Search results for: Hospitals

Authors: B. Alajmi, L. Marouf, A. S. Chaudhry

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Knowledge management is considered as an important factor in improving health care services. KM facilitates the transfer of existing knowledge and the development of new knowledge in hospitals. This paper reviews practices adopted by doctors in Kuwait for capturing, sharing, and generating knowledge. It also discusses the perceived impact of KM practices on performance of hospitals. Based on a survey of 277 doctors, the study found that KM practices among doctors in the sampled hospitals were not very effective. Little attention was paid to the main activities that support the transfer of expertise among doctors in hospitals. However, as predicted by previous studies, good km practices were perceived by doctors to have a positive impact on performance of hospitals. It was concluded that through effective KM practices hospitals could improve the services they provide. Documentation of best practices and capturing of lessons learnt for re-use of knowledge could help transform the hospitals into learning organizations.

Keywords: Health Sector, Hospitals, Knowledge Management, Kuwait, Tools and Practices.

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Authors: Saleem Ahmed Aladhrai, Pier Luigi Ingrassia, Nahid K. El- Bakri

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Objective: The objective of this paper is to assess the hospitals preparedness for emergency using WHO standards. Method: This is a cross-sectional study, consisted of site visit, questionnaire survey, 16 health facilities were included. The WHO standard for emergency preparedness of health facilities was used to evaluate and assess the hospitals preparedness of health facilities. Result: 13 hospitals were responded. They scored below average in all measure >75%), while above average score was in 7 out 9 nine measure with a range of 8%-25%. Un acceptable below average was noted in two measures only. Discussion: The biggest challenge facing the hospitals in their emergency intervention is the lack of pre-emergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. Conclusion: The studied hospitals presently are far from international disasters preparedness protocols. That necessitates improvements in emergency preparedness, as well as in physician skills for injury management.

Keywords: Arab Spring, Yemen, Hospital Preparedness, Disaster.

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Authors: H. Nur Gorkemli, Mehmet Fidan

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After the first acquaintance with internet in April 1993, number of internet users increased rapidly in Turkey. Almost half of the population between 16-74 age group use internet in the country. Hospitals are one of the areas where the internet is intensively being used like many other businesses. As a part of public relations application, websites are important tools for hospitals to reach a wide range of target audience within and outside the organization. With their websites, hospitals have opportunities to give information about their organization, strengthen their image, compete with their rivals, interact with shareholders, reflect their transparency and meet with new audiences. This study examines web sites of totally 34 hospitals which are located in Konya. Institutions are categorized as public and private hospitals and then three main research categories are determined: content, visual and technical. Main and sub categories are examined by using content analysis method. Results are interpreted in scope of public and private institutions and as a whole.

Keywords: Health Communication, Hospital, Internet, Webpages, Websites

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Authors: A. Teke, O. Timur

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Hospitals represent approximately 6% of total energy consumption in the utility buildings sector. Heating, Ventilation and Air Conditioning (HVAC) systems are the major part of electrical energy consumption at the hospitals. The air-conditioning system is responsible for around 70% of total electricity consumption. Electric motors and lighting systems in a hospital represent approximately 19% and 21% of the total energy consumption, respectively. In this paper, profiles of hospital energy end-use consumption and an overview of energy saving areas at the hospitals are presented.

Keywords: Energy efficiency, energy saving, healthcare energy consumption, hospital.

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Authors: A. A. AlRasheed, A. Atkins, R. Campion

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This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: Knowledge management, visualisation, patients, hospitals, healthcare workers, workflow, improvements.

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Authors: J. Silva, P. Arezes, R. Schierl, N. Costa

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In order to study environmental contamination by cytostatic drugs in Portugal hospitals, sampling campaigns were conducted in three hospitals in 2015 (112 samples). Platinum containing drugs and fluorouracil were chosen because both were administered in high amounts. The detection limit was 0.01 pg/cm² for platinum and 0.1 pg/cm² for fluorouracil. The results show that spills occur mainly on the patient`s chair, while the most referenced occurrence is due to an inadequately closed wrapper. Day hospitals facilities were detected as having the largest number of contaminated samples and with higher levels of contamination.

Keywords: Antineoplastic, drugs, exposure, surface.

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Authors: Nasir Baba Ahmed, Nicolas Daclin, Marc Olivaux, Gilles Dusserre

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The Mobile field hospital is critical in terms of managing emergencies in crisis. It is a sub-section of the main hospitals and the health sector, tasked with delivering responsive, immediate, and efficient medical services during a crisis. With the aim to prevent further crisis, the assessment of the cyber assets follows different methods, to distinguish its strengths and weaknesses, and in turn achieve cyber resiliency. The work focuses on assessments of cyber resilience in field hospitals with trends growing in both the field hospital and the health sector in general. This creates opportunities for the adverse attackers and the response improvement objectives for attaining cyber resilience, as the assessments allow users and stakeholders to know the level of risks with regards to its cyber assets. Thus, the purpose is to show the possible threat vectors which open up opportunities, with contrast to current trends in the assessment of the mobile field hospitals’ cyber assets.

Keywords: Assessment framework, cyber resilience, cyber security, Mobile Field Hospital.

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Authors: A. Alrasheed, I. Connerton

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Daily provision of high quality food and hygiene to patients is a challenging goal of the healthcare. In Saudi Arabia, matters related to food safety and hygiene are regulated by the Ministry of Health (MOH) and the Saudi Food and Drugs Authority (SFDA). The purpose of this research is to discuss the food safety management inconsistencies and flaws, in particular the ones related to Hazard Analysis and Critical Control Points (HACCP) in Riyadh’s MOH hospitals. As required by law, written HACCP regulations must be implemented, and food handlers need to receive the training accordingly. However, in Saudi hospitals, this is not a requirement, and the food handlers do not need to hold training certificates in food safety or HACCP. Nowadays, the matter of food safety and hygiene have become increasingly important since the decision makers want to align these regulations with the majority of the world and to implement HACCP fully and for this purpose, the SFDA was established. 

Keywords: Food safety, patients, hospitals, HACCP, Saudi Arabia.

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Authors: M. Aslan, A. Karaaslan, S. Selcuk

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The research was conducted in order to determine the organizational socialization levels of nurses working in hospitals in the form of a descriptive study. The research population was composed of nurses employed in public and private sector hospitals in the province of Konya with 0-3 years of professional experience in the hospitals (N=1200); and the sample was composed of 495 nurses that accepted to take part in the study voluntarily. Statistical evaluation of data was conducted in SPSS.16 software. The results of the study revealed that the total score taken by nurses at the organizational socialization scale was 262.95; and this was close to the maximum score. Particularly the departmental socialization sub-dimension proved to be higher in comparison to the other two dimensions (organization socialization and task socialization). Statistically meaningful differences were found in the levels of organization socialization in relation to the status of organizational orientation training, level of education and age group.

Keywords: Nurses, Newcomers, Organizational Socialization.

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Authors: A. Ahmed Haza’a, M. Ali Odhah, S. Ahmed Al-Ahdal, A. Saleh Al-Jaradi, G. Ghaleb Alrubaiee

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Patient safety in hospitals is an essential professional indicator that should be noticed. The threat of fires is potentially the most dangerous risk that could harm patients and personnel. The aim of the study is to assess the knowledge of operating room (OR) staff toward prevention and control sources of fires. Data collection was done between March 1 and March 30, 2022. A descriptive cross-sectional study was conducted. The sample of the study consisted of 89 OR staff from different governmental hospitals. Convenient sampling was applied to select the sample size. Official approvals were obtained from selected settings for start collection data. Data were collected using a close-ended questionnaire and tested for knowledge. This study was conducted in four governmental hospitals in Sana'a, Yemen. Most of the OR staff were male. Of these, 50.6% of them were operation technician professionals. More than two-thirds of OR staff have less than ten years of experience; 93% of OR staff had inadequate knowledge of sources of fires, and inadequate knowledge toward control and prevention of fires (73%, 79.8%), respectively; 77.5% of OR staff had inadequate knowledge of prevention and control sources of fires. The study concluded that most of OR staff had inadequate knowledge of sources, controls, and prevention of fires, while 22.5% of them had adequate knowledge of prevention and control sources of fires. We recommended the implementation of training programs toward sources, controls, and prevention of fires or related workshops in their educational planning for OR staff of hospitals.

Keywords: Staff, fire source, operation room safety.

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Authors: M. Farzadkia, S. Jorfi

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Hospital waste is a category of waste consisting of infectious and non-infectious waste, which pose environmental and health risks. Therefore, special planning and management is required, due to the potential hazards of them. The lack of valid and comprehensive information regarding the generation and management of hospital waste in Iran is one of the most important problems in this field. This research aimed to evaluate hospital waste management efficiency in Karaj city, Iran. The four greatest hospitals in Karaj city had been selected in this cross-sectional study. Site observations and interviews with employees were implemented. The data was gathered based on the hospital waste management questionnaire which was designed by World Health Organization for developing countries. Collected Data had been analyzed using SPSS software. The average of solid waste which was generated per bed was 2.78 kg, which included 90% of domestic waste and 10% of infectious waste. Based on the quantitative analysis of general and infectious waste in these hospitals, the highest contributors of general waste were consisting of food waste (37.39%), while textile (28.06%) were the highest contributors of the infectious waste. According to the information contained in the questionnaires, the main defects of waste management in these hospitals were; inadequate staff in waste management sector, poorly disinfection of solid waste containers and temporary storage locations, and a lack of proper infectious waste treatment. According to the results of this research, waste management in these hospitals were far from optimum conditions. In order to improve the existing conditions, mentioned problems must be solved quickly, and planning for continuous monitoring in the waste management field in these hospitals should be established.

Keywords: Waste management, hospital wastes, solid wastes, Iran.

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Authors: Helia Moayedi, Mahdi Moaidi

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Nowadays, the managing and planning of hospitals is facing many problems. Failure to recognize the main criteria for strategic management to ensure long-term hospital performance can lead to many health problems. To achieve this goal, a qualitative-quantitate method titled Delphi-Fuzzy has been applied. This strategy makes it possible for experts to screen among the most important criteria in strategic management. To conduct this operation, a statistical society consisting of 20 experts in Ahwaz hospitals has been questioned. The final model confirms the key criterions after three stages of Delphi. This model provides the possibility to focus on the basic criteria and can determine the organization’s main orientation.

Keywords: Delphi-Fuzzy Method, hospital management, long-term planning, qualitative-quantitate method, screening of strategic criteria, strategic planning.

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Authors: Mohammad Ahmadinejad, Mohammad Reza Shakibaie, Kyvan Shams, Mohammad Khalili

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Legionella pneumophila is involved in more than 95% cases of severe atypical pneumonia. Infection is mainly by inhalation the indoor aerosols through the water-coolant systems. Because some Legionella strains may be viable but not culturable, therefore, Taq polymerase, DNA amplification and semi-nested-PCR were carried out to detect Legionella-specific 16S-rDNA sequence. For this purpose, 1.5 litter of water samples from 77 water-coolant system were collected from four different hospitals, two nursing homes and one student hostel in Kerman city of Iran, each in a brand new plastic bottle during summer season of 2006 (from April to August). The samples were filtered in the sterile condition through the Millipore Membrane Filter. DNA was extracted from membrane and used for PCR to detect Legionella spp. The PCR product was then subjected to semi-nested PCR for detection of L. pneumophila. Out of 77 water samples that were tested by PCR, 30 (39%) were positive for most species of Legionella. However, L. pneumophila was detected from 14 (18.2%) water samples by semi-nested PCR. From the above results it can be concluded that water coolant systems of different hospitals and nursing homes in Kerman city of Iran are highly contaminated with L. pneumophila spp. and pose serious concern. So, we recommend avoiding such type of coolant system in the hospitals and nursing homes.

Keywords: Legionella pneumophila, water-coolant system, semi-nested -PCR.

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Authors: María Araya Léon, Ainoa Abella, Aura Murillo, Ricardo Guasch, Laura Clèries

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This article aims to examine scientific theory framed within the term hospitals of the future from a multidisciplinary and cross-sectional perspective. To understand the connection that the various cross-sectional areas, we studied have with architectural spaces and to determine the future outlook of the works examined and how they can be classified into the categories of need/solution, evolution/revolution, collective/individual, and preventive/corrective. The changes currently taking place within the context of healthcare demonstrate how important these projects are and the need for companies to face future changes. A systematic review has been carried out focused on what will the hospitals of the future be like in relation to the elements that form part of their use, design, and architectural space experience, using the WOS database from 2016 to 2019. The large number of works about sensoring & big data and the scarce amount related to the area of materials is worth highlighting. Furthermore, no growth concerning future issues is envisaged over time. Regarding classifications, the articles we reviewed address evolutionary and collective solutions more, and in terms of preventive and corrective solutions, they were found at a similar level. Although our research focused on the future of hospitals, there is little evidence representing this approach. We also detected that, given the relevance of the research on how the built environment influences human health and well-being, these studies should be promoted within the context of healthcare. This article allows to find evidence on the future perspective from within the domain of hospital architecture, in order to create bridges between the productive sector of architecture and scientific theory. This will make it possible to detect R&D opportunities in each analyzed cross-section.

Keywords: Hospitals, trends, architectural space, disruptive approach.

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Authors: Tahvilian R., Siahi Shadbad MR., Hamishehkar H., Aghababa Gharehbagh V.

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Nowadays pharmaceutical care departments located in hospitals are amongst the important pillars of the healthcare system. The aim of this study was to evaluate quality of hospital drugstores affiliated with Kermanshah University of Medical Sciences. In this cross-sectional study a validated questionnaire was used. The questionnaire was filled in by the one of the researchers in all seventeen hospital drugstores located in the teaching and nonteaching hospitals affiliated with Kermanshah University of Medical Sciences. The results shows that in observed hospitals,24% of pharmacy environments, 25% of pharmacy store and storage conditions, 49% of storage procedure, 25% of ordering drugs and supplies, 73% of receiving supplies (proper procedure are fallowed for receiving supplies), 35% of receiving supplies (prompt action taken if deterioration of drugs received is suspected), 23.35% of drugs delivery to patients and finally 0% of stock cards are used for proper inventory control have full compliance with standards.

Keywords: Hospital pharmacy standards, Kermanshah, pharmacy management

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Authors: Tessy Treesa Jose, Sripathy M. Bhat

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Nursing is recognized as a stressful occupation and has indicated a probable high prevalence of distress. It is a helping profession requiring a high degree of commitment and involvement. If stress is intense, continuous and repeated, it becomes a negative phenomenon or "distress," which can lead to physical illness and psychological disorders. The frequency of common psychosomatic symptoms including sleeping problems, tension headache, chronic fatigue, palpitation etc. may be an indicator of nurses’ work-related stress level. Objectives of the study were to determine psychiatric morbidity among nurses and to find its association with selected variables. The study population consisted of 1040 registered nurses working in selected medical college hospitals and government hospitals of Udupi and Mangalore districts. Descriptive survey design was used to conduct the study. Subjects were selected by using purposive sampling. Data were gathered by administering background proforma and General Health questionnaire. Severe distress was experienced by 0.9% of nurses and 5.6% had some evidence of distress. Subjects who did not have any distress were 93.5%. No significant association between psychiatric morbidity in nurses and demographic variables was observed. With regard to work variables significant association is observed between psychiatric morbidity and total years of experience (z=10.67, p=0.03) and experience in current area of work (z=9.43, p=0.02).

Keywords: Psychiatric morbidity, nurse, selected hospitals, working.

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Authors: R. Miniati, F. Dori, E. Iadanza, M. Fregonara Medici

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management of medical devices in hospitals includes the planning of medical equipment acquisition and maintenance. The presence of critical and non-critical areas together with technological proliferation render the management of medical devices very complex. This study creates an easy and objective methodology for the analysis of medical equipment maintenance, that makes the management of medical devices more feasible. The study has been carried out at Florence Hospital Careggi and it aims to help the clinical engineering department to manage medical equipment by clarifying the hospital situation through a characterization of the different areas, technologies and fault typologies.

Keywords: Clinical Engineering, Maintenance, Medical DevicesManagement, Key Performance Indicators.

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Authors: T. Theodosiou, P. Polychronidou, A. G. Karasavvoglou

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The latest years the number of immigrants at Greece has increased dramatically. Their impact on the National Health System (NHS) has not been yet thoroughly investigated. This paper analyses the cost of immigrants to the NHS hospitals of the region of Eastern Macedonia and Thrace. The data are collected from 2005 to 2011 from five different hospitals and are analysed using linear mixed effects models in order to investigate the effects of nationality and year on the cost of hospitalization and treatment. The results show that generally the Greek nationality patients have a higher mean cost of hospitalization compared to the immigrants and that there is an increasing trend for the cost except for the year 2010.

Keywords: Cost, Eastern Macedonia, Thrace, immigrants, national health system.

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Authors: Bu Seog Ju, Woo Young Jung

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The cost of damage to the non-structural systems in critical facilities like nuclear power plants and hospitals can exceed 80% of the total cost of damage during an earthquake. The failure of nonstructural components, especially, piping systems led to leakage of water and subsequent shut-down of hospitals immediately after the event. Consequently, the evaluation of performance of these types of structural configurations has become necessary to mitigate the risk and to achieve reliable designs. This paper focuses on a methodology to evaluate the static and dynamic characteristics of complex actual piping system based on NFPA-13 and SMACNA guidelines. The result of this study revealed that current piping system subjected to design lateral force and design spectrum based on UBC-97 was failed in both cases and mode shapes between piping system and building structure were very different

Keywords: Nonstructural component, piping, hospital, seismic, bracing.

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Authors: Woo Young Jung, Min Ho Kwon, Bu Seog Ju

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A failure of the non-structural component can cause  significant damages in critical facilities such as nuclear power plants  and hospitals. Historically, it was reported that the damage from the  leakage of sprinkler systems, resulted in the shutdown of hospitals for  several weeks by the 1971 San Fernando and 1994 North Ridge  earthquakes. In most cases, water leakages were observed at the cross  joints, sprinkler heads, and T-joint connections in piping systems  during and after the seismic events. Hence, the primary objective of  this study was to understand the seismic performance of T-joint  connections and to develop an analytical Finite Element (FE) model  for the T-joint systems of 2-inch fire protection piping system in  hospitals subjected to seismic ground motions. In order to evaluate the  FE models of the piping systems using OpenSees, two types of  materials were used: 1) Steel02 materials and 2) Pinching4 materials.  Results of the current study revealed that the nonlinear  moment-rotation FE models for the threaded T-joint reconciled well  with the experimental results in both FE material models. However,  the system-level fragility determined from multiple nonlinear time  history analyses at the threaded T-joint was slightly different. The  system-level fragility at the T-joint, determined by Pinching4 material  was more conservative than that of using Steel02 material in the piping  system.

Keywords: Fragility, T-joint, Piping, Leakage, Sprinkler.

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Authors: Temitope O. Tokosi

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Healthcare is a human right. The sensitivity of health issues has necessitated the introduction of Enterprise Content Management (ECM) at district hospitals in the Western Cape Province of South Africa. The objective is understanding clinicians’ perception of ECM at their workplace. It is a descriptive case study design of constructivist paradigm. It employed a phenomenological data analysis method using a pattern matching deductive based analytical procedure. Purposive and s4nowball sampling techniques were applied in selecting participants. Clinicians expressed concerns and frustrations using ECM such as, non-integration with other hospital systems. Inadequate access points to ECM. Incorrect labelling of notes and bar-coding causes more time wasted in finding information. System features and/or functions (such as search and edit) are not possible. Hospital management and clinicians are not constantly interacting and discussing. Information turnaround time is unacceptably lengthy. Resolving these problems would involve a positive working relationship between hospital management and clinicians. In addition, prioritising the problems faced by clinicians in relation to relevance can ensure problem-solving in order to meet clinicians’ expectations and hospitals’ objective. Clinicians’ perception should invoke attention from hospital management with regards technology use. The study’s results can be generalised across clinician groupings exposed to ECM at various district hospitals because of professional and hospital homogeneity.

Keywords: Clinician, electronic content management, hospital, perception, technology.

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Authors: Mahmoud A. El-Banna

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The need to increase the efficiency of health care systems is becoming an obligation, and one of area of improvement is the discharge process. The objective of this work is to minimize the patients discharge time (for insured patients) to be less than 50 minutes by using six sigma approach, this improvement will also: lead to an increase in customer satisfaction, increase the number of admissions and turnover on the rooms, increase hospital profitability.Three different departments were considered in this study: Female, Male, and Paediatrics. Six Sigma approach coupled with simulation has been applied to reduce the patients discharge time for pediatrics, female, and male departments at hospital. Upon applying these recommendations at hospital: 60%, 80%, and 22% of insured female, male, and pediatrics patients respectively will have discharge time less than the upper specification time i.e. 50 min.

Keywords: Discharge Time, Healthcare, Hospitals, Patients, Process Improvement, Six Sigma, Simulation

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Authors: Abdulrahim Shamayleh, John Fowler, Muhong Zhang

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Operating rooms are important assets for hospitals as they generate the largest revenue and, at the same time, produce the largest cost for hospitals. The model presented in this paper helps make capacity planning decisions on the combination of open operating rooms (ORs) and estimated overtime to satisfy the allocated OR time to each specialty. The model combines both decisions on determining the amount of OR time to open and to allocate to different surgical specialties. The decisions made are based on OR costs, overutilization and underutilization costs, and contribution margins from allocating OR time. The results show the importance of having a good estimate of specialty usage of OR time to determine the amount of needed capacity and highlighted the tradeoff that the OR manager faces between opening more ORs versus extending the working time of the ORs already in use.

Keywords: capacity planning, contribution margins, operating room, overutilization

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Authors: Stella Ouma, M. E. Herselman

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The Application of e-health solutions has brought superb advancements in the health care industry. E-health solutions have already been embraced in the industrialized countries. In an effort to catch up with the growth, the developing countries have strived to revolutionize the healthcare industry by use of Information technology in different ways. Based on a technology assessment carried out in Kenya – one of the developing countries – and using multiple case studies in Nyanza Province, this work focuses on an investigation on how five rural hospitals are adapting to the technology shift. The issues examined include the ICT infrastructure and e-health technologies in place, the knowledge of participants in terms of benefits gained through the use of ICT and the challenges posing barriers to the use of ICT technologies in these hospitals. The results reveal that the ICT infrastructure in place is inadequate for e-health implementations as a result to various challenges that exist. Consequently, suggestions on how to tackle the various challenges have been addressed in this paper.

Keywords: Challenges, e-health, healthcare, information communication technology, rural areas.

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Authors: K. Zigan

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Not with standing the importance of foreign highly skilled professionals for host economies, there is a paucity of research studies investigating the role of the corporate social context during the integration process. This research aims to address this paucity by exploring the role of social capital in the integration of foreign health professionals. It does so by using a qualitative research approach. In this pilot study the hospital sector forms this study-s sample and interviews were conducted with HR managers, foreign health professionals and external HR consultants. It was found that most of the participating hospitals had not established specific HR practices and had only partly linked the development of organisational social capital with a successful integration process. This research contributes, for example, to the HR literature on the integration of self-initiated expatriates by analysing the role of HRM in generating organisational social capital needed for a successful integration process.

Keywords: Corporate integration, hospitals, self-initiated expatriates, organisational social capital.

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Authors: N. Mpofu, M. Sears

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In this paper, we propose a novel algorithm for delineating the endocardial wall from a human heart ultrasound scan. We assume that the gray levels in the ultrasound images are independent and identically distributed random variables with different Rician Inverse Gaussian (RiIG) distributions. Both synthetic and real clinical data will be used for testing the algorithm. Algorithm performance will be evaluated using the expert radiologist evaluation of a soft copy of an ultrasound scan during the scanning process and secondly, doctor’s conclusion after going through a printed copy of the same scan. Successful implementation of this algorithm should make it possible to differentiate normal from abnormal soft tissue and help disease identification, what stage the disease is in and how best to treat the patient. We hope that an automated system that uses this algorithm will be useful in public hospitals especially in Third World countries where problems such as shortage of skilled radiologists and shortage of ultrasound machines are common. These public hospitals are usually the first and last stop for most patients in these countries.

Keywords: Endorcardial Wall, Rician Inverse Distributions, Segmentation, Ultrasound Images.

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Authors: Wei-Wen Liu, Feng-Chuan Pan, Pei-Chi Wen, Sen-Ji Chen, Su-Hui Lin

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Nurses in an Armed Force Hospital (AFH) expose to stronger stress than those in a civil hospital, especially in an emergency department (ED). Ironically, stresses of these nurses received few if any attention in academic research in the past. This study collects 227 samples from the emergency departments of four armed force hospitals in central and southern Taiwan. The research indicates that the top five stressors are a massive casualty event, delayed physician support, overloads of routine work, overloads of assignments, and annoying paper work. Excessive work loading was found to be the primary source of stress. Nurses who were perceived to have greater stress levels were more inclined to deploy emotion-oriented approaches and more likely to seek job rotations. Professional stressors and problem-oriented approaches were positively correlated. Unlike other local studies, this study concludes that the excessive work-loading is more stressful in an AFH.

Keywords: Emergency nurse, Job stressor, Coping behavior, Armed force hospital.

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Authors: Nazedah Ain Ibrahim, Mohamed Mansor Manan

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Information regarding early onset neonatal sepsis (EONS) pathogens may vary between regions. Global perspectives showed Group B Streptococcal (GBS) as the most common causative pathogens, but the widespread use of intrapartum antibiotics has changed the pathogens pattern towards gram negative microorganisms, especially E. coli. Objective of this study is to describe the pathogens isolated, to assess current treatment and risk of EONS. Records of 899 neonates born in three General Hospitals between 2009 until 2012 were retrospectively reviewed. Proven was found in 22 (3%) neonates. The majority was isolated with gram positive organisms, 17 (2.3%). All grams positive and most gram negative organisms showed sensitivity to the tested antibiotics. Only two rare gram negative organisms showed total resistant. Male was possible risk of proven EONS. Although proven EONS remains uncommon in Malaysia, nonetheless, the effect of intrapartum antibiotics still required continuous surveillance.

Keywords: Early onset neonatal sepsis, neonates, pathogens, gram positive, gram negative.

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Authors: Khelood A. Mkalaf, Peter Gibson, John Flanagan

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This study investigates the relationship between the reliability of critical medical equipment (CME) and the effectiveness of CME maintenance management strategies in relation to patient outcomes in 84 public hospitals of a top 20 OECD country. The work has examined the effectiveness of CME maintenance management strategies used by the public hospital system of a large state run health organization. The conceptual framework was designed to examine the significance of the relationship between six variables: (1) types of maintenance management strategies, (2) maintenance services, (3) maintenance practice, (4) medical equipment reliability, (5) maintenance costs and (6) patient outcomes. The results provide interesting insights into the effectiveness of the maintenance strategies used. For example, there appears to be about a 1 in 10 000 probability of failure of anesthesia equipment, but these seem to be confined to specific maintenance situations. There are also some findings in relation to outsourcing of maintenance. For each of the variables listed, results are reported in relation to the various types of maintenance strategies and services. Decision-makers may use these results to evaluate more effective maintenance strategies for their CME and generate more effective patient outcomes.

Keywords: Critical medical equipment, maintenance strategy, patient outcomes, reliability.

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Authors: Young Kwon Yang, In Sung Kang, Jung Ha Hwang, Jin Chul Park

Abstract:

The present study is a foundational study for performance improvements on isolation wards to prevent proliferation of secondary infection of infectious diseases such as SARS, H1N1, and MERS inside hospitals. Accordingly, the present study conducted an analysis of the effect of sealing mechanisms and filling of openings on ensuring air tightness performance in isolation wards as well as simulation on air currents in improved isolation wards. The study method is as follows. First, previous studies on aerial infection type and mechanism were reviewed, and the review results were utilized as basic data of analysis on simulation of air current. Second, national and international legislations and regulations in relation to isolation wards as well as case studies on developed nations were investigated in order to identify the problems in isolation wards in Korea and improvement plans. Third, construction and facility plans were compared and analyzed between general and isolation wards focusing on large general hospitals in Korea, thereby conducting comparison and analysis on the performance and effects of air-tightness of general and isolation wards through CFD simulations. The study results showed that isolation wards had better air-tightness performance than that of general wards.

Keywords: AII Room, air-borne infection, CFD, computational fluid dynamics.

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