ABSTRACT
Objectives: Knowledge of intensive care unit [ICU] admission patterns and characteristics is necessary for the development of critical care services, particularly in low-resource settings. This study aimed to describe the characteristics of critically-ill patients admitted to ICUs in Sudan
Methods: This prospective observational study was conducted between February and May 2017 in the ICUs of two government tertiary care hospitals in Khartoum, Sudan. A total of 100 consecutive adult patients admitted to the ICUs were included in the study. The patients demographic and clinical characteristics and Acute Physiologic Assessment and Chronic Health Evaluation [APACHE II] scores upon admission were recorded, as well as the reason for admission, presence of any underlying comorbidities, interventional requirements like mechanical ventilation or haemodialysis, length of stay in the ICU and patient outcome
Results: Of the sample, 58% were female and 42% were male. The mean age was 47.4 +/- 18.3 years old. Upon admission, the mean APACHE II score was 14.2 +/- 9.6. In total, 54% of the patients had no known underlying comorbidities. The most common reasons for ICU admission were neurological diseases [27%], sepsis or infectious diseases [19%] and postoperative management [12%]. Mechanical ventilation and haemodialysis were required by 35% and 11% of the patients, respectively. The average length of stay was 10.0 +/- 7.2 days and the mortality rate was 24%
Conclusion: Most of the patients admitted to the ICUs were middle-aged females with no known underlying comorbidities. Larger studies are necessary to provide a comprehensive understanding of the critical care needs of Sudanese hospitals
ABSTRACT
Objectives: This study aimed to show the impact of a multidisciplinary quality improvement project on adherence to antimicrobial prophylaxis guidelines in oncological surgery
Methods: This pre- and post-intervention prospective observational study was carried out at the King Hussein Cancer Centre [KHCC] in Amman, Jordan, between August 2009 and February 2012. The quality improvement project consisted of revising the institutional guidelines for surgical antimicrobial prophylaxis, assigning a clinical pharmacist to the surgical department, establishing an operating room satellite pharmacy and providing education regarding the appropriate utilisation of antibiotics. The medical records of adult cancer patients who underwent surgery were evaluated one month before and one month after the project was implemented to assess adherence to the guidelines with regards to antibiotics prescribed, drug doses and timing and treatment duration
Results: A total of 70 patients were evaluated before and 97 patients were evaluated after the intervention, of which 57 [81.4%] and 95 [97.9%] patients received antibiotics, respectively. In comparing the pre- and post-intervention groups, an improvement was observed in the proportion of patients who received antibiotics at the appropriate time [n = 12 versus n = 79; 21.1% versus 83.2%; P <0.01], for the appropriate duration of time [n = 22 versus n = 94; 38.6% versus 99.0%; P <0.01] and in the appropriate dose [n = 9 versus n = 87; 56.3% versus 98.9%; P <0.01]
Conclusion: Adherence to the antimicrobial prophylaxis guidelines at KHCC improved significantly after the implementation of a quality improvement project