فهرست مطالب
Hospital Practices and Research
Volume:6 Issue: 3, Summer 2021
- تاریخ انتشار: 1400/07/22
- تعداد عناوین: 8
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Pages 85-92
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. Many depressed patients do not complain of dysphoric mood, and their predominant clinical features present as anxiety, physical complaints, fatigue, and genital symptoms such as changes in sleep and appetite, or as psychosis. But the physical symptoms of depression are less noticeable. The prevalence of this disorder in medical and surgical departments is 2 to 3 times higher than its prevalence in the general population. Immune system disorders are one of the most important problems that depression causes. Studies show that depression, on the one hand, suppresses the appropriate response to infectious agents by inducing the responses of type 2 helper T lymphocytes (responses involved in causing allergies), and some antibody-dependent autoimmunity, and on the other hand Causes chronic and destructive inflammation by the immune system. Given the functional importance of inflammatory cytokines as well as 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 in the pathophysiology of major depressive disorder in hospitalized patients. 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, interleukin-2.
Keywords: Interleukin 2, Depressive disorder, Hospitalization, depression, anxiety, Inflammation -
Pages 93-97Background
There are very few studies in the literature evaluating the effects of mask use on physiological parameters.
ObjectivesThe aim of this study is to examine physiological changes due to use of masks in healthcare workers who use respiratory masks for long hours in the emergency room during the pandemic process.
MethodsCross-sectional and prospective study was carried out with healthcare professionals with FFP2 type valve mask.The transcutaneous oxygen saturation, pulse and respiratory rate of the participants were measured before wearing the respirator mask, and at 30 and 60 minutes after wearing the mask.
ResultsSPO2 values of the participants decreased gradually at 0th,30th and 60th minutes, and respiratory rate increased gradually at 0th, 30th and 60thminutes.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 nonsmokers at 0, 30 and 60 minutes,but no significant decrease was observed in nonsmokers. 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. Respiratory rate gradually increased in smokers at 0th, 30th and 60th minutes.SPO2 values were found to be lower at 60th minute compared to 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
ConclusionIt is recommended to follow the physiological parameters and to regulate the working conditions when necessary.
Keywords: COVID-19 pandemic, Pandemics, N95 FFRs, respiration, Vital signs -
Pages 98-104BACKGROUND
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 ICUs.
OBJECTIVESThe study aims to elucidate their trends in an adult Intensive Care Unit (ICU).
METHODSOver a period of 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. Monthly hand hygiene compliance rates were assessed during latter period of the study by direct observation method.
RESULTSNosocomial DAI rate was 49.38 DAI/1000 ICU days. The overall rates of CAUTI, CLABSI and VAP were 17.38, 26.85, 21.08 per 1000 device days and device utilization ratios were 0.99, 0.61 and 0.02 respectively.
CONCLUSIONThe institute had high DAI rates in comparison to other studies from the same city. Declining trend of CAUTI rates roughly coincided with surveillance for hand hygiene compliance in ICU. This establishes a baseline data and underscores the need for focused HIC for maximal impact on patient outcome.
Keywords: Infection Control, Intensive Care Unit, Policy -
Pages 105-111Introduction
Some studies the recent years investigate Type-D personality as a key factor in the development of depression and reduction of quality of life.
ObjectivesThe aim of this study was to compare depression and quality of life after open-heart surgery in patients with and without Type-D personality.
MethodsSixty-nine patients undergoing open-heart surgery in Ahwaz Imam Khomeini Hospital participated in this cross-sectional study. Depression and quality of life evaluated via WHOQOL-BREF questionnaire, Type-D personality scale, and Beck’s Depression Inventory 1 to 1.5 months after heart surgery. The collected data analyzed by ANOVA and correlation tests.
ResultsThere was a significant difference regarding depression and quality of life scores between patients with and without Type-D personality after heart surgery. Depression and quality of life impairment were higher in patients with Type-D personality. The relationship between depression and quality of life of patients with Type-D personality and their age, sex, and occupation was not significant.
ConclusionDepression and quality of life disorder were higher in Type-D personality patients after open-heart surgery compared to patients without Type-D personality. Screening these patients can prevent future physical and psychological problems.
Keywords: depression, Quality of Life, Type-D personality, Open-heart surgery -
Pages 112-115Background
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. In this study the effect of patients’ and physicians’ punctuality on waiting time was assessed.
MethodsThis 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.
Resultsabout 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).
ConclusionAppointment 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 was 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.
Keywords: Patient appointment, Waiting time, Outpatients -
Pages 116-122Background
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.
ObjectivesThe main purpose of this study was to evaluate mortality in ARDS patients who underwent NMBA.
MethodsA retrospective secondary analysis of 4,200 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. The primary outcome was the ICU mortality
ResultsIn 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 LOS (p <0.001). Logistic regression analysis revealed that the high dose vs. low dose of NMBAs was increased the risk of mortality among patients between 80 to 84 years old (OR: 3.142, 95% CI: 1.461-6.756, P=0.003). However, higher doses of NMBA than low doses reduce the risk of death in patients between 50 and 54 years of age (OR: 0.432, 95% CI: 0.267-0.798, P=0.006).
Conclusionthis study provides evidence that the administration of different doses of NMBAs had no effect on patients’ mortality with mild or moderate-to-severe ARDS.
Keywords: Acute Respiratory Distress Syndrome, Neuromuscular Blocking Agent, mortality -
Pages 123-126Background
Since kidney calculi are the most common cause of kidney failure, in this study, we aimed to investigate the prevalence of renal colic and its risk factors in the patients referred to two emergency departments during a year.
MethodsThis was a descriptive cross-sectional study conducted in two hospitals in Kerman city, south-east of Iran, during 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.
ResultsA 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 of them (60.1%) were males and had a 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%).
ConclusionConsidering 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.
Keywords: Body mass index, Emergency Department, kidney calculi, Prevalence, Renal colic -
Pages 127-128