Background: Extensive use of antibiotics is prevalent throughout India, and this is a matter of serious concern. There are several reports linking antibiotic usage to resistance. Towards addressing this problem, assessment of current prescribing pattern of antibiotics needs to be undertaken to monitor its appropriate use. This study was meant to assess the utilization of cephalosporins and its compliance towards the hospital antibiotic policy in surgery ward of a tertiary care teaching hospital.Methods: A prospective observational study was conducted with 250 inpatients of surgery ward. The demographic details, lab investigations, clinical diagnosis and current treatment were noted. The collected data was analysed for utilization of cephalosporin using World Health Organization (WHO) core prescribing indicators and defined daily dose per 100 bed-days. The hospital antibiotic policy was used as a benchmark for analyzing compliance of therapy.Results: Out of 250 patients, 69% was male and 31.2% was female population with mean age of 42.12±17.33 years. Majority of cases were clean-contaminated (36%) followed by clean (30.4%) and contaminated (17.6%) wounds. The average number of overall antibiotics and cephalosporins per encounter was 2.1 and 1 respectively. Among the total parenteral antibiotics, 63.9% were cephalosporins. Cephalosporins utilization was 2.68 DDD per 100 bed-days. Compliance with all the stated criteria was observed only in 124 (49.6%) patients.Conclusions: The rate of prescribing of cephalosporins has increased evidently which may result in the occurrence of bacterial resistance. A suboptimal rate of compliance recommends a strict monitoring in the usage of cephalosporins with periodical updation of policy.

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Background: Emergence of bacterial resistance in hospital settings due to the liberal use of antibiotics which led to an altered impact on its therapeutic efficacy and outcome, thereby increasing the treatment costs in patients. In this regard the study aims to evaluate the cephalosporins utilization and compliance to the hospital antibiotic policy in general medicine ward.Methods: A prospective observational study was carried out over an eleven-month period in patients prescribed with cephalosporins. Clinical data of inpatients were collected and evaluated by using World Health Organization (WHO) core prescribing indicators and defined daily dose per 100 bed-days. The comparison between the cephalosporins prescribed in the chart records to the recommendations mentioned in the institutional antibiotic policy v.2.0, help to determine the deviations in their usage pattern.Results: A total of 370 patients were enrolled in the study, of which 54.6% were females. Cephalosporins were empirically prescribed in 240 (64.9%) cases. The average number of total antibiotics and cephalosporins per encounter was 1.6 and 1 respectively. Among the total antibiotics, 63.7% were cephalosporins. Third generation cephalosporins (98.4%) were commonly prescribed, with ceftriaxone (93%) in parenteral form for respiratory tract infections (31.9%). Total parenteral antibiotics prescribed were found to be 68.8% of which 88.6% were cephalosporins. Utilization pattern of cephalosporins amounted to be 4.95 DDD/100 bed-days. Overall compliance was achieved in 191 (51.6%) prescriptions.Conclusions: The rate of prescribing of cephalosporins was marginally high. There was a low rate of compliance towards policy which reflects the urgent need for repetitive intervention to comply antibiotic policy.

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Background: The COVID-19 pandemic challenged all healthcare professionals to re-think how patient care is provided. Faculty in nursing schools faced similar challenges in offering adequate clinical hours to nursing students, because of the limited availability of clinical placements. Methods: A faculty in one school of nursing introduced virtual simulation resources to supplement in-person clinical hours. The faculty developed a revised clinical curriculum for students that included weekly objectives and deliverables for virtual simulations. The Simulation Effectiveness Tool-Modified (SET-M) was utilized to evaluate the effectiveness of the virtual simulations. Results: 130 students (88.4%) completed the post-implementation survey. After using the virtual simulations, 50% of the students reported feeling confident in providing interventions that foster patient safety. Furthermore, students reported a sound understanding of disease pathophysiology (60%) and medications (53.8%). The qualitative data indicated that students found the virtual simulations beneficial and a safe learning environment. Conclusion: Pre-pandemic virtual simulations were not used by this school of nursing to replace the traditional in-person clinical experiences. However, the pandemic demonstrated that the utilization of innovative virtual simulations are effective methods for student learning to augment traditional clinical experiences.