AUTHOR LOGIN Close
Please enter author credentials to view Author Manual
Username:
Password:  
   
for New Author Registration
JAYPEE JOURNALS
International Scientific Journals from Jaypee
IndexCopernicus Value: 81.58
Home Instructions Editorial Board Current Issue Pubmed Archives Subscription Advertisement Contact Us
 
LOGIN  
Username: Password:
 
New Author Registration | Forgot Password ?
 
 
 
Most Downloaded Articles of the Journal
 
 
List of All Articles
1.  ORIGINAL ARTICLE
A Small Nudge can make a Difference: Impact of Passive Feedback on Prescription Behavior
VK Tadia, R Ahlawat, SK Arya, DK Sharma
[Year:2016] [Month:January-June] [Volume:4 ] [Number:1] [Pages:50] [Pages No:31-34] [No of Hits : 1188]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1057 | FREE

ABSTRACT

It is generally believed that big changes can be brought about by big interventions. Sometimes, small interventions also can show spectacular results. This case describes the impact of simple intervention, audit and feedback on change in the behavior of clinicians. In this case, the impact of simple intervention in the form of passive feedback has been documented. All the prescriptions received in pharmacy during the period of study were scrutinized for specific prescription errors. An overall error rate of 0.12% was observed in phase 1 of the study, which was reduced to 0.04% during phase 2 of the study after implementation of the intervention, which further dropped to zero during phase 3. It was concluded that a simple audit and feedback nudged the recipients of the feedback to modify their behavior.

Keywords: Audit, Feedback, Nudge, Passive feedback, Prescription behaviour.

How to cite this article: Tadia VK, Ahlawat R, Arya SK, Sharma DK. A Small Nudge can make a Difference: Impact of Passive Feedback on Prescription Behavior. Int J Res Foundation Hosp Health Adm 2016;4(1):31-34.

Source of support: Nil

Conflict of interest: None

 
2.  ORIGINAL ARTICLE
To Study the Antimicrobial Stewardship Program in a Large Tertiary Care Teaching Center
Madhav Madhusudan Singh, Shakti Kumar Gupta, YK Gupta, DK Sharma, Aarti Kapil
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:56] [Pages No:13-24] [No of Hits : 7069]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1031 | FREE

ABSTRACT

Introduction: As antimicrobial resistance continues to increase and new antimicrobial development stagnates, antimicrobial stewardship programs are being implemented worldwide. The goal of antimicrobial stewardship is to optimize antimicrobial therapy with maximal impact on subsequent development of resistance. Thirty to fifty percent of hospitalized patients receive antimicrobial therapy. Previous data suggest that inappropriate use results in higher mortality rates, longer lengths of stay, and increased medical costs. Antimicrobial stewardship programs (ASPs) reduce the improper use of antimicrobials and improve patient safety. Despite increased awareness about the benefits of these programs, few medical and surgical ASPs exist and fewer comprehensive studies evaluate their effects.

Aim: To study the antimicrobial stewardship program in a large tertiary care teaching center.

Objectives

  • To study the antibiotic prescribing practices in a tertiary care government hospital
  • To compare the antibiotic prescribing practices with the standard guidelines available with the hospital
  • To make recommendation if any for rational use of antibiotics.

Materials and methods

  • Review of literature
  • Prospective study of 15 days in selected general medicine and general surgery ward in which 5 to 6 reading will be taken in to know the antibiotic prescribed to patients.
  • Retrospective study of 15 days for study of patient records to know the antibiotic prescribed to patients.
  • Interaction with faculty and senior residents of general medicine and surgery to know about the pattern of infection and antibiotic prescription.
  • Interaction with microbiology department and their faculty to know the microbial resistance pattern and possible suggestion which need to be incorporated in antibiotic Stewardship program.

Results: The present study on antibiotic prescribing practices was undertaken in a super specialty hospital at New Delhi. A sample size of 100 case records was considered. There is no such stewardship program in tertiary care hospital, although it was demanded in various forum and meetings. There are no recommendations available either for patients of renal failure or other such compromised metabolic or immune states in the form of written antibiotic stewardship program of the hospital. The appropriateness of antibiotics prescribed in the case records was examined in light of the antibiotic stewardship program of the hospital. It was found that the overall adherence to antibiotic stewardship program was nil as no existing antibiotic stewardship program is exiting in this hospital. Gautum Dey in a study conducted at this hospital in New Delhi found that in 40.7% preoperative cases and 60.3% postoperative cases two or more than two antibiotics were given. The author has also commented that there was no evidence of adhering to antibiotic stewardship program or utilising culture and sensitivity reports to guide the therapy. The data obtained from the present study on further analysis has shown that in seven cases, the antibiotics prescribed were inadequate in terms of dose and duration. Thus resulting in an apparently lower cost of treatment than what was recommended by the antibiotic stewardship program of the hospital. Although such inappropriate prescription results in increased chances of antibiotic resistance, the immediate or short-term effects are not very conclusive. It is observed that there were 26 (26%) cases in medical and 12 (12%) cases in surgery disciplines in which the initial and final diagnosis was different. Uncertainty about the final diagnosis promotes empirical prescribing practices.

Conclusion: Antimicrobial stewards are a prominent part of local and national efforts to contain and reverse antimicrobial resistance. A range of intervention options is available with varying levels of resources and can yield substantial improvements in morbidity, mortality, quality of care, and cost. The cost of delivering such programs is dwarfed by the benefits and provides an opportunity for hospital epidemiologists to garner support. This suggests that antimicrobial management programs belong to the rarefied group of truly cost saving quality improvement initiatives. Considering the enormous implications of antibiotic resistance, it is necessary that we act in haste, lest our wonder drugs and magic bullets become ineffectual. Future systems promise greater integration and analysis of data, facilitated delivery of information to the clinician, and rapid and expert decision support that will optimize patient outcomes while minimizing antimicrobial resistance. They may also offer our best hope for avoiding an ‘Antibiotic armageddon’. In addition, the ASP plays an integral role in providing guidance to clinicians and ensures that the appropriate antimicrobial agents are used.

Keywords: Antibiotic, Stewardship program, Antimicrobial resistance, Rational use.

How to cite this article: Singh MM, Gupta SK, Gupta YK, Sharma DK, Kapil A. To Study the Antimicrobial Stewardship Program in a Large Tertiary Care Teaching Center. Int J Res Foundation Hosp Healthc Adm 2015;3(1):13-24.

Source of support: Nil

Conflict of interest: None

 
3.  RESEARCH ARTICLE
Application of 3D Music Inventory Control Technique for the Controlled Drugs in Intensive Care Unit of a Tertiary Care Hospital
Sameer Mehrotra, Sunil Basukala, Pawan Kapoor, Sunil Kant, RK Ranyal, Punit Yadav, Swati Varshney, SK Patnaik, Madhav Madhusudan Singh
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:56] [Pages No:5-9] [No of Hits : 2334]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1029 | FREE

ABSTRACT

Approximately 35% of annual hospitals budget is spent on buying materials and supplies, including medicines. The medical store is one of the most extensively used facilities of the hospital and hence it is essential that health managers use scientific methods to achieve efficient management and patient satisfaction.

Aims and objectives: To apply selective inventory control techniques for the drugs used in intensive care unit of tertiary care teaching hospital.

Materials and methods: The annual consumption and expenditure incurred on each item of controlled drugs in medical intensive care unit (ICU) for the years 2013 to 2014 was analyzed, and inventory control techniques, i.e. ABC, VED and ABC-VED matrix analysis, were applied.

Results: It was observed that 13 medicines (43.33%) out of 30 were classified in the category1 (AV + BV + CV + AE + AD) for stringent control.

Conclusion: Scientific inventory control management to be applied for efficient management of medical stores.

Keywords: ABC, VED analysis, Inventory control.

How to cite this article: Mehrotra S, Basukala S, Kapoor P, Kant S, Ranyal RK, Yadav P, Varshney S, Patnaik SK, Singh MM. Application of 3D Music Inventory Control Technique for the Controlled Drugs in Intensive Care Unit of a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015; 3(1):5-9.

Source of support: Nil

Conflict of interest: None

 
4.  RESEARCH ARTICLE
Personal Protective Equipment used for Infection Control in Dental Practices
AP Pandit, Neha Bhagatkar, Mallika Ramachandran
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:56] [Pages No:10-12] [No of Hits : 833]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1030 | FREE

ABSTRACT

The potential size of India’s dental market is vast and is expected to become one of the largest single country markets for overseas dental products and materials. The total market for the dental equipment and materials is estimated to be around US$ 90 million annually. There are more than 1, 80,000 dental professionals in India, 297 dental institutes and over 5,000 dental laboratories. Thus, there is a huge potential for the market of personal protective equipment (PPE) used for infection control in dentistry. India’s market for dental products is extremely dynamic, with a current estimated growth rate of between 25 and 30%. Overall, the dental market is expected to grow by 20%.1
The personal protective equipment used in the practice of dentistry in India. Since dentistry is predominantly a surgical discipline, it leads to exposure to the pathogenic microorganisms harbored in blood, body fluids and other potentially infectious material. Thus, the use of adequate and good quality PPE is imperative for infection control in dental practice. With the growing potential of India’s dental market, the growth of the market for PPE is inevitable. But, it is equally important to raise the awareness among dental community about good quality products adhering to required standards to prevent the usage of low-cost, uncertified and sub-standard products that decrease the safety levels of personnel.
The present study is conducted with a view to observe the personal protective equipment used for infection control in dental practices.

Keywords: Personal protective equipments, Infection control, AAMI standard, Dental practice.

How to cite this article: Pandit AP, Bhagatkar N, Ramachandran M. Personal Protective Equipment used for Infection Control in Dental Practices. Int J Res Foundation Hosp Healthc Adm 2015;3(1):10-12.

Source of support: Nil

Conflict of interest: None

 
5.  RESEARCH ARTICLE
Beyond Accreditation: Issues in Healthcare Quality
Feroz Ikbal
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:56] [Pages No:1-4] [No of Hits : 833]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1028 | FREE

ABSTRACT

In the last few years, there is an increased interest among Indian Healthcare institutions to get accredited from bodies, such as national accreditation board for hospitals and healthcare providers (NABH), Joint Commission International (JCI), Australian Council on Healthcare Standards (ACHS), and college of american pathologists Laboratory accreditation programme (CAP), etc. Hospital administrators, clinicians, academicians, promoters of the hospitals, policy makers and even government feel that accreditation is a panacea for all the problems associated with healthcare quality. But with the incidence of fire in one of the NABH accredited hospital in a metropolitan city, questions began to be asked on the correlation between quality and accreditation. Most of the hospitals use accreditation as a promotional tool, rather than a tool for continuous quality improvement. Often the entire focus of quality in a hospital is confined to the process of accreditation and re-accreditation. Time has come to think on the entire process of accreditation of hospitals in India, though it has a history of less than a decade. This paper intends to discuss various issues of quality in hospitals, outside the realms of accreditation. Need for strengthening and re-engineering the accreditation is also discussed. Accreditation essentially identifies the capability of the hospital to deliver quality care. It does not assure that hospitals delivers quality care. This aspect of accreditation has been often forgotten by the various stakeholders in healthcare. In this paper, an attempt is made to discuss other issues of quality, such as spurious drugs, quality of biomaterials, such as stents and biomedical equipments, quality of human resources, etc. which are often neglected by health institutions in its obsession to accreditation.

Keywords: Quality, Healthcare institution, Obsession, Accreditation.

How to cite this article: Ikbal F. Beyond Accreditation: Issues in Healthcare Quality. Int J Res Foundation Hosp Healthc Adm 2015;3(1):1-4.

Source of support: Nil

Conflict of interest: None

 
6.  REVIEW ARTICLE
Planning and Designing an Isolation Facility in Hospitals: Need of the Hour
K Shweta, Shakti Kumar Gupta, R Chandrashekhar, S Kant
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:56] [Pages No:48-56] [No of Hits : 791]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1036 | FREE

ABSTRACT

Emerging infectious diseases represent an ongoing threat to the health and livelihoods of people globally. Over the past decade, numerous infectious diseases have shown up in the United States including SARS in 2003, H1N1 or ‘swine flu’ in 2009, and now, the Ebola virus.
Isolation of a patient is essentially an escalation of the core healthcare process. Best practice demands that isolation rooms be provided where care for the underlying medical condition is optimal. As uncontroversial as infection control may seem, the infrastructure required (such as washbasins and isolation rooms) is often lacking in hospitals. And if isolation rooms are available, proper maintenance of pressure gradients is an issue. In normal circumstances no purpose is served by routine cleaning of ventilation ducts. During replacement, dust is shed from old filters. All extract grilles and some types of supply grilles accumulate dust. These represent an infection risk. The dust reflects the air-borne flora at the time of deposition with organism death taking place at a rate determined by microbial, environmental and other factors.
It is vital that regular monitoring and maintenance of the ventilation system is in place. The physical design of a hospital is an essential component of its infection control measures to minimize the risk of transmission of any infectious disease. Today, with a more progressive outlook, it is the fundamental requirement to adopt a holistic view of the design and management of hospitals. This document will not only help in making strategy for planning or renovating an isolation room and also helps in cleaning or maintenance of ventilation.

Keywords: Infection control, Isolation room design, Ventilation system.

How to cite this article: Shweta K, Gupta SK, Chandrashekhar R, Kant S. Planning and Designing an Isolation Facility in Hospitals: Need of the Hour. Int J Res Foundation Hosp Healthc Adm 2015;3(1):48-56.

Source of support: Nil

Conflict of interest: None

 
7.  ORIGINAL ARTICLE
Code Blue Policy for a Tertiary Care Trauma Hospital in India
Sheetal Singh, DK Sharma, Sanjeev Bhoi, Sapna Ramani Sardana, Sonia Chauhan
[Year:2015] [Month:July-December] [Volume:3 ] [Number:2] [Pages:79] [Pages No:114-122] [No of Hits : 780]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1047 | FREE

Abstract

“Code Blue” is generally used to indicate a patient requiring resuscitation or in need of immediate medical attention, most often as the result of a respiratory arrest or cardiac arrest. When called overhead, the page takes the form of “Code Blue, (floor), (room)” to alert the resuscitation team where to respond. Every hospital, as a part of its disaster plans, sets a policy to determine which units provide personnel for code coverage. In theory, any emergency medical professional may respond to a code, but in practice the team makeup is limited to those with advanced cardiac life support or other equivalent resuscitation training. Frequently, these teams are staffed by physicians (from anesthesia and internal medicine in larger medical centers or the emergency physician in smaller ones), respiratory therapists, pharmacists, and nurses. A code team leader will be a physician in attendance on any code team; this individual is responsible for directing the resuscitation effort and is said to “run the code”. This phrase was coined at Bethany Medical Center in Kansas City, Kansas. The term “code” by itself is commonly used by medical professionals as a slang term for this type of emergency, as in “calling a code” or describing a patient in arrest as “coding”.1

The purpose of this study is to make available policy with regard to Code Blue which can be followed in a tertiary care hospitals. It was a descriptive cross-sectional study carried out between January and June 2015. The study population included doctors, nursing personnel, paramedical staff and quality managers of tertiary care hospital from public and private hospitals. Checklist was made after an exhaustive review of literature which was then improvised. The checklist was discussed in focused group discussion held on 1 June 2015, and suggestions were incorporated. Validation of the checklist was also done by experts in various private and public hospitals. Subsequently, interaction was done with study population against the backdrop of the checklist and Code Blue policy was formulated.

Keywords: Cardiac arrest, Code Blue, Crash cart.

How to cite this article: Singh S, Sharma DK, Bhoi S, Sardana SR, Chauhan S. Code Blue Policy for a Tertiary Care Trauma Hospital in India. Int J Res Foundation Hosp Healthc Adm 2015;3(2):114-122.

Source of support: Nil

Conflict of interest: None

 
8.  ORIGINAL ARTICLE
Adverse Drug Reaction Policy in a Tertiary Care Hospital
S Singh, Shakti Kumar Gupta, S Arya, DK Sharma, V Aggarwal
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:56] [Pages No:41-47] [No of Hits : 580]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1035 | FREE

ABSTRACT

Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality and contribute to the incidence of adverse events, resulting in increased healthcare costs. Healthcare providers need to understand their role and responsibility in the detection, management, documentation, and reporting of ADRs. The purpose of this study is to provide guidelines regarding the procedure of reporting ADRs to hospital authority. It was a descriptive cross-sectional study carried out between April and August 2013. The study population included doctors, nursing personnel, paramedical staff and quality managers of tertiary care hospital from one public and two private hospitals. Interaction was done with study population against the back drop of the checklist and ADR policy was formulated.

Keywords: Adverse drug reactions, Adverse drug event, Medication error, Near-miss, Drug-related side effects.

How to cite this article: Singh S, Gupta SK, Arya S, Sharma DK, Aggarwal V. Adverse Drug Reaction Policy in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015; 3(1):41-47.

Source of support: Nil

Conflict of interest: None

 
9.  ORIGINAL ARTICLE
Who is More Hands on with Hand-offs? A Comparative Study of Clinical Handovers among Doctors and Nurses in a Tertiary Care Center in India
Parmeshwar Kumar, V Jithesh, Aarti Vij, Shakti Kumar Gupta
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:56] [Pages No:33-40] [No of Hits : 561]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1034 | FREE

ABSTRACT

Background: Standardized handovers have been known to improve outcome, reduce error and enhance communication. Few, if any, comparative studies on clinical handovers have been conducted in the India.

Objective: To study clinical handover practices among nurses and doctors in a neurosciences center in India.

Design and setting: This descriptive and cross-sectional study was conducted over 4 months in a 200 bedded public sector tertiary care facility in New Delhi, India.

Materials and methods: The handover practices of nurses and resident doctors in a neurology ward were assessed across shifts, weekdays and weekends using a pretested checklist. Ten elements were observed under the categories of time, place, record, process, staff interaction and patient communication. Outcomes were analyzed using z-test, analysis of variance (ANOVA) and Spearman’s correlation coefficient.

Results: Three hundred and eighty-two handovers each of nurses and doctors revealed varying adherence for time (44%), place (63%), documentation (50%), process (78%), staff interaction (50%) and patient communication (45%) related elements with overall compliance being 55%. Doctors fared better only in process elements and bedside handovers; however, only nurses had a statistically significant fall in levels over weekends and in night shifts. Staff interaction and patient communication were positively correlated and bedside handover was negatively related to handover duration in both groups. No statistically significant difference was found between the two groups when assessed as categories.

Conclusion: Study revealed a need for a system change and standardization of clinical handovers. Greater administrative commitment, use of technology, customized training and leadership development will aid in continuity of care, promote patient safety and ensure better outcomes.

Keywords: Clinical handovers, Shifts, Standardization.

How to cite this article: Kumar P, Jithesh V, Vij A, Gupta SK. Who is More Hands on with Hand-offs? A Comparative Study of Clinical Handovers among Doctors and Nurses in a Tertiary Care Center in India. Int J Res Foundation Hosp Healthc Adm 2015;3(1):33-40.

Source of support: Nil

Conflict of interest: None

 
10.  ORIGINAL ARTICLE
An Analysis of Knowledge, Attitude and Practices regarding Standard Precautions of Infection Control and Impact of Knowledge and Attitude of ICU Nurses on Self-reported Practices of Infection Control
Ginny Kaushal, Prakash Doke, Aejaz Shah, Vivek Verma
[Year:2015] [Month:July-December] [Volume:3 ] [Number:2] [Pages:79] [Pages No:86-90] [No of Hits : 536]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1041 | FREE

Abstract

Context: World Health Organization (WHO) defines healthcare-associated infection (HCAI) as infection acquired in hospital or a healthcare setting by a patient who was admitted for a reason other than that infection. The healthcare associated infections are one of the leading causes of mortality, morbidity and increase cost. Adherence to standard precautions for infection control and simple techniques like effective hand hygiene is essential for reducing healthcare associated infections. However, compliance of healthcare workers to hand hygiene (HH) guidelines are reportedly poor. It is important, therefore, to instill adequate knowledge and good attitudes and practices at the time of primary training of the healthcare workers. This study is an attempt to identify gaps in knowledge, attitudes and practices (KAP) to improve existing training programs and give recommendation to enhance good practices in the future.

Aims: The aim of the study is to analyze KAP of nursing professionals of intensive care units (ICUs) in a tertiary care hospital and to find the impact of knowledge and attitude of the ICU nurses on self-reported practices.

Settings and design: The study design is a survey research which has used a self-administered questionnaire to compare the KAP of nursing professionals of an ICU in a tertiary care hospital.

Materials and methods: The WHO standard precautions for infection control were used as a guideline for preparing the self-administered questionnaire. The scoring system was based on a study done by Uba et al (2015).

Statistical analysis: Correlation and analysis of variance (ANOVA) were used to establish associations between the independent and dependent variables.

Results: Participants had an average level of knowledge (79%), good attitude (89%) toward infection control guidelines and very good self-reported practices (91%). The collective KAP score of all the participants is good (85%) which indicates that average levels of knowledge are balanced by good attitude and very good practices. However, good knowledge is crucial for ensuring expected levels of infection control practices, and hence ensures patient safety.

Conclusion: To achieve an environment of patient safety, it is essential that the healthcare staff should have sound knowledge and positive attitude. The study shows the need for further improvement of the existing infection control training programs to address the gaps in KAP.

Keywords: Attitude, Healthcare-associated infections Infection control, Knowledge, Practice, Standard precautions.

Key message: Good knowledge and positive attitude are essential for attaining expected levels of infection control practices among critical care nurses.

How to cite this article: Kaushal G, Doke P, Shah A, Verma V. An Analysis of Knowledge, Attitude and Practices regarding Standard Precautions of Infection Control and Impact of Knowledge and Attitude of ICU Nurses on Self-reported Practices of Infection Control. Int J Res Foundation Hosp Healthc Adm 2015;3(2):79-85.

Source of support: Nil

Conflict of interest: None

 
   Previous |  Next  
Logo
 
     
 
© Jaypee Brothers Medical Publishers (P) Ltd.
logo