This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti...cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, base...d on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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Diabetic foot ulcers are a complication affecting approximately 15% of the total population with diabetes mellitus. There are three and half million diabetic patients in Saudi Arabia alone. Aim: to determine capacity building for nurses’ knowledge and practice regarding prevention of diabetic foot... complications. Research Questions: 1. Does the nurse’s knowledge prevent diabetic foot ulcer and other foot complications? 2. Does the high practice of the nurses during foot screening can prevent diabetic foot ulcer in primary health care centers in Saudi Arabia? Design: Descriptive, research designs have been utilized. Setting: Chronic disease clinic in primary health care centers in Jeddah city. Subjects: a purposive sample of 30 nurses and convenience sample of 30 patients. Tools: A. Diabetic foot ulcer Structured interview questionnaire to assess nurse’s knowledge regarding diabetes mellitus and diabetic foot. B. Health status assessment questionnaire to assess health history status of diabetic client. C. An observational checklist to assess the nurse practice once during diabetic foot screening. Results: Significant increase in nurse's knowledge had been observed, while the majority of them had poor practice in relation to foot screening. Whereas complicated diabetic patients represent 35.7% of diabetic patients have neuropathy. Moreover, only 7.1% have neuropathy and diabetic ketoacidosis. Also there was a significant moderate positive correlation between the overall score of nurse’s knowledge and the overall score of the practice regarding diabetic foot complications. Conclusions: Proper foot care, early recognition and management of risk factors prevent foot ulcer. Recommendations: Developing a structured training educational program for nurses dealing patients with diabetic foot disorders.
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Disaster Preparedness Training Programme
L’évaluation externe de la qualité (EEQ) est une composante importante des systèmes qualité des services de transfusion sanguine. L’EEQ est l’évaluation externe de la qualité générale des résultats obtenus par un laboratoire dans l’analyse d’échantillons de contrôle dont le cont...enu est connu, mais n’a pas été dévoilé, et la comparaison de ces résultats avec ceux qu’ont obtenus d’autres laboratoires qui ont analysé les mêmes échantillons. Dans les laboratoires qui pratiquent le dépistage des infections transmissibles par transfusion (ITT) dans les dons de sang, la participation à l’EEQ aide à surveiller et améliorer la qualité des résultats. Les informations issues de l’EEQ permettent d’améliorer continuellement la qualité en mettant en évidence les erreurs d’un laboratoire et d’appliquer des mesures pour éviter qu’elles se reproduisent. L’EEQ joue ainsi un rôle essentiel dans l’amélioration de la sécurité transfusionnelle.
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It is our hope and prayer that the guidance and multiple tools provided herein to manage
the entire lifecycle of a food security program are useful to our food security staff, our
local partners, and our fellow international Cooperating Sponsors throughout the world.
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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The value of this assessment is both in the DOING and in the outcome.
You do need to keep in mind the maturity of your organization and not expect that a newly formed NGO have in place many of the mechanisms and structures mentioned in the assessment form.
But this does give the interested NGO... leader, a way to monitor your NGO’s development and also to take note of various aspects of NGO work that might be implemented in the coming months.
Accessed 26th of November 2015.
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Strengthening health-system emergency preparedness.
A Modular Manual. This practical, experience-based, action-oriented manual on Analysing Disrupted Health Sectors in crisis includes: countries on the verge of an economic, political and/or military catastrophe, protracted crises and situations of transition from disaster to recovery. The intended us...ers are apprentice analysts, already with field experience, familiar with quantitative techniques, attempting to analyse a disrupted health sector
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Core Knowledge for Emergency Preparedness and Response
Yemen has already lost 2 decades of Human Development
The study warns of exponentially growing impacts of conflict on human development. It projects that if the war ends in 2022, development gains will have been set back by 26 years — almost a generation. If it continues through 2030, that setbac...k will increase to four decades.
Large File 35 MB!!!
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The map shows access constrainst as of 10 April 2019.
The CHW Toolkit assists the assessment, improvement, and planning of CHW programs by deepening understanding of the elements of successful programs and the use of best practices as an evidence-based approach to improvement. The toolkit is framed around ten key themes that describe the definition, en...try level, age, gender, recruitment, training, scope of work, supervision, career progression, entry level and remuneration of CHWs.
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Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ...ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
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