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   Table of Contents - Current issue
Coverpage
January-June 2022
Volume 3 | Issue 1
Page Nos. 1-27

Online since Monday, October 31, 2022

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ORIGINAL ARTICLES  

Fall-Related injuries and their prevention strategies of in-patient population in tertiary health care setup p. 1
Suneetha Raghu, MN Raghu, Amitha P Marla, Supala S Kotian, Nirmala Kumari
DOI:10.4103/QAIJ.QAIJ_8_22  
Introduction: In-hospital falls are one of the major causes of morbidity and rarely mortality in India. Most horrible part is most of the times these are considered as “never happened events” and they are never recorded and recognised. Till now, there are only few documented studies, especially in the Indian setup regarding the study of fall-related injuries in hospital. Aim: The main aim of this study is the documentation and interpretation of context and characteristics of fall and fall-related injuries. Using internal communication system, in-built software, falls and fall-related injuries were documented. An extensive search was made to find out time and cause for the fall- and fall-related injuries. Many inbuilt programs were made to prevent and reduce fall- and fall-related injuries. Results: Most of falls and fall-related injuries occurred during the night and early morning times in wash rooms and toilets. Elderly people (60–89 years) and males had more incidence of falls compared to other age groups and females respectively. Conclusion: Falls and fall-related injuries in hospital can lead to significant secondary complications for individual patients. Since they are easily preventable, they represent an attractive target to increase the quality of care and lower the cost of overall medical treatment.
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Quality evaluation of sample collection facilities of resource-limited medical laboratories in various states of India: A comparison between accredited and nonaccredited laboratories p. 8
Manikchandra Ramkripal Tiwari, Arti Rauthan, Preeti Chavan, Papagudi Ganesan Subramanian, Sumeet Gujral, Vivek Bhat
DOI:10.4103/QAIJ.QAIJ_13_22  
Background and Aims: The majority of medical laboratory errors occur at the preexamination stage leading to poor patient outcomes. Very less information is available on the analysis of resource-limited medical laboratories (RLMLs) following the sample collection facility (SCF) checklist to improve their sample collection and handling practices and thus reduce occurring of such errors. The aim of this study is to find out the percentage SCFs complying with checklist criteria and to evaluate the importance of accreditation as a tool of quality improvement. Materials and Methods: SCFs of both accredited and nonaccredited RLMLs were compared for compliance with criteria given in the National Board for Accreditation of Testing and Calibration Laboratories 112 SCF checklist. Among 50 SCFs, seven were from accredited and 43 from nonaccredited RLMLs. Compliance was assessed for 43 criteria. The percentage SCFs complying with each criterion was evaluated; in addition, Chi-square testing with P value significant at P < 0.005 was calculated for each criterion. Results: All accredited SCFs showed compliance with most of the criteria. Out of 43 criteria evaluated for both accredited and nonaccredited SCFs, statistically significant difference in compliance was seen in 30 criteria with P < 0.005, whereas 13 criteria showed nonsignificant difference. Conclusion: Nonaccredited SCFs were found to be in poor compliance as compared to accredited SCFs. There is scope of improvement for deficiencies noted at multiple levels at such SCFs. Preexamination errors may be reduced by implementing criteria of the related SCF checklist.
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A study of the causes of delay in patient discharge process in a large multi-speciality hospital with recommendations to improve the turn around time p. 13
Jatin Kumar
DOI:10.4103/QAIJ.QAIJ_14_22  
On an average, around 25–30 discharges occur/day which includes cash and insurance patients. Approximately 45% are cash discharges and 55% are insurance discharges. This study deals with an analysis and evaluation of the delay in discharge process of cash and insurance patients once the discharge advice is given by the treating doctor. Methods of analysis include pareto analysis and descriptive statistics. The study draws attention to the fact that the average time taken for discharge of cash patients is 3 h and 57 min and for insurance patients is 5 h and 9 min that is a delay of 1 h and 41 min and 1 h and 23 min for cash and insurance patients, respectively. Results of the analyzed data show the delay in each process of discharge excluding the process of file sent to billing after discharge intimation is done by the nurse. Hence, improvement is required at each and every step involved in discharge process. Pareto analysis is used to prioritize the factors responsible for causing major delays and recommendations are given for the same. Most of the time was consumed in the process of bill preparation due to the delay in getting clearance from laboratory, pharmacy, and radiology department followed by finalization of discharge summary. Following are the recommendations based on the study:
  • Reducing the time taken for clearance from various departments
  • Improving and making some changes in the Hospital Information System (HIS)
  • Delegation of work.
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Measures taken by Indian hospitals toward healthcare worker and workplace safety during COVID-19 pandemic p. 21
Lallu Joseph, Vijay Agarwal, Pravin J Patel, Joydeep Majumder, J Jayalakshmi
DOI:10.4103/QAIJ.QAIJ_17_22  
Background: Healthcare workers at hospital settings were increasingly vulnerable to the COVID-19 virus and it was therefore essential to ensure that steps were taken to reduce the risk of both nosocomial transmissions to patients under their care as well as to each other. The aim of this study was to analyze the effect of measures taken by various Indian hospitals, toward the safety of their healthcare workers during the pandemic. Materials and Methods: The data were collected as the part of a competition conducted among the interested healthcare organizations (HCOs) on measures taken by Indian hospitals toward healthcare worker and workplace safety during the COVID-19 pandemic. Information about the various health and safety measures undertaken was collected from 93 Indian hospitals, through a self-reported questionnaire, which were compiled and analyzed. Results: The HCOs demonstrated 100% compliance with providing adequate personal-protective equipment based on risk stratification and physical distancing precautions, with 94% of organizations redesigning their workflows, accordingly. They also showed 97% compliance to mandatory handwashing protocols and 99% compliance to thermal screening. However, only 52% provided psychological counseling for workers, 35% provided medical care for dependents, 31% undertook WASH (water, sanitation and hygiene) certifications, and 40% obtained feedback from staff for areas of improvement. Out of the 110,679 staff involved in clinical care among the 93 HCO, 6189 staff (6%) tested positive for COVID-19, being higher (13%) among staff working in the COVID-19 wards compared to 4% among those working in the non-COVID-19 wards. Conclusion: Healthcare workers are at a higher risk of exposure to SARS-CoV-2 infection and can also transmit infections to the community. The HCOs surveyed incorporated innovative solutions to tackle the threat of COVID-19, which demonstrated success with relatively low incidence of infections among the staff evaluated. This study highlights strengths and exposes weaknesses, which should be considered for disaster mitigation plans as an effective step toward future pandemic preparedness.
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