Tag: hospitals

Categories : HospitalsTags :

Health Department Misses Another Deadline to Provide Nurses with Uniforms

On By ModernMedia

The department has committed to paying nurses a once-off allowance by the end of November

By Marecia Damons

Photo by Cottonbro on Pexels

The Department of Health has missed another deadline to provide nurses at public hospitals and clinics with uniforms by 1 September. Instead, a once-off allowance of R3 307 will be paid to nurses by 30 November to buy their own uniforms.

The Democratic Nursing Organisation of South Africa (DENOSA) says its 84 000 members “can hardly afford to get one set of uniforms” with that allowance.

Since 2005, nurses have received an annual allowance to buy their uniforms. In terms of a new agreement signed in March 2023, the department committed to providing uniforms directly to nurses, instead of the allowance of R2,600.

According to the bargaining council agreement, nurses were to receive seven sets of uniforms over two years. The uniform set includes a dress, or a skirt and a top (blouse or shirt), or a pair of trousers and a top (blouse or shirt). Accessories include a brown belt, brown shoes, a maroon jacket and a maroon jersey.

The agreement required the department to supply nurses with four sets of uniforms, one pair of shoes and one jersey in the first year, and three sets of uniforms, one belt, and one jacket in the second year.

However, as the 1 October 2023 deadline approached, the department said it was facing difficulties with the procurement process. In a last-minute bargaining council meeting in September 2023, the department informed nurses’ unions that it would not meet the 1 October 2023 deadline. Instead, it said, the supply of uniforms would be postponed until 1 September 2024 and a temporary allowance would again be paid meanwhile. Uniforms were to be procured through tenders in each province.

But in response to concerns expressed by DENOSA at a meeting in June 2024, the department acknowledged that it was battling with suppliers and would not meet the new deadline either.

Department spokesperson Foster Mohale said there were delays in procurement in some provinces and this was “receiving the urgent attention it deserves”.

He said the department had proposed a new plan and a new deadline of 1 September 2025.

Meanwhile, he said, nurses would be paid a once-off uniform allowance of R3307.60 by 30 November 2024. But DENOSA says this is “too little to buy uniforms”.

“With that amount, a nurse can hardly afford to get one set of uniforms. For a nurse to buy a proper uniform for the whole week, they need between R8500 and R14 000,” the union said in a statement.

Mohale said the uniforms will be supplied in line with the Preferential Procurement Policy Framework Act which stipulates that goods ordered by state institutions must contain a minimum of local content. The policy was first introduced in 2011 in a bid to protect South African industry and jobs.

But DENOSA said a centralised procurement system, similar to those used for police and army uniforms would be more effective than provincial procurement.

“The issue of quality is extremely concerning to us…This is going to open up the whole process to corruption which we have warned against, but it looks like the department has closed its ears on that matter,” DENOSA spokesperson Sibongiseni Delihlazo said.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Read the original article.

Categories : HospitalsTags :

Buckets to Catch Water in Free State Hospital’s Leaking Wards

On By ModernMedia
A theatre recovery room at Boitumelo Regional Hospital. The photo was taken in January. The hospital says leaks have since been fixed. Photo: Rethabile Nyelele

By Rethabile Nyelele for GroundUp

Crumbling infrastructure is hampering patient care at Boitumelo Regional Hospital in Kroonstad, Free State.

We first visited the hospital two weeks ago. Buckets have been set out on the floors of some wards and theatre rooms to catch water leaking from broken ceilings.

An extension of the hospital building and upgrades started in 2010. In July 2014, further renovations were done. But staff, who spoke to GroundUp on condition of anonymity, said conditions at the hospital are deteriorating, with leaking ceilings, and broken windows covered with cardboard.

Last week, nurses and other staff downed tools over the poor condition of the hospital. They also demanded to be paid for overtime. Most staff resumed their duties on Monday night, pending further negotiations with management on 17 February.

Boitumelo is the only regional hospital in the Fezile Dabi District and caters for patients from about 19 surrounding towns. The hospital has six theatres but we were told of at least 80 patients whose surgeries had to be rescheduled between October and December 2022.

“I’ve been going to the hospital for surgery since 2018 … They keep postponing,” said Langelihle Makhoba.

Another patient, Mamiki Mnguni from Oranjeville, who lives about 100km from the hospital, said, “I was scheduled for a gallstone removal on 19 January 2023, but I was told the theatre is not working. I was told to return in April.”

Hospital CEO Sibongile Mthimkhulu referred our questions to the Free State Department of Health.

The department’s spokesperson, Mondli Mvambi, responded to our questions with a screengrab from a memo sent by Mthimkhulu which details progress made on infrastructure repairs. The memo stated that ceiling panels had been replaced and two theatres had been painted, among other things.

But when we visited the hospital again on 6 February, ceiling panels were still broken and we were told that some of the theatres were not yet fully functional.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Ethics and Law HospitalsTags :

FBI Disrupts Cybercrime Group Which Extorted Hospitals

On By ModernMedia
Photo by Nahel Abdul Had on Unsplash

The Hive ransomware group that has targeted more than 1500 victims in over 80 countries around the world, including hospitals, has been disrupted in a months-long campaign against, the US Justice Department has announced.

Hive ransomware attacks have caused major disruptions in victim daily operations around the world and hindered responses to the COVID pandemic. In one case, a hospital attacked by Hive ransomware had to fall back to pen and paper to treat existing patients and could not take new admissions shortly after the attack. 

The Justice Department revealed that the FBI had penetrated Hive’s computer network and captured its decryption keys, which were then offered to victims around the world. This saved them $130 million in ransom they would have had to otherwise pay to get their networks back.

Finally, the department announced that, in coordination with German and Dutch law enforcement, it has seized control of the servers and websites that Hive uses to communicate with its members, disrupting Hive’s ability to attack and extort victims.

Since June 2021, the Hive ransomware group has targeted more than 1500 victims around the world and received over $100 million in ransom payments.  

Hive used a ransomware-as-a-service (RaaS) model featuring administrators, and affiliates. RaaS is a subscription-based model where the administrators develop an easy-to-use ransomware strain and then recruit affiliates to deploy the ransomware against victims. Affiliates identified targets and deployed this readymade malicious software to attack victims and then earned a percentage of each successful ransom payment.

Hive actors used a double-extortion model of attack: before encrypting the victim’s system, the affiliate would steal sensitive data. The affiliate then sought a ransom for both the decryption key necessary to decrypt the victim’s system and a promise to not publish the stolen data – usually the most sensitive, such as hospital patient data. After a victim pays, the affiliates and administrators split the ransom 80/20. Victims who do not pay on the Hive Leak Site. After Consulate Health Care was unable to pay the ransom, since its insurance did not cover such cyber crimes, Hive posted 550GB of personally identifiable information on its patients and employees online.

For more information about the malware, including technical information for organisations about how to mitigate its effects, is available from CISA, visit https://www.cisa.gov/uscert/ncas/alerts/aa22-321a.

Categories : HospitalsTags :

Inpatient Blood Draws are Often Performed During Sleep Hours

On By ModernMedia
Blood sample being drawn
Photo by Hush Naidoo Jade Photography on Unsplash

The sleep of hospitalised patients may be often interrupted due to non-urgent blood draws, according to findings from a Yale study published in JAMA. This may be exacerbating sleep deprivation, and putting them at greater risk for health events later on.

In an analysis of more than 5 million non-urgent blood draws collected at Yale New Haven Hospital from 2016 to 2019, a team of researchers found that a high proportion of them occurred during a three-hour window in the early morning.

“We found that nearly four in 10 of total daily blood draws were performed between 4am and 7am,” said César Caraballo-Cordovez, MD, a postdoctoral associate at Yale Center for Outcomes Research and Evaluation (CORE) and co-lead author of the study. “Importantly, we found that this occurred across patients with different sociodemographic characteristics, including older individuals who are at highest risk of adverse health events from sleep deprivation.”

Although early morning blood draws are often considered necessary to inform decisions during morning medical rounds, the authors suggest that sleep interruptions may increase the risk of delirium and other adverse events. “Patients who were recently hospitalised experience a period of generalised risk for myriad adverse health events, a condition named posthospital syndrome,” added Dr Caraballo-Cordovez. “The stress that patients experience during the hospitalisation – including stress from sleep deprivation – is a key contributor to this period of increased risk.”

“This is not an issue at just one hospital,” said Harlan M. Krumholz, MD, SM, professor of medicine and public health at Yale and CORE director. “Our findings reflect an aspect of how inpatient hospital care is being delivered in modern medicine. A more patient-centered care would limit nonurgent tests during sleep hours. However, these early morning blood draws are often considered necessary to make decisions during rounds.”

“We need to re-design our process to protect patients’ sleep, but major changes in our practice must be informed by solid studies that demonstrate the efficacy of strategies to do so without untoward effects,” added Krumholz.

Source: Yale School of Medicine

Categories : Paediatrics Respiratory DiseasesTags :

Hospital Readmissions for Children with Asthma on The Increase

On By ModernMedia
Photo by Kelly Sikkema on Unsplash

Hospital readmissions for asthma are increasing among children, likely stemming from COVID lockdowns reducing immunity to common respiratory viruses. These are the findings of a new study published in the Journal of Asthma. The finding highlights the gaps in health care for this most common of chronic paediatric illnesses.

The Australian study, led by the Murdoch Children’s Research Institute, found about one in three children, mostly pre-schoolers, are readmitted to hospital for asthma compared to one in five a decade ago.

Most asthma hospital presentations were preventable, Murdoch Children’s Dr Katherine Chen said, which emphasises the need for a holistic evaluation of each child’s asthma management to prevent future readmissions.

The study involved 767 children, aged three to 18 years, who were admitted to three hospitals in Victoria state between 2017-2018 with a diagnosis of asthma. It found that 34.3% were readmitted to hospital for asthma, with those aged three to five years accounting for 69.2%. Of the 767 participants, 20.6% were readmitted once, and 13.7% had two or more readmissions in 12 months. 

“Our study highlighted gaps in the children’s asthma care,” Dr Chen said. Over a third of children hadn’t had a review of their inhaler technique, and only about a quarter were prescribed a preventer or asked to continue using it.

“Almost three quarters were discharged without a preventer medication, and over 80 per cent did not have a follow-up clinic booked at the hospital, often reserved for children with difficult-to-control asthma. Most families, therefore, need to navigate their child’s asthma follow-up with their GP.”

Recently, said Dr Chen, asthma admissions had spiked due to the rise in respiratory infections and children lacking immunity to common viruses as a result of COVID lockdowns.

Professor Harriet Hiscock at MCRI said that the findings confirmed the important role of GPs in paediatric asthma management and how targeted interventions at each hospital could reduce readmissions.

“Less than 10 per cent were readmitted within 30 days suggesting the importance of ongoing community care and longer-term asthma control,” she said. The need to regularly review overall asthma management, minimise risk factors, arrange follow-up, and support optimum care in the community are key.

“Interactive digital symptom monitoring with specialist nurse support, home-based education and a culturally tailored education program could also help.”

Prof Hiscock said linked datasets were important to objectively measure the burden of asthma cases on health services.

“Our current dataset cannot verify whether the follow-up appointment was attended, whether caregivers had arranged follow-up post-discharge and if the medications were used as prescribed,” she said. “Integrating datasets such as health services and medication use into clinical care will improve the clinician’s understanding of the child’s asthma control and medication adherence and would assist in providing targeted treatments.”

Asthma is the most common chronic paediatric illness in industrialised countries, affecting 8–10% of children.

Source: Murdoch Children’s Research Institute

Categories : HospitalsTags :

Physicians Prescribe Less Analgesic Medication during Nightshifts

On By ModernMedia
Photo by Mulyadi on Unsplash

Physicians prescribe less analgesic medication during nightshifts than during the day, according to a new study published in PNAS.

In the first part of the study, 67 doctors were given empathy assessment tasks in the morning and asked to respond to simulated patient scenarios. These doctors were either at the end of a 26-hour shift or just beginning their workday. The study found that doctors who recently completed night shift showed less empathy for patient’s pain. For example, these physicians’ exhibited decreased emotional responses to pictures of people in pain and consistently scored their patients low on pain assessment charts.

In the second part of the study, the researchers looked at actual medical decisions made by emergency room doctors in the United States and Israel. Analysed 13 482 discharge letters for patients who came to the hospital in 2013–2020 with a chief complaint of pain, they found that physicians were 20–30% less likely to prescribe an analgesic during nightshifts (compared to daytime shifts) and in amounts less than generally recommended by the World Health Organization. “They’re tired and therefore they’re less empathic to patients’ pain. When we looked at ER doctors’ discharge papers, we found that they prescribed fewer painkillers,” explained Professor Shoham Choshen-Hillel from the Hebrew University of Jerusalem (HU)’s School of Business Administration and Federmann Center for the Study of Rationality, who led the study.

The bias persisted after adjusting for patients’ reported level of pain, patient and physician’s demographics, type of complaint, and emergency department characteristics. “Our takeaway is that nightshift work is an important and previously unrecognised source of bias in pain management, likely stemming from impaired perception of pain. The researchers explain that even medical experts, who strive to provide the best care for their patients, are susceptible to the effects of a nightshift,” noted co-lead author HU Psychology Department’s Dr Anat Perry.

Looking ahead, the researchers suggest implementing more structured pain management guidelines in hospitals. Another important implication relates to physician work structure, and the need to improve physicians’ working schedules. “Our findings may have implications for other workplaces that involve shiftwork and empathic decision-making, including crisis centres, first responders, and the military. In fact, these results should probably matter to all people who are sleep-deprived,” added co-lead author Dr Alex Gileles-Hillel from Hadassah Medical Center and HU.

Source: ScienceDaily

Categories : General Interest HospitalsTags :

Another Fire Breaks Out at Steve Biko Academic Hospital

On By ModernMedia
Source: Pixabay CC0

On Sunday evening, another fire broke out at Steve Biko Academic Hospital – the second in two weeks. The fire damaged linen and prompted an evacuation but fortunately, there were no injuries resulting from the incident, Times Live reported.

Gauteng health department spokesperson Kwara Kekana said the cause of the latest fire was due to till-burning cigarette butts discarded by patients which “touched the ward linen room lights, burning the steel shelves and linen.”

Kekana said the damage was limited to a few items of linin. The fire started at around 6.15pm in a linen closet in a medical ward.

“The fire was quickly extinguished by staff. Patients were temporarily evacuated as a safety precaution because of smoke. By 8.15pm, patients were returned to the ward after the City of Tshwane declared the site safe,” Kekana said.

The previous fire at the hospital broke out at around 1:20am in a temporary storage area for COVID medical waste and as an in-transit corpse area. That fire affected temporary structures outside the hospital casualty area, and forced the evacuation of 18 patients.

This is the latest in a string of fires in Gauteng hospitals, such as the devastating fire at Charlotte Maxeke hospital – something which has caused concern for Gauteng Health MEC Nomathemba Mokgethi.

Speaking about the previous fire, she said that, “It looks like every year in the Department of Health we have to deal with fires. I will be getting a report the afternoon from the law enforcement agency, especially on the Charlotte issue.”

The problem of hospital fires is not confined to Gauteng: exactly a week earlier, a blaze broke out at Chatsmed Hospital in Durban.

Source: Times Live

Categories : HospitalsTags : 1 Comment

Hospitals in Ukraine Face Oxygen Shortage, MSF Suspends Operations

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Supplies of medical oxygen in Ukraine are dangerously low due to disruption caused by the Russian invasion, the World Health Organization has warned.

Due to the crisis, the WHO estimates that the country needs an additional 20–25% increase in oxygen supplies over and above its normal needs. As it currently stands, the transport of oxygen cylinders across the country is being disrupted, especially into the capital Kyiv. As of 27 February, many hospitals across the country, including in Kyiv, had less than 24 hours’ supply remaining.

Furthermore, oxygen production facilities are experiencing shortages of zeolite, which is needed for the safe production of oxygen in the pressure swing absorption process. 

Prior to the conflict, the WHO had worked with Ukraine to improve its oxygen supply infrastructure, especially during the COVID pandemic. “Of the over 600 health facilities nationwide assessed by WHO during the pandemic, close to half were directly supported with supplies, technical know-how and infrastructure investments, enabling health authorities to save tens of thousands of lives,” the WHO said. This progress is threatening to be undone.

“Compounding the risk to patients, critical hospital services are also being jeopardised by electricity and power shortages, and ambulances transporting patients are in danger of getting caught in the crossfire,” the WHO said in its press release.

To offset this, the WHO is working through regional networks to bring in oxygen, as well as providing trauma treatment supplies. These would be brought in through a safe logistics corridor in Poland.

Médecins Sans Frontières (MSF) has announced that it is suspending activities in Ukraine. “These included care for people living with HIV in Severodonetsk; care for patients with tuberculosis in Zhytomyr; and improving access to healthcare access in Donetsk, in eastern Ukraine, where we have been providing much-needed healthcare, including for mental health, to conflict-affected communities,” the organisation said in an announcement.

However, it is working to ensure some continuity of its operations, and are working to provide trauma training to certain hospitals and have provided some trauma supplies.

The Ukrainian capital of Kyiv has also put out a call for donations of medicines, such as the antiviral amixin, the antibiotic nifuroxazide and the haemostatic agent aminocaproic acid.

Source: World Health Organization

Categories : HospitalsTags :

Greenspaces in Hospitals Calm Patients and Visitors

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It can be stressful and time-consuming for patients and visitors to become accustomed to navigating large, unfamiliar hospitals, and so an architecture researcher tested a simple remedy: to let nature in with the use of indoor greenspaces and large windows.

Research conducted by West Virginia University’s associate professor Shan Jiang showed that introducing nature into large hospitals can humanise the institutional environment and reduce the stress of patients, visitors and healthcare providers.

Prof Jiang made use of immersive virtual environments for a controlled experiment that asked participants to complete various wayfinding tasks in a simulated hospital.

Though participants saw the same layout, one group encountered large windows and nature views among the corridor walls. The control group meanwhile saw solid walls without any daylight or views of nature, more like a typical modern hospital. Participants in the greenspace group used shorter time and walked less distance to complete wayfinding tasks.

“In terms of spatial orientation and wayfinding, window views of nature and small gardens can effectively break down the tedious interiors of large hospital blocks,” Prof Jiang said, “and serve as landmarks to aid people’s wayfinding and improve their spatial experience.”

In the greenspace group, participants’ mood states, particularly anger and confusion, were also found to be “significantly relieved”.

Prof Jiang’s findings are published in the Health Environments Research and Design Journal.

Based on prior research, it’s estimated that a patient or hospital visitor must go through at least seven steps in the wayfinding process to arrive at the final destination. WVU’s Center for Health Design cites wayfinding issues as an environmental stressor and a concerning topic in healthcare design.

Prof Jiang said that she was prompted to do the study by those factors, coupled with her own personal experiences (her family members have worked in healthcare) and others’ accounts of feeling lost in hospitals.

“Large hospitals can be visually welcoming but the functionality and internal circulation are indeed complex and confusing,” she said.

Greenspaces positioned at key decision points, such as main corridors or junctions, can help improve navigation.

With a background in landscape architecture, Jiang has been interested in the immediate surroundings of people in a smaller scope, particularly the indoor-outdoor relationship and the boundaries between architecture and landscapes.

Gardens and plants also tend to have strong therapeutic effects on people, she found.

“You may explain such therapeutic effects from multiple perspectives: people’s colour/hue preferences tend to range from blue to green, nature and plants are positive distractions that could restore people’s attentional fatigue, and human beings could have developed genetic preference of greenery from evolutionary perspectives,” Prof Jiang said. “All mechanisms together contribute to the positive experience when looking at gardens and nature views.”

Prof Jiang noted that many European hospitals have successfully integrated “hospital in a park” concepts. In the United States, the Lucile Packard Children’s Hospital Stanford in California has patios and window nooks in every patient room, and most rooms have direct views of a large healing garden, she said. The Alder Hey Children’s Hospital in the UK was literally built in a park.

Source: West Virginia University

Categories : HospitalsTags :

A New Easy-to-Apply Antimicrobial Coating

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Image by Quicknews

Researchers have developed an inexpensive, non-toxic coating for almost any fabric that decreases the infectivity of SARS-CoV-2 by up to 90%. It could even be developed to be applied to fabric by almost anyone.

“When you’re walking into a hospital, you want to know that pillow you’re putting your head onto is clean,” said lead author Taylor Wright, a doctoral student at the University of British Columbia. “This coating could take a little bit of the worry off frontline workers to have Personal Protection Equipment with antimicrobial properties.”

Researchers soaked fabric in a solution of an antimicrobial polymer which contains a molecule that releases reactive oxygen species when light shines on it. They then used UV light to turn this solution to a solid, fixing the coating to the fabric. “This coating has both passive and active antimicrobial properties, killing microbes immediately upon contact, which is then amped up when sunlight hits the cloth,” said senior author Professor Michael Wolf.

Both components are safe for human use, and the entire process takes about one hour at room temperature, said Wright. It also makes the fabric hydrophobic, without sacrificing fabric strength. The researchers detailed their study in American Chemical Society Applied Materials & Interfaces.

The coating can also be used on almost any fabric, with applications in hospital fabrics, masks, and activewear. While other such technologies can involve chemical waste, high energy use, or expensive equipment, the UBC method is relatively easy and inexpensive, said Wright. “All we need is a beaker and a light bulb. I’m fairly certain I could do the whole process on a stove.”

To test the coating’s antimicrobial properties, the researchers bathed treated fabric in bacterial soups of Escherichia coli and Methicillin-resistant Staphylococcus aureus (MRSA). They found that 85% of viable E. coli bacteria remained after 30 minutes, which fell to three per cent when the treated cloth was exposed to green light for the same amount of time. Similarly, 95% of viable MRSA bacteria remained, dropping to 35% under green light. No bacteria remained after four hours.

While sunlight or fluorescent lights have a lesser percentage of green in their spectrums, the team expects similar but less intense results for fabric exposed to those light sources, said Wright. “Particularly in the Pacific Northwest, it’s not always a sunny day. So, at all times you’re going to have that layer of passive protection and when you need that extra layer of protection, you can step into a lit room, or place the fabric in a room with a green light bulb – which can be found for about $35 online.”

The researchers also looked into whether the coating reduced the infectivity of SARS-CoV-2 by bathing treated fabric in a solution of the virus particles and then adding that solution to living cells to see if they could infect them. They found the passive properties were ineffective against the virus, but when treated fabric was exposed to green light for two hours, there was up to a 90% drop in the virus’ infectivity. “In other words, only one tenth of the amount of virus signal was detected on cells infected with the UV-fabric and light treated virus”, says co-author Professor François Jean.

The team found they needed an 18cm2 piece of fabric to kill microbes with material containing 7% of the active ingredient by weight, but that increasing this to 23% increased the effectiveness of the fabric at four times less material, said Wright.

Researchers also found that keeping the fabric under green light for more than 24 hours failed to produce the sterilising forms of oxygen, highlighting an area for further study. This is a similar effect to the colour fading on clothing after being exposed to sunlight for too long.

“Biomanufacturing face masks based on this new UBC technology would represent an important addition to our arsenal in the fight against COVID, in particular for highly transmissible SARS-CoV-2 variants of concern such as Omicron”, said Prof Jean. The coating can also be used for activewear, with an ‘anti-stink’ coating applied to areas where people tend to sweat, killing off the bacteria that makes us smell. Indeed, hospital fabric and activewear companies are already interested in applying the technology, and the university has applied for a patent in the United States, said Prof Wolf.

Source: University of British Columbia