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Publications

Publication Accepted :

International Journal of Nursing Research (IJNR), Volume 4 (3), Page No. 171-175, October 2018.
A study to assess the effectiveness of infusion experts on the nursing interventions of peripheral intravascular devices among patients admitted to a tertiary care hospital of the city.
Pankaj Punjot, Jincy Mathew, Saly Suseel, Valsa Thomas*
Abstract:
Aim: The study aimed to scrutinize best practices in infusion nursing among the nurses in a private tertiary care center hospital in Mumbai, India.
Introduction: Infusion nursing verticalization is the vision of nursing in our hospital and to fulfill the vision there are infusion experts who work round the clock with patients and provide competent and best practices in the field of infusion nursing in the hospital. Infusion experts are supported by Infusion Nursing Society (INS) and Centers for Disease Control and Prevention (CDC) guidelines for the specialized team in the hospital to prevent complication in infusion therapy.
Material and Methods: A total of 400 IV cannulation were evaluated on the basis of the IV therapy monitoring chart among the nurses. 20 nurses were included in the study. 10 IV cannulation of each nurse was assessed and then infusion expert training was imparted to them with 4 days training in which pre and post evaluation of knowledge test was done. Later 10 IV cannulation from the same experts were evaluated to see the effectiveness of training. The evaluation was based on Visual Thrombophlebitis Score (VTS) and rate of grades of phlebitis.
Result: The present study was conducted to assess the effectiveness of infusion experts in the reduction of thrombophlebitis rate and give best practices in infusion nursing. 20 nurses were included in the study in which each of their 10 IV cannulation records was evaluated with the IV therapy-monitoring chart in the month of January and February 2018. Then infusion expert training was imparted to them in the month of March 2018. Before and after the infusion expert training, knowledge of nurses on infusion practice was evaluated on the basis of a structured questionnaire. Post-training again 10 IV cannulation records were evaluated in the month of April and May 2018.
Conclusion: The findings of this study show that there is highly statistical significant relation difference between pre and post-training phlebitis grade and no significant relation between the selected patient variables and phlebitis. Infusion nursing is the newer perspective and primary need of the patient in the hospital. Infusion experts play a vital role in phlebotomy and maintenance of IV line, and the study paved to fulfill the nursing vision of verticalization in infusion nursing with best practices in our hospital.
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Journal of Hospital Administration, Online Published: June 13 2018, Volume 7, No. 4
Factors associated with patient satisfaction in a private health care setting in India: A cross-sectional analysis.
Sudhaya Vinodkumar, Binu Gigimon Varghese, Maninder Singh Setia*
Abstract: The present study was conducted to assess patient satisfaction and factors associated with it in a tertiary care hospital in India; and to evaluate the delay in discharge process and its association with satisfaction. It is a cross-sectional analysis of secondary data abstracted from patient satisfaction forms of 1,054 individuals. We analysed factors associated with rating of hospital services and overall hospital experience. We also evaluated the delay in discharge process and its association with overall satisfaction of these patients. We used regression models to assess factor associated with satisfaction scores and “good hospital experience”.
Introduction: Patient satisfaction has been defined as “fulfillment or meeting of expectations of a person from a service or product”. [1, 2] It has been argued that patients and their relatives expect good clinical care as well as good facilities during their visit to the hospital, and these may be useful markers of quality of care. [1, 3–5] In addition, Morris and colleagues highlight that “patient satisfaction” may also be a part of the “pay-for-performance metrics” and added incentives to hospitals. [6] Customer satisfaction can be a complex process; numerous authors have discussed various theories about customer satisfaction in detail. [7, 8] Currently, when the patients particularly the ones that accesses health care in a private setting have many options, future return to the same health care provider will depend on how satisfied they are with the health care settings. [9] In addition, it has been shown that satisfaction is also associated with treatment adherence.
Material and Methods: The present study is a cross-sectional analysis of secondary data from 1,054 patients over a three month period in Mumbai, India.
Result: The median age (IQR) of these 1,054 patients was 36 (24-58) years. The median age (IQR) of 521 male patients was 34 (26-55) years and of 533 female patients was 40 (23-61) years; the difference was statistically significant (p = .03). Most of the patients were admitted in the internal medicine ward (27%), pediatrics (15%), gynecology (13%), and surgery (10%). The patients were admitted for a median (IQR) of 3 (2-5) days; there were no significant differences in the duration of admission between males and females (see Table 1). The median (IQR) duration of discharge process was 157 (99-239) minutes. The median time from doctor’s visit to issuance of discharge summary was 19 (10-60) minutes and the median time from issuance to discharge summary to payment of hospital bills was 120 (60-185) minutes. About 23% of the patients did not report any delay in the discharge process.
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International Journal of Current Advanced Research Volume 7, Issue 8(D), August 2018, Page No. 14834-14839
Establishing Best Practices in Diabetes Care at a Tertiary Care Hospital.
Pankaj Punjot*., Sushma Jain., Capt. Valsa Thomas and Vimal Pahuja
Abstract
Introduction: This study aimed to study best practices in Glycemic control of patient with diabetes in private tertiary hospital in Mumbai, India. Glycemic control policy is a structured way to manage inpatient hyperglycem ia with Oral hypoglycemic Agents and insulin. A special protocol for Intravenous insulin infusion has also been formulated as a part of the Glycemic control policy.
Material and Methods: A total of 924 diabetic patient records were included in the study. Before implementing the Glycemic control policy, it was designed and validated for 1 month in the hospital for inpatient hyperglycemia management. Training on Glycemic control policy was imparted to 60 nurses and they were evaluated pre and post training. The adherence towards Glycemic control policy was evaluated four times in different time intervals of 3 months.
Result: The results of a 3 months study from December 2016 to February 2017 reflect the average adherence to Glycemic control policy as 30.13%. Before the training session the knowledge regarding Glycemic control policy was 33.66% and after the training session it improved up to 74.13%. The final phase of the study was from January 2018 to March 2018 which shows adherence increased up to 94.35%.
Conclusion: In the beginning there was a lack of knowledge and non adherence to the Glycemic control policy but through constant training and supervision there was a remarkable improvement. The study paved the way to establish best practices in diabetes care in a tertiary care hospital.
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International Journal of Medical and Health Research Volume 4, Issue 7, July 2018, Page No. 139-142
Original research article: A comparative study to assess the response to a medical emergency and its effect on the patient wellbeing, within the healthcare setting and from outside the healthcare setting.
Pankaj Punjot 1*, Asmita Garate 2, Saly Suseel 3
Abstract
Introduction: This study is intended to address the emic perspective of cardiac arrest resuscitation teams and the organizational and educational approaches that would best support their functioning.
Objectives: The specific objectives of this study are as follows:
  • To describe the emergency response events within and outside the hospital.
  • To identify organizational factors in order to improve cardiac arrest resuscitation training, teamwork and patient care.
Material and Methods: The present study is a longitudinal analysis of secondary data collected from patients in Mumbai, India. The data was collected from the Emergency response Closure form filled by the ICU Intensivist after the emergency for patient from within the healthcare setting. The hospital follows the CPR policy for medical emergencies from within the healthc are setting.
Result: Though in our study the results shows that there was no significant difference in the neurological outcome of patient of calls from within the hospital and outside the hospital. The variable of age in this study depicted that the emergency calls from outside the hospital were patient aged more than 60 years, than from within the hospital emergency calls. A study has also suggested that with increasing challenges of aging population, the crude annual rate of emergency transportations across all age groups increased from 32 per 1000 people in 1994–95 to 58 per 1000 people in 2007–08. The rate of transportation for all ages increased by 75% (95% CI, 62%–89%) over the 14-year study period, representing an average annual growth rate of 4.8% (95% CI, 4.3%–5.3%) beyond that explained by demographic changes. Patients aged = 85 years were eight times (incident rate ratio, 7.9 [95% CI, 7.6–8.3]) more likely to be transported than those aged 45–69 years over. The study also reflects that most of the emergency calls from outside the hospital were due to cardiovascular emergency. The study results also show that the response time to outside emergency calls took more time as compared to internal call. The response time to internal calls was 1min as compared to external calls of 20 mins.
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International Journal of Recent Scientific Research Vol. 9, Issue, 6(A), pp. 27244-27250, June, 2018
A Study to Assess The Effectiveness Of Structured Teaching Program On Nursing Procedures Among The Newly Inducted Nurses In Dr L H Hiranandani Hospital, Mumbai.
Pankaj Punjot, Silvia Mathew,Saly Suseel, Elizebeth Thomas, Binu Gigimon and Jincy Mathew
Abstract

Nursing involves comprehensive care of the sick, not only of the individual patient but of the family and community. She should have required qualifications and the license to practice in the position entrusted to her. She should be competent - have good knowledge in her field as well as technical, administrative and critical thinking skills to perform in her designated role. A right attitude towards her profession is very pertinent too. The nurse should function optimally through team work to provide quality nursing care to her patients.

The patient as an individual and a member of the community has a right to be treated with dignity and respect and has a right to expect planned, individualized nursing care. The Mission of the hospital is “to be the preferred choice of healing and health” and we aim to provide high quality nursing care to patients and their families regardless of their religion, disease condition or status. This is achieved with compassion, honesty and caring, through competent and patient oriented nursing service and by continually assessing, planning, prioritizing, implementing and evaluating nursing care interventions.

The nurses undergoing induction where they are taught and demonstrated about basic nursing procedures which is already part of the Nursing degree/diploma curriculum. A pretest was conducted to assess the knowledge of the newly inducted nurses. The average score was 62%. After the training for basic nursing procedures a post test was conducted and they scored an average of 90%. The nurses inducted to the hospital 98% of nurses werein the age group of 20 to 30 years and only 2% were in the age group of 30 to 35 years and there were none above 35 years age. It was also found that 72% of the nurses were having qualification of four years i.e. B.Sc nursing while 28% of nurses were Diploma in nursing which is a 3 years course.

It was found that 65% of newly inducted nurses were fresher’s i.e. with no experience, 16% nurses had two years experience, 15% came with 2-4 years experience and only 4% came with more than four years experience. Even though the hospital recruits male as well as female nurses, it was found that all nurses recruited during that period were females.

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Indian Journal of Dermatology Volume 60, Issue no: 6, November – December 2015.
A Study of the Factors Associated with Risk for Development of Pressure Ulcers: A Longitudinal Analysis.

Elizebeth Thomas, Sudhaya Vinodkumar, Silvia Mathew, Maninder Singh Setia

Abstract

Background: Pressure ulcers (PUs) are prevalent in hospitalized patients; they may cause clinical, psychological, and economic problems in these patients. Previous studies are cross sectional, have used pooled data, or Cox regression models to assess the risk for developing PU. However, PU risk scores change over time and models that account for time varying variables are useful for cohort analysis of data.

Aims and Objectives: The present longitudinal study was conducted to compare the risk of PU between surgical and nonsurgical patients, and to evaluate the factors associated with the development of these ulcers over a period of time.

Materials and Methods: We evaluated 290 hospitalized patients over a 4 months period. The main outcomes for our analysis were:

(1) Score on the pressure risk assessment scale; and

(2) The proportion of individuals who were at severe risk for developing PUs. We used random effects models for longitudinal analysis of the data.

Results: The mean PU score was significantly higher in the nonsurgical patients compared with surgical patients at baseline (15.23 [3.86] vs. 9.33 [4.57]; P < 0.01). About 7% of the total patients had a score of >20 at baseline and were considered as being at high risk for PU; the proportion was significantly higher among the nonsurgical patients compared with the surgical patients (14% vs. 4%, P = 0.003). In the adjusted models, there was no difference for severe risk for PU between surgical and nonsurgical patients (odds ratios [ORs]: 0.37, 95% confidence interval [CI]: 0.01–12.80). An additional day in the ward was associated with a significantly higher likelihood of being at high-risk for PU (OR: 1.47, 95% CI: 1.16–1.86).

Conclusion: There were no significant differences between patients who were admitted for surgery compared with those who were not. An additional day in the ward, however, is important for developing a high risk score for PU on the monitoring scale, and these patients require active interventions.

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* Tag Team” Approach to care for critically ill patients. NURSING 2015, Vol. 45, 63. Published in issue: May 2015 by Sheena Binu, Asmita Garate, and Dr Maninder Singh Setia
Critically ill patients require intensive, well-coordinated interventions because they're at risk for developing complications such as extubation failures, mechanical ventilator weaning failures, malnutrition, and infections. Evidence-based nursing care, including frequent assessments, close monitoring, and timely communication of patient status to the multidisciplinary team are important when caring for these patients. However, ICU nurses are susceptible to burnout from the stress of caring for critically ill patients. To manage the specific requirements of these patients while simultaneously addressing the concerns of the nurses caring for them, we devised a new type of nursing care model—the "tag team" approach—to care for critically ill patients. This article takes a look at the tag team approach we used when caring for one critically ill patient who was admitted to our hospital in Mumbai, India, for over 3 months and discusses how the new care model improved the care the patient received.