BACKGROUND Although modern psychiatric services seek alternatives to hospitalisation wherever appropriate, the national trend toward higher bed occupancies on acute psychiatric wards has refocused attention on community-based alternatives and methods of assessing reed for acute care. METHOD We surveyed key decision makers in a community-oriented district service with a low acute psychiatric b...

BACKGROUND Endemic infections because of Pseudomonas aeruginosa were observed on a surgical intensive care unit (ICU) for a period of >24 months. Tap water probing revealed persistent colonization of all ICU water taps with a single P aeruginosa clonotype. METHODS Water outlets of the ICU were equipped with disposable point-of-use water filters, changed in weekly and, later, 2-week intervals....

Despite control efforts, the burden of health-care-associated infections in Europe is high and leads to around 37,000 deaths each year. We did a systematic review to identify crucial elements for the organisation of effective infection-prevention programmes in hospitals and key components for implementation of monitoring. 92 studies published from 1996 to 2012 were assessed and ten key componen...

BACKGROUND Patient overcrowding and violent assaults by patients are two major problems in psychiatric healthcare. However, evidence of an association between overcrowding and aggressive behaviour among patients is mixed and limited to small-scale studies. AIMS This study examined the association between ward overcrowding and violent physical assaults in acute-care psychiatric in-patient hosp...

In several countries of sub-Saharan Africa more than 10% of the adult population are infected with HIV, while in large towns such as Kampala, Lusaka, Blantyre, Kigali and Harare this proportion exceeds 25%. One of the most obvious consequences is the increased occupancy of hospital beds by patients with HIV infection, perhaps to the exclusion of patients with other ailments. This paper gives an...

OBJECTIVE This paper aims to explore the options available for developing community-based care and improving the quality of care in psychiatric hospitals in Ghana. METHOD Semi-structured interviews (SSIs) and focus group discussions (FGDs) were conducted: with a cross-section of stakeholders including health professionals, researchers, policy makers, politicians, users and carers. The SSIs an...

OBJECTIVE The sudden closure of 30 out of 54 acute psychiatric beds in Cornwall presented a stressful challenge to staff but also a natural experiment on how a service dealt with this situation. We aimed to evaluate the outcomes of patients needing to leave the closed ward, how bed occupancy rates were affected and the impact on admission rates. DESIGN A service evaluation of the impact of th...

BACKGROUND Public hospitals have come under heavy scrutiny across the world owing to rising expenditures. However, much of the focus has been on cutting down costs to raise efficiency levels. Although not denying the importance of efficiency measures, this article targets a performance issue that is relevant to address the quality of services rendered in public hospitals. Thus, it is important ...