 95% CI: 1.339, 3.357), underweight (BMI < 18.5 kg/m2) (AOR = 1.952, 95% CI: 1.240, 3.071), being HIV positive (AOR = 2.144, 95% CI: 1.372, 3.349) and having no treatment adherence support (AOR = 2.016, 95% CI: 1.270, 3.201). In this study, socio-demographic, clinical, and treatment-related factors contributed to the risk of unsuccessful treatment outcomes. Targeted interventions should be taken into consideration to diminish poor tuberculosis treatment outcomes among high-risk groups throughout the whole tuberculosis treatment course.

Epidemiology and Antibiotic Resistance Patterns of Klebsiella pneumoniae Infections Among Male Patients in a Long-Term Care Hospital in Riyadh, Saudi Arabia: A Retrospective Study

Epidemiology and Antibiotic Resistance Patterns of Klebsiella pneumoniae Infections Among Male Patients in a Long-Term Care Hospital in Riyadh, Saudi Arabia: A Retrospective Study

Study the Level of Patients’ Service Satisfaction of Luang Prabang Provincial Hospital

The purpose of this research was to study the level of patients’ service satisfaction of Luang Prabang provincial hospital and comparison of patients’ service satisfaction classified by personal information of Luang Prabang provincial hospital. The samples of this study were 385 patients and their relatives who received services at the Luang Prabang provincial hospital. The research were using the questionnaire as a tool to collect data. Data were analyzed by using mean, standard deviation, T-test, F-test (One-way ANOVA). Finding indicated that the overall opinion on service satisfaction was at a median level patient in Luang Prabang provincial hospital. The respondent with different personal demographic data by sex, status, age, education, occupation, income, and types of patient care; were no different in service satisfaction; but the respondent with different personal demographic data by who services at each unit were different in service satisfaction.

Efficacy and safety of tenofovir amibufenamide in the treatment of patients over 65 years of age with chronic hepatitis B

Objective: To investigate the efficacy and safety of tenofovir amibufenamide in patients over 65 years old with chronic hepatitis B and liver cirrhosis. Methods: We recruited 45 patients in Linyi People's Hospital with chronic hepatitis B and liver cirrhosis who were treated with TMF antiviral therapy for 48 weeks, compared the virologic response rate and HBV DNA decrease level at 12, 24 and 48 weeks, and the changes in hepatitis B surface antigen, alanine aminotransferase, glomerular filtration rate, creatinine, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, serum phosphorus and blood lipids, and the changes in ALT normalization rate at 48 weeks. P<0.05 was statistically significant. Results: The age of the enrolled patients was 69.0 (67.0, 72.5) years. At 12, 24, and 48 weeks of treatment, the complete virological response rates were 32.4% (12/37), 70.0% (28/40), and 84.6% (33/39) respectively, and the level of HBV DNA decreased from baseline (P＜0.05). After 48 weeks of treatment, the level of HBsAg decreased (P<0.05), and there was no negative HBsAg conversion and seroconversion. After 48 weeks of treatment, the level of ALT decreased (P<0.05). At 48 weeks of treatment, the rates of ALT reverted to normality were 88.9% (16/18) and 70.4% (19/27), respectively. There was no significant difference in the levels of glomerular filtration rate, creatinine, phosphorus, triglycerides, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol estimated at baseline before and after treatment (P＞0.05), and no serious adverse events were observed. Conclusions: For patients over 65 years old with chronic hepatitis B and liver cirrhosis, TMF can significantly inhibit HBV DNA replication, and the ALT normalization rate is high and well tolerated.

Episodic syndromes associated with migraine (clinical and epidemiological study in pediatric practice)

Migraine in children can manifest itself in non-pain clinical phenotypes, among which several episodic syndromes associated with migraine (ESAM) are identified. A significant association with the later development of migraine was found for infantile colic syndrome, benign torticollis, abdominal migraine (AM), cyclic vomiting syndrome (CVS) and benign paroxysmal vertigo (BPV).Objective: to identify the clinical and epidemiological characteristics of childhood ESAM and its association with migraine.Material and methods. The study was conducted in Tambov Children's Clinical Hospital. A total of 250 children were included in the study: 120 (48%) girls and 130 (52%) boys aged 5 to 18 years (mean age 13±2.9 years, median age 13 [11; 15] years) with headache complaints. The diagnosis of ESAM was made according to the ICHD-3 criteria.Results. ESAM was observed in 95 (38%) patients aged 5–18 years. An analysis of the prevalence of ESAM in the different age groups showed that in children aged 5–10 years CVS (n=12; 4.8%) was more common than AM (n=6; 2.4%) and BPV (n=5; 2%). In the group of 11–14 year-old children, the frequency of AM clearly predominated (n=11; 4.4%), while in the group of 15–18 year-old adolescents, BPV (n=15; 6%) was observed more frequently compared to CVS (n=9; 3.5%) and AM (n=5; 2%).Conclusion. The results of the study indicate a high incidence of ESAM in child and adolescent patients of somatic and neurological hospitals. The data obtained show the importance of timely diagnosis and correct treatment of ESAM.

Dietary Probiotic Pediococcus acidilactici GKA4, Dead Probiotic GKA4, and Postbiotic GKA4 Improves Cisplatin-Induced AKI by Autophagy and Endoplasmic Reticulum Stress and Organic Ion Transporters.

Acute kidney injury (AKI) syndrome is distinguished by a quick decline in renal excretory capacity and usually diagnosed by the presence of elevated nitrogen metabolism end products and/or diminished urine output. AKI frequently occurs in hospital patients, and there are no existing specific treatments available to diminish its occurrence or expedite recovery. For an extended period in the food industry, Pediococcus acidilactici has been distinguished by its robust bacteriocin production, effectively inhibiting pathogen growth during fermentation and storage. In this study, the aim is to assess the effectiveness of P. acidilactici GKA4, dead probiotic GKA4, and postbiotic GKA4 against cisplatin-induced AKI in an animal model. The experimental protocol involves a ten-day oral administration of GKA4, dead probiotic GKA4, and postbiotic GKA4 to mice, with a cisplatin intraperitoneal injection being given on the seventh day to induce AKI. The findings indicated the significant alleviation of the renal histopathological changes and serum biomarkers of GKA4, dead probiotic GKA4, and postbiotic GKA4 in cisplatin-induced nephrotoxicity. GKA4, dead probiotic GKA4, and postbiotic GKA4 elevated the expression levels of HO-1 and decreased the expression levels of Nrf-2 proteins. In addition, the administration of GKA4, dead probiotic GKA4, and postbiotic GKA4 significantly reduced the expression of apoptosis-related proteins (Bax, Bcl-2, and caspase 3), autophagy-related proteins (LC3B, p62, and Beclin1), and endoplasmic reticulum (ER) stress-related proteins (GRP78, PERK, ATF-6, IRE1, CHOP, and Caspase 12) in kidney tissues. Notably, GKA4, dead probiotic GKA4, and postbiotic GKA4 also upregulated the levels of proteins related to organic anion transporters and organic cation transporters. Overall, the potential therapeutic benefits of GKA4, dead probiotic GKA4, and postbiotic GKA4 are significant, particularly after cisplatin treatment. This is achieved by modulating apoptosis, autophagy, ER stress, and transporter proteins to alleviate oxidative stress.

Alice in Wonderland Syndrome in Children With Severe Acute Respiratory Syndrome SARS-CoV-2 Infection: A Case Series of Two Patients in an Italian Hospital

BackgroundAlice in Wonderland syndrome (AIWS) is a disorienting neurological condition that affects human perception to the senses of vision, hearing, touch, and sensation and the phenomenon of time. Herein we report two pediatric cases of AIWS temporally related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Case presentationAn eight-year-old-girl without history of migraine or epilepsy experienced some episodes of visual distortions (micropsia, macropsia, and teleopsia) and misperception of sound, sometimes associated with headache. The onset of symptoms began at the occurrence of fever (38°C), during SARS-CoV-2 infection. Another six-year-old girl, with no history of migraine or epilepsy, experienced short-term episodes of visual (metamorphopsia) and color disturbance (chromatopsia), during an otherwise asymptomatic SARS-CoV-2 infection. In both cases, clinical examination was unremarkable; surface electroencephalography showed normal findings, without any correlation between visual phenomena and cortical activity; and brain magnetic resonance was normal. The patients were given symptomatic treatment, consisting of anti-inflammatory drugs on demand. The frequency of episodes decreased progressively following a negative SARS-CoV-2 test, with full remission in a few weeks. At the moment of hospital admission, none of the patients had completed the two-dose vaccination schedule for SARS-CoV-2. ConclusionBased on our clinical experience, we believe SARS-CoV-2 may be responsible for AIWS, in addition to other neurological symptoms more frequently documented in the literature. Pathogenesis is multifactorial and arises from the activation of inflammatory pathways. We therefore suggest also searching for SARS-CoV-2, among other viruses linked with AIWS, in children presenting with visual and/or auditory hallucinations, even as isolated symptoms.

Factors affecting time to recovery from diabetic ketoacidosis in adult diabetic patients in Alexandria Main University Hospital

BackgroundDiabetic ketoacidosis (DKA) is a life-threatening condition as a complication of diabetes and represents a significant healthcare global burden. The current study goal was to determine factors affecting time to recovery from DKA in Alexandria Main University Hospital.Patients and methodsOne hundred fifty patients who had been admitted with DKA were included in this study. All patients were managed with hospitalization for IV fluids, continuous intravenous insulin infusion, electrolyte correction, as well as detection and treatment of the predisposing factor until the full resolution of DKA.ResultsMales contributed to 58.7% of the total patients in this study with a mean age of 32.16 ± 15.06 years. DKA mean time of resolution was 18.76 ± 14.07 h. The majority of patients were with T1DM (86%), while T2DM were 14%. Missed insulin dose was the leading precipitating factor (60.7%) followed by infections (38.7%). There was a statistically significant relationship between DKA resolution time with age, time of presentation, type of diabetes, initial pH, initial serum K+ level, initial HCO3− level, initial anion gap, initial base excess, and initial RBS (p value < 0.001).ConclusionDelayed time of resolution from DKA was associated with initial lower pH, initial lower HCO3− level, initial lower base excess level, initial higher anion gap level, type 2 diabetes mellitus, patients on pre-mixed insulin regimen, old patients, delayed time for seeking medical care, and abnormal serum K+ level.

General hospital patients’ attitude towards systematic health risk behavior screening and intervention

BackgroundSystematic counseling on behavioral health risk factors (HRFs) may be suitable to promote health among general hospital patients. This study aimed to investigate the openness of patients towards systematic screening and intervention of HRFs, its relation to actual participation in a multi-behavioral intervention, and whether socio-economic characteristics, HRFs and health indicators are related to approval.MethodsAll 18- to 64-year-old patients hospitalized in five medical departments at the University Medicine Hospital Greifswald in Germany were asked between May and July 2022 to participate in a survey and in a subsequent pre-post intervention study. Among all eligible patients, 225 (78.9%) participated in the survey. Patients’ approval of systematic screening and intervention of HRFs was assessed using five statements with a total sum score of 0–20 (i.e., scores of 0–6, 7–13, 14–20 referring to low, medium and high approval). Associations with intervention participation, socio-economic, behavioral and health-related patient characteristics were analyzed using logistic and multivariable linear regression analyses.ResultsThe mean total approval of screening and intervention was 13.8 (SD = 4.8). Of the 125/ 73/ 16 patients with high/ medium/ low approval, 88.0%/ 78.1%/ 50.0% participated in the subsequent intervention, respectively. Approval was independent of socio-demographic and -economic characteristics and self-rated general health. Current tobacco smoking was the only HRF negatively (p = 0.02) and diabetes mellitus was the only disease positively (p = 0.01) associated with approval.ConclusionHigh approval of HRF screening, which was rather independent of socio-economic characteristics and worse self-rated general health, speaks in favor of proactively approaching and motivating all general hospital patients to participate in health behavior change intervention. Tobacco smokers might need higher efforts to motivate participation than non-smokers.Trial registrationClinicalTrials.gov Identifier NCT05365269 on May 9, 2022.

Structural equation modeling analysis of factors influencing decisional conflict between dialysis modality among end-stage kidney disease patients in Wuhan

ObjectivesTo explore the influencing factors and relationships associated with decisional conflict of dialysis modality in End-stage kidney disease (ESKD) patients.MethodsThis study was a survey-based cross-sectional investigation conducted on 150 ESKD patients in a third-class hospital in Wuhan. The general information questionnaire, decisional conflict scale, Montreal cognitive assessment, frail scale, perceived social support scale, and brief health literacy screen were used for investigation. SPSS 25.0 was used to compare the differences between the decisional and non-decisional conflict groups, and AMOS 23.0 was used to construct a structural equation model to explore the influencing factors.ResultsThe incidence of decisional conflict in 150 ESKD patients was 33.3% (50/150). Binary logistic regression analysis showed that the independent risk factors for decisional conflict of dialysis modality in ESKD patients included monthly household income (OR = 0.184), cognitive function (OR = 7.0), social support (OR = 0.891), health literacy (OR = 0.608), the level of eGFR (OR = 1.488), and the level of cTnI (OR = 9.558). The constructed path analysis model had a good fit (x2/df = 1.499, GFI = 0.957, AGFI = 0.911, NFI = 0.906, CFI = 0.967, RMSEA = 0.055). The path analysis showed that health literacy (0.577) had the greatest impact on the decisional conflict, with a direct effect of 0.480 and an indirect effect of 0.097 through cognitive function and monthly household income. Next was social support, with an effect value of 0.434.ConclusionsIn clinical practice, it is important to enhance the health literacy of patients and their families and to provide advanced education on dialysis plans. Additionally, in managing and planning chronic kidney disease progression and dialysis, it is recommended to regularly and systematically assess cognitive function, particularly before the patient’s cognitive impairment worsens or the severity of the disease progresses. Advanced care planning can be established through collaboration between healthcare professionals and patients to ensure appropriate decision-making and management.Implications for the profession and patient careThis paper finds that the factors that influence and relate to dialysis methods in end-stage renal disease patients help nurses exercise autonomy better, assist patients in reducing their decisional conflict, and improve clinical outcomes.Patient or public contributionPatients received a relevant questionnaire survey, and caregivers assisted in conducting the study.

Identifying Candida auris transmission in a hospital outbreak investigation using whole-genome sequencing and SNP phylogenetic analysis.

Candida auris poses a global public health challenge, causing multiple outbreaks within healthcare facilities. Despite advancements in strain typing for various infectious diseases, a consensus on the genetic relatedness threshold for identifying C. auris transmission in local hospital outbreaks remains elusive. We investigated genetic variations within our local isolate collection using whole-genome-based single nucleotide polymorphism (SNP) phylogenetic analysis. A total of 74 C. auris isolates were subjected to whole-genome sequencing (WGS) and SNP phylogenetic analysis via the QIAGEN CLC Genomics Workbench. Isolates included known related strains from the same patient, strains from different hospitals, strains from our hospital patients with no epidemiological link, and 19 patient isolates from a recent C. auris outbreak. All but three isolates were identified to be Clade IV. By examining the genetic diversities of C. auris within patients and between patients, we identified a SNP variation range of 0-13 for identifying related isolates. During an outbreak investigation, utilizing this range, maximum likelihood phylogenetic analysis revealed two distinct clusters that aligned with the epidemiological links. Determining a SNP variation range to delineate genetic relatedness among isolates is crucial for the application of WGS and SNP phylogenetic analysis in identifying C. auris transmission during hospital outbreak investigations. The use of WGS SNP phylogenetic analysis via the CLC Genomics Workbench has emerged as a valuable method for typing C. auris in clinical microbiology laboratories.

Prevalence and Risk Factors Associated with Benign Prostate Hyperplasia among Elderly Patients in Baidoa Hospitals in Somalia Cross Sectional Study

Background The disorder known as benign prostatic hyperplasia (BPH) is closely linked to ageing. Its clinical presentation as lower urinary tract symptoms (LUTS) lowers the patient's quality of life, despite the fact that it is not life- threatening. Among males over 65, up to 30% may experience problematic LUTS.  Objectives of the Study The aim of this study is to determine the prevalence and risk factors contributing benign prostate hyperplasia among elder patients in Baidoa hospitals in Somalia.  Materials and Methods The study design was a hospital based cross sectional study.  Results The prevalence of BPH shows that 19.01 % of the participants were becomes BPH while the remaining majority 80.99 was not. The age, the largest group is those aged 70-79 years, with 157 participants, representing 40.9%. In terms of family history of (BPH), 310 participants (80.7%) reported no family history, while 74 individuals (19.3%) indicated that they do have a family history of BPH. Examining systemic diseases, 51 participants (13.2%) have diabetes mellitus, and 67 individuals (17.3%) have hypertension. A smaller subset, 26 participants (6.7%), reported having both diabetes and hypertension. Regarding physical exercise, 310 individuals (80.7%), reported not engaging in regular physical activity, while only 74 participants (19.3%) they do exercise.  Conclusion In summary, the data and reports from this study point to a 19.01% prevalence of benign prostatic hyperplasia (BPH). The development of BPH is significantly predicted by age. Bivariate chi-square analysis revealed a significant link between BPH and erectile dysfunction, kidney illnesses, diabetes mellitus, and urine retention (p-value &lt;0.05). On the other hand, bivariate chi-square analysis revealed a significant relationship between BPH and being overweight and frequently consuming caffeine (p-value &lt;0.05). Diet and lifestyle could be factors in this.  Recommendations Lifestyle and behavioral interventions are reasonable first-line treatments for all patients. Straightforward interventions include limiting intake of the following: fluids prior to bedtime or travel; mild diuretics, such as caffeine and alcohol; and bladder irritants, such as highly seasoned or irritative foods. Older be aware that blocking of the urethra (the urine tube): As the prostate grows larger, it may block the bladder outlet and stop the bladder from emptying. In some cases, urine may get stored up until it starts to leak out. If this happens, see a doctor straight away, so the patients should urinate quickly before experiencing any problem.

Fall prevention among psychiatric patients in an Iranian hospital: a best practice implementation project.

Falls are the main cause of disability among psychiatric patients, as well as being the most common adverse event in hospitals. The aim of this evidence implementation project was to improve fall prevention and management among psychiatric patients in a neurology ward in an Iranian tertiary psychiatric hospital. This project used the JBI Evidence Implementation Framework, which recommends an audit, feedback, and re-audit strategy. A baseline audit was conducted to evaluate current fall prevention practices among 50 psychiatric patients and 20 health care professionals. The baseline audit was used to identify gaps in compliance. After the implementation of improvement strategies, a follow-up audit was conducted to measure any changes in practice. The baseline and follow-up audits revealed that compliance with best practices improved in ward transfer fall risk assessment (Criterion 2: 87% to 90%), patient participation in fall risk assessment (Criterion 3: 95% to 96%), revising patient fall risk status (Criterion 9: 50% to 86%), and person-centered education of health care providers (Criterion 11: 78% to 96%). Other audit criteria remained unchanged. However, for Criterion 6 on patient engagement in goal-setting and treatment planning, compliance dropped from 100% at baseline to 94% at follow-up. This project successfully increased evidence-based practices regarding fall prevention and management, as well as providing mechanisms for sustaining the practice changes. Future audits are required to further improve outcomes. http://links.lww.com/IJEBH/A267.

The Greek version of the Richards‐Campbell Sleep Questionnaire: Reliability and validity assessment

Background: The lack of sleep is a significant concern for ICU patients, necessitating effective sleep-promoting interventions by nurses. A user friendly and reliable tool is essential for Greek nurses to evaluate the impact of these interventions on patients' sleep. This study aimed to translate the Richards Campbell Sleep Questionnaire (RCSQ) into Greek and ascertain the reliability and validity of this version in measuring sleep quality among ICU patients in a Greek hospital. Method and Material: The study assessed the night-time sleep of 50 patients in the general ICU of a tertiary hospital in Athens, Greece, from January 2022 to March 2023. The translation of the RCSQ into Greek adhered to all guidelines for translating and adapting psychometric scales. The reliability of the RCSQ scale was tested using Cronbach's alpha (𝛼). Results: The study included 32 male and 18 female patients. Cronbach's alpha (𝛼) was calculated to be 0.906, indicating excellent reliability for the RCSQ. The overall mean RCSQ score was 52.8 (SD=15.41), ranging from 12 to 78. About 60% of participants reported "good sleep", while 8% experienced "very poor sleep". Conclusion: The assessment of patient sleep should utilize a valid and reliable instrument. The Greek version of the RCSQ shows great promise for use in Greek hospital settings. It is concise, user-friendly, and comprehensible, and it has demonstrated reliability and validity in capturing various sleep domains, thereby providing a comprehensive assessment of sleep akin to the original version.

Clinical Features and Risk Factors for Outcome in Hemodialysis Patients with COVID-19 after Complete Liberalization of Epidemic Control in China

Introduction: Patients undergoing hemodialysis (HD) are highly vulnerable during the COVID-19 pandemic. We aimed to investigate the risk factors associated with the severity of COVID-19 and death after the complete liberalization of epidemic control in China. Methods: We followed the outcomes of the HD patients of Central Hospital of Dalian University of Technology, from December 6, 2022, to January 8, 2023. The non-contrast-enhanced chest computed tomography (CT) was performed on all COVID-19-infected hospitalized patients. We recorded the patient’s clinical characteristics, demographic features, vaccination history, treatments, and lung lesions. Odds ratios and 95% confidence intervals were calculated using logistic regression models to identify independent risk factors for COVID-19-related severity and mortality. Results: This study included a total of 858 HD patients, of which 660 were infected with COVID-19. The mean age was (55.61 ± 14.61) years, with a median (interquartile range) dialysis duration of 44.5 (69.5) months. Over half (60%) of the study participants were male, and the majority had hypertension as a comorbidity. Multivariable analysis revealed that age, pre-dialysis diastolic pressure, fever, white blood cell (WBC) count, potassium, β2-microglobulin level, and calcium were independent risk factors for disease severity, while platelets, urea nitrogen, serum chlorine and creatinine were identified as independent protective factors. Furthermore, total iron-binding capacity and vaccination were found to be independent protective factors against mortality, and WBC count was an independent risk factor for in-hospital mortality (p < 0.05). The most frequent CT finding among hospitalized patients with chest symptoms was patchy shadow or pleural effusion, observed in 64.8% of cases. More than half of the patients exhibited bilateral lung lesions, and over 60% involved two or more lobes. Conclusion: The majority of HD patients are susceptible to COVID-19. Demographic, clinical features, and laboratory indicators can be used to predict the severity and mortality associated with COVID-19. Our findings will assist clinicians in identifying markers for the early detection of high mortality risk in HD patients with COVID-19.

Review on Acute Reactions while Administration of Intravenous Medications

The most common invasive procedure that patients admitted to hospital wards likely undergo is intravenous (IV) access. Medications through IV fluid injection is administered to up to 80% of hospital patients. Certain medications, such as phenytoin, vancomycin, ampicillin/sulbactam combinations, steroids, and cefotaxime, might result in abrupt responses when intravenous fluids are administered. antibiotics such as mitomycin, daunorubicin, dactinomycin, and doxorubicin. Antineoplastic drugs such as methotrexate, cyclophosphamide, etoposide, vinorelbine, carboplatin, oxaliplatin, paclitaxel, and epirubicin. Dopamine, noradrenaline, amiodarone, adrenaline, and pituitrin are examples of inotropic substances. Bevacizumab, Cisplatin, Heparin, Glucocorticoids, Tamoxifen, Testosterone, and Antidepressants. When administering IV medication, Clinical Pharmacist are crucial in identifying and reporting drugs that cause acute responses. Clinical Pharmacist can be involved because they can be crucial in ensuring safe pharmaceutical use in hospitals.