scholarly journals Building health system responsiveness to noncommunicable diseases for Gweru District adults, Zimbabwe: a case study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Blender Muzvondiwa ◽  
Roy Batterham
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Systems ◽  
Grey Literature ◽  
Care Staff ◽  
Noncommunicable Diseases ◽  
Health Care Staff ◽  
Local Health ◽  
Content Type ◽  
Local Health Care

PurposeGweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and management of NCDs. Despite numerous initiatives, reorienting health services has been slow in many countries. Gweru District has similar challenges. The purpose of this paper is to explore what the health systems in Zimbabwe have done, and are doing to respond to increasing numbers of NCD cases in adults in the nation, especially in the district of GweruDesign/methodology/approachThe study employed a descriptive narrative review of the academic and grey literature, supplemented by semi-structured key informant interviews with 14 health care staff and 30 adults living with a disease or caring for an adult with a disease in Gweru District.FindingsRespondents identified many limitations to the response in Gweru. Respondents said that screening and diagnosis cease to be helpful when it is difficult securing medications. Nearly all community respondents reported not understanding why they are not freed of the diseases, showing poor understanding of NCDs. The escalating costs and scarcity of medications have led people to lose trust in services. Government and NGO activities include diagnosis and screening, provision of health education and some medication. Health personnel mentioned gaps in transport, medication shortages, poor equipment and poor community engagement. Suggestions include: training of nurses for a greater role in screening and management of NCDs, greater resourcing, outreach activities/satellite clinics and better integration of diverse NCD policies.Research limitations/implicationsParticipant responses were greatly influenced by the current political and economic situation in Zimbabwe, so responses may reflect short-term crises rather than long-term trends.Originality/valueThis research offers an understanding of NCD strategies and their limitations from the bottom-up, lived experience perspective of local health care workers and community members.

scholarly journals Needs assessment and staff education to effect long-term change in emergency medicine in rural Nepal

CJEM ◽  
2004 ◽  
Vol 6 (04) ◽  
pp. 266-270
Author(s):  
Valerie F. Krym ◽  
Russell D. MacDonald
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Needs Assessment ◽  
Care Staff ◽  
Standards Of Care ◽  
Health Care Staff ◽  
Local Health ◽  
Staff Education ◽  
Local Health Care

ABSTRACT Medical work in developing countries is challenging and rewarding. To make a lasting impact on the local community, a health care worker must be willing to listen to the needs of the people. The long-term impact of a needs assessment and staff education on emergency medicine at a rural hospital in Nepal is presented. The Scheer Memorial Hospital is a 102-bed non-governmental, not-for-profit hospital in Banepa, Nepal. Nepalese and ex-patriot health care professionals staff the hospital. Medical supplies are obtained from local manufacturers or as donations from foreign organizations. The hospital waives fees for those who cannot afford care. Two academic emergency physicians with expertise in international health undertook a needs assessment to assist in planning for long-term health care goals related to emergency medicine. The assessment focused on health care planning and education of the local health care staff. Based on interviews and objective assessments, a plan was developed and implemented to address 4 key areas: physical plant, equipment, staff training and essential tasks. Sustainable positive change was accomplished by acknowledging local customs and standards of care, meeting the needs of local health care staff and using available resources.

scholarly journals KlebSeq, a Diagnostic Tool for Surveillance, Detection, and Monitoring of Klebsiella pneumoniae

2016 ◽  
Vol 54 (10) ◽  
pp. 2582-2596 ◽  
Author(s):  
Jolene R. Bowers ◽  
Darrin Lemmer ◽  
Jason W. Sahl ◽  
Talima Pearson ◽  
Elizabeth M. Driebe ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Klebsiella Pneumoniae ◽  
Group Identification ◽  
Amplicon Sequencing ◽  
Multidrug Resistant ◽  
Care Staff ◽  
Health Care Staff ◽  
Health Crisis ◽  
Content Type

Health care-acquired infections (HAIs) kill tens of thousands of people each year and add significantly to health care costs. Multidrug-resistant and epidemic strains are a large proportion of HAI agents, and multidrug-resistant strains ofKlebsiella pneumoniae, a leading HAI agent, have caused an urgent public health crisis. In the health care environment, patient colonization byK. pneumoniaeprecedes infection, and transmission via colonization leads to outbreaks. Periodic patient screening forK. pneumoniaecolonization has the potential to curb the number of HAIs. In this report, we describe the design and validation of KlebSeq, a highly informative screening tool that detectsKlebsiellaspecies and identifies clinically important strains and characteristics by using highly multiplexed amplicon sequencing without a live-culturing step. We demonstrate the utility of this tool on several complex specimen types, including urine, wound swabs and tissue, and several types of respiratory and fecal specimens, showingK. pneumoniaespecies and clonal group identification and antimicrobial resistance and virulence profiling, including capsule typing. Use of this amplicon sequencing tool to screen patients forKlebsiellacarriage could inform health care staff of the risk of infection and outbreak potential. KlebSeq also serves as a model for next-generation molecular tools for public health and health care, as expansion of this tool can be used for several other HAI agents or applications.

scholarly journals The Psychological Experience of Frontline Perioperative Health Care Staff in Responding to COVID-19: Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Toni Withiel ◽  
Elizabeth Barson ◽  
Irene Ng ◽  
Reny Segal ◽  
Daryl Lindsay Goulding Williams ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Lived Experience ◽  
Health Care Workers ◽  
Team Leadership ◽  
Care Staff ◽  
Health Care Staff ◽  
Frontline Staff ◽  
Care Workers ◽  
Psychological Impacts

BACKGROUND The rapid spread of the novel coronavirus (COVID-19) has presented immeasurable challenges to health care workers who remain at the frontline of the pandemic. A rapidly evolving body of literature has quantitatively demonstrated significant psychological impacts of the pandemic on health care workers. However, little is known about the lived experience of the pandemic for frontline medical staff. OBJECTIVE This study aimed to explore the qualitative experience of perioperative staff from a large trauma hospital in Melbourne, Australia. METHODS Inductive thematic analysis using a critical realist approach was used to analyze data from 9 semistructured interviews. RESULTS Four key themes were identified. <i>Hospital preparedness</i> related to the perceived readiness of the hospital to respond to the pandemic and encompassed key subthemes around communication of policy changes, team leadership, and resource availability. Perceptions of readiness contributed to the perceived <i>psychological impacts of the pandemic</i>, which were highly varied and ranged from anger to anxiety. A number of <i>coping strategies</i> were identified in response to psychological impacts which incorporated both internal and external coping mechanisms. Finally, <i>adaptation with time</i> reflected change and growth over time, and encompassed all other themes. CONCLUSIONS While frontline staff and hospitals have rapidly marshalled a response to managing the virus, relatively less consideration was seen regarding staff mental health in our study. Findings highlight the vulnerability of health care workers in response to the pandemic and reinforce the need for a coordinated approach to managing mental health.

The recognition and management of delirium superimposed on dementia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Margaret Robertson
Keyword(s):  
Health Care ◽  
Professional Practice ◽  
Critical Discussion ◽  
Care Staff ◽  
Health Care Staff ◽  
Training And Education ◽  
Content Type ◽  
The University ◽  
Practical Implications ◽  
Delirium Superimposed On Dementia

Purpose This essay was written as a university assignment for an expert dementia practice module as part of the Masters in Applied Professional Practice. This paper aims to provide a critical discussion of the recognition and management of delirium superimposed on dementia. Design/methodology/approach The findings of this paper showed that the recognition of delirium superimposed of dementia is not well recognized, but early intervention and management can result in preferential outcomes. This requires the use of appropriate recognition tools and for all health-care staff to have specific training within this area. Findings Education is imperative to improving delirium recognition. Research limitations/implications Education is imperative to improving awareness. Practical implications The research implications of this paper demonstrate that appropriate training and education of health-care staff is imperative for the timely recognition of delirium and the improvement of care. Originality/value This paper was undertaken as an assignment for the University of Highlands and Islands.

Bringing an entrepreneurial mindset to health-care: a new tool for better outcomes

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Laurence Murray Gillin ◽  
Lois Marjorie Hazelton
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Professional Practice ◽  
Health Care Industry ◽  
Care Staff ◽  
Health Care Staff ◽  
Content Type ◽  
Care Industry ◽  
Entrepreneurial Behaviour

Purpose The purpose of this paper is to consider the value of an industry ecosystem in providing context for both identifying and evaluating organisation opportunities and related entrepreneurial behaviour for future strategic growth by reference to a case study in the health-care industry. Using a validated entrepreneurship mindset audit instrument, an assessment is made of the leadership, decision-making, behaviour and awareness dimensions of professional practice health-care staff to create the internal culture that fosters an entrepreneurial orientated organisation that can deliver effective innovation for satisfied users of health-care services. Design/methodology/approach This case study examines the distinctive dimensions of entrepreneurial mindset – leadership, decision-making, behaviour and awareness – within a practice-based health-care (nursing) ecosystem and how these dimensions impact organisation performance throughout the health-care industry. Findings This study validates research findings that entrepreneurial leadership encourages entrepreneurial behaviour and an entrepreneurial culture supports the development of innovations. Opportunities for such cultural behaviour are best understood by measuring the staff’s and leaders’ “entrepreneurial mindset”. Research limitations/implications Generalising results from this case study requires caution. The positive outcome from the professional practice examples, and their strong association with impactful entrepreneurial mindset values on service delivery, requires further evaluation. Practical implications Using an entrepreneurial mindset audit to assess organisation’s cultural behaviour enables management to identify factors fostering or inhibiting entrepreneurial activity and to devise interventions to improve strategic direction. Originality/value Entrepreneurial mindset is not a new concept, but adding the critical significance of spiritual awareness to creative entrepreneur behaviour, together with a visioning map, adds both value and understanding to enhance organisation performance.

scholarly journals Awareness, attitude and practises of biomedical waste management amongst public health-care staff in Karnataka, India

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Javeed Ahamed Golandaj ◽  
Karabasappa Gadigeppa Kallihal
Keyword(s):  
Public Health ◽  
Health Care ◽  
Cross Sectional Study ◽  
Public Health Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Special Focus ◽  
Public Health Importance ◽  
Cross Sectional ◽  
Content Type

Purpose Enormous amount of biomedical wastes (BMW) produced everyday across the world. Management of BMW depends on adherence to protocol. BMW management at generation point, definitely, depends upon the awareness, attitudes and practises of health-care staff, the purpose of this study will assess the awareness, attitude and practise regarding different aspects of BMW. Design/methodology/approach An observational with appropriate checklists, and a cross-sectional study, involving questionnaires, was conducted during 7-24 January 2016. The existing system of BMW management, funds, resources, etc., knowledge, attitude and practises about BMW were assessed amongst 273 health-care workers in selected public health-care institutes of Karnataka. Findings Of 273 study participants, majority (54%) of them have not received any training pertaining to BMW. The results showed a poor level of knowledge and awareness of BMW management amongst health-care personnel. Merely, 43% of the participants correctly knew the categorization of BMW and its disposal in proper colour-coded bins/bags. Awareness is very poor amongst the lower age group, male participants, lab-technicians/pharmacists and supporting staff. Doctors were good at theoretical knowledge such as rules, legislation and public-health importance of BMW management than the practical aspects such as categorization and colour-coding. Further, the attitude of health-care staff is favourable about BMW. Immunization for hepatitis-B was very poor amongst waste handlers (43%). Originality/value As the awareness and practise regarding BMW management were poor across different health-care staff there is a need to conduct periodic training and regular monitoring with special focus on the proper use of personal protective equipment. Further, precautionary immunization should be provided, especially waste handlers and sanitary workers.

scholarly journals Multiple burdens of stigma for prisoners participating in opioid antagonist treatment (OAT) programmes in Indonesian prisons: a qualitative study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rita Komalasari ◽  
Sarah Wilson ◽  
Sudirman Nasir ◽  
Sally Haw
Keyword(s):  
Health Care ◽  
Drug Use ◽  
Care Staff ◽  
Opioid Antagonist ◽  
Health Care Staff ◽  
Prison Staff ◽  
Content Type ◽  
Effective Strategies ◽  
Programme Participation

Purpose In spite of the effectiveness of opioid antagonist treatment (OAT) in reducing injecting drug use and needle sharing, programmes in prison continue to be largely stigmatised. This affects programme participation and the quality of programmes delivered. This study aims to explore how Indonesian prison staff and prisoners perceived and experienced stigma relating to prison OAT programmes and identify potential strategies to alleviate this stigma. Design/methodology/approach Three prisons in Indonesia were selected as part of a qualitative case study. Two of the prisons provided OAT, in the form of methadone maintenance treatment (MMT). Purposive and snowball sampling were used to recruit study participants. In total, 57 semi-structured interviews were conducted with prison governors, health-care staff, prison officers and prisoners. Prisoners included both participants and non-participants in methadone programmes. The data were analysed thematically. Findings MMT programme participants were perceived by both prison staff and other prisoners to be engaged in illicit drug use, and as lazy, poor, dirty and unproductive people. They were also presumed to be HIV-positive. These multi-layered, intersectional sources of (inter-personal) stigma amplified the effects on prisoners affecting not only their quality of life and mental health but also their access to prison parole programmes, and therefore the possibility of early release. In addition, organisational factors – notably non-confidential programme delivery and lack of both family and institutional supports for methadone prisoners – exacerbated the stigmatisation of MMT programme participants. Practical implications Effective strategies to alleviate stigma surrounding OAT programmes such as MMT programmes are urgently needed to ensure participation in and the quality of programmes in prisons. Originality/value Many prisoners reported experiencing stigma relating to their participation in MMT programmes in both the methadone prisons studied. They often emphasised the ways that this stigmatisation was amplified by the ways that MMT programme participation was associated with drug use and HIV infection. However, these intersecting experiences and concerns were not recognised by health-care staff or other prison staff. Effective strategies to alleviate stigma surrounding OAT programmes such as MMT programmes are urgently needed to ensure participation in and the quality of programmes in prisons.

Health Care Access for Migrants in Europe

2018 ◽  
Author(s):  
Catherine A. O'Donnell
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Asylum Seekers ◽  
Disease Risk ◽  
Care Staff ◽  
Health Care Staff ◽  
Undocumented Migrants ◽  
The European Union ◽  
Host Countries ◽  
Irregular Migrants

Migration is a reality of today’s world, with over one billion migrants worldwide. While many choose to move voluntarily, others are forced to migrate due to economic reasons or to flee war, conflict, or persecution. Such migrants often find themselves in precarious and marginalized situations—particularly asylum seekers, refugees, and undocumented or irregular migrants. While often viewed as a single group, the legal status and entitlements of these three groups are different. This has implications for their ability to access health care; in addition, rights and entitlements vary across the 28 countries of the European Union and across different parts of national health systems. The lack of entitlement to receive care, including primary and secondary care, is a significant barrier for many asylum seekers and refugees and an even greater barrier for undocumented migrants. Other barriers include different health profiles and awareness of chronic disease risk amongst migrants; awareness of the organization of health systems in host countries; and language and communication. The use of professional interpreters can help to overcome communication barriers, but entitlement to free interpreting services is highly variable. Host countries need to consider how to ensure their health systems are “migrant-friendly”: solutions include provision of professional interpreters; ensuring that health care staff are aware of migrants’ rights to access health care; and increasing knowledge of migrants in relation to the organization of the health care system in their host country and how to access care, for example through the use of patient navigators. However, perhaps one of the greatest facilitators for migrants will be a more favorable political situation, which stops demonizing people who are forced to migrate due to situations out of their control.

Involving patients in quality improvements – a case study

2019 ◽  
Vol 32 (2) ◽  
pp. 348-361
Author(s):  
Åsa Robinson ◽  
Caterina Finizia ◽  
Susanne Gustavsson
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Research Area ◽  
Care Staff ◽  
Health Care Staff ◽  
Quality Improvements ◽  
Specific Patient ◽  
Content Type ◽  
Individual Interviews

Purpose The purpose of this paper is to illuminate strengths and limitations in quality improvement work, when involving patients. Design/methodology/approach The experience-based co-design (EBCD) method was used when improving care for patients undergoing otosclerosis surgery. Individual interviews and focus groups were interpreted using qualitative content analysis. Findings Strengths mentioned by patients were that their participation made a difference. The first steps were found effective in giving an in-depth view of patients’ experiences and the staff got an increased understanding about specific patient needs. However, weaknesses were found in the latter phases, those of improving and follow-up, health care staff had difficulties to keep their focus on patients’ experiences and invite patients to be involved. Patients’ participation decreased, and there was a lack of tools to support the process. Research limitations/implications The content in this paper is mainly based on one case. However, the findings are in congruence with earlier research and add further knowledge to the research area. Practical implications The findings can be used in healthcare when involving patients in improvement work. Originality/value There is no earlier study which involves patients with otosclerosis when using EBCD. Furthermore, this paper illuminates that there is a need to increase collaboration with patients. The latter phases often seem to be handled by health care professionals without involving patients; this paper suggest a development using dedicated quality tools.

The “disease” of violence against health-care workers is a wicked problem. Managing and preventing violence in health-care

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Alycia Jacob ◽  
Damhnat McCann ◽  
Penny Buykx ◽  
Brodie Thomas ◽  
Evelien Spelten ◽  
...  
Keyword(s):  
Health Care ◽  
Violence Prevention ◽  
Design Methodology ◽  
Care Staff ◽  
Disciplinary Action ◽  
Wicked Problem ◽  
Health Care Staff ◽  
Violent Behaviour ◽  
Content Type ◽  
Care Workers

Purpose This paper aims to illustrate the complexity of understanding and managing violent behaviour in health care. The authors will show how different perceptions of the reasons for violent behaviour, and linkages between violent behaviour and illness have contributed to the creation of a wicked problem and added significant complexity to the management of violence towards staff within health-care settings. This paper will conclude with a call for strong multi-disciplinary action to address this ongoing issue. Design/methodology/approach A narrative review was undertaken to explore the ways that violence has been perceived in health care and the ways in which the concept of violence has moved from being seen as a criminal issue to being within the realms of disease. This paper will show the importance of understanding who is perpetrating violence in health care, why and in what settings. It will expound on the idea that considering violence as a consequence of disease necessarily adds a layer of complexity to both individual and organisational responses to violence towards health-care staff. Findings Understanding the complexity in preventing and managing violence against health-care staff can assist policymakers and managers to develop multi-faceted approaches to violence prevention, including better recognition and understanding of perpetrators of violence. Originality/value This paper provides a unique perspective on thinking about violence in health care and the implications of its complexity.

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