Teleradiology can be used to provide health care to rural populations, especially where there is a scarcity of resources, including on-site radiologists. We have established a network link between a commercial teleradiology provider in Bangalore, south India and the Ramakrishna Mission Hospital (RKMH), located over 3000 km away in the north east of India. Image files were transferred to Bangalore via an ADSL connection using secure file transfer protocol. In the 12-month period beginning in August 2007, a total of 962 studies was sent to Bangalore from the RKMH. The average turnaround time for the report to reach the hospital once the images had been received in Bangalore was six hours for non-emergency cases. For emergency cases the turnaround time was consistently below 30 minutes. Because the RKMH was a charitable institution providing rural patients with free or low-cost treatment, no charge was made for the reporting. Our experience demonstrates that remote implementation of teleradiology is possible in rural India. The service has proved valuable for the remote hospital concerned.
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Introduction Due to the COVID-19 pandemic, many medical and surgical wards were reassigned as COVID-19 cohort wards to accommodate the number of patients admitted with the virus. Nurses and healthcare assistants (HCAs) from various departments and backgrounds were redeployed to these areas. Within the geriatrics population, patients with severe COVID-19 often have high oxygen requirements and can rapidly deteriorate. Therefore, we conducted a quality improvement project within the geriatrics COVID-19 ward focused on improving patient safety by improving oxygen administration to patients. We also aimed to enhance the knowledge and confidence levels of nurses and HCAs in regards to oxygen administration. Method From April–July 2020, we compared the oxygen that was administered to COVID-19 patients against the oxygen therapy that was documented on observation charts. This included whether the correct type of device, flow rate and target oxygenation saturations were used. We carried out multiple Plan-Do-Study-Act (PDSA) cycles including a staff education session on oxygen administration, placed an oxygen guidelines poster on each patient’s bedside, administered a short quiz and distributed reminder lanyard cards. We also conducted a staff survey comparing knowledge and confidence on oxygen administration before and after an education session. Results Overall there has been an improvement in oxygen charting and administration after 4 PDSA cycles. There is 100% correct use of oxygen device and correct setting of oxygen flow rate after the 2nd and 3rd PDSA cycles. After the teaching session, all staff reported feeling more confident in oxygen management. Based on the audit data and quiz results, there was an improvement in knowledge of oxygen administration. Conclusions We have demonstrated that by using simple time-efficient and cost-effective interventions, improvements can be made in oxygen administration and subsequently patient safety. This has the potential to influence prognostic outcomes among the geriatrics population with COVID-19.
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