Role Of Health Care Personnel Research Articles

IJCM_38A: Impact of perinatal death audit on healthcare delivery in two districts of Karnataka- A health system intervention research

Background: Perinatal mortality is a sensitive indicator of maternal and child health care. However, there is no universal perinatal death (PND) audit system in India. Objective: To identify the impact of the proposed model of PND audit on health care delivery in two districts of Karnataka. Methodology: Hospitals with maternal and child care facilities which met inclusion criteria in Dakshina Kannada (DK- high performing) and Koppal (low performing) districts were included after institutional ethics committee approval and permission from Mission Director, National Health Mission, Directorate of Heath and Family Welfare Services, Government of Karnataka. The healthcare delivery system was analyzed in both districts. A PND audit system was designed. All neonatal deaths during the study period were analyzed by an expert committee (Local senior pediatricians and obstetricians). Following variables were studied: (i) Documentation and reporting systems in these hospitals; (ii) Role of health care personnel in documentation and reporting (iii) Existing system of audit, if any. Doctors feedback, in-depth interviews, death certification analysis, risk analysis, PND reporting format, expert committee feedback, medical social worker feedback, data from district health office were recorded and analysed. The changes in documentation, information yield, reporting of PND, time taken for submitting death report and changes in infrastructure in facilities in the two time periods of 6 months was analysed. Results: Significant changes were recorded in documentation of care delivered in the facility specially in Koppal district. There was an increase in reporting of PND in the second half. The PND audit assisted in preventability of death assertion. Improved data resulted in better performance of expert committee, thereby reducing the proportion of unclassified segment of neonatal deaths. There was significant improvement in infrastructure in the health facilities. Conclusion: Auditing perinatal deaths had a positive impact at point of care resulting in improved documentation, reporting and infrastructure upgradation.

1164. Acquisition of Methicillin-Susceptible Staphylococcus aureus in the Neonatal Intensive Care Unit: Molecular Comparison of Relatedness of Isolates

BackgroundIn the NICU MSSA infections occur frequently and cause morbidity and mortality. Colonization is a risk factor for infection. Optimal infection prevention strategies await a more complete understanding of acquisition and transmission. To investigate possible transmission, we studied whether newly MSSA colonized infants share a strain with another contemporaneously colonized infant.MethodsThis is a prospective observational study in a level IV NICU from April through November 2019. Infants had weekly MSSA nasal surveillance cultures. Isolates from newly MSSA colonized infants and other infants colonized with MSSA during the same/previous week were subjected to staphylococcal protein A (spa) typing; most pairs with a concordant (CC) spa type were analyzed by whole genome sequencing (WGS; Illumina MiSeq). Pairs of isolates with a CC spa type and < 25 single nucleotide polymorphism differences on WGS were considered closely related (CC pairs). A control group consisted of pairs of isolates from a newly colonized infant with one randomly chosen colonized infant with a discordant (DC) spa type during the same/previous week. The medical records were reviewed for staff member (SM) and room assignment. Fischer’s exact test was used to compare proportions.ResultsIsolates from 60/68 consecutive newly MSSA colonized infants and 111/133 comparison infants were available for spa typing. Of these 60 infants, 23 (38 %) had a CC spa type with another infant colonized during the same/previous week. Of 18 isolate pairs from infants with a CC spa type that were subjected to WGS, 12 (67%) pairs of isolates were closely related. 7/12 (58 %) of CC pairs had a SM in common compared to 2/13 (15 %) in the DC pair groups, p=0.04. 2/12 (17 %) of CC pairs shared a room compared to 2/13 (15 %) pairs in the DC group, p=1.0.ConclusionAmong newly MSSA colonized infants at least 25% are colonized with an isolate closely related to that of another colonized infant indicating likely infant to infant transmission. WGS is more discriminatory than spa typing for MSSA. Given the lack of commonality of room assignment and the commonality of SM assignment, a possible role of healthcare personnel in MSSA transmission should be further investigated.Disclosures Anne-Catrin Uhlemann, MD, PhD, Merck (Grant/Research Support)

The Role of Healthcare Personnel in Delivering Healthcare Interventions for High Blood Pressure: A Desk Review of Available Evidence

Hypertension is worldwide major cause of morbidity and mortality due to cardiovascular diseases. Globally, hypertension is responsible for 300 million years of life lost (YLL) and cause to contribute more than 35 million years for disability adjusted life years (DALYs) [1].

Documentation and Reporting of Perinatal Deaths in Two Districts of Karnataka, India: A Situational Analysis

In Karnataka state, perinatal mortality rate is almost equal to infant mortality rate. This preliminary study was conducted in two districts of Karnataka to study potential problems to start of perinatal death audit. Hospitals providing maternal and child health care services, which met study inclusion criteria, in Dakshina Kannada and Koppal Districts were included. Following variables were studied: (i) Documentation and reporting systems in these hospitals; (ii) Role of health care personnel in documentation and reporting (iii) Existing system of audit, if any. Totally 94 hospitals met our criteria with Dakshina Kannda District having 63 (67.02%) and the rest in Koppal District. Documentation and reporting was poor in Koppal District and inadequate in Dakshina Kannada district. Health care personnel were apprehensive about perinatal death audit. Problems identified need to be addressed before starting perinatal death audit.

A study of knowledge and behaviour regarding blood donation among medical college students of Ajmer, Rajasthan, India

Background: Blood is specialized body fluid in humans that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from that same cells.Methods: The study was conducted among undergraduate medical students of J.LN. Medical College, Ajmer, Rajasthan, India in March 2019. It was a descriptive cross‑sectional study among 1st professional MBBS students.Results: The study participants included age range of 17-20 years. 96 (78.04%) study participants were knows blood group “O” is a universal donor and 94 (76.42%) were know blood group “AB” is universal recipient. majority of study participants 48 (45.28%) not donate due to fear of procedure.Conclusions: Role of health care personnel and medical students of a medical college for blood donation are pivotal.

Ergonomics and the Musculoskeletal Disorders in the Work of Nurses

Ergonomics in healthcare industry is still in its early stages. The role of healthcare personnel is to take care of population's health. This is why it is very important to care about healthcare personnel. First, this article is a presentation of a survey conducted in Slovakia. The survey focused on nurses working in inpatient departments. Therefore, the main objective was to verify the physical nursing workload and determine the most frequent musculoskeletal disorders of nurses. The survey was conducted by using the Nordic Questionnaire. The results of the survey confirm the most serious difficulties for nurses with a musculoskeletal apparatus. Moreover, the results also show pain-related dependence in one body part of a nursing professional depending on his or her profile. The second part of the article shows model situations that may occur in nursing work and the physical loading they impose on health of nursing professionals.

THE THEORETICAL AND PRACTICAL ASPECTS OF APPLYING MEDICAL SOCIAL ON-LINE SERVICES IN MANAGEMENT OF REHABILITATION OF PATIENTS OF TRAUMATOLOGICAL ORTHOPEDICS PROFILE

The issue of digital technologies implementation in practice of health care becomes one of the priorities in the conditions of resources deficiency. The digitalization of health care system is economically expedient as it allows achieving particular medical and social results without significant infrastructural investments. The on-line communication possesses significant potential in this regard. The digital health care using on-line communication democratizes access to medical services and allows to qualitatively remodel the existing model of interaction between patient and health care system. In the sociology of medicine, the sociology of rehabilitation is selected to investigate such issues as social and organizational context of rehabilitation, social orientation of medical care, role of health care personnel and other interested specialists. The article substantiates the efficiency of on-line communication in management of rehabilitation of patients as exemplified by the Monitoring and Feedback System designed and introduced in the Research Institute of Traumatology, Orthopedics and Neurosurgery of V.I. Razumovsky Saratov State Medical University.

The role of healthcare personnel in the maintenance and spread of methicillin-resistant Staphylococcus aureus

Healthcare workers may acquire methicillin-resistant Staphylococcus aureus (MRSA) from patients, both hospital and home environments, other healthcare workers, family and public acquaintances, and pets. There is a consensus of case reports and series which now strongly support the role for MRSA-carrying healthcare personnel to serve as a reservoir and as a vehicle of spread within healthcare settings. Carriage may occur at a number of body sites and for short, intermediate, and long terms. A number of approaches have been taken to interrupt the linkage of staff-patient spread, but most emphasis has been placed on handwashing and the treatment of staff MRSA carriers. The importance of healthcare workers in transmission has been viewed with varying degrees of interest, and several logistical problems have arisen when healthcare worker screening is brought to the forefront. There is now considerable support for the screening and treatment of healthcare workers, but it is suggested that the intensity of any such approach must consider available resources, the nature of the outbreak, and the strength of epidemiological associations. The task of assessing healthcare personnel carriage in any context should be shaped with due regard to national and international guidelines, should be honed and practiced according to local needs and experience, and must be patient-oriented.

Factors associated with influenza vaccination coverage among the elderly:role of health care personnel

Factors associated with acceptance of influenza vaccination in an elderly population were investigated in order to find ways of improving vaccination coverage. Three administrative districts with different vaccination coverages were selected, and a random sample of 10 percent (N = 497) of the elderly population living outside institutions was taken from the official lists maintained by the Central Statistical Office. The data were collected by means of a postal questionnaire. The questionnaire inquired about influenza vaccination status during the autumn 1992 campaign, demographic factors, health status, previous experiences and beliefs about influenza vaccination and influenza as a disease, and source of information about the vaccination campaign. The highest positive associations were found between a high influenza vaccination acceptance rate and the perceived need for vaccination (Relative risk (RR) 4.6, 95% confidence interval (CI) 2.7-7.9), belief in its effectiveness (RR 3.6, 95% CI 2.1-6.1) and information received from health visitors (RR 2.2, 95% CI 1.8-2.6). Vaccination acceptance was negatively associated with a belief in its adverse effects, (RR 0.4, 95% CI 0.2-0.6). Information received from health visitors was associated with more frequent occurrence of positive beliefs about influenza vaccination and with higher acceptance of vaccination irrespective of positive or negative beliefs regarding it. In order to obtain high vaccination coverage health care personnel should be carefully informed about the importance of influenza vaccination and encouraged to inform the public.