Hospital Practices and Research最新文献

{"title":"Punctuality of Patients and Physicians in an Outpatient Setting: Which Has a Greater Effect on Waiting Time?","authors":"A. Aeenparast, F. Maftoon, F. Farzadi, S. H. Yahyazadeh","doi":"10.34172/hpr.2021.21","DOIUrl":"https://doi.org/10.34172/hpr.2021.21","url":null,"abstract":"Background: Patients’ waiting time for healthcare services is identified as one of the key measurements of an effective health system. This factor has an important role in patients’ satisfaction as well. One factor that is related to the waiting time is patients’ punctuality. Objectives: the objective of this study was assessing the effect of patients’ and physicians’ punctuality on outpatients’ waiting time. Methods: This was a cross-sectional study. The study population was outpatients that were admitted in clinics of a general non-educational hospital. 3500 samples were selected from all clinics. The sampling method was stratified randomized method. Samples were included after taking the informed consent. Data gathered by check lists that recorded the patients work flow at the clinic and the time of arrival to and departure of each station. Results: About 34% of patients had appointment that 98.5% of them were unpunctual. The correlation of patient unpunctuality (positive and negative) and their waiting time indicated that these variables had positive correlation (P<0.001). Assessing the correlation of physicians’ punctuality and patients’ waiting time indicated that these variables also had positive correlation (P<0.001). Conclusion: Appointment systems are very useful in controlling patients waiting time. This study identified that patient’s unpunctuality will increase patients waiting time. By the way negative punctuality will affect waiting time more that positive punctuality. Other important findings of this study were revealing the relation of physicians’ unpunctuality and patients’ waiting time. Punctuality of patients and providers are very important in the performance of appointment system in outpatient settings.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"1 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85062802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of the Role of Interleukin-2 in the Pathophysiology of Major Depressive Disorder in Hospitalized Patients","authors":"Seyed Alireza Seyed Ebrahimi, E. Karamian, Z. Goli, Leila Sadat Mirseifi","doi":"10.34172/hpr.2021.17","DOIUrl":"https://doi.org/10.34172/hpr.2021.17","url":null,"abstract":"Background: Hospitalization due to any reason or medical condition is associated with fear, anxiety, and depression. Psychological and physiological factors have a significant impact on hospitalization outcomes. Objectives: Given the functional importance of inflammatory cytokines and studies in previous studies on the relationship between inflammatory cytokines and major depressive disorder, we will focus more on studies on the role of interleukin 2 (IL-2) in the pathophysiology of major depressive disorder in hospitalized patients. Methods: We used PubMed, Scopus, and Elsevier databases to search for articles from 1999 to 2021, emphasizing the studies of the last five years. Results: In general, there was no consistent pattern in the observed relationships between cytokine concentrations or changes and clinical signs of significant depression. IL-2 and IL, two receptors in the body, play an essential role in the treatment and the pathophysiology of depression and major depression. Conclusion: Finally, it can be concluded that hospitalization generally exposes the patient to inflammation. Studies show an increased risk of inflammation following hospitalization of patients, and many studies confirm the association of major depression with inflammatory cytokines and, more concentrated, IL-2.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74982363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics for the Neurosurgeons in COVID-19 Pandemic","authors":"L. Moscote-Salazar, E. García-Ballestas, A. Agrawal, Md Moshiur Rahman, Sabrina Rahman","doi":"10.34172/hpr.2021.24","DOIUrl":"https://doi.org/10.34172/hpr.2021.24","url":null,"abstract":"Copyright © 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http:// creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dear Editor, The coronavirus disease (COVID-19) pandemic has affected the lives of a million people worldwide and has put healthcare workers, particularly neurosurgeons, under challenging situations.1 The medico-legal facts of the practice of neurosurgeons in COVID-19 prompted us to delve more into the ethical issues surrounding the neurosurgical practice during this pandemic. We would want to focus on the ethical concerns that neurosurgeons faced during COVID-19 and the urgency of neurosurgical procedures compared to other surgery. Patients that require neurosurgical treatments are a particular group of patients whose diseases are timesensitive, according to the patients’ optimum care. Unlike most other body cells and tissues, neurons exposed to insults are prone to irreparable damage over time.2 As a result, postponing most neurosurgical operations, especially elective ones, poses a difficult ethical burden.2 The pandemic COVID-19 outbreak had a significant impact on world healthcare, with Europe experiencing its worst. When the pandemic initially broke out, clinics were canceled, and elective procedures were halted. Some research looked at the actual variety of neurosurgical procedures throughout a vast area when the practice was most restricted owing to a COVID-19 through a multicenter survey.3 European Association for Neurosurgical Societies (EANS) introduces suggestions for elective neurosurgery and a neurosurgery triage system.4 A range for patients whose quality of life and impairment are in danger should be included in ethical considerations. In such circumstances, delaying neurosurgical intervention worsens the patient’s long-term outcome. Using functionality rather than selectivity to prioritize neurosurgical procedures during the COVID-19 pandemic is a great-proposed technique for selecting and prioritizing non-elective patients.5 To prevent any ethical concerns in urgent cases in all neurosurgery subspecialties should only be triaged and intervened.6 It is recommended that neurosurgical teams remark firsthand on the legal implications of their triaging policies. In this case, the neurosurgeon must explicitly articulate why they believe the patient requires emergency surgery under the accountability for reasonableness approach. In all challenging aspects, their decision-making process must be transparent. The pandemic will almost certainly have a long-term impact on health care. Therefore, neurosurgeons must devise a strategy for dealing with this and other global health crises that may happen in the future. Even in the face of fear and uncertainty, we should all adhere to the fundamental principles of probity in decision-making and e","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79998980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of Physiological Changes Seen in Workers Using Breathing Masks During COVID-19 Pandemic","authors":"Hasan Sultanoğlu, M. Boğan, Tuba Erdem Sultanoğlu, H. B. Altınsoy","doi":"10.34172/hpr.2021.18","DOIUrl":"https://doi.org/10.34172/hpr.2021.18","url":null,"abstract":"Background: There are very few studies in the literature evaluating the effects of mask use on physiological parameters. Objectives: This study aims to examine physiological changes due to masks in healthcare workers who use respiratory masks for long hours in the emergency room during the pandemic process. Methods: Cross-sectional and prospective study was carried out with healthcare professionals with an FFP2 type valve mask. The participants’ transcutaneous oxygen saturation, pulse, and respiratory rate were measured before wearing the respirator mask and at 30 and 60 minutes after wearing the mask. Results: SPO2 values of the participants decreased gradually at 0th, 30th, and 60th minutes and respiratory rate increased gradually at 0th, 30th, and 60th minutes. The statistically significant difference arises from the 0 and 60 minutes values. Higher SPO2 values were found at 0 and 30 minutes in non-smokers. SPO2 value gradually decreased in non-smokers at 0, 30, and 60 minutes, but no significant decrease was observed in non-smokers. Pulse rate was found to be higher at 60th minute compared to 0th minute in non-smokers. No significant difference was found between smokers and non-smokers. The respiratory rate gradually increased in smokers at 0th, 30th, and 60th minutes. SPO2 values were lower at the 60th minute compared to the 0th minute in both women and men. There was no significant difference in pulse rates. Respiratory rate was found to be higher at 60th minute in men than at 0th minute. Conclusion: It is recommended to follow the physiological parameters and to regulate the working conditions when necessary.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"700 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76891966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Trend of Device-Associated Hospital Acquired Infections in an Adult Intensive Care Unit of a Tertiary Care Hospital: A Need to Revamp Preventive Strategies","authors":"B. Kashyap, R. Jhamb, R. Saha, P. Prasad","doi":"10.34172/hpr.2021.19","DOIUrl":"https://doi.org/10.34172/hpr.2021.19","url":null,"abstract":"Background: Device-associated infections (DAIs) like ventilator-associated pneumonia (VAP), central-line-associated blood stream infections (CLABSI), and catheter-related urinary tract Infection (CAUTI) constitute predominant healthcare-associated infections (HAIs) in intensive care units (ICUs). Objectives: The study aims to elucidate their trends in an adult ICU. Methods: Over 21 months, monthly VAP, CLABSI, and CAUTI rate, and device utilization ratios were calculated in an adult ICU of a tertiary care hospital as part of routine surveillance activity. All cases of VAP, CLABSI, and CAUTI during these 21 months were included. In addition, monthly hand hygiene compliance rates were assessed during the latter period of the study by direct observation method. Results: Nosocomial DAI rate was 49.38 DAI/1000 ICU days. CAUTI, CLABSI, and VAP rates were 17.38, 26.85, 21.08 per 1000 device days, and device utilization ratios were 0.99, 0.61, and 0.02, respectively. Conclusion: The institute had high DAI rates in comparison to other studies from the same city. The declining trend of CAUTI rates roughly coincided with surveillance for hand hygiene compliance in ICU. Thus, it establishes baseline data and underscores the need for focused HIC to maximize patient outcomes.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85110385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Renal Colic in the Emergency Departments: A Multi-center Study","authors":"Mehdi Torabi, Fahimeh Shojaee, M. Mirzaee","doi":"10.34172/hpr.2021.23","DOIUrl":"https://doi.org/10.34172/hpr.2021.23","url":null,"abstract":"Background: Kidney calculi are the most common cause of kidney failure. Objectives: This study aimed to investigate the prevalence of renal colic and its risk factors in the patients referred to two emergency departments during a year. Methods: This was a descriptive cross-sectional study conducted in two hospitals in Kerman city, south-east of Iran, for one year from March 2019 to March 2020. All the archives of the two emergency departments were reviewed, and the required information was recorded in a checklist. The data was analyzed in SPSS 20 software. Results: A total of 504 patients were included in the study. The prevalence of renal colic was 0.5%. Most of the patients (58.5%) had an age between 19 and 39 years, and the majority (60.1%) were males and had a body mass index (BMI) above 25. A family history of renal colic was reported in 68.7% of the patients, and 63.9% had either hypertension or diabetes. Most of the patients consumed less than 3 liters of water per day. The highest referrals were seen in autumn (31.5%) and summer (27.4%). Conclusion: Considering the relationship between renal colic and age, sex, BMI, occupation, a family history of the disease, the presence of underlying diseases, the amount and type of drinking water, and the season of referral, it is recommended to control these risk factors to reduce the incidence of the disease.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75739424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Depression and Quality of Life after Coronary Artery Bypass Graft Surgery in Patients With and Without Type D Personalities","authors":"S. Mali, N. Khajehmougahi, Somaye Hajatnia, A. Farsham, E. Hasibi, R. Bidaki","doi":"10.34172/hpr.2021.20","DOIUrl":"https://doi.org/10.34172/hpr.2021.20","url":null,"abstract":"Background: Recently, some studies have investigated type D personality as a critical factor in developing depression and reducing the quality of life. Objectives: This study aimed to compare depression and quality of life after coronary artery bypass graft surgery in patients with and without type D personalities. Methods: Sixty-nine participants who underwent coronary artery bypass grafting at Imam Khomeini hospital, Ahvaz, Iran, referred to the cardiac surgery clinic for their first visit (1 to 1.5 months after surgery) were included in the study. All participants completed the World Health Organization Quality of Life questionnaire, type D personality scale, and Beck’s Depression Inventory. Finally, depression and quality of life were compared in two groups with and without type D personalities using ANOVA and correlation tests. Results: The two groups were significantly different in depression and quality of life scores after coronary artery bypass graft surgery. Depression and quality of life impairment were higher in participants with type D personality. There was no significant relationship between depression and quality of life with age, gender, and occupation in participants with type D personality. Conclusion: Depression and quality of life were higher in patients with type D personality after coronary artery bypass graft surgery than patients without type D personality. Episodic screening of these patients can prevent future somatic and psychological problems.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90243400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromuscular Blocking Agent Use in Acute Respiratory Distress Syndrome: Which Variable is Important?","authors":"Farshid Rahimibashar, M. Salesi, A. vahedian-azimi, Masoum Khosh Fetrat","doi":"10.34172/hpr.2021.22","DOIUrl":"https://doi.org/10.34172/hpr.2021.22","url":null,"abstract":"Background: The study of neuromuscular blocking agents (NMBAs) in the management of acute respiratory distress syndrome (ARDS) has provided conflicting results in terms of their effect on mortality. Objectives: The main purpose of this study was to evaluate mortality in ARDS patients who underwent NMBA. Methods: A retrospective secondary analysis of 4200 patients with ARDS was collected from two academic medical centers, Tehran, Iran. This study was performed to assess the impact of NMBAs use in ARDS patients with different subgroups including mild and moderate-to-severe ARDS, age more and less than 65 years, having medical turnover vs. not-having, and high acute nursing care vs. moderate to low nursing care. Results: Intensive care unit (ICU) mortality has occurred in 1169 (27.8%) participants. The mortality rate was 28.6% and 27.5% in patients with mild and moderate-to-severe ARDS, respectively. In the subjects without medical turnover, the moderate dose of NMBAs significantly reduces the mortality of patients (P=0.044). In patients who need high acute nursing care, increasing the NMBAs dose significantly reduces patients’ mortality (P=0.010). In addition, increasing the NMBAs doses significantly reduces ICU length of stay (LOS). Conclusion: This study provides evidence that the administration of different doses of NMBAs had no effect on patients’ mortality with mild or moderate-to-severe ARDS. However, higher doses of NMBAs than low doses increased the risk of mortality in patients over 80 years and can reduce the risk of death in patients less than 55 years.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79364120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non Invasive Ventilation a Threat for Health Care Workers in COVID-19 Outbreak","authors":"Y. Saeid, Mohammad Ali Sheikh Beig, M. Moayed","doi":"10.34172/hpr.2021.16","DOIUrl":"https://doi.org/10.34172/hpr.2021.16","url":null,"abstract":"Copyright © 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http:// creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dear Editor, Coronavirus disease (COVID-19) is a pandemic disease with unknown process and treatment that has affected the population worldwide. Patients with COVID-19 need respiratory support following acute respiratory failure.1 According to severe acute respiratory failure and its symptoms, performing respiratory support using high flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIV), and finally, intubation and the onset of invasive mechanical ventilation will be indicated.2 The oxygen therapy and respiratory support with proper technique in acute respiratory failure syndrome or acute respiratory distress syndrome with less intensity could have a significant role in treating tissue hypoxia.3 One of the effective measures in respiratory support of COVID-19 patients before tracheal intubation and the onset of invasive mechanical ventilation is “non-invasive mechanical ventilation,” which provides positive airway pressure for respiratory support without invasive intubation. One of the positive consequences of NIV is the appropriate effectiveness in the management of acute respiratory failure, reduction of mortality, and ventilatordependent pneumonia. However, NIV for COVID-19 patients is one of the major concerns for health care workers (HCWs) due to the increased chance of spreading the virus and subsequent infection.3 Providing optimal conditions for safe care is essential to maintain the health of medical staff in NIV.4 To reduce the risk of HCW the patient should be isolated under NIV and hospitalized in a negative pressure environment. HCWs must have all considerations related to personal protection; wearing a mask N95, shield, isolation gown, and gloves must be observed. Making the correct settings, using the right interface such as non-vented full mask, Helmet, and oronasal mask Received February 16, 2021; Accepted April 6, 2021; Online Published April 21, 2021 http://www.jhpr.ir Hosp Pract Res. 2021 June;6(2):83-84 doi 10.34172/hpr.2021.16","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"18 1","pages":"83-84"},"PeriodicalIF":0.0,"publicationDate":"2021-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73211500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pachymeningitis in a Patient With Granulomatosis With Polyangiitis; A Case Report","authors":"G. Alishiri, Ehsan Rahmanian, M. Ramezanpour","doi":"10.34172/hpr.2021.15","DOIUrl":"https://doi.org/10.34172/hpr.2021.15","url":null,"abstract":"Introduction: Granulomatosis with polyangiitis (GPA) is a systematic and necrotizing vasculitis with positive autoimmune antibodies. Some studies have reported the prevalence of eye involvement between 40%-50% of cases. Retro orbital granuloma is a rare complication of GPA which should be treated by surgical involvements, while pachymeningitis can be diagnosed by MRI and treated by medical management. In this study, we tried to present a case of GPA with optic neuritis and typical central nervous system (CNS) involvement, while there were no definite features of sinusitis or kidney injuries. Case Presentation: A 15-year-old girl was admitted because of blurred vision in her left eye. She was a known case of GPA three years ago with initial features, including left facial nerve paresis due to pan-sinusitis and pulmonary cavity. Neurologic evaluations, including sensory and motor features, were normal, too. Ophthalmologic examinations showed that visual acuity of the right eye was good, while the visual acuity in the left eye decreased to the point of finger counting at a distance of 20 cm. The left eye Marcus gunn test was positive (3+); anterior and posterior eye segments were normal. The patient was evaluated by brain MRI with gadolinium and a pathologic enhancement in the left cavernous was seen which had a pressure effect on the optic nerve. She was treated by intravenous methylprednisolone followed by rituximab. Conclusion: Reporting orbital mass in a patient who had GPA can be supposed as granuloma which needs a biopsy to confirm a diagnosis. In our case, the imaging manifestation was heterodox for granuloma, while neurosurgical consultation recommended drug treatment for pachymeningitis.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89357488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}