Rationale: Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. Objectives: To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. Methods: A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives (QIIs) in hospitals. Measurements and Main Results: A total of 1,023 hospitals in 69 countries were included. Most of them, 835 (81.6%), were in Europe. Sepsis screening was used in 54.2% of emergency departments (EDs), 47.9% of wards, and 61.7% of ICUs. Sepsis management was standardized in 57.3% of EDs, 45.2% of wards, and 70.7% of ICUs. The implementation of comprehensive QIIs was associated with increased screening (EDs, +33.3%; wards, +44.4%; ICUs, +23.8% absolute difference) and increased standardized sepsis management (EDs, +33.6%; wards, +40.0%; ICUs, +17.7% absolute difference) compared with hospitals without QIIs. A total of 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. Conclusions: The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regard to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.
- MeSH
- Antimicrobial Stewardship MeSH
- Guideline Adherence * statistics & numerical data MeSH
- Intensive Care Units standards MeSH
- Humans MeSH
- Hospitals * standards statistics & numerical data MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Sepsis * therapy diagnosis MeSH
- Practice Guidelines as Topic MeSH
- Emergency Service, Hospital standards MeSH
- Quality Improvement * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Surgical site infections (SSIs) in cardiac surgery significantly impact patient outcomes. This study examines cardiac antimicrobial prophylaxis guidelines in Czech and Slovak hospitals, crucial for reducing SSI incidence. METHODS: An electronic survey was conducted across cardiac surgery departments in both countries, focusing on surgical antibiotic prophylaxis (SAP) protocols, antibiotic choices, dosages, timing and postoperative infection rates. Responses were collected over three months, ensuring a comprehensive overview. FINDINGS: Most surveyed hospitals (79%) implement SAP, but guidelines exhibit notable variability. Cefazolin dominates as the primary prophylactic choice, with varying dosing regimens. Challenges include timing inconsistencies and prolonged prophylaxis durations, particularly in implant-related procedures. Regular guideline revisions are reported in 18% of hospitals within the last year, emphasizing the need for updated practices. CONCLUSIONS: This study shows the importance of standardizing SAP practices, aligning them with evolving evidence, and implementing regular guideline revisions. The observed variations highlight opportunities for enhanced SSI prevention strategies in cardiac surgery, ultimately contributing to improved patient outcomes.
- MeSH
- Anti-Bacterial Agents * therapeutic use administration & dosage MeSH
- Antibiotic Prophylaxis * standards statistics & numerical data MeSH
- Surgical Wound Infection * prevention & control MeSH
- Cardiac Surgical Procedures * MeSH
- Humans MeSH
- Hospitals statistics & numerical data MeSH
- Surveys and Questionnaires MeSH
- Practice Guidelines as Topic MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Geographicals
- Czech Republic MeSH
- Slovakia MeSH
Cíl: Cílem studie byla evaluace a srovnání výsledků pacientů vyšetřených tzv. CT polytraumatickým protokolem ve Fakultní nemocnici Olomouc a v Zemské nemocnici v Rakouském Hornu v letech 2018 a 2019. Zvláštní pozornost byla věnována odlišnostem v postupech a výsledcích nemocnic obou států. Metodika: Do této retrospektivní, observační studie byli zahrnuti pacienti vyšetření standardizovaným polytraumatickým CT protokolem. Kromě sběru obvyklých dat, jako jsou věk pacienta, pohlaví, datum a čas vyšetření, zde byly dále zahrnuty i údaje jako například, zda bylo vyšetření provedeno ve službě a případné požití alkoholu nebo drog. Důraz při sběru a analýze dat byl kladen mimo jiné na mechanismus úrazu, stejně jako délku hospitalizace. Poranění byla klasifikována podle zasažených tělesných regionů a závažnosti zranění pomocí tzv. Abbreviated Injury Scale (AIS) a tzv. Injury Severity Score (ISS). Výsledky: Z celkem 486 pacientů převažovali muži, v Olomouci ze 75 % a v Hornu z 68 %. Signifikantně vyšší věk měli pacienti rakouské nemocnice (52,5 let) než v české (48 let). Ukázala se korelace zranění hlavy při pádu ze stoje, dále hrudníku u sebevrahů a cyklistů a poranění dolních končetin u motocyklistů. Závažnost úrazů statisticky významně stoupala s věkem. Hospitalizováni byli pacienti s podobným ISS, ale propuštění pacienti z rakouské nemocnice měli ISS podstatně vyšší (4,5) než z FN Olomouc (1). Závěr: Co do profilu pacientů a nemocniční péče nebyly prokázány u většiny parametrů podstatné rozdíly mezi oběma nemocnicemi. K výjimkám náleží vyšší věk pacientů v rakouské nemocnici, stejně jako vyšší průměrná hodnota ISS u pacientů propouštěných domů bez hospitalizace tamtéž.
Purpose: Purpose of our study was to evaluate and compare data of patients examined by standardized CT protocol in FN Olomouc (the Czech Republic) and in hospital in Horn (Austria) in years 2018 and 2019. Special attention was paid to the differences in procedures and results at these two hospitals in both states. Methods: In this retrospective observational study were involved patients examined with CT standardized protocol. Apart to the usual data such as age, sex, date and time of examination, we also collected data of consumption of drugs or alcohol as well as a fact weather was the examination done during a shift. Furthermore, the mechanism of injury and the length of hospitalization were marked. Injuries were classified according to affected body regions and severity of the injury with Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Results: From total of 486 patients were more frequent male, in Olomouc they comprised 75% and in Horn 68%. Patients of the Austrian hospital had significantly higher age (52.5 years) than in the Czech one (48 years). Correlation of a head injury and a fall from upright position, correlation of thorax injury and suicides and cycling as well as correlation of lower extremity injury and motorcycle accidents was found. The severity of injury had statistically significant growth with age. Patients at both hospitals were hospitalized with similar ISS, but patients discharged from Horn had ISS significantly higher (4.5) compared to FN Olomouc (1). Conclusions: In the profile of patients and hospital care were no relevant differences in majority of the parameters between both hospitals. Exceptions were higher age of the patients in Horn, as well as the higher average value of ISS in patients discharged home without hospitalization.
- MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Hospitals statistics & numerical data MeSH
- Tomography, X-Ray Computed * MeSH
- Multiple Trauma * diagnostic imaging epidemiology MeSH
- Aged MeSH
- Trauma Severity Indices MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
- Geographicals
- Czech Republic MeSH
- Austria MeSH
Introduction: Patient safety culture is described as employees' shared values, attitudes, and behaviours in a healthcare organization. Its main goal is to improve patient safety. Assessment of patient safety culture in the hospital environment is most often carried out using self-assessment tools. Although several of these tools have been developed, their comprehensive overview is lacking in literature. Aim: To provide an overview of instruments measuring patient safety culture in a hospital setting. Methods: The study has a character of a narrative literature review. The search was performed in the scientific databases Scopus, ProQuest, and PubMed in January 2021. The search produced a total of 1,767 studies and was limited to language (English). The search and the retrieval process reflected PRISMA's recommendations. The content analysis method was used in the data synthesis. Results: We identified 24 tools for assessing the patient safety culture in a hospital setting, of which seven were developed for specific workplaces; others are considered general. Eighteen tools might be utilized by all healthcare professionals within the hospital setting and only three were designated explicitly for nurses. The most commonly used instruments were the Hospital Survey on Patient Culture and the Safety Attitudes Questionnaire. Conclusion: Assessing a patient safety culture is considered one of the strategies for improving patient safety while increasing care quality. An appropriate tool's choice depends on the target population, the instrument's validity and reliability, and other aspects. Awareness of the various assessment tools can help hospitals choose the one that best suits their circumstances.
- MeSH
- Patient Safety * statistics & numerical data MeSH
- Humans MeSH
- Hospitals statistics & numerical data MeSH
- Personnel, Hospital psychology statistics & numerical data MeSH
- Review Literature as Topic MeSH
- Surveys and Questionnaires MeSH
- Safety Management methods statistics & numerical data MeSH
- Health Care Quality, Access, and Evaluation MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
The aim of the present study is to describe the ongoing spread of the KPC-producing strains, which is evolving to an epidemic in Czech hospitals. During the period of 2018-2019, a total of 108 KPC-producing Enterobacterales were recovered from 20 hospitals. Analysis of long-read sequencing data revealed the presence of several types of blaKPC-carrying plasmids; 19 out of 25 blaKPC-carrying plasmids could be assigned to R (n = 12), N (n = 5), C (n = 1) and P6 (n = 1) incompatibility (Inc) groups. Five of the remaining blaKPC-carrying plasmids were multireplicon, while one plasmid couldn't be typed. Additionally, phylogenetic analysis confirmed the spread of blaKPC-carrying plasmids among different clones of diverse Enterobacterales species. Our findings demonstrated that the increased prevalence of KPC-producing isolates was due to plasmids spreading among different species. In some districts, the local dissemination of IncR and IncN plasmids was observed. Additionally, the ongoing evolution of blaKPC-carrying plasmids, through genetic rearrangements, favours the preservation and further dissemination of these mobile genetic elements. Therefore, the situation should be monitored, and immediate infection control should be implemented in hospitals reporting KPC-producing strains.
- MeSH
- Anti-Bacterial Agents pharmacology MeSH
- Drug Resistance, Bacterial * MeSH
- Bacterial Proteins genetics metabolism MeSH
- beta-Lactamases metabolism MeSH
- Epidemics MeSH
- Klebsiella Infections epidemiology microbiology MeSH
- Klebsiella pneumoniae isolation & purification metabolism MeSH
- Humans MeSH
- Hospitals statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
- MeSH
- COVID-19 MeSH
- Disease Outbreaks statistics & numerical data MeSH
- Respiratory Care Units statistics & numerical data MeSH
- Coronavirus Infections MeSH
- Ventilators, Mechanical statistics & numerical data MeSH
- Hospitals statistics & numerical data MeSH
- Publication type
- Popular Work MeSH
- Geographicals
- Czech Republic MeSH
AIMS: To describe the associations between dysphagia and malnutrition risk and to identify predictors for dysphagia in a group of persons at risk of malnutrition in hospitals and nursing homes. DESIGN: A secondary analysis of cross-sectional data from the years 2012-2016. METHODS: The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool for Adults (MUST). The data were compared regarding malnutrition risk and dysphagia. Regression analyses were conducted to identify variables that were associated with the risk of malnutrition and dysphagia. RESULTS: Patients (N = 17,580) were included in the study sample. The prevalence of dysphagia was 6.6% and the prevalence of malnutrition risk was 18.9%. A multivariable logistic regression analysis resulted in the identification of dysphagia and cancer as variables with the highest odds ratios with regard to malnutrition risk. Patients with cancer, stroke or respiratory diseases represent a high-risk group for the co-occurrence of dysphagia and risk of malnutrition. CONCLUSIONS: Screening for dysphagia should be carried out on patients at risk of malnutrition as an integral part of their admission to a healthcare institution and especially on the higher risk group of patients with cancer, a stroke or a respiratory disease. IMPACT: What problem did the study address? This study identified the relationship between dysphagia and malnutrition risk and associated factors. What were the main findings? Dysphagia among patients in the research sample was associated with more than two times higher prevalence of the malnutrition risk. Where and on whom will the research have an impact? Thorough malnutrition risk and dysphagia screening lead to better nursing care.
- MeSH
- Stroke epidemiology MeSH
- Comorbidity MeSH
- Middle Aged MeSH
- Humans MeSH
- Logistic Models MeSH
- Neoplasms epidemiology MeSH
- Respiratory Tract Diseases epidemiology MeSH
- Hospitals statistics & numerical data MeSH
- Nursing Homes statistics & numerical data MeSH
- Malnutrition epidemiology MeSH
- Deglutition Disorders epidemiology MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
THEORY: Patients falls have a multifactorial character and typically have multiple causalities. GOAL: The goal of the study was to identify risk factors for falls of hospitalized patients. METHODOLOGY: This was a case-control study. The study included 222 patients who experienced a fall during their hospitalization (cases) and 1,076 patients who did not fall during their hospitalization (controls). The study involved four hospitals in the South Bohemian Region of the Czech Republic. The study took place during the 2017 calendar year. RESULTS: The average age of patients who experienced a fall was 77.9 years. The group of cases included 5-times more patients with a history of falls than the controls. Patients who fell were in higher risk of falls than patients in the control group at hospital admission. The group of cases also had a higher prevalence of confused and restless patients; however, the group did not include a statistically significantly higher number of incontinent patients, patients with eating and drinking disorders, or patients with intravenous therapy than the control group. CONCLUSION: Interventions aimed at prevention of falls should be included in care plans, especially for older patients, patients who have fallen in the past, patients who have movement restriction, patients with cognitive dysfunction, and patients with increased need of assistance with basic daily activities.
- MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Hospitals statistics & numerical data MeSH
- Prevalence MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Case-Control Studies MeSH
- Accidental Falls statistics & numerical data MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
