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Quality management in the institution of primary health care in Republic of Srpska – Health centre Bijeljina
journal of patient safety & infection control 3 ( 2 0 1 5 ) 50–69
and oncology units respectively. Antifungal susceptibility patterns revealed that all isolates were sensitive to posaconazole (0.03–0.125 g/ml) and voriconazole (0.06–0.125 g/ml). Itraconazole and amphotericin B showed lower MIC values on in-vitro testing. Caspofungin was the only drug that showed higher MECs of 16–32 g/ml to maximum isolates. The band patterns obtained on RAPD showed similarity in three clinical and environmental isolates. Conclusions: In Aspergillus infection, environmental factors (contamination of the hospital environment by fungal spores) play an important role in addition to host factors. In this study, three isolates from the patients and the environment had the same genotype, indicating the source of infection as the hospital environment. This study imparts the need of antifungal susceptibility and regular surveillance in ICUs and other hospital area so that spread of hospital infection can be contained. Funding: The present study was funded from institutional/research funds of the authors. No pharmaceutical grants were used for this study. http://dx.doi.org/10.1016/j.jpsic.2015.10.029
C024 Quality management in the institution of primary health care in Republic of Srpska – Health centre Bijeljina J. Ruzica ∗ , M. Zlatko, R. Cedomir, M. Srdjan Health Center Bijeljina, Bosnia and Herzegovina Introduction: One of the goals of health system reform in the Republic of Srpska is to improve the quality of health care (application of accreditation and certification standards). Method: The aim of this paper is to emphasize the impact of the implementation of standards (ISO 9001:2008, certification and accreditation) the quality of services, increase customer satisfaction, and efficiency and effectiveness of their own process. Analytical methods are presented the achievements obtained in the Health Centre Bijeljina, which are the result of many years of planning activities and leadership efforts and all employees. Result: Health Centre Bijeljina is certified and recertified medical institution according to quality standard ISO 9001:2008. 30 teams of Family Medicine, Center for Mental Health and CBR have been accredited. The European Foundation for Quality Management awarded Health Centre Bijeljina an award for business excellence in three areas: leadership, results at users of medical services and key results in the category of large organizations outside of the Republic of Serbia 2012. Health center Bijeljina became the first certified medical institution in the Republic of Srpska. Conclusions: The implementation of these standards resulted in higher levels of customer satisfaction and commitment of employees. Management team has been recognized by all stakeholders so that today Health Centre Bijeljina considered to be one of the best organized health care institutions in the region. http://dx.doi.org/10.1016/j.jpsic.2015.10.030
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C025 Staff perception on health care waste management: A qualitative study in a rural tertiary care hospital in India V. Diwan 1,∗ , J. Sudhir Chandra 1 , T. Ashok 1 , S. Megha 1 , P. Ashish 1 , S. Cecilia 2 1
R.D. Gardi Medical College, Ujjain, India Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
2
Introduction: Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management. Method: A qualitative study was conducted using 10 focus group discussions (FGDs), with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the topics: (i) role of Health Care Waste Management (HCWM) in prevention of health care associated infections (ii) awareness of and views about HCWM related guidelines/legislation (iii) current HCWM practices and (iv) perception and preparedness related to improvements of the current practices and (v) proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi) and analyzed using content analysis. Result: Two themes were identified, Theme (A) Challenges in integration of HCWM in organizational practice with the categories (I) Awareness and views about HCWM, (II) Organizational practices regarding HCWM, and (III) Challenges in Implementation of HCWM, and Theme (B) Interventions to improve HCWM three categories, (I) Educational and motivational interventions, (II) Organizational culture change, and (III) Policy-related interventions. Conclusions: A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings. http://dx.doi.org/10.1016/j.jpsic.2015.10.031
C026 Contact precaution: Does knowledge really leads to improve compliance? Shweta Sharma ∗ , Anu Gupta, Paumi Sam Fortis Escorts Heart Institute, New Delhi, India Introduction: Multidrug-resistant organisms (MDROs) comprise a significant portion of healthcare associated infections and pose a unique challenge in both treatment and prevention. Contact isolation precaution helps in the prevention of transmission of MDROs. However different studies have shown poor compliance with contact isolation precaution.
and oncology units respectively. Antifungal susceptibility patterns revealed that all isolates were sensitive to posaconazole (0.03–0.125 g/ml) and voriconazole (0.06–0.125 g/ml). Itraconazole and amphotericin B showed lower MIC values on in-vitro testing. Caspofungin was the only drug that showed higher MECs of 16–32 g/ml to maximum isolates. The band patterns obtained on RAPD showed similarity in three clinical and environmental isolates. Conclusions: In Aspergillus infection, environmental factors (contamination of the hospital environment by fungal spores) play an important role in addition to host factors. In this study, three isolates from the patients and the environment had the same genotype, indicating the source of infection as the hospital environment. This study imparts the need of antifungal susceptibility and regular surveillance in ICUs and other hospital area so that spread of hospital infection can be contained. Funding: The present study was funded from institutional/research funds of the authors. No pharmaceutical grants were used for this study. http://dx.doi.org/10.1016/j.jpsic.2015.10.029
C024 Quality management in the institution of primary health care in Republic of Srpska – Health centre Bijeljina J. Ruzica ∗ , M. Zlatko, R. Cedomir, M. Srdjan Health Center Bijeljina, Bosnia and Herzegovina Introduction: One of the goals of health system reform in the Republic of Srpska is to improve the quality of health care (application of accreditation and certification standards). Method: The aim of this paper is to emphasize the impact of the implementation of standards (ISO 9001:2008, certification and accreditation) the quality of services, increase customer satisfaction, and efficiency and effectiveness of their own process. Analytical methods are presented the achievements obtained in the Health Centre Bijeljina, which are the result of many years of planning activities and leadership efforts and all employees. Result: Health Centre Bijeljina is certified and recertified medical institution according to quality standard ISO 9001:2008. 30 teams of Family Medicine, Center for Mental Health and CBR have been accredited. The European Foundation for Quality Management awarded Health Centre Bijeljina an award for business excellence in three areas: leadership, results at users of medical services and key results in the category of large organizations outside of the Republic of Serbia 2012. Health center Bijeljina became the first certified medical institution in the Republic of Srpska. Conclusions: The implementation of these standards resulted in higher levels of customer satisfaction and commitment of employees. Management team has been recognized by all stakeholders so that today Health Centre Bijeljina considered to be one of the best organized health care institutions in the region. http://dx.doi.org/10.1016/j.jpsic.2015.10.030
59
C025 Staff perception on health care waste management: A qualitative study in a rural tertiary care hospital in India V. Diwan 1,∗ , J. Sudhir Chandra 1 , T. Ashok 1 , S. Megha 1 , P. Ashish 1 , S. Cecilia 2 1
R.D. Gardi Medical College, Ujjain, India Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
2
Introduction: Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management. Method: A qualitative study was conducted using 10 focus group discussions (FGDs), with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the topics: (i) role of Health Care Waste Management (HCWM) in prevention of health care associated infections (ii) awareness of and views about HCWM related guidelines/legislation (iii) current HCWM practices and (iv) perception and preparedness related to improvements of the current practices and (v) proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi) and analyzed using content analysis. Result: Two themes were identified, Theme (A) Challenges in integration of HCWM in organizational practice with the categories (I) Awareness and views about HCWM, (II) Organizational practices regarding HCWM, and (III) Challenges in Implementation of HCWM, and Theme (B) Interventions to improve HCWM three categories, (I) Educational and motivational interventions, (II) Organizational culture change, and (III) Policy-related interventions. Conclusions: A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings. http://dx.doi.org/10.1016/j.jpsic.2015.10.031
C026 Contact precaution: Does knowledge really leads to improve compliance? Shweta Sharma ∗ , Anu Gupta, Paumi Sam Fortis Escorts Heart Institute, New Delhi, India Introduction: Multidrug-resistant organisms (MDROs) comprise a significant portion of healthcare associated infections and pose a unique challenge in both treatment and prevention. Contact isolation precaution helps in the prevention of transmission of MDROs. However different studies have shown poor compliance with contact isolation precaution.