Academic literature on the topic 'Hospital Administration/*methods'
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Journal articles on the topic "Hospital Administration/*methods"
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Chung, Ji Yeon, Seung Jae Lee, Hyuck Jin Lee, Jeong Bin Bong, Chan-Hyuk Lee, Byoung-Soo Shin, and Hyun Goo Kang. "Aconitine Neurotoxicity According to Administration Methods." Journal of Clinical Medicine 10, no. 10 (May 16, 2021): 2149. http://dx.doi.org/10.3390/jcm10102149.
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We evaluated the toxic effects of aconitine on the human nervous system and its associated factors, and the general clinical characteristics of patients who visited the emergency room due to aconitine intoxication between 2008 and 2017. We also analyzed the differences related to aconitine processing and administration methods (oral pill, boiled in water, and alcohol-soaked), and the clinical characteristics of consciousness deterioration and neurological symptoms. Of the 41 patients who visited the hospital due to aconitine intoxication, 23 (56.1%) were female, and most were older. Aconitine was mainly used for pain control (28 patients, 68.3%) and taken as oral pills (19 patients, 46%). The patients showed a single symptom or a combination of symptoms; neurological symptoms were the most common (21 patients). All patients who took aconitine after processing with alcohol showed neurological symptoms and a higher prevalence of consciousness deterioration. Neurological symptoms occurred most frequently in patients with aconitine intoxication. Although aconitine intoxication presents with various symptoms, its prognosis may vary with the processing method and prevalence of consciousness deterioration during the early stages. Therefore, the administration method and accompanying symptoms should be comprehensively investigated in patients who have taken aconitine to facilitate prompt and effective treatment and better prognoses.
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Ford, Clyde D., Julie Killebrew, Penelope Fugitt, Janet Jacobsen, and Elizabeth M. Prystas. "Study of Medication Errors on a Community Hospital Oncology Ward." Journal of Oncology Practice 2, no. 4 (July 2006): 149–54. http://dx.doi.org/10.1200/jop.2006.2.4.149.
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Purpose Medication errors (MEs) have been a significant problem resulting in excessive patient morbidity and cost, especially for cancer chemotherapeutic agents. Although some progress has been made, ME measurement methods and prevention strategies remain important areas of research. Methods During a 2-year period (2003-2004), we conducted a prospective study on the oncology ward of a large community hospital, with the goals of (1) complete nurse reporting of observed medication administration errors (MAEs), (2) classifying observed MAEs, and (3) formulating improvement strategies. We also conducted a retrospective review of a randomly chosen sample of 200 chemotherapy orders to assess the appropriateness of ordering, dispensing, and administration. Results Our nurses reported 141 MAEs during the study period, for a reported rate of 0.04% of medication administrations. Twenty-one percent of these were order writing and transcribing errors, 38% were nurse or pharmacy dispensing errors, and 41% were nurse administration errors. Only three MAEs resulted in adverse drug events. Nurses were less likely to report MAEs that they felt were innocuous, especially late-arriving medications from the pharmacy. A retrospective review of 200 chemotherapy administrations found only one clear MAE, a miscalculated dose that should have been intercepted. Conclusions Significant reported MAE rates on our ward (0.04% of drug administrations and 0.03 MAEs/patient admission) appear to be relatively low due to application of current safety guidelines. An emphasis on studying MAEs at individual institutions is likely to result in meaningful process changes, improved efficiency of MAE reporting, and other benefits.
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Goto, Michihiko, Rajeshwari Nair, Bruce Alexander, Brice Beck, Christopher Richards, Eli N. Perencevich, and Daniel J. Livorsi. "2894. Metrics of Antimicrobial Use Within Inpatient Settings: Impacts of Statistical Methods and Case-Mix Adjustments." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S81. http://dx.doi.org/10.1093/ofid/ofz359.172.
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Abstract Background The necessary data elements and optimal statistical methods for benchmarking hospital-level antimicrobial use are still being debated. We aimed to describe the relative influence of case-mix adjustment and different statistical methods when ranking hospitals on antimicrobial use (AU) within inpatient settings. Methods Using administrative data from the Veterans Health Administration (VHA) system in October 2016, we calculated total antimicrobial days of therapy (DOT) and days present according to the National Healthcare Safety Network (NHSN) protocol. Patient-level demographics, comorbidities, and recent procedures were used for case-mix adjustments. We compared hospital rankings across 4 different methods: (A) crude antimicrobial DOT per 1,000 days present, aggregated at the hospital-level; (B) observed/expected (O/E) AU ratio with risk adjustment for ward-level variables (analogous to NHSN’s Standardized Antimicrobial Administration Ratio); (C) O/E AU ratio with risk adjustment for ward-/patient-level variables; (D) predicted/expected (P/E) AU ratio with risk adjustment for ward-/patient-level variables, based on a multilevel model accounting for clustering effects at hospital- and ward-levels. Results The cohort included 165,949 DOTs and 318,321 days present at 122 acute care hospitals within VHA. Crude DOTs per 1,000 days present ranged from 153.6 to 900.8 (Figure A), and ward-level risk adjustment only modestly changed rankings (Figure B). When adjusted for ward- and patient-level variables (including demographics, 14 comorbidities and 22 procedures), rankings changed substantially (Figure C). Risk-adjustment by a multilevel model changed rankings even further, while shrinking variabilities (Figure D). Ten hospitals in the lowest and 11 hospitals in the highest quartiles by O/E risk adjustment for only ward-level variables were classified to different quartiles on P/E risk adjustment. Conclusion We observed that the selection of variables and statistical methods for case-mix adjustment had a substantial impact on hospital rankings for antimicrobial use within inpatient settings. Careful consideration of methodologies is warranted when providing benchmarking metrics for hospitals. Disclosures All Authors: No reported Disclosures.
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Lyons, Imogen, Dominic Furniss, Ann Blandford, Gillian Chumbley, Ioanna Iacovides, Li Wei, Anna Cox, et al. "Errors and discrepancies in the administration of intravenous infusions: a mixed methods multihospital observational study." BMJ Quality & Safety 27, no. 11 (April 7, 2018): 892–901. http://dx.doi.org/10.1136/bmjqs-2017-007476.
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IntroductionIntravenous medication administration has traditionally been regarded as error prone, with high potential for harm. A recent US multisite study revealed few potentially harmful errors despite a high overall error rate. However, there is limited evidence about infusion practices in England and how they relate to prevalence and types of error.ObjectivesTo determine the prevalence, types and severity of errors and discrepancies in infusion administration in English hospitals, and to explore sources of variation, including the contribution of smart pumps.MethodsWe conducted an observational point prevalence study of intravenous infusions in 16 National Health Service hospital trusts. Observers compared each infusion against the medication order and local policy. Deviations were classified as errors or discrepancies based on their potential for patient harm. Contextual issues and reasons for deviations were explored qualitatively during observer debriefs.ResultsData were collected from 1326 patients and 2008 infusions. Errors were observed in 231 infusions (11.5%, 95% CI 10.2% to 13.0%). Discrepancies were observed in 1065 infusions (53.0%, 95% CI 50.8% to 55.2%). Twenty-three errors (1.1% of all infusions) were considered potentially harmful; none were judged likely to prolong hospital stay or result in long-term harm. Types and prevalence of errors and discrepancies varied widely among trusts, as did local policies. Deviations from medication orders and local policies were sometimes made for efficiency or patient need. Smart pumps, as currently implemented, had little effect, with similar error rates observed in infusions delivered with and without a smart pump (10.3% vs 10.8%, p=0.8).ConclusionErrors and discrepancies are relatively common in everyday infusion administrations but most have low potential for patient harm. Better understanding of performance variability to strategically manage risk may be a more helpful tactic than striving to eliminate all deviations.
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Wundavalli, Laxmitej, SG Bulkapuram, NL Bhaskar, and N. Satyanarayana. "Patient safety at a public hospital in southern India: A hospital administration perspective using a mixed methods approach." National Medical Journal of India 31, no. 1 (2018): 39. http://dx.doi.org/10.4103/0970-258x.243415.
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Rozen, Warren M., Elan D. Kaplan, Katharine J. Drummond, and Robert J. Millar. "A tale of two colleges: do specialist trainees receive adequate hospital-based training?" Australian Health Review 31, no. 3 (2007): 362. http://dx.doi.org/10.1071/ah070362.
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Background: Both medical and surgical trainees have a dual reliance on their specialist training college and their respective teaching hospitals to maintain standards in teaching and training. Although guidelines are in place for the administration of this teaching, hospital-based teaching has been minimally regulated. A review of trainee satisfaction with current levels of hospital-based training was performed, both to reflect the thoughts of trainees themselves and to highlight specific areas requiring improvement. Methods: Sixty-four basic specialist trainees (44 surgical [BSTs] and 20 physician [BPTs]) from all of the major Melbourne metropolitan teaching hospitals completed an anonymous survey. Results: Surgical trainees considered all areas of hospital-based training to be deficient, with overall dissatisfaction significantly greater for BSTs compared with BPTs (P = 0.046). A requirement for increased hospital-based training was similarly greater for BSTs (P = 0.0072). Conclusion: The study confirms the need for a change in the regulation and administration of hospital-based teaching for surgical trainees.
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Pedersen, Craig A., Philip J. Schneider, Michael C. Ganio, and Douglas J. Scheckelhoff. "ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2020." American Journal of Health-System Pharmacy 78, no. 12 (March 23, 2021): 1074–93. http://dx.doi.org/10.1093/ajhp/zxab120.
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Abstract Purpose Results of the 2020 ASHP national survey of pharmacy practice in hospital settings are presented. Methods Pharmacy directors at 1,437 general and children’s medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. Survey completion was online. IQVIA supplied data on hospital characteristics; the survey sample was drawn from the IQVIA hospital database. Results The response rate was 18.7%. Almost all hospitals (92.5%) have a method for pharmacists to review medication orders on demand. Most hospitals (74.5%) use automated dispensing cabinets (ADCs) as their primary method for drug distribution. A third of hospitals use barcodes to verify doses during dispensing in the pharmacy and to verify ingredients when intravenous medications are compounded. More than 80% scan barcodes when restocking ADCs. Sterile workflow management technology is used in 21.3% of hospitals. Almost three-quarters of hospitals outsource some sterile preparations. Pharmacists can independently prescribe in 21.1% of hospitals. Pharmacist practice in ambulatory clinics in 46.2% of health systems and provide telepharmacy services in 28.4% of health systems. Conclusion Pharmacists continue their responsibility in their traditional role in preparation and dispensing of medications. They have successfully employed technology to improve safety and efficiency in performance of these duties and have employed emerging technologies to improve the safety, timeliness, and efficiency of the administration of drugs to patients. As pharmacists continue to expand their role to all aspects of medication use, new opportunities highlighted in ASHP’s Practice Advancement Initiative 2030 have been identified.
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Vanwesemael, Toke, Koen Boussery, Patricia van den Bemt, and Tinne Dilles. "The willingness and attitude of patients towards self-administration of medication in hospital." Therapeutic Advances in Drug Safety 9, no. 6 (March 26, 2018): 309–21. http://dx.doi.org/10.1177/2042098618764536.
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Background: Literature suggests a positive impact of self-administration of medication during hospitalization on medication adherence and safety, and on patient satisfaction. However, self-administration is not a common practice in Belgian hospitals. The aim of this study was to describe patients’ willingness towards self-administration of medication while in hospital. Methods: A cross-sectional observational study was conducted in three Belgian hospitals in November and December 2015. All patients of 14 randomly selected wards were asked to participate. The structured questionnaire comprised patient characteristics, their willingness and attitude towards self-administration of medication, perceived ability to self-administer during hospitalization, and prerequisites and perceived consequences. Results: In total, 124 patients participated (36% of all eligible patients). The main reasons not to participate were the patients’ physical and mental condition (30%) and the absence of patients during the time of data collection (23%). The majority of the 124 participating patients had a positive attitude towards the implementation of self-administration; 83.9% were willing to self-administer their medication while in hospital. Most important prerequisites were self-administration at home before and after hospitalization, patients’ motivation, and a regular evaluation of the patients’ competences. Patients acknowledged benefits such as an increase in autonomy, independence and medication knowledge. Patients did not expect self-administration would cause important safety issues. Conclusion: The majority of patients, capable of participating in the study, would want to self-administer medication during hospitalization. They had a positive attitude towards self-administration of medication. Nevertheless, patients stated important conditions which need to be considered in order to implement self-administration.
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Jeong, Heon-Jae, Wui-Chiang Lee, Hsun-Hsiang Liao, Feng-Yuan Chu, Tzeng-Ji Chen, and Pa-Chun Wang. "The Hospital Patient Safety Culture Survey: Reform of Analysis and Visualization Methods." International Journal of Environmental Research and Public Health 16, no. 19 (September 27, 2019): 3624. http://dx.doi.org/10.3390/ijerph16193624.
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Understanding the topography of hospital safety culture is vital for developing, implementing, and monitoring the effectiveness of tailored safety programs. Since 2009, the Chinese version of the Safety Attitudes Questionnaire (SAQ-C) has been introduced and administered to providers in many Taiwanese hospitals. The mean percentage of SAQ survey respondents who demonstrate attitudinal agreement within each of the SAQ domains, the percent agreement (PA) score, is used worldwide as the main parameter of safety culture surveys. However, several limitations within PA scoring have been identified. Our study sought to improve scoring methodology and develop a new graph layout for cultural topography presentation. A total of 37,163 responses to a national SAQ-C administration involving 200 Taiwan hospitals were retrospectively analyzed. To understand the central tendency and spread of safety culture scores across all participating hospitals, the median and interquartile range (IQR) of PA scores to the SAQ’s teamwork domain were calculated, plotted, and named “safety culture grid.” Study results denote limitations in the current PA scoring scheme, suggest SAQ analysis modification, and introduce a visualization graph layout that can provide richer information about safety culture dissemination than that available from currently utilized tools.
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Shealy, Stephanie, Joseph Kohn, Emily Yongue, Casey Troficanto, Brandon Bookstaver, Julie A. Justo, Michelle Crenshaw, Hana Winders, Sangita Dash, and Majdi Al-Hasan. "Motivational Application of Standardized Antimicrobial Administration Ratios Within a Healthcare System." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s321. http://dx.doi.org/10.1017/ice.2020.918.
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Background: Hospitals in the United States have been encouraged to report antimicrobial use (AU) to the CDC NHSN since 2011. Through the NHSN Antimicrobial Use Option module, health systems may compare standardized antimicrobial administration ratios (SAARs) across specific facilities, patient care locations, time periods, and antimicrobial categories. To date, participation in the NHSN Antimicrobial Use Option remains voluntary and the value of reporting antimicrobial use and receiving monthly SAARs to multihospital healthcare systems has not been clearly demonstrated. In this cohort study. we examined potential applications of SAAR within a healthcare system comprising multiple local hospitals. Methods: Three hospitals within Prisma Health-Midlands (hospitals A, B, and C) became participants in the NHSN Antimicrobial Use Option in July 2017. SAAR reports were presented initially in October 2017 and regularly (every 3–4 months) thereafter during interprofessional antimicrobial stewardship system-wide meetings until end of study in June 2019. Through interfacility comparisons and by analyzing SAAR categories in specific patient-care locations, primary healthcare providers and pharmacists were advised to incorporate results into focused antimicrobial stewardship initiatives within their facility. Specific alerts were designed to promote early de-escalation of antipseudomonal β-lactams and vancomycin. The Student t test was used to compare mean SAAR in the preintervention period (July through October 2017) to the postintervention period (November 2017 through June 2019) for all antimicrobials and specific categories and locations within each hospital. Results: During the preintervention period, mean SAAR for all antimicrobials in hospitals A, B, and C were 0.69, 1.09, and 0.60, respectively. Notably, mean SAARs at hospitals A, B, and C in intensive care units (ICU) during the preintervention period were 0.67, 1.36, and 0.83 for broad-spectrum agents used for hospital-onset infections and 0.59, 1.27, and 0.68, respectively, for agents used for resistant gram-positive infections. After antimicrobial stewardship interventions, mean SAARs for all antimicrobials in hospital B decreased from 1.09 to 0.83 in the postintervention period (P < .001). Mean SAARs decreased from 1.36 to 0.81 for broad-spectrum agents used for hospital-onset infections and from 1.27 to 0.72 for agents used for resistant gram-positive infections in ICU at hospital B (P = .03 and P = .01, respectively). No significant changes were noted in hospitals A and C. Conclusions: Reporting AU to the CDC NHSN and the assessment of SAARs across hospitals in a healthcare system had motivational effects on antimicrobial stewardship practices. Enhancement and customization of antimicrobial stewardship interventions was associated with significant and sustained reductions in SAARs for all antimicrobials and specific antimicrobial categories at those locations.Funding: NoneDisclosures: None
Dissertations / Theses on the topic "Hospital Administration/*methods"
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Anderson, Ruby O. "Assessing Nurse Manager Competencies in a Military Hospital." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2393.
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Military health care organizations need competent frontline managers with knowledge and skills to manage health care complexity and ensure evidence-based practice. With systematic, planned turn over of military managers, more civilian managers are needed to fill permanent positions in military hospitals. The purpose of this project was to provide a better understanding of the competencies perceived by nurse managers at a military medical center and whether they differed by military or civilian status. The American Organization of Nurse Executives competency model and framework provided the theoretical framework for the project. The design was nonexperimental, with an observational, descriptive, cross-sectional approach. The Chase Nurse Manager Competency Instrument was used to collect data from 53 military and civilian nurse managers who ranked the top 10 competencies needed for effective leadership. The top competencies chosen by the managers were the knowledge and ability to use effective communication, decision making, problem solving, nursing practice standards, time management, and effective staffing strategies. Using t test statistics, only minimal differences were identified between military and civilian nurse managers' perceptions of the top competencies, which allows the medical center to create one integrated leadership curriculum to assist in the development of a competent, unified leadership team of civilian and military managers. Social change to improve patient outcomes can occur within military health care organizations by assessing and developing leadership competencies in all nurse managers to ensure reliable cultures of safety, quality, and value-based productivity within their military hospital environments.
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Suthers, Amber L. "Evaluating Effective Communication Methods: Improving Internal Communication." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etd/3293.
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Relaying information from a Chief Communications Officer (CIO), or centralized communications departments to hospital employees is not always efficient or effective. Employees may not be informed of important changes to department protocols or hospital policies. The purpose of the study was to determine the most efficient and effective forms of internal communications in the hospital setting.
A total of 83 surveys were mailed to communication officers working in Tennessee hospitals in and east of Nashville. Sixteen communication officers responded. This low response rate may be attributed to poor designation of communication responsibilities and an abdication of responsibilities to an off campus (corporate) source. One significant difference was found regarding the preference of supervisor contact to relay feedback in the age groups of 31-40 and 51-60. Those 31-40 were less likely to prefer direct supervisor contact as their favored communications channel as opposed to 51-60 year olds who favored this method.
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Wilson, Jeanne Lynn. "Employee Turnover in Frontline Hospital Staff." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3129.
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Employee turnover is costly in service-intensive organizations where employee-customer interactions directly affect the organization's success. The purpose of this multiple case study was to identify strategies community hospital leaders use to reduce frontline support employee turnover. The study population consisted of leaders of a community hospital in southeast Louisiana. The conceptual framework for this study is Kahn's model of employee engagement. Semistructured interviews were conducted with eight hospital leaders in southeast Louisiana who were selected through census sampling. Interview transcripts were analyzed and coded following Yin's case study analysis process. Methodological triangulation allowed for a comparison of the findings of the interviews with information derived from exit interviews and employee engagement survey results. Four themes emerged from the interviews and document review: leadership, hiring and onboarding strategies, pay and compensation, and organizational-related factors. Reducing turnover among frontline hospital support employees can positively affect the quality of care provided to patients, and improve the level of service provided by the hospital to the community it serves. Beyond increasing organizational efficiency, the findings of this study can contribute to social change benefits for employees as continued employment allows individuals to provide for themselves and their families.
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Mkandawire, Collins Yazenga. "Hospital Outcomes Based on Physician Versus Non-Physician Leadership." Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10257047.
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Hospital performance metrics are an indicator of leadership performance. However, there is inadequate research on whether physician or nonphysician chief executive officers (CEOs) perform better in the U.S. hospitals. The purpose of this study was to examine which type of leaders is better. Leadership trait, situational leadership, and leadership behavior theories constituted the theoretical foundation. The key research question examined the relationship between a hospital’s outcomes, which in this study, included hospital net income, patient experience ratings, and mortality rates, and the type of CEO in that hospital: physician or non-physician. A quantitative, causal comparative design was used to answer this question. Three hypotheses were tested using multivariate analysis of variance. The dependent variable was hospital outcomes: hospital net income, patient experience ratings, and mortality rates. The independent variable was the type of hospital CEO: physician and nonphysician. Datasets from 2014-2015 were used, which were publically available on the websites of U.S. based hospitals, research organizations, and journals. A sample of 60 hospitals was drawn from U.S. non-federal, short-term, acute care hospitals, based on number of staffed beds (n = 60). No significant differences were found between nonphysician and physician CEOs on hospitals’ net income (p = .911), patient experience ratings (p = .166), or mortality rates ( p = .636). Thus, the null hypotheses were retained. Findings suggest that physician and non-physician CEOs may produce similar outcomes in the hospitals they lead. Based on these findings, hospital boards can view CEO applicants equally when considering whom to hire and understanding U.S. hospital leadership.
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Buffenbarger, Jennifer Sylvia. "Nurses' Experiences Transitioning from Staff Nurse to Management in a Community Hospital." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2346.
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This project study addressed the problem of frequent turnover of nurse managers at a Northeastern community hospital. The lack of retention of nurse managers has led to attenuated support for the nursing staff who continued to hold the front line in patient care. The purpose of this qualitative bounded case study was to explore nurse managers' experiences with turnover in order to identify strategies for enhancing retention. Work empowerment and servant leadership theories served as the frameworks for the study. Research questions focused on nurse managers' perceptions of empowerment and servant leadership characteristics that were important in decisions to assume and remain in a management/leadership role. Data collection included audio-recorded interviews with seven current or past full-time nurse managers, and observation of three of the participants at a leadership meeting. Interview transcripts were open coded and thematically analyzed. Observation data were categorized according to empowerment and servant leadership characteristics. Five themes were identified that related to research questions: struggling in management transition, seeking opportunity for transformation, being committed but powerless, embarking unprepared on an unplanned journey, and having the presence to lead others by serving. The findings of this study guided development of a 12-month program for new nurse managers that integrated characteristics of servant leadership to empower leaders and others. These contributions may promote positive social change by preparing new nurse managers for their role and developing their skills to become successful nurse managers.
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Heydrich, Joana. "Padrão de prescrição, preparo e administração de medicamentos em usuários de sondas de nutrição enteral internados em um hospital universitário." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2006. http://hdl.handle.net/10183/8210.
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As sondas de alimentação constituem uma via alternativa para a administração de medicamentos em pacientes cuja situação clínica impede a utilização da via oral. É sabido que a utilização de medicamentos nesses pacientes requer cuidados especiais, tanto na seleção da forma farmacêutica quanto no preparo e na administração dos mesmos. Para se conhecer as características dos pacientes internados usando sondas de nutrição enteral (SNE) no Hospital de Clínicas de Porto Alegre, bem como os medicamentos prescritos e utilizados via SNE, foram analisados 315 prontuários médicos na primeira etapa do estudo. A maioria dos pacientes era formada por adultos (51%) do sexo masculino (59%), com diagnóstico de câncer (32%) ou doença neurológica (21%). A média de uso da SNE foi de 15 dias. Noventa e cinco por cento dos pacientes utilizaram algum fármaco na forma farmacêutica sólida, principalmente comprimidos (72%), cápsulas (12%) e drágeas (9%). A taxa de troca de sonda correspondeu a 32%. Na segunda etapa do estudo, auxiliares de enfermagem foram observados em suas rotinas de trabalho no hospital, visando analisar o processo de preparo e administração dos medicamentos aos pacientes. Foi observado que esses profissionais não utilizavam técnicas adequadas nos momentos de preparo dos medicamentos e administração dos mesmos aos pacientes com SNE. A alta incidência do uso de formas farmacêuticas sólidas, o número de medicamentos prescritos, os dias de uso da sonda e a diversidade de métodos de trabalho utilizados no momento da derivação, diluição e administração dos medicamentos pelos auxiliares de enfermagem mostram que, apesar da ampla informação disponível na literatura sobre o uso de medicamentos em pacientes com SNE, a prática clínica está sendo realizada de modo inconsistente em relação aos dados disponíveis, trazendo assim dificuldades para o tratamento dos pacientes.The tube feeding constitutes an alternative way for patients with a clinic situation that the oral way is hindered. It is known that these patients require particular methods in the drug utilization process, even in the selection of the pharmaceutical form of the medicine as in the preparation and administration of these drugs. To understand the patient characteristics using enteral tube feeding (ETF) in the Hospital de Clínicas de Porto Alegre as well as the drugs prescribed by ETF way, the medical records of 315 interned patients were analyzed in the first stage of the research. The majority of patients was adults (51%) of male gender (59%) with cancer (32%) or neurological disease (21%) diagnostic. The ETF using average was 15 days. Ninety five per cent of the analyzed patients used some kind of drug in the solid pharmaceutical form, mainly tablets (72%), capsule (12%) and coated tablet (9%). The ETF using average was 15 days. Ninety five per cent of the analyzed patients used some kind of drug in the solid pharmaceutical form, mainly tablets (72%), capsule (12%) and coated tablet (9%). The average of ETF changing was 32%. In the second stage of this research, nurse assistants were observed in their routine of working in the hospital to analyze the process of preparation and administration of the drugs to patients with ETF. It was observed that the nurses assistant neither use proper techniques in the moment of the drugs preparation nor in the administration of these drugs to patients with ETF. The high incidence of using solid pharmaceutical forms; the number of drugs prescribed, the using days of ETF and the diversity of working methods used in the derivation, dilution and administration moment by the nurse assistants showed that despite good amount of information in the literature about the administration of drugs in patients using ETF, the clinical practice is being carried out in a way that is inconsistent with the data available, causing difficulties for the patient treatment.
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Cook, Destin. "The Survival of Healthcare in Rural Texas." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5689.
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Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and reassembling of the data into 19 common themes. The 4 most common themes included poor payer mix and uninsured population, inconsistency with evidence-based measures, costs of providing care exceeding reimbursement, and the movement of inpatient procedures to outpatient. The study findings may help advance the practice of leadership in both rural and urban healthcare. This study may contribute to positive social change by creating awareness of how rural hospitals are in danger of closures, and how these closures can affect urban hospitals and overall quality of life for rural Americans.
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Koppenhaver, II Kenneth E. "Effects of an Integrated Electronic Health Record on an Academic Medical Center." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2666.
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The debate about healthcare reform revolves around a triple aim of improving the health of populations, improving the patient experience, and reducing the cost of care. A major tool discussed in this debate has been the adoption of electronic health record (EHR) systems to record and guide care delivery. Due to low adoption rates and limited examples of success, the problem was a lack of understanding by healthcare organizations of how the EHR fundamentally changes an organization through the interactions of people, processes, and technology over time. The purpose of this case study was to explore the people, processes, and technology factors that change as a result of an EHR implementation. Complexity theory was used as the lens to evaluate the effects of the EHR on the holistic system of healthcare. Data were collected using semistructured interviews and observations of physicians, nurses, and administrators, as well as document reviews of organizational documents related to the EHR. Data were analyzed using open coding to identify themes and patterns of usage that redesign or restructure institutional resources. The results of this study demonstrated positive changes in the interactions of healthcare providers with increasing collaboration on process changes and reliance on EHR for communication. These findings may positively affect government policy and the organizational approach to adoption and ongoing use of EHRs to create organizational change beyond the implementation of such systems, thus benefiting both health care employees and patients.
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Ott, Kenneth Brad. "The Closure of New Orleans' Charity Hospital After Hurricane Katrina: A Case of Disaster Capitalism." ScholarWorks@UNO, 2012. http://scholarworks.uno.edu/td/1472.
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Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, took advantage of the mass internal displacement of New Orleans’ populace in the aftermath of Hurricane Katrina in an attempt to abandon Charity Hospital’s iconic but neglected facility and to supplant its original safety net mission serving the poor and uninsured for its neoliberal transformation to favor LSU’s academic medical enterprise.
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Mills, Pamela Ruth. "Hospital electronic prescribing and medicines administration system implementation into a district general hospital : a mixed method evaluation of discharge communication." Thesis, Robert Gordon University, 2016. http://hdl.handle.net/10059/1581.
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Hospital electronic prescribing and medicines administration (HEPMA) system implementation is advocated by national e-health strategies to produce patient safety benefits. No previous study has evaluated HEPMA implementation impacting discharge information communication or assessed discharge prescribing errors. The aims were to assess HEPMA system implementation impact on medicines related discharge communication and prescribing errors, and to gain the perspective of hospital staff involved in the communication process. Following a narrative literature review, a convergent parallel mixed methods was selected, consisting of interpretative phenomenology and experimental before and after study design. Face-to-face semi-structured interviews of a purposive sample of hospital staff involved in discharge information communication were undertaken using the Theoretical Domains Framework (TDF) as a theoretical lens. In addition a quasi experimental retrospective case notes review, both before and after implementation was completed. Pre-implementation, staff described patient safety concerns with traditional discharge communication processes. They cited frequent prescribing errors, and associated adverse events and hospital readmissions. HEPMA implementation was anticipated to improve patient safety and create more efficient discharge communication. Post-implementation staff articulated improved information quality highlighting fewer omitted medicines and improved patient safety. TDF findings of behaviour change highlighted behavioural alteration including adaption of processes to improve discharge quality. Quantitative data collection (n=159 before and after) confirmed qualitative findings; increased compliance with discharge documentation, for example staff grade recorded increased from 40% to 100% (p<0.001). Prescribing error quantity and severity were reduced; errors reduced from 99% to 23% of patients (p<0.001); only 22% of identified errors likely to cause harm. Omitted medicines decreased from 42% to 11% of patients (p<0.001). The findings contribute original knowledge concerning HEPMA implementation impacting discharge information communication and prescribing errors. The study demonstrated reduced prescribing errors and improved patient safety which potentially impacted health and wellbeing. Qualitative findings and quantitative results are transferable and applicable to other NHS organisations or similar healthcare settings.
Books on the topic "Hospital Administration/*methods"
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Dhar, Upinder. Case methods in health and hospital management. Jaipur: Institute of Health Management Research, 2011.
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Taylor, Vaden H., ed. Fifty effective print ads for hospitals. Chicago, Ill: American Hospital Pub., 1986.
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Unland, James J. The trustee's guide to understanding hospital business fundamentals. Westchester, Ill: Healthcare Financial Management Association, 1991.
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The challenge of hospital governance: How to become an exemplary board. Chicago, IL: American Hospital Pub., 1992.
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Fyke, L. Dawn. Hospital-based health promotion. Ottawa, Ont: Canadian Hospital Association, 1989.
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Simendinger, Earl A., and Terence F. Moore. Hospital turnarounds: Lessons in leadership. Washington, D.C: Beard Books, 1999.
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Jarrard, David. Healthcare mergers, acquisitions, and partnerships: An insider's guide to communication. Danvers, MA: Health Leaders Media, 2013.
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Anticipate, respond, recover: Healthcare leadership and catastrophic events. Chicago, IL: Health Administration Press, 2011.
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Langabeer, James R. Health care operations management: A quantitative approach to business and logistics. Sudbury, Mass: Jones and Bartlett Publishers, 2008.
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Hospitalist recruitment and retention: Building a hospital medicine program. Hoboken, N.J: Wiley-Blackwell, 2010.
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Jaccoulet, Emmanuel, Claire Smadja, and Myriam Taverna. "Quality Control of Therapeutic Monoclonal Antibodies at the Hospital After Their Compounding and Before Their Administration to Patients." In Methods in Molecular Biology, 179–84. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-1-4939-4014-1_14.
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Solvoll, Terje. "Mobile Communication in Hospitals." In Healthcare Administration, 688–702. IGI Global, 2015. http://dx.doi.org/10.4018/978-1-4666-6339-8.ch034.
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The work setting in hospitals is communication intensive and can lead to significant difficulties related to interruptions from co-workers. Physicians often need information fast, and any delay between the decision made and the action taken could cause medical errors. One suggested solution for this problem is to implement wireless phone systems. However, psychological theory and empirical evidence, both suggest that wireless phones have the potential of creating additional problems related to interruptions, compared to traditional paging systems. The fact that hospital workers prefer interruptive communication methods before non-interruptive methods, amplifies the risk of overloading people when phones are widely deployed. This challenge causes some hospital staff to resist the diffusion of wireless phones, and a key is how to handle the balance between increased availability, and increased interruptions. In this chapter, the authors present solutions based on context aware communication systems, aiming to reduce interruptions.
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Esteves, Francisco Madeira, Luís Manuel de Macedo Gomes Lagartinho, and Pedro Fernandes da Anunciação. "Information Systems for Management Decision Support in Portuguese Public Hospital." In Healthcare Administration, 1015–33. IGI Global, 2015. http://dx.doi.org/10.4018/978-1-4666-6339-8.ch053.
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The information systems have assumed a central role in the health sector. Particularly in the public domain, health institutions have traditionally been marked by management practices based on contextual contingencies without much concern of the accurate results and their assessment. The traditional concern about the low efficiency and effectiveness in managing public resources has been replaced by the emerging and urgent need for rational management instruments and methods. This need presents the opportunity for a new management paradigm that should not be restricted to the financial aspects of health institutions, but it should include all dimensions of core and non-core activities. The budget slippages and ruptures cannot continue being used as the excuse for the need of systematic and permanent increase of financial resources spent on provision of public health services, often justified by an increasing of the population or the average life expectancy. The budget problems and difficulties of the Portuguese State, particularly the urgent need of the expenditure growth control, show the need of a new management paradigm. This demand has caused, on the one hand, a heavy investment in information technologies to support management decisions, and on the other hand, it has shown other problems, such as the difficulty experienced in the architectural integration of information and technologies as well as problems of a significant complexity and high resource consumption. This chapter discusses the current information systems for management decision support in Portuguese public hospitals based on the analysis of a district hospital in Portugal.
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Joseph, Victor Vuni. "The Effects of Telehealth on Patients with Long-Term Conditions in Routine Healthcare Use and Lessons from Practical Application." In Healthcare Administration, 1197–216. IGI Global, 2015. http://dx.doi.org/10.4018/978-1-4666-6339-8.ch065.
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There is increasing uptake of telehealth for long-term conditions (LTCs). However, evidence of their effectiveness remains largely inconclusive. Similarly, success factors for implementation of telehealth into routine healthcare practice are not fully understood. The objectives of this chapter are to determine the effectiveness of telehealth; and to update existing checklist on key success factors for implementation of telehealth. Both randomized controlled trial (RCT) and observational study methods were used as case-studies. Analysis was carried out using logistic regression model and summary statistics. There was a statistically significant reduction in hospital admissions in favour of the intervention groups in the RCT, with an odds ratio (OR) of 0.08 (95% CI: 0.01, 0.81); p-value = 0.03, while in the observational study, the mean hospital admission per person reduced from 2.19 (95% CI: 1.67, 2.69) to 1.20 (95% CI: 0.88, 1.52); p-value 0.0004. Key success factors identified were used to update the second version of telehealth checklist tool. Telehealth was effective in reducing hospital admission in patients with COPD, heart failure, and diabetes. Key success factors were updated to support telehealth practitioners in embedding telehealth in routine practice.
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Kabadayi, Nihan, and Sündüs Dağ. "Fuzzy Logic in Health Services." In Advances in Healthcare Information Systems and Administration, 121–57. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-7998-2581-4.ch007.
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Healthcare inventory management is a complex task which contains critical decision phases. One of the efficient ways of healthcare inventory management is to classify inventory items into predefined categories in terms of their significant features. This chapter proposes a guideline to healthcare decision makers to implement appropriate inventory control methods. The proposed method combines Fuzzy AHP (Analytical Hierarchy Process), TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) and ABC (Always Better Control) analysis methods to determine the priority of inventory items. The corresponding method, which takes into account multiple criteria in the classification of inventory items, cope with the limits of the classical ABC method. It also helps to reduce the uncertainty in the inventory classification problem as the proposed method is based on the fuzzy logic approach. A real-life case study is conducted in a hospital laboratory to test the proposed method.
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Yucesan, Melih, Muhammet Gul, Suleyman Mete, and Erkan Celik. "A Forecasting Model for Patient Arrivals of an Emergency Department in Healthcare Management Systems." In Advances in Healthcare Information Systems and Administration, 266–84. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-7071-4.ch012.
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Emergency departments (EDs) are one of the most valuable departments of healthcare management systems. Patient arrivals at the EDs are crucial for planning of the future. Accurate forecasting of patient arrivals contributes to better organized human resources and medical devices in the EDs. Therefore, in this chapter, the authors aim to develop a hybrid model including the methods of autoregressive integrated moving average with external variables (ARIMAX) and artificial neural network (ANN) in a hospital ED. The arrival data was collected from the hospital information system of a public hospital in eastern Turkey. The model incorporates factors related to ED arrivals such as climatic and calendar variables. By the aid of the proposed model, an insight to arrangement and planning of ED resources can be provided in a better way.
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Bruun, Anders, and Jan Stage. "Evaluating the Usability of Home Healthcare Applications." In Advances in Healthcare Information Systems and Administration, 319–39. IGI Global, 2011. http://dx.doi.org/10.4018/978-1-60960-177-5.ch014.
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Home healthcare applications have the potential to reduce healthcare costs and improve the quality of life for elderly people who prefer to stay in their own homes instead of making frequent visits to the hospital. This requires ambient assisted living applications that fulfil relevant needs of the users; yet it also requires applications with a high level of usability in order to achieve user acceptance, especially when the target user group is elderly people. This chapter proposes a method to be used for conducting usability evaluations of smart healthcare applications. It includes a report from a usability evaluation where the method was used to evaluate a simple home healthcare application for collecting personal health data in the home. The usability evaluation demonstrates that the method presented here facilitates identification of key usability problems, while the efforts required to conduct the evaluation are considerably reduced compared to conventional methods.
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Picoito, Célia, and Maria João Major. "New Public Management Reforms in the Portuguese NHS." In Handbook of Research on ICTs and Management Systems for Improving Efficiency in Healthcare and Social Care, 1156–71. IGI Global, 2013. http://dx.doi.org/10.4018/978-1-4666-3990-4.ch060.
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New Public Management (NPM) is a global paradigm that affects all public sectors, health included. Following the course of NPM reforms, Portuguese hospitals adopted a more business-oriented approach. Among various transformations hospitals have been through, the way they are financed changed from a retrospective finance system, based on a budget determined by the previous year’s costs, to “contratos-programa” that are established between each hospital, the provider, and Central Administration of the Health System (ACSS), the financier. Once these “contrato-programa” are based in prices per production lines, it is extremely important to have an effective cost system that can calculate accurate costs for each production line. With this purpose, in 2007 a pilot project was initiated to replace the existing and mandatory cost department method by Activity-Based Costing (ABC) method. In this chapter, the authors analyze the changes performed in the Portuguese hospitals by NPM movement and the role that traditional (cost department) and ABC methods play in it.
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Gartner, Daniel, and Rema Padman. "Mathematical Programming and Heuristics for Patient Scheduling in Hospitals." In Handbook of Research on Healthcare Administration and Management, 627–45. IGI Global, 2017. http://dx.doi.org/10.4018/978-1-5225-0920-2.ch038.
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The effective and efficient treatment of individual patients subject to scarce hospital resources is an increasingly important and challenging problem for decision makers to address. A recent study by the U.S. Bureau of Labor Statistics listed Registered Nursing among the top occupations in terms of job growth until the year 2022 (American Association of Colleges of Nursing (2015)). This growing demand can be explained in part by the large number of aging baby boomers with multi-morbid health conditions who typically require more treatments and longer length of stay in a variety of healthcare delivery settings (Vetrano et al. (2014)). Given the projected demand growth and reduced mobility of elderly patients, efficient operational research methods have to be developed and deployed for optimizing the process of scheduling the treatment of individual patients in highly resource constrained environments. We will henceforth denote this process as ‘patient scheduling' and provide a problem definition and a review of current approaches in the course of this chapter.
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Şahinbaş, Kevser. "Decision Support Proposal for Imbalanced Clinical Data." In Advances in Healthcare Information Systems and Administration, 168–200. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-7998-7709-7.ch010.
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The difficult diagnosis of acute appendicitis of patients appealing to the hospital with abdominal pain often leads to unnecessary acute appendicitis operations. Accordingly, the aim of this study is to be able to provide the correct diagnosis whether the existing case indeed necessitates operation or not through machine learning algorithms based on classification. To that purpose, SMOTE, random oversampling, and random undersampling methods were proposed to reduce the negative effects of imbalanced data set problem on classification, and it was benefitted from the risk factors in relation to Alvarado Score to predict the diagnosis of acute appendicitis. Additionally, a classification model was generated by using support vector machine classification algorithm. A decision support system was developed that could contribute to the decision making by generating interface for support vector machine algorithm in which the best performance was obtained.
Conference papers on the topic "Hospital Administration/*methods"
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Gloria, Chrismatovanie. "Compliance with Complete Filling of Patient's Medical Record at Hospital: A Systematic Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.29.
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ABSTRACT Background: The health information system, especially medical records in hospitals must be carried out accurately and completely. Medical records are important as evidence for the courts, education, research, and policy makers. This study aimed to investigate the factors affecting the compliance with completeness of filling patient’s medical records at hospitals. Subjects and Methods: A systematic review was conducted by searching from ProQuest, Scopus, and National journals using keywords medical records, filling of medical records, and non- compliance filling medical records. The abstracts and full-text articles published between 2014 to 2019 were selected for this review. A total of 62,355 articles were conducted screening of eligibility criteria. The data were reported using PRISMA flow chart. Results: Eleven articles consisting of eight articles using observational studies and three articles using experimental studies met the eligible criteria. There were two articles analyzed systematically from the United States and India, two articles reviewed literature from the United States and England, and seven articles were analyzed statistically from Indonesia, America, Australia, and Europe. Six articles showed the significant results of the factors affecting non-compliance on the medical records filling at the Hospitals. Conclusion: Non-compliance with medical record filling was found in the hospitals under study. Health professionals are suggested to fill out the medical record completely. The hospital should enforce compliance with complete medical record filling by health professionals. Keywords: medical record, compliance, hospital Correspondence: Chrismatovanie Gloria. Hospital Administration Department, Faculty Of Public Health, Universitas Indonesia, Depok, West Java. Email: chrismatovaniegloria@gmail.com. Mobile: +6281321161896 DOI: https://doi.org/10.26911/the7thicph.04.29
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Hall, Elke, Fiona Dakin, Christine Hirsch, John Speakman, and Jon Tomas. "25 A mixed-methods study to investigate nursing attitudes towards administration of ‘as required’ prescribed symptom control medication at end of life in a hospital setting." In Accepted Oral and Poster Abstract Submissions, The Palliative Care Congress 1 Specialty: 3 Settings – home, hospice, hospital 19–20 March 2020 | Telford International Centre. British Medical Journal Publishing Group, 2020. http://dx.doi.org/10.1136/spcare-2020-pcc.46.
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Bossaert, L., H. Demey, L. Colemont, and H. HRM. "PREHOSPITAL THROMBOLYTIC TREATMENT: A FEASIBILITY STUDY." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642982.
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Aim of the study: Thrombolysis is the treatment of choice in acute myocardial infarction (AMI). The delay between onset of symptoms and administration of thrombolytic drugs is critical for successful reperfusion and myocardial salvage. We studied the feasibility and safety of early prehospital thrombolytic treatment of AMI “at home”Methods: Eminase(R)(APSAC;BRL 26921 ) was used as thrombolytic agent: its long half-life allows administration as a single IV bolus. The study was performed in collaboration with a well organised group of GP's, extensively retrained in ECG and CPR for the purpose of this study. Whenever a GP made the tentative diagnosis of AMI of less than 2 hours, inclusion and exclusion criteria were reviewed using a check-list, and the mobile intervention team of the hospital (MITUZA), consisting of CCU physicians and emergency nurses, was activated. After rechecking all criteria, including a 12 lead ECG, brief medical history and physical examination, a single IV bolus of 30 U Eminase(R) was given, followed by transferral to the CCU. Follow-up included estimation of infarct-size and LV function using biochemical, ECG, radionuclide and angiographic methods.Results: Up till now, 15 male patients (age=57±9) have been treated using this protocol. Initial prehospital treatment consisted of Eminase(R) IV in 10 (reperfusion 9/10). Subsequent in-hospital treatment was streptokinase in 3 (reperfusion 2/3). In the 11 reperfused patients, PTCA was performed in 7 and CABG in 4. After onset of symptoms, the GP arrived after 55±24 min (15-90 min), Eminase(R) was administered after 95±28 min (75-130 min). The total calculated time gain (interval between treatment at home and admission in the CCU) was 42±15 min (20-75 min). There were no adverse events.Conclusion: This pilot study indicates that prehospital thrombolytic treatment of AMI is feasible and safe, resulting in a considerable time gain. Early reperfusion was obtained in 90%. Collaboration with a well organised and trained group of GP's, clearly defined inclusion and exclusion criteria and administration of the thrombolytic drug exclusively by experienced critical care physicians are mandatory.
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Erungan, Rianti Merviane. "Readiness of Human Resource, Logistics, and Finance in Handling Pandemic Covid-19 at Bhakti Wira Tamtama TNI Hospital, Semarang." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.25.
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ABSTRACT Background: Covid-19 is a highly infectious disease. In response to the estimated potential impact of COVID-19, standardized hospital preparedness and readiness measures are essential to contain nosocomial outbreaks and operate hospitals safely. This study aimed to investigate the human resource, logistics, and finance readiness in handling pandemic Covid-19 at Bhakti Wira Tamtama TNI hospital, Semarang. Subjects and Method: A qualitative study with a phenomenological approach was conducted at Bhakti Wira Tamtama TNI AD hospital, Semarang, Central Java, from April to May 2020. A total of 3 informants was selected by purposive sampling. The data were collected by in-depth interview, document review, and WHO Hospital Readiness questionnaire. The data were analyzed by classification, compilation, and tabulation compared to the WHO Hospital Readiness checklist. Results: Based on the WHO Hospital Readiness checklist, Bhakti Wira Tantama TNI AD hospital had sufficient human resources readiness for a capacity of 160 patients. But it showed limited readiness in logistics and financial resources in handling the Covid-19 pandemic. Conclusion: Bhakti Wira Tantama TNI AD hospital had sufficient human resource readiness but limited logistics and financial resources in handling the Covid-19 pandemic. Keywords: COVID-19, hospital readiness, World Health Organization (WHO) Correspondence: Rianti Merviane Erungan. Hospital Administration Study Program, Faculty of Public Health, Universitas Indonesia. Jl. Margonda Raya, Pondok Cina, Beji, Depok, Java Barat, 16424. Email: riantimaria@yahoo.com. Mobile: +628118899922 DOI: https://doi.org/10.26911/the7thicph.04.25
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R., Senthil J., Santa A., Pavan KB, Rakesh P., Pravanika G., Pravanika G., Narander Ch, and Krishna MMVT. "An Analysis of Acute Adverse Drug Reactions Occurring in Day Care Chemotherapy Setting in a Tertiary Care Cancer Centre." In Annual Conference of Indian Society of Medical and Paediatric Oncology (ISMPO). Thieme Medical and Scientific Publishers Pvt. Ltd., 2021. http://dx.doi.org/10.1055/s-0041-1735376.
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Abstract Introduction Acute adverse drug reactions (ADRs) in day care chemotherapy are not uncommon and easily manageable many a time. However, sometimes they may lead to untoward events. It is of paramount importance to document and analyze such events in contemporary medical oncology practice for the best utilization and planning of available personnel and resources. Objectives This study was aimed to analyze the acute ADRs occurring in day care cancer chemotherapy setting. Materials and Methods All acute ADRs reported in day care cancer chemotherapy setting, during the administration of chemotherapy, at Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India, were included in the study from June 15, 2020 to September 30, 2020. The ADRs were classified in to anaphylactic, allergic, and gastrointestinal (nausea/vomiting/heart burns/chest tightness). All ADRs were graded according to CTCAE version 5.0. Suspected drugs, time to reaction, and corrective measures were analyzed. Results During the study period, a total of 8,600 sessions of day care chemotherapy were administered. ADRs were noticed in 83 cases (~1%). Among the reported ADRs, anaphylactic reactions were noted in 20 patients (24%); allergic reactions of grades 1 and 2 were noted in 41 patients (49%). Gastrointestinal ADRs were noted in 30 patients (36%). Adverse reactions are mostly seen in oxaliplatin (22.8%), rituximab (14.4%), paclitaxel (15.6%), carboplatin (13.2%), and docetaxel (7.2%). In grade-I (10%) and grade-II (63%) resections, supportive treatment was provided and chemotherapy was continued. Grade-III ADRs were noted in 21 patients (25%) out of whom, 3 patients required short-term intensive care, chemotherapy was withheld until the next cycle in one patient, and chemotherapy regimen was changed in 3 patients. No patient died of ADR. Conclusion Serious ADRs are rare in contemporary medical oncology practice during day care chemotherapy administration. Most acute ADRs were easily managed.
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Hidayat, Rakhmad, and Budi Hidayat. "Dispute Analysis of Claims for Covid-19 Patients at Hospitals of Indonesia University." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.17.
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ABSTRACT Background: Indonesia is one of the countries affected by COVID-19 pandemic. In overcoming this pandemic, the government waives the service fees for COVID-19 patients. It provides an opportunity for hospitals serving COVID-19 patients to submit claims for treatment financing to the Ministry of Health. There are technical guidelines for payment; there are still frequent problems, leading to a dispute. This is also experienced by the University of Indonesia Hospital (RSUI) as one of the COVID-19 referral hospitals. This study aimed to provide an overview of the claim problem encountered and their solution. Subjects and Method: This was a descriptive study conducted at University of Indonesia Hospital from July, 2020. The theme of this study was problem in claiming payments for COVID-19 patients. Several informants were selected for this study included: hospital claim officers, medical record units, inpatient units and registration units. The data were collected by observation, in-depth interview, disputed claim data. Results: The results of the investigation found that the problem of dispute claims for COVID-19 in RSUI was dominated by the incompleteness of filling in administrative files as evidence of service practice for patients in the field, such as incomplete ventilator usage curves (7.8%), swab results (3.9%), and rapid test (6.8%) which was not listed. Conclusion: Discipline needs to be applied in the completeness of documents, and a clear flow of patient care is required to avoid incomplete records. Keywords: dispute, claim, COVID-19, hospital, health insurance Correspondence: Rakhmad Hidayat. Pascasarjana Kajian Administrasi, Fakultas Kesehatan Masyarakat Universitas Indonesia, Pondok Cina, Kecamatan Beji, Kota Depok, Jawa Barat 12345. Email: rhidayat.md@gmail.com. Mobile: (021) 7864975 DOI: https://doi.org/10.26911/the7thicph.04.17
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Sembiring, Dian Agnesa, Atik Nurwahyuni, and Wahyu Sulistiadi. "Analysis Study of The Comparative Quality of Patient Services Before and After Covid-19 Pandemic in Installation of Siloam Hospital TB Simatupang Installation." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.23.
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ABSTRACT Background: In the COVID-19 (Coronavirus Disease 2019) pandemic crisis that has hit Indonesia since early March 2020, urgent action is needed to overcome the situation while maintaining and improving relationships with customers so that they are still satisfied with the quality of services in hospitals, especially inpatient services. Since the COVID-19 pandemic, there has been a significant decrease in the number of inpatient visits at Siloam Hospitals TB Simatupang. This study aimed to analyze the comparison of the level of quality of patient service before and after the COVID-19 pandemic in installation of Siloam hospital TB Simatupang installation. Subjects and Method: This was a descriptive observational study conducted at Siloam Hospitals TB Simatupang from September 2020. A sample of 88 patients was selected by purposive sampling. The data was collected by questionnaire. The operationalization of this research variable is service quality, which is measured from five dimensions, namely Tangibles, Reliability, Responsiveness, Assurance, and Empathy. The data analysis used a series of tests such as validity test, reliability test, descriptive statistics and independent sample T-test. Results: During the COVID-19 pandemic, patients had a better perception than before the COVID-19 pandemic, it can be seen from service quality (Mean= 4.11), while during the COVID-19 pandemic (Mean= 4.250). Conclusion: Quality of services provided in outpatient installations during the COVID-19 pandemic is better than before the COVID-19. Keywords: service quality, COVID-19, outpatient Correspondence: Dian Agnesa Sembiring. Magister Program in Hospital Administration. Faculty of Public Health, University of Indonesia, Depok, West Java. Email: dianagnesa17@gmail.com DOI: https://doi.org/10.26911/the7thicph.04.23
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Gontina S, Willia, and Atik Nurwahyuni. "Determinants of Inpatient Cost for Patients with ST-Elevation Myocardial Infarct at Mayapada Hospital, Tangerang." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.27.
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ABSTRACT Background: Inpatient health services for heart attack patients is a complex problem and the highest billing rate in hospitals. Due to the high cost of hospitalization, delay treatment cases may cause fatal health consequences. This study aimed to determine factors affecting the inpatient cost for patients with ST-elevation myocardial infarction at Mayapada hospital, Tangerang, West Java. Subjects and Method: A cross-sectional study was conducted at Mayapada hospital, Tangerang, West Java, from July to December 2019. A sample of 31 patients diagnosed with ST-elevation myocardial infarction (STEMI) was selected by total sampling. The dependent variable was total inpatient service costs counted according to the clinical pathway. The independent variables were doctor in charge presented the direct cost, age, gender, patient’s distance to hospital, payment method, and length of stay. The data were collected using medical records. The data were analyzed by multiple linear regression. Results: Inpatient service cost in STEMI patients was positively associated with the doctor direct cost (b= 0.51; p= 0.003), distance to hospital (b= 0.13; p= 0.501), and length of stay (b= 0.39; p= 0.330). Inpatient service cost in STEMI patients was negatively associated with age (b= -0.30; p= 0.107), gender (b= -0.13; p= 0.550), and payment method (b= -0.26; p= 0.214). Conclusion: Inpatient service cost in STEMI patients have a positive association with the doctor direct cost, distance to hospital, length of stay, and negative association with age, gender, and payment method. Keywords: inpatient service cost, length of stay, STEMI patients Correspondence: Willia Gontina S. Masters Program in Health Policy and Administration, Faculty of Public Health, Universitas Indonesia, Depok, West Java. Email: amyamandacp@gmail.com. Mobile: +6281280778000. DOI: https://doi.org/10.26911/the7thicph.04.27
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Sidabalok, Jhonferi. "The Effect of Infection Prevention and Control Link Nurse Supervision and Resource Availability on Paramedic Hand Hygiene at Hanau Hospital, Seruyan District, Central Kalimantan." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.01.19.
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ABSTRACT Background: Hand hygiene was the most straightforward and most effective behavior to prevent nosocomial infection. Doing hand-hygiene in 5 moments must be endeavored to improve the quality of service in the hospital. Hospitals must have a PPI team where the Infection Prevention and Control Link Nurse (IPCLN) is part of the structure. The availability of facilities in the hospital is needed to support hand hygiene behavior. This study aimed to know the effect of IPCLN supervision and facilities’ availability on paramedical hand hygiene behavior at Hanau Hospital. Subjects and Method: This was a cross-sectional conducted at Hanau Hospital, Seruyan District, Central Kalimantan. A sample of 83 paramedics at Hanau Hospital was selected for this study by total sampling. The dependent variable was the behavior of hand hygiene paramedic. The independent variable was IPCLN supervision and the availability of facilities. The data were collected by questionnaire. The data was analyzed by Chi Square. Results: The respondents in this study were 67.5% women, 72.3% were under 30 years old, 74.7% had a Diploma-III education, and 69.9% worked less than 5 years. The supervision carried out by IPCLN (OR = 35.25; CI: 4.36 to 258.22), and the availability of facilities (OR = 24.35; CI: 5.10 to 116.26) was statistically significant (p <0.001). Variables that influence the behavior of paramedic hand hygiene at Hanau Hospital are supervision of the IPCLN towards paramedics (B = 2.86; OR = 17.42; 95% CI= 1.94 to 156.78; p= 0.011) together with the variable availability of facilities (B = 2.62; OR = 13.69; 95% CI= 2.62 to 71.49; p= 0.002). Conclusion: The supervision of IPCN and the availability of facilities affect the hand hygiene behavior of paramedics at Hanau Hospital. Keywords: hand hygiene, IPCLN, Supervision, Facilities, PPI Correspondence: Jhonferi Sidabalok, Hospital Administration Studies Master Program, Faculty of Public Health, Indonesia University. Email: jfs.usu98@gmail.com. Mobile 082154643424 DOI: https://doi.org/10.26911/the7thicph.01.19
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Bachtiar, Adang. "Effectiveness of Material Using CT Scan and MRI After Use of Picture Archiving and Commucating System and Radiology Information System at Radiological Installation of Bukit Tinggi National Hospital, West Sumatra." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.05.23.
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ABSTRACT Background: Efficiency while paying attention to service quality is the top priority of the hospital. The efficiency in radiology installations has also not gone unnoticed. The implementation of Picture Archiving and Commucating System (PACS) and Radiology Information System (RIS) is one of the efforts to control costs in radiology installations, especially in consumables’ efficiency (BHP). Bukittinggi National Stroke Hospital (RSSN), as one of the vertical hospitals located in the City of Bukittinggi, West Sumatra, has become a precursor to the implementation of PACS and RIS in this province. This study aimed to determine effect of material using ct scan and mri after use of picture archiving and communicating system and radiology information system at radiological installation of Bukittinggi national hospital, West Sumatra. Subjects and Method: This was a descriptive study conducted at Radiological Installation Of Bukittinggi National Hospital, West Sumatra from July 2020. The data were collected by observation and monthly report data. Results: The results of the analysis of the use of PACS and RIS had a significant impact on the cost efficiency of BHP CT scans and MRIs in the RSSN radiology installation reaching 97.9%. Conclusion: Transfer of CT scan and MRI results from film to DVD-R for internal RSSN patients with considerable efficiency. Keyword: PACS, RIS, cost control, BHP Correspondence: Widya. Postgraduate Administrative Studies, Faculty of Public Health, Universitas Indonesia. Pondok Cina, Kecamatan Beji, Kota Depok, Jawa Barat 12345. Email: mnwidya@gmail.com. Mobile: (021) 7864975 DOI: https://doi.org/10.26911/the7thicph.05.23
Reports on the topic "Hospital Administration/*methods"
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Lumpkin, Shamsie, Isaac Parrish, Austin Terrell, and Dwayne Accardo. Pain Control: Opioid vs. Nonopioid Analgesia During the Immediate Postoperative Period. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0008.
Full textAbstract:
Background Opioid analgesia has become the mainstay for acute pain management in the postoperative setting. However, the use of opioid medications comes with significant risks and side effects. Due to increasing numbers of prescriptions to those with chronic pain, opioid medications have become more expensive while becoming less effective due to the buildup of patient tolerance. The idea of opioid-free analgesic techniques has rarely been breached in many hospitals. Emerging research has shown that opioid-sparing approaches have resulted in lower reported pain scores across the board, as well as significant cost reductions to hospitals and insurance agencies. In addition to providing adequate pain relief, the predicted cost burden of an opioid-free or opioid-sparing approach is significantly less than traditional methods. Methods The following groups were considered in our inclusion criteria: those who speak the English language, all races and ethnicities, male or female, home medications, those who are at least 18 years of age and able to provide written informed consent, those undergoing inpatient or same-day surgical procedures. In addition, our scoping review includes the following exclusion criteria: those who are non-English speaking, those who are less than 18 years of age, those who are not undergoing surgical procedures while admitted, those who are unable to provide numeric pain score due to clinical status, those who are unable to provide written informed consent, and those who decline participation in the study. Data was extracted by one reviewer and verified by the remaining two group members. Extraction was divided as equally as possible among the 11 listed references. Discrepancies in data extraction were discussed between the article reviewer, project editor, and group leader. Results We identified nine primary sources addressing the use of ketamine as an alternative to opioid analgesia and post-operative pain control. Our findings indicate a positive correlation between perioperative ketamine administration and postoperative pain control. While this information provides insight on opioid-free analgesia, it also revealed the limited amount of research conducted in this area of practice. The strategies for several of the clinical trials limited ketamine administration to a small niche of patients. The included studies provided evidence for lower pain scores, reductions in opioid consumption, and better patient outcomes. Implications for Nursing Practice Based on the results of the studies’ randomized controlled trials and meta-analyses, the effects of ketamine are shown as an adequate analgesic alternative to opioids postoperatively. The cited resources showed that ketamine can be used as a sole agent, or combined effectively with reduced doses of opioids for multimodal therapy. There were noted limitations in some of the research articles. Not all of the cited studies were able to include definitive evidence of proper blinding techniques or randomization methods. Small sample sizes and the inclusion of specific patient populations identified within several of the studies can skew data in one direction or another; therefore, significant clinical results cannot be generalized to patient populations across the board.