Dr Ghassan Al-Sabbagh MD - Gastroenterology and Hepatology SpecialistGhassan Al-sabbagh MD
Dr Ghassan Al-Sabbagh MD is a professional doctor expert in Gastroenterology and Hepatology. Ghassan Al-Sabbagh has done Doctor of Medicine from Damascus University School of Medicine
Dr Ghassan Al-Sabbagh MD - Gastroenterology and Hepatology SpecialistGhassan Al-sabbagh MD
Dr Ghassan Al-Sabbagh MD is a professional doctor expert in Gastroenterology and Hepatology. Ghassan Al-Sabbagh has done Doctor of Medicine from Damascus University School of Medicine
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
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The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
2. Joseph F. Sullivan Center
• The Sullivan Center is a
Nursing and Wellness Clinic.
It is run by nurses and nurse
practitioners and serves both
Clemson employees and the
underserved community in
the area.
• Located on the first floor of
Edwards Hall on Clemson’s
campus and various off-site
locations
Joseph F. Sullivan Center
College of Health, Education, and Human
Development
101 Edwards Hall Clemson, SC
864-656-3076
3. Vision: The Joseph F. Sullivan Center is an
integrating force for creating multidisciplinary
partnerships focused on innovative methods to
enhance community well-being that promotes
human development, skill building and creative
leadership.
http://www.clemson.edu/centers-institutes/sullivan/aboutus/Mission.html
4. Mission Statement/ Goals
Mission: The Joseph F. Sullivan Center will drive community
health research initiatives providing innovative, real-life student
learning.
Values:
o Relationships define health.
o Holistic balance is wellness.
o Affordable care is a right of all
o Transdiciplinary teams promote
positive skills.
o A global and environmental
perspective is critical to human
development.
http://www.clemson.edu/centers-institutes/sullivan/aboutus/Mission.html
5. Services Offered
• Acute care is provided onsite by nurse practitioners and other providers.
• Health management services are provided to help patients monitor
chronic conditions or to screen for potential diseases.
• CU4Health is a health promotional service offered to Clemson employees,
faculty, and staff which includes a health risk appraisal, blood work, blood
pressure and BMI screening, and a follow-up counseling session with a
trained health educator to review your results and help lower risk areas.
• Medical Surveillance and Immunizations
• Dermatology and Acupuncture Services
• Best Chance Network is a program that works towards reducing breast
and cervical cancer deaths through early detection and prevention by offering
free breast and cervical cancer screenings in women aged 47-64 who are
uninsured and meet certain income guidelines.
• Walhalla and Clemson Free Clinics serve the low income uninsured
population in the local area by traveling to locations that are convenient to
patients and offering services to patients regardless of their ability to pay.
6. My Roles
• Taking vital signs (blood pressure, height, weight, temperature,
heart rate)
• Taking patient health history and reason for visit
o Becoming proficient at Allscripts (charting)
• Performing lab tests (UA, glucose, hemoglobin, pregnancy test)
• Keeping rooms clean and restocked
• Preparing for BCN and off-site clinics and making Wise Women
binders
• Conducting CU4Health Counseling
• Stock room (unpacking new materials and keeping it organized
and documenting where supplies are located)
7. Vital Signs
• While working at the Sullivan
Center, I learned how to take
a patient’s vital signs, both
electronically and manually.
• These vital signs included
height and weight
measurements, as well as
temperature and blood
pressure.
8. Patient Work Up
• I learned the importance of
getting a complete health
history of a patient to give
the provider a holistic view
of the patient’s health.
• I also learned the value in
taking a thorough and
efficient patient intake to
allow the providers the most
concise yet effective time
with their patients.
9. Proficiency With Allscripts
• Allscripts was the Electronic
Health Record that the
Sullivan Center used to chart
patient information.
• With Allscripts I learned how
to input vital signs, chart
patient history and reason for
visit, as well as ordering and
inputting laboratory results.
10. Flu Shot Work Up
• During the fair I charted 200
patients.
• For the Clemson Employee
Benefits fair, my job was to
chart the employees who
received flu shots.
11. Performing Lab Tests
• Often, I would perform
routine in-house lab tests.
• These tests included:
Urinalysis, Glucose,
Hemoglobin, Pregnancy, and
Strep.
12. Clean & Restock
• It was also my job to
maintain the cleanliness of
each of the four exam rooms
after patient visits and make
sure they were restocked for
the next patient visit.
13. • The Sullivan Center runs two
off-site clinics and a Best
Chance Network for the
underserved communities in the
surrounding area.
• I was responsible for making
sure the materials were gathered
and packed for each off-site and
BCN clinic.
• This included packing the Wise
Women binders that contained
health wellness information for
the women involved in the BCN
program.
Off-Site & BCN Clinics
14. CU4Health Counseling
• I conducted follow-up
counseling sessions with
patients regarding lab results
of blood work and a health
risk appraisal analyzing their
lifestyle and health habits and
identifying ways to lower
their risk for certain chronic
diseases.
15. • During my internship, I was
assigned special projects to
work on throughout the
semester.
o Keeping storage room neat and
organized
o Documenting where all storage
room supplies are kept
o Making sure BCN and WW
supplies are packed for each
visit
o BCN Packing Materials
document
Projects
16. Conclusion
Overall, I thoroughly enjoyed my internship at the
Joseph F. Sullivan Center. In addition to the tangible
skills of charting, taking vital signs, working with
health technology, and working up patients, I have
learned the importance of working well with a team
to create an efficient and effective practice with a
focus on patient-centered care. I have also gained a
better appreciation for the need of care for
underserved populations. It has been empowering
knowing that I can use my healthcare knowledge to
make a difference in my community.