Analysis and prevention of integrity risks in the use of medical insurance funds in a hospital / 中华医院管理杂志

Medical insurance fund is the foundation for the healthy operation of the medical insurance system, which is related to the well-being of the people and social stability. Medical institutions, as important entities in the implementation of medical insurance policies and the use of medical insurance funds, should continuously improve and optimize their self-management, and strengthen the prevention and control of clean risks in the use of medical insurance funds. This is not only a necessary response measure in the context of strict supervision of national medical insurance funds, but also an inevitable choice for hospitals under the trend of high-quality development. This article took a certain hospital as an example to illustrate the practice of sorting out the relevant authority directory for the use of medical insurance funds, analyze the integrity risk points of doctors, patients, and medical insurance reimbursement auditors; And introduced the practice of using a clean risk prevention and control grid to strengthen the hospital′s medical insurance fund, including improving the medical insurance management system, cultivating a sustainable culture of integrity, optimizing process design, improving information system construction, and improving medical insurance service modes, so as to provide reference for other medical institutions.

Effect of Health Education on Malaria Control Practices among Mothers of Under-Five Children in a Rural Nigerian Community

Background/Purpose:Malaria is an established health challenge and a major cause of mortality and morbidity among under-five children in Nigeria. This community-based study was designed to assess the effect ofhealth education packages on the malaria control practices of mothers of under-five children in Ibeagwa Nike Enugu State.Methods:The study utilized a quasi-experimental study design with a sample size of 124 mothers that attended the infant welfare clinic at the community health center and those that received treatment of minor childhood illnesses for six months. A multistage random sampling technique was used in choosing the required samples. The instrument for the collection of data was a self-adapted and validated questionnaire. Reliability was assessed and yielded a Cronbach’s correlation coefficient of 0.823. Data generatedwere summarized using simple descriptive statistics of frequencies and percentages and analyzed using Fishers’ exact test and Chi-square. Results:Findings of the study showed that: the practice of malaria control practices was very low below 40% before health education intervention; malaria control practices increased significantly above 40% after the health education intervention; hindrances to the practice of malaria control measures reduced after the health education intervention; there is poor awareness of environmental hygiene as a method of malaria control measure before health education.Conclusion:Periodic health education on the importance of malaria control practices should be conducted in the community regularly, to promote control of malaria

Perceived effectiveness of infection control practices in Laundry of a tertiary healthcare centre / 世界急诊医学杂志（英文）

@#Hospital management in modern milieu has become patient oriented and good patient outcome is a result of effective and efficient medical care along with provisions of hygienic food, clean linen, safe environment, congenial atmosphere and good interpersonal relationship.[1] Laundry is one such important support service which ensures prevention as well as containment of hospital infections and is also a determining factor for maintenance of good image of a hospital.[2]

Nosocomial Infection in the Neonatal Ward of a Tertiary Care Hospital: The Role of Active Surveillance in the Control of Klebsiella pneumoniae Outbreak.

Aim: To describe an outbreak which occurred in a neonatal ward and the role of active surveillance in the control of further outbreaks. Study Design: Cross Sectional Observational Study. Place and Duration of Study: Lady Hardinge Medical College and Associated Hospitals, between May 2013 and June 2014. Methodology: The Infection Control Team (ICT) conducts active surveillance in the neonatal ward (NNW) routinely every year. The data regarding the above mentioned period were analysed and infection rates were calculated on monthly basis and compared. Attack rate was calculated as number of patients who acquired hospital acquired infections/ total number of admissions during that month. Results: A sudden increase in bloodstream infection (BSI) from 2 cases to 16 cases were observed over a period of 2 months (November 2013, and December 2013). Therefore an outbreak was suspected. Sixteen cases of primary blood stream infections caused by ceftazidime/ amoxicillin – clavulanic acid -resistant Klebsiella pneumoniae were observed over a two month period. Case definition was made. Recommendations for Infection control practices with immediate effect were sent. The ICT visited NNW and main labour room. Relevant samples were collected and Klebsiella species was isolated from suction tubing, baby cot, feeding katori, fingertip of health care worker (HCW) and soap sludge. Bacterial identification and antimicrobial susceptibility testing was performed by using the automated Vitek 2 instrument. The antibiogram of Klebsiella species from the samples and cases was found to be similar. It was found that NNW staff was changed recently without any training in Infection control practices. There was breach in Infection control practices. Conclusion: Active surveillance plays a very important role in detection of early onset of outbreak. All the HCWs including resident doctors, nursing and subsidiary staff and others must be trained in Infection control practices before they are posted to high risk areas.

A study on the impacts of infection control education on dental hygienists' perceptions for hepatitis type B and their practices to prevent infection / 대한치과보철학회지

PURPOSE: The purpose of this study is to examine the impacts of infection control education on dental hygienists'perceptions for hepatitis B and their behaviors. MATERIALS AND METHODS: Study participants were chosen by random selection among dental hygienists working in Seoul, Korea. A total of 150 questionnaires were sent out for the survey from April 2013 to May 2013, of which 140-excluding incomplete responses-were used for the study. Chi-square tests and t-tests were used (SPSS 19.0), and post-hoc analysis was performed as well. The maximum significance level was 0.05. RESULTS: Average 1.53 times infection control education was taken, but dental hygienists' perceptions for hepatitis B and their behaviors did not show statistical differences whether the education was done or not. Practices to prevent infection showed differences depending on categories, especially disinfection and sterilization were well performed by educated group. The most common reasons for not taking the education and noncompliance with infection prevention guidelines are lack of time and opportunity due to busy schedule. CONCLUSION: 1. The more highly educated, the greater number of patients per day, and the greater size of hospitals, the better infection control education was conducted. 2. Although hepatitis B is one of the most common chronic liver diseases in Korea, no significant correlation between perceptions of hepatitis B and infection control education was found. 3. Dental hygienists who received infection control education performed more efficient practices for protection against infections than those who did not.

Body Weight Satisfaction: Association with Weight Control Practices among Type 2 Diabetic Patients

Introduction: The recommendation to lose weight has been the guiding principle in the treatment of type 2 diabetic patients. However, to facilitate this process, it is vital to understand factors associated with personal feelings about body weight and related behaviour. Methods: The objectives of this cross-sectional study were (1) to determine mean BMI and weight of satisfaction and (2) to measure the association between body weight satisfaction vs. sex, BMI, glycaemic control (as measured by Fasting Blood Glucose (FBG), and attempts to lose weight among type 2 diabetic patients. Descriptive statistics and non-parametric tests were employed (SPSS 16). A total of 67 subjects were recruited from Klinik Kesihatan Bandar Kuantan (age = 54.1 ± 8.1 years; female = 62.7%; Malay = 73.1%; overweight/obese = 62.7%) who completed a set of self-administered questionnaires. Results: The mean BMI and weight of satisfaction were 27.9 ± 5.3 kg/m2 and 62.7 ± 10.9kg respectively. A greater proportion of women (65.0%) reported dissatisfaction with their body weight. Patients with higher BMI generally reported greater dissatisfaction with body weight compared to those with lesser BMI (p = 0.090). There was no significant difference in the glycaemic control of patients who were satisfied or dissatisfied with their weight (p = 0.839). There was also no significant association between body weight satisfaction and diet (p = 0.957), physical activity (p = 0.517) or both (p = 0.734). Conclusion: This study implies that body weight satisfaction alone is not a strong factor that may drive type 2 diabetic patients to control their body weight.

Correlations between genotyping and antibiograms of clinical isolates of Pseudomonas aeruginosa from three different south Indian hospitals.

Purpose : To compare the molecular relationships and antibiograms of nosocomial isolates of Pseudomonas aeruginosa obtained from three different genres of hospitals located in Southern India, two located at Hyderabad (one private hospital and an ophthalmic hospital) and one in Puducherry (tertiary care teaching hospital). Each of these hospitals, which follow different infection control strategies and various problems associated with it, were investigated. Materials and Methods : Antibiograms generated by disk diffusion susceptibility testing for clinically relevant antibiotics and genotyping through fluorescent amplified fragment length polymorphism analysis (fAFLP) were the tools used in the study. Results: Molecular genotyping revealed a heterogeneous group of unrelated molecular clusters of P. aeruginosa strains having higher resistance that are apparently being endemic throughout the tertiary care teaching hospital. In eye care hospital, only a few distinct strains of P. aeruginosa predominating the study period were shown to be responsible for outbreaks. The third private hospital witnessed a group of resistant and persistent strains that might have clonally originated from a diverse collection of strains. Conclusions : The divergent kind of strains in our study suggests that there may be a direct link between the infection control practices followed in each hospital and kind of strains isolated in that particular setup. The study also emphasizes the need for maintaining infection control practices in hospitals with superior standards, failure of which might result in thriving of persistent P. aeruginosa clones in the hospitals.

Survey on control and management practices of equine helminthes infection / Inquérito sobre práticas de manejo e controle das helmintoses em éguas no Brasil

Twenty-nine stud farms were selected in the Medium Paraíba region of the Rio de Janeiro state, Brazil. After an interview with the person responsible for the animals, faecal samples were collected from mares and analyzed via the EPG technique, faecal cultures, Sedimentation-centrifugo-flotation, and modified Ueno and Baermann techniques. The prevalence of helminths in the mares and in the stud farms was calculated. The stocking rates of pasture, change of horse bedding, absence of pasture rotation, absence of technology in the property, and less frequent treatment of the animals were associated with a greater prevalence of helminths, showing that these variables must be considered in equine control programs. The intensity of the parasitism was also associated with the stocking rate of pasture, absence of dunghill, presence of the animals only in paddocks, lack of technology in the property, less frequent treatment of the animals, and absence of the use of rotation regarding the anthelmintic class.

Vinte nove haras foram selecionados na região do Médio Paraíba, Estado do Rio de Janeiro, os responsáveis pelos animais entrevistados e amostras fecais de éguas foram coletadas e submetidas às técnicas de OPG, Coprocultura, Sedimento-centrifugo-flutuação, Ueno e Baermann modificadas. A prevalência dos helmintos para as éguas e haras foi calculada. A capacidade de suporte, a troca de cama nas baias, a ausência da rotação do pasto, a ausência do tecnificação na propriedade e menor freqüência do tratamento dos animais foram associadas à prevalência maior dos helmintos, indicando que estas variáveis devem ser consideradas em programas de controle dos helmintos de eqüinos. A intensidade do parasitismo foi também associado à capacidade de suporte do pasto, à ausência de esterqueira, à presença dos animais somente nos pastos, à ausência do tecnificação na propriedade, à menos freqüência do tratamento e à ausência de uso da rotação da classe anti-helmintica.