Evaluation of National Patient Safety Implementation Framework in Selected Public Healthcare Facilities of Tamil Nadu: An Operational Research.

BACKGROUND: The Ministry of Health and Family Welfare has introduced the "National Patient Safety Implementation Framework" to ensure the patient safety at different levels of healthcare delivery system. However, there is limited effort made in evaluating the implementation status of this framework. Hence, we have performed the process evaluation of National Patient Safety Implementation Framework across the public healthcare facilities in Tamil Nadu. METHODS: This was a facility-level survey conducted by research assistants who visited 18 public health facilities across 6 districts of Tamil Nadu, India, for the purpose of documenting the presence of structural support systems and strategies to promote patient safety. We developed a tool for data collection based on the framework. It comprised a total of 100 indicators under the following domains and subdomains: structural support, systems for reporting, workforce, infection prevention and control, biomedical waste management, sterile supplies, blood safety, injection safety, surgical safety, antimicrobial safety, and COVID-19 safety. RESULTS: Only one facility (subdistrict hospital) belonged to the high-performing category with a score of 79.5 on the implementation of patient safety practices. About 11 facilities (4 medical colleges and 7 Government Hospitals) belonging to medium-performing category. The best-performing medical college had a score of 61.5 for patient safety practices. Six facilities (2 medical colleges, 4 Government Hospitals) belonged to low-performing category in terms of patient safety. The least-performing facilities (both subdistrict hospitals) had scores of 29.5 and 26 for patient safety practices, respectively. Because of COVID-19, there was a positive effect on biomedical waste management and infectious disease safety across all facilities. Most performed poor in the domain with structural systems to support quality and efficiency of healthcare and patient safety. CONCLUSIONS: The study concludes that based on the current situation of patient safety practices in public health facilities, it will be difficult to perform full-fledged implementation of patient safety framework by the year 2025.

Effectiveness of Covishield vaccine in preventing Covid-19 - A test-negative case-control study.

INTRODUCTION: This study aimed at assessing the vaccine effectiveness (VE) of Covishield, which is identical to AstraZeneca vaccine, in preventing laboratory-confirmed Covid-19. METHODS: Using test-negative case-control design, information on vaccination status of cases with Covid-19 among healthcare workers in our institution in Puducherry, India, and an equal number of controls matched for age and date of testing, was obtained. The groups were compared using multivariable conditional logistic regression to calculate odds ratios (OR). VE was calculated as 100*(1-adjusted odds ratio)%. RESULTS: Using data from 360 case-control pairs, VE of one dose and of two doses, in providing protection against Covid-19 was 49% (95% CI: 17%-68%) and 54% (27%-71%), respectively. Among cases with moderately severe disease that required oxygen therapy, VE following any number of vaccine doses was 95% (44%-100%). CONCLUSION: Covishield vaccine protected significantly against Covid-19, with a higher protection rate against severe forms of disease.

Prevalence of Depression and Anxiety during the COVID-19 Pandemic among the Residents of an Urban Slum in North India.

Objectives This study aimed to estimate the prevalence of depression and anxiety, and assess the knowledge, practice, and concerns regarding coronavirus disease 2019 (COVID-19) among the residents of an urban slum in Chandigarh, India. Materials and Methods Participants were screened using Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales. Results The mean (standard deviation) age of 200 enrolled participants was 33 (13) years with 83% ( n = 166) being females. The prevalence of depression and anxiety was 3.5% (95% confidence interval [CI]: 0.95-6.05) and 2.5% (95% CI: 0.34-4.66), respectively. Of total, 46% ( n = 92) knew that COVID-19 can transmit through droplets and 30.5% ( n = 61) were concerned that they might get infected with disease. Half of the participants ( n = 100) believed that there was unnecessary worry regarding COVID-19 and 78% ( n = 156) covered mouth while coughing or sneezing. Conclusion To cope with this critical situation, it is necessary to strengthen the awareness programs targeting the mental health issues of the people.