Introductions: Studies have shown inadequate use of prophylaxis for venous thromboembolism (VTE) in hospital admitted medical patients. This study aims to evaluate the use of VTE prophylaxis in admitted medical patients in a tertiary care teaching hospital. Methods: This was a cross sectional observational study for three weeks from 19 March to 8 April 2017 in patients admitted in the medical ward of Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. Patient charts were reviewed for appropriate VTE prophylaxis as per modified Padua risk Assessment model. Risks of VTE, presence of bleeding risks, demographics (age, BMI), hospital stay were descriptively analysed. Results: Out of 122 patients, 81 (66.4%) were at risk of VTE. Among 81 at risk, 69 were eligible for VTE pharmacoprophylaxis with no risk of bleeding only 29 (42%) received pharmacoprophylaxis and 12 eligible for prophylaxis but with the risk of bleeding did not receive any prophylaxis. Reduced mobility was the most common indication of thromboprophylaxis in 79 (64%), followed by acute infection 50 (41%). Conclusions: There was suboptimal use of thromboprophylaxis in hospital admitted medical patients at risk of venous thromboembolism, VTE.
Introduction: Hand hygiene is the most effective infection prevention measure. This research aims to find out the knowledge and practice of hand hygiene among the doctors of major departments of Patan Hospital. Method: A cross-sectional study was conducted among doctors of selected departments of Patan Hospital, Lalitpur, Nepal. The knowledge of hand hygiene was assessed using a WHO knowledge questionnaire. The practice was assessed using a WHO observation checklist. The data was recorded in Epi-info and the analysis was done for knowledge score and compliance with practice using SPSS v15. A p-value of <0.05 was considered statistically significant. Result: A total of 104 (98%) of the participants completed each part (knowledge and practice) of the study. The overall mean score (± SD) was 64% ± 8 on knowledge questions about hand hygiene. Knowledge of hand hygiene was not significantly different among departments (p=0.351) and gender (p=0.994). Out of 1022 opportunities, the compliance of hand hygiene among the doctors was 532(52%). The highest compliance for hand hygiene was after exposure to body fluids 93%. The mean time taken for hand rub was 8 seconds and the mean steps performed were 4 out of 8. Compliance with hand hygiene was statistically significant among departments (p= 0.001). However, it was not statistically significant among gender(p=0.198). Conclusion: Participants performed relatively well with a moderate score (64%) on knowledge questions but it was not reflected in practice (overall compliance 52%). The majority performed hand hygiene after body fluid exposure (93%) and after touching patients (64%).
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