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   Table of Contents - Current issue
Coverpage
January-June 2016
Volume 3 | Issue 1
Page Nos. 1-42

Online since Thursday, August 4, 2016

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REVIEW ARTICLES  

Methods of smoking cessation p. 1
Apexa B Patel, Advaita B Patel, Baldev V Patel
DOI:10.4103/2319-1880.187747  
Smoking is the leading preventable cause of morbidity and mortality worldwide. Cessation of smoking significantly reduces the risk of dying from tobacco-related diseases such as oral cancer, heart diseases, and lung cancer. Since smoking is considered to be a major health hazard in the world, dentists and health-care workers need to consider it seriously and assist their patients in smoking cessation. This review article summarizes different smoking cessation methods, withdrawal symptoms and health benefits due to smoking cessation.
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Zika virus disease: An obscure disease which became a public health emergency p. 9
Apexa B Patel, Advaita B Patel, Baldev V Patel
DOI:10.4103/2319-1880.187752  
Zika virus remained in relative obscurity for many years, but within a period of just 1 year, it has spread into Brazil, Pacific Island, and throughout the Americas. Zika virus disease has become the fetal infectious disease which is associated with human birth defects and created such global havoc that the World Health Organization declared a public health emergency of international concern. This review summarizes the transmission, distribution, clinical features, diagnosis, prevention, and future perspectives of Zika virus disease.
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ORIGINAL ARTICLES Top

Exploratory study on the knowledge and skill of critical care nurses on endotracheal suctioning p. 13
Sruthy T Varghese, KT Moly
DOI:10.4103/2319-1880.187753  
Background and Objectives: A descriptive exploratory study to assess the knowledge and skill of critical care nurses on endotracheal (ET) suctioning was conducted in the eight Intensive Care Units of AIMS, Kochi. The objectives of the study were (1) to assess the knowledge of critical care nurses on ET suctioning, (2) to assess the clinical skill of critical care nurses in performing ET suctioning, and (3) to find out the correlation between knowledge and clinical skill of critical care nurses on ET suctioning. Materials and Methods: The sampling technique used was nonprobability convenience (n = 50). Results: Majority of the participants (70%) had an acceptable level of knowledge. Most of the participants (64%) had least acceptable level of knowledge on the actual suction event and 54% on postsuctioning practice. The nurses who had an acceptable level of skill in performing ET suctioning were 56% whereas skill in practices before suctioning was least acceptable in 86% of the nurses. A significant difference (P < 0.001) was obtained between the current practice observed and the best recommended practice on ET suctioning. The elements of ET suctioning which were not followed by majority of the nurses include auscultation of chest (2%), postsuctioning assessment (2%), wearing apron (6%), maintaining suction pressure (10%), reassuring the patient before (30%) and after suctioning (18%), hand washing before (42%) and after suctioning (28%), time of suction applied (36%), and maintaining the suction catheter's sterility (46%). Interpretation and Conclusion: Even though nurses had an acceptable level of knowledge and skill, inadequacies exist in the practice of various phases of ET suctioning. Hence, training on ET suctioning could be focused specifically to those phases.
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Evaluation of request forms received in blood bank and biochemistry laboratory in a teaching hospital in North India: A comparative study of preanalytical errors p. 20
Sonam Kansay, Minni Verma
DOI:10.4103/2319-1880.187754  
Background: Clinical laboratories usually focus their attention on quality control methods and quality assessment programs in dealing with the analytical aspects of testing. However, quality in clinical laboratories cannot be assumed by merely focusing on analytical aspects only. Preanalytical processes are equally important for ensuring quality services since most of the laboratory errors occur in this phase thus influencing patient outcomes and cost. Objective: The aim of this study was to evaluate and compare the level of completion of request forms in blood bank (BB) and biochemistry (BC) laboratory of a teaching hospital in North India. Materials and Methods: A total of 3532 requisitions were received in BB and 18,410 in BC laboratory between November 2014 and April 2015. The information regarding incomplete/inappropriate requisitions and samples in both departments were recorded, compared, and analyzed. Results: The most common deficiency was the absence of clinical/provisional diagnosis among both the outpatient department (OPD) (50.7%) and inpatient department (IPD) (3.2%) request forms in BC. Doctor's name not mentioned in 1.1% of the OPD requisitions and platelet count not mentioned on 7.8% of platelet request forms in IPD requisitions were the most common deficiencies in BB. The only well-documented parameter was the patient's name. Maximum numbers of incomplete requests were received from medicine OPD's followed by Intensive Care Units, emergency and medicine wards. Conclusions: As laboratory data play a significant role in medical diagnosis, incorrect/incomplete data provided to the laboratory significantly affects the comments and successful outcome of the treatment that patient receives. Therefore, clinicians and paramedical staff should be trained to adequately fill all the required information into the request forms and appreciate its importance to patient's management. Furthermore, feedback/interpretation of significant results by the laboratory physicians to the clinicians should be emphasized.
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Knowledge levels of medical students about hand hygiene p. 27
Dattatreya Prabhakumar, Murali Chakravarthy, Shruthi Nayak, Rajathadri Hosur, Sumant Padgaonkar, Chidanannda Harivelam, Ashwin Bharadwaj
DOI:10.4103/2319-1880.187757  
Introduction: Hand hygiene is one of the least expensive easy to train procedure which can sub substantially decrease hospital associated infections. Healthcare workers perhaps are the major contributors to health care associated infection by their non compliance to this simple practice. It is important that knowledge and training about this preventive measure be inculcated during the training of healthcare workers. Training of young medical students is undoubtedly an important pivot to ensure reduction in hospital associated infections. Aim: A survey regarding hand hygiene practices among medical students was conducted with an aim to find out the knowledge and practices of the students regarding hand hygiene during their interaction with patients and their routine hospital visits. Methods: An electronic survey using 'survey monkey' was conducted in a medical college in the city of Bengaluru to assess the knowledge levels of medical students. Medical students of all the years of education were included. Full fledged doctors were excluded from participation. Results: Our results suggest that knowledge regarding hand hygiene is sub-optimal among the students (40%) and the compliance is low (63%) as a consequence of non availability of hand rubs at various locations. Theoretical knowledge among the medical students was high. More than 70% knew that the gloves cannot be replacement of hand hygiene. But the other details of the procedure of hand hygiene, were not known to them. Only 44% of the respondents an-swered that 10 seconds contact time with an alcohol, 29% answered it as 20 seconds, 23% an-swered as 1 minute and 4% answered 3 seconds. These data suggest that the medical institu-tions must taken upon themselves to train the prospective doctors in this vital, life saving simple. Conclusion: The knowledge levels of medical students about hand hygiene is far below expecta-tions; the administrators should take upon themselves to include this topic in the educational curriculum.
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A retrospective analysis of the NABH feedback forms used for training purpose as a tool for continuous quality improvement p. 32
Prashant Paschal, KK Kalra, Bhupendra Kumar Rana
DOI:10.4103/2319-1880.187764  
Introduction: Feedback is one of the crucial elements of learning and achievement, but its outcome can be either positive or negative. Drawing on findings from different trainings on Program On Implementation (POI) organized by NABH, this study reveals the extent to which effectiveness can be accurately measured. The study argues that the participants are in the best position to judge the effectiveness of feedback, but may not always recognize the benefit it provides. Aims and Objectives: The aim and objective of this study are: (1) To find out the effectiveness of the NABH training programs and efficiency of faculties related to its effect on learning, improvement, and achievement. (2) To find out ways to improve the NABH form related to delivery, content, and its appropriateness. Patients and Methods: All the feedback forms were collected from the participants after the successful completion of the program and then the interpretations and comments if any provided by them were viewed and analyzed. Statistical Analysis: Responses were analyzed using average percentage method which reflected the satisfaction level of participants as well as the appropriateness of NABH training (POI) programs. Results: The feedback forms obtained by the participants are analyzed in two ways. (1) Detailed analysis of feedback forms of all the programs together. (2) Program wise analysis. Conclusions: The overall conclusion of the feedback analysis was that NABH needs to take evaluation feedback much more seriously if they are to achieve the dual benefits of greater accountability and more effective learning.
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Identifying discharge process factors causing an increased length of stay p. 39
Meenal Kulkarni, Anil Parameshwar Pandit, Priyamvada Singh
DOI:10.4103/2319-1880.187767  
Introduction: The purpose of continuous quality improvement programs is to improve health care by identifying problems, implementing and monitoring corrective action, and studying its effectiveness. Aim: The present study aims to find out the present length of stay (LOS) of inpatients at a superspeciality hospital. Objectives: 1. To study the existing system of discharge process of patients, 2. to find out the reasons for the delays, 3. To recommend suitable suggestions to reduce length of stay. Mehodology and Results: By considering the LOS of 128 random patients, 32 from each ward A, B, C, and D. The average LOS (ALOS) was found to be 5.69. Factors have been identified by studying the delays through time and motion study in the discharge process. Recommendations: Recommendations have been made for appropriate changes to be considered to reduce ALOS and bring it to 5.0 so that proper resource utilization occurs, and at the same time, there is an improvement in bed turnover rate and thereby in bed occupancy rates.
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