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HSS
Hospitals Services Sector
© DHA, Hospitals Services Sector, Monthly Newsletter, Volume 05, September 2011
المـدير التنفيذي لمـستشفي دبــي-كلمة الدكـتور عبـدالرزاق الـمدني
تهنئـة بمناسـبة عيـد الفطـر الـمبارك
انه لمن دواعي سروري أن أهنئكم جميعا ً بمناسبة حلول عيد الفطر المبارك أعاده هللا علينا وعلى األمة
.اإلسالمية والعربية باليمن والخير والبركات
بالصيام،شهر رمضان المبارك فرصة ثمينة لتطهير أنفسنا روحانيا ً وجسديا من جميع الذنوب والخطايا
.واإلكثار من الصالة وتالوة القرآن وبنهاية الشهر يتم االحتفال بالعيد وما يحتويه من مسرة وبهجة
إننا المسلمين محظوظين جداً كوننا نعيش في دولة عربية تتخذ من ديننا اإلسالمي الحنيف منهجا ً للرقي بحضارة األمة
ونستطيع ممارسة شعائرنا الدينية بكل فخر واعتزاز كاحتضان شهر رمضان الكريم واالحتفال بعيد،اإلسالمية والعربية
.الفطر المبارك وغيرها من المناسبات الدينية بكل ما تحتويها الكلمة من معنى
ألدعو جميع سكان دولة اإلمارات العربية المتحدة سوا ًء كانوا من مواطني دولتنا الحبيبة أو من المقيمين،وانتهز هذه المناسبة
باغتنام هذه الفرصة والمشاركة في االحتفاالت بعيد الفطر بكل حماس واالستفادة من األجازة الخاصة،على أرضها الطيبة
. لتوثيق أواصر الصلة بين األهل واألصدقاء بالتزاور،لهذه المناسبة السعيدة
ً
، وخصوصا بعد شهر رمضان وما يتم فيه من ضبط النفس،)كطبيب أود أن أؤكد على أهمية تطبيق مفهوم (االحتفال الصحي
ولكن من المستحسن أن تراقب عدد،فمن الطبيعي أن تكون لدينا رغبة ملحة في تناول وجبات دسمة خالل احتفاالت العيد
كما يجب عليك االلتزام بالنظام الغذائي الخاص بك والسيما إن كنت مصابا ً بداء السكري،السعرات الحرارية التي تتناولها
.أو ارتفاع ضغط الدم أو أي أمراض صحية مزمنة أخرى
كل عام وانتم بخير وعساكم من عواده
Eid Al Fitr Al Mubarak!!
It is my great pleasure to address otherwise busy lives. Observing Zakat is a
you all on the auspicious and joyous necessity for us and to obtain great blessings
occasion of Eid Al Fitr. With great faith and from Allah, we should extend ourselves to
delight, we cleansed ourselves spiritually the under-privileged people around us. Send
and physically during Ramadan and now them your support in advance, whether as
we are enthusiastically looking forward to money or food or clothes, and help them
celebrating Eid and rejoicing in the rewards celebrate the Eid.
and blessings from Almighty Allah.
As Muslims living in an Islamic Nation, we As a physician, I would like to emphasize the
are privileged that we can celebrate the Holy importance of a “Healthy Celebration”. After
month and the Eid in its full meaning and the self-denial exercised during Ramadan, it
vigor. is natural that we will have an urge to overeat
I call upon each one of you to utilize this great during the Eid celebrations.
blessing and observe the holiday appreciating But it is highly advisable to count your
the full spiritual, social and physical benefits. calories and keep a close watch on your diet
It is indeed a great sight to see all UAE especially if you have diabetes, hypertension
residents, irrespective of their religion, or any other chronic health conditions.
energetically joining us in the festivities. Wishing you all a peaceful, healthy and
Since we observe National Public Holidays blessed Eid
during Eid, therefore, we have the opportunity
to get-together with our friends and families Dr. Abdulrazzak Almadani
which is highly relevant considering our CEO- Dubai Hospital
Layout Artist: Amir Javanpour 1
Dubai Gynaecology & Fertility Center
DGFC Dubai Gynaecology & Fertility Center
is a regional centre for assisted
reproduction and a leading Gulf centre for INFERTILITY
TREATMENT. His Highness Sheikh Hamdan Bin Rashid Al
Maktoum officially opened the centre in 1991. It is the only
government centre in the UAE addressing the specialized
field of infertility treatment. Since 1991, the centre has seen
couples from the Middle East, Asia, Africa and Europe. The
centre is managed by a hand-picked team of qualified and
experienced medical professionals and a patient relation
team catering to different cultural needs of the patients. 180 children reunion party
DGFC is equipped with ‘state-of-the-art’ technology and
medical equipments in Operating Theatre, Laboratory and
Ultrasonography Department. In 2009, the centre shifted
from Rashid Hospital premises to it’s current location in
Dubai Healthcare City (DHCC) which is the medical hub of
Dubai. DGFC has been involved in clinical research [Anti-
Mullerian Hormone poor responders, PCOS (Poly Cystic
Ovarian Syndrome) patients].
A Baby party was organized recently at the centre on the
occasion of 180 babies being born as a result of treatment
at the centre in DHCC (see photos below). DGFC has been
receiving visiting experts in the field of infertility treatment,
exchanging experiences, discussing difficult case scenarios Mother & baby share their joy with DGFC staffs
and indulging in mutual laboratory cooperation. All these
efforts have enabled us to maintain our position as a leading
centre for Reproductive Medicine in the Middle East. An
Annual Emirates Obstetrics/Gynecology & Fertility Forum
(EOFF) 2011 is being organized in Dubai this year from
October 20th till 22nd. (To see the flyer, Click here).
Twin treat from DGFC
DGFC’s hardworking doctors & paramedical staff
An elated mom & gift of triplets to her
www.dha.gov.ae 2
Interview w
ith Nawal Juma, S
taff Nurse of TC
Thank you for coming to Head I strongly prefer to work in clinical units with all
Quarters for this interview, can you challenges even though nursing is a difficult job. My duty
please introduce yourself? timings (12 hours) are very exhausting but I am happy with
I’m Nawal Juma, 25 years my profession and I like it. However, I am not very fond of
old, just got married (I met him in the administration as a profession because it is very complicated
hospital!!!) and I have six brothers and I need more support.
and five sisters.
What is your grade and what do you think about the nurses’
Great, can you please tell me about income?
Ms. Nawal Juma your education and when you joined I am grade 9, but I think that nurses deserve more
Emirati Staff Nurse DHA? than the current remuneration as they have a difficult job. You
Trauma Center
I completed Bachelor’s should be a nurse to understand what I mean.
Ward: 18
Degree in Nursing from Sharjah
Trauma & Surgical Unit
University in the year 2009 and then,
I joined DHA after four months.
How did you decide to go for Nursing profession?
Actually, once my Aunt visited us at home and she
gave me a brochure advertising Nursing program for UAE
nationals. As I went through the brochure, I found that a lot of
facilities were offered for UAE nationals. Till that time, I had
never thought about pursuing Nursing as a profession, but
information in the brochure convinced me to study Nursing
in order to get a lot of benefits after graduation. But I now
realize that the information was not accurate at all.
Interviewer: Mr. Amir Javanpour
While I was in second year of my training in hospitals, I
came face to face with the reality of nursing profession. I was What is your favorite quote?
shocked as I was not briefed correctly before or else, it would I like this Hadith: إن هللا يحب إذا عمل أحدكم عمال أن يتقنه
have be easier for me to accept the truth. It means: God loves those who are good at the work they do.
If you could go back in time, what would you choose to do? Would you like to share your recent achievements with the
Hmm!!!, I might go for Laboratory discipline or readers?
Medicine, but at the same time, I would like to clarify that I Yes, I was part of a group which represented UAE
have come to terms with the fact that I am a nurse now and I nurses in International Council of Nurses (ICN) Conference
am trying my best to be a good nurse and I like Nursing very 2011 in Malta and delivered a speech about; “GIVING NEW
much. I have a problem with giving false information to the EMIRATI NURSES A VOICE”.
public, otherwise everything is alright.
After our successful participation in the international
What are your plans for future? congress, I reported our trip achievements to Rashid Hospital
Well, my plan is to apply for Charge Nurse post in staff during Thursday meeting in the Auditorium.
Surgical Unit in the near future. And my future plans also
include pursuing Master’s Degree in Zayed University or any We were also invited to Dubai TV for a television show to
other university that is affordable. discuss UAE national nurses’ status and other related issues.
That program was warmly welcomed by UAE people.
Do you prefer to work directly with the patients or in
administration in an office setting? Thank you Ms. Nawal Juma once again, and good day!
3
Modified Early Warning Signs MEWS
MEWS a scoring system that identifies high-risk patients using vital signs as physiological
indicators. The vital signs are converted into scores. The higher the score, the more
interventions and support are required
Score 3 2 1 0 1 2 3
Temperature Less than 35.0 35.1 to 36 36.1 to 37.9 38. to 38.9 More than 39
Systolic BP Less than 70 71 to 80 81 to 100 101 to 179 180 to 199 More than 200
Heart Rate/Min less than 40 40 to 50 51 to 100 101 to 110 111 to 129 More than 130
Resp. Rate/Min 8 or less 9 to 18 19 to 25 26 to 29 More than 30
Conscious level Responds to pain Respond to
Alert
New agitation,
Mr. Fouad Hussein Chehab
(AVPU) / Unresponsive voice confusion
Asst. Director of Nursing
SPO2 89% or less 90 t0 93% 94 to 96% Greater than 96% Rashid Hospital
How it works;
»
»Upon admission, at the start of each shift, or more often if indicated, patients are assigned a MEWS score based on six
vital signs: Heart Rate, Blood Pressure, Respiratory Rate, Temperature, Level of Consciousness (AVPU scale) and Level of
Oxygen Saturation. [AVPU – Alert, Voice, Pain, Unresponsive]
» nurse logs the vital sign data on the vital signs chart and a number ranging from 0-3 is assigned to each of the parameters.
»A
»
»The nurse then calculates a total MEWS score that corresponds to a set response ranging from: 4 hourly observation/2
hourly observation/One hourly close observation on designated bed/One hourly observation with continuous monitoring on
designated High Dependency Beds or Intensive Care Unit (ICU) beds
MEWS was implemented in Rashid Hospital as a pilot in Medical, Surgical and Neurosurgical units on 24th May 2010 and the
program went hospital-wide on 26th Sep 2010. Nurses and Doctors were trained prior to implementation.
Purpose
1. To improve the quality of patient observation and monitoring.
2. To improve communication within the multidisciplinary team with regards to changes in patient condition.
3. To ensure timely intervention for the deteriorating patient.
4. To support timely nursing and medical decisions in placing patients on proper beds with appropriate observation level.
5. To decrease number of patients in Emergency Department (ED).waiting for admission
It must be emphasized that the MEWS system may not trigger a score in some patients who are or becoming acutely unwell.
Therefore, healthcare practitioners must remember this tool alone will not always highlight when a patient is deteriorating and
should be used to guide best practice. Healthcare practitioners must use their clinical judgment in conjunction with the MEWS
tool at all times.
Outcome:
»
»MEWS is found to be an effective system for early detection of deteriorating patients.
»
»MEWS provides consistency of patients’ observations.
»
»MEWS helps in better utilization of high dependency beds and close observation beds
»
»MEWS reduced the number of patients waiting in ED for admission as an inpatient.
The following Graphs show the effect of MEWS on number of patients waiting in ED for admission:
Number of patients attended ED Number of patients waiting in ED for admission
from Jan to Dec 2010 from Jan to Dec 2010
14000 700
12000 600
10000 500
8000 400
6000 300
4000 200
2000 100
0 0
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan
(This shows marked reduction in total number of patients waiting
for admission in October, November and December 2010)
These outcomes reflect the cooperation between Medical, Nursing and Case
Management Departments and the full support of Rashid Hospital Executives.
www.dha.gov.ae 4
Al Wasl Hospital HAND HYGEINE CAMPAIGN IN NICU
H ealthcare-Associated Infections are an important cause
of morbidity and mortality among hospitalized patients
worldwide. The importance of hand hygiene as the single
5. Provision of samples of alcohol hand rubs to all healthcare
personnel: Samples of ‘Purell’ hand sanitizer were provided
to all healthcare personnel demonstrating the hand hygiene
most important strategy to reduce the burden of infection technique.
with multidrug-resistant organisms in healthcare settings is
undisputed.
In view of the concerns related to multidrug-resistant
organisms in Neonatal Intensive Care Unit (NICU), AWH,
the NICU ICC Task Force led by Dr. Mahmoud ElHalik
in coordination with the Infection Control Team and the
Hospital Administration, decided to organize a Hand Hygiene
Campaign based on the theme “Save Lives through Clean
Hands” on 13th & 14th July 2011. It was a joint effort by all An important and interesting perception about the campaign
doctors and nursing staff working in NICU, AWH. was that of parents related to their active participation in the
hand hygiene campaign. Parents showed a lot of interest
The campaign primarily focused on improving hand hygiene in performing the proper steps of hand hygiene. They
compliance and on enhancing the knowledge and perception commented “It is a very good campaign for everybody”.
of healthcare personnel/ parents/ visitors about hand hygiene There is a need to reinforce parents on the importance of
in NICU. hand hygiene including the proper steps of hand hygiene and
also that their signatures are obtained at the time of admission
of their babies to the unit.
Activities included the following:
1. Observation of hand hygiene by all healthcare personnel/ Hand hygiene practice improvements must be maintained
parents and visitors entering the Unit and demonstration of and their sustainability can be accomplished to a great extent
the correct technique for hand hygiene. through on-going hand hygiene compliance observations,
UlraViolet (UV) light was used to demonstrate the importance staff education and providing feedback of the results of hand
of correct technique of hand hygiene. hygiene audit to all staff members. Hand hygiene campaigns
2. Distribution of hand-outs to the public (in English and should be conducted frequently in order to maximize the
Arabic languages): Hand-outs on the importance of hand potential this strategy has demonstrated for patient safety.
hygiene and the proper technique of hand hygiene were
distributed to all parents who visited the unit during the
campaign.
3. Distribution of badges to all healthcare personnel: Badges
showing the pictures of hand washing were also distributed
to all healthcare personnel as a reminder to perform hand
hygiene.
4. Conducting a survey on hand hygiene practices using a
questionnaire: All NICU Staff were asked to fill out a simple
questionnaire on hand hygiene to assess their knowledge of
hand hygiene practices. Contributed by: Sheela Anne George,
Infection Control Practitioner On behalf of NICU, ICC Task Force, AWH
S t o p I n f e c t i o n
Fight germs by making sure your hands are clean
before and after you come in contact with a patient.
www.dha.gov.ae 5
Winner of previous JAP question is:
Ms. Marlene R. Estrella
Pain Link Nurse – Ward 24
Rashid Hospital
Previous JAP question:
O ne of the new JCIA standard requirements for hospitals, Fourth Edition, Effective
1st January 2011 is to have policies and procedures that address patient’s right to
seek a second opinion without fear of compromise to their care within or outside the
organization (Patient and Family Rights - PFR.2, Page 63).
List the important components that should be covered in
the policy?
To view the correct answer, Click here
Be a Winner with JAP
Answer this question and be the lucky winner of 200 AED gift voucher!
P atients, or those making decisions on their behalf, may decide not to proceed with the
planned care or treatment or to continue care or treatment after it has been initiated.
As per JCIA standard requirements, what information is expected from hospitals to
patients and families who refuse or discontinue treatment?
Please send your answers by email to: Dr. Mohammed Amber Khan (Click) before (17/09/2011)
Do not forget to mention following information in your email:
■■Your Name
■■Staff Number
■■Organization Name
■■Contact Number.
A note from the editing manager!
HSS appreciates you for spending time with this newsletter which is a channel of
communication among staff.
HSS newsletter will be released on a monthly basis.
We will be more than happy to hear from you to help us improve further.
Kindly feel free to contact me if you have any news/ articles that can be published by HSS
newsletter.
Please send your valuable comments and any feed back related to the contents or design of the
newsletter to Mr. Amir Javanpour on 219 7210, My email; AJPour@dha.gov.ae.
Special thanks to Dr. Mohammed Amber Khan for his contribution to text review.
www.dha.gov.ae 6
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