Perspectives of Nurses About Factors Affecting Quality of Care at the Solomon Islands National Referral Hospital During the 2016-2017 Dengue Outbreak: A Qualitative Study

2021 ◽  
pp. 101053952110362
Author(s):  
Norma Denty Goulolo ◽  
Hugo Bugoro ◽  
Maxine Whittaker ◽  
Sarah Larkins ◽  
Humpress Harrington ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Nursing Care ◽  
Solomon Islands ◽  
Referral Hospital ◽  
Key Factors ◽  
Group Discussions ◽  
Factors Affecting ◽  
Dengue Outbreak ◽  
National Referral Hospital

During the 2016-2017 Solomon Islands dengue outbreak, the National Referral Hospital (NRH) in Honiara was the epicenter for the national response. High-quality nursing care is critical for successful management and this study investigated the factors affecting the quality of nursing care for patients admitted to NRH with dengue. Data were collected using 2 methods: ( a) Focus group discussions with nurses who cared for dengue patients and ( b) a self-administered questionnaire completed by a senior manager. Analysis of qualitative data using a thematic technique found 2 key factors affected care: ( a) training on protocols and guidelines for clinical management and ( b) planning and preparedness of NRH. Quality of care was influenced by lack of basic equipment, transport provided for nursing staff to attend shifts, and confusion between allowances for regular salaried staff and extra staff assisting with the outbreak. Specific attention is needed in future outbreaks to ensure staff understand protocols, follow guidelines, and that adequate equipment is provided.

scholarly journals Factors Affecting the Initial Engagement of Older Adults in the Use of Interactive Technology

2021 ◽  
Vol 18 (6) ◽  
pp. 2847
Author(s):  
Lina Lee ◽  
Mary Lou Maher
Keyword(s):  
Older Adults ◽  
Interactive Technology ◽  
Key Factors ◽  
Group Discussions ◽  
Interactive Technologies ◽  
Factors Affecting ◽  
Diary Studies ◽  
User Focus ◽  
Depth Interviews

Smart environments and the use of interactive technology has the potential to improve the quality of life for the senior community as well as to support the connections among the senior community and the world outside their community. In addition to the increasing number of studies in the field of aging and technologies, research is needed to understand the practical issues of user focus, adoption, and engagement for older adults to accept interactive technologies in their lives. In this study, we use two commercial technological interventions (uDraw and GrandPad) to understand technology-related perceptions and behaviors of older adults. We present five case studies that emerge from empirical observations of initial engagement with technology through research methods such as focus group discussions, in-depth interviews, observations, and diary studies. The contributions of this study are identification of the key factors that influence the initial engagement with interactive technology for older adults.

scholarly journals Individual and Social Factors Affecting Nurses’ Attitudes Toward and Quality of Care Given to Patients Who Attempted Suicide

2018 ◽  
Vol 3 (2) ◽  
pp. 82
Author(s):  
Fariba Bolourchifard ◽  
Fatemeh Basaadat Kavkouhi ◽  
Ali Darvishpoor Kakhaki ◽  
Maliheh Nasiri
Keyword(s):  
Quality Of Care ◽  
Nursing Care ◽  
Significant Relationship ◽  
Work Experience ◽  
Attempted Suicide ◽  
Factors Affecting ◽  
The Social ◽  
Critical Patients ◽  
Quality Of Nursing

Introduction: Nurses are the first healthcare professionals who meet patients who attempt suicide, and their attitudes toward these patients may be important. The purpose of this study was to evaluate the effect of demographic factors on nurses’ attitudes toward patients who attempt suicide and the quality of nursing care that these patients receive.Materials and Methods: This descriptive-correlational study was performed using the convenience sampling method on 182 nurses working at selected hospitals of medical universities in Tehran, Iran. Data were collected using questionnaires that gathered information about demographics, nurses’ attitudes toward patients who attempted suicide, and the quality of nursing care provided. Data were analyzed by the Statistical Package for the Social Sciences v.20 software and by the Pearson test and t-tests.Results: Regarding social and mental aspects, we found no significant statistical relationship between age and work experience with respect to nurses’ attitudes toward and the quality of care provided to patients who attempted suicide, but women provided higher-quality nursing care than men (P=0.046). Although the relationship between education and quality of nursing care was statistically significant (P=0.007), we found no significant relationship between education and attitude.Conclusion: We found no significant relationship between age and work experience with respect to nurses’ attitudes toward, and the quality of care provided to, patients who attempted suicide, but women provided higher-quality nursing care than men. Furthermore, quality of care was higher from nurses who had a bachelor-level education, suggesting that higher-educated nurses should be recruited to care for critical patients.

scholarly journals A clinical audit report on quality of nursing documentation at Jigme dorji Wangchuck national referral Hospital, 2018

2019 ◽  
Vol 5 (2) ◽  
pp. 15-20
Author(s):  
Kencho Zangmo ◽  
Tshering Dema ◽  
Bhagawat Acharya ◽  
Sonam Sonam ◽  
Tshering Choden ◽  
...  
Keyword(s):  
Nursing Care ◽  
Oral Communication ◽  
Referral Hospital ◽  
Care Process ◽  
Sources Of Information ◽  
Nursing Documentation ◽  
Cross Sectional ◽  
National Referral Hospital ◽  
Quality Of Nursing

Introduction: Whether it is a written documentation or an oral communication, the practice and delivery of healthcare is debated to be critically dependent on effective and efficient communication. Nursing documentation is one of the principal sources of information about patient care and an important tool for communication. This descriptive study assessed both quantitative completeness and quality of nursing documentation by major in-patient units of Jigme Dorji Wangchuck National Referral Hospital. Methods: This cross-sectional study used D-catch tool. Data of randomly selected 317 patient records from six major in-patient units were entered into EpiData file. Using STATA version IC/14, descriptive statistics and multi variable analysis were carried out. Results: Overall quantitative completeness (M-3.4, SD-.59) of the nursing documentation was higher compared to the quality of the documents maintained (M-2.8, SD-.79). The basic and less time-consuming information such as admission data and vital signs charting are documented better compared to the more time consuming and complex documentation such as nursing care process. Conclusion: Systems should not only be in place to enhance documentation quantitatively but also consider uplifting the quality of the documents maintained. Initiating centralized admission system in the hospital may reduce nurses’ burden of clerical documentation, which will allow them to focus on quality nursing documentation and overall nursing care of patients.

Nurses’ Perceptions of a Care Plan Information Technology Solution With Hundreds of Clinical Practice Guidelines in Adult Intensive Care Units: Survey Study (Preprint)

2018 ◽  
Author(s):  
Azizeh Khaled Sowan ◽  
Meghan Leibas ◽  
Albert Tarriela ◽  
Charles Reed
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Clinical Practice ◽  
Nursing Care ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Care Plan ◽  
System Use ◽  
Nurses Perceptions

BACKGROUND The integration of clinical practice guidelines (CPGs) into the nursing care plan and documentation systems aims to translate evidence into practice, improve safety and quality of care, and standardize care processes. OBJECTIVE This study aimed to evaluate nurses’ perceptions of the usability of a nursing care plan solution that includes 234 CPGs. METHODS A total of 100 nurses from 4 adult intensive care units (ICUs) responded to a survey measuring nurses’ perceptions of system usability. The survey included 37 rated items and 3 open-ended questions. RESULTS Nurses’ perceptions were favorable with more than 60.0% (60/100) in agreement on 12 features of the system and negative to moderate with 20.0% (20/100), to 59.0% (59/100) in agreement on 19 features. The majority of the nurses (80/100, 80.0% to 90/100, 90.0%) agreed on 4 missing safety features within the system. More than half of the nurses believed they would benefit from refresher classes on system use. Overall satisfaction with the system was just above average (54/100, 54.0%). Common positive themes from the narrative data were related to the system serving as a reminder for complete documentation and individualizing patient care. Common negative aspects were related to duplicate charting, difficulty locating CPGs, missing unit-specific CPGs, irrelevancy of information, and lack of perceived system value on patient outcomes. No relationship was found between years of system use or ICU experience and satisfaction with the system (P=.10 to P=.25). CONCLUSIONS Care plan systems in ICUs should be easy to navigate; support efficient documentation; present relevant, unit-specific, and easy-to-find information; endorse interdisciplinary communication; and improve safety and quality of care.

scholarly journals Effective coverage and budget implications of skill-mix change to improve neonatal nursing care: an explorative simulation study in Kenya

2019 ◽  
Vol 4 (6) ◽  
pp. e001817 ◽  
Author(s):  
Apostolos Tsiachristas ◽  
David Gathara ◽  
Jalemba Aluvaala ◽  
Timothy Chege ◽  
Edwine Barasa ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Neonatal Mortality ◽  
Nursing Care ◽  
Public Hospitals ◽  
Sensitivity Analyses ◽  
Full Time ◽  
Skill Mix ◽  
Neonatal Nursing ◽  
Low Middle Income Countries

IntroductionNeonatal mortality is an urgent policy priority to improve global population health and reduce health inequality. As health systems in Kenya and elsewhere seek to tackle increased neonatal mortality by improving the quality of care, one option is to train and employ neonatal healthcare assistants (NHCAs) to support professional nurses by taking up low-skill tasks.MethodsMonte-Carlo simulation was performed to estimate the potential impact of introducing NHCAs in neonatal nursing care in four public hospitals in Nairobi on effectively treated newborns and staff costs over a period of 10 years. The simulation was informed by data from 3 workshops with >10 stakeholders each, hospital records and scientific literature. Two univariate sensitivity analyses were performed to further address uncertainty.ResultsStakeholders perceived that 49% of a nurse full-time equivalent could be safely delegated to NHCAs in standard care, 31% in intermediate care and 20% in intensive care. A skill-mix with nurses and NHCAs would require ~2.6 billionKenyan Shillings (KES) (US$26 million) to provide quality care to 58% of all newborns in need (ie, current level of coverage in Nairobi) over a period of 10 years. This skill-mix configuration would require ~6 billion KES (US$61 million) to provide quality of care to almost all newborns in need over 10 years.ConclusionChanging skill-mix in hospital care by introducing NHCAs may be an affordable way to reduce neonatal mortality in low/middle-income countries. This option should be considered in ongoing policy discussions and supported by further evidence.

scholarly journals Improving nursing documentation for surgical patients in a referral hospital in Freetown, Sierra Leone: protocol for assessing feasibility of a pilot multifaceted quality improvement hybrid type project

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nataliya Brima ◽  
Nick Sevdalis ◽  
K. Daoh ◽  
B. Deen ◽  
T. B. Kamara ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Sierra Leone ◽  
Referral Hospital ◽  
Audit And Feedback ◽  
Health System Strengthening ◽  
Theory Of Change ◽  
Improve Quality ◽  
Nursing Documentation

Abstract Background There is an urgent need to improve quality of care to reduce avoidable mortality and morbidity from surgical diseases in low- and middle-income countries. Currently, there is a lack of knowledge about how evidence-based health system strengthening interventions can be implemented effectively to improve quality of care in these settings. To address this gap, we have developed a multifaceted quality improvement intervention to improve nursing documentation in a low-income country hospital setting. The aim of this pilot project is to test the intervention within the surgical department of a national referral hospital in Freetown, Sierra Leone. Methods This project was co-developed and co-designed by in-country stakeholders and UK-based researchers, after a multiple-methodology assessment of needs (qualitative, quantitative), guided by a participatory ‘Theory of Change’ process. It has a mixed-method, quasi-experimental evaluation design underpinned by implementation and improvement science theoretical approaches. It consists of three distinct phases—(1) pre-implementation(project set up and review of hospital relevant policies and forms), (2) intervention implementation (awareness drive, training package, audit and feedback), and (3) evaluation of (a) the feasibility of delivering the intervention and capturing implementation and process outcomes, (b) the impact of implementation strategies on the adoption, integration, and uptake of the intervention using implementation outcomes, (c) the intervention’s effectiveness For improving nursing in this pilot setting. Discussion We seek to test whether it is possible to deliver and assess a set of theory-driven interventions to improve the quality of nursing documentation using quality improvement and implementation science methods and frameworks in a single facility in Sierra Leone. The results of this study will inform the design of a large-scale effectiveness-implementation study for improving nursing documentation practices for patients throughout hospitals in Sierra Leone. Trial registration Protocol version number 6, date: 24.12.2020, recruitment is planned to begin: January 2021, recruitment will be completed: December 2021.

Grain Refinement and Hot Tearing of Aluminium Alloys - How to Optimise and Minimise

2009 ◽  
Vol 630 ◽  
pp. 213-221 ◽  
Author(s):  
Mark Easton ◽  
David H. StJohn ◽  
Lisa Sweet
Keyword(s):  
Grain Refinement ◽  
Aluminium Alloys ◽  
Hot Tearing ◽  
Key Factors ◽  
Grain Refiner ◽  
Factors Affecting ◽  
Equiaxed Grains

Grain refinement and hot tearing are important key factors affecting the quality of castings. There have been substantial advances in the understanding of both of these phenomena over the last two decades. The paper discusses strategies for obtaining the lowest cost grain refiner addition and provides an explanation for how the refinement of equiaxed grains leads to a reduction in hot tear susceptibility. However, it also provides a warning that adding more grain refiner may not be better for reducing hot tear susceptibility. Alloy factors affecting hot tearing are also discussed. Finally, a list of six key considerations is provided to help casthouse and foundry engineers when trying to optimise grain refinement and reduce hot tearing.

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