Context:Operation theater (OT) utilization.Aims:To analyze the time utilization and to assess the stated causes of cancellations of scheduled cases in the OT complex of a tertiary care teaching institute.Settings and Design:This prospective study was carried out from December 2010 to April 2011.Materials and Methods:each of the 16 OT tables was observed for 6 days (total 96 days). The available resource hours were taken as 0800-1600 hrs. (480 min/day; 46,080 min in 96 days). The following parameters were recorded — time spent on supportive services, time spent on actual surgery, room turn over time, time spent for total procedure and time between entry and exit of patient.Statistical Analysis:Data were analyzed using the SPSS software version 15.Results:Of the total 325 scheduled cases, 252 were operated and 73 (22.5%) were cancelled. There were delays on 15 days (15.63%) in starting the OT table at the scheduled time. Of the total resource hours (46,080 min), the mean “Raw utilization” was 37,573 min (81.54%) and the “Adjusted utilization” was 39,668 min (86.09%). The mean time spent on “supportive services” was 5539 min (12.02%) and on “actual surgery”’ was 28,277 min (61.37%), and the “room turn over time” was 2095 min (5.39%). Among the stated reasons for cancellations, lack of operating time — 57 cases (78.1%) — was the most common.Conclusion:Study of time utilization and cancellation are important tools in assessing the optimal utilization of available resource hours in an OT.

Objectives Data from point prevalence surveys (PPSs) in India are scarce. Conducting PPSs is especially challenging in the absence of electronic medical records, a lack of dedicated resources and a high patient load in resource-poor settings. This multicentre survey was conducted to provide background data for planning and strengthening antimicrobial stewardship programmes across the country. Methods This inpatient PPS was conducted over 2 weeks in May 2019 simultaneously across five study centres in India. Data about patient characteristics, indications for antimicrobials use and details of each antimicrobial prescribed including supportive investigation reports were collected in predesigned forms. Results A total of 3473 admitted patients in wards and ICUs were covered across five study centres. Of these, 1747 (50.3%) patients were on antimicrobials, with 46.9% patients being on two or more antimicrobials. Out of the total antimicrobials prescribed, 40.2% of the antimicrobials were prescribed for community-acquired infection requiring hospitalization followed by surgical prophylaxis (32.6%). Third-generation cephalosporins and drugs from the ‘Watch’ category were prescribed most commonly. Only 22.8% of the antimicrobials were based on microbiology reports. Conclusions The survey demonstrated a high use of antimicrobials in admitted patients with a considerable proportion of drugs from the ‘Watch’ category. The targets for interventions that emerged from the survey were: improving surgical prophylaxis, decreasing double anaerobic cover, initiating culture of sending cultures and de-escalation with targeted therapy.

BACKGROUND:As per the "Disaster Management Act, 2005" of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1 900 bed tertiary care hospital, in consultation and involvement of all concerned stakeholders. METHODS:A committee of members from hospital administration, clinical, diagnostic and supportive departments worked on an initial document prepared according to the Act and gave their inputs to frame a fi nal disaster manual. RESULTS:The prepared departmental standard operating procedures involved 116 people (doctors and paramedical staff), and were then synchronized, in 12 committee meetings, to produce the fi nal hospital disaster manual. CONCLUSIONS:The present disaster manual is one of the few comprehensive plans prepared by the stakeholders of a government hospital in India, who themselves form a part of the disaster response team. It also helped in co-ordinated conduction of mock drills.

ObjectivesHealthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty.SettingOur tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless.ParticipantsWe recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone.ResultsBetween 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment.ConclusionA multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.

INTRODUCTION: Food handlers with poor personal hygiene and lack of awareness in preventing foodborne diseases working in hospitality sectors or hospitals could spread foodborne infections. OBJECTIVE: Our study objective was to ascertain the impact of a video-based educational intervention program and administrative measures on improvement in personal hygiene of food handlers in hospital. METHODOLOGY: We conducted this pilot study among all 103 food handlers who were working in a tertiary care hospital. A checklist-based scoring and physical examination were conducted by the investigator for the food handlers. After baseline scoring S1, intervention 1 and 2 was implemented, and score was obtained as S2 and S3, respectively. Descriptive statistics was calculated, and score was compared by repeated measures ANOVA test using SPSS-22 software. RESULTS: Our study revealed that a total of 19.2% of food handlers had health complaints. More than half (54.8%) admitted that they had suffered from any kind of illness since last 6 months. Common illness was viral fever (40.3%) followed by typhoid (5.7%), dengue (4.8%) and urinary tract infection (3.8%). Most of the food handlers had long hair (62.5%) followed by long nail (57.69%). Nearly, one-fifth (20.1%) of food handlers nail was infected with fungus. Worm was found in 14.4% cases by stool examination. Statistically significant ( P < 0.05) improvement in score was observed after each intervention. DISCUSSION: Poor hygiene (Score-1 = 23.76) was observed at baseline study although there was a mechanism in place for a yearly health checkup and regular (6 monthly) hygiene training. After interventions (video-based training and administrative measures), the score was improved to Score-3 (42.57). Statistically significant ( P < 0.05) differences in hygiene score were observed for variables such as state of residence, education level, and working experiences (inside or outside the hospital). CONCLUSION: It is possible to improve personal hygiene among food handlers using video-based interactive training methods and administrative measures with no extra or minimal cost. RECOMMENDATIONS: This “piggyback” approach of training can be imparted in addition to routine training measures among the food handlers for improving their personal hygiene in the hospital setting.