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A STUDY TO ASCERTAIN THE ADEQUACY OF OBSERVANCE OF UNIVERSAL PRECAUTIONS IN ACUTE MEDICAL AND SURGICAL WARDS OF A LARGE TEACHING HOSPITAL.

ABSTRACT: The present study was a cross-sectional analytic epidemiological design to assess the frequency of observance of universal precautions in acute care wards of a large teaching hospital and to assess the epidemiological determinants of such observance. A total population of medical officers, nurses, paramedical and ancillary workers working in acute medical and surgical wards was studied using direct observations recorded on a pre-tested, structured format. The study revealed that handwashing was more frequently practiced by medical officers and ancillary staff (68% to 93%) as compared to nurses and paramedicals (38% to 58%) (p<0.01). Significantly higher proportion of medical officers in medical wards (93%) and nurses (63.3%) and ancillary workers in surgical ward (89%) were practicing handwashing (p<0.01). The practice of usage of gloves was significantly more frequent among medical officers and ancillary workers (72% to 100%) while it was quite inadequate among nurses and paramedicals (28% to 36%), (p<0.001). However, use of gloves was significantly better among nurses in surgical ward and paramedicals in medical ward (p<0.05). A linear trend analysis of the use of protective clothing revealed that the odds of nurses adequately using the same were much lower while those of ancillary workers were much higher as compared to medical officers, the trend being highly significant in both the type of wards (p<0.001). The study reveals a definite need of stepping up educational and motivational methods for observance of universal precautions by health care workers in large teaching hospitals. In particular, nurses and paramedical workers have been identified as high risk groups, needing concerted efforts for observing these precautions.

SUBMITTER: Pandit AP

PROVIDER: S-EPMC5531323 | biostudies-other | 1998 Apr

REPOSITORIES: biostudies-other

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Project description:BackgroundAdverse drug events (ADEs) are an important public health problem with considerable clinical and economic costs. However there are limited studies of ADE incidence in adult inpatients in low-income countries, particularly in Ethiopia. Hence, this study aimed to assess the incidence of adverse drug events and associated factors in patients hospitalized in the medical wards of Wolaita Sodo University teaching referral hospital (WSUTRH).MethodsA prospective observational study was conducted involving 240 patients admitted to the medical wards of WSUTRH. A checklist was used for data collection, while standard tools were employed for assessing the probability and characterization of ADEs. A multifaceted approach involving daily chart review, patient interview, attendance at ward rounds and/or meetings, and staff reports were employed to collect the data. To identify factors independently associated with ADEs, logistic regression analysis was conducted using Stata version 15.ResultsPatients were followed from ward admission to discharge, accounting for 2200 patient-days of hospital stay. Overall, 976 medications were ordered during the hospital stay. Sixty-four ADEs were identified with an incidence of approximately 27 per 100 admissions and 29 per 1000 patient days. Of the total ADEs, 59% were preventable. Regarding the severity, 2% of the ADEs were severe, while 54% were moderate. The risk of ADEs increased with longer hospital stay (LOHS) (p = 0.021), in patients with blood and immune disease diagnosis (p = 0.001), use of cardiovascular medicines (p = 0.028), and an increase in the number of medications prescribed (p = 0.021).ConclusionsIn this study, ADEs were identified in about one-quarter of the participants. Longer hospital stays, blood and immune diseases, cardiovascular medicines use, and multiple medication use had increased the likelihood of ADE occurrences. The majority of the ADEs were preventable, indicating the existence of a window of opportunity to ensure patient safety.

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A STUDY TO ASCERTAIN THE ADEQUACY OF OBSERVANCE OF UNIVERSAL PRECAUTIONS IN ACUTE MEDICAL AND SURGICAL WARDS OF A LARGE TEACHING HOSPITAL.

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