BACKGROUND AND OBJECTIVE

Proper documentation of patient safety events is important to be able to provide changes that can prevent events from occurring again. The Philippine General Hospital launched an online platform for reporting patient safety events in 2017. This paper aimed to describe the patient safety events, initial response to the event, and preventive actions done in the institution.

This is a retrospective descriptive study of patient safety event records from August 2017 to April 2022. General data of the patients, details surrounding the events, response to the event, and preventive measures done after the event were documented. Descriptive analysis was performed.

There was a total of 625 events reported with 525 total unique reports. There was an increased rate of patient safety event reports from 2021 to 2022. The average rate was 23.8 and 25.7 reports per month, respectively. Most reports were for in-patient cases and were type 3 preventable adverse events. The general initial response of healthcare personnel to the adverse events is to provide the appropriate clinical care. Preventive measures include re-orientation and event specific actions.

Documentation is crucial for patient safety events to provide solutions and prevent reoccurrence of these events that can cause harm to patients.

BACKGROUND AND OBJECTIVES

With the global population aging, there is an emerging need for access to quality longterm care (LTC) services. Many countries have developed LTC systems while others are at the infancy stage. This paper aimed to provide an overview of the country’s readiness for LTC based on the perspectives of relevant stakeholders. Specifically, it described the roles, initiatives, and challenges of relevant organizations and community leaders for LTC provision. It also described the older persons (OPs) and carers’ perspectives towards LTC including their awareness, capacity, and preferences.

The study utilized a descriptive design using qualitative methods of data collection namely key informant interviews (KIIs) and focus group discussions (FGDs). Participating institutions and their designated representatives were purposively sampled as key informants. OPs and carers from select barangays in NCR and Region IVA participated in the FGDs. Guided by the interpretivism approach, thematic analysis was performed. A trained research assistant coded the FGD and KII transcripts through the Nvivo PRO plus software and verified by the first author. Themes were reviewed and validated by the multidisciplinary team.

A total of 15 KIIs and two FGDs were conducted. The participating institutions and organizations were found to have varied roles and initiatives relevant to LTC; from strategic planning, development of policies and standards of care, training and capacity-building, and up to the actual implementation of LTC services. Identified challenges include implementation issues, financial issues, lack of political and stakeholder support, OPs and familial issues, and lack of knowledge on LTC.

Participants shared their description on what LTC is, an LTC facility, and the conditions of those in LTC facility. OPs expressed their willingness to utilize LTC services and identified several factors related to their preferred LTC arrangements. Carers identified various topics related to taking care of OPs that they would like to learn.

The roles, initiatives, and awareness of relevant stakeholders, older persons, and carers towards LTC were found to greatly vary. Policy makers, health workforce, families, communities, and the older persons themselves should have a better understanding of longterm care before they can provide or utilize the system. With the current landscape of LTC provision, the country still has a long way to go in achieving the integrated continuum of LTC appropriate to promote healthy aging. Promoting awareness, integrating LTC in the current programs and services for older persons in the country, capacitating the formal and non-formal caregivers, and strengthening collaborations are recommended.

Further research on quantitative measures of readiness for long-term care with focus on the health system and in-depth studies on the varieties or models of long-term care are recommended.

BACKGROUND

The migration from classroom learning to real patient encounters during clinical clerkship is a transformative journey that carries with it many challenges which serve as rich sources of meaning. The actual patient interactions are pivotal opportunities that provide transcendental meanings which contribute to the well-rounded development of medical clerks, ultimately enhancing their ability to deliver better patient care.

Utilizing a qualitative phenomenological approach, the study allowed exploration of intricate layers of meaning embedded within the encounters of three female medical clerks in a medical university hospital in Manila, Philippines. The gathered narratives were analyzed and meanings were derived from these statements. The identified meanings were then organized into themes and essential insights that represented the core essence of the phenomenon being studied.

The reflections extracted from narratives revealed the emergence of 10 significant major themes stemming from medical clerks’ patient encounters. These encounters were consistently described as a sacred responsibility, providing opportunities for profound connections, resilience, deepened faith and comprehensive personal and professional development within a caring and compassionate environment.

The transformative journey was marked by profound personal and spiritual growth among medical clerks. Beyond developing their clinical skills, they experienced a transcendence that spoke to human desire for meaning beyond the material world. This "spirituality of encounter" fostered deeper connections with patients and enriched their perspectives on clinical practice that can further enhance their holistic development as medical students.

BACKGROUND: Hospitalization in neonatal intensive care units (NICU) exposes preterm infants to adverse stimuli, including continuous 24-hour lighting. There is currently no standardized NICU layout advised for the best development of preterm neonates. This meta-analysis aimed to assess the impact of cycled light (CL) exposure on clinical outcomes in premature infants admitted to NICU as synthesized in previous studies. MATERIALS AND METHODS: This meta-analysis protocol was developed following the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. A search was performed in PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases using the MeSH/key words: ―light exposure‖ AND pre-term AND cycled AND (RCT OR trials OR ―randomized controlled trial). The pooled Mean Difference with corresponding 95% CI was computed for weight gain, duration until start of enteral feeding, and duration of ICU stay using the Mantel–Haenszel random-effect model. RESULTS: Nine studies were included. The pooled mean difference showed that among preterm infants who had cycled light exposure, average daily weight gain (MD=6.24 grams, 95%CI=1.36 to 11.13, p=0.01) was significantly higher than those with continuous light exposure. The average time to start enteral feeding (MD=-3.84 days, 95%CI=-7.56 to -0.13, p=0.04) and average ICU stay (MD=-8.43 days, 95%CI=-12.54 to -4.31, p<0.0001) among neonates who had cycled light exposure were significantly shorter. CONCLUSION Benefits were seen in preterm infants when exposed to cycled light as opposed to continuous light. CL exposed infants showed a daily weight gain that was 6.24 grams higher, on average, and began enteral feeding nearly 4 days sooner. It led to a decrease in the duration of ICU stay by around 8 to 9 days on average. Further trials to determine the impact of cycled light exposure on morbidity and mortality among preterm neonates is recommended.
Human ; Male,Female ; Systematic review ; Meta-analysis ; Infant, Premature ; Intensive care units, Neonatal ; Intensive care, Neonatal ; Light ; Lighting ; Critical care

This essay laid out the development of a nurse's identity from clinical practitioner to developing researcher, with a focus on the importance of patient-centered and nurse-centered care as the cornerstone pillars of nursing research. Through narrative and application of qualitative and participatory research approaches, the author showed the intersection of everyday experience, philosophical inquiry, and scholarly pursuit along the path toward becoming a nurse researcher. The article examined how emotional experiences within the perioperative environment have instigated research questions aimed at improving patient and nurse well-being. Through the incorporation of academic models and theoretical perspectives, the author presented an emerging investment in health equity, social determinants of health, and collective inquiry, framing this individual path within the greater nursing science mission.

Palliative care has emerged as a crucial component of healthcare, particularly in the context of an aging population and the increasing prevalence of chronic and life-limiting illnesses. In the Philippines, however, access to palliative care remains significantly limited, especially in rural and underserved areas. This disparity is primarily driven by systemic challenges such as inadequate healthcare infrastructure, a shortage of trained professionals, and insufficient public awareness. While the inclusion of palliative care in the Universal Health Care (UHC) Act of 2019 (Republic Act No. 11223) reflects a progressive step toward addressing these needs, the implementation of comprehensive palliative services continues to face considerable hurdles. This paper advocated for the stronger integration of palliative care into primary health care systems at the barangay level, emphasizing the need to strengthen policy frameworks, ensure adequate resource allocation, and actively engage communities in this endeavor. Such efforts are essential to guaranteeing equitable, compassionate, and dignified care for all individuals, regardless of their stage of life or even socioeconomic status.

INTRODUCTION

Chronic Kidney Disease (CKD) is a leading cause of morbidity and mortality in the Philippines. Most Filipino CKD patients prefer hemodialysis due to barriers such as cost and availability of Kidney Transplant. End-stage kidney disease (ESKD) patients face high symptom burden and unmet palliative care needs. Even with advancement in dialysis technology, the annual mortality rate of dialysis patients remains between 20% and 25%. While Advance Care Planning (ACP) can help align care with patient preferences by facilitating discussions about values and future decisions, its utilization in dialysis population remains low due to barriers in implementation. There is limited research specifically addressing the preferences and influencing factors of Advance Care Planning among CKD patients on hemodialysis in the Philippines.

This study aimed to determine the ACP preferences of CKD patients undergoing hemodialysis and to identify the clinicodemographic factors associated with these preferences.

An analytic cross-sectional study was conducted involving 96 chronic kidney disease (CKD) patients undergoing hemodialysis at Baguio General Hospital and Medical Center (BGHMC) from October to November 2024. Data were collected using validated questionnaires administered either through face-to-face interviews or self-administration, depending on patients’ preferences and capabilities. Descriptive and inferential statistical methods were employed for data analysis.

The study revealed limited awareness of ACP among participants (86.5%), underscoring the need for education. Family-centered decision-making was prominent, with most participants preferring family members as surrogate decision-makers and confidants. Quality of life was prioritized over life extension, and preferences for “Do Not Resuscitate” (DNR) orders were notable. Educational attainment and ethnicity significantly influenced preferences, with higher education linked to greater awareness; and Ethnicity shaping preferences for decision-makers, confidants, timing of discussions, and resuscitation choices. Additionally, duration of dialysis was linked to care setting preferences, while social support systems influenced the preferred place for discussions.

The findings highlight critical associations between clinicodemographic factors and ACP preferences among hemodialysis patients. Addressing these associations through targeted education and culturally sensitive approach can promote high-quality end-of-life care, aligned with diverse patient needs, values, and preferences.

Endovascular thrombectomy (EVT) has revolutionized the management of acute ischemic stroke (AIS) caused by large-vessel occlusion, significantly improving outcomes worldwide. This single-center case series evaluated the early outcomes of EVT in AIS patients treated at this institution, focusing on its implications within a low- or middleincome country setting. The study aimed to assess the feasibility, safety, and efficacy of EVT, analyzing premorbid comorbidities, time to treatment, revascularization rates, procedural complications, and clinical outcomes. Five consecutive cases of AIS due to large-vessel occlusion treated with EVT were analyzed. The patients in this series were aged 21 to 75 years, all with a baseline modified Rankin Scale (mRS) score of 0. The average NIH Stroke Scale (NIHSS) score on admission was 17. Four patients received Alteplase before EVT within four hours of symptom onset. Successful recanalization (TICI 2b-3) was achieved in all cases. Post-thrombectomy, two patients developed re-occlusion, with one resulting in mortality. Among the patients, 40% achieved a favorable outcome, defined as a modified Rankin Scale (mRS) score of 2 at three months. This initial experience demonstrates promising results in achieving successful recanalization and improving clinical outcomes in AIS patients with large-vessel occlusion. However, the study also highlights challenges such as procedural complications and post-thrombectomy re-occlusion, underscoring the need for ongoing evaluation and optimization of patient selection and procedural protocols in lowresource settings. Future studies with larger sample sizes are warranted to further validate these findings and refine EVT protocols tailored to local healthcare contexts.

BACKGROUND

In Family and Community Medicine (FCM) residency training, the biopsychosocial approach to care was translated to a teaching strategy and cognitive framework called patient-centered, family-focused, and communityoriented (PFC) lens. However, the PFC lens documented in a matrix has no evidence of its implementation acceptability and appropriateness for the users in the FCM training program.

To determine the acceptability and appropriateness of the integration of the PFC lens in the Ortho- Geriatrics Fracture Liaison Service (OG-FLS) in applying the family medicine principles and achieving family practice required competencies of the residents in a tertiary hospital FCM training program.

A cross-sectional survey was conducted using a 15-item self-administered pre-tested online questionnaire to gather feedback and experiences on the PFC lens integration. Answers to open-ended questions were coded and analyzed with MaxQDA and synthesized into themes while numerical rating scales were analyzed with Microsoft Excel into means and standard deviation.

Nineteen residents answered the questionnaire. There were 47 OG-FLS patients referred to the service. Overall, the acceptability of the approach among FCM residents had an average score of 9.26 (SD ± 0.99) while appropriateness was rated 9.26 (SD ± 1.09) with 10 points as the highest score. The competencies achieved reported by residents were communicating effectively, collaborating with interprofessional teams, demonstrating clinical competence, and practice of biopsychosocial approach.

The PFC lens integration in OG-FLS is acceptable and appropriate in the practice of multidisciplinary care in the in-patient setting among FCM residents. Its integration is aligned with the expected competencies of a family physician that trainees can apply in future practice.

Background: The association of obesity with adverse COVID-19 outcomes is known, but unexplored in younger adults. Objective: To determine the association of obesity [body mass index (BMI) of ≥30] with severe COVID-19 outcomes in younger and older adults. Design: Retrospective cohort study. Participants: 391 patients with COVID-19 (226 younger adults aged 18-60 years, and 165 older adults aged >60 years). Setting: Southern Philippines Medical Center, Davao City, January 2021 to September 2021. Main outcome measures: Severe COVID-19 outcomes (high-flow oxygen administration, ICU admission, mechanical ventilation, death); odds ratio of severe outcomes in patients with BMI of ≥30. Main results: Of 391 patients (median age of 57 years), 286 had a BMI of <30, while 105 had a BMI of ≥30. Univariate regression analysis showed that a BMI of ≥30 was significantly associated with any severe COVID-19 outcomes (OR=2.68; 95% CI 1.68 to 4.27; p<0.001). This remained after adjusting for age, sex, hypertension, diabetes, and cardiovascular disease (adjusted OR=3.19; 95% CI 1.93 to 5.27; p<0.001). A BMI of ≥30 was also significantly associated with any severe outcomes among younger adults (adjusted OR=4.04; 95% CI 2.23 to 7.32; p<0.001), but not among older adults (adjusted OR=1.80; 95% CI 0.70 to 4.64; p=0.227). Conclusion In our study, among all adults, a BMI of ≥30 significantly increased the odds of experiencing any severe COVID-19 outcomes. This association was also observed in the younger adult subgroup, but not in the older adult subgroup.
SARS-CoV-2 ; Body Mass Index ; Immunity ; Critical Care