High alert medications administration errors in neonatal intensive care unit: A pediatric tertiary hospital experience

This is a hospital-based descriptive cross sectional study, implemented in the NICU, at Cairo University Pediatric hospital. A convenient sample of 33 bedside NICU nurses, who agreed to participate was recruited. A valid, reliable questionnaire was used to measure NICU nurses' general and specific knowledge regarding five therapeutic HAM. An observational checklist was used to assess nurses' administration practices. Both revealed that the mean percentage score of the nurses' knowledge (76.2±11.6) was higher than the mean percentage score of their total practice (69.1±13.3). Analysis of types of nurses' errors, showed that the most common error type was the wrong dose (15%), followed by wrong drug type (13.6%). Nurses' knowledge and training are not mandatorily interpreted into improved implementation practices. Interventions highlighted for preventing HAM errors were developing specific training on HAM for nurses and establishing neonate centered, multidisciplinary teams formed of physicians, nurses, and pharmacists

Hospital Preparedness for Critical Care during COVID-19 Pandemic: Exploratory Cross-sectional Study

AIM: The researchers conducted the study to assess intensive care units (ICUs) preparedness in Cairo University Hospitals to deal efficiently and effectively with COVID-19 upcoming waves. METHODS: An exploratory cross-sectional study was conducted at Cairo University Intensive Care Units 6 pediatric ICUs, and 2 adult ICUs in the period from the end of February to the first week of March, 2020; almost 2 weeks after the appearance of the first case of COVID-19 in Egypt by hand-delivered questionnaire method with one of the ICU staff members who were available and have time to take part in the study. WHO checklist for hospital readiness was used; this checklist based on current knowledge and available evidence on the COVID-19 pandemic for WHO’s Regional Office for the Eastern Mediterranean Region. The WHO has developed the checklist to help hospital managers prepare for COVID-19 patient management by optimizing each hospital’s capacities. The list composed of 10 key components: (1) Leadership and coordination; (2) operational support, logistics and supply management; (3) information; (4) communication; (5) human resources; (6) continuity of essential services and surge capacity; (7) rapid identification; (8) diagnosis; (9) isolation and case management; and (10) infection prevention and control. RESULTS: The overall preparedness in both pediatric and adult ICUs was 54%. Overall, adult ICUs were more prepared than pediatric ICUs, especially in communication; continuity of essential services and surge capacity; rapid identification; diagnosis; isolation; and case management. Both of them were comparable regarding operational support, logistics and supply management; human resources; and infection prevention and control, while information component was lower in both types but reached critical values 10% in adult ones. CONCLUSION: The current study demonstrated the intermediate readiness of ICUs at initial outbreak; further assessment during different phases of pandemic is required. Continues education of HCWs and active communication should be established

Assessment of the performance of the Pediatric Index of Mortality 2 (PIM2) among Egyptian pediatric patients admitted to the intensive care

AbstractBackgroundMortality prediction models are useful in pediatric intensive care units (PICUs) as risk assessment tools and as a benchmark for the quality of care.ObjectivesTo assess the performance of the Pediatric Index of Mortality 2 (PIM2) in terms of calibration and discrimination between survivors and non-survivors among pediatric patients.MethodsThis is a cohort prospective study including 317 pediatric patients admitted to two PICU settings in a tertiary care hospital in Egypt over a period of one year (from June 2012 till June 2013). Collected data included personal characteristics, hospital data, diagnosis, outcome and variables included in PIM2 scoring.ResultsNon-survivors constituted 8.5%. Most common diagnosis was respiratory diseases (47.9%). Only CNS morbidities (11.7% of survivors versus 37% of non-survivors, P=0.001) and a higher PIM2 score (2.39±5.49 in survivors versus 41.38±36.06 in non-survivors, P=0.001) were associated with increased risk of non-survival. The area under the curve (AUC) for PIM2 is 0.796 (95% CI 0.675–0.916), P<0.001. The Hosmer–Lemeshow goodness-of-fit was 2.850, 8df, P=0.943. PIM2.ConclusionThe calibration and the discriminative ability of PIM2 scoring system aiming to distinguish survivors from non-survivors are satisfactory for this sample of pediatric patients. PIM2 is easily calculated and is freely available. Thus, this tool provides a good incentive for ICU settings in Egypt for admission of high risk patients in the light of the limited PICU bed complement capacity in relation to the demands

Hospital Preparedness for Critical Care during COVID-19 Pandemic: Exploratory Cross-sectional Study

AIM: The researchers conducted the study to assess intensive care units (ICUs) preparedness in Cairo University Hospitals to deal efficiently and effectively with COVID-19 upcoming waves.&#x0D; METHODS: An exploratory cross-sectional study was conducted at Cairo University Intensive Care Units 6 pediatric ICUs, and 2 adult ICUs in the period from the end of February to the first week of March, 2020; almost 2 weeks after the appearance of the first case of COVID-19 in Egypt by hand-delivered questionnaire method with one of the ICU staff members who were available and have time to take part in the study. WHO checklist for hospital readiness was used; this checklist based on current knowledge and available evidence on the COVID-19 pandemic for WHO’s Regional Office for the Eastern Mediterranean Region. The WHO has developed the checklist to help hospital managers prepare for COVID-19 patient management by optimizing each hospital’s capacities. The list composed of 10 key components: (1) Leadership and coordination; (2) operational support, logistics and supply management; (3) information; (4) communication; (5) human resources; (6) continuity of essential services and surge capacity; (7) rapid identification; (8) diagnosis; (9) isolation and case management; and (10) infection prevention and control.&#x0D; RESULTS: The overall preparedness in both pediatric and adult ICUs was 54%. Overall, adult ICUs were more prepared than pediatric ICUs, especially in communication; continuity of essential services and surge capacity; rapid identification; diagnosis; isolation; and case management. Both of them were comparable regarding operational support, logistics and supply management; human resources; and infection prevention and control, while information component was lower in both types but reached critical values 10% in adult ones.&#x0D; CONCLUSION: The current study demonstrated the intermediate readiness of ICUs at initial outbreak; further assessment during different phases of pandemic is required. Continues education of HCWs and active communication should be established.</jats:p