A draft End of Life Care Plan has been adopted for use in KanturkCommunityHospital; this will be piloted for residents at the end stage of their life. This Care Plan will be developed in consultation with the resident and/or their family and will ensure only appropriate interventions are carried out. It will also act as a guide for nursing staff to treatment and documenting progress and promoting comprehensive communication for the multidisciplinary Team.
KanturkCommunityHospital was a single storey, 40 bedded facility situated on the outskirts of the town. The inspection was carried out over the course of two days by one inspector on the first day and two inspectors on the second day. During this inspection, which was a renewal of registration inspection, the inspectors met with a number of residents, relatives and staff members. The inspectors observed practices and reviewed records such as nursing care plans, medical records, accident and incident logs, policies and procedures and a sample of personnel files.
KanturkCommunityHospital is a designated centre operated by the Health Service Executive (HSE). It is located on the outskirts of the town of Kanturk, Co. Cork. The centre is a single-storey building and the layout comprises a long corridor with multi- occupancy wards on either side of the corridor. Bedroom accommodation comprises six single rooms with wash-hand basins and five multi-occupancy rooms with four to six residents. Toilet, shower and bath facilities are available throughout. Communal areas comprise a day room which is also the dining area, a conservatory, church, and a small quiet room and a secure garden area with seating. The service provides 24- hour nursing care to both male and female residents whose dependency range from low to maximum care needs. Long-term care, respite and palliative care is provided, mainly to older adults.
professionals. These included access to occupational and physiotherapy, as well as regular attendance by a speech and language therapist. Resources in relation to palliative care were available. There was access to community mental health services and referrals could be made to a consultant psychiatrist and gerontologist. Residents had regular access to a general practitioner (GP) and the services of a pharmacist were available. Management systems to support arrangements for supervision were in place. Staff had received appropriate clinical and professional training, however a number of staff had not received refresher training in the areas of safeguarding and fire-safety as required by the regulations. The inspector spoke with members of staff across the service and observed their practice in delivering care and undertaking their daily duties. The inspector also engaged with residents and visitors, seeking feedback on their experience of the service. Throughout the inspection both staff and management were responsive in providing information as requested. The inspectors observed effective and appropriate communication and interaction between staff and residents at all times. Residents and relatives spoken with expressed a very positive level of satisfaction with the care provided.
Officer is due to meet with Cork County Council Fire Authority on site to discuss the planned works and to ascertain if any additional works may be required by the Fire Authority. These works will involve the widening of doors in a number of wards and will entail the reduction of beds in the hospital from 40 to 33, for which the Chief Officer has approved. The removal of these 7 beds has already taken place to allow for evacuation drills to happen and also to prepare for the
An evidence based system will be put in place to ensure that the service provided is safe, appropriate consistent and effective .Audits will be carried out in order to capture appropriate data on areas such as: Nursing Care Plans, Pressure Ulcers, Environment, Resident Experience, Falls, Restraint, Health and Safety. Current weekly data collection will be discontinued. The hospital is involved in a Falls Project since Jan 2016, part of this project is to establish a baseline, identify trends, establish ways of preventing and reducing falls .Issues raised at residents’ meetings will be addressed adequately,
All study subjects were identified using the Electronic Sur- veillance System (ESS) Database . The ESS Database was developed by a multidisciplinary group of microbiolo- gists, infectious disease specialists, and information tech- nology and quality and safety experts and has registered all residents of the Calgary Zone with BSI since 2000. This database has been developed through linkages between regional microbiology and acute care hospital administra- tive databases with validated algorithms used to define incident episodes of BSI and allow their classification as either CA, HCA, or HA. Although patients managed in the community are included in the ESS, detailed clinical data is only available for those admitted to hospital. Only patients admitted to hospital were included in this study.
Bloodstream infections was diagnosed by the presence of clinical or laboratory evidence of sepsis. The definition of sepsis was based on the ACCP/SCCM consensus confer- ence committee . The possibility of a contaminated blood culture was determined after agreement by two doctors. A community-acquired BSI was defined when bacteremia occurred within the first 48 hours of hospital admission for patients from the local community. A nurs- ing home-acquired BSI was defined when it occurred at the time of hospital admission or within 48 hours of ad- mission for patients who came from the hospital affiliated nursing home. A hospital-acquired BSI was defined when it occurred more than 48 hours after the beginning of a period of hospitalization. Patients who were transferred from other hospitals or other nursing homes were ex- cluded from the study. In addition, polymicrobial blood stream infections were also excluded.
ABSTRACT: On the aspect of health care services establishments of hospitals and health institutions such as Schools of Nursing and Midwifery, Schools of Health Technology and Medical Laboratory Science are very significant in any community. It is evident that governments of all nations had established public health institutions like the above mentioned in all nooks and corners of their territories. However, with the contemporary trend of population growth especially in developing nations the need arises for establishments of private health institutions in order to supplement government efforts towards health care delivery. It is in this direction that Muslim Organisations and communities in Northern Nigeria embarked on establishments and running of some hospitals and health institutions, side by side with the existing public health institutions, towards enhancement of health care delivery to all people within their environments regardless of religious, sectional or tribal affiliations.
third-generation cephalosporins, flouroquinolones and extended-spectrum beta-lactams. Antibiotic resistance among hospital acquired urinary tract isolates is found to be much higher than community acquired isolates (16). The prevalence of resistance in E.coli both to single antibiotic and multi-drugs continues to increase in Europe. The resistance of E.coli against third generation cephalosporin for ESBL-production, imipenem and/or meropenem reported from Hungary and Australia (17-18). Studies from USA (1) Africa (19), Ethiopia (20), Iran (21), India (22). Pakistan (23) and Saudi Arabia (24- 25) also report a high rise in antibiotic resistance pattern of hospital acquired E.coli urinary tract infections. The antimicrobial resistance patterns of uropathogenic E.coli from around the world are at rise which is a matter of grave concern. Since treatment of UTI is frequently started empirically, which usually follows the known susceptibilities of urinary pathogen in that community, whereas multidrug resistance limits these therapeutic choices. It, therefore, is utmost important to have current knowledge on antimicrobial susceptibility pattern in a particular region which is essential for appropriate therapy of E.coli UTIs. Therefore, the objectives of the study were to determine antibiotic susceptibility patterns of E.coli isolated from patients with community and hospital acquired UTIs in Makkah region, to determine the magnitude of multidrug resistance among clinical E.coli isolates to suggest appropriate antibiotics for empirical therapy.
ABSTRACT. Objectives. We designed an Internet- based surveillance network that linked community clinic diagnoses with viral isolation rates and admission pat- terns at a related children’s hospital. We hypothesized that community surveillance would successfully predict subsequent hospital admissions and laboratory viral iso- lations. Secondarily, we expected the network to monitor trends in disease and that posting this information on a Web site would be useful to physicians in daily practice. Study Design. Data were collected from December 1999 through August 2000. Information was summarized and posted weekly on a Web site. Active public piloting of the site took place during August 2000, after which the project was evaluated through an electronic mail survey. The predictive ability of the community surveillance data was evaluated by multivariate linear regression.
Data was captured at 1 and 3 months post recruitment to provide an additional data point on the trajectory of FD compared to what has been provided in previous HARP validation studies (all of which only collected data at three months post assessment). Participants completed a tele- phone interview at both time points. For the six patients with poor English comprehension and language (identified at baseline), all were accompanied by an English-speaking family member who assisted with translating questions and answers in the ED. Similar support from family members was provided for these participants at telephone follow-up. At each telephone follow-up, subjects confirmed their eligibility and consent, postcode, current living status, use of care and gait aid, and receipt of formal community supports. Subjects provided responses to the same IADLs questions, 28 as well as
There were written policies and procedures in place for end-of-life care. Staff provided end of life care to residents with the support of their GP and the community palliative care team. There were no residents at active end of life stage on the days of inspection. The inspector reviewed the record of a deceased resident and was satisfied that end-of- life care was provided to a good standard. Records indicated the involvement of the family and the support of the palliative care team. There was ongoing assessment of pain using a recognised pain assessment tool and medicines were titrated to support the resident to be pain free. The care plan used, however, was generic and did not provide guidance on the care to be provided on an individual basis. The inspector was informed that a new person-centred care plan would be created as part of the introduction of new care plans.
Systems were in place to prevent unnecessary hospital admissions including early detection and screening for infections. Should admission to the acute services be required a hospital passport was in place to ensure that the hospital had sufficient information to appropriately care for residents with dementia. A detailed transfer form was also completed. The inspector noted that similar information was provider on discharge back to the centre including updates from members of the multidisciplinary team.
Results are important to each community and its own pa- tients, to hospital administrators and to the referral tertiary hospital. At the community level the results address the issues of what services can or should be available at the core of every hospital providing pediatric care. It affords an opportunity to review this information, examine how it fits into the mission plan of a specific hospital, and also allows for discussion of alternatives to these services if none exist. The results provide guidance to the administration of the communityhospital in identifying resources including personal, equipment, and space for appropriate pediatric care. It is equally important for the communityhospital trustees to find resources to meet these needs. The results are important to the tertiary hospital in fulfilling its regional or systems obligation. The tertiary hospi- tal must be receptive to the needs of the community and pro- vide leadership in a proactive approach for quality pediatric care in the respective region.
Inspectors observed that residents had access to newspapers and radios. There were notice boards available in the premises which provided information, for residents and visitors, about activities and events in the centre as well as in the community. Staff informed inspectors that each resident was afforded choice as regards their daily routine and their daily activities. However, staff also informed inspectors that they had a system for getting residents up in the mornings, in the multi occupancy rooms. This was done to facilitate the easy movement of heavy, cumbersome chairs and commodes where required. This routine was also followed to afford as much privacy and space as possible to residents who required full care. Staff said that when a resident in the neighbouring bed was up and out of the room they could then pull the privacy curtain around both beds. This provided a more spacious environment in which to work with the respective resident.
Bandon CommunityHospital, established in 1929, was a single-storey building which had been renovated in the past few years. It provided long-term, respite and palliative care for 22 residents. At the time of inspection there were 21 residents accommodated in the centre. There was one vacant bed. There were four single rooms, one with an en suite assisted toilet and shower and one with a shared en suite, which could also be accessed from the main corridor. There were three twin bedded rooms, one of which was accessed through the seven-bedded unit. One toilet area was shared by these nine residents. There was a five-bedded unit with en suite containing wash-hand basin, assisted toilet and shower. However, inspectors observed that some of the bedrooms lacked natural light as another building had been erected within the grounds. This was directly outside the windows of a multi-occupancy bedroom. This meant that the room had a dark and dreary appearance and was 'corridor like' in design.
Bandon CommunityHospital, established in 1929, was a single-storey building which had been extensively renovated since the previous inspection. The provider, the Health Service Executive (HSE), had developed and agreed plans which were forwarded to HIQA for a new extension, consisting of 21 single bedrooms and two twin bedrooms. The previous person in charge had been involved in these plans from the beginning and the new person in charge had continued to suggest improvements and changes. The provider had made a substantial sum of money available to ensure that the centre complied with the regulatory requirements for premises in designated centres for older adults. On this inspection the provider and new person in charge had submitted an application to register the new extension and to increase the number of available beds to 25 from the previous 22.