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Novel technologies allow continuous wireless monitoring systems (CWMS) to measure vital signs and these systems might be favorable compared to intermittent monitoring regarding improving outcomes. However, device safety needs to be validated because uncertain evidence challenges the clinical implementation of CWMS. This review investigates the frequency of device-related adverse events in patients monitored with CWMS in general hospital wards. Systematic literature searches were conducted in PubMed and Embase. We included trials of adult patients in general hospital wards monitored with CWMS. Our primary outcome was the frequency of unanticipated serious adverse device effects (USADEs). Secondary outcomes were adverse device effects (ADEs) and serious adverse device effects (SADE). Data were extracted from eligible studies and descriptive statistics were applied to analyze the data. Seven studies were eligible for inclusion with a total of 1485 patients monitored by CWMS. Of these patients, 54 patients experienced ADEs (3.6%, 95% CI 2.8–4.7%) and no USADEs or SADEs were reported (0%, 95% CI 0–0.31%). The studies of the SensiumVitals® patch, the iThermonitor, and the ViSi Mobile® device reported 28 (9%), 25 (5%), and 1 (3%) ADEs, respectively. No ADEs were reported using the HealthPatch, WARD 24/7 system, or Coviden Alarm Management. Current evidence suggests that CWMS are safe to use but systematic reporting of all adverse device effects is warranted. [ABSTRACT FROM AUTHOR]

Background: The Food and Agricultural Organization (FAO) defines food waste as food fit for human consumption that is thrown away, whether it has been held over its expiration date or has been allowed to expire. Food waste has drawn a lot of attention recently and is increasingly recognized as the root of a number of detrimental repercussions, including problems with health, the economy, society, and the environment. Objective: The current study aimed to evaluate the causes of hospital food waste in surgical wards as mentioned by patients. Patients and Methods: Design: A descriptive exploratory research design was used. Setting: The study was carried out in surgical wards of two hospitals, AL-Hussein and Bab-ELSharia University Hospitals, Egypt. Subjects: A convenient sample of 161 adult patients from both genders who agreed to participate in the study. Tools: Three tools were used to collect data; Patients personal data, Rate of food waste questionnaire and Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ). Results: The participants' ages ranged between <30and 75 years, 44.1% of them had appetite worse than normal in the hospital and 42.2% said that they had less than usual intake of food in the hospital. About 30.4% of the studied patients said that the hospital food rarely has been as good as they expected, and 31.7% of them said that they never be able to choose a healthy meal in hospital. Conclusion: The research provides a helpful foundation for understanding the meals that patients throw away. The findings reveal a concerning amount of food waste that calls for a determined action by hospital officials. The repercussions of this waste may not only have negative effects on the economy or the environment, but also adverse effects on patients' indirect health. Create a customized, flexible meal reservation procedure based on patient's unique needs, tastes, and dietary requirements raise the quality of the meal. [ABSTRACT FROM AUTHOR]

In the Romanian healthcare system, public hospitals' contract for the provision of healthcare services with the National Health Insurance Services (NHIS) is the main source of revenue in a hospital's income and expenditure budget. In Romania, for acute diseases, payment is made on a per-case basis for hospitals financed under the diagnostic-related groups (DRG) system, which is calculated according to the indicators achieved. The main objective of the study aimed at the quantitative and comparative analysis of hospital performance indicators used in the calculation of the contracted amount with NHIS, in order to quantify the results and evaluate the effectiveness of the measures taken in the surgical wards of the Emergency Clinical County Hospital of Oradea (ECCHO) compared to the annual average values at the national level, in the period 2012-2022. The indicators, such as the number of beds, number of cases, average length of hospitalization (LOH), and case complexity index (CCI), were analyzed at the level of the ECCHO, a tertiary care hospital in the surgical wards. Rehabilitation and modernization of wards, laboratories, operating theatres, and high-performance equipment have been made possible through efficient management and monthly monitoring of medical and financial activity. The average LOH actually carried out on the surgical wards has been decreasing over the 11 years analyzed, with a lower number of hospital days than at the national level. The CCI achieved by the hospital's surgical wards has had an increasing evolution throughout the period analyzed, higher than the national value. The maximum amount contracted and the amount contracted by the hospital is higher when the LOH and CCI indicators achieved by each section are included in the formula than the indicators established at the national level. A lower LOH and a higher CCI than the national values facilitated the contracting of a higher amount. Optimization of the indicators by hospital performance is correlated with improved funding by the NHIS. Increasing the contracted amount facilitates the contracting of an exponential annual number of cases, resulting in more efficient medical services in the surgical wards., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Vladu et al.)

Introduction and aim: Oral hydration is essential in older adults as poor hydration can complicate existing medical conditions and increase morbidity. Older adults in surgical wards are at risk of dehydration due to insufficient fluid consumption. The aim of this project is to ensure patients aged 65 years and above are adequately hydrated. Methods: The current project was conducted over 7 months from February to August 2019 and involved pre and postimplementation audits to ensure compliance with best practice. The Joanna Briggs Institute Practical Application of Clinical Evidence System and the Getting Research into Practice tools were used as a guide. Audits were conducted at four surgical wards with a sample of 42 patients at each audit. The measures implemented include educating nurses on the importance of oral hydration in older adult patients and labelling water jugs to encourage fluid intake among these patients. Results: Nurses' compliance in monitoring older adult patients' daily fluid intake increased from 5 to 76% at follow-up audit (P < 0.05). In addition, the average amount of fluid consumed over 3 days increased from 858.23 to 1037.50 ml. Conclusion: This project demonstrated a significant increase in oral fluid intake among older adult patients during hospitalization and their understanding of adequate fluid intake. Nurses play an important role in ensuring adequate amounts of daily fluid intake by these patients. [ABSTRACT FROM AUTHOR]

Introduction: The continuous increase of antimicrobial resistance (AMR) requires antimicrobial stewardship programs (ASPs) to optimize antimicrobial use, including selection, dose, duration, and way of administration. Methods and Results: An “Antimicrobial Stewardship Team” (AST) was established at “F. Miulli” Hospital of Bari. The AST is a multidisciplinary group formed by a pharmacist, an infectious disease specialist, a microbiologist, an anesthetist and a hygienist. The AST has started a clinical path of professional interactions and optimization of antimicrobial use. The AST was focused on surgical antibiotic prophylaxis, planning events/meetings with 13 wards of “F. Miulli” hospital and writing 13 operating guidelines. The AST was focused on antimicrobial therapies too. On this occasion, the AST did not organize events or meetings but was focused on professional interactions with clinicians to optimize the antimicrobial use in the treatment of multi-drug resistant (MDR) pathogens. A reduction of antimicrobial use (defined daily dose, DDD) and pharmaceutical expenditure was reached in surgical wards during 2017-2018, while, in the same period, an increase of antimicrobial use (DDD) and pharmaceutical expenditure was observed in non-surgical wards. Conclusions: The “Antimicrobial Stewardship Team” programs are essential to monitor the hospital economic resources and to support the purchase of the innovative antimicrobial therapies to treat multi-drug resistant pathogens.

Background: Nursing documentation has been one of the most important functions of nurses. Objectives: To evaluate quality of nursing documents for nursing care at surgical ward and to find out the relationship between demographic characteristic with nursing documents. Methodology: A descriptive design study was conducted in the period of 1st January 2017 to 15th August 2017. Utilizing a stratified random sampling method (60) nurses working in surgical ward at Baghdad teaching hospitals. Results: The majority of the study participants were female who accounted for (58.3%) of the total participants while male constituted (41.7%) making a female male ratio of 1.5:1. Most of the study participants (46.7%) were between ages 18 and 27 years old. (71.7) of the nurses were married and the remainder was single. (45%) of the participants had institute graduate. Majority of them (31.7%) were employee (1-5) years in surgical wards, and finally most of nurses (66.7%) have training session in the nursing documentation. Conclusions: The study showed that nurses have poor nursing documentation in surgical ward and there is no significant association between the nursing documentation with some demographic characters of selected nurses but significant association between the nursing documentation with training course. [ABSTRACT FROM AUTHOR]

Background: Nursing documentation has been one of the most important functions of nurses. Objectives: To evaluate quality of nursing documents for nursing care at surgical ward and to find out the relationship between demographic characteristic with nursing documents. Methodology: A descriptive design study was conducted in the period of 1st January 2017 to 15th August 2017. Utilizing a stratified random sampling method (60) nurses working in surgical ward at Baghdad teaching hospitals. Results: The majority of the study participants were female who accounted for (58.3%) of the total participants while male constituted (41.7%) making a female male ratio of 1.5:1. Most of the study participants (46.7%) were between ages 18 and 27 years old. (71.7) of the nurses were married and the remainder was single. (45%) of the participants had instituite graduate. Majority of them (31.7%) were employee (1-5) years in surgical wards, and finally most of nurses (66.7%) have training session in the nursing documentation. Conclusions: The study showed that nurses have poor nursing documentation in surgical ward and there is no significant association between the nursing documentation with some demographic characters of selected nurses but significant association between the nursing documentation with training course. [ABSTRACT FROM AUTHOR]

Background: Nursing documentation has been one of the most important functions of nurses. Objectives: To evaluate quality of nursing documents for nursing care at surgical ward and to find out the relationship between demographic characteristic with nursing documents. Methodology: A descriptive design study was conducted in the period of 1st January 2017 to 15th August 2017. Utilizing a stratified random sampling method (60) nurses working in surgical ward at Baghdad teaching hospitals. Results: The majority of the study participants were female who accounted for (58.3%) of the total participants while male constituted (41.7%) making a female male ratio of 1.5:1. Most of the study participants (46.7%) were between ages 18 and 27 years old. (71.7) of the nurses were married and the remainder was single. (45%) of the participants had institute graduate. Majority of them (31.7%) were employee (1-5) years in surgical wards, and finally most of nurses(66.7%) have training session in the nursing documentation. Conclusions: The study showed that nurses have poor nursing documentation in surgical ward and there is no significant association between the nursing documentation with some demographic characters of selected nurses but significant association between the nursing documentation with training course. [ABSTRACT FROM AUTHOR]

Background: Staffing patterns refers to the number and types or categories of staff assigned to the particular wards in a hospital. Staffing patterns that accommodate imbalanced patient to nurse ratios can affect nursing staff negatively. The negative experiences increased emotional stress, physical exhaustion, high nurse turnover and consequences of poor patient outcomes. The high patient to nurse ratios and the profitability factor of private hospitals virtually dictates the type of staffing patterns that are used in these wards. As such, the current staffing patterns appear to require nursing staff to work longer shifts as well as overtime work without a choice, the consequences of which are the effects highlighted above. Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards. Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study. Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns. Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively.

Antimicrobial Resistance (AMR) and Healthcare Associated Infections (HAIs) are major global public health challenges in our time. This study provides a broader and updated overview of AMR trends in surgical wards of Mulago National Referral Hospital (MNRH) between 2014 and 2018. Laboratory data on the antimicrobial susceptibility profiles of bacterial isolates from 428 patient samples were available. The most common samples were as follows: tracheal aspirates (36.5%), pus swabs (28.0%), and blood (20.6%). Klebsiella (21.7%), Acinetobacter (17.5%), and Staphylococcus species (12.4%) were the most common isolates. The resistance patterns for different antimicrobials were: penicillins (40–100%), cephalosporins (30–100%), β-lactamase inhibitor combinations (70–100%), carbapenems (10–100%), polymyxin E (0–7%), aminoglycosides (50–100%), sulphonamides (80–100%), fluoroquinolones (40–70%), macrolides (40–100%), lincosamides (10–45%), phenicols (40–70%), nitrofurans (0–25%), and glycopeptide (0–20%). This study demonstrated a sustained increase in resistance among the most commonly used antibiotics in Uganda over the five-year study period. It implies ongoing hospital-based monitoring and surveillance of AMR patterns are needed to inform antibiotic prescribing, and to contribute to national and global AMR profiles. It also suggests continued emphasis on infection prevention and control practices (IPC), including antibiotic stewardship. Ultimately, laboratory capacity for timely bacteriological culture and sensitivity testing will provide a rational choice of antibiotics for HAI.

Background: The implementation of patient education within a hospital is a difficult task that plays a key role in improving and controlling diseases and providing quality healthcare services. Objective: The current study evaluated the effect of patient education on the quality of nursing care and inpatient satisfaction in surgical wards of selected hospitals in Isfahan, Iran. Methods: This quasi-experimental study was conducted in 2014. The sample group consisted of 64 patients admitted to the surgical wards of select hospitals in Isfahan and selected using the voluntary sampling method. Participants were randomly divided into experimental (n=32) and control (n=32) groups. A patient education program was implemented for each subject in the experimental group (during hospitalization and after discharge), but no intervention was conducted for the control group. Data was collected from both groups before and after the educational intervention using the standard questionnaire SERVQUAL to measure expectations (with a reliability of 87%), perceptions (with a reliability of 85%), and inpatient satisfaction (with a reliability of 83%). Data was analyzed using descriptive statistics, univariate and multivariate analysis of covariance, Kolmogorov-Smirnov, Chi-square, and t-tests in SPSS software (ver. 20). Results: The results of covariance analysis showed that the patient education program significantly increased the mean scores of the quality of nursing services and inpatient satisfaction in the experimental group compared with the control group (p Conclusion: A patient education program is an important pillar for improving public health. It is also a low-cost intervention to increase a patient's hope in living a good quality life.

The article discusses the psychotropic drugs in general medicine and surgical wards of a teaching hospital. Topics include the study has approved by the Institutional Human Ethical Committee; and according to a study by the centers for disease control and prevention, psychotropic medications have being received by the patients without prior evaluation by mental health professional.

Objective: To determine the prevalence and associated factors of major depressive episode in the surgical wards inpatients at a university hospital in Thailand. Materials and Methods: The present study was a descriptive cross-sectional study. Participants were 174 inpatients who were admitted to the surgical wards during January and November 2015. Baseline demographic and clinical characteristics were collected. The patients were assessed for depressive symptoms by using the Thai version of the Two-question screening for depression and Mini International Neuropsychiatric Interview, Thai version [MINI] modules for Major Depressive Episode and Suicide ideality. Results: The prevalence of major depressive episodes in the surgical inpatients was 5.7%. Associated factors of depression were psychoactive drugs use (adjusted OR 9.63, 95% CI 1.27 to 72.99) and diagnosis in certain infectious and parasitic diseases (adjusted OR 21.38, 95% CI 1.60 to 285.26). Conclusion: The prevalence of depression at 5.7% in surgical inpatients was higher than that in the general Thai population. The associated factors of depression were psychoactive drug use and diagnosis of certain infectious and parasitic diseases. [ABSTRACT FROM AUTHOR]

Background: Staffing patterns refers to the number and types or categories of staff assigned to the particular wards in a hospital. Staffing patterns that accommodate imbalanced patient to nurse ratios can affect nursing staff negatively. The negative experiences increased emotional stress, physical exhaustion, high nurse turnover and consequences of poor patient outcomes. The high patient to nurse ratios and the profitability factor of private hospitals virtually dictates the type of staffing patterns that are used in these wards. As such, the current staffing patterns appear to require nursing staff to work longer shifts as well as overtime work without a choice, the consequences of which are the effects highlighted above. Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards. Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study. Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns. Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Trauma presents a significant global health burden. Death resulting from trauma remains high in low income countries despite a steady decrease in developed countries. Analysis of the pattern of death will enable intervention to reduce these deaths from trauma in developing countries. This study aims to present the pattern of trauma-related deaths in the surgical wards of University of Port Harcourt Teaching Hospital (UPTH). METHODS: this was a retrospective study of all patients who died from trauma during admission into the surgical wards of UPTH from 2007 to 2012. Data on demography and traumatic events leading to death were collected from surgical wards, the emergency unit, and theatre records and analyzed using SPSS version 16.0. RESULTS: trauma accounted for 219 (42.4%) of the 527 mortalities recorded. Most of the deaths (62.6 %) occurred between 20 and 59 years. There were 148 males

Introduction: Trauma presents a significant global health burden. Death resulting from trauma remains high in low income countries despite a steady decrease in developed countries. Analysis of the pattern of death will enable intervention to reduce these deaths from trauma in developing countries. This study aims to present the pattern of trauma-related deaths in the surgical wards of University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a retrospective study of all patients who died from trauma during admission into the surgical wards of UPTH from 2007 to 2012. Data on demography and traumatic events leading to death were collected from surgical wards, the emergency unit, and theatre records and analyzed using SPSS version 16.0. Results: Trauma accounted for 219 (42.4%) of the 527 mortalities recorded. Most of the deaths (62.6 %) occurred between 20 and 59 years. There were 148 males (67.6 %). The yearly mortality rates were as follows: 2007(12.3 %); 2008 (16.9%); 2009 (9.1%), 2010 (12.8 %), 2011 (23.3%) and 2012 (25.6%). Most of the patients (91.3%) died within 1 month of admission. The major events leading to deaths were burns 105(47.9%), traumatic brain injuries were 63(28.8%), and spinal cord injuries 21(9.6%). The secondary causes of death were mainly septic shock 112(51.1%); Respiratory failure 60(27.4%); and Multiple organ dysfunction 44(20.1%). Conclusion: Trauma is a leading cause of mortality in the surgical wards of our hospital. Trauma-related deaths continues to increase over the years. Safe keeping of petroleum products and adherence to traffic rules will reduce these avoidable deaths. [ABSTRACT FROM AUTHOR]

Background and aim: Dressing is a covering or bandage applied to a wound, Bleeding cases, Open fractures and superficial burns to protect it, prevent the complication and the patient's dressings need to be changed regularly. The study aimed to identify the level of knowledge about Dressing Process among nurses and to examine the relationship between demographic characteristics of the nurses and their Knowledge with regard to Dressing Process. Materials and Method: This descriptive study design as a quantitative approach was adopted through the period from 1st of August - 2011 to the 1st of September - 2012. The sample of the study included (140) nurses working in two hospitals in Mosul city in the center of Nineveh Governorate. In order to collect the data, a questionnaire was constructed depending on the previous studies and related literatures. Content validity of the questionnaire was determined by presenting the questionnaire to a panel of (15) experts and the reliability of the study was determined by applying the tool to (20) nurses in Ibn-Sina Teaching Hospital, while Person's Correlation Coefficient was ( r = 0.83; P.< 0.05 ). Results: The data analysis showed that there were significant statistical relationships among some categories of knowledge regarding Dressing Process with the attributes of the sample. Conclusion: The study concluded that knowledge of dressing process acceptable, while gender and enrollment in training sessions had an obvious association with nurses' knowledge. Keywords: Nurses, Knowledge, Dressing, Surgical Wards.

Improving the quality and effectiveness of care is a key priority of any health policy. The outcomes of health care can be considered as indicators of effectiveness or quality. The scientific literature that evaluates the association between the volume of activity and the outcome of health interventions has greatly developed over the past decade, but, for practical reasons, ethical and social issues, a few randomized controlled studies were made to evaluate this association, although there are numerous observational studies of outcome and systematic reviews of the studies themselves. The colorectal surgery is the most studied area and it represents the ideal testing ground to determine the effectiveness of the quality indicators because of the high incidence of the disease and the wide spread in the territory of the structures that aim to tackle these issues. Numerous studies have documented an association between the large number of colo-rectal surgical procedures and the quality of results. In particular, the volume of activity is one of the characteristics of measurable process that can have a significant impact on the outcome of health care. In conclusion, the ability to use volume thresholds as a proxy for quality is very tempting but it is only part of reality. Infact, the volume–outcome relationship strictly depends on the type of cancer (colon vs rectum) and it appears somehow stronger for the individual surgeon than for the hospital; especially for the 5-year overall survival, operative mortality and number of permanent stoma. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to evaluate whether Clostridium difficile infection (CDI) contributed to hospital mortality and whether the correlation between intensive care units (ICUs) and surgical wards in hospital CDI risk still remain controversial. Methods By meta-analysis, 12 eligible studies involving 8,509 cases and 247,285 controls were identified via PubMed and Embase. Results CDI patients had a higher risk of hospital mortality than non-CDI patients (odds ratio [OR], 1.899; 95% confidence interval [CI], 1.269-2.840), especially in 30-day mortality (OR, 2.521; 95% CI, 1.800-3.531). No correlation was found between hospital CDI and Charlson comorbidity index (OR, 0.830; 95% CI, 0.559-1.231). Patients treated in the ICU have an increased risk of hospital CDI (OR, 1.820; 95% CI, 1.161-2.851). However, the risk of CDI in patients who used to have surgery in surgical wards was not different to patients in the other departments (OR, 1.054; 95% CI, 0.838-1.325). Moreover, CDI patients in studies from the most recent 5 years have a higher risk of hospital mortality (OR, 2.171; 95% CI, 1.426-3.304). Conclusion Hospital CDI was associated with an increased risk of hospital mortality, especially in 30-day mortality. In addition, when compared with past years, CDI patients have a higher risk of hospital mortality in the most recent 5 years. Given the rapid dissemination of this organism worldwide, there is a need to aggressively develop and evaluate primary preventive strategies targeting CDI among hospitalized patients, especially in ICUs. [ABSTRACT FROM AUTHOR]

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Background: Surgeons and nurses sometimes perceive a high workload on the surgical wards, which may influence admission decisions and staffing policy. This study aimed to explore the relative contribution of various patient and care characteristics to the perceived patients' care intensity and whether differences exist in the perception of surgeons and nurses.Methods: We invited surgeons and surgical nurses in the Netherlands for a conjoint analysis study through internet and e-mail invitations. They rated 20 virtual clinical scenarios regarding patient care intensity on a 10-point Likert scale. The scenarios described patients with 5 different surgical conditions: cholelithiasis, a colon tumor, a pancreas tumor, critical leg ischemia, and an unstable vertebral fracture. Each scenario presented a mix of 13 different attributes, referring to the patients' condition, physical symptoms, and admission and discharge circumstances.Results: A total of 82 surgeons and 146 surgical nurses completed the questionnaire, resulting in 4560 rated scenarios, 912 per condition. For surgeons, 6 out of the 13 attributes contributed significantly to care intensity: age, polypharmacy, medical diagnosis, complication level, ICU-stay and ASA-classification, but not multidisciplinary care. For nurses, the same six attributes contributed significantly, but also BMI, nutrition status, admission type, patient dependency, anxiety or delirium during hospitalization, and discharge type. Both professionals ranked 'complication level' as having the highest impact.Discussion: The differences between surgeons and nurses on attributes contributing to care intensity may be explained by differences in professional roles and daily work activities. Surgeons have a medical background, including technical aspects of their work and primary focus on patient curation. However, nurses are focused on direct patient care, i.e., checking vital functions, stimulating self-care and providing woundcare.Conclusions: Surgeons and nurses differ in their perception of patients' care intensity. Appreciation of each other's differing interpretations might improve collaboration between doctors and nurses and may help managers to match hospital resources and personnel. [ABSTRACT FROM AUTHOR]

Interest regarding the impact of a person's spiritual and religious beliefs and practices within a variety of health care settings has increased over recent years. This article seeks to highlight a number of ways that these beliefs and practices can be met within a general medical or surgical ward of a general hospital and within a care or nursing home environment. [ABSTRACT FROM AUTHOR]

The principles of lean production originating from the Toyota production system has spread from manufacturing to healthcare. Needless to say, this raises concern whether such principles are actually applicable where the product are humans in need of medical care and what are the consequences for the medical staff. The literature on lean does not suggest that lean should not be applicable in healthcare. Still this paper begins by discussing if the principles of lean from a theoretical perspective can be expected to work in healthcare. It is found that that it will be useful in certain types of settings but it is not a universal tool that may be applied to all aspects of healthcare. A case of lean in a surgical ward is presented and it is observed that patients have been split in to two flows, which can be described as a lean and a normal flow. [ABSTRACT FROM AUTHOR]

Antimicrobial Resistance (AMR) and Healthcare Associated Infections (HAIs) are major global public health challenges in our time. This study provides a broader and updated overview of AMR trends in surgical wards of Mulago National Referral Hospital (MNRH) between 2014 and 2018. Laboratory data on the antimicrobial susceptibility profiles of bacterial isolates from 428 patient samples were available. The most common samples were as follows: tracheal aspirates (36.5%), pus swabs (28.0%), and blood (20.6%). Klebsiella (21.7%), Acinetobacter (17.5%), and Staphylococcus species (12.4%) were the most common isolates. The resistance patterns for different antimicrobials were: penicillins (40-100%), cephalosporins (30-100%), β -lactamase inhibitor combinations (70-100%), carbapenems (10-100%), polymyxin E (0-7%), aminoglycosides (50-100%), sulphonamides (80-100%), fluoroquinolones (40-70%), macrolides (40-100%), lincosamides (10-45%), phenicols (40-70%), nitrofurans (0-25%), and glycopeptide (0-20%). This study demonstrated a sustained increase in resistance among the most commonly used antibiotics in Uganda over the five-year study period. It implies ongoing hospital-based monitoring and surveillance of AMR patterns are needed to inform antibiotic prescribing, and to contribute to national and global AMR profiles. It also suggests continued emphasis on infection prevention and control practices (IPC), including antibiotic stewardship. Ultimately, laboratory capacity for timely bacteriological culture and sensitivity testing will provide a rational choice of antibiotics for HAI.

Abstract: Objective: To identify deaths in the surgical wards, elicit the cause of death and suggest changes that will ensure improved surgical care of patients and outcome. Study design: Retrospective. Methods: Records collected from the theatre operation registers, ward registers and case notes of all patients who were admitted into the surgical wards Federal Medical Centre, Owerri whether elective or emergency from January 1997 to December 2001 were reviewed. Data extracted included date of admission, age, sex, educational status, residence; surgical diagnosis and clinical cause of death Data obtained were analyzed and presented in tabular and descriptive forms. Results: There were 4583 surgical admissions in all the surgical wards of which males were 2751 and females 1832. During this period there were 419 deaths with an overall death per admission crude mortality rate of 9.14%. The leading causes of death were acute abdomen (22.20%), RTA with head injury (18.14%) and malignances (14.56%). Of the 419 deaths males were 305 (72.79%) and females 114 (27.21%) in a ratio of 2.68:1. Conclusion: Aggressive enlightenment and healthcare campaigns, health education, improvement of healthcare facilities and accessibility to healthcare facilities are highlighted. Structured study in the management of surgical cases is emphasized. [Copyright &y& Elsevier]

Objectives The purpose of the CANWARD study was to assess the antimicrobial activity of a variety of available agents against 22 746 pathogens isolated from patients in Canadian hospitals between 2007 and 2011. Methods Between 2007 and 2011, 27 123 pathogens were collected from tertiary-care centres from across Canada; 22 746 underwent antimicrobial susceptibility testing using CLSI broth microdilution methods. Patient demographic data were also collected. Results Of the isolates collected, 45.2%, 29.6%, 14.8% and 10.4% were from blood, respiratory, urine and wound specimens, respectively. Patient demographics were as follows: 54.4%/45.6% male/female, 12.8% ≤17 years old, 45.1% 18–64 years old and 42.1% ≥65 years old. Isolates were obtained from patients in medical and surgical wards (37.8%), emergency rooms (25.7%), clinics (18.0%) and intensive care units (18.5%). The three most common pathogens were Escherichia coli (20.1%), Staphylococcus aureus [methicillin-susceptible S. aureus and methicillin-resistant S. aureus (MRSA)] (20.0%) and Pseudomonas aeruginosa (8.0%), which together accounted for nearly half of the isolates obtained. Susceptibility rates (SRs) for E. coli were 100% meropenem, 99.9% tigecycline, 99.7% ertapenem, 97.7% piperacillin/tazobactam, 93.7% ceftriaxone, 90.5% gentamicin, 77.9% ciprofloxacin and 73.4% trimethoprim/sulfamethoxazole. Twenty-three percent of the S. aureus were MRSA. SRs for MRSA were 100% daptomycin, 100% linezolid, 100% telavancin, 99.9% vancomycin, 99.8% tigecycline, 92.2% trimethoprim/sulfamethoxazole and 48.2% clindamycin. SRs for P. aeruginosa were 90.1% amikacin, 93.1% colistin, 84.0% piperacillin/tazobactam, 83.5% ceftazidime, 82.6% meropenem, 72.0% gentamicin and 71.9% ciprofloxacin. Conclusions The CANWARD surveillance study has provided important data on the antimicrobial susceptibility of pathogens commonly causing infections in Canadian hospitals. [ABSTRACT FROM PUBLISHER]