Ph.D, MPhil, DCH, MBBS

Dr. Sanjeev K. Singh currently serves as Medical Superintendent at Amrita School of Medicine, Kochi.


Publication Type: Journal Article

Year of Publication Title


La Kumar, Dominic, Mb, Rajan, Sa, and Dr. Sanjeev K. Singh, “Impact of modified quality control checklist on protocol adherence and outcomes in a post-surgical intensive care unit”, Indian Journal of Anaesthesia, vol. 61, pp. 29-35, 2017.[Abstract]

Background and Aims: Quality improvement (QI) is the sum of all activities that create desired changes in the quality. An effective QI system results in a stepwise increase in quality of care. The efficiency of any health-care unit is judged by its quality indicators. We aimed to evaluate the impact of QI initiatives on outcomes in a surgical Intensive Care Unit (ICU). Methods: This was an observational study carried out using a compliance checklist, developed from the combination of the World Health Organization surgery checklist and Society for Healthcare Epidemiology of America guidelines for the prevention of infections. A total of 170 patients were prospectively evaluated for adherence to the checklist and occurrence of infections. This was compared with a random retrospective analysis of 170 patients who had undergone similar surgeries in the previous 3 months. Results: Introduction and supervised documentation of comprehensive checklist brought out significant improvement in the documentation of quality indicators (98% vs. 32%) in the prospective samples. There was no difference in mortality, health-care-related infection rates or length of ICU stay. Conclusion: The introduction of comprehensive surgical checklist improved documentation of parameters for quality control but did not decrease the rates of infection in comparison to the control sample. © 2017 Indian Journal of Anaesthesia.

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Sa Krishna, Dr. Sanjeev K. Singh, Dinesh, K. Ra, KP, Rc, Siyad, Id, and Karim, Sa, “Percutaneous endoscopic gastrostomy (PEG) site infections: a clinical and microbiological study from university teaching hospital, India”, Journal of Infection Prevention, vol. 16, pp. 113-116, 2015.[Abstract]

Percutaneous endoscopic gastrostomy (PEG) is used to provide enteral access in patients who are unable to swallow. Infection of the stoma is an important complication and there is little data from India on this problem, which can be used to inform infection prevention and prophylactic strategies.

The objective was to assess the prevalence and the role of contributory factors in PEG site infections.

A total of 173 patients underwent PEG insertion from January 2011 to May 2012. Clinical and microbiological data were collected for culture-positive cases. Insertion was performed using a standard sterile pull-through technique. Infections were defined as two of: peristomal erythema, induration, and purulent discharge.

A total of 54 PEG infections occurred in 43 patients (28.85%). Seventy-seven organisms were isolated. Pseudomonas aeruginosa was the most common (n=29) followed by coliforms (n=21) and meticillin resistant Staphylococcus aureus (MRSA) (n=6). Thirty-one (72%) received amoxicillin-clavulanic acid as prophylaxis and 12 (28%) were receiving concomitant antibiotics for their underlying conditions. The occurrence of PEG site infections was statistically independent of the administered prophylactic antibiotics (p=0.3).

This study has demonstrated the importance of PEG sites as a cause of healthcare associated infections. Educating patients on wound care practices would play a significant role in prevention of PEG site infections.

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