BACKGROUND AND OBJECTIVES

Inpatient physical therapy (PT) care entails careful provision of service for individuals across a spectrum of disorders needing evidence-based physical rehabilitation during their hospital admission. The main difficulty is identifying adequate time allocation for safe patient service within an eight-hour working time frame. At a selected tertiary teaching government-run hospital, an arbitrary personnel-population ratio method is used for human resource allocation which may lead to issues in service delivery and healthcare workforce wellness. Apart from patient care, physical therapists also assume non-clinical roles revolving on administration, clinical education, and research. This highlights the importance of identifying the duration of tasks to assess work efficiency and manage time constraints posed by the limitations of the work shift. Practice guidelines may help improve staff workload scheduling, however, there is a lack of available guidelines regarding physical therapy practice in the hospital or acute care setting for developing countries. The purpose of this study was to determine the duration of care for inpatients with musculoskeletal and neurological conditions and administrative tasks, and to determine the relationship of duration of care with months of experience.

A continuous observation time motion study of a typical workday of all physical therapists in an in-patient setting of a tertiary teaching hospital was conducted. An external observer will time the tasks done by the PT. The external observer kept distance from the direct patient encounter to minimize interference that may affect timing. Patients with conditions of different etiologies and functional levels were included.

Nineteen physical therapists with a mean experience of 54.63 months were observed. There were no adverse events during the implementation of this study. The total mean time in minutes of management of neurological patients is 37:32, and musculoskeletal patients is 28:30. Time for administrative tasks took an average of 20:33 minutes. There was also a low positive correlation on months of experience and treatment duration for patients with neurologic conditions (p=0.0471). Results showed that the allocated treatment duration is determined to be sufficient for performing PT activities. The optimal number of patients to be decked can also be appropriately determined to optimize resource allocation.

Our pilot study attempted to quantify the duration of PT care in an inpatient setting that caters to patients with different diagnosis and varying needs for PT management. Although descriptive statistics and a weak to insignificant correlation was seen in most of the variables, there may be some benefit in gathering more duration data across different acute care settings within the country. Our pilot time and motion study can contribute to the limited evidence of duration of inpatient care that may inform human resource allocation, deliverables prioritization, and employee wellness and development. Figures have been presented which could be the basis for future policy research for management science and resource allocation studies.

No abstract available.
Hematology* ; Tertiary Care Centers* ; Tertiary Healthcare* ; Thrombocytopenia*

PURPOSE: The purpose of the study was to compare salivary cortisol levels, self-reported occupational stress, and anxiety before duty to those after duty in the shift and regular work nurses, and the relationships among them. METHODS: Thirty nurses working in a tertiary hospital participated in the study. Salivary specimens were collected before and after daytime duty for 2 days. The occupational stress and state anxiety were also evaluated using self-report questionnaires. RESULTS: The average level of salivary cortisol was 0.40 µg/dL before duty and 0.20 µg/dL after duty in Korean nurses. Overall levels of salivary cortisol, self-reported occupational stress, and anxiety were higher in shift working nurses than regular working nurses. In shift working nurses, the salivary cortisol gap between before and after duty was attenuated on the first day of daytime duty. Significant positive correlation was found between the level of cortisol before duty and anxiety after duty. CONCLUSION: Strategies to alleviate occupational stress and anxiety are needed for shift working nurses, especially for those with elevated levels of cortisol. It seems to require 3days to recover from attenuated cortisol rhythm during nighttime duty in shift working nurses.
Anxiety* ; Hydrocortisone* ; Tertiary Care Centers

PURPOSE: The purpose of the study was to identify the mediating effect of organizational citizenship behavior between job embeddedness and turnover intention in hospital nurses. METHODS: Data were collected from 241 nurses in 3 tertiary hospitals and 2 secondary hospitals in Daegu and analyzed using descriptive statistics, Pearson correlations and structural equation model (SEM) with the PASW 18.0 and AMOS 18.0 program. RESULTS: There were negative relationships between job embeddedness and turnover intention (r=-.53, p<.01), and organizational citizenship behavior and turnover intention (r=-.39, p<.01) but a positive relationship between job embeddedness and organizational citizenship behavior (r=.39, p<.01). There was a partial mediating effect of organizational citizenship behavior between job embeddedness and turnover intention (chi2=91.02, p<.001). CONCLUSION: The results of this study indicate that organizational citizenship behavior has a mediating effect on the relationship between job embeddedness and turnover intention in hospital nurses, suggesting that enhancing organizational citizenship behavior is required. in order to promote job embeddedness and reduce turnover intention.
Intention ; Negotiating ; Tertiary Care Centers

No abstract available.
Referral and Consultation* ; Tertiary Care Centers*

No abstract available.
Humans ; Hypoglycemia* ; Tertiary Care Centers*

No abstract available.
Humans ; Hypoglycemia* ; Tertiary Care Centers*

The rate of admission in the Obstetrics and Gynecology Department in a tertiary hospital in Quezon City is continuously increasing, sometimes more than its bed capacity. An average of 2-3 mothers occupying a single bed with their newborn children can be overwhelming, to the point where the comfort hygiene and wellness of the patients after delivery are sacrificed. It is important for us to find a way in which the ward can accommodate all patients without any risk of losing the comfort that the hospital can offer during their stay. A faster patient turnover can at least help in this kind of situation. This study aims to investigate if early feeding can lead to early return of normal bowel function which could mean shorter hospital stay due to lesser post-operative discomfort and early ambulation. A randomized, three arm study was done in a tertiary hospital from June 2016 to September 2016. Ninety three women who underwent elective Cesarean Section were admitted and were randomly assigned into three groups. Group A had regular progression of diet, Group B were those who were fed early and Group C those who were given Domperidone before they were fed early. The primary outcome would be the time to regular diet tolerance. Secondary outcomes include the time of first flatus, time to ambulation out of bed, duration of intravenous infusion, duration of indwelling foley catheter and finally, length of hospital stay.
Tertiary Care Centers ; Domperidone ; Pregnancy

Background: Phototherapy had been a less favourable treatment in recent years. Our study aims to audit the usage of NB-UVB phototherapy service in a tertiary hospital in East Malaysia. Methods: This is a retrospective study. Phototherapy file of patients who underwent NB-UVB phototherapy between year 2016 and 8 March 2021 were reviewed. Demographic data, treatment history, and acute side effects were analysed. Results: Forty eight subjects were recruited in this study. The majority (33.3%) of the subjects were in 20-29 age group. There was an equal number of male and female subjects. About 66.7% of the subjects had psoriasis and 18.8% of them had vitiligo. Nearly 36.6% of the subjects had 26-50% body surface area involved at initial phototherapy. Almost 54.2% of the subjects had <50 sessions of NB-UVB phototherapy. About 52.1% of the subjects had a cumulative dose of NB-UVB <25 J/cm2 while 26.7% of subjects had a cumulative dose >200 J/cm2. Acute side effects including burning (17.8%), pruritus (4.4%) and flare of psoriasis (2.2%). Discussion: Low utilization rate of NB-UVB phototherapy was likely due to logistical and transportation factors. Psoriasis was the commonest indication for NB-UVB in our study followed by vitiligo. Annual skin malignancy surveillance should be done especially on patients received NB-UVB >350 sessions even after the discontinuation of treatment. Most patients tolerate NB-UVB phototherapy well with no major side effects. Conclusion In conclusion, NB-UVB phototherapy is a relatively safe yet underutilised treatment in our centre.
Phototherapy ; Tertiary Care Centers ; Malaysia

Introduction: Acute Ischemic Stroke (AIS) is a medical emergency that affects people globally. In the Philippines, it remains as the third leading cause of mortality. This study aims to determine the use of platelet-lymphocyte ratio (PLR) - a simple, economical, and safe tool - as a predictor of in-hospital outcomes in patients with acute ischemic stroke. Methods: A retrospective cross-sectional study was conducted among AIS patients at the Remedios Trinidad Romualdez Hospital (RTRH) Tacloban City, Leyte, Philippines from January 2020 to December 2022. Clinical demographics, laboratory profile, and hospital outcomes were described. Descriptive statistics, Mann-Whitney test, and T-test were utilized to determine the association between PLR and in-hospital outcomes. Results and Conclusions There were 76 patients enrolled in the study, majority were females (57.9%), and hypertensive (84.2%). Risk factors that are pivotal to the development of AIS were also identified. To note, half of the population presented with unilateral body weakness. Moreover, only 7.9% died due to the disease. Higher PLR levels resulted from an increased platelet count and a decreased lymphocyte count. However, no significant association between PLR levels and AIS outcomes was noted, hence the need for further investigation of these parameters.
Ischemic Stroke ; Tertiary Care Centers