Job satisfaction of the Nurses at Emergency Ward of Mahosot Hospital / Lao Medical Journal

Background and Rational@#Improving quality of services is one of the main strategies of the Ministry of Health to strengthen health care services, aiming to provide better care. The Emergency Ward (ER) of Mahosot Hospital provides services to patients 24 hours a day. Since the work there is very busy, some complaints were arisen from the nurses regarding the workload, insufficient staffing levels, and staffs did not have time for families. In addition, three nurses asked to change their jobs and 6 ask to move to another ward. We, therefore, conducted this study to assess job satisfaction of the nurses and obstacles in regards to their work and management.@*Methodology@#A descriptive cross-sectional study was conducted from 19-25 February 2018. Thirty-three nurses working in ER were interviewed using pre-designed and pre-tested questionnaire comprising 4 parts. Data analysis was done using SPSS.@*Result@#The mean age of the respondents was 34.3 years, 85% were female and 73% were married. Nearly half of them did not have children. Thirty-nine percent of them have worked for 6-10 years with 73% having a nursing degree. The majority of them are satisfied with their current work (90.9 %) and 79% of them said that they had a great job with appreciation from their colleagues. More than half had the appropriate opportunity for short-course training and support from the head of department. Observing their practice, we found that they had clean nursing uniform (66.7%), showed appropriate behaviors (54.5%), friendly service (54.5%) and had good relationships with their colleagues (63.6%). Regarding the obstacles and solution, they reported that some problems need to be solved including those related to human resource (90.9%), relationships with other nurses (21.2%), head nurses (9%), doctors (27.16%), nature of workplace and environment (63%), facility and management (27%), equipment and medicine availability (72.7%), remuneration (51.5%) and others (30%).@*Conclusion@#The job satisfaction level of the nurses at ER of Mahosot Hospital is high but there remain some concerns related to work safety, working environment, equipment and salary. Therefore, it is vital that these problems should be solved urgently in order to strengthen quality of health care service.

Knowledge, attitude and practice of needle stick injury and post exposure prophylaxis in undergraduate medical students

Background: Needle stick injury are the most common reason behind occupational blood exposure and most important source of exposure to another person’s blood.Methods: A cross-sectional observational questionnaire-based study of 450 undergraduate medical students which includes 100 from each years, Second year: Part I (II/I: Third Semester), Second year: Part II (II/III: Fifth Semester), Third Year (III: Seventh Semester), Fourth year (IV: Ninth Semester) MBBS and 50 Interns. The participation was voluntary and written consent was taken prior to enrollment. The objectives of study were explained, and validated questionnaire was administered to the students and collected in a single visit after 30-40 minutes.Results: The average age was 21.91±2.03 years. About 406 students were aware of disease transmitted by NSI. 189 students felt that occurrence of NSI, first person to be contacted is Medicine Physician. 208 don’t know of existence of PEP. 164 felt PEP is to be given for 4 weeks. According to 138 students PEP guidelines were proposed by NACO while 101 students felt WHO. 261 students felt that most probable chance of getting NSI was in emergency ward. 363students felt that need for NSI PEP training before clinical exposure is very important. 345 felt the need for insurance of HCWs for diseases transmitted by NSI.Conclusions: Medical students are highly vulnerable to NSI and there is need to provide adequate preventive measures, frequent training for needle stick injury and postexposure prophylaxis to all healthcare workers.

Factors for inhibition of early discharge from the psychiatric emergency ward for elderly patients

BACKGROUND@#As society is aging, the number of elderly patients with psychiatric disorder, such as dementia, is increasing. The hospitalization period of elderly patients in psychiatric wards tends to be prolonged. In this study, we have determined the factors that inhibit early discharge from the psychiatric emergency ward for elderly patients in Japan.@*METHODS@#The information was collected from patients admitted to our hospital's emergency ward for elderly patients with psychiatric disorders between May 2015 and April 2016. We compared various factors between the early discharge group and the non-early discharge group. In addition, we used a multiple logistic regression model to clarify the risk factors for non-early discharge.@*RESULTS@#Of the 208 elderly patients, body mass index (BMI) and serum albumin level were significantly lower in the non-early discharge group. In addition, we also showed that higher serum C-reactive protein (CRP) (> 0.5 mg/dL) and use of seclusion or physical restraint significantly inhibited the early discharge of patients. The results of multiple logistic analysis showed that the BMI ≤ 17.5 kg/m (OR, 2.41 [95% confidence interval (CI) 1.06-5.46]), serum albumin level ≤ 30 g/L (OR, 3.78 [95% CI 1.28-11.16]), and use of seclusion or physical restraint (OR 3.78 [95% CI 1.53-9.37]) are particularly important explanatory factors.@*CONCLUSIONS@#Hypoalbuminemia, low BMI, and the use of seclusion or physical restraint were identified as the factors that inhibit early discharge from the psychiatric emergency ward for elderly patients. These factors reflect malnutrition and extremely serious psychiatric symptoms.

Etiology and Drug Resistance of Lower Respiratory Tract Infection in Emergency Ward / 中华医院感染学杂志

OBJECTIVE To analyze the pathogens distribution and the antibiotic resistant characters.METHODS Sputum culture was performed in 267 cases who suffered from lower respiratory tract infection in emergency ward from Jan 2004 to Jun 2007.The results of 183 pathogens and drug sensitivity were analyzed.RESULTS The detected 183 strains of pathogens showed that Gram-negative bacilli accounted for 77.1%(Klebsiella pneumoniae was in the first place) and Gram-positive cocci were for 22.9%(Enterococcus faecium and Staphylococcus aureus were in the first places),the total drug resistance rate of Gram-negative bacilli to gentamicin,cefazolin,SMZ/TMP,piperacillin,ciprofloxacin and aztreonam had highly reached 60.5-70%,however to meropenem,cefepime,amikacin,imipenem and Sulperazone was 32.5-38.6%.Gram-positive cocci appeared generally higher multidrug resistant,the drug resistance rate of Gram-positive cocci to penicillins and erythromycin was all 100%,but the resistantce of Gram-positive cocci to vancomycin hadn′t been found.CONCLUSIONS Gram-negative bacilli are major pathogens in lower respiratory tract infection of emergency ward,K.pneumoniae is in the first place of Gram-negative bacilli and E.faecium and S.aureus are in the first places of Gram-positve cocci,both of them appearing highly multidrug resistant,analysis of pathogens and drug sensitivity are necessary to rational antibiotics usage,and the immunological protection should be enhanced.