April - The International Hospital of Bahrain

Transcription

Issue No. 6
an IHB in-house publication
www.ihb.net
|
Volume 1
|
APRIL 2012
Monthly Newsletter
International Hospital of Bahrain
W.L.L.
the tomato garden
This time the scene is a small town in the United States. Our story is about an old, retired gentleman living all alone
in a small house on a small plot of land. He always grew tomatoes and other vegetables on his plot. He enjoyed that.
It brought him some income. But what is most important, the manual work made him feel self-actuated and happy.
His only son always helped the old man with his gardening over the years. The gardening bonded father and son.
Lately the son was arrested by the police; accused of murdering someone and was put behind bars. This time the
police did not find the body. The police had to find the body of the victim. They very much wanted to find the dead
body. This is crucial to their kind of work. They had to find the body. This is their job. The incarcerated son stuck to
his, "I do not know about any body" spiel. He denied the murder, and denied any knowledge of a body.
The old man was not only saddened by his son's incarceration, but he really missed his son. He felt bad about him
being put away, and acutely felt his absence. The old man felt too old to continue digging his garden. It seemed such
a very big job. What is worse, digging his garden reminded him of how much he missed his son, and how much of a
great help his son was to him. With his failing health, his missing his only son and not able to do his gardening the
old man wrote to his son to express his feelings. His letter to the son went something like this: "My dearest son, I do
miss your being with me. I tried to do the gardening today, but I could not do the digging. It was back-breaking and
very hard. How much I wish you were here with me. You would have done it all in no time. I will not enjoy the tomatoes and the rest of the vegetables this year. How I wish you to be here with me." Or something to that effect, of
course not in English but in Americanese.
The son sent an urgent letter to his dad, with the letter marked in big letters, "Confidential and Urgent". Again in
Americanese the letter went something like this, "Hey, dad. Don’t dig the garden, whatever you do. Sure you will get
me into real trouble if you do."
The prison authorities intersected the letter. They read its contents. It meant only one thing to them. The body. Yes,
the body must be buried in the old man’s garden. Otherwise why would the son tell the father not to dig the plot?
The smart police all agreed that it can only mean that there is where the body was buried. Quietly and without causing suspicion the intelligent police obtained authority to dig the old man’s garden.
Very early at dawn the next day the police were on the old man’s garden; digging for the body. You see, they did not
want to lose any time incase someone else got wiser and did something about the body, maybe moving it. The police
are smart. They were very confident that the son’s note to the father will lead them to the body of the victim. Yes,
the prisoner buried the body of his victim in his father's garden. There was no doubt. The police all agreed. It made
sense. It was logical. It is all obvious what has to be done. So without losing any time they let their tractors, diggers,
and experts attack the old man’s plot of land digging for the missing body.
They were sure they were onto something very big. They dug the whole garden, north to south, east to west, up and
down. There was no body to be found anywhere. What a shame. They apologised to the old man, who did not know
what the hell it was all about. They even compensated the old man for his trouble.
The old man looked at what the police did to his garden. They made a superb job of thoroughly and properly digging
all of it for him! Wow, it is all ready to seed!
The next day the son wrote to his father, "Now you can grow your tomatoes and vegetables, Dad. This is the least I
can do for you under the circumstances. I love you".
Now, why am I telling you this story?
Just to remind you about lateral thinking.
Disclaimer:
Although every effort has been made to ensure the accuracy of information on this publication, the International Hospital of Bahrain cannot be held liable for any errors or omissions
contained in this publication. Readers are advised to seek specialist advice before acting on information contained in this publication which is provided for general use and may not be
appropriate for the reader’s particular circumstances.
Issue No. 6 | Volume 1 | APRIL 2012
International Hospital of Bahrain W.L.L.
Monthly Newsletter
Ms. Hina Rauf
Trainer - Human Resource Deparment
Changing times call for a change in managerial roles. Compared to fifty years ago, information is exploding, new
areas of knowledge multiplying, technology changing, competition growing far more swiftly, creating new challenges
and unfamiliar situations. Above all, people are more educated. In such times, the old model of a leader who knows
best, who is always in control, who always has a better answer than his subordinates, who can pull them out of any
crisis; this sort of heroic model is less and less functional for it is less and less possible. For most organization today,
the heroic model is out and the emphasis is on a leader manager or a developer.
Of course, there may be situations today where heroic model of leadership is useful. Where technology is not
changing, where employees are not educated, where teamwork is not crucial, there the appropriate model may still
be that of the hero, and some managers may find themselves riding to the rescue in situation never dealt within
management books.
Where however, you competent people, where their work in interdependent, where technology is changing,
competition keen, and new and challenging situations a constant occurrence, there the leadership model should be
that of the manager as developer. So not hero, not technician, not even coach, but developer of a vision that gives
meaning and inspiration to work, developer of a shared responsibility team, and developer of people, i.e., a leader
under whom people can grow.
One day a farmer's donkey fell down into a well. The animal cried piteously for hours as the farmer tried to figure
out what to do. Finally, he decided the animal was old, and the well needed to be covered up anyway; it just wasn't
worth it to retrieve the donkey.He invited all his neighbors to come over and help him. They all grabbed a shovel and
began to shovel dirt into the well. At first, the donkey realized what was happening and cried horribly. Then, to
everyone's amazement he quieted down.A few shovel loads later, the farmer finally looked down the well. He was
astonished at what he saw. With each shovel of dirt that hit his back, the donkey was doing something amazing. He
would shake it off and take a step up.As the farmer's neighbors continued to shovel dirt on top of the animal, he
would shake it off and take a step up. Pretty soon, everyone was amazed as the donkey stepped up over the edge of
the well and happily trotted off!
Do you have that hidden talent for writing? If you do then why not share your talent with us and let the whole IHB Community how
good a writer you are! Send those articles to: pulse@ihb.net
What’s Inside
02 HUMAN RESOURCE CORNER / INSPIRATIONAL | 03 PATIENT CARE | 04 EVENTS and PLACES | 05 MEDICAL
NOTES | 07 MEDICAL FINE POINTS | 08 HEALTH INFORMATICS JOURNAL | 11 HEALTH AWARENESS
13 30 THINGS TO STOP DOING TO YOURSELF | 14 FACILITY MANAGEMENT | 15 MARKETING and CRD CORNER
16 STAFF PROMOTIONS | 17 HOW TO SAVE MONEY on GROCERIES and STILL EAT a HEALTHY DIET
18 BIRTDAY CELEBRANTS / SOMETHING TO READ ABOUT | 19 WELCOME TO THE IHB FAMILY
20 HEALTHY HEARTY RECIPE / SUDOKU and LETTERWORDS
The PULSE is published for the staff of the International Hospital of Bahrain and is produced in-house by the Informatics Department. For your comments, suggestions &
contributions, email pulse@ihb.net.
PULSE ONLINE
http://ihb.net/index.asp?id=media&section=pulse
EDITOR-IN-CHIEF Faysal S. Zeerah
CONTRIBUTORS Mr. Timothy Gardner | Dr. Ghoneimy Abdel Azeem | Mr. Vincent Soares
Mr. Sayed Esmat Elsayed Aly Mahmoud | Ms. Hina Rauf
GRAPHICS & DESIGN Mildred Belen | Bryan
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02
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Monthly Newsletter
Tim Gardner
Assistant Administrator
Caring for patients is our reason for being. All our
patients have certain ‘rights’ that they can expect from
us. They also have certain ‘responsibilities’ towards the
hospital and the staff. These rights and responsibilities
are explained to the patients upon registration along
with a printed leaflet entitled “Patient’s Rights and
Responsibilities”.
Patient’s Rights
All Patients going to the IHB have certain rights. These
include the right to: freely access care; be treated with
respect and dignity; receive only the highest quality service;
privacy and confidentiality; be provided with informed
treatment choices; and receive all information related to
their treatment and care in a manner that they can clearly
understand.
Patient’s Responsibilities
Patients also have a responsibility to the IHB and its staff.
The patient is responsible to: provide all relevant information in an honest manner to the treating physician; follow
treatment instructions; follow hospital policies; arrive on
time for any booked appointments; and treat other patients,
staff and visitors with courtesy and respect.
What is your role as a staff member?
It is the role of every staff member to be fully familiar with and comply with the patient’s rights. The role of the Registration Officer is to ensure that all new patients are informed of their rights and responsibilities and to offer the
patient a copy of the “Patient Rights and Responsibilities” leaflet.
When a patient is admitted, it is the role of the Admission Officer to remind the patient, and/or the patient’s family,
of these rights and responsibilities. Once admitted, it is the role of the nurse in-charge to confirm that the patient,
and/or family, is aware of these rights and responsibilities. Every member of staff must be familiar with the patient’s
rights and responsibilities, sometimes referred to as the Patient Bill of Rights.
Remember that some patients may not fully understand English; they may understand some simple terms but not
complicated medical terms related to their care and treatment. Please ensure that whenever required, someone
translates the information to the patient so that we can be sure they understand properly. One of the rights of the
patient is that any information given to them is provided in a manner that they fully understand.
Quality and safety are the cornerstones of our care. This includes listening to our patients, and their relatives, and
answering their questions in a polite and courteous manner. If any patient requires information related to their treatment then they must be referred to the Physician in charge of their case.
We have a duty to inform the patient of how they should behave whilst in the hospital including respect for hospital
staff and adherence to hospital policies, for example the No Smoking policy.
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1 IHB
Monthly Newsletter
st
Saturday 24th March 2012
Intercontinental Regency Hotel Bahrain
04
FOUR
For more photos, visit the IHB Facebook page (www.facebook.com/ihb.net)
Monthly Newsletter
Five classes visited IHB on 5th, - 8th & 15th of March. Having some fun in the pediatric fun area and have a simple
training about how cute children eat, drink, and self-hygiene.
Friday 16th of March IHB First Aid support to
the wheelathon Participants.
Junior Rugby Festival and Trainings 9th & 16th of
March. IHB First Aid Support to the Rugby Players.
World Health Day | World Autism Awareness Day
Stay tuned for the schedule of these events in our Facebook page (www.facebook.com/ihb.net).
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Monthly Newsletter
Dr. Ghoneimy Abdel Azeem
Internist
Familial Mediterranean Fever (FMF) or recurrent
polyserositis is an inherited multisystem disease
manifested by recurrent painful attacks affecting the
abdomen, chest or joints, often accompanied by fever
and sometimes a skin rash.
FMF is a genetic condition, inherited in an autosomal
recessive fashions. FMF could be described as a disorder
of inappropriate inflammation of one or more of serosal
membranes (serositis). That is, an event that in a normal
situation causes a mild or unnoticeable inflammation,
might cause a severe inflammatory response in someone
with FMF.
FMF is also known by many other names, they include:
recurrent hereditary polyserositis, benign paroxysmal
peritonitis, familial recurrent polyseositis. The disease
took that name because it is prevalent around the
Mediterranean Sea. So, it is most prevalent in people of
Armenian, Sephardic Jewish, Levantine Arabic and
Turkish ancestries. So, as Arabs we have to know well
about that disease.
The symptoms of FMF are due to inflammation of the
sheets of tissue covering of one or more organs (serosal
membranes) inside the abdominal cavity (peritonitis), the
chest cavity (pleurisy) and joints (arthritis).
Attacks
There are seven types of attacks. 90% of all patients have their first attack before they are 20 years old. All develop
over 2-4 hours and last anytime between 6 hours and 4 days. Most attacks involve fever:
1. Abdominal attacks, featuring abdominal pain affecting the whole abdomen with all signs of acute abdomen (e.g.
appendicitis). They occur in 95% of all patients and may lead to unnecessary laparotomy. Incomplete
attacks, with local tenderness and normal blood tests, have been reported.
2. Joint attacks, occurring in large joints, mainly of the legs. Usually, only one joint is affected. 75% of all FMF
patients experience joint attacks.
3. Chest attacks with pleuritis (inflammation of the pleural lining) and pericarditis (inflammation of the
pericardium). Pleuritis occurs in 40%, but pericarditis is rare.
4. Scrotal attacks due to inflammation of the tunica vaginalis. This occurs in up to 5% and may be mistaken for acute
scrotum (i.e. testicular torsion)
5. Myalgia (rare in isolation)
6. Erysipeloid (a skin reaction on the legs, rare in isolation)
7. Fever without any localizing signs nor symptoms other than fever.
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cont...
Complications
Amyloidosis with renal failure is a complication and may develop without overt crises. AA (amyloid protein) is
produced in very large quantities during attacks and at a low rate between them, and accumulates mainly in the
kidney, as well as the heart, spleen, gastrointestinal tract and the thyroid.
Diagnosis
The diagnosis is clinically made on the basis of the history of typical attacks, especially in patients from the ethnic
groups in which FMF is more highly prevalent. An acute phase response is present during attacks, with high C-reactive
protein levels, an elevated white blood cell count and other markers of inflammation. FMF should be suspected for
any patient who:
1. Has had at least four episodes of abdominal pain or chest pain or both, lasting from 24-72 hours.
2. Without symptoms between attacks.
3. Does not have any other condition that would explain the symptoms.
4. Has positive family history of FMF.
5. Responds to colchicine.
A genetic test is also available now that the disease has been linked to mutations in the MEFV gene that is present
on short arm of chromosome 16.
Treatment
Attacks are self-limiting, and require analgesia and non-steroidal anti-inflammatory drugs. Since 1970s, colchicine, a
drug otherwise mainly used in gout, has been shown to decrease attack frequency in FMF patients. The exact way in
which colchicine suppresses attacks is unclear. While this agent is not without side-effects (such as abdominal pain
and muscle pains), it may markedly improve the quality of life in patients. The dosage is typically 1-2 mg a day.
Development of amyloidosis is delayed with colchicine treatment.
Prognosis
Patients who are compliant with daily colchicine probably can expect to have a normal lifespan. For those individuals
who are diagnosed early enough and take colchicine consistently, the prognosis is excellent. Most will have very few,
if any, attacks of fever and polyserositis and will likely not develop serious complications of amyloidosis. Even with
amyloidosis, the use of colchicine, dialysis and renal transplantation, should extend a patient survival beyond age 50
years.
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Monthly Newsletter
Q. What is the incubation period for influenza?
A. 1 to 3 days. The flu is airborne and spread through direct contact.
Influenza virus infection, one of the most common
infectious diseases, is a highly contagious airborne disease
that causes an acute febrile illness and results in variable
degrees of systemic symptoms, ranging from mild fatigue
to respiratory failure and death. These symptoms
contribute to significant loss of workdays, human
suffering, mortality, and significant morbidity.
Although the usual strains of influenza that circulate in
the annual influenza cycle constitute a substantial public
health concern, far more lethal influenza strains than
these have emerged periodically. These deadly strains
produced 3 global pandemics in the last century, the
worst of which occurred in 1918. Called the Spanish flu
(although cases appeared earlier in the United States and
elsewhere in Europe), this pandemic killed an estimated
20-50 million persons, with 549,000 deaths in the United
States alone.
In addition to humans, influenza also infects a variety of
animal species. Some of these influenza strains are species
specific, but new strains of influenza may spread from
other animal species to humans (see Pathophysiology).
The term avian influenza used in this context refers to
zoonotic human infection with an influenza strain that
primarily affects birds.
Swine influenza (H1N1) refers to infections from strains
derived from pigs. A recombinant influenza consisting of
a mix of swine, avian, and human gene segments.
source: http://emedicine.medscape.com
Q: What part of the body do these malaria parasites feed on?
A. red blood cells. Malaria parasites have voracious appetites! In just a few hours, they can suck as much as one
quarter of a pound of hemoglobin from the red blood cells of an infected person causing severe anemia!!
Red blood cells are the principal sites of infection in malaria. All the clinical manifestations are primarily due to the
involvement of red blood cells.
Malaria parasites are transmitted by the bite of an infected mosquito. In humans, they enter red blood cells and start
replicating after being released from the disease's first target, the liver. Once parasites escape into the bloodstream,
disease symptoms emerge including chills, fever, headache, body aches, vomiting and exhaustion.
Malaria affects 10 percent of the world's population, killing nearly one million people a year in developing countries
and crippling their economies. Most who die or become ill are poor pregnant women and children under age 5 in
tropical and subtropical regions of Africa, Asia and South America.
source: http://www.malariasite.com | http://esciencenews.com
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Monthly Newsletter
The influence of electronic medical record usage on
nonverbal communication in the medical interview
John M. McGrath, Nedal H. Arar and Jacqueline A. Pugh
Second of 4 Parts
Procedure
Prior to videotaping the interviews, physicians read and signed a consent form approved by the hospital’s
Institutional Review Board. Patients were asked to participate as they waited to see their doctor, and read and signed
a consent form at that time. Participants were informed that this study was designed to explore informational needs
during the medical interview, but they were not told that doctor–patient communication and the use of the EMR was
the focus of the analysis. This was done to minimize the risk of participants changing their communication behaviors
during the interview. It is also important to note that previous research on the medical interview has shown that
participants typically are not influenced by the presence of a video recorder and tend to forget about the camera
because they are too busy or involved with their activities to worry about it [28, 29].
Data collection and analysis.
Data were derived from unstructured observations that were made independently by two observers who then
developed themes and linked them to identified dimensions of nonverbal behavior [30]. In order to operationalize
the meaning of nonverbal communication we reviewed the literature and identified the common, general categories
of signals that encompass nonverbal messages, which include:
1. Kinesics: visual bodily movements, including gestures, facial expression, trunk, and limb movements, posture,
gaze, and gait.
2. Vocalics or paralanguage: use of vocal cues other than words themselves, including such features as pitch,
loudness, tempo, pauses, and inflection.
3. Physical appearance: features such as clothing, hairstyles, cosmetics, fragrances, and adornments.
4. Haptics: use of touch, including the frequency, intensity, and type of contact.
5. Proxemics: use of interpersonal distance and spacing relationships.
6. Chronemics: use of time as a message system, including such code elements as punctuality, waiting time, lead
time, and amount of time spent with someone.
7. Artifacts: manipulable objects and environmental features that may convey messages from their designers or
users [21].
We defined EMR use as any contact with the computer during the consultation, regardless of whether physicians
were talking or not. With these definitions in mind, two observers took detailed field notes of each interview,
focusing on how physician EMR use influenced nonverbal communication. This inductive approach is analogous to
ethnographic observational fieldwork, with the added advantage of being able to pause or rewind the tapes in order
to write out specific impressions that are vital to the so-called ‘thick descriptions’ of qualitative research [28, 31, 32].
Using two observers enhanced the validity of the observations, as researchers later were able to crosscheck each
other’s findings and eliminate inaccurate interpretations [30, 33, 34].
After taking notes, observers first worked independently by following a content analytic procedure that calls for a
movement from the specific to the general [35, 36]. Observers began by examining the details of their notes, and
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Monthly Newsletter
cont...
then identified patterns or similarities in their observations among the interviews. Each observer then named general
themes of nonverbal behaviors, and classified the themes according to the nonverbal categories identified above (i.e.
kinesics, proxemics, etc.).
An initial comparison between general categories of nonverbal behavior revealed strong agreement between the two
observers. Both observers concluded that kinesics (themes: physical orientation, gaze and gestures), proxemics
(theme: distance between doctor, patient and EMR), chronemics (theme: time using the EMR), and artifacts (theme:
EMR location and office setup) were related to the ways in which physicians used the EMR. One observer also
included the vocalics category, but neither included the categories of physical appearance or haptics. The results of
this initial comparison showed that observers agreed on six out of the seven nonverbal categories.
Subsequent discussion revealed that one observer included vocalics because of the relevance of pausing; the other
observer grouped pausing with chronemics and did not include the vocalics category. Since pausing is related to the
use of time and since the other elements of vocalics (i.e. pitch, loudness, tempo) were not identified by either
investigator to be associated with EMR use, we decided to group pausing with chronemics. This adjustment resulted
in full agreement on the nonverbal categories that help explain the EMR’s impact on nonverbal communication. In
summary, we agreed that four of the seven nonverbal categories identified by Burgoon and Hoobler [21] were
associated with EMR use (kinesics, proxemics, chronemics and artifacts) and three categories were not (vocalics,
physical appearance and haptics). This comparison provided a starting point for organizing our discussion of the
more detailed impressions made by each observer. We then pooled our notes, discussed all of our observations and
agreed on a number of other conclusions.
Results
Time spent using the EMR
One of the first nonverbal dimensions both observers noticed related to the time spent using the EMR, which seemed
to vary considerably among physician interviews. In most interviews, physicians used the EMR extensively and it
appeared to be an integral part of the interview, but in a discernible minority of interviews physicians spent very little
time at the computer and the EMR appeared to have little or no role in the interaction. We decided to time all
interviews and determined the average interview length to be 22.6 minutes (range 5–47, SD 8.9). We then
determined how much time physicians spent using the EMR in each interview and found that in 13 out of 50
interviews the EMR was used for 2 minutes or less; this was less than 10 per cent of their average interview length.
In the remaining interviews, physicians used the EMR for at least 5 minutes and an average of 11.35 minutes (range
5–27); this was approximately 50 per cent of the average interview time. Based on these observations and
calculations, we labeled these two groups ‘high EMR usage’ and ‘low EMR usage.’ This division helped us focus our
attention on the 37 interviews in which substantial use of the EMR occurred. Further analysis showed that four out
of six physicians conducted both high and low use interviews, and none conducted only low use interviews,
suggesting that the time using the EMR was not physician dependent.
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cont...
Physical orientation
In comparing our observations of the 37 high EMR use interviews, we found that EMR use was influenced by
nonverbal communication related to kinesics, particularly the physicians’ physical orientation or body positioning. In
order to access the EMR, physicians physically oriented themselves toward the computer rather than the patient, and
spent a considerable time in this position. Not surprisingly, computer use caused a reduction in doctor–patient eye
contact and gestures, and an increase in the amount and length of pausing during interactions. We also concluded
that the doctors’ physical orientation depended on the location of the EMR in relation to the physician, the
physician’s desk and the patient’s seating arrangement. It was apparent that spatial arrangement (proxemics) and
desk/chair location (artifacts) also played an important role in the interviews. Among the 37 high EMR use interviews,
20 interviews fell into the first and most common condition, where the EMR was located on the left side of the
physician’s desk (from the physician’s vantage point) and patients were seated just to the left of the desk, facing
forward, so that they were positioned in an approximate 45 degree angle toward the physician. Even though the
physicians were physically oriented toward the computer, patients remained in their general field of vision.
In the second condition, which occurred in 13 interviews, the EMR was situated to the right side of the desk and the
patient’s chair was away from the desk, closer to the middle of the office. The impact of this different arrangement
was that physicians had to turn their backs on patients in order to access the EMR. This also involved moving farther
away from their patients than in the first condition, and it was the only arrangement in which patients remained
totally outside the physicians’ field of vision during EMR use. The final condition occurred in only four interviews, and
was one in which the EMR was positioned toward the right side of the desk, with the patient seated to the right of
the desk but behind the EMR. In this case, the EMR was blocking the field of vision between physician and patient.
We labeled the first condition open, the second condition closed, and the third position blocked. Figure 1 provides
illustrations of each of these office arrangements, depicting how the physicians’ orientation toward their patients
would change depending on the arrangement of the office. In summary, kinesics (physical orientation, eye contact),
artifacts (arrangement of the EMR, desk and seating), and proxemics (movements within the space) worked in
concert to produce noticeable differences in doctor–patient nonverbal communication.
References
21 Burgoon J K, Hoobler G D. Nonverbal signals. In Knapp M L, Daly J A eds Handbook of Interpersonal Communication 3rd edn, 240–99. Thousand Oaks, CA: Sage, 2002.
22 Patterson M L. A parallel model of nonverbal communication. J Nonverbal Behaviour 1995; 19; 3–29.
23 Anderson P A. Nonverbal immediacy in interpersonal communication. In Siegman A W, Feldstein S eds Multichannel Integrations of Nonverbal Behavior 1–36.
Hillsdale, NJ: Erlbaum, 1985.
24 Wiener M, Mehrabian A. Language within Language: Immediacy, A Channel in Verbal Communication. New York: Appleton-Century-Crofts, 1968.
25 Woods E. Associations of nonverbal decoding ability with indicators of person-centered communication ability. Communication Reports 1996; 9; 12–22.
26 Burgoon J K. Nonverbal signals. In Knapp M L,Miller G eds Handbook of Interpersonal Communication 2nd edn, 229–85. Thousand Oaks, CA: Sage, 1994.
27 Argyle M, Alkema F, Gilmore R. The communication of friendly and hostile attitudes by verbal and nonverbal signals. European Journal of Social Psychology 1971; 1;
385–402.
28 Bottorﬀ J L. Using videotaped recordings in qualitative research. In Morse J M ed. Critical Issues in Qualitative Research 242–51. Newbury Park, CA: Sage, 1994.
29 Morse J M, McHutchion E. Releasing restraints: providing safe care for the elderly. Research in Nursing and Health 1991; 14; 187–96.
30 Adler P A, Adler P. Observational techniques. In Denzin N K, Lincoln Y S eds Handbook of Qualitative Research 377–92. Thousand Oaks, CA: Sage, 1994.
31 Adler P A, Adler P. Membership Roles in Field Research. Newbury Park, CA: Sage, 1987.
32 Denzin N K. Interpretive Interactionism 2nd edn. Thousand Oaks, CA: Sage, 2001.
33 Denzin N K. The Research Act 3rd edn. Englewood Cliﬀs, NJ: Prentice-Hall, 1989.
34 Phillips B. Sociological Research Methods. Homewood, IL: Dorsey, 1985.
35 Patten M Q. Qualitative Research and Evaluation Methods 3rd edn. Thousand Oaks, CA: Sage, 2002.
36 McCraken G. The Long Interview. Newbury Park, CA: Sage, 1988.
11
ELEVEN
Monthly Newsletter
21 - 28 April 2012
To underscore the importance of immunization in saving lives, and
to encourage families to vaccinate their children against deadly
diseases WHO is uniting countries across the globe for a week of
vaccination campaigns, public education and information sharing
under the umbrella of World Immunization Week.
Worldwide collaboration provides an opportunity to boost
momentum and focus on specific actions such as: raising
awareness on how immunization saves lives; increasing vaccination
coverage to prevent disease outbreaks; reaching under served and
marginalized communities (e.g. those living in remote areas,
deprived urban settings, fragile states and strife-torn regions) with
existing and newly available vaccines; reinforcing the medium and
long-term benefits of immunization (e.g. giving children a chance
to grow up healthy, go to school and improve their life prospects).
Immunization is one of the most successful and cost-effective
health interventions. It prevents between 2 and 3 million deaths
every year. Immunization prevents debilitating illness, disability
and death from vaccine-preventable diseases such as diphtheria,
hepatitis A and B, measles, mumps, pneumococcal disease, polio,
rotavirus diarrhoea, tetanus and yellow fever. The benefits of
immunization are increasingly being extended to adolescents and
adults, providing protection against life-threatening diseases such
as influenza, meningitis, and cancers (e.g. cervical and liver
cancers) that occur in adulthood.
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Malaria is a serious disease caused by a parasite. Infected
mosquitoes spread it. Malaria is a major cause of death worldwide,
but it is almost wiped out in the United States. The disease is
mostly a problem in developing countries with warm climates. If
you travel to these countries, you are at risk. There are four different types of malaria caused by four related parasites. The most
deadly type occurs in Africa south of the Sahara Desert.
Malaria symptoms include chills, flu-like symptoms, fever, vomiting, diarrhea and jaundice. The disease can be life-threatening.
However, you can treat malaria with medicines. The type of medicine depends on which kind of malaria you have and where you
were infected.
Malaria can be prevented. When traveling to malaria-prone
regions.
See your doctor for medicines that protect you
Wear insect repellent with DEET
12
TWELVE
Cover up
Sleep under mosquito netting
source: http://www.who.int | http:www.cdc.gov
Monthly Newsletter
7. Stop being scared to make a mistake. – Doing
something and getting it wrong is at least ten times more
productive than doing nothing. Every success has a trail
of failures behind it, and every failure is leading towards
success. You end up regretting the things you did NOT
do far more than the things you did.
(PART 1 of 2)
As Maria Robinson once said, “Nobody can go back and
start a new beginning, but anyone can start today and
make a new ending.” Nothing could be closer to the
truth. But before you can begin this process of transformation you have to stop doing the things that have been
holding you back.
Here are some ideas to get you started:
1. Stop spending time with the wrong people. – Life is
too short to spend time with people who suck the
happiness out of you. If someone wants you in their life,
they’ll make room for you. You shouldn’t have to fight
for a spot. Never, ever insist yourself to someone who
continuously overlooks your worth. And remember, it’s
not the people that stand by your side when you’re at
your best, but the ones who stand beside you when
you’re at your worst that are your true friends.
2. Stop running from your problems. – Face them
head on. No, it won’t be easy. There is no person in the
world capable of flawlessly handling every punch thrown
at them. We aren’t supposed to be able to instantly solve
problems. That’s not how we’re made. In fact, we’re
made to get upset, sad, hurt, stumble and fall. Because
that’s the whole purpose of living – to face problems,
learn, adapt, and solve them over the course of time. This is what ultimately molds us into the person we
become.
3. Stop lying to yourself. – You can lie to anyone else in
the world, but you can’t lie to yourself. Our lives improve
only when we take chances, and the first and most
difficult chance we can take is to be honest with
ourselves. 4. Stop putting your own needs on the back burner.
– The most painful thing is losing yourself in the process
of loving someone too much, and forgetting that you are
special too. Yes, help others; but help yourself too. If
there was ever a moment to follow your passion and do
something that matters to you, that moment is now.
5. Stop trying to be someone you’re not. – One of the
greatest challenges in life is being yourself in a world
that’s trying to make you like everyone else. Someone
will always be prettier, someone will always be smarter,
someone will always be younger, but they will never be
you. Don’t change so people will like you. Be yourself
and the right people will love the real you.
6. Stop trying to hold onto the past. – You can’t start
the next chapter of your life if you keep re-reading your
last one.
13
THIRTEEN
8. Stop berating yourself for old mistakes. – We may
love the wrong person and cry about the wrong things,
but no matter how things go wrong, one thing is for sure,
mistakes help us find the person and things that are right
for us. We all make mistakes, have struggles, and even
regret things in our past. But you are not your mistakes,
you are not your struggles, and you are here NOW with
the power to shape your day and your future. Every
single thing that has ever happened in your life is
preparing you for a moment that is yet to come.
9. Stop trying to buy happiness. – Many of the things
we desire are expensive. But the truth is, the things that
really satisfy us are totally free – love, laughter and
working on our passions.
10. Stop exclusively looking to others for happiness.
– If you’re not happy with who you are on the inside, you
won’t be happy in a long-term relationship with anyone
else either. You have to create stability in your own life
first before you can share it with someone else. 11. Stop being idle. – Don’t think too much or you’ll
create a problem that wasn’t even there in the first place. Evaluate situations and take decisive action. You cannot
change what you refuse to confront. Making progress
involves risk. Period! You can’t make it to second base
with your foot on first.
12. Stop thinking you’re not ready. – Nobody ever
feels 100% ready when an opportunity arises. Because
most great opportunities in life force us to grow beyond
our comfort zones, which means we won’t feel totally
comfortable at first.
13. Stop getting involved in relationships for the
wrong reasons. – Relationships must be chosen wisely. It’s better to be alone than to be in bad company. There’s no need to rush. If something is meant to be, it
will happen – in the right time, with the right person, and
for the best reason. Fall in love when you’re ready, not
when you’re lonely.
14. Stop rejecting new relationships just because old
ones didn’t work. – In life you’ll realize that there is a
purpose for everyone you meet. Some will test you,
some will use you and some will teach you. But most
importantly, some will bring out the best in you.
15. Stop trying to compete against everyone else.
– Don’t worry about what others are doing better than
you. Concentrate on beating your own records every
day. Success is a battle between YOU and YOURSELF
only.
Monthly Newsletter
Mr. Vincent Soares
Facility Management Director
Healthcare facilities are designed not only to support and facilitate state-of-the-art medicine and technology, patient
safety, and quality patient care, but to also embrace the patient, family, and caregivers in a psycho-socially supportive
therapeutic environment. The characteristic of the physical environment in which a patient receives care affects patient
outcomes, patient satisfaction, patient safety, staff efficiency, staff satisfaction, and organizational outcomes can be
positive or negative. Healthcare architects, interior designers, and researchers have identified four key factors which, if
applied in the design of a healthcare environment, can measurably improve patient outcomes:
Reduce or eliminate environmental stressors
Enable social support
Provide positive distractions
Give a sense of control
THE IHB ROYAL SUITE ACCOMMODATION
Some important aspects of creating a therapeutic interior are:
Using familiar and culturally relevant materials wherever consistent with sanitation and other functional needs.
Using cheerful and varied colors and textures, keeping in mind that some colors are inappropriate and can interfere with
provider assessments of patients' pallor and skin tones, disorient older or impaired patients, or agitate patients and staff,
particularly some psychiatric patients.
Admitting ample natural light wherever feasible and using color-corrected lighting in interior spaces which closely
approximates natural daylight.
Providing views of the outdoors from every patient bed, and elsewhere wherever possible; photo murals of nature
scenes are helpful where outdoor views are not available.
Designing a "way-finding" process into every project. Patients, visitors, and staff all need to know where they are, what
their destination is, and how to get there and return. A patient's sense of competence is encouraged by making spaces
easy to find, identify, and use without asking for help. Building elements, color, texture, and pattern should all give cues,
as well as artwork and signage
Appropriate, durable finishes for each functional space
Careful detailing of such features as doorframes, casework, and finish transitions to avoid dirt-catching and hard-toclean crevices and joints
Adequate and appropriately located housekeeping spaces
14
FOURTEEN
Monthly Newsletter
Sayed Esmat Elsayed Aly Mahmoud
CRD Manager
After the nuclear bomb disaster happened 67 years ago, Japan was very persistent to build their economy and to
distinguish itself in the industrial sector and they were successful in doing so. That's why they started embracing the
concept of total quality management which allows them to implement predefined quality standards for the
production process from inception to completion to have a high quality product as a final outcome. At this time they
were looking for a way to improve work quality from a stage to stage or from one worker to another to achieve total
planned quality for the final output. So they started embracing the internal customer concept based on considering
their colleagues, managers, subordinates, customers and then identify their needs and hand them the best quality
service possible to satisfy them as a customer. And this where this concept becomes a part of the total quality
management and a well-known concept in today's management.
By embracing the concept of the internal customer and handing over the best quality possible in your work to your
manager, colleague, subordinates or other departments that will make the final outcome to your external customer
a unique one.
Theory into Practice
1. Identify your internal customers (managers, colleagues, subordinates, or the other departments you are
dealing with them most)
2. Identify how can you satisfy them and give them the best quality of work, for example reports they need. Clear
information, time commitment, tasks completion with the predefined criteria.
3. Get a feedback from them as a customer and set with them to identify how to present the best quality of work
possible for future stages as a tool of retention and excellence.
4. Make it a habit of work in your life.
5. Now your work quality is different and you are more committed person for your internal and external
customers.
Changing times call for a change in managerial roles. Compared to fifty years ago, information is exploding, new
areas of knowledge multiplying, technology changing, competition growing far more swiftly, creating new challenges
and unfamiliar situations. Above all, people are more educated. In such times, the old model of a leader who knows
best, who is always in control, who always has a better answer than his subordinates, who can pull them out of any
crisis; this sort of heroic model is less and less functional for it is less and less possible. For most organization today,
the heroic model is out and the emphasis is on a leader manager or a developer.
Of course, there may be situations today where heroic model of leadership is useful. Where technology is not
changing, where employees are not educated, where teamwork is not crucial, there the appropriate model may still
be that of the hero, and some managers may find themselves riding to the rescue in situation never dealt within
management books.
Where however, you competent people, where their work in interdependent, where technology is changing,
competition keen, and new and challenging situations a constant occurrence, there the leadership model should be
that of the manager as developer. So not hero, not technician, not even coach, but developer of a vision that gives
meaning and inspiration to work, developer of a shared responsibility team, and developer of people, i.e., a leader
under whom people can grow.
15
FIFTEEN
Monthly Newsletter
From left to right: Dr. Farooq Ahmed Batkoo (Consultant Hospitalist), Dr. Sameer Ulhas Patankar (Senior Specialist
Paediatrician), Dr. Faysal Saeed Zeerah (IHB President) and Dr. Abdul Shaheed Naseeb (Medical Director)
The International Hospital of Bahrain has always been a part of career advancement of every employee. We recognize
and uphold our people as our greatest asset and commit to respect and look after them well, encouraging individual
initiative and improvement.
We proudly honor and congratulate two new doctors for this promotions. Dr. Farooq Ahmed Batkoo of Health
Check department from Senior Specialist Physician to Consultant Hospitalist and Paediatrics department Dr. Sameer
Ulhas Patankar from Specialist Paediatrician to Senior Specialist Paediatrician.
From the Board of Directors, Members and Staff of IHB... WE ARE PROUD OF BOTH OF YOU!
16
SIXTEEN
Monthly Newsletter
Eating healthy does not necessarily mean spending so much on food and groceries.
There are ways to budget your meals and yet have a balanced diet. It is all about
shopping smart. Here are some tips.
Plan your meals ahead of time. With this procedure, you are not only psyching
yourself about the things that you should be eating, you are also able to organize
your eating which will give you the opportunity to list down only the things that
you will need to buy at the grocery.
Avoid eating out and opt for eating home. In doing so, not only are you saving up
on the bucks, you are also able to control your calorie intake by making your
meals on your own.
Focus on the outer aisles of the grocery store. The outer aisles in grocery stores
usually have “man’s basic commodities”, like carbs, meats and the like. On the
other hand, the ones in the middle usually carry junk foods and sweets that may
be a threat to your healthy diet. Though it is okay to splurge once in awhile with
a bag of chips or a box of chocolates, make sure that you do not do it to often.
Include your junk food “binges” on your weekly meal plans. That you way, you
can control your intake and at the same time, monitor how much empty calories
you are taking in.
Try out frozen vegetables. Some frozen vegetables are actually as good, tasty and
healthy as their freshly picked counterparts. They are cheaper and you can easily
stock up on them if you think swinging by the grocery store weekly for fresh
veggies is too much of a hassle for you.
Research on vegetarian options. Vegetables are a lot cheaper than meat products.
They are cheaper too. So if you think that you have the tongue for leafy vegetables, why not include some vegetarian options on your weekly meal plan.
Buy items that you commonly use in bulk. Just like with anything else off the
store, goods come out cheaper when bought in bulk. This applies most especially
for goods that take time to expire like potatoes, onions, garlic, etc.
Learn to grown your own foods. Make a little vegetable patch in your backyard if
you have the extra space. It is a great way to unwind and of course, save money
because all you have to do is pick out your favorite vegetable from the patch and
cook it your style when you have the urge for it.
Buy store brands over brand name items. If you thoroughly skim through the
grocery aisles, you are sure to find the same goods, only cheaper. Store brands
only differ in name and packaging. But you can expect the quality to remain the
same as the branded ones.
Use coupons. Love your coupons and clip those that you think you can use up in
your favorite grocery stores.
Cut out the junk. True! Junk foods are an additional $10-20 on your grocery bill
and you probably don’t even notice it. So limit your junk food munching to 1-2
times a week and cut down on the amount that you buy at the grocery regardless
if they are on sale.
Stick to your grocery list. The grocery can be a very tempting place to squander
your bank account. But if you come up with a list of things that you need to buy
and try not to digress from it, then you might be able to save yourself a ton of
money. Commit to buy only the things that you need and chuck aside the items
that you just want.
Always ask yourself “Do I need this?” the next time your hands land on a random
item at the grocery. It takes perseverance and commitment to eat healthy and live
a frugal lifestyle. But it doesn’t mean that you can’t do it.
17
SEVENTEEN
source: http://www.howtodothings.com | Olivia Cooper
Monthly Newsletter
Maryam Abdulla Ahmed Madan Abdulla
Srijith Mannarazhikam Sudhakaran
01 - Operation Theatres
Muhammad Islam
02 - Facility Management
Nilcri Rabaya Terora
03 - Pulmonology
Remedios Ringor Loresca
04 - Rheumatology
Martyn James Hayden
13 - Patient Care & Administration
Legi Mathew
Dhanapathi Rajamanickam
16 - Pharmacy
Maria Aleth Mercado
04 - Nursing Administration
Mahdi Abdulla Abdulhusain Abdulla Al Asfera
16 - Finance
Mohan Pradeesh
05 - Marketing and Community Relation
Divya Thakidiyel Mohandas
05 - Ward 2
Jasim Mohamed Isa Yaqoob Al Haddad
Dr. Yasser Abdel Latif Mohamed El Sawaf
18 - Gastroenterology
Dr. Ashraf Abd El Moneim Ahmed El Mitwalli
06 - Neurology
Dr. Deepak Khosla
07 - Ophthalmology
Ratheesh Ravindran
19 - Nephrology
Shiji Mathew
20 - Ward 1
Keloth Basheer
08 - Informatics
Mirvat Abdel Moaty El Sayed Mohammed
21 - Internal Medicine
Dr. Sujith Subramanian
08 - Human Resources
Sawsan Jaffar Mohammed Faraj
08 - Finance
Pramod Mathews John
10 - Pathology & Laboratory
Ameena Abdulla Abdulnabi Al Asfoor
Mohamed Sakeel
21 - Human Resources
Sivaprasad Sivadasan
Dr. Mohamed Ibrahim Abdel Maguid Ibrahim
23 - ENT
Asha Rajan
23 - Emergency
April Joy Renales Orbe
10 - Rheumatology
Dr. John Jacob Meakkara
24 - Dental
Blangatt Pankajakshan Shinoj
Wilmar Luceno Cerbas
12 - Ward 1
Dr. Emad Kamil Meshraky Guirguis
26 - Dermatology
Ma. April Cristina Palayar Alejo
28 - Dental
Sherryl Lim Bok
29 - Pharmacy
BEFORE
Who made
the World
Dad?
18
EIGHTEEN
God made the
world my
son.
NOW
Who made
the World
Dad?
Look it up on
Google my son.
Monthly Newsletter
FEBRUARY 2012
Preetha Abraham
Nurse-Staff Nurse
Date Joined: 15-02-2012
MARCH 2012
Manju Manuel
Nurse - Staff Nurse
Shahid Mahmood
Security Accommodation
Srijith Mannarazhikam
Sudhakaran
Service Worker
Graziella Mendoza Barrios
Infection Control Nurse
Nithin Blangatt Purushothaman
Informatics Support Technician
Dr. Jameela Hajeeh Abdul
Rahman Bahman
Specialist Hospitalist
Dr. Shatha Abdulshaheed
Salman Binjamal
Senior Specialist Ob-Gynae
Kirth Jerico Almoneda Caramat
Nurse - Staff Nurse
Dr. Hesham Salama Abdel Rasoul
Abdel Rahman
Consultant Paediatrician
Imran Khan
Waiter
Ali Mashalla Mohammed Haji
Accommodation Officer
Hasan Shehab Ahmed
Ebrahim Al Fardan
Trainee
19
NINETEEN
Catherine Bayan Canonaso
Physiotherapist
Dr. Rafeeq Adnan Juma Ebrahim Ali
Consultant Endocrinology
Nikhil Raj Puthuparampil
Maintenance Aide
Basher Ulla
Gardener
Christelle Guiang De Luna
Echocardiographer
Monthly Newsletter
HEALTHY HEARTY
RECIPE
7
5
9
1
3
2
8
4
6
2
1
4
8
6
7
3
9
5
Nutritional Value per serving
Carbohydates – 31.195 gms
Protein – 14.31 gm
Fat – 6 gm
Calorie – 181.57 cal
Sodium – 190.87 mg
K
R
O
20
TWENTY
8
3
6
5
4
9
2
7
1
Makes 4 servings.
1
5
3 8
3
8
2
7
1
4
6
5
9
Blanch green pepper in boiling water 1 minute; drain. Cut each
chicken breast into 4 pieces. Alternately thread chicken, green
pepper and pineapple onto skewers. Combine 57 Sauce and
honey. Brush kabobs with 57 Sauce mixture. Broil,
about 6 inches from heat source, 12 to 14
minutes, turning and brushing with 57 Sauce
mixture once.
1 9
8
4
6
4
1
3
9
5
7
2
8
Preparation
5 7
R
V
T
9
7
5
2
8
6
4
1
3
1 can drained pineapple chunks
1 medium green pepper
1/2 cup Heinz 57 Sauce
1/4 cup honey
4 skinless boneless chicken breast halves
2
4 3
2
6
1
9
3
4
7
8
5
6
2
9
3
1
9 4
8
2
8
6
5
1
9
3
7
6
6 3
7
8
I
S
E
7
9
5
6
7
9
2
3
1
8
4
4

April - The International Hospital of Bahrain

Transcription

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