Evaluation of inappropriate prescribing to the hospitalized elderly patients in Al Shifa hospital, Gaza, Palestine

Background: The current study aimed to assess the prevalence of inappropriate prescribing (IP) for hospitalized elderly patients at Al Shifa Hospital, Gaza, Palestine.Methods: This study was a retrospective cross-sectional study. A total of 2385 prescribed drugs for 380 elderly inpatients in internal, cardiology, and respiratory departments were screened for IP. Four criteria were used to detect IP using chart review method; Drug-drug interactions (DDIs), drug contra-indications (CI), duplication of therapy and Beers' criteria 2012.Results: The results showed that 44.2% of patients had at least one IP. Around 33.2% of the patients had DDIs, 19.2% had IP according to Beers' criteria and 1.1% had drug CI. There was no duplication of therapy. A total of 323 IP instances were detected. Of them, 74% for DDIs and 24.8% for Beers' criteria. The prevalence of overall IP was significantly influenced by age (p-value=0.024), polypharmacy (p-value<0.001), degree of morbidity (p-value<0.001), and departments (p-value=0.018). The prevalence of DDIs was influenced by polypharmacy (p-value<0.001), degree of morbidity (p-value=0.001), and departments (p-value=0.005). Finally, the prevalence of IP according to Beers' criteria was significantly influenced by departments with the highest in the cardiology department (29.7%) (P-value=0.007).Conclusions: Although the overall IP was common, it was not far higher than that reported worldwide. The majority of IP was DDIs. Age, polypharmacy, degree of morbidity and departments influenced the occurrence of IP

Evaluation of inappropriate prescribing to the hospitalized elderly patients in Al Shifa hospital, Gaza, Palestine

Background: The current study aimed to assess the prevalence of inappropriate prescribing (IP) for hospitalized elderly patients at Al Shifa Hospital, Gaza, Palestine.Methods: This study was a retrospective cross-sectional study. A total of 2385 prescribed drugs for 380 elderly inpatients in internal, cardiology, and respiratory departments were screened for IP. Four criteria were used to detect IP using chart review method; Drug-drug interactions (DDIs), drug contra-indications (CI), duplication of therapy and Beers' criteria 2012.Results: The results showed that 44.2% of patients had at least one IP. Around 33.2% of the patients had DDIs, 19.2% had IP according to Beers' criteria and 1.1% had drug CI. There was no duplication of therapy. A total of 323 IP instances were detected. Of them, 74% for DDIs and 24.8% for Beers' criteria. The prevalence of overall IP was significantly influenced by age (p-value=0.024), polypharmacy (p-value&lt;0.001), degree of morbidity (p-value&lt;0.001), and departments (p-value=0.018). The prevalence of DDIs was influenced by polypharmacy (p-value&lt;0.001), degree of morbidity (p-value=0.001), and departments (p-value=0.005). Finally, the prevalence of IP according to Beers' criteria was significantly influenced by departments with the highest in the cardiology department (29.7%) (P-value=0.007).Conclusions: Although the overall IP was common, it was not far higher than that reported worldwide. The majority of IP was DDIs. Age, polypharmacy, degree of morbidity and departments influenced the occurrence of IP

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically