Prolonged Length of Hospital Stay and Associated Factors Among Patients Admitted at a Surgical Ward in Selected Public Hospitals Arsi Zone, Oromia, Ethiopia, 2022

Fetene, Deriba; Tekalegn, Yohanis; Abdela, Jabir; Aynalem, Amdehiwot; Bekele, Gezahegn; Molla, Ezedin

doi:10.1101/2022.10.18.22281234

Cited by 5 publications

(9 citation statements)

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“…There were two outcomes on this: "prolonged hospital stay" and "not prolonged". Prolonged hospital stay was de ned as hospital stay of more than the 75th percentile, according to a study that was conducted in Ethiopia (9). This was more than 5 ( ve) days in the current study.…”

Section: Variable Handlingmentioning

confidence: 95%

Improving Clerkship to Enhance Patients’ Quality of Care (ICEPACQ): A Baseline Study

Kennedy,

Kagoya,

Nsubuga

et al. 2023

Preprint

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Background: Proper and complete clerkship of patients has long been shown to contribute to correct diagnosis and improved care of patients. All sections for clerkship must be carefully and completely done, to guide the diagnosis and the plan of management; moreover, one section guides the next. Failure to perform a complete clerkship has been shown to lead to misdiagnoses with its unpleasant outcomes like delayed recovery, prolonged inpatient stay, high cost of care and at worst death. Objective: The objectives of the study are; to determine the gap in clerkship of patients admitted, treated and discharged at the gynecological ward in Mbale RRH, the impact of incomplete clerkship on the length of hospital stay of the patients, to explore the causes of the gap in clerkship of the patients and the strategies which can be used to improve clerkship of the patients. Methodology: This was a mixed methods study involving collection of secondary data by review of patients’ files and collection of qualitative data by key informant interviews. The files of patients who were admitted from August 2022 up to December 2022, treated and discharged were reviewed by use of a data extraction tool. Data analysis was done using STATA version 15 by descriptive statistics, while qualitative data was analyzed by deductive thematic analysis using Atlas ti version 9. Results: Data was collected from 612 patient files. Social history had the most participants with no information provided at all (83.5 % not captured), with biodata and vital sign examination (20% not captured) having the least number. On patients’ biodata, at least each parameter was captured in all the patients, with the most gap noted in capturing the nearest health facility of the patient (91 % not captured). In the past history, the most gap was noted in the history of current pregnancy (37.5 % not provided at all); however, there was also a big gap in the past gynecological history (71 % not captured at all), past medical history (71 % not captured at all), past surgical history (73 % not captured at all) and family history (80% not captured at all). The physical examination had the most gap on abdominal examinational (43 %), with also substantial gaps in general examination (38.5 % not captured at all) and vaginal examination (40.5 % not captured at all) and vital sign examination having the least gap. There is no patient that received a complete clerkship. There was a significant association between clerkship and the length of hospital stay. The causes of the gap in clerkship were multifactorial from those related to the hospital, those related to the health worker, those related to the health care system and those related to the patient. The strategies to improve the clerkship of patients also ranged from measures to be taken by the health care worker, measures to be taken by hospital and measures to be taken by the government. Conclusion and recommendation: There is a gap in clerkship of patients on the gynecological ward, that is recognized by the stakeholders on the ward, with some components of clerkship captured better than others, with no patients that received a complete clerkship. There was a significant association between clerkship and the length of hospital stay. The following is recommended provision of clerkship tools, like the standardized clerkship guide and equipment for patient examination, continuous education of the health workers on clerkship and training them on how to use the available tools, developing SOPs for patient clerkship, promoting clerkship culture and supervision of the health workers.

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Section: Variable Handlingmentioning

confidence: 95%

Improving Clerkship to Enhance Patients’ Quality of Care (ICEPACQ): A Baseline Study

Kennedy,

Kagoya,

Nsubuga

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The data were collected from adult surgical patients admitted to a surgical ward using a pretested, structured interviewer-administered questionnaire, patient chart review, and direct measurement. The data collection instrument was adapted from previously published studies [17–19], whereas wealth index assessment questions were adopted from EDHS 2016 [45], and the functional status assessment tool was adopted from the Katz Index of Assessing Tool [46]. The questionnaire had sociodemographic information, wealth index assessment questions, admissions-related characteristics, clinical variables, behavioral information, and the Katz Index of functional status assessment tools.…”

Section: Methodsmentioning

confidence: 99%

“…In European hospitals, 7.98% to 16.67% of patients experienced a prolonged length of hospital stay [11][12][13]. In Asia, studies have shown that 5.4% to 30.5% of patients had prolonged hospital stays [14][15][16], and in Africa, 24.7% to 63% of patients experienced prolonged hospital stays [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have revealed that factors such as older age, preoperative hypoalbuminemia, ASA class 3 or 4, duration of operation, in-hospital complications, comorbidity, and reoperation were factors independently associated with prolonged hospital stays [19,22,25,31,32]. However, there is a lack of consistency in what influences patients’ length of stay, particularly in surgical wards [33].…”

Section: Introductionmentioning

confidence: 99%

“…However, there is a lack of consistency in what influences patients’ length of stay, particularly in surgical wards [33]. On the other hand, this research topic covers a number of previously unexplored aspects that have attracted research interest, such as postponed surgery, preoperative anemia, functional status, and source of referral [18,19], which should be investigated further. An investigation of these factors is necessary to reduce unnecessary stays in the hospital.…”

Section: Introductionmentioning

confidence: 99%

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Length of hospital stay and associated factors among adult surgical patients admitted to a surgical ward in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia

Dadi,

Habte,

Mulu

et al. 2023

Preprint

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IntroductionHospitals across the country are experiencing a rise in the length of hospital stays, ranging from 2% to 14%. As a result, patients who remain hospitalized for a prolonged period are three times more likely to suffer in-hospital deaths. Therefore, identifying contributing factors for prolonged hospital stays enhances the ability to improve services and the quality of patient care. However, there is limited documented evidence in Ethiopia as well as in the study area about factors associated with prolonged hospital stays among surgical inpatients.ObjectiveThis study aimed to assess the length of hospital stay and associated factors among adult surgical patients admitted to a surgical ward in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia, 2023.MethodsAn institutional-based cross-sectional study was conducted among 452 adult surgical patients from April 17 to May 22, 2023. Data were collected based on a pretested, structured interviewer-administered questionnaire, patient chart review, and direct measurement. Study participants were selected using a systematic random sampling technique. The collected data were cleaned, entered into EpiData 4.6.0 and exported to STATA version 14 for analysis. Binary logistic regression analysis was used. Variables with a p value < 0.05 in the multivariable logistic regression analysis were considered statistically significant.ResultsIn the current study, the prevalence of prolonged hospital stay was 26.5% (95% CI: 22.7–30.8). Patients referred from another public health institution (AOR = 2.46; 95% CI: 1.09, 5.57), hospital-acquired pneumonia (AOR = 3.18; 95% CI: 1.28, 7.89), duration of surgery ≥110 minutes (AOR = 2.48; 95% CI: 1.25, 4.91), and preoperative anemia (AOR = 3.37; 95% CI: 1.88, 6.04) were factors associated with prolonged hospital stays.ConclusionThis study found a significant proportion of prolonged hospital stays. Source of referral, preoperative anemia, duration of surgery, and hospital-acquired pneumonia were factors associated with a prolonged hospital stay. Strengthening the established information system among hospitals when referring patients and early screening and treating anemia upon admission to hospitals can reduce the length of stays.

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Improving Clerkship to Enhance Patients’ Quality of care (ICEPACQ): a baseline study

Pangholi,

Kagoya,

Nsubuga

et al. 2024

BMC Health Serv Res

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Background Proper and complete clerkships for patients have long been shown to contribute to correct diagnosis and improved patient care. All sections for clerkship must be carefully and fully completed to guide the diagnosis and the plan of management; moreover, one section guides the next. Failure to perform a complete clerkship has been shown to lead to misdiagnosis due to its unpleasant outcomes, such as delayed recovery, prolonged inpatient stay, high cost of care and, at worst, death. Objective The objectives of the study were to determine the gap in clerkship, the impact of incomplete clerkship on the length of hospital stay, to explore the causes of the gap in clerkship of the patients and the strategies which can be used to improve clerkship of the patients admitted to, treated and discharged from the gynecological ward in Mbale RRH. Methodology This was a mixed methods study involving the collection of secondary data via the review of patients’ files and the collection of qualitative data via key informant interviews. The files of patients who were admitted from August 2022 to December 2022, treated and discharged were reviewed using a data extraction tool. The descriptive statistics of the data were analyzed using STATA version 15, while the qualitative data were analyzed via deductive thematic analysis using Atlas ti version 9. Results Data were collected from 612 patient files. For qualitative data, a total of 8 key informant interviews were conducted. Social history had the most participants with no information provided at all (83.5% not recorded), with biodata and vital sign examination (20% not recorded) having the least number. For the patients’ biodata, at least one parameter was recorded in all the patients, with the greatest gap noted in terms of recording the nearest health facility of the patient (91% not recorded). In the history, the greatest gap was noted in the history of current pregnancy (37.5% not provided at all); however, there was also a large gap in the past gynecological history (71% not recorded at all), past medical history (71% not recorded at all), past surgical history (73% not recorded at all) and family history (80% not recorded at all). The physical examination revealed the greatest gap in the abdominal examination (43%), with substantial gaps in the general examination (38.5% not recorded at all) and vaginal examination (40.5% not recorded at all), and the vital sign examination revealed the least gap. There was no patient who received a complete clerkship. There was a significant association between clerkships and the length of hospital stay. The causes of the gap in clerkships were multifactorial and included those related to the hospital, those related to the health worker, those related to the health care system and those related to the patient. The strategies to improve the clerkship of patients also included measures taken by health care workers, measures taken by hospitals and measures taken by the government. Conclusion and recommendation There is a gap in the clerkships of patients at the gynecological ward that is recognized by the stakeholders at the ward, with some components of the clerkship being better recorded than others, and no patients who received a complete clerkship. There was a significant association between clerkships and the length of hospital stay. The following is the recommended provision of clerkship tools, such as the standardized clerkship guide and equipment for patient examination, continuous education of health workers on clerkships and training them on how to use the available tools, the development of SOPs for patient clerkships, the promotion of clerkship culture and the supervision of health workers.

show abstract

Prolonged Length of Hospital Stay and Associated Factors Among Patients Admitted at a Surgical Ward in Selected Public Hospitals Arsi Zone, Oromia, Ethiopia, 2022

Cited by 5 publications

References 12 publications

Improving Clerkship to Enhance Patients’ Quality of Care (ICEPACQ): A Baseline Study

Improving Clerkship to Enhance Patients’ Quality of Care (ICEPACQ): A Baseline Study

Length of hospital stay and associated factors among adult surgical patients admitted to a surgical ward in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia

Improving Clerkship to Enhance Patients’ Quality of care (ICEPACQ): a baseline study

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