Abstract
 
Keywords: Blood Borne Infections, Gloves, Injection Practices, Safe Injection Introduction: Injections are among the most commonly used medical procedure with an estimated 16 billion administrations each year worldwide.  An overwhelming majority (90%-95%) of these injections are administered for curative purposes. (1) Immunization accounts for around 3% of all injections. (2) According to IPEN Study, 03-06 billion injections were administered annually in India.
 
Objective
To Assess  the Knowledge, Skill and Practice of Health Care Providers of an Outdoor of a Tertiary Care Hospital (J.A. Group of Hospitals) of G.R. Medical College Gwalior (M.P.)  regarding use of ‘Safe Injection Practices’ in ‘Immunization Clinic & Injection Room’.
Methodology: 
The present study was a cross sectional study done  from July 2013 to September 2013 in a outdoor of  a tertiary care hospital in a G.R.Medical College in which a total of three health care providers were assessed  for their knowledge and 250 injection procedures of different age groups & at different sites were assessed for their skills  and practices regarding use of ‘safe injection practices’.
 
Result:   
A  total of three  Health Care Providers of an outdoor of a Tertiary Care Hospital were  taken . All the three had 100% knowledge regarding the use of safe injection practices but in 250 injection procedures which were observed   only 100 (40% ) wored gloves during the procedure.
Conclusion : There was a great disparity between therotical & practical Knowledge regarding ‘Safe Injection Practices’ . Efforts are to be needed to be done in this regard for the  benefit of both Health Care Provider and the patients. 
 
 
 
Abstract
For increasing the efficiency of hospital services, several concepts from manufacturing industries have been successfully applied. Value Engineering is applied to reduce the cost of the product or service without affecting the quality. Ever since L D miles started using this concept, Value Engineering has been used as an important tool for improving productivity across industries. This paper discusses the application of Value Engineering in Angioplasty conducted in a Tertiary Care Hospital in Hyderabad. Increased incidences of Coronary Artery Diseases have made Angioplasty a revenue generating procedure in tertiary care centers. Angioplasties are performed at Cardiac Catheterization Laboratories (Cath Lab). Though around 52 different types of procedures can be conducted in a Cath Lab, Angiogram and Angioplasty form the largest chunk of procedures. 
Key words- Value Engineering, Angioplasty, Cath Lab, Basic Function, 
Abstract:
Kidney Tranaplant Procedure (KTP)is the important modality of treatment for ESRD. Total cost involved  in KTP were studied in the study hospital. Direct & Indirect Cost Centres were identified in total kidney transplant process using the Activity Based Costing approach.  The total cost of the open KT surgery came to Rs.1,86,732.92/- out of which manpower cost is Rs.78,802.7/-& cost to the patient is Rs. 44,460.44/- on account of consumables purchased from the market.The total cost of the laparoscopic KT surgery came to Rs.2,00,039.1/- out of which manpower cost is Rs. 73,934.7/-& cost to the patient is Rs. 44,460.44/- on account of consumables purchased from the market.
 
Key Words:
Kidney Transplant Process, Cost Center, Direct Costs, Indirect Costs
 
 
 
 
Abstract
 
Key words: Medication dispense, Turn-around time, Inpatient pharmacy
 
Objective:
To understand the basic functioning of the pharmacy department in the hospital and identify the reasons of delay.
 
Method: 
An observational study was conducted in a tertiary care hospital of Rajasthan, India for a period of 20 days. A total of 300 medicine indents from a general ward (75), a critical ward (75) and inpatient pharmacy (IP pharmacy) (150) were observed. A dispense tracking sheet was prepared separately for wards and pharmacy for noting the turn-around time (TAT) starting from indent time to the time of receiving of items. At each step, the delays were observed and reasons behind them were found out. 
 
Results
The average time taken from indenting till receiving of items (medicines & consumables) in general ward and critical ward was found to be 2 hours 32 min. and 1 hour 42 min. respectively. In both the cases, the TAT was found to be more as compared to the hospital standard of 2 hours for general ward and 1 hour for critical ward. The main reasons of delay were identified to be sudden rush of indents in pharmacy at a particular time and delay in registration of indents through hospital software.
 
Conclusion
Medication dispensing process is a crucial interlinked process. It requires coordination and cooperation among all the involved departments. To maintain an effective medication dispense process, strict monitoring of each step is required. 
 
 
 
 
 
 
Abstract: 
Clinical doctors have, traditionally, dictated the demand and supply of drugs to patients in hospitals. With the growing awareness of the public, and the efforts of the government at regulating the pharmaceutical sector through its emphasis on generic drugs, open tendering and fair competition, hospitals have also been forced to revisit their supply chain models for drugs. This article compares the experience of a tertiary care teaching and research hospital in the procurement of generic medicines through an open tender as against the earlier practice of procurement of medicines through a limited tender with regard to identified performance indicators through a retrospective record analysis. Information thus gathered has been analyzed through the SPSS software, using the chi square test of significance to test the null hypothesis, followed by the TOWS matrix, in order to identify the optimum mechanism of drug procurement throughevidence - based administrative practices.
 
Key-words: generic medicines, open tender, limited tender
 
Abstract: 
 
Context:
Accurate and reliable information on cause-of-death (CoD) information is vital for improving the quality of care and for policy-making.The Medical Certification of Cause-of-Death (MCCD) is the national health information system for reporting and studying deaths certified by physicians in India.
 
Aims: 
The aim of our study was to assess the completeness and accuracy of reporting of the medical certification of cause-of-death (MCCD) system in a tertiary-care hospital in southern India
Settings and Design: We employed a cross-sectional epidemiological study design in a tertiary-care teaching hospital in Bangalore city, southern India.
 
Methods and Material: 
Data was abstracted on an online database on  a server using a combination of a mobilephone-based questionnaire by a research assistant followed by online review by two physicians. Two hundred and forty five death certificates completed during a 4-month period in 2011 were reviewed.
Statistical analysis used: Simple descriptive statistics
 
Results:
An appropriate death certificate was used in all cases; and completeness of relevant information on the deceased, hospital details, the certifying physician and on manner of death was seen in 98%. Accuracy of certification was however suboptimal. A major error was noted in about 80% of certificates; and a minor error in nearly 95% of certificates. The commonest major error (71%) was incorrect sequencing of events leading to death. Overall proportion of error-free death certificates was only 5%.
 
Conclusions:
There is considerable scope for improvement in the quality of death certification in hospitals through appropriate and timely training of certifying physicians.
 
Key-words:cause of death, death certificate, quality control, India
 
Key Messages:
  • Completeness of death certificates by physicians was high (>95%)
  • Accuracy of death certification was suboptimal with 80% of death certificates having at least one major error and proportion of error-free certificates being <5%
  • Appropriate training of certifying physicians is critical to improving quality of death certification 
 
 
 
 
Abstract: 
 
Background: 
Quality end-of-life care, the subject of intense and controversial discussion in medical ethics, is barely discussed in India.
 
Discussion: 
We argue that a tabooing of the topic will not provide a solution. An open societal, professional and ethical discussion and regulation are essential. A multidisciplinary team approach is often required in order to support ethical decision-making and to assist in devising an individualized end of life patient management plan. The authors discuss the medical, ethical, legal, and psychosocial challenges, strategies to quality end-of-life care in India with a focus on available international guidelines, recommendations and practices. 
 
Conclusions: 
For the end-of-life patient, important areas of focus are receiving adequate pain and symptom management, avoiding inappropriate prolongation of dying, achieving a sense of control, relieving burden, and strengthening relationships with loved ones. From the care giver’s perspective, we need to stress on the need is to recast quality end-of-life care as a global public health concern, strengthen capacity to deliver quality end-of-life care to improve strategies to acquire information about the quality of end-of-life care.
 
Keywords: assisted suicide; wish to die; palliative care; hasten death; End-of-life care; Euthanasia.
 
 
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