International Journal of Research Foundation of Hospital and Healthcare Administration

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2015 | July-December | Volume 3 | Issue 2

EDITORIAL

Pieter Stepaniak

Need for Managing Variability of Healthcare Processes

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jrfhha-3-2-v  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Sanjeev Davey, Anuradha Davey, S Vivek Adhish, Rajni Bagga

Impact of Nutritional Services of Anganwadi Workers in Improving Nutritional Status of Infants in Delhi: A Study by Mixed Method Technique

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:8] [Pages No:57 - 64]

PDF  |  DOI: 10.5005/jp-journals-10035-1037  |  Open Access |  How to cite  | 

Abstract

Background

Despite the presence of integrated child development services (ICDS) program in rural area of Delhi, the real impact of nutritional services of ICDS program on nutritional status of infants is not very clear, therefore, studying this area may provide new insights in this field.

Materials and methods

This study was carried out from 1st January 2015 to 31st March 2015 (3 months). All children up to 1 year of age (in AWC 1 and 2 area of a one rural ICDS block) were examined for their nutritional status by weight for age criteria. The registered infants of both these Anganwadi centers (AWCs) and their mothers were simultaneously observed for all kind of nutritional services they received from Anganwadi workers (AWWs) by way of key informants interviews and this was further confirmed by applying secret customer technique.

Results

The prevalence of mild to moderate malnutrition among infants in both the AWC area (AWC 1 area—6 months to 1 year category—52.9%, AWC 2 area (from 0—6 months and 6 months—1 year—69.3%) was higher. The key feeding factors identified for such scenario were: Improper colostrums feeding, wrong age of initiation of semisolid feeding, exclusive breastfeeding not done for 6 months, etc. [especially for AWC 2 area (p < 0.05) and AWC 1 area (p > 0.05)] among the AWCs. These factors were further confirmed by poor efforts of both AWWs in providing nutritional services toward mother and infants.

Conclusion

Anganwadi workers need to focus on quality of nutritional services provided toward mothers of infants and this area needs regular monitoring and supervision from ICDS and health system meticulously.

How to cite this article

Davey S, Davey A, Adhish SV, Bagga R. Impact of Nutritional Services of Anganwadi Workers in Improving Nutritional Status of Infants in Delhi: A Study by Mixed Method Technique. Int J Res Foundation Hosp Healthc Adm 2015;3(2):57-64.

RESEARCH ARTICLE

Jharna Bajpai

Employee Satisfaction and the Role of Motivation: A Study of a Super-specialty Hospital

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:4] [Pages No:65 - 68]

PDF  |  DOI: 10.5005/jp-journals-10035-1038  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Bajpai J. Employee Satisfaction and the Role of Motivation: A Study of a Super-specialty Hospital. Int J Res Foundation Hosp Healthc Adm 2015;3(2):65-68.

RESEARCH ARTICLE

Surinder Singh, Shakti Kumar Gupta, Akanksha Bisht

Transfusion Reaction Reporting Culture in Hemovigilance Program of India since Its Inception

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:2] [Pages No:69 - 70]

PDF  |  DOI: 10.5005/jp-journals-10035-1039  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Bisht A, Gupta SK, Singh S. Transfusion Reaction Reporting Culture in Hemovigilance Program of India since Its Inception. Int J Res Foundation Hosp Healthc Adm 2015;3(2):69-70.

RESEARCH ARTICLE

Ashok Mittal, Ginny Kaushal, Nikita Sabherwal, NK Pandey, Paul Kaustav

A Study of Patient-Physician Communication and Barriers in Communication

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:8] [Pages No:71 - 78]

PDF  |  DOI: 10.5005/jp-journals-10035-1040  |  Open Access |  How to cite  | 

Abstract

Context

Effective doctor-patient communication is the basic requirement in building a good doctor-patient relationship. Safe practices and effective, patient-centered communication is key to quality care. Good doctor-patient communication has the potential to help regulate patients’ emotions, facilitate comprehension of medical information and allow for better identification of patients’ needs, perceptions and expectations. Doctors with better communication and interpersonal skills are able to detect problems earlier, can prevent medical crisis and expensive intervention, and provide better support to their patients.

Current research indicates that ineffective communication among healthcare professionals is one of the leading causes of medical errors and patient harm. There are many barriers to good communication in the doctor-patient relationship, including patients’ anxiety and fear, doctors’ burden of work, fear of litigation, fear of physical or verbal abuse, and unrealistic patient expectations. National accreditation board for hospitals and healthcare providers (NABH) standards and international patient safety goals focus on the importance of effective communication in healthcare settings and how it leads to patient safety.

This study is an attempt to identify gaps in patient physician communication in the current healthcare settings, find the barriers in communication and give recommendation to enhance good practices in the future.

Aims

The aim of the study is to analyze the current levels of effective patient communication in a tertiary care hospital in Delhi-NCR with help of a self-administered questionnaire. The study will assess the level of information shared with the patient.

Settings and design

The design of our proposed study is a descriptive study where we will use a self-administered questionnaire to assess the level of patient-physician communication in the selected study setting.

Materials and methods

The NABH standard were used as a guideline for preparing the self-administered questionnaire. All admitted vulnerable patients of the selected study area will consist of the population for the study. Simple random sampling technique will be used to derive the sample out of the population.

Statistical analysis used

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

Results

The study shows that 48% of the respondents were of opinion that they were given partial information, while 20% of the respondents alleged that they were not given any information about the explanation of their disease, its prognosis and the treatment option that were available, i.e. a total of 62% of the patients said that they had partial information to complete lack of information that would have made them aware of their diseases, its prognosis and the treatments options available to cure it, while only 32% of the patients agreed that they were supplied with thorough information during their interaction with the physicians.

Conclusion

The majority of the patients were not wellinformed about their disease, its prognosis, treatment plan and continuity of care. There was a significant positive correlation between the communication made at initial stages of hospital stay and during the end stages of stay of patient. The main barrier to patient physician communication was time.

Key message

To ensure patient safety, it is imperative to inform patients about all the important aspects starting from admission till discharge.

How to cite this article

Sabherwal N, Mittal A, Pandey NK, Kaushal G, Kaustav P. A Study of Patient-Physician Communication and Barriers in Communication. Int J Res Foundation Hosp Healthc Adm 2015;3(2):71-78.

RESEARCH ARTICLE

Ginny Kaushal, Prakash Doke, Aejaz Shah, Vivek Verma

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

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:7] [Pages No:79 - 85]

PDF  |  DOI: 10.5005/jp-journals-10035-1041  |  Open Access |  How to cite  | 

Abstract

Context

World Health Organization (WHO) defines healthcareassociated 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.

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.

RESEARCH ARTICLE

Murali Chakravarthy, Sharmila Sengupta, Sanjeev Singh, Neeta Munshi, Tency Jose, Vatsal Chhaya

Incidence Rates of Healthcare-associated Infections in Hospitals: A Multicenter, Pooled Patient Data Analysis in India

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:5] [Pages No:86 - 90]

PDF  |  DOI: 10.5005/jp-journals-10035-1042  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this study was to collect the multicenter data of healthcare-associated infections (HAIs) to assess the infection control scenario in India in context with CDC/NHSN and INICC database.

Materials and methods

Four National Accreditation Board for Hospitals and Health Care Providers (NABH) accredited hospitals were selected on random basis and raw data on healthcare-associated infections—number of days and number of infections in all intensive care patients was obtained as per the CDC-NHSN definitions and formula. Three major device related infections were considered for analysis based on the prevalence of HAIs and discussions with subject matter experts. All nodal champions from each hospital were trained and common data collection sheet for surveillance in accordance to CDC-NHSN was formed. The pooled means for HAI rates and average of the pooled means for all were calculated using data from four hospitals and were compared with CDC/NHSN and international nosocomial infection control consortium (INICC) percentiles of HAIs rates.

Results

The Indian pooled mean HAI rates for all infections were above CDC/NHSN percentile threshold but below INICC percentile. Ventilator-associated pneumonia (VAP) was considered as matter of prime concern, crossing P90 line of CDC/NHSN threshold. However, no HAI rate was in limit of P25.

Conclusion

Indian HAI rates were higher when mapped with CDC threshold. This promotes the need for more standardized and evidence-based protocols been adhered to so as to bring HAI within CDC/NHSN thresholds. However, the four hospitals have better HAI rates as compared to pooled INICC database.

How to cite this article

Singh S, Chakravarthy M, Sengupta S, Munshi N, Jose T, Chhaya V. Incidence Rates of Healthcareassociated Infections in Hospitals: A Multicenter, Pooled Patient Data Analysis in India. Int J Res Foundation Hosp Healthc Adm 2015;3(2):86-90.

RESEARCH ARTICLE

Moonis Mirza, Farooq A Jan, Syed Hina Mumtaz, Fayaz Ahmad Sofi, Rauf Ahmad Wani

A Study of Patient Safety with Special Reference to Incidence of Adverse Events taking Place in Patients in a Tertiary Care Hospital in North India

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:7] [Pages No:91 - 97]

PDF  |  DOI: 10.5005/jp-journals-10035-1043  |  Open Access |  How to cite  | 

Abstract

Background

Adverse events in hospitals are now widely agreed to be a serious problem, annually killing more people than breast cancer or AIDS. Aims: To study incidence of adverse events in admitted patients by current record review.

Aims

To study incidence of adverse events in admitted patients by current record review.

Materials and methods

A two-staged prospective study for a period of 1 year was carried out. Current records of inpatients were screened for adverse events. The adverse event was categorized as preventable or nonpreventable on the basis of World Health Organization (WHO) set confidence score of preventability.

Results

A total of 3150 patients were screened, among which 488 (15.5%) patients were screened positive for having adverse event. Readmission during last 12 months to any given healthcare for the same health condition (32.79%) was the most common adverse event seen. Hospital acquired infection/sepsis (26.64%) was the second most common adverse event seen. The 78% of adverse events presented with untoward outcome among which 81.8% of adverse events resulted in admission in wards, 4.33% adverse events were associated with death, 23.4% adverse events were associated with disability at discharge and 35.5% adverse events were associated with prolonged stay. A total of 67.4% of studied adverse events showed signs of healthcare team responsible for causing adverse events, among which 76.8% of adverse events occurred outside SKIMS before the index admission. A total of 71.3% of adverse events were categorized preventable.

Conclusion

Hospital acquired infection was found responsible for prolonged stay of the patients. Proper referral policy must be followed by the department of health services.

How to cite this article

Mirza M, Jan FA, Mumtaz SH, Sofi FA, Wani RA. A Study of Patient Safety with Special Reference to Incidence of Adverse Events taking Place in Patients in a Tertiary Care Hospital in North India. Int J Res Foundation Hosp Healthc Adm 2015;3(2):91-97.

RESEARCH ARTICLE

Kanika Jain, IB Singh, Amit Lathwal, Sanjay Kumar Arya, Ravinder Ahlawat

A Study of the Awareness Levels of Universal Precautions in High-risk Areas of a Super-specialty Tertiary Care Hospital

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:5] [Pages No:98 - 102]

PDF  |  DOI: 10.5005/jp-journals-10035-1044  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Lathwal A, Arya SK, Singh IB, Ahlawat R, Jain K. A Study of the Awareness Levels of Universal Precautions in High-risk Areas of a Super-specialty Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015;3(2):98-102.

RESEARCH ARTICLE

Shakti Kumar Gupta, Sanjay Arya, Sheetal Singh, Vijay Aggarwal, T Thuilephy

Hand Hygiene Policy for a Tertiary Care Hospital

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:7] [Pages No:103 - 109]

PDF  |  DOI: 10.5005/jp-journals-10035-1045  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Singh S, Gupta SK, Arya S, Aggarwal V, Thuilephy T. Hand Hygiene Policy for a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015;3(2):103-109.

RESEARCH ARTICLE

Shakti Kumar Gupta, DK Sharma, Amit Lathwal, Sanjay Kumar Arya, Mukunda Chandra Sahoo

Study of the Traffic Management System at an Apex Tertiary Care Teaching Hospital and Recommendations for Improvement

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:4] [Pages No:110 - 113]

PDF  |  DOI: 10.5005/jp-journals-10035-1046  |  Open Access |  How to cite  | 

Abstract

Introduction

Hospital parking services often represent the very first contact patients and visitors have with our hospital and to make a positive perception of our hospital, we need ample patient and visitor parking. Over last decade, there has been a quantum increase in workload by 6 to 7 times and a corresponding increase in the number of vehicles entering the tertiary care teaching hospital premises. Aim of traffic management at tertiary care hospital is to decongest, improve and smoothen traffic by advocating lane discipline, platooning, signal lights, parking, footpaths, reducing the number of private vehicles, efficient public transport, car pooling, etc.

Aims and objective

To study vehicular traffic management system at a Apex Tertiary Care Teaching Hospital.

Methodology

This was done by survey of the area and observation of traffic flow and its measurement. The data, thus, collected were analyzed and based on the analysis an action plan was drawn.

Conclusion

As regards parking arrangements at the tertiary care teaching hospital are concerned, there is a need to create integrated parking lots on surface as well as basement of the buildings for parking of approximately 7600 vehicles which will also take into account the future needs. These parking lots should also include multilevel intelligent parking system with a computerized system of lifts stacking each car in a berth, and thus reducing the need for parking and service personnel.

How to cite this article

Sahoo MC, Gupta SK, Sharma DK, Arya SK, Lathwal A. Study of the Traffic Management System at an Apex Tertiary Care Teaching Hospital and Recommendations for Improvement. Int J Res Foundation Hosp Healthc Adm 2015;3(2):110-113.

RESEARCH ARTICLE

Sanjeev Bhoi, DK Sharma, Sheetal Singh, Sapna Ramani Sardana, Sonia Chauhan

Code Blue Policy for a Tertiary Care Trauma Hospital in India

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:9] [Pages No:114 - 122]

PDF  |  DOI: 10.5005/jp-journals-10035-1047  |  Open Access |  How to cite  | 

Abstract

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.

REVIEW ARTICLE

Shakti Kumar Gupta, S Kant, Vijaydeep Siddharth

Integration in Operation Theater: Need of the Hour

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:6] [Pages No:123 - 128]

PDF  |  DOI: 10.5005/jp-journals-10035-1048  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Siddharth V, Kant S, Chandrashekhar R, Gupta SK. Integration in Operation Theater: Need of the Hour. Int J Res Foundation Hosp Healthc Adm 2015;3(2):123-128.

REVIEW ARTICLE

Madhav Madhusudan Singh, Saroj Kumar Patnaik, Pradeep Srivastva, Harish K Satia, Mahavir Singh

Planning and Designing of Clinical Engineering Department in a Hospital

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:6] [Pages No:129 - 134]

PDF  |  DOI: 10.5005/jp-journals-10035-1049  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Singh MM, Patnaik SK, Srivastva P, Satia HK, Singh M. Planning and Designing of Clinical Engineering Department in a Hospital. Int J Res Foundation Hosp Healthc Adm 2015;3(2):129-134.

RESEARCH ARTICLE

Surinder Singh, Akanksha Bisht

Regulation of Biologicals: Indian Perspective

[Year:2015] [Month:July-December] [Volume:3] [Number:2] [Pages:2] [Pages No:135 - 136]

PDF  |  DOI: 10.5005/jp-journals-10035-1050  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Singh S, Bisht A. Regulation of Biologicals: Indian Perspective. Int J Res Foundation Hosp Healthc Adm 2015;3(2):135-136.

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