Discharge Policy Analysis in Prince Hamzah Hospital

A discharge policy is intended to ensure provision of fit, timely discharge arrangements to an appropriate safe environment for all patients on completion of their hospital care. This paper analyzes the current discharge policy in Prince Hamzah Hospital, to discover if it can be made more effective. The analysis is based on Patton and Sawicki’s six-step model of policy analysis. According to Patton and Sawicki’s six-step model of policy analysis, the process involves problem identification, determining policy objectives, establishing evaluation criteria, suggesting and assessing possible alternatives, and implementing, monitoring, and evaluating the policy after modification. It was concluded that the policy should remain a live document that could be refined, updated and expanded as appropriate.

Seclusion Room in Psychiatric Setting (National Center for Mental Health): Policy Analysis

Background: Improving the quality of care in psychiatric settings is the most important goal of policy through the delivery of a comprehensive care, treatment, control, protection, and rehabilitation of patients with mental disorders. The main concern in mental health care is the continuing use of seclusion and the slow pace of change. Purpose: Analyze the seclusion room policy in National Center for Mental Health (NCMH) in Jordan to recognize the issue and present alternative solutions in order to modify and improve the current seclusion room policy. Method: The authors got seclusion room policy from NCMH;the method in this analysis will be used six-step model;and then searched the database for alternatives using EBSCO, PUBMED, MEDLINE, CINAHL, and Ovid. Result: The authors discuss use medications, training program, manipulate environment, de-escalation technique, and status quo alternatives that helps in minimizing use of seclusion, decreasing the incidence of aggressive behaviors occurrences, and decreasing unsafe behaviors against health care providers in the psychiatric settings. Conclusion: Manipulates environment is the best alternative after evaluated alternatives according to criteria.

Invasive Procedures and Length of Stay among Critically Ill Patients in ICU over Three Years: A Retrospective Study

Introduction: Intensive care unit (ICU) provides advanced specialized medical and nursing care for critically ill patients. Advanced monitoring techniques are needed to prevent physiologic deterioration, while the underlying disease treated and resolved. Frequents invasive procedure and treatment are used and affect the death rate and length of hospitalization. This study aimed to describe the variables associated with critically ill patients and describe the standard invasive procedures or treatments used among patients in ICU. Method: A retrospective comparative study which utilized the ICU electronic database. The data of 446 dead patients who have admitted to ICU between January 2014 and December 2016 as a case of sepsis, heart failure or COPD exacerbation were enrolled. Result: Almost of all patients had received intravenous fluid and vasoactive drugs. The mechanical ventilation support and insertion of the indwelling urethral catheter commonly used among patients with critical illnesses;78.3%, 41.3% respectively. One-third of all sepsis and heart failure patients were received CVC during ICU stay;patients with sepsis illness had less hospital length of stay than patients with heart failure and COPD (p Conclusion: We found a reduction in the death number among sepsis, heart failure and COPD patients with move forwards in years, the variety of death rate depends on the type of invasive procedure and treatment performed for each illness, mechanical ventilation support and insertion of indwelling urethral catheter commonly used among patients with critical illnesses.

Biphasic Insulin Aspart 30 Therapy in Insulin-Naïve and Insulin-Experienced Patients with Type 2 Diabetes: Results from the Jordanian Subgroup of the A₁chieve Study

Objective: To analyse the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in a Jordanian subgroup of the 24-week, non-interventional A1chieve study. Methods: A total of 509 Jordanian patients with type 2 diabetes (392 insulin-naive and 117 insulin-experienced) starting BIAsp30, alone or in combination with oral glucose-lowering drugs, were included. Safety and effectiveness outcomes were analysed over 24 weeks. Results: Patients had a mean age of 55.8 years, body mass index of 28.8 kg/m2 and diabetes duration of 9.4 years at baseline. Two serious adverse drug reactions of hypoglycaemia were reported. The proportion of patients who reported major hypoglycaemic events decreased (2.4% at baseline vs. 0.2% at Week 24, p = 0.0039). The proportion of patients reporting overall hypoglycaemia increased marginally (6.3% at baseline vs. 9.9% at Week 24, p = 0.0378), primarily attributed to a rise in minor and nocturnal hypoglycaemia reported in insulin-naive patients. From baseline to Week 24, the mean ± SD glycated haemoglobin A1c level decreased from 9.8% ± 1.4% to 7.4% ± 0.9% (p < 0.001). Significant reductions after 24 weeks were also noted in the mean fasting plasma glucose, postprandial plasma glucose, lipids, systolic blood pressure and quality of life (all p < 0.001), while the mean body weight increased by 1.8 ± 6.5 kg (p < 0.001). Conclusion: Overall, BIAsp 30 therapy was well-tolerated and resulted in improved glycaemic control in this Jordanian subgroup over 24 weeks.

Effects of Prophylactic Laxatives for Opioid-Induced Constipation on Constipation Severity and Quality of Life among Patients with Cancer

Background: To reduce patients’ unnecessary suffering, Opioids Induced Constipation (OIC) should be identified and treated as early as possible with the most current treatment. Aims: to investigate the effectiveness of prophylactic laxatives in reducing the severity of OIC and its impact on cancer patients’ quality of life. Methods: A Randomized Clinical Trial design was used. 57 cancer patients from one oncology clinic at a governmental hospital participated in the study. Patients in the intervention groups were given an oral colonic stimulant laxative (i.e. Bisacodyl, Dose = 3 tab/day) or an oral colonic osmotic laxative (i.e. Lactulose, Dose = 15 ml three times per day), while patients in the control continue receiving their routine care as usual. Results: A significant decrease in the severity of constipation symptoms among the intervention group at four weeks post-intervention was noted (p Conclusions: It can be concluded that the use prophylactic of first line laxatives concurrently with opioids decreased the severity of OIC and improved the QOL for cancer patients.