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Simonetti M, Aiken LH, Lake ET. Association between the nurse work environment and patient experience in Chilean hospitals: A multi-hospital cross-sectional study. J Nurs Scholarsh 2023; 55:1248-1257. [PMID: 36991497 DOI: 10.1111/jnu.12898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION International evidence shows that nurses' work environments affect patient outcomes, including their care experiences. In Chile, several factors negatively affect the work environment, but they have not been addressed in prior research. The aim of this study was to measure the quality of the nurse work environment in Chilean hospitals and its association with patient experience. DESIGN A cross-sectional study of 40 adult general high-complexity hospitals across Chile. METHODS Participants included bedside nurses (n = 1632) and patients (n = 2017) in medical or surgical wards, who responded to a survey. The work environment was measured through the Practice Environment Scale of the Nursing Work Index. Hospitals were categorized as having a good or poor work environment. A set of patient experience outcomes were measured through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Adjusted logistic regression models were used to test associations between the environment and patient experiences. RESULTS For all outcomes, the percentage of patients satisfied was higher in hospitals with good as compared to poor work environments. In good environment hospitals patients had significantly higher odds of being satisfied with communication with nurses (OR 1.46, 95% CI: 1.10-1.94, p = 0.010), with pain control (OR 1.52, 95% CI: 1.14-2.02, p = 0.004), and with nurses' timely responses in helping them to go to the bathroom (OR 2.17, 95% CI: 1.49-3.16, p < 0.0001). CONCLUSIONS Hospitals with good environments outperform hospitals with poor environments in most patient care experience indicators. Efforts to improve nurses' work environment hold promise for improving patient experiences in Chilean hospitals. CLINICAL RELEVANCE Hospital administrators and nurse managers should value, especially in the context of financial constraints and understaffing, the implementation of strategies to improve the quality of nurses´ work environments so that they can provide patients with a better care experience.
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Kim M, Shin YS. Risk factors for device-related pressure injuries in general ward inpatients of a tertiary general hospital: A case-control study. J Tissue Viability 2023; 32:601-606. [PMID: 37558560 DOI: 10.1016/j.jtv.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/03/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
AIMS To identify the characteristics of device-related pressure injuries (DRPI) in general ward inpatients, and to confirm the DRPI risk factors by examining differences between a DRPI and non-DRPI group. METHODS This study is a retrospective case-control study. High-risk adult patients for pressure injuries (rated at 16 points or less on the Braden scale) who were admitted to a general ward of a tertiary general hospital in South Korea from January 1 to September 30, 2021 were enrolled in this study. Among them, participants were selected by matching the patients with DRPI (n = 50) to the non-DRPI patient group (n = 100) in a ratio of 1:2. RESULTS As for risk factors, longer hospitalization periods and the presence of oedema increased DRPI risk. In blood tests, higher glucose levels increased the risk by 1.03 times, and lower albumin levels increased the risk by 0.08 times. Furthermore, the risk of developing DRPI was 7.89 times higher when sedatives were administered. CONCLUSIONS Based on the DRPI risk factors identified in this study, patients who have oedema, who have long hospital stays, use sedatives and devices, have a low albumin level, and whose blood glucose is not well controlled should be recognized as having a high risk of developing DRPI. In order to prevent the development of DRPI, it is necessary to recognize risk factors at an early stage, increase actively preventive interventions. The results of this study contribute to recognizing the risk of DRPI in patients and evaluating risk factors for DRPI prevention.
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Bete DY, Sibhatu MK, Godebo MG, Abdulahi IJ, Liyew TW, Minas SM, Bryce E, Ashengo TA, Varallo J. Improving surgical safety checklist utilisation at 23 public health facilities in Ethiopia: a collaborative quality improvement project. BMJ Open Qual 2023; 12:e002406. [PMID: 37940334 PMCID: PMC10632882 DOI: 10.1136/bmjoq-2023-002406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/25/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND In 2009, the WHO introduced the surgical safety checklist (SSC) as one of the interventions for improving patient safety. The systematic use of structured checklists during surgery has been shown to reduce perioperative morbidity and mortality. However, SSC utilisation has been challenging in low-income and middle-income countries, including Ethiopia. Jhpiego Ethiopia implemented a quality improvement project (QIP) aimed to increase SSC utilisation. METHODOLOGY A model for improvement was used to design and implement a collaborative QIP to improve SSC utilisation at 23 public health facilities (13 primary health care facilities, 4 general hospitals and 6 tertiary hospitals) in Ethiopia from October 2020 to September 2021. SSC utilisation was defined as when a patient chart had SSC attached and each part of the checklist was completed. Training of surgical staff on safe surgery packages, monthly clinical mentorship and cluster-based learning platforms were implemented during the study period. We analysed bimonthly chart audit reports from each facility to assess the proportion of surgeries where the SSC was used. Shewhart charts were used to conduct a time-series analysis. Additionally, the Z-test for two sample proportions was used to determine if there is a statistically significant change from the baseline measure with a p<0.05. RESULT In the postintervention period, the overall SSC utilisation improved by 39.9 absolute percentage points to 90.3% (p<0.0001) compared with the baseline value of 50.4% early in 2020. A time-series analysis using Shewhart charts showed a shift in the mean performance and signals of special cause variation. The largest improvement was observed in primary health care facilities in which the SSC utilisation improved from 50.8% to 97.9% (p<0.0001). CONCLUSION This study demonstrates that onsite clinical capacity building, mentorship and collaborative cluster-based learning platforms can improve SSC utilisation across all levels of facilities performing surgery.
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Barbosa GM, Weber A, Garcia APRF, Toledo VP. Experience of hospitalization of the family with children and adolescents in psychological distress. Rev Esc Enferm USP 2023; 57:e20220457. [PMID: 37930233 PMCID: PMC10615362 DOI: 10.1590/1980-220x-reeusp-2022-0457en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 09/03/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE To learn about the experience of families of children and adolescents in psychological distress facing hospitalization in a psychiatric inpatient unit of a general university hospital. METHOD This is a qualitative phenomenological-social study, with data collection carried out from February to March 2022 through open interviews, analyzed using Alfred Schutz's framework with the construction of categories of meaning. RESULTS Based on the analysis of eight interviews, it was possible to understand changes in the families' way of life, impacts on their routine, work, and social relationships. Their expectations were about the recovery of mental health and autonomy. CONCLUSION This study allowed us to understand the experience of families faced with the hospitalization of children and adolescents in psychological distress and understand their members' needs. The need for implementation of care spaces that incorporate the relationship between the multidisciplinary team and the family is highlighted.
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Eun Na J, Kim B, Hoon Jung S, Choi A, Kim S, Kim TO. Usage trends of colorectal endoscopic submucosal dissection according to hospital types based on nationwide claims data. Medicine (Baltimore) 2023; 102:e35514. [PMID: 37904446 PMCID: PMC10615467 DOI: 10.1097/md.0000000000035514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/14/2023] [Indexed: 11/01/2023] Open
Abstract
Although the use of colorectal endoscopic submucosal dissection (ESD) for colorectal lesions has increased, there is a lack of analysis of the recent usage trends of ESD. Thus, this study aimed to identify changes in the annual utilization of ESD and determine the proportion of surgeries after ESD according to hospital types. Using Health Insurance Review and Assessment data from 2012 to 2019, 26,502 colorectal ESD cases were analyzed to assess the annual usage trends of ESD according to hospital type, additional early and late surgeries after ESD, changes in the distribution of colorectal lesions, and factors associated with early and late surgery. Trend analysis was performed using the chi-squared test for trend in proportions. Colorectal ESD increased from 2046 in 2012 to 5319 in 2019. Additional early and late surgeries rose from 135 (6.6%) in 2012 to 441 (8.2%) in 2019 (P < .05) and from 9 (0.3%) in 2013 to 52 (1.0%) in 2019 (P < .05), respectively. In tertiary and general hospitals, the proportion of submucosal cancers decreased, whereas the proportion of intramucosal cancers increased. Submucosal cancer was associated with early (odds ratio: 108.90, 95% confidence interval: 61.67-192.35) and late surgery (odds ratio: 3.55, 95% confidence interval: 2.27-5.56). Using nationwide data, our study identified the clinical usage trends of colorectal ESD based on the annual increase in utilization and the proportion of additional surgeries after ESD.
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Kebbeh A, Dsane-Aidoo P, Sanyang K, Darboe SMK, Fofana N, Ameme D, Sanyang AM, Darboe KS, Darboe S, Sanneh B, Kenu E, Anto F. Antibiotics susceptibility patterns of uropathogenic bacteria: a cross-sectional analytic study at Kanifing General Hospital, The Gambia. BMC Infect Dis 2023; 23:723. [PMID: 37880663 PMCID: PMC10599079 DOI: 10.1186/s12879-023-08373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/04/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Antimicrobial resistance poses a public health threat for the treatment of community-acquired urinary tract infections. This study determined the susceptibility patterns of uropathogens and associated risk factors among outpatients diagnosed with urinary tract infections at the Kanifing General Hospital in the Gambia. METHODS A cross-sectional analytic study was conducted among patients with suspected urinary tract infections at Kanifing General Hospital from March to May 2021. Data on socio-demographic and other risk factors were collected from the study participants using a structured pre-tested questionnaire. Mid-stream urine samples were collected, and bacteria identification and antimicrobial susceptibility testing done using standard microbiological methods. Descriptive and inferential statistical analysis were done to determine factors associated with urinary tract infection at 95% confidence level and a p -value < 0.05. RESULTS A total of 422 patients were enrolled with 82.5% (348/422) being females. The prevalence of community acquired urinary tract infection was 12.8% (54/422). Escherichia coli was the most prevalent isolate (74.1%, 40/54), followed by Klebsiella spp (8.5%, 10/54). Antimicrobial resistance was highest for Ampicillin (87.0%, 47/54), Trimethoprim/Sulfamethoxazole (77.8%, 42/54) and Tetracycline (75.9%, 41/54). Uropathogens sensitivity was 77.8% (42/54) for Nitrofurantoin and 75.9% (41/54) for Ceftazidime. Being female (aOR 5.90 95% CI = 1.48-23.67), previous history of urinary tract infection (aOR 2.34, 95% CI = 1.06-5.14), use of unprescribed antibiotics (aOR 2.0, 95% CI = 1.05-3.62) and having no formal education (aOR 8.02, 95% CI = 1.04-62.0) were significant factors associated for having uropathogenic bacterial infection. CONCLUSION E. coli was the most prevalent uropathogen isolated. Ciprofloxacin, Nitrofurantoin and Ceftazidime were the most sensitive antibiotics. Routine surveillance of susceptibility of uropathogenic bacteria would be helpful to update clinicians on the choice of antibiotics.
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Vaughan-Shaw PG, Joel AS, Farah M, Ofoezie F, Harji D, Liane M, Choudhary S, Royle JT, Holtham S, Farook G. Evaluation of an established colorectal robotic programme at an NHS district general hospital: audit of outcomes and systematic review of published data. Langenbecks Arch Surg 2023; 408:416. [PMID: 37874420 DOI: 10.1007/s00423-023-03152-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION Robotic-assisted surgery (RAS) offers potential advantages over traditional surgical approaches. This study aimed to assess outcomes from a district general hospital (DGH) robotic colorectal programme against published data. MATERIALS AND METHODS The robotic programme was established following simulator, dry/wet lab training, and proctoring. We performed a case series analysing technical, patient, and oncological outcomes extracted from a prospective database of colorectal RAS cases (2015-2022). A registered systematic review (PROSPERO CRD42022300773; PubMed, Web of Science, EMBASE) of single-centre colorectal series from established robotic centres (n>200 cases) was completed and compared to local data using descriptive summary statistics. Risk of bias assessment was performed using an adapted version of the Cochrane ROBINS-I tool. RESULTS Two hundred thirty-two RAS cases were performed including 122 anterior resections, 56 APERs, 19 rectopexies, and 15 Hartmann's procedures. The median duration was 325 (IQR 265-400) min. Blood loss was < 100 ml in 97% of cases with 2 (0.9%) cases converted to open. Complications (Clavien-Dindo 3-5) occurred in 19 (8%) patients, with 3 (1.3%) deaths in < 30 days. Length of stay was 7 (IQR 5-11) days. In 169 rectal cancer cases, there were 9 (5.3%) cases with a positive circumferential or distal margin and lymph node yield of 17 (IQR 13-24). A systematic review of 1648 abstracts identified 13 studies from established robotic centres, totaling 4930 cases, with technical, patient, and oncological outcomes comparable to our own case series. CONCLUSIONS Outcomes from our robotic colorectal programme at a UK DGH are comparable with the largest published case series from world-renowned centres. Training and proctoring together with rolling audit must accompany the expansion of robotic surgery to safeguard outcomes.
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Jung J, Ryu JH, Shon S, Min M, Hyun TG, Chun M, Lee D, Lee M. Predicting in-hospital cardiac arrest outcomes: CASPRI and GO-FAR scores. Sci Rep 2023; 13:18087. [PMID: 37872179 PMCID: PMC10593798 DOI: 10.1038/s41598-023-44312-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
It is important to predict the neurological prognoses of in-hospital cardiac arrest (IHCA) patients immediately after recovery of spontaneous circulation (ROSC) to make further critical management. The aim of this study was to confirm the usefulness of the Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) and Good Outcome Following Attempted Resuscitation (GO-FAR) scores for predicting the IHCA immediately after the ROSC. This is a retrospective analysis of patient data from a tertiary general hospital located in South Korea. A total of 488 adult patients who had IHCA and achieved sustained ROSC from September 2016 to August 2021 were analyzed to compare effectiveness of the CASPRI and GO-FAR scores related to neurologic prognosis. The primary outcome was Cerebral Performance Category (CPC) score at discharge, defined as a CPC score of 1 or 2. The secondary outcomes were survival-to-discharge and normal neurological status or minimal neurological damage at discharge. Of the 488 included patients, 85 (20.8%) were discharged with good prognoses (CPC score of 1 or 2). The area under the receiver operating characteristic curve of CASPRI score for the prediction of a good neurological outcome was 0.75 (95% CI 0.69-0.81), whereas that of GO-FAR score was 0.67 (95% CI 0.60-0.73). The results of this study show that these scoring systems can be used for timely and satisfactory prediction of the neurological prognoses of IHCA patients after ROSC.
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Sberro-Cohen S, Amit I, Barenboim E, Roitman A. Resilience, sense of danger, and reporting in wartime: a cross-sectional study of healthcare personnel in a general hospital. HUMAN RESOURCES FOR HEALTH 2023; 21:81. [PMID: 37821896 PMCID: PMC10568793 DOI: 10.1186/s12960-023-00866-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND AND AIMS Maintaining healthcare services and ensuring the presence of healthcare personnel (HCP) during periods of conflict and high-intensity warfare in Israel including the significant security event that occurred on May 2021, pose significant challenges for hospitals in the range of missile attacks. The May 2021 event, marked by intense hostilities and military actions, brought about heightened security escalations and increased risks in the region. Despite the prevailing threat of missile attacks and ongoing security concerns, hospitals in the affected areas were required to sustain their services and uphold care standards. In light of these circumstances, this study aims to identify the factors that influence the percentage of HCP reporting for work during these intense periods of security escalations and wartime in Israel. Specifically, it explores the relationships between resilience, sense of danger, and HCP absenteeism in the context of the ongoing conflict. The findings of this study can provide valuable insights for designing interventions aimed at decreasing HCP absenteeism during security escalations, wartime, and emergency situations, ultimately contributing to the resilience and effectiveness of healthcare delivery in this challenging environment. METHODS During a relative calm period from December 2021 to January 2022, a cross-sectional study was conducted at a southern Israeli general hospital, situated within the range of missile attacks in the midst of a longstanding conflict. The study focused on HCP who were employed before May 21, which marked the end of the last war state at that time. The questionnaire, consisting of measures for resilience using the Conor-Davidson scale (CD-RISC 10) and the sense of danger assessed with the Solomon & Prager inventory, was administered online to all hospital employees at Assuta Ashdod Hospital, located in the southern city of Ashdod, Israel. This approach was chosen due to the challenging nature of conducting a study during an existing war, making it impractical to carry out the research during such periods of active war. RESULTS In total, 390 employees completed the survey (response rate of 24%). Of this sample, 77.4% reported fully to work during the last security escalations in May 2021. Most of the sample (84.1%) felt insecure on the way to work. The HCP who reported fully to work had a higher level of resilience than employees who reported partially or did not come to work at all (p = .03). A higher sense of danger in the workplace correlated with a 73% increase in absenteeism (p < .01). Absenteeism (partial or full) was higher among HCP with children who require supervision (p < .01). Hospital preparedness for emergencies as perceived by the employees increased HCP attendance at work (p = .03). CONCLUSIONS Hospital management should consider designing programs aimed at potentially strengthening the level of resilience and fostering a greater sense of security among hospital personnel, which might encourage greater attendance at work during wartime, crises, or emergencies.
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Fraig H, Gibbs DMR, Lloyd-Jones G, Evans NR, Barham GS, Dabke HV. Early experience of a local pathway on the waiting time for MRI in patients presenting to a UK district general hospital with suspected cauda equina syndrome. Br J Neurosurg 2023; 37:1094-1100. [PMID: 35232306 DOI: 10.1080/02688697.2022.2039377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/02/2022] [Indexed: 11/02/2022]
Abstract
AIM This study evaluated the impact of the Salisbury Protocol for Assessment of Cauda Equina Syndrome (SPACES) on the waiting time for MRI in patients presenting with suspected Cauda Equina Syndrome (sCES) within a UK district general hospital. PATIENTS AND METHODS All consecutive patients undergoing an MRI scan in our hospital, for sCES, over a 12 month period, prior to and following the introduction of SPACES, were identified. Patient's gender, age, MRI diagnosis, time from MRI request to imaging and outcome were recorded. RESULTS In the year prior to the introduction of SPACES, 66 patients underwent MRI for sCES, out of which 10.6% had cauda equina compression (CEC), 63.5% had other spinal pathology and 25% had a normal scan. In the year after introduction of SPACES, 160 patients underwent MRI for sCES out of which 6.2% had CEC, 70.7% had other spinal pathology and 23% had a normal scan. Despite the referrals for sCES increasing by more than 2-fold following the introduction of SPACES, the median time from MRI request to scan decreased from 9.1 to 4.2 hours (p = 0.106, Mann-Whitney-U) and the number of patients transferred to the regional hub hospital decreased from 7 to 3. CONCLUSION Implementation of SPACES for patients with sCES resulted in a substantial reduction in waiting time for MRI and decreased the number of transfers to the regional hub hospital. Based on our early experience, we encourage other centres within the UK to introduce such a pathway locally, to improve the management of patients with sCES.
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Moretti P, Caramanico G, Zebi L, Cataldo A, Masini F, Ghiandai N, Gonfia L, Toshi D, Sani M, Pasquini A, Balducci PM, De Giorgi F, Menculini G. Consultation-Liaison Psychiatry-From Theory to Clinical Practice: an Observational Study in a Psychiatric Unit in the General Hospital of Perugia. PSYCHIATRIA DANUBINA 2023; 35:302-307. [PMID: 37800245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
BACKGROUND Subjects suffering from psychiatric disorders are frequently hospitalized due to medical comorbidities. In the present study, we analyzed consultation-liaison psychiatry (CLP) activity in a General Hospital, describing the sociodemographic, diagnostic, and therapeutic characteristics of the evaluated subjects, as well as reasons for consultation requests. SUBJECTS AND METHODS Data concerning psychiatric consultation performed at the Perugia General Hospital during a 1-year period (01/06/2022-20/06/2023) were collected and analyzed by means of descriptive statistics. RESULTS A total of 707 psychiatric consultations were performed. The primary reason that led to psychiatric consultations was psychomotor agitation. 85 (18.5%) patients attempted suicide; the most frequent modality was the assumption of drugs at non-therapeutic doses. The 72% of the sample (n=509) presented a clear-cut medical comorbidity. In most cases, subjects were referred to Community Mental Health and Addiction services (n=22, 32.4%). CONCLUSIONS CLP plays a crucial role in the perspective of the overall well-being of hospitalized subjects, but also for the overall management of complex cases. Despite this, a homogeneous approach with standardized guidelines is needed in this field.
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Freyleue SD, Arakelyan M, Leyenaar JK. Epidemiology of pediatric hospitalizations at general hospitals and freestanding children's hospitals in the United States: 2019 update. J Hosp Med 2023; 18:908-917. [PMID: 37661338 DOI: 10.1002/jhm.13194] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/01/2023] [Accepted: 08/11/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND General hospitals (GH) provide inpatient care for the majority of hospitalized children in the United States, yet the majority of hospital pediatrics research is conducted at freestanding children's hospitals. OBJECTIVE Updating a prior 2012 analysis, this study used 2019 data to describe characteristics of pediatric hospitalizations at general and freestanding hospitals in the United States and identify the most common and costly reasons for hospitalization in these settings. DESIGNS, SETTING, AND PARTICIPANTS This study examined hospitalizations in children <18 years using the Healthcare Cost and Utilization Project's 2019 Kids' Inpatient Database, stratifying neonatal and nonneonatal hospital stays. INTERVENTION Not applicable. MAIN OUTCOME AND MEASURES Sociodemographic and clinical differences between hospitalizations at general and freestanding children's hospitals were examined, applying survey weights to generate national estimates. RESULTS There were an estimated 5,263,218 pediatric hospitalizations in 2019, including 3,757,601 neonatal and 1,505,617 nonneonatal hospital stays. Overall, 88.6% (n = 4,661,288) of hospitalizations occurred at GH, including 97.6% of neonatal hospitalizations and 65.9% of nonneonatal hospitalizations. 11.4% (n = 601,930) of hospitalizations occurred at freestanding children's hospitals, including 2.4% (n = 88,313) of neonatal hospitalizations and 34.1% (n = 513,616) of nonneonatal hospitalizations. In total, 98.9% of complicated birth hospitalizations and 66.0% of neonatal nonbirth hospitalizations occurred at GH. Among nonneonatal stays, 85.2% of mental health hospitalizations, 63.5% of medical hospitalizations, and 61.3% of surgical hospitalizations occurred at GH.
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Miller EM, Porter JE, Barbagallo MS. The Effects of the Ward Environment and Language in Palliative Care: A Qualitative Exploratory Study of Victorian Nurses' Perspectives. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:146-158. [PMID: 37265375 PMCID: PMC10621022 DOI: 10.1177/19375867231177299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The current study aimed to explore regional nurses' perspectives of how bad news is delivered and the physical, natural, social, and symbolic environments where these conversations occur. BACKGROUND In regional hospitals within Victoria, Australia, palliative and end-of-life patients are cared for in acute wards that are often busy, noisy, and do not have a palliative psychosocial focus. On the other hand, Palliative Care Units (PCUs) have more home-like dedicated spaces, yet nearly all these facilities are in metropolitan areas. Diagnostic/prognostic (bad news) conversations about life-limiting illnesses often occur at the bedside in both environments. METHOD Nurses providing palliative or end-of-life care in regional or metropolitan Victorian hospital inpatient wards were invited to interview and recruited through social media and snowballing. Six semi-structured, audio-recorded online interviews were conducted between March and May 2022, and themes were developed using reflexive thematic analysis. RESULTS Semi-structured online interviews were conducted with six female, registered nurses, four of whom worked in regional Victorian hospitals and two in metropolitan PCUs as Nurse Unit Managers. Three central themes were developed: "conducting family meetings," "palliative care practice," and "the environment matters." CONCLUSIONS A therapeutic environment for palliative patients and their families consists of home-like ambience and aesthetics and a psychosocial environment created by staff who can provide holistic palliative care. Holistic palliative care requires mentoring and mirroring of expert practice to increase the expertise and capacity of the palliative care workforce in acute general hospital wards.
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Patigny P, De Wilde M, Jacques D. Patient's Expectations Regarding Alcohol Misuse Prevention in General Hospitals. PSYCHIATRIA DANUBINA 2023; 35:332-335. [PMID: 37800251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
BACKGROUND The general hospital can be regarded as a suitable place to provide secondary prevention for patients with alcohol misuse. It appears that screening and/or brief interventions on alcohol are acceptable for patients in hospital wards. The aim of this exploration study is to assess patients' expectations regarding the prevention of alcohol misuse carried out in general hospitals. METHOD This study is based on the results of an online survey conducted in February 2023. The survey was in free access on the CHU UCL Namur hospital's website. RESULTS Only the alcohol consumption of 18.9% of our sample is usually assessed by hospital caregivers; however, we observe a high level of satisfaction with receiving information on the prevention of alcohol misuse. Among the proposed prevention interventions, screening feedback seems to be the most popular approach. CONCLUSION This study confirms the recommendations on the role of the general hospital in the prevention of alcohol misuse. The big challenge remains to understand why the level of screening for alcohol misuse in general hospitals is so low. Future studies should assess the determinants of alcohol abuse screening behaviors among caregivers to understand why the screening rate is so low.
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Lindgren T, Kodakandla H, Caraway SM, Shah KB, Huang X, Ibekwe SO. Red Blood Cell Conservation and Use in the Cardiovascular Operating Rooms at Ben Taub General Hospital. J Cardiothorac Vasc Anesth 2023; 37:1946-1950. [PMID: 37455220 DOI: 10.1053/j.jvca.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES A conservative hemoglobin transfusion threshold is noninferior to a liberal threshold in cardiac surgery. However, red blood cell (RBC) transfusion remains common during cardiac surgery. The authors' single-center, retrospective study aimed to decrease RBC transfusions for hemoglobin >7.5 g/dL in nonemergent cardiovascular surgeries utilizing cardiopulmonary bypass (CPB), by educating the anesthesiology and surgical staff on the benefits of a conservative threshold for transfusions, and incorporating the discussion and routine use of blood conservation methods for all nonemergent cardiac surgeries. DESIGN This was a single-center, retrospective study that included all nonemergent coronary artery bypass grafting and single-valve cases utilizing CPB from January 2018 to December 2021 before and after the intervention in July 2019. SETTING The data involved a single community hospital. PARTICIPANTS A total of 417 patients were included in the study. INTERVENTIONS The authors adopted a conservative threshold for blood transfusion and implemented a collaborative multidisciplinary approach to blood conservation. MEASUREMENTS AND MAIN RESULTS Baseline patient characteristics were summarized, and the incidence of RBC transfusion before and after the intervention on July 26, 2019, were compared by Wilcoxon rank sum and chi-square tests. Multivariate logistic regression was used. The intervention was significantly associated with reduced RBC transfusion rate after adjusting for confounding variables (p < 0.05). The odds of receiving an RBC transfusion among patients after the intervention was 0.615 times the odds among patients before intervention (95% CI: 0.3913-0.9663). CONCLUSIONS The authors' goal was to improve patient outcomes and the quality of perioperative care during cardiac surgery. By implementing a protocol and educating anesthesiologists, surgeons, and perfusionists, they successfully decreased the incidence of RBC transfusion above a hemoglobin of 7.5 g/dL.
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Álvarez-Bulnes O, Casals-Sánchez A, Roig-Albertos M. Epidemiology of eye-related emergencies in children under 18 years of age at a General Hospital in Spain from 2019 to 2021. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:564-567. [PMID: 37640143 DOI: 10.1016/j.oftale.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/21/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE To know which ophthalmological pathologies are the most prevalent attending the emergency department. To assess what changes have occurred because of the COVID pandemic. METHOD Review of emergency reports in children under 18 years of age attended in our Hospital from January 2019 to December 2021. Comparison of pre-pandemic, pandemic and "back-to-normal" data when comparing the periods 2019-2021 with each other. RESULTS There is a 57% reduction in the eye-related emergency visits in 2020. This reduction affects the three more prevalent diagnostic groups: conjunctivitis and red eye (69% fall), trauma and foreign body (45% decrease) and palpebral pathology (35% less). In 2021 there is a partial recovery in the three groups, but not reaching the 2019 data. On the other side, eye and periocular pain show an increase in consultation in both 2020 (16,7% more) and 2021 (100% increase). CONCLUSION There are differences in the distribution of eye-related conditions that consulted at the Emergency Department at our hospital during years 2019-2021. This suggests a more rational use of the Health System, less banal pathology attending and an impact of mobility restrictions, handwashing and face masks wearing on ophthalmological pathology.
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Farley E, Karinja MN, Lawal AM, Olaleye M, Muhammad S, Umar M, Gaya FK, Mbaeri SC, Sherlock M, Kabila DW, Peters M, Samuel J, Maloba G, Usman R, van der Kam S, Ritmeijer K, Ariti C, Amirtharajah M, Lenglet A, Falq G. Proportion of paediatric admissions with any stage of noma at the Anka General Hospital, northwest Nigeria. PLoS Negl Trop Dis 2023; 17:e0011508. [PMID: 37889919 PMCID: PMC10645368 DOI: 10.1371/journal.pntd.0011508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/14/2023] [Accepted: 10/03/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Noma is a rapidly spreading infection of the oral cavity which mainly affects young children. Without early treatment, it can have a high mortality rate. Simple gingivitis is a warning sign for noma, and acute necrotizing gingivitis is the first stage of noma. The epidemiology of noma is not well understood. We aimed to understand the prevalence of all stages of noma in hospitalised children. METHODS We conducted a prospective observational study from 1st June to 24th October 2021, enrolling patients aged 0 to 12 years who were admitted to the Anka General Hospital, Zamfara, northwest Nigeria. Consenting parents/ guardians of participants were interviewed at admission. Participants had anthropometric and oral examinations at admission and discharge. FINDINGS Of the 2346 patients, 58 (2.5%) were diagnosed with simple gingivitis and six (n = 0.3%) with acute necrotizing gingivitis upon admission. Of those admitted to the Inpatient Therapeutic Feeding Centre (ITFC), 3.4% (n = 37, CI 2.5-4.7%) were diagnosed with simple gingivitis upon admission compared to 1.7% of those not admitted to the ITFC (n = 21, CI 1.1-2.6%) (p = 0.008). Risk factors identified for having simple gingivitis included being aged over two years (2 to 6 yrs old, odds ratio (OR) 3.4, CI 1.77-6.5; 7 to 12 yrs OR 5.0, CI 1.7-14.6; p = <0.001), being admitted to the ITFC (OR 2.1; CI 1.22-3.62) and having oral health issues in the three months prior to the assessment (OR 18.75; CI 10.65, 33.01). All (n = 4/4) those aged six months to five years acute necrotizing gingivitis had chronic malnutrition. CONCLUSION Our study showed a small proportion of children admitted to the Anka General Hospital had simple or acute necrotizing gingivitis. Hospital admission with malnutrition was a risk factor for both simple and acute necrotizing gingivitis. The lack of access to and uptake of oral health care indicates a strong need for oral examinations to be included in routine health services. This provision could improve the oral status of the population and decrease the chance of patients developing noma.
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Mernier A, Patigny P, Jassogne C, Jacques D. Alcohol Use Disorder in a University General Hospital: a Four-Year Observational Study of Liaison Psychiatry. PSYCHIATRIA DANUBINA 2023; 35:329-331. [PMID: 37800250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
BACKGROUND Alcohol use disorder is insufficiently treated because it is poorly detected. Improved screening in general hospitals is a major issue in treatment organisation. SUBJECT AND METHOD Through a retrospective exploratory study based on a review of medical records over four years (2016-19) before the COVID pandemic, we recorded the number of liaison psychiatric referrals for alcohol use disorder and identified two indicators: follow-up care implemented and survival at three years. RESULTS Subject to the limitations of a retrospective review of medical records, we observed that 136 of 859 referrals concerned an alcohol use disorder. At three years, 25% (34 patients) had died. The causes of death were analysed, which revealed that 65% were directly attributable to alcohol consumption. Ongoing follow-up care was documented for only 17% (15 patients) of the 136 referred patients. Twelve patients who were followed up (80%) were in remission at one year. CONCLUSION Although the results showed the efficacy of psychiatric follow-up care, the low recruitment of patients receiving regular follow-up care confirmed the problem of access to treatment. Our results support the need for screening and earlier intervention in general hospitals by raising awareness and training all doctors, but also by reflecting on new methods of liaison psychiatry treatment.
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Dalky HF, Alnajar M, Dalky AF, Mahmoud N, Al‐Ma'ani M, Mosleh S, Hamdan‐Mansour AM. Social cognitive elements of mental illness stigma among healthcare professionals currently working in general hospitals: A cross-sectional study from Jordan. Nurs Open 2023; 10:6980-6988. [PMID: 37515452 PMCID: PMC10495734 DOI: 10.1002/nop2.1953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/21/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
AIM To assess the social cognitive elements of the stigma of mental illness (knowledge, attitudes and behaviours) among healthcare professionals (HCPs) in Jordan. DESIGN A cross-sectional descriptive design. METHODS A total of 206 HCPs were conveniently recruited from general hospitals in Jordan. The mental attitude, knowledge and intended behaviours scales were used to measure stigma elements. RESULTS Participants reported a moderate level of knowledge, a moderate negative attitude and a moderate or not greater interest to deal with people with mental health illnesses. The bivariate correlation revealed a negative significant correlation between HCPs' knowledge and attitude, indicating that HCPs with more knowledge significantly have more positive attitude (lower average score) towards those suffering from the illness. A more significant correlation was found between HCPs' knowledge and behaviour. The HCPs who had more knowledge were holding more interest and willingness towards dealing with persons with mental illness. PATIENT OR PUBLIC CONTRIBUTION Negative attitudes among HCPs demand awareness programmes pertaining to the stigma of mental illness to afford higher standards of practice for patients with mental problems.
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Hopkins J, Skudder E, Vroegop P, Sundram F. Broadening the state of play - the second national survey of Consultation-Liaison Psychiatry services in New Zealand, 2021. Australas Psychiatry 2023; 31:635-645. [PMID: 37632731 DOI: 10.1177/10398562231191689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
Abstract
OBJECTIVE The original national survey of Consultation-Liaison Psychiatry (CLP) services in New Zealand (NZ) that was undertaken in 2018 (CLPSNZ-1) established a baseline but was limited in scope. The aim of the current study was to conduct a more in-depth national survey. METHOD A 44-question survey was emailed to clinicians at each of the 16 general hospitals in NZ with specialist adult CLP services in 2021. RESULTS Responses were obtained from all 16 CLP services. These services were found to be under-resourced (with mean total full-time equivalents of 0.26 psychiatrists and 1.10 clinicians per 100 inpatient beds, respectively), operate with highly variable service models (with major variations in operating hours and coverage of age groups, the Emergency Department and outpatients) and provide a predominantly consultation service. CONCLUSION While many of the findings from CLPSNZ-1 remain relevant, the current survey has extended our understanding of the circumstances, achievements and challenges of this psychiatric subspecialty in NZ.
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Gopal Rao G, Jinjika S, James D, Mukombe N, Patel B, Chietcheu A, Macmanus C, Adeboyeku D, Davies E, Brown B. Nosocomial outbreak in a respiratory ward caused by the SARS-CoV-2 Omicron BA 5.2.1 subvariant associated with non-severe illness in vaccinated patients. Epidemiol Infect 2023; 151:e171. [PMID: 37750016 PMCID: PMC10600893 DOI: 10.1017/s0950268823001590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023] Open
Abstract
In this short report, we describe an outbreak of COVID-19 caused by Omicron subvariant BA.5.2.1 in highly vaccinated patients in a respiratory ward in a large acute general hospital in North West London, United Kingdom. The attack rate was high (14/33 (42%)) but the clinical impact was relatively non-severe including in patients who were at high risk of severe COVID-19. Twelve of fourteen patients had COVID-19 vaccinations. There was only one death due to COVID-19 pneumonitis. The findings of this outbreak investigation suggest that while the transmissibility of Omicron BA.5.2.1 subvariant is high, infections caused by this strain are non-severe in vaccinated patients, even if they are at high risk of severe COVID-19 infection.
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Sasaki K, Koeda Y, Yoshizawa R, Ishikawa Y, Ishida M, Itoh T, Morino Y, Saitoh H, Onodera H, Nozaki T, Maegawa Y, Nishiyama O, Ozawa M, Osaki T, Nakamura A. Comparing In-Hospital Outcomes for Acute Myocardial Infarction Patients in High-Volume Hospitals Performing Primary Percutaneous Coronary Intervention vs. Regional General Hospitals. Circ J 2023; 87:1347-1355. [PMID: 37558468 DOI: 10.1253/circj.cj-23-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
BACKGROUND It has been reported that patients with acute myocardial infarction (AMI) transferred to low-volume primary percutaneous coronary intervention (PCI) hospitals (<115/year) in low population density areas experience higher in-hospital mortality rates. This study compared in-hospital outcomes of patients admitted to high-volume primary PCI hospitals (≥115/year) with those for other regional general hospitals.Methods and Results: Retrospective analysis was conducted on data obtained from 2,453 patients with AMI admitted to hospitals in Iwate Prefecture (2014-2018). Multivariate analysis revealed that the in-hospital mortality rate of AMI among patients in regional general hospitals was significantly higher than among patients in high-volume hospitals. However, no significant difference in mortality rate was observed among patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI. Although no significant difference was found in the in-hospital mortality rate of patients with Killip class I STEMI, significantly lower in-hospital mortality rates were observed in patients admitted in high-volume hospitals for Killip classes II, III, and IV. CONCLUSIONS Although in-hospital outcomes for patients with STEMI undergoing primary PCI were similar, patients with heart failure or cardiogenic shock exhibited better in-hospital outcomes in high-volume primary PCI hospitals than those in regional general hospitals.
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Huang KC, Jeang SR, Hsieh HL, Chen JW, Yi CH, Chiang YC, Wu HP. Survey of knowledge, self-efficacy, and attitudes toward suicide prevention among nursing staff. BMC MEDICAL EDUCATION 2023; 23:692. [PMID: 37740184 PMCID: PMC10517497 DOI: 10.1186/s12909-023-04685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE This study aimed to explore the knowledge, self-efficacy, and attitudes toward suicide prevention among nurses with different demographic characteristics. METHODS A cross-sectional descriptive design was adopted, and the study was conducted between August and September 2020. The content of the questionnaire included basic demographics, knowledge, self-efficacy, and attitudes toward suicide prevention. Correlation analysis was performed to determine nurses' knowledge, self-efficacy, and attitudes toward suicide prevention. RESULTS The sample comprised 778 nursing staff from a medical center in southern Taiwan. The results showed that age, years of nursing experience, department type, education on suicide prevention, and care experience of nursing staff were associated with their knowledge, self-efficacy, and attitudes toward suicide prevention in general hospital patients. Younger and less experienced nurses demonstrated superior knowledge, self-efficacy, and attitudes toward suicide prevention. Nurses who received suicide-related education and training exhibited better self-efficacy and attitudes than those who did not. Nurses with care experience had better knowledge of suicide prevention than those without experience. Knowledge and self-efficacy in suicide prevention were both significantly and positively correlated with attitudes. CONCLUSION Younger, less experienced, psychiatric nurses demonstrated superior knowledge, self-efficacy, and attitudes toward suicide prevention. Therefore, education on suicide prevention should be strengthened for older, experienced, and non-psychiatric nurses.
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Assefa MG, Deksisa A, Abdo M, Alemayehu OT, Daka DW. Predictors of underweight among adult patients receiving antiretroviral therapy in Bishoftu general hospital, central Ethiopia: Case-control study. PLoS One 2023; 18:e0291602. [PMID: 37733681 PMCID: PMC10513338 DOI: 10.1371/journal.pone.0291602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Underweight affects the overall clinical outcome and quality of life and increases the risk of mortalities in Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) patients. Though studies have examined the various determinants of being underweight in people living with HIV/AIDS (PLHIV), scanty evidence exists about the influence of dietary diversity scores and dietary counseling on underweight HIV patients in Ethiopia. This study aimed to identify the determinants of being underweight among adult patients receiving antiretroviral therapy at Bishoftu General Hospital, central Ethiopia. METHODS An institution-based unmatched case-control study was conducted among 279 participants (93 cases and 186 controls) from April to May 2022. Cases were selected consecutively as they occur, and then two subsequent controls that visited the antiretroviral therapy(ART) clinic were interviewed until the sample size was attained. Data were collected using a pretested structured questionnaire and involved patient interviews and chart review. Bivariate and Multivariable logistic regression was used to identify determinants of underweight. The presence of statistically significant association was declared with p-value <0.05, and a 95% confidence interval was used to show the precision in the measure of the strength of association. RESULTS The response rate of participants was 91.2% for each of the cases and controls. Monthly income of patients ≤2000 birr (AOR = 6.63, 95% CI: 2.96-14.85), absence of support giver (AOR = 3.22, 95% CI: 1.38-7.50), being having an eating problem (AOR = 14.48, 95% CI: 5.06-41.40), dietary diversity score of four to five (AOR = 2.36, 95% CI: 1.92, 6.08), not getting dietary counseling support and advice (AOR = 2.53, 95% CI: 1.11, 5.72) and chewing khat (AOR = 3.36, 95% CI: 1.99,11.33) were determinants of underweight in adult HIV patients. CONCLUSIONS This study revealed that household dietary diversity, counseling and education on nutrition, monthly income, eating problems, support giver, and khat chewing were predictors of being underweight in HIV patients. This inquires an integrated nutritional intervention including income-generating activities, counseling and education on nutrition and bad habits, and regular monitoring of the nutritional status during clinic visits.
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Herrera-Zarate GE, Cardona-Torres LM. [Classification of caesarean sections by 10 Robson groups in a second level hospital]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:S343-S349. [PMID: 38016464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/07/2023] [Indexed: 11/30/2023]
Abstract
Background In recent years, cesarean section (CS) rates have increased alarmingly. The World Health Organization (WHO) proposes to use the Robson classification system as a global standard, which contributes to a better analysis of CS indications, making it possible to establish strategies to reduce them. Objective To analyze the classification of CS by Robson groups from July to September 2020 at the Hospital General de Zona No. 4 (District General Hospital [DGH] No. 4), in Celaya, Guanajuato. Material and methods Retrospective study which included 160 records of women undergoing CS. Robson's group classification was used, and descriptive statistics and cluster analysis were performed to better understand the classification groups. Results The average age was 27.6 ± 5.6 years. 53.1% had secondary school; 46.9% was a housewife; 46.3% was laborer; 42.8% were cohabitating; 50% had 1 or more births; 42.5% previous CS; 96.9% 1 fetus; 91.9% cephalic presentation; 78.8% 37 weeks of gestational age or more. Robson's group 5 (previous CS) had the highest percentage (42.5%), followed by group 2 (primiparous) with 20.6%, and group 10 (premature) 13.1%. Cluster analysis formed 3 groups, where cluster 1 and 3 contained group 5 of Robson's classification. Conclusions DGH No. 4 must carry out the necessary strategies so that women with a previous cesarean section can have a vaginal delivery, without compromising the well-being of the mother-child pair, in addition to interventions to avoid primary CS, because women in group 1 and 2 will potentially belong to group 5, in the next obstetric event.
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