1.Factors associated with prolonged length of stay in the ambulatory care unit of a tertiary government hospital.
Erika A. Macalalad ; Marishiel D. Mejia-Samonte ; Jonathan D. Babsa-ay
Acta Medica Philippina 2024;58(13):45-49
BACKGROUND
Length of stay is one of the metrics of crowding in the emergency department. Identification of the factors associated with prolonged length of stay is vital for staffing and policy making to prevent overcrowding at the ambulatory care unit.
OBJECTIVEThis study aimed to determine the association of sociodemographic, clinical, and temporal factors with length of stay among patients seen at the ambulatory care unit of a tertiary government training hospital.
METHODSA retrospective case-control study was conducted between January to December 2019 at the ambulatory care unit of a tertiary government hospital. Charts of patients who stayed for more than six (6) hours were classified as cases, while those who stayed for more than two (2) hours up to six (6) hours were classified as controls. Charts were reviewed to obtain the clinicodemographic profile of patients who satisfied the inclusion criteria.
RESULTSThe case group consisted of 86 patients, while the control group consisted of 172 patients. Eight factors had an effect on the probability of prolonged length of stay at the ambulatory care unit: age 40-59 years old (OR = 2.29, 95% CI: 1.16-4.49), ESI 3 at triage level (OR = 3.35, 95% CI: 1.50-8.38), psychiatric complaint (OR = 6.97, 95% CI: 2.53-19.21), medications given and diagnostics done (OR = 2.16, 95% CI: 1.16-3.99), medications given/diagnostics/ referral to other services done (OR = 7.67, 95% CI: 2.70-21.80), psychiatric/substance-related case (OR = 6.97, 95% CI: 2.63-18.49), transferred to other services (OR = 3.25, 95% CI: 1.33-7.94), and endorsed to next shift (OR = 6.94, 95% CI = 3.90-12.35).
CONCLUSIONThe factors associated with prolonged length of stay were middle-aged adults, conditions with severe presentation, psychiatric/substance-use-related cases, need for more diagnostic test and treatment intervention, and decision to transfer care to other services.
Ambulatory Care ; Urgent Care
2.Home care of persons receiving continuous ambulatory peritoneal dialysis..
Journal of Korean Academy of Adult Nursing 1992;4(1):62-78
No abstract available.
Home Care Services*
;
Humans
;
Peritoneal Dialysis, Continuous Ambulatory*
3.A Study on Self Care Compliance Related to Infection Management for Continuous Ambulatory Peritoneal Dialysis Patients.
Journal of Korean Academy of Fundamental Nursing 1998;5(2):313-323
This study was a descriptive research on the level of self-care available to continuous ambulatory peritoneal dialysis patients( here-inafter referred to as "CAPD patient" ) related to the specific area of infection management. The method employed for the collection of data was a modified instrument of the self-care survey essentially based on Young Sook Choi's instrument. The relevant data was collected from september 1, 1996 to september 30, 1996. the subjects were provided with an open-ended question regarding the reasons behind why they did not seek self-care. The answers provided about self-care compliance were analyzed by SPSS for frequency, percentage, mean, t-test, ANOVA. Reasons for non-compliance were analyzed by content analysis. The results of the study were as follows : 1. The percentage of patients engaging in self-care were according to the following self performed tasks : preparation of dialysis : 30.58 points Dialysate exchange procedures : 49.40 points - Two bag type : 50.50 points - Spike type : 48.80 points - Neo type : 48.90 points Catheter exit site care : 25.13 points More specifically, in relation to the preparation of dialysis as referred to above, those patients engaging in self care was relatively high with respect to the cleaning of the dialysis before use and for the preservation of peritosol. However, in dialysate exchange procedures, data revealed that those patients engaging in self-care are relatively low with respect to putting on a mask during the performance of peritosol exchange. Similarly in peritosol exchange procedure and catheter exit care, low levels of self-care performance were fond in the area of putting on a mask during the peritosol exchange procedures and catheter line testing procedures, respectively. 2. In general characteristics, there appeared to be no distinction in self-care compliance among CAPD patients. 3. The main reasons for non-compliance were based in the following factor : intellectual, attitude, environmental surrounding and physical. As a result of the foregoing finding, nurses should provide adequate assistance to promote self-care compliance by CAPD patients by checking the preparation of dialysis, dialysate exchange procedure, and catheter exit site care which received ow point in this research.
Catheters
;
Compliance*
;
Dialysis
;
Humans
;
Masks
;
Peritoneal Dialysis, Continuous Ambulatory*
;
Self Care*
4.Nontuberculous Mycobacterial Peritonitis in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis
Yoshitaka Maeda ; Tomomi Uno ; Akiko Yoshida ; Akiko Takahashi ; Naoto Inaba ; Tatsuo Shiigai
Journal of Rural Medicine 2008;4(2):75-79
Non-tubercuous mycobacterial (NTM) infection in peritoneal dialysis (PD) patients has been rarely reported. We report a case of a 55-year-old female on continuous ambulatory peritoneal dialysis (CAPD). After a 2-year-history of recurrent exit-site infection of a PD catheter caused by Mycobacterium abscessus (M. abscessus), the patient was admitted to the hospital with signs of peritonitis. Since the same species, M. abscessus, was isolated from the CAPD effluent, multiple antibiotics were administered. However, the treatments could not relieve the symptoms of her infection. Consequently, the PD catheter was removed. Her condition gradually recovered over the course of subsequent, long-term, empirical antimicrobial therapies. NTMs, especially a rapidly growing NTM infection, have rarely been reported in PD patients and are commonly resistant to a variety of antimicrobial agents. Routine acid-fast staining is most likely helpful in promptly initiating treatment against NTM infection in PD patients. Moreover, an appropriate treatment regimen for a rapidly growing NTM infection should be established by accumulating data from cases as reported here.
Infection as complication of medical care
;
PUPILLARY DISTANCE
;
Peritoneal Dialysis, Continuous Ambulatory
;
Peritonitis
;
Patients
5.Laparoscopic Continuous Ambulatory Peritoneal Dialysis (CAPD) Catheter Placement Using a Two-Port Method in Adult End-stage Renal Disease (ESRD) Patients: Early Experience.
Journal of Minimally Invasive Surgery 2014;17(1):5-8
PURPOSE: Laparoscopy is being widely utilized beyond the field of surgery. We report on the early experience of laparoscopic CAPD catheter placement in adult ESRD patients. In addition, we investigate the question of whether laparoscopic CAPD catheter insertion can be used as a feasible long-term procedure. METHODS: Laparoscopic CAPD catheter placement was performed in 28 patients by one surgeon, between June, 2010 and October, 2013, and observed. A retrospective outcome study was conducted based on review of medical records. RESULTS: A total of 28 laparoscopic procedures were performed. The mean age of patients who underwent laparoscopic placement of a catheter was 60.3 years old. The most common cause of ESRD was uncontrolled hypertension combined with diabetes. The procedure took 45.7 minutes. Peritoneal dialysis was introduced on postoperative day eight, after one week of daily washing and no dialysate leaks were observed. Two incidences of catheter-related complications were observed: one incidence of catheter obstruction (due to its m igration and omental w rapping, w hich was m anaged with surgical removal) and one incidence of peritonitis (which was controlled with antibiotics). CONCLUSION: Laparoscopic CAPD catheter placement using tw o ports is a simple procedure with minimal complication. Laparoscopic CAPD catheter placement will gain greater acceptance as an alternative to the traditional method of CAPD catheter placement.
Adult*
;
Catheter Obstruction
;
Catheters*
;
Humans
;
Hypertension
;
Incidence
;
Kidney Failure, Chronic*
;
Laparoscopy
;
Medical Records
;
Outcome Assessment (Health Care)
;
Peritoneal Dialysis
;
Peritoneal Dialysis, Continuous Ambulatory*
;
Peritonitis
;
Retrospective Studies
6.Continuous Ambulatory Peritoneal Dialysis.
Journal of the Korean Medical Association 2000;43(1):59-64
No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*
7.Surgical complications of CAPD.
Chan Dae PARK ; Jin Young KWAK ; Ho Jung KIM ; Chan Hyun PARK ; Chong Myung KANG ; Han Chul PARK
The Journal of the Korean Society for Transplantation 1992;6(1):127-132
No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*
8.Clinical outcome of safe lock system in CAPD.
Ho Yung LEE ; Young Ki KIM ; Ki Yong KIM ; Seung Hwan SOHN ; Heung Soo KIM ; Kyu Hun CHOI ; Dea Suk HAN
Korean Journal of Nephrology 1991;10(2):201-208
No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*
9.Clinical outcome of safe lock system in CAPD.
Ho Yung LEE ; Young Ki KIM ; Ki Yong KIM ; Seung Hwan SOHN ; Heung Soo KIM ; Kyu Hun CHOI ; Dea Suk HAN
Korean Journal of Nephrology 1991;10(2):201-208
No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*
10.A clinical review of continuous ambulatory peritoneal dialysis.
Jong Yeon JANG ; Woo Song HA ; Soon Tae PARK ; Sang Kyung CHOI ; Soon Chan HONG ; Ho Seong HAN ; Young Chai KIM
Journal of the Korean Surgical Society 1992;42(3):361-366
No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*