ABSTRACT
Background@#The COVID-19 pandemic has emphasized the critical task of the UP Health Service in recognizing and addressing the primary care needs of health care workers and support staff of the Philippine General Hospital. This helps in effective staff management and engendering trust in the hospital that performs critical functions in the pandemic response.@*Objectives@#To determine the service and waiting time in the facilities of the UPHS and describe good practices and areas for improvement for better service delivery at the UPHS during the COVID-19 pandemic@*Methods@#A cross-sectional study using patient flow analysis of processes in the non-COVID, COVID, and swabbing areas of the UPHS was conducted from June 1 to 5, 2020. All clinic visits by PGH employees and health care workers, including consultations and procedure for swabbing, were included in the study. Average service and waiting time in three areas of the UPHS were measured and analyzed from recorded time points using Microsoft Excel. Daily observations recorded on field notes were transcribed and analyzed using MaxQDA Analytics Pro 2020.@*Results@#A total of 604 PGH employee visits in the three main service areas of the UPHS were recorded during the 5-day study period. The average total service time was 25 (SD±17) minutes in the non-COVID clinic and 12 (SD±5) minutes in the COVID clinic. The mean swabbing time was 2 (SD±3) minutes. The average waiting time was longest in the COVID clinic at 46 (SD±39) minutes, followed by the swabbing area at 33 (SD± 32) minutes, and was shortest in the non-COVID clinic at 10 (SD±17) minutes. Good practices were observed in the areas of communication and coordination among the UPHS team, staff complementation, and application of telehealth solutions. Meanwhile, improvements may be made in identifying a practical and robust queuing system, enforcing firmer infection prevention and control measures and providing clearer patient instructions and cues especially during patient surge.@*Conclusion@#The average service time in the non-COVID, COVID and swabbing areas of the UPHS, were 25, 12 and 2 minutes, respectively. The average waiting time was longest in the COVID clinic, followed by the swabbing and non-COVID areas. Good practices were observed in terms of leadership, communication, staff complementation and feedback process while infection control and prevention measures, queuing system for crowd control and patient instructions can be further improved.
Subject(s)
Health Services , COVID-19ABSTRACT
Objective To understand pathogenic microorganism contamination status of medical waste sharps containers with different use time, explore the reasonable duration of service time of sharps containers, provide reference for the management of medical waste.Methods Twelve 2 L sharps containers on treatment trolleys in a tertiary first-class infectious disease specialty hospital were randomly selected, viral loads of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) as well as bacterial colonies on inner and outer surfaces of sharps containers at different time points were detected, three unused sharps containers were taken as control at the same time.Results Sixty eluent specimens of outer surface and contents of sharps containers in trial group and control group were collected respectively at four time points (48 h, 72 h, 5 d, 7 d), no HIV and HCV were detected, and no HBV was detected in specimens of outer surface of sharps containers, HBV was detected in the eluent of contents in one sharps container 72 hours after the use, concentration of HBV was 2.20 E+01 IU/mL. Changes in bacteria in the eluent of used sharps containers: 100％ of the eluent of contents in sharps containers grew bacteria on the 5 th day after use, bacterial load of the eluent of contents in sharps containers on the 7 th day after use was incalculable. Bacterial load on the outer surface of sharps containers ranged from 1 to 9 CFU/cm2. No significant changes were observed in the inner and outer surfaces of all sharps containers, and no discomfort odor emerged.Conclusion With the storage time prolonged to 7 days, bacterial colonies on the outer surface of sharps containers didn't increase significantly, HIV, HBV and HCV were not detected. It is suggested that service time of sharps containers with small production of contents should not be set compulsorily at 48 hours (even if the contents in sharps container is less than 3/4 of storage capacity after 48 hours of use).
ABSTRACT
Objective: To compare the post-reduction service time between using a narcotic and combination of a narcotic with sedative drugs for reduction of acute anterior shoulder dislocation. Methods: Between 2004-2010, medical records and radiographs of patients who sustained acute anterior shoulder dislocation and obtained the successful reduction under sedation were reviewed. The patients were divided into 2 groups. Group 1, reduction was done under either intravenous morphine or pethidine and group 2, under either intravenous morphine or pethidine combined with diazepam. Post-reduction service times were recorded. The statistically significant difference was considered at p ≤ 0.05. Results: 42 patients were divided to 2 groups (21 patients in each group). The mean post-reduction service time of group 1 was 62.10 (SD = 31.42) and group 2 was 87.57 (SD = 32.07) minutes. The statistical analysis showed that group 1 significantly spent 25.47 minutes less post-reduction service time than group 2 (p = 0.013). Conclusion: Reduction of acute anterior shoulder dislocation under a narcotic significantly uses shorter post-reduction service time than under a combination of a narcotic with sedative drug in the emergency room.
ABSTRACT
Most extended care facilities have admitted both the healthy and unhealthy elderly, among which members' average caring demand vary. The Aged Welfare Law, however, currently provides no reasonable basis on the staffing policy for extended care facilities. It just reflects the admitted number of the elderly rather than differences in members' average caring demand among facilities. This study is designed to estimate the need for caring staff on the basis of the correlation between the individual health status measured by various tools including Activities of Daily Living and caring demand by actual service time for each one. The sample included all of the admitted elderly(187 persons) in 4 extended care facilities, two in Seoul and the other two in KangWon-Do over the survey period October 5 through October 20, 1996. The survey process consisted of 3 stages. (1) The current staffing information was collected through self-completed written questionnaires left for head official in each facility. (2) Six graduate students at School of Public Health interviewed all residents to collect information on their health status and sociodemographics. The response rate for the interview was relatively high(85%). (3) Information on direct and indirect caring time consumed for each residents came from self-completed written questionnaires given to nurses and helpers in each target facilities. Analysis of the data was made using Pearson's correlation and multiple regression technique through SAS program. Based on this procedure, the following was found. 1. No facility meet the staffing standard in the Aged Welfare Law completely. 2. It is actual service time that is most correlated with ADL(Activities of daily living). 3. When all of the elderly are divided by four groups based on the level of ADL, the mean values of needed caring time in each group are 15, 21, 36 and 88 minutes respectively. 4. There is no significant difference among facilities in distribution of elderly person by group. 5. No facility meets the estimated number of nurses and helpers which reflects health status of the admitted elderly. Therefore, it is required that severity of the admitted elderly be considered in establishing staffing standard for extended care facility.