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Abstract Objective This study analyzes the role of clinical simulation in internal medical residency programs (IMRP) in Obstetrics and Gynecology (OB/GYN), attributed by the supervisors, in the training of residents in the city of São Paulo (SP). Methods Cross-sectional descriptive, qualitative, and exploratory approach. Semi-structured interviews were performed with ten supervisors of Medical Residency programs in Obstetrics and Gynecology. Interviews were analyzed by means of content analysis under the thematic modality, starting with the core the role of clinical simulation in Obstetrics and Gynecology Medical Residency Programs. Results Supervisors view Clinical simulation as: a complementary tool for the teaching and learning process, a possibility of a safe teaching and learning environment, an opportunity to learn from mistakes, a support for professional practice committed to patient safety, a learning scenario for teamwork, a scenario for reflection on the work process in Obstetrics and Gynecology, a scenario for evaluative processes in the medical residency. Still according to supervisors, Clinical Simulation favors decision-making and encourages the resident participation in activities. Conclusion Supervisors recognize Clinical Simulation as a powerful pedagogical tool in the learning process of resident doctors in Obstetrics and Gynecology Residency Programs.
Resumo Objetivo O presente estudo analisa o papel da Simulação Clínica em programas de Residência Médica (PRM) de Obstetrícia e Ginecologia, atribuído pelos supervisores, na formação do residente no município de São Paulo (SP). Métodos Abordagem qualitativa, transversal, de natureza exploratória e descritiva. Foram realizadas entrevistas semiestruturadas com dez supervisores de programas de Residência Médica de Obstetrícia e Ginecologia. Para análise das entrevistas foi realizada análise de conteúdo na modalidade temática partindo do seguinte núcleo: o papel da simulação clínica nos Programas de Residência Médica de Obstetrícia e Ginecologia. Resultados A Simulação Clínica, na visão dos supervisores, emerge como: ferramenta complementar para o processo de ensino e aprendizagem; possibilidade de um ambiente de ensino e aprendizagem seguro; possibilidade de aprendizagem a partir do erro; suporte para prática profissional comprometida com a segurança do paciente; cenário de aprendizagem para o trabalho de equipe; cenário de reflexão sobre o processo de trabalho em Obstetrícia e Ginecologia; favorecimento na tomada de decisão; cenários de processos avaliativos na residência; e, por fim, estímulo à participação dos residentes nas atividades. Conclusão Os supervisores reconhecem a Simulação Clínica como uma ferramenta pedagógica potente no aprendizado dos médicos residentes em Obstetrícia e Ginecologia.
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Humans , Obstetrics and Gynecology Department, Hospital , Health Human Resource Training , Patient Safety , Simulation Training , Internship and ResidencyABSTRACT
AIM: To clarify the content of nursing care provided to sexually assaulted females when they present at a medical institution immediately after the assault. DESIGN: Qualitative descriptive study. METHODS: Individual semi-structured interviews were conducted with 20 female nurses and midwives affiliated with medical institutions collaborating with the one-stop Support Center for sexual violence victims. Data were analysed using content analysis. RESULTS: The study identified five forms of nursing care: providing safety and reassurance, supporting smooth physical exams, building trusting relationships, supporting the recovery of emotional/physical health and dignity, and ensuring continuity of support. There were three types of institutional systems in victim care: (a) male doctors are sometimes involved in care, (b) female doctors provide care with nursing supervisors, and (c) female doctors take the lead to provide care. Nursing care content extracted in this study was influenced by the structure of the medical institution with which the nurses were affiliated.
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Crime Victims , Nursing Care , Sex Offenses , Humans , Male , Female , Emergency Service, Hospital , Qualitative ResearchABSTRACT
OBJECTIVE: The practices pertaining to hereditary breast and ovarian cancer (HBOC) in Japan have been rapidly changing owing to the clinical development of poly(ADP-ribose) polymerase inhibitors, the increasing availability of companion diagnostics, and the broadened insurance coverage of HBOC management from April 2020. A questionnaire of gynecologic oncologists was conducted to understand the current status and to promote the widespread standardization of future HBOC management. METHODS: A Google Form questionnaire was administered to the members of the Japan Society of Gynecologic Oncology. The survey consisted of 25 questions in 4 categories: respondent demographics, HBOC management experience, insurance coverage of HBOC management, and educational opportunities related to HBOC. RESULTS: A total of 666 valid responses were received. Regarding the prevalence of HBOC practice, the majority of physicians responded in the negative and required human resources, information sharing and educational opportunities, and expanded insurance coverage to adopt and improve HBOC practice. Most physicians were not satisfied with the educational opportunities provided so far, and further expansion was desired. They remarked on the psychological burdens of many HBOC managements. Physicians reported these burdens could be alleviated by securing sufficient time to engage in HBOC management, creating easy-to-understand explanatory material for patients, collaboration with specialists in genetic medicine, and educational opportunities. CONCLUSION: Gynecologic oncologists in Japan are struggling to deal with psychological burdens in HBOC practice. To promote the clinical practice of HBOC management, there is an urgent need to strengthen human resources and improve educational opportunities, and expand insurance coverage for HBOC management.
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Oncologists , Ovarian Neoplasms , Breast Neoplasms , Carcinoma, Ovarian Epithelial , Female , Humans , Japan , Surveys and QuestionnairesABSTRACT
SUMMARY OBJECTIVE: This study aimed to evaluate the knowledge of the obstetricians and gynecologists in the care of women victims of violence in the public health system and the existence of institutional mechanisms to support them. METHODS: A cross-sectional and observational study was conducted with an electronic questionnaire by physicians who provided care in the obstetrics and gynecology emergency unit of the public health system. This study aimed to identify the care for victims of violence who received the institutional mechanisms of support, the difficulties encountered in determining the appropriate care, and estimates of the prevalence of violence against women. RESULTS: Notably, 92 physicians responded to the questionnaire. Of these, 85% had already provided care in one or more cases of violence, and 60% believed that <20% of the women received adequate care in these cases, mainly due to the short-time frame of the consultation, lack of team preparation, and lack of institutional resources. A total of 61% of the participants believed that they were not prepared to provide adequate care in those cases. CONCLUSIONS: Most of the physicians interviewed, although reported to have sufficient knowledge to adequately treat victims of violence, did not provide such care due to lack of institutional support.
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The COVID-19 pandemic has stressed healthcare systems in the United States and globally. Limited hospital resources, increasing patient surge, and growing demands on healthcare providers have led to the United States Surgeon General and the Centers for Medicare & Medicaid Services calling for suspension of all nonessential adult elective surgery and medical procedures. As of March 27, 2020, 30 states had issued similar declarations related to elective procedures in the setting of the continuing COVID-19 pandemic. Two major questions have emerged as these events have unfolded: (1) What is the definition of an "elective" procedure? and (2) Are there specialty-specific considerations for obstetric and gynecologic procedures? This article provides insights into each of these questions and provides a working framework for obstetrician/gynecologists to advocate for their patients and coordinate with their hospital systems to develop "elective" procedure guidelines that incorporate considerations for women's and maternal health.
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OBJECTIVE: Residents have a professional obligation with respect to the stewardship of health care resources, yet there is a paucity of research on how to improve residents' cost-awareness. Rising health care expenditures highlight a critical need to improve education related to this competency. This study aimed to test if an educational module can teach residents to make cost-conscious decisions and reduce health care spending. METHODS: All Canadian obstetrics and gynaecology residents in 2017 were eligible to participate in this randomized controlled trial. The study was administered online via REDCap. Interested residents were enrolled, stratified by level of training, and block randomized. Residents completed a survey to determine their management of 4 obstetrical scenarios. The intervention group reviewed an educational module on cost-effective ordering prior to completing the survey; the control group was given the option to review the module afterward. The primary outcome was mean total expenditures, compared between the 2 groups using the t test. RESULTS: Eighty-five residents were enrolled between August and November 2017, and 63 residents from 13 Canadian residency programs completed the study requirements (33 control and 30 intervention). Mean total expenditure was CAD$291.03 (95% CI 259.38-322.68) versus CAD$192.98 (95% CI 170.67-215.29) for the control and intervention groups, respectively. These figures corresponded to a 33.69% or CAD$98.05 reduction in total expenditures (P = 0.0001). CONCLUSION: This educational module decreased expenditures by Canadian obstetrics and gynaecology residents managing hypothetical obstetrical cases. This introduces a potential curriculum innovation to improve resident education in judicious use of health care resources.
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Gynecology/education , Health Care Costs , Internship and Residency , Obstetrics/education , Adult , Canada , Clinical Competence , Cost-Benefit Analysis , Curriculum , Female , Health Resources , Humans , Male , Pregnancy , Resource AllocationABSTRACT
BACKGROUND: The frequency of surgical site infection (SSI) is different according to the different hospitals and is not completely known in the hospital. OBJECTIVE: To describe the clinical and laboratory characteristics in gynecological and obstetric patients with SSI, as well as its frequency, associated risk factors and the most frequently isolated microorganism in cultures. MATERIAL AND MEHOTDS: Descriptive, cross-sectional, retrospective and observational study. The total number of SSI patients in the gynecology and obstetrics services were studied, consulting the database of the epidemiology service, clinical and electronic records; the data collection and the statistical analysis were carried out, reporting the results with means, standard deviations and percentages. RESULTS: In the 11,967 surgeries performed in 2017, SSI was detected in 110 gynecological patients and 249 obstetric patients. The relevant risk factors were obesity and previous abdominal surgeries. The most commonly isolated microorganism in cultures in both patients was Escherichia coli. CONCLUSIONS: The frequency of SSI was 2.4% for gynecological procedures and 3.3% for obstetric procedures, similar to that reported by the Centers for Disease Control and Prevention.
INTRODUCCIÓN: La frecuencia de infección de sitio quirúrgico (ISQ) es distinta según los hospitales. OBJETIVO: Describir las características clínicas y de laboratorio en pacientes ginecológicas y obstétricas con ISQ, así como su frecuencia, los factores de riesgo asociados y el microorganismo más frecuentemente aislado en los cultivos. MATERIAL Y MÉTODOS: Estudio descriptivo, transversal, retrospectivo y observacional. Se estudiaron todas las pacientes con ISQ en los servicios de ginecología y obstetricia, consultando la base de datos del servicio de epidemiología y los expedientes clínicos y electrónicos. Se llevó a cabo la recolección de la información y el análisis estadístico, reportando los resultados con medias, desviaciones estándar y porcentajes. RESULTADOS: En las 11,967 intervenciones quirúrgicas realizadas en 2017 se detectó ISQ en 110 pacientes ginecológicas y 249 pacientes obstétricas. Los factores de riesgo relevantes fueron obesidad y cirugías previas abdominales. El microorganismo más aislado en los cultivos en ambos tipos de pacientes fue Escherichia coli. CONCLUSIONES: La frecuencia de ISQ fue del 2.4% para los procedimientos ginecológicos y del 3.3% para los obstétricos, similar a lo referido por los Centers for Disease Control and Prevention de los Estados Unidos de Norteamérica.
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Laboratories , Surgical Wound Infection , Cross-Sectional Studies , Female , Humans , Pregnancy , Retrospective Studies , Risk Factors , Surgical Wound Infection/diagnosis , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiologyABSTRACT
The hospital, specialized in obstetrics and gynecology, has developed a specialty development system and clinical practice model based on its clinical pharmacy practice. The model features enhancing the service capability of clinical pharmacologists, development of a pharmacologist training pipeline, enhanced popularization of relevant knowledge, and tapping potential for clinical pharmacy research. These experiences provide useful references for pharmacy specialty development at specialized hospitals.
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Objective To explore and assess the reasonable application of integrated collaborative service mode in obstetrics and gynecology clinical service.Methods 152 pregnant women admitted in obstetric outpatient from March 2016 to May 2016 were randomly assigned into observation group and control group,76 cases in each group.The control group received obstetric traditional outpatient treatment and hospitalization mode,while the observation group implemented the integrated collaborative service mode.It was a integrated mode based on the traditional mode and multidisciplinary professionals integrated into groups for synergistic services,from the beginning of pregnancy to discharge.Results The number of cases who were knowledged maternal diseases,intraoperative coordination,reasonable diet and breastfeeding of the observation group (69,70,69,66) were superior to those of the control group (51,40,54,50) (x2=17.56,52.58,12.44,11.11,all P<0.001).The incidence rate of maternal and neonatal complications of the observation group were significantly lower than those of the control group(t=12.04,6.49,2.87,9.26,-7.14,all P<0.005).And patients satisfaction survey was improved,the number of satisfaction and complaint in the observation group was 70 persons,1 person,which of the control group was 70 persons,6 persons (x2=7.65,P<0.01).Conclusion Integrated collaborative service mode can improve the quality of medical service and patients' satisfaction,while reduce cesarean section rate,postpartum hemorrhage and maternal complications.Integrated collaborative service mode is an effective method to promote the development of perinatal medicine.
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ABSTRACT Objective To evaluate laparoscopic skills of third-year Gynecology and Obstetrics residents after training at a training and surgical experimentation center. Methods Use of a prospective questionnaire analyzing demographic data, medical residency, skills, competences, and training in a box trainer and in pigs. Results After the training, there was significant improvement in laparoscopic skills according to the residents (before 1.3/after 2.7; p=0.000) and preceptors (before 2.1/after 4.8; p=0.000). There was also significant improvement in the feeling of competence in surgeries with level 1 and 2 of difficulty. All residents approved the training. Conclusion The training was distributed into 12 hours in the box trainer and 20 hours in animals, and led to better laparoscopic skills and a feeling of more surgical competence in laparoscopic surgery levels 1 and 2.
RESUMO Objetivo Avaliar a habilidade laparoscópica dos residentes do terceiro ano de residência médica em Ginecologia e Obstetrícia após treinamento em um centro de treinamento e experimentação cirúrgica. Métodos Aplicação de questionário de forma prospectiva analisando dados demográficos, da residência médica, da habilidade, da competência e do treinamento em caixa preta e em porcas. Resultados Após o treinamento, houve melhora da habilidade em laparoscopia de forma significativa na avaliação dos residentes (antes 1,3/depois 2,7; p=0,000) e preceptores (antes 2,1/depois 4,8; p=0,000). Houve melhora significativa na sensação de competência em cirurgias de níveis 1 e 2 de dificuldade. Todos os residentes aprovaram o treinamento. Conclusão O treinamento dividido em 12 horas de caixa preta e 20 horas em animais trouxe melhora na habilidade em laparoscopia e na sensação de melhora na competência cirúrgica em cirurgias laparoscópicas de níveis 1 e 2.
Subject(s)
Humans , Animals , Adult , Clinical Competence , Laparoscopy/standards , Gynecology/standards , Internship and Residency , Obstetrics/education , Swine , Teaching , Program Evaluation , Surveys and Questionnaires , Laparoscopy/education , Models, Animal , Gynecology/educationABSTRACT
Despite low childbirth rate in Korea, the number of women with high-risk pregnancies is steadily increasing, mostly due to increased maternal age, multiple pregnancies, and obesity. In fact, one out of five Korean women is above 35 years old at childbirth. It is well known that high risk pregnancy is closely related with increased maternal mortality, either by direct or indirect causes. Despite such problems, however, Korea's health care infrastructure for childbirth has deteriorated, leaving approximately 20% of the geographic area of the country medically underserved with regard to optimal maternity care. Such a collapse has been caused by the decrease in the number of maternity hospitals and their financial difficulties due to medical fee reimbursement for childbirth being too low. The problem is aggravated by a lack of obstetricians who can provide skilled attendance at childbirth. In addition, extensive legal pressure has dissuaded talented medical students from pursuing obstetrics and gynecology, thereby resulting in aging and severe gender imbalance in such professions. The direct consequence of the collapse in infrastructure for childbirth is an increased maternal mortality ratio, especially in underserved areas. Moreover, increased maternal death caused by postpartum bleeding reflects an obvious sign of danger in the maternal health care system. Furthermore, the number of tertiary hospitals that can provide optimal care to high risk pregnant women has decreased to two-thirds of what it once was, and the training of competent obstetricians for the mothers of the future continues to be a difficulty.
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Female , Humans , Pregnancy , Aging , Aptitude , Delivery of Health Care , Fees, Medical , Gynecology , Hemorrhage , Hospitals, Maternity , Korea , Maternal Age , Maternal Death , Maternal Health , Maternal Mortality , Medically Underserved Area , Mothers , Obesity , Obstetrics , Obstetrics and Gynecology Department, Hospital , Parturition , Postpartum Period , Pregnancy, High-Risk , Pregnancy, Multiple , Pregnant Women , Students, Medical , Tertiary Care CentersABSTRACT
Objective To better understand the knowledge, attitudes, practice (KAP) and relative demand of precon?ception and prenatal care (PAPC) in medical staffs of obstetrics and gynecology department in Tianjin. Methods Using ran?dom, stratified and clustered sampling approach, we selected 382 obstetrics and gynecology personnels in Tianjin. A self-ad?ministered questionnaire on PAPC KAP was employed to survey their general characteristics, their awareness of PAPC knowledge, their attitudes to PAPC, their service capabilities of PAPC and their request of continuing education. Results The respondents were lacking of KAP in Calcium and Iron supplementation, alternative preconception examination and emerging prenatal examination but present good KAP in folic acid supplemen, necessary prenatal items and classic prenatal examination. Doctors′average knowledge score was higher than nurses′. The scores in primary health care institutions was significantly higher than that in tertiary and secondary medical institutions. Young and junior medical respondents showed higher awareness than older and senior ones. Most (91.21%) respondents believe that PAPC is necessary. But 86.54%of re?spondents are not confident enough to provide comprehensive PAPC services. There were 63.74%, 54.67%, 38.74% and 32.42%of the respondents who could provide special PAPC advisory of adverse pregnancy history, thyroid dysfunction, re?productive infections and diabetes respectively. The most urgent training contents include PAPC knowledge in presence of complications or risk factors, advances in prenatal diagnosis, nutrition during pregnancy and consulting skills. Conclusion It′s necessary to intervent obstetrics and gynecology personnels to improve their cognitive level to PAPC, as well as to amelio?rate relative attitudes and behavior so they can provide more scientific and comprehensive PAPC service.
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Objective To understand the knowledge, attitude, practice (KAP) status and relative demand to combined oral contraceptives (COCs) in medical staffs of obstetric and gynecological department in Tianjin, providing reference basis for the effective intervention measures. Methods By using random, stratified and clustered sampling approach, we selected 382 medical staffs of obstetric and gynecological department in Tianjin. A self-administered Questionnaire on COCs KAP was employed to survey the general characteristics, awareness of COCs knowledge, attitudes to COCs, service capabilities of contraceptive counseling, prescribing behavior and request of continuing education. Results The respondents showed de?fects in COCs indications, non-contraceptive benefits, relationship with cancer and birth defects. The average knowledge score was higher in doctors than that of nurses. The higher the titles and qualifications, the higher the knowledge score. A to?tal of 90.11%of respondents believed that strengthening the contraceptive guidance can help to reduce pregnancy. Strength?ening the interpretation of misunderstanding (81.04%) and enhancing the treatment and follow-up of adverse reactions (62.09%) can help to reduce stop taking. Only 25.82%of respondents could provide detailed COCs relative consulting servic?es;42.96%of obstetricians and gynecologists refused prescribing COCs for women over the age of 40 for the purpose of con?traception. A total of 93.13%medical personnel showed demand on relative training. Conclusion It’s necessary to perform continuing education to medical staffs via different intervention, so as to improve their cognitive level to COCs, ameliorate COCs relative attitudes and behavior, and help them providing better service to women of childbearing age.
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Objective To evaluate the efficacy and safety of domestic cefepime ,ceftazidime and cefathiami-dine on bacterial infection in gynecology .Methods 460 patients were randomly divided into Group A (155 patients) for 2.0g.bid of cefepime,Group B (155 patients) for 2.0g.bid of ceftazidime and Group C (150 patient) for 2.0g. bid of cefathiamidine ( intramuscular injection:once every 12 hours ) , and the periods of treatment were all 7 to 10 days.Control observation and study was carried out following Guiding Principle of Clinical Application of Antibacterial Agents.Results The clinical efficacies in Groups A ,B and C were 94.84%,82.58% and 67.33%respectively(χ2 =11.63,37.96,all Pthat of Group B>that of Group C;the adverse effectives were 9.68%,10.32% and 9.33% respectively (χ2 =0.09,P>0.05).Conclusion Cefepime may still be used as the first line drugs ,and drug resistance of various degrees has occurred to ceftazidime and cefathi -amidine,and especially cefathiamidine ,which should be used with caution .
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BACKGROUND:Recently, the biodegradable materials with good biocompatibility and with no adverse reaction have been widely applied in the clinical treatment and care of gynecology and obstetrics. The development of the biodegradable material is very rapid. OBJECTIVE:To summarize the application of biodegradable materials in gynecology and obstetrics. METHODS: The first author searched PubMed and CNKI databases for articles related to biodegradable materials in gynecology and obstetrics using the keywords of “degraded materials, biodegradable materials, gynecological care, surgery” in Chinese and English respectively. This article has an outlook of the potential application in gynecology and obstetrics based on clinical experience. RESULTS AND CONCLUSION:Biodegradable materials with good biocompatibility and biological security play an important role in biomedical materials. Their polymers and degradation products show smal adverse reactions to the body, and have good biomechanical properties, physical and chemical properties and good workability, which have been widely used in gynecology and obstetrics, such as absorbable stylolite and tampon tape. Although we have made a great progress on the biomaterial research, it stil has the limitation and safety flaws in the clinic. As the biomaterial research is further developed, the biomaterial application prospect wil be more promising.
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Se realizó un estudio analítico en el Hospital “Referal Baucau” de Timor Leste, en el Sudeste de Asia, con el objetivo de comparar la atención obstétrica de la brigada médica cubana en los años 2006 y 2007. La población de estudio estuvo constituida por 2 163 gestantes en el 2006 y 2 520 en el 2007, las cuales fueron atendidas durante el embarazo, parto y puerperio por médicos cubanos. Los datos fueron obtenidos de las historias clínicas individuales y del registro hospitalario existente. Existió un aumento en la frecuencia de partos en el segundo año de estudio, predominaron los partos a término, con peso adecuado del recién nacido; descendieron las complicaciones maternas, las tasas de mortalidad perinatal, fetal y neonatal. Se concluye que todos los indicadores analizados se comportaron favorables a la salud materno-fetal en el 2007, en relación con el 2006.
An analytic study was made in “Referal Baucau” Hospital from Timor Leste, South East- Asia, with the aim of comparing obstetric attention of the Cuban Medical Brigade from 2006 to 2007.Study population was constituted by 2 163 expectant woman from 2006 and 2 520 from 2007, who were attended by Cuban physicians during pregnancy, delivery and puerperium. Data were obtained from individual medical charts and the existing hospital register. There was an increase of deliveries in the second year studied; term labor predominated with an adequate weight; maternal complications decreased, as well as, perinatal, fetal and neonatal mortality rates. As a conclusion, all analyzed indicators of maternal-child health from 2007 were favourable, in relation to 2006.
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Obstetrics and Gynecology Department, Hospital , Delivery, ObstetricABSTRACT
This study aimed violence against obstetrics and gynaecology nurses and assess their reaction and cross-sectional study was conducted in 2009 among 416 randomly selected nurses in obstetrics and gynaecology departments in 8 hospitals in Cairo, Egypt. Data were collected using a self-completed questionnaire and Likert scale to record sociodemographic characteristics, exposure to workplace violence and nurses' reaction and attitude to it. The majority of nurses [86.1%] had been exposed to workplace violence. Patients' relatives were the greatest source of violence [38.5%] and psychological violence was the most common form [78.1%]. Carelessness [40.5%] and malpractice of nurses [35.8%] were reported as the usual causes of violence. For psychological and physical violence < 50% of the nurses used the formal system to report abuse. Most nurses [87.2%] considered workplace violence had a negative effect of on them. Guidelines for protection of nursing staff are needed
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Workplace , Nurses , Attitude , Obstetrics and Gynecology Department, Hospital , Cross-Sectional Studies , Surveys and Questionnaires , ViolenceABSTRACT
Objective To investigate the utilization of antibacterials in perioperation for obstetrics and gynecology after the issuing of the notice by the general office of the Ministry of Health "further strengthen in the management of clinical application of antibacterials". Methods According to the survey on the use of antibacterials, 272 cases of surgical patients from April to December 2007 (treatment group) and 270 cases ofsurgical patients from April to December 2008 (control group) in obstetrics and gynecology department were selected,the utilization after the application of antibacterials were investigated and compared. Results The utilization rate of prophylactic use of antibacterials in treatment group and control group were 83.09% (226/272), 84.44%(228/270) respectively (P>0.05). Preoperative use were 77.94%(212/272), 85.19% (230/270) respectively (P< 0.05). The time of medication were (5.8 ± 2.8) d and (4.5 ± 3.8) d respectively (P<0.0l). Drug sensitivity rates were 2.94%(8/272), 2.22%(6/270) respectively (P>0.05). Both used intravenous as the main administration route, double therapy used as the major drug combination. Conclusions Comparison of utilization of antibacterials in perioperation for obstetrics and gynecology before and after the enforcement of "the guiding principle of clinical use of antibacterials" and "further strengthen in the management of clinical application of antibacterials" issued by the general office of the Ministry of Health. The utilization of antibacterials exist some defects:remains high starting point for administration;without an additional if operative time exceed three hours;longer administration time and double therapy as the major drug combination. In summary,there still are some deficiencies that needs co-management and improvement
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OBJETIVOS: Avaliar a aplicabilidade da profilaxia da oftalmia neonatal em cinco serviços de obstetrícia de maternidades da Grande Florianópolis no período de março de 2007. MÉTODOS: Cinco serviços de obstetrícia de maternidades da Grande Florianópolis foram visitados e questionados quanto ao método realizado na prevenção da ON, o custo por unidade de colírio utilizado, o conhecimento do método de Credé e a legislação vigente. RESULTADOS: As soluções profiláticas utilizadas foram a iodopovidona a 2,5 por cento e o vitelinato de prata a 10 por cento. O uso do vitelinato de prata a 10 por cento foi predominante entre os serviços analisados (60 por cento) e também o de menor custo (de R$ 5,26 a R$ 7,23 por frasco de 5ml), quando comparado a iodopovidona a 2,5 por cento que apresentou custo de R$ 15,00 por frasco de 5 ml e R$ 25,40 por frasco de 10 ml. Entre os entrevistados, apenas um tinha conhecimento sobre a legislação vigente acerca da aplicabilidade da profilaxia da oftalmia neonatal. CONCLUSÃO: A aplicabilidade da profilaxia neonatal na maioria dos serviços de obstetrícia das maternidades da Grande Florianópolis é realizada de maneira incorreta e não está em concordância com a legislação vigente.
OBJECTIVE: To evaluate the applicability of the ophthalmia neonatorum prophylaxis in five maternities obstetric services of Greater Florianopolis, Brazil; during march 2007. METHODS: Five maternities obstetric services of Greater Florianopolis were visited and questioned about the method carried through in the prevention of the ON, the cost for unit of used eye drops unit, the knowledge of the Credé method and the current legislation. RESULTS: The prophylactic solutions used were povidone-iodine 2.5 percent and silver vitelinate 10 percent. The use of silver vitelinate 10 percent was predominant in the analyzed services (60 percent) and also of lower cost (from R$ 5,26 to R$ 7,23 for bottle of 5 ml) when compared with povidone-iodine 2.5 percent that had cost of R$ 15,00 the 5 ml bottle and R$ 25,40 the 10 ml bottle. Among interviewees only one had knowledge on the current legislation concerning the applicability of the prophylaxis of the ophthalmia neonatorum. CONCLUSIONS: The applicability of the neonatal prophylaxis in the majority of the maternities obstetric services of Greater Florianopolis is carried through incorrect way and it is not in agreement with the current legislation.
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Conjunctivitis/prevention & control , Hospitals, Maternity/legislation & jurisprudence , Ophthalmia Neonatorum/economics , BrazilABSTRACT
In 1993, the Ministry of Health in Bahrain implemented a utilization management programme at the largest public hospital in the country, aimed at reducing patients' mean length of stay from 8.3 days in 1993 to 6.0 days in 2000. Time series analysis, using linear trend modelling and the annual disparity reduction rate, were used to estimate performance towards achieving the targets. The study found that the length of stay declined consistently between 1984 and 2000, with a steeper decline in the period 1994-2000, which could be attributed to the utilization management programme. Overall, length of stay was reduced by 20.5% between the two periods, short of the target 27.8% proposed in 1993. Individual clinical departments showed mixed results, with better performance demonstrated by the Departments of Medicine and Surgery
