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4. Ventilator‑associated pneumonia – What price does the public health system pay?

Author

Thimmaiah, Guruprasad, Pandey, Navin, Prinja, Shankar, Jain, Kajal, Biswal, Manisha, Agarwal, Ritesh, Koushal, Vipin, and Sethi, Saru

Subjects
VENTILATOR-associated pneumonia, WAGES, DEVELOPING countries, PRICES, INTENSIVE care units
Abstract

Background: Ventilator‑associated pneumonia (VAP) is the commonest healthcare‑associated infection (HAI) in intensive care units (ICU), especially in trauma patients. VAP imposes a significant cost burden on the healthcare ecosystem. However, there are few data from the developing world. Methodology: We conducted this study in the trauma ICU (TICU) of PGIMER, Chandigarh, from October 2021 to December 2022. The incidence, incidence density, and average length of stay (ALOS) of both VAP and non‑VAP patients were established. The health system cost was assessed using a mixed (top‑down and bottom‑up) micro‑costing approach. We collected data for all the resources (direct and indirect costs) utilized during service delivery and estimated the health system cost per bed per day. Results: In this study, 494 patients were admitted to TICU, of which 484 received Mechanical Ventilation (MV) and 47 developed VAP. We included 41 and 44 patients with and without VAP. The VAP incidence rate was 9.7% and the VAP incidence density was 10.79/1000 MV days. The ALOS for VAP patients was 21 days, and for non‑ VAP patients was 8.2 days. Our study estimated a total health system cost of INR 25,927 per bed per day. The health system cost of treating a VAP patient was INR 544,467 compared to INR 207,416 for a non‑VAP patient. Conclusion: Treatment of VAP poses substantial costs for the health system and patients. There is a need to focus on preventing VAP, which would eventually reduce the length of stay and the resultant financial impact on the health system and the patient. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Multipronged strategy for protection and motivation of healthcare workers during the COVID-19 pandemic: a real-life study.

Author

Premkumar, Madhumita, Dutta, Usha, Sandhu, Anchal, Kaur, Harman, Singh, Mini P, Goyal, Kapil, Guru, Rashmi Ranjan, Lakshmi, PVM, Gupta, Madhu, Biswal, Manisha, Ghosh, Arnab, Sachan, Anurag, Guleria, Shikha, Sahoo, Swapanjeet, Grover, Sandeep, Gupta, Tulika, Koushal, Vipin, Devnani, Mahesh, Talati, Shweta, and Mohindra, Ritin

Published
2024
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8. Authors' response

Author

Suri, Vikas, primary, Soni, ShivLal, additional, Kajal, Kamal, additional, Yaddanapudi, LN, additional, Malhotra, Pankaj, additional, Puri, GoverdhanDutt, additional, Bhalla, Ashish, additional, Singh, MiniP, additional, Sehgal, InderpaulSingh, additional, Koushal, Vipin, additional, Varma, Neelam, additional, Biswal, Manisha, additional, M. Lakshmi, PV, additional, Sharma, Sadhna, additional, Deepy, Z, additional, Ram, Sant, additional, Yadav, Jaivinder, additional, Pandey, Navin, additional, Sharma, Prashant, additional, Malik, Nabhajit, additional, Goyal, Kapil, additional, Mehra, Aseem, additional, Sahoo, Swapnajeet, additional, Mohindra, Ritin, additional, Francis, Jijo, additional, Bhargava, Mudit, additional, Singla, Karan, additional, Babu, Preena, additional, Verma, Amiy, additional, Khaire, NiranjanShiwaji, additional, and Guru, RR, additional

Published
2023
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19. Bacterial coinfections and secondary infections in COVID-19 patients from a tertiary care hospital of northern India: Time to adhere to culture-based practices

Author

Sharma, Bhawna, primary, Sreenivasan, Priya, additional, Biswal, Manisha, additional, Mahajan, Varun, additional, Suri, Vikas, additional, Singh Sehgal, Inderpaul, additional, Ray, Pallab, additional, Dutt Puri, Goverdhan, additional, Bhalla, Ashish, additional, Narayana Yaddanapudi, Lakshmi, additional, Koushal, Vipin, additional, and Angrup, Archana, additional

Published
2021
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23. Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study

Author

Dutta, Usha, primary, Sachan, Anurag, additional, Premkumar, Madhumita, additional, Gupta, Tulika, additional, Sahoo, Swapnajeet, additional, Grover, Sandeep, additional, Sharma, Sugandhi, additional, Lakshmi, P V M, additional, Talati, Shweta, additional, Biswal, Manisha, additional, Suri, Vikas, additional, Singh, Mini P, additional, Ghai, Babita, additional, Chhabra, Rajesh, additional, Bharti, Bhavneet, additional, Samanta, Jayanta, additional, Arora, Pankaj, additional, Mohindra, Ritin, additional, Malhotra, Sunita, additional, Singh, Gurmeet, additional, Guru, Rashmi Ranjan, additional, Pandey, Navin, additional, Koushal, Vipin, additional, Kumar, Ashok, additional, Bhogal, Ranjitpal Singh, additional, Aggarwal, Arun K, additional, Goel, Kapil, additional, Malhotra, Pankaj, additional, Yaddanapudi, Narayana, additional, Mahajan, Pranay, additional, Thakur, J S, additional, Sehgal, Rakesh, additional, Ghosh, Arnab, additional, Sehgal, Inderpaul Singh, additional, Agarwal, Ritesh, additional, Jayashree, Muralidharan, additional, Bhalla, Ashish, additional, Jain, Sanjay, additional, Kochhar, Rakesh, additional, Chakrabarti, Arunaloke, additional, Puri, Goverdhan Dutt, additional, and Ram, Jagat, additional

Published
2021
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25. Demographic & clinical profile of patients with COVID-19 at a tertiary care hospital in north India

Author

Suri, Vikas, primary, Soni, ShivLal, additional, Kajal, Kamal, additional, Yaddanapudi, LN, additional, Malhotra, Pankaj, additional, Puri, GoverdhanDutt, additional, Bhalla, Ashish, additional, Singh, MiniP, additional, Sehgal, InderpaulSingh, additional, Koushal, Vipin, additional, Varma, Neelam, additional, Biswal, Manisha, additional, Lakshmi, P.V.M., additional, Sharma, Sadhna, additional, Deepy, Z, additional, Ram, Sant, additional, Yadav, Jaivinder, additional, Pandey, Navin, additional, Sharma, Prashant, additional, Malik, Nabhajit, additional, Goyal, Kapil, additional, Mehra, Aseem, additional, Sahoo, Swapnajeet, additional, Mohindra, Ritin, additional, Francis, Jijo, additional, Bhargava, Mudit, additional, Singla, Karan, additional, Babu, Preena, additional, Verma, Amiy, additional, Khaire, NiranjanShiwaji, additional, and Guru, RR, additional

Published
2021
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34. Response to a Fire Incident in the Operation Room: A Cautionary Tale.

Author

Sharma, Raman, Kumar, Ashok, and Koushal, Vipin

Subjects
HEALTH facilities, OPERATING rooms, FIRE, MEDICAL care
Abstract

Health care facilities are always seen as places of haven and protection for managing external incidents, but situations become difficult and challenging when such facilities themselves are affected by internal hazards. Such incidents are arguably more disruptive than external incidents, because patients are dependent on supportive measures and are neither in position to respond to such crisis situation nor do they know how to respond. Operating room fires are rare but potentially catastrophic, involving loss of costly resources and possibly lives. This case report details a true operating room fire incident in an emergency operating room and details the real-life challenges encountered by operating room staff in preserving both life and property. As a result of this work, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer health care environment for every worker and patient. [ABSTRACT FROM AUTHOR]

Published
2020
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36. Awareness of andropause in males: A North Indian study

Author

Ashat, Munish, Puri, Sonia, Singh, Amarjeet, Sarpal, Sandeep, Goel, Naveen, and Koushal, Vipin

Subjects
Health, Science and technology
Abstract

Byline: Munish. Ashat, Sonia. Puri, Amarjeet. Singh, Sandeep. Sarpal, Naveen. Goel, Vipin. Koushal Background: According to the Indian census 2011, India has the largest population of the elderly. Very few [...]

Published
2011

37. Needle stick injury and HIV risk among health care workers in North India

Author

Ashat, Munish, Bhatia, Vikas, Puri, Sonia, Thakare, Meenal, and Koushal, Vipin

Subjects
HIV (Viruses) -- Risk factors -- Health aspects, Workers -- Health aspects, Health care industry -- Health aspects, Medical personnel -- Health aspects, Health care industry, Health, Science and technology
Abstract

Byline: Munish. Ashat, Vikas. Bhatia, Sonia. Puri, Meenal. Thakare, Vipin. Koushal Objectives: To determine the occurrence of needle stick injuries among various categories of health care workers (HCWs), the causal [...]

Published
2011

40. A study of sociodemographic profile and level of awareness of the decision makers for organ donation of deceased organ donors in a Tertiary Care Hospital.

Author

Bansal, Navdeep, Koushal, Vipin, and Mehra, Aditi

Abstract

Aim: Organ transplants have developed into a successful therapy to treat end-stage organ disease. Family members play a prominent role in decisions related to organ donation of brain-dead patients. Having different imaginations about brain death among the people may be highly influenced by culture, experience, and other sociodemographic variables. Thus, the study was undertaken to analyze the sociodemographic profile of the decision makers for organ donation in case of potential deceased donors and to determine the level of awareness and its relation with the sociodemographic variables. Methods: The study was conducted at a tertiary care hospital of North India from January 2016 to August 2017. The current research is a qualitative study with exploratory approach. Data were collected through interviews with 59 family members who gave consent to organ donation of their family members. A purposive sampling method was used. Results: The results showed that most (76.3%) of the decision makers were totally unaware of the concept of organ donation before they were counseled for the same. The results showed that awareness of organ donation was dependent on gender, education, and monthly income. Most of the decision makers had only primary education. Although they were initially not aware about the concept, their decision-making was not influenced by the level of education. Majority (90%) of the females were unaware about the organ donation, but eventually consented for the cause. Conclusion: The scope of mass education and awareness can be expanded to further strengthen the program and improve the outreach. [ABSTRACT FROM AUTHOR]

Published
2019
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43. Enhancing the safety of frontline healthcare workers during coronavirus disease: a novel real-time remote audiovisual aided doffing approach.

Author

Dhandapani, Manju, Kaur, Sukhpal, Das, Karobi, Guru, Rashmi Ranjan, Biswal, Manisha, Mahajan, Pranay, Koushal, Vipin, and Puri, Goverdhan D.

Subjects
MEDICAL personnel, COVID-19, SARS-CoV-2, EBOLA virus disease, HEALTH facilities
Abstract

Perceived benefits of real-time remote audio-visual aided (RT-RAVA) doffing approach The RT-RAVA doffing approach has the rewards of reducing the self-contamination among HCWs while doffing and hence, the virus transmission. The RT-RAVA doffing approach also aids in essential corrective steps for the HCWs who had a minor breach and quarantining the HCWs with major breach after risk identification [[8]]. [Extracted from the article]

Published
2021
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50. Needle stick and sharp injuries among house-keeping workers: A case study of a city hospital.

Author

Sharma, Raman, Yadav, Ravinder, Koushal, Vipin, Aggarwal, Pallvi, Sharma, Meenakshi, and Saini, Varinder

Subjects
NEEDLESTICK injury prevention, HOUSEKEEPERS, HEALTH facilities, HOSPITAL housekeeping, EDUCATIONAL programs
Abstract

Needle stick and sharp injuries (NSSI) among Health Care have a significant impact on the morbidity and mortality. Preventing NSSI is an essential part and every healthcare facility should have an infection control program in work place. A two months descriptive study was conducted in city hospital, Chandigarh to evaluate NSSI among Housekeeping Workers (HkW) specifically to determine the occurrence of NSSI, circumstances under which NSSI occur and measures to prevent NSSIs. Out of 434 HkW, 244 were identified at risk of NSSI. The self structured questionnaire were administered to participants to assess awareness and importance of handling BMW, education and training of BMW handling, causes of injuries etc. 93.0% (214) of HkW had knowledge of segregation, categorization and significance of color coding, 96.5% (222) were well aware of the efforts taken by the hospital authorities in the BMW management. No HkW has ever been imparted training regarding BMW management and all came to know while working in the hospital only. After NSSI exposure 32% (74) of HkW responded immediately, 10 per cent took action later on the same day while the rest did not take any action. When asked about factors for NSSI, 94% (214) responded that they themselves were responsible. NSSIs are observed in all categories of Healthcare workers (HCW) and there is a scope for improvement in safety protocols. Preventive strategies have to be devised andreporting must be made mandatory. Such programs and innovations are necessary for all HCW safety and security. [ABSTRACT FROM AUTHOR]

Published
2016

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