Introduction: To protect patients and healthcare providers from healthcare-associated infections (HAIs), standard precautions have been promoted universally. Nurses are the forefront force in patient care; therefore, evidence-based and up to date knowledge and practices can play a vital role in helping nurses apply standard precautions (SPs). Methods: The analytical cross-sectional study design was used. Through purposive sampling, the data were collected from 320 nurses, via, a self-administered questionnaire, from April to May 2017, from a public tertiary level hospital in Islamabad. The validity and reliability of each section was established. Mean and standard deviation were computed for continuous variables’ whereas; frequencies with percentages were calculated for categorical variables. The Multiple linear regression was applied for inferential statistics, maintaining 95% CI for important associations. Results: Out of 320 participants, the mean age of the participants were 33.04 ± 6.65 years. More than half of the study participants (66.88%) were females’ whereas 33.13% were male nurses. The mean knowledge and practice were 19.6 ±3.3 and 13.00± 5.23, respectively, with a maximum score of 24 and 25. The results showed that the knowledge of the participants were better as compared to practices, though, in general knowledge they were reported as relatively deficient. Continuing training sessions on SPs revealed a significant 0.66 (95% C.I; 1.07, 3.67) relationship with the knowledge score in the final model. Practices were found to be better. Similarly, the Hep. B vaccinated nurses showed a positive impact of 1.49 (95% C.I; 0.07, 2.91) on the level of practices in MLR. Conclusion: The overall level of knowledge and practices among female nurses regarding standard precautions were inadequate. The study findings highlighted the need to continue intensive and in-service trainings sessions on SPs of infection control, using innovative approaches.

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Objective: To assess the effect of acute myocardial infarction standard clinical pathway among acute myocardial infarction patients on length of stay in public tertiary care settings. Methods: The quasi-experimental non-randomised case-control study was conducted at the Department of Cardiology, Dr Ruth Pfau Civil Hospital, Karachi, from September to December 2018, and comprised acute myocardial infarction in-patients. Those admitted before the implementation of acute myocardial infarction standard clinical pathway formed the control group, while those admitted after the implementation were in the intervention group. Acute myocardial infarction standard clinical pathway was implemented and the interventional clinical practices of healthcare professionals, including cardiologists, postgraduates, residents, nurses and critical care technicians, were assessed using a standard checklist. Data was analysed using SPSS 21. Results: Of the 100 participants, 50(50%) were in the control group; 31(62%) males and 19(38%) females. The intervention group also had 50(50%) patients; 35(70%) males and 15(30%) females. Regarding effectiveness of the implementation of standard clinical pathway, length of hospital stays reduced significantly in the intervention group compared to the control group (p=0.003). Conclusion: The implementation of acute myocardial infarction standard clinical pathway reduced the length of hospital stay of acute myocardial infarction in- patients. Key Words: Acute Myocardial Infarction, AMI standard clinical pathway, Length of hospital stay, LOS, Angiography, Angioplasty, Health care professionals. Continue...

Objective: To determine the frequency of hyponatremia and itsassociation of with associated factors and its impact on in-hospital outcome in patients with acute ST elevated myocardial infarction. Study Design:AnalyticalStudy. Study Setting: Study was conducted at Aga Khan University Hospital, Karachi (AKUH). Subjects and Methods: This is an analytical study conducted at Aga Khan University Hospital, Karachi (AKUH) between the period of 2016 to 2017.Informed consent to enroll and use data of patients was obtained from all the 225 patients before commencing the study. All patients of age between 20 to 75 years of either gender diagnosed with ST elevation acute myocardial infarction in emergency or outpatient department were enrolled in the study.Hyponatremia was labelled as serum sodium level less than 135mEq/L (Normal is 135-145mEq/L).A detailed history was taken followed by complete examination at admission.In hospital outcomes were measured within 72 hours of admission. Report was collected and findings were noted in the Performa.Data was analyzed on SPSS Version 16. Results:A total of 225 patients admitted in Department of Cardiology, Aga Khan University Hospital, Karachi were included in this study. Mean age in our study was 56.80±7.56 years.135 (60%) were male and 90 (40%) were female. Out of 225 patients, 43 (19.1%) had hyponatremia and 182 (80.9%) did not have hyponatremia. In-hospital mortality was 22 (100%) who had hyponatremia. Conclusion:The results showed that hyponatremia has very strongly association with in-hospital mortality. Cardiovascular mortality among patients with acute STElevationmyocardial infarction. Plasma sodium levels may serve as a simple marker to identify patients at risk. Key Words: Acute ST elevated myocardial infarction,Hyponatremia, in-hospital mortality, associated factors.

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