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Submission content Introduction: This is a story about the day I wheeled a patient outside. I know, it sounds somewhat underwhelming. But little did I know that this short trip down a hospital corridor and beyond the entrance foyer would mark a profound shift in perspective both for me and my patient, which I hope will influence me for the rest of my career. Main Body: "Paul" was in his 50s and severely afflicted by COVID-19, resulting in a protracted ICU admission with a slow and arduous ventilator wean. Throughout his time on the unit, Paul had seen no daylight;no view of the outside world. He was struggling to make progress and was becoming exasperated. His deteriorating mood in turn affected his sleep, which further undermined his progress. Due to COVID-19, visiting was not permitted and Paul's cuffed tracheostomy meant that he couldn't speak to his family. One day, witnessing Paul's psychological decline, I asked him if he fancied a trip outside. Despite initial reluctance, he eventually gave in to some gentle persuasion from the staff nurse, with whom he had developed a close bond. So there we went;Paul, his nurse and me. And as we wheeled his bed through the door into open air, Paul's whole demeanour suddenly changed. He appeared as though the weight of the world had been lifted from his shoulders and his face lit up with awe, a tear emerging in the corner of his eye. In that moment he rediscovered life. Not as a hospital patient, but as a person. Watching the world go by, he remembered what it was like to be a member of the human race, not the subject of endless tests and treatments. He tasted freedom. Conclusion(s): Awakened by his experience of the forgotten outside world, when we eventually returned to the ICU Paul was an entirely different man. To Paul, the trip outside symbolised progress. After weeks of frustration and despair, he finally had a purpose;a motivation to get better. Meanwhile, I was having my own quiet realisation. I now understood what it truly meant to deliver holistic care. It can become all too easy to focus on the clinical aspects;to obsess about the numbers. But in fact, often what matter most to patients are the 'little things', to which no amount of medication is the solution. I now try to consider during my daily review: what matters to this patient? How are they feeling? What are they thinking? What else can I do to help their psychological recovery? And as for me personally? Having witnessed Paul's reaction to the outside world, I suddenly became aware of how little attention I normally pay to the world around me. How little I appreciate the simple ability to walk outside, and the fundamental things we take for granted. Now, when I'm feeling annoyed or frustrated about something trivial, I stop and think of Paul. I then thank my lucky stars for what I have to be grateful for. Ultrasound Ninja.
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Background: A considerable number of front-line workers are under risk due to repeated infection and exposure. The pattern of COVID 19 infection among the front-line workers was important, so that more focus would be laid on protecting them. Contact tracing is one key strategy for interrupting chains of transmission of SARS-CoV-2. This study aimed to find the pattern of COVID 19 infection among front line health workers and describe the process of contact tracing. Methodology: The list of front-line workers with possible symptoms of COVID-19 or had come in direct contact with a "case" was shared with the department of community medicine for contract tracing activity as per the guidelines. The front-line workers who were categorized as High Risk were quarantined immediately and those who were categorized as Low-Risk were advised to be vigilant regarding the development of symptoms and were asked to continue with their routine duties with extra precautionary measures as they form a very vital part of the resource in this combat against COVID-19. Result(s): About 138 front line health workers were affected by COVID-19 among which staff nurses (51) amounted to the maximum number who were affected. Conclusion(s): COVID-19 was high among front-line workers and had a large number of high-risk contacts. Nurses were found to be most affected with COVID 19 infection.Copyright © 2023, Institute of Medico-legal Publication. All rights reserved.
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Prevention is better than cure This covid-19 pandemic has made many changes in everyone's life, in this pandemic WHO focuses on the safety of healthcare workers and Safety ofpatients, WHO set COVID-19 protocols. Aim(s): Assessment of educational intervention on knowledge regarding World Health Organization covid-19 protocols during delivery among staff nurses. Methodology: The present study is evaluative study with methodological research design. A total of 60 samples were selected for the study by using the non -probability purposive sampling technique based on the selection criteria. The reliability was done by using the test re-test method for structured questionnaire. Data were analysed by using descriptive and inferential statistics. Result(s): In pre-test, 43.3% of the staff nurses had average knowledge (Score 4 to 6), 55% of them had good knowledge (Score 7 to 9) and 1.7% of them had excellent knowledge (Score 10) regarding WHO covid 19 protocols.In post-test, 18.3% of them had good knowledge (Score 7 to 9) and 81.7% of them had excellent knowledge (Score 10) regarding WHO covid 19 protocols. This indicates that the knowledge among the staff nurses regarding WHO covid 19 protocols had improved remarkably after the health teaching. Researcher had applied paired t-test for the effect of health teaching on knowledge regarding WHO covid 19 protocols. Average knowledge scorein pre-test was 6.8;which increased to 9.8 in post-test. T-value for this test was 14.08 with 59degrees of freedom. Corresponding p-value was small (less than 0.05), the null hypothesis is rejected. It is evident that the knowledge among the staff nurses regarding WHO covid 19protocols had improved significantly after health teaching. Conclusion(s): there is a significant gap in the knowledge score WHO COVID-19 Protocol among labour room nurses, and hence there is need for a WHO COVID-19 Protocol for the improvement of knowledge.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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INTRODUCTION. COVID 19 outbreak of the disease has put a lot of psychological pressure on Hospital staff who are in a direct contact with the patients. According to World Health Organization, among physical and mental illnesses, depression is one of the most common mental disorder in the world. Nursing out of all the other occupations ranked 27th amongst those prone for mental illness. During COVID-19 pandemic, the heavier workload and life-threatening condition of nurses aggravated the psychological pressure and were more at risk for after contacting with COVID-19 patients. Methodology: This cross-sectional study was conducted at tertiary care centre using convenience sampling after approval by Institutional ethics Committee. Tools used were ICD 10 for diagnosis, Patient Health Questionnaire (PHQ-9). Socio demographic factors and clinical variables were compiled using semi structured proforma. Result(s): Out of 150 nurses working in tertiary care hospital,74.7% (109)were females and 25.3%(38) were males of which 83% (125)were married and 14.7%(22) were single. 40.7% were diagnosed with minimal depression, 45.3% had mild depression,10.7% had moderate depression with 2% had moderately severe, 1.3% with severe depression. Conclusion(s): During the pandemic, nurses have worked under intense pressure, which has negatively affected their resilience and caused higher levels of depression. Awareness of health administration about the level of stress, anxiety, and depression and can help to provide psychological support programs for improving the mental health of nurses during the COVID-19 pandemic.
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Emotional Intelligence is an individual's ability to understand, use, and manage their own emotions in a positive way to relieve stress. The Staff Nurses has to possess the necessary skills in dealing with such stressful situations and to manage their emotions when in contact with patients especially in critical situationsBackground-Researcher Goleman explains that for success in a workplace, it is important for an individual to be emotionally intelligent rather than possessing intelligence quotient. Emotional Intelligence is very much required in the workplace, Emotional Intelligence can very well be taught in a lecture class and developed through an active listening, engagement, and participation. Objective(s): 1) To Assess the Effectiveness of self-Instructional module on knowledge regarding emotional intelligence among staff nurses working in COVID-19 unit in selected hospitals of the city. 2)To assess the pre-test knowledge regarding emotional intelligence among staff nurses working in COVID-19 unit in selected hospitals of the city. 3). To assess the post-test knowledge regarding emotional intelligence among staff nurses working in COVID-19 unit in selected hospitals of the city 4) To associate the post-test knowledge score with selected demographic variables. Methodology:A pre-experimental one group pre-test post-test design used for the study. It was conducted over 60 staff nurses by using non probability convenient sampling technique. Result(s): Assessment was done by Semi Structured questionnaire on demographic variable and self structured questionnaire on knowledge regarding Emotional Intelligence, Analysis reveals that s mean pre test knowledge score was 12.23 and mean post test knowledge score was 20.50. The calculated 't' value is 26.04 is greater than table value 2.00 at 0.05 level of significance. Hence it is statistically interpreted that self-instructional module on knowledge regarding emotional intelligence among staff nurses working in COVID-19 unit in selected hospitals was effective .The study also reveals that there is association post test knowledge score with age (in years) and educational qualification. ConclusionIt is statistically interpreted that self instructional module regarding emotional intelligence among staff nurses working in COVID-19 unit in selected hospitals was effective, based on the above findings it was concluded that self instructional module helped the staff nurses to understand emotional intelligence also they increased their knowledge with self instructional module. Copyright © 2022, Anka Publishers. All rights reserved.
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Introduction: Frontline Healthcare Workers (F-HCWs) are at the front position for medical care against Coronavirus Disease 2019 (COVID-19) pandemic which has life-threatening potentials. Poor level of knowledge, practices and negative attitudes as well as high-risk of psychological distress among F-HCWs can directly lead to delayed diagnosis, treatment and poor infection control practices. Aim: To assess the level of Knowledge, Attitude and Practices (KAP) as well as risk of psychological distress among F-HCWs for COVID-19 pandemic. Materials and Methods: This descriptive, hospital-based, cross-sectional study was conducted at Government Medical College, Azamgarh, Uttar Pradesh, India, located in tertiary care centre in rural area) from October 2021 to December 2021 among 223 F-HCWs using convenient sampling technique. To assess the level of KAP as well as risk of psychological distress among F-HCWs a prevalidated structured questionnaire was used consisting 15 knowledge questions, six attitude questions, 15 practices questions and six questions on risk of psychological distress. Chi-square test was performed to examine the association between risk of psychological distress and level of KAP as well as with demographic characteristics of F-HCWs. Results: Out of total 223 participants more than half of physicians (52.9%) and one-third of staff nurses (35.9%) were from age group of 25-35 years, respectively. Majority of both physicians (57.1%) and staff nurses (87.6%) were married and had nuclear type of family as of 64.3% and 74.5%, respectively. Most of the physicians (92.9%) had good level of knowledge but they had less positive attitude (84.3%) compare to staff nurses (92.8%). Majority of both physicians (64.3%) and staff nurses (58.2%) had no or low risk of psychological distress while only few of them had its high level. Conclusion: In this study majority of F-HCWs reported overall 'good' level of knowledge, attitude and practices for prevention of COVID-19. As for as risk of psychological distress was concerned, majority of F-HCWs had its no or low risk.
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Aims To understand barriers of implementing a near-miss reporting and sharing of lessons as part of patient safety II culture. Staff must be encouraged to report less serious incidents and near misses as well as more serious errors if lessons are to be learned and patient safety enhanced.1 A key task in the enhancement of patient safety involves the ability to learn from error.2 The intention is that any staff member, irrespective of role, grade, seniority, or experience, can call 'Stop the Line' if they see that required safety procedures and checks are not being followed. All members of staff are encouraged to 'Stop the Line' if they notice a series of steps/process that could potentially cause harm to a patient. The event/incident that is stopped is referred to as a 'near miss'. Methods Stop the line piloted in specific clinical area in our trust (Paediatrics unit, surgical ward, neurosurgical theatres). This project was commenced on 1st November 2020. But due to Covid 19 clinical workload pressure it was paused from April 2021, I took over the project last September 2021. -Despite the project being piloted since last year, still considerable number of staff not fully understanding the project and what are near misses and small numbers of near misses reported throughout following months. -A survey formulated and distributed to health staff across the trust to explore their knowledge of near misses and the barriers for lack of reporting. Results The survey designed and published to the staff through global email. Survey structured of four segments including the Department and Job position, Knowledge about the project, definition of a near miss event and how to report a near miss, questions to check situations classifications as near misses or not and questions regarding their perception of barriers for reporting near misses. -Total 60 Respondents from different departments and roles: -Respondents included variant range of roles in the health care system including Consultants, Support workers, Junior doctors, Staff Nurses, Head of Outpatient Services, Healthcare assistants, ward clerks, Pharmacist, Digital Communications Managers, Project officers, members from Patient Safety & Improvement, Resuscitation officers. 90% of respondents reported knowledge of near miss definition, and similar proportion acknowledges that near misses should be reported (87%) (figure 1). -Approximately two thirds of staff respondents were knowledgeable how to report near misses (63%) compared to 37% who did not (figure 1). -Among variable scenarios 73-88% of respondents could identify the near miss events. -Main suggested barriers to reporting near miss events were time constraints, lack of awareness of importance of near misses reporting and fear of reporting on colleagues involved in the event. Conclusion There is a gap between staff intent to record a near miss occurrence and actual event reporting which could be either due to low incidence of near misses in the health organization or simply because of under reporting. (Figure Presented).
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Background and aims: Since 2015, the medical intensive care unit (ICU) with a focus on hepatology of the Department of Internal Medicine 1 at the University Hospital Regensburg, Germany, has a particular emphasis on interprofessional collaboration with staff nurses and hospital pharmacists. The hospital pharmacists have access to the hospital information system and the electronic charting program. Consultations take place on daily basis. Furthermore, weekly joint rounds within the antibiotic stewardship program are performed. Furthermore, there is a joint training and teaching of medical, nursing and pharmacy students within the intensive care training ward Regensburg (I’M A-STAR project). The study aims to investigate to what extent the newly introduced structural changes affect clinical and economic outcomes. Method: We examined clinical performance data and consumption figures for antibiotics and other drugs over a 10-year period from 2011 to 2021. Data from the hospital pharmacy, hospital administration, electronic charting, and hospital information systems were included in the analyses. An electronic platform was developed specifically to improve documentation. The years 2020 and 2021 were considered separately due to the COVID-19 pandemic and the care of numerous COVID-19 patients in the ICU. Results: It could be shown that the pharmacist’s recommendations regarding drug administration were mainly related to indication (43.6%), dosage (27.6%), interactions (9.4%), and side effects (4.1%). Antibiotic consumption was reduced by 12.2% from 2015 to 2019. Encouragingly, this included a 23.4% reduction in carbapenem use. Antibiotic spending was reduced by 24.9% overall. An analysis of the intensive care G-DRGs showed that the case-mix points increased significantly by 31.6% during the period under review. Similarly, patient severity of illness as measured by the SAPS II score increased by 21.4%. The proportion of mechanically ventilated patients exceeded 50%. In another analysis, antibiotic spending per case-mix point was calculated. While spending was EUR 60.22 per case-mix point in 2015, this could be reduced by 42.9% to EUR 34.37 per case-mix point by 2019. Conclusion: Through close interprofessional collaboration between physicians, staff nurses, and pharmacists, the consumption of antibiotics and other drugs (e.g., albumin) was significantly reduced, thus improving patient care. There was also a positive economic effect-with a simultaneous increase in case-mix points, expenditure on antibiotics was significantly reduced. Responsible use of resources and high-performance medicine are not contradictory. In our view, a close interprofessional collaboration between physicians, staff nurses, and pharmacists will be of outstanding importance in the future, particularly in intensive care medicine.
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Introduction: The new Coronavirus Disease 2019 (COVID-19) has put a strain on healthcare workers, and the virus offers major personal and professional threats. Mental health has been affected by the COVID-19 epidemic, causing them to be fear of becoming sick. During the COVID-19 pandemic, health care professionals have been psychologically impacted including fear, anxiety, and depression. Aim: To determine the level of COVID-19 fear among hospital nurses in tertiary hospital care hospital, Erode dristrict, Tamil Nadu. Materials and Methods: This cross-sectional survey study was conducted among employees of Government Erode Medical College Hospital and nearby Hospitals in Erode district, Tamil Nadu, India, from July 2020 to August 2020, to evaluated the fear of COVID-19 using the Fear of COVID-19 Scale (FCV-19S). It used a self-administered questionnaire (online Google form survey). It consisted of two parts, first was socio-demographic details and second was fear of COVID-19 Scale (FCV-19S). The inclusion criteria of participants were all staff nurses working in COVID-19 ward, for minimum of three months in Erode district and willingness to participate. One-way Analysis of Variance (ANOVA) F-test and student Independent t-test analysis was performed to examine the relationship between demographic characteristics and fear levels. results: The study included a total of 277 staff nurses. The participant's mean age was 32.25±6.45 years, with females accounting for 93.5% of the total. The scale's internal reliability was excellent, with a Cronbach's alpha of 0.902. Overall, the mean COVID-19 fear score was (59.3%) 20.8 out of 35. The maximum fear score was for the statement "I am most afraid of Corona" (65%) and the minimum fear score was for "I cannot sleep because I am worried about getting Corona" (51.8%). Fear levels were higher in females (p-value=0.02), overweight people (p-value=0.001), those living in joint families (p-value=0.01), married individuals (p-value=0.03), participants with two children (p-value=0.001), and Primary Healthcare Center (PHC) staff (p-value=0.001). conclusion: The survey found a high level of fear in staff nurses who work in COVID-19 wards. Steps must be taken to preserve their health, by providing adequate resources to relieve their worries and anxiety, enabling them to carry out their frontline duties in the face of the COVID-19 epidemic.
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Background. Antimicrobial resistance is a major public health threat internationally but, particularly in Colombia. High and increasing rates of carbapenemases are challenging. Implementing antimicrobial stewardship programs (AMSs) in a large, academic, public network hospitals in Bogotá, Colombia.will help curb inappropriate antibiotic use. Methods. AMS was established in April 2020 consisting of an administrative champion, Infectious Diseases staff, nurse, General Physician, microbiologist, and pharmacists. Antimicrobial stewardship program interventions included postprescriptive audit and establishment of institutional guidelines. The AMS tracked appropriate drug selection including loading dose, maintenance dose, frequency, route, duration of therapy, de-escalation, and compliance with AMS recommendations. Defined daily dose (DDD) of drugs and health economics evaluations of antimicrobials (April-December 2020). Recommendations are placed in the electronic medical record as a progress note. Results. From April to December 2020, 1013 patients were evaluated by means of a prospective methodology. Unnecessary 689 days of hospitalization and 4420 days of antibiotic therapy were avoided. Among the top antibiotics discontinued were piperacillin tazobactam for the months of July, August, November and December, while for September and October was meropenem. The intensive care unit was the most frequently intervened service (52%), followed by hospitalization (43%) and the emergency department (5%).Over the course of the year, there was significant adherence to the program, with 100% in July, followed by 93.3% in April, 87% in December, 86.6% in May and June, 83% in November, 80% in September, 73.3% in August and 57% in October. The AMS program was able to save $47.409US in antibiotics and $55.529US in hospitalization, and 11% decrease in nephrotoxicity events (14 renal failures were avoided), which also saved additionally $ 23.503 US for a total of an estimated cost saving for the network public hospitals of $ 126.441 US by 2020. Conclusion. Implementation of a multidisciplinary antibiotic stewardship program in this academic, large, academic, public network hospitals in Bogotá, Colombia demonstrated feasibility and economic benefits even in a Covid19 pandemic situation.
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Objectives: To Analyse the impact of clinical pharmacist intervention on the administration of injectable anti-viral agents by nurses in the treatment of COVID-19 infection. Methods: A One-group pre-test, post-test experimental study was conducted during the month of May 2021 among the staff nurses of a secondary care hospital using a pre-structured and pre-validated questionnaire. The questionnaire was organized into 3 domains i.e, Knowledge, Attitude, and Practice (KAP) regarding injectable anti-viral agents including Remdesivir were evaluated. Demographic details, as well as the related information, were also collected. Paired-t-test and Chi-square tests were employed to evaluate the statistical significance of the study variables. Results: A total of 56 nurses were included in the study, among which the majority (59.7%) were diploma holders and the rest of them were degree holders in nursing. On analyzing the years of experience of study samples, it was found that the majority had 1-4 years experience (46.3%) followed by 4-8 years (28.6%) and the least percentage had experience for more than 12 years. The pre-test vs post-test values of the staff nurses shows a significant improvement in Knowledge (6.7vs.10.5, p<0.001), Attitude (6.7vs 8.9, p=0.003), and Practice domain (7.1604 vs 8.3, p<0.001). No statistically significant association was observed between knowledge and practice of the nurses with the baseline variables like level of education or years of experience (P=0.07). Conclusions: Clinical Pharmacist initiated continuing education programs for the nurses related to the administration practices of anti-viral agents like Remdesivir is very much crucial in assuring the proper clinical care to critically ill COVID-19 patients.