Lessons Learnt From a Greenfield Hangar-Based 1,000-Bedded Temporary Hospital in India.

During the COVID-19 pandemic, the total number of hospital beds in the National Capital Region (NCR) of Delhi was 54,321 (roughly 300 beds per one lakh population), which was inadequate for the patients. Therefore, the Indian government initiated the construction of a 1,000-bedded greenfield hangar-based hospital to bridge the healthcare gap. As a result, Intensive Care Unit (ICU) beds in the facility augmented the COVID-19 care ICU beds in the city by 11%. The authors were involved in the planning, developing, and initiating the functioning of 1,000-bedded Dedicated COVID-19 Hospital (DCH). The hospital was conceptualized, built, and operationalized in 12 days only. Lessons learned from this experience would be of benefit should similar situations arise in future. Coordinating structural designing early with the entire project team-from facility administrators and medical practitioners to architects, consultants, and contractors-can result in a structure that better matches the facility's long-term needs and often saves construction time and costs. This article enumerates various challenges faced and the way they were addressed. This hangar-based hospital can be rapidly constructed and deployed on a massive scale. While structural integrity is essential, the planning team was particularly aware of the patient-centric modality of healthcare. Many modifications were carried out in the structure based on patient inputs. Informal discussions with discharged patients and relatives revealed that the human-centric approach was the mainstay of the therapy.

Surgical site infection and antibiotics use pattern in a tertiary care hospital in Nepal.

OBJECTIVE: To obtain information on surgical site infection (SSI) and the regimens used for surgical prophylaxis. METHODS: The study was carried out at Manipal Teaching Hospital, Pokhara, Nepal from 1st January to 30th June 2004. Inpatients and outpatients undergoing surgical procedures in General Surgery department were included. Data was collected on a specially designed proforma. Demographic details, details of SSI, results of culture/sensitivity testing and antibiotics used for prophylaxis were noted. Associations of SSI with different variables were studied. RESULTS: A total of 507 patients were included. SSI was noted in 37 patients (7.3%), of which 21 (56.8%) were superficial SSI. Total duration of antibiotic use, type of anaesthesia and post-operative fever showed significant statistical association with SSI. Organisms were isolated in 12 out of 37 SSI cases (32.4%). E. coli was the most organism isolated. Combination of ampicillin and cloxacillin was the most commonly used antibiotic regimen (138 patients) followed by combination of ampicillin, cloxacillin and metronidazole (26 patients). CONCLUSIONS: The incidence of SSI was higher compared to developed countries. Surveillance systems for SSI and hospital guidelines for antibiotic prophylaxis are required.