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Background: High risk pregnancies in intra-partum period are vulnerable, and if not appropriately attended, may roll on to maternal death or dreaded maternal near-miss cases. Despite the presence of a number of standard treatment guidelines designed to address most of the high risk conditions, their adherence and implementation continues to be uncommon. To assess the adherence to recommended guidelines during referral of high risk pregnancies in labour in mothers of the difficult terrains of eastern Himalaya. Methods: A descriptive epidemiological study with cross-sectional design was conducted among mothers with high risk pregnancies admitted in the labour ward, North Bengal Medical College Hospital, Darjeeling. 433 subjects were studied using complete enumeration technique. Results: Anaemia in pregnancy (22%), obstructed labour (19%), pre-term rupture of membranes (15%) and pregnancy induced hypertension (15%) were the high risk conditions identified. Referral linkage existed in most (70.7%) but no pre-referral treatment was given to 61.4% of the intra-partum mothers. Multivariate analysis shows mothers with age more than 35 years (AOR 4.97), bad obstetric history (AOR 2.40) & not attended by doctors (AOR 5.02) were found to be having more odds of missing the pre-referral treatment. About 86% of the gaps in pre-referral treatment were due to doctors not attending patients, lack of referral communication, not providing JSSK facilities and non-maintenance of Partograph as per Pareto analysis. Conclusions: Most of the non-adherence to standard treatment guidelines in high risk intra-partum mothers are related to health service delivery and can be ameliorated through proper administrative measures.
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OBJECTIVE@#To explore the effect of Pareto analysis on the investigation of DR (Digital Radiography) high fault rate.@*METHODS@#The quality control team was established to analyze the causes of DR high fault rate by using the fault statistics of eight DR in our hospital for nearly three years,and to formulate and implement countermeasures,then compare them with the data after rectification.@*RESULTS@#After three months of implementation,the number of DR faults in our hospital decreased from 130 times/quarter to 47 times/quarter,a year-on-year drop was 63.8%.Among them,the number of console faults decreased from 105 times/quarter to 25 times/quarter,a year-on-year drop was 76.2%,close to 80%.@*CONCLUSIONS@#Pareto analysis is effective in reducing DR fault rate and is worthy of being promoted to other medical devices.
Subject(s)
Humans , Radiographic Image Enhancement , Reference StandardsABSTRACT
Objective To analyze the regularity and characteristics of 2621 cases of adverse drug reaction (ADR) occur-ring in our hospital during 2013-2016 ,and to explore the factors and causes of ADRs ,so as to provide evidence for the contin-uous improvement of rational use of drugs .Methods 2621 cases of ADR reports were retrospectively analyzed by monitoring software to extract ADR report source ,patient age and sex ,related pharmaceutical dosage forms ,routes of administration , clinical characterization ,organ involvement and other information .The Pareto method was used to identify the main drugs that caused ADR and ADR factorial analysis was performed with Fishbone diagram .Results ADR mainly reported by physicians (2573 cases ,98 .17％ ) and pharmacists reported at least (3 cases ,0 .11％ );population aged >70 years accounted for the lar-gest proportion (570 cases ,21 .74％ );ADR mainly caused by intravenous infusion (1680 cases ,64 .10％ ) .The clinical mani-festations were gastrointestinal system lesions (717 cases ,24 .17％ ) .Pareto analysis showed that the main drug factors in-volved anti-infective drugs ,anti-neoplastic drugs ,Chinese medicine injections and parenteral nutrition drugs .Fishbone analysis showed that elderly patients ,intravenous administration ,incomplete monitoring and related drugs were the determining factors associated with ARDs .Conclusion The close attention should be paid to monitoring and guidance of special populations ,espe-cially the elderly ;reducing intravenous forms ,monitoring the main factors of medicines ,carrying out the individualized medica-tion monitoring ,strengthening clinical pharmacy ,in order to promote clinical rational use drug and reduce the occurrence of drug-induced diseases .
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Objective To study the value of objective information transformation by analyzing oral diseases in outpa-tient department of our hospital and the diagnosis and treatment of oral diseases between expert clinic and outpatient clinic. Methods Oral diseases in over 50000 cases who visited the outpatient department of our hospital in 2015 were classified according to the ICD10 and analyzed by Pareto analysis. Results Dental carries, pulpitis, chronic periodontitis and dental crowding were the major diseases detected in outpatient department of our hospital, ac-counting for 80% of the total outpatients, and importance was thus attached to their treatment. Oral diseases re-ceived orthodontic therapy in expert clinic and received tooth implantation in outpatient clinic. Conclusion Hospi-tals should scientifically allocate their medical resources, strengthen the training of their young dentists, bring into full play of their limited medical resources according to the distribution of oral diseases in their outpatient depart-ments in order to meet the increasing demand of oral healthcare.
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[Objective] The disease distribution of in-patients in different age groups from 1993 to 2002 in respiratory disease department of Guangdong Provincial Hospital of Traditional Chinese Medicine (TCM) was analyzed to provide evidence for clinical treatment. [ Methods ] A retrospective research was adopted. Fourteen categories of diseases and 3 age groups were classified according to the case history recorded from 1993 to 2002 in respiratory disease department of Guangdong Provincial Hospital of TCM. Reasons for hospitalization of the in-patients in different age groups during 10 years were analyzed by descriptive analysis and Vilfredo Pareto analysis. [Results] The principal and secondary reasons for hospitalization were respiratory tract infection, pulmonary tuberculosis and pneumothorax in the young age group while in the old age group, they were chronic bronchitis, pulmonary emphysema, chronic pulmonary heart disease and lung cancer. [Conclusion] The focus of daily medical treatment in the department of respiratory disease should vary with the age groups and disease categories, and the control of infectious diseases should be generally strengthened.