scholarly journals Multiparameter Continuous Physiological Monitoring Technologies in Neonates Among Health Care Providers and Caregivers at a Private Tertiary Hospital in Nairobi, Kenya: Feasibility, Usability, and Acceptability Study (Preprint)

2021 ◽  
Author(s):  
Amy Sarah Ginsburg ◽  
Mai-Lei Woo Kinshella ◽  
Violet Naanyu ◽  
Jessica Rigg ◽  
Dorothy Chomba ◽  
...  

BACKGROUND Continuous physiological monitoring technologies are important for strengthening hospital care for neonates, particularly in resource-constrained settings, and understanding user perspectives is critical for informing medical technology design, development, and optimization. OBJECTIVE This study aims to assess the feasibility, usability, and acceptability of 2 noninvasive, multiparameter, continuous physiological monitoring technologies for use in neonates in an African health care setting. METHODS We assessed 2 investigational technologies from EarlySense and Sibel, compared with the reference Masimo Rad-97 technology through in-depth interviews and direct observations. A purposive sample of health care administrators, health care providers, and caregivers at Aga Khan University Hospital, a tertiary, private hospital in Nairobi, Kenya, were included. Data were analyzed using a thematic approach in NVivo 12 software. RESULTS Between July and August 2020, we interviewed 12 health care providers, 5 health care administrators, and 10 caregivers and observed the monitoring of 12 neonates. Staffing and maintenance of training in neonatal units are important feasibility considerations, and simple training requirements support the feasibility of the investigational technologies. Key usability characteristics included ease of use, wireless features, and reduced number of attachments connecting the neonate to the monitoring technology, which health care providers considered to increase the efficiency of care. The main factors supporting acceptability included caregiver-highlighted perceptions of neonate comfort and health care respondent technology familiarity. Concerns about the side effects of wireless connections, electromagnetic fields, and mistrust of unfamiliar technologies have emerged as possible acceptability barriers to investigational technologies. CONCLUSIONS Overall, respondents considered the investigational technologies feasible, usable, and acceptable for the care of neonates at this health care facility. Our findings highlight the potential of different multiparameter continuous physiological monitoring technologies for use in different neonatal care settings. Simple and user-friendly technologies may help to bridge gaps in current care where there are many neonates; however, challenges in maintaining training and ensuring feasibility within resource-constrained health care settings warrant further research. INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2019-035184

10.2196/29755 ◽  
2021 ◽  
Vol 23 (10) ◽  
pp. e29755
Author(s):  
Amy Sarah Ginsburg ◽  
Mai-Lei Woo Kinshella ◽  
Violet Naanyu ◽  
Jessica Rigg ◽  
Dorothy Chomba ◽  
...  

Background Continuous physiological monitoring technologies are important for strengthening hospital care for neonates, particularly in resource-constrained settings, and understanding user perspectives is critical for informing medical technology design, development, and optimization. Objective This study aims to assess the feasibility, usability, and acceptability of 2 noninvasive, multiparameter, continuous physiological monitoring technologies for use in neonates in an African health care setting. Methods We assessed 2 investigational technologies from EarlySense and Sibel, compared with the reference Masimo Rad-97 technology through in-depth interviews and direct observations. A purposive sample of health care administrators, health care providers, and caregivers at Aga Khan University Hospital, a tertiary, private hospital in Nairobi, Kenya, were included. Data were analyzed using a thematic approach in NVivo 12 software. Results Between July and August 2020, we interviewed 12 health care providers, 5 health care administrators, and 10 caregivers and observed the monitoring of 12 neonates. Staffing and maintenance of training in neonatal units are important feasibility considerations, and simple training requirements support the feasibility of the investigational technologies. Key usability characteristics included ease of use, wireless features, and reduced number of attachments connecting the neonate to the monitoring technology, which health care providers considered to increase the efficiency of care. The main factors supporting acceptability included caregiver-highlighted perceptions of neonate comfort and health care respondent technology familiarity. Concerns about the side effects of wireless connections, electromagnetic fields, and mistrust of unfamiliar technologies have emerged as possible acceptability barriers to investigational technologies. Conclusions Overall, respondents considered the investigational technologies feasible, usable, and acceptable for the care of neonates at this health care facility. Our findings highlight the potential of different multiparameter continuous physiological monitoring technologies for use in different neonatal care settings. Simple and user-friendly technologies may help to bridge gaps in current care where there are many neonates; however, challenges in maintaining training and ensuring feasibility within resource-constrained health care settings warrant further research. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2019-035184


2018 ◽  
Vol 12 (2) ◽  
pp. 5-10
Author(s):  
Chanda Karki Bhandari ◽  
Gehanath Baral

Aims: The aim of the review is to understand the concept of abuse in health care in general and its various forms. It includes- review what is meant by healthcare and health care abuse; identify its various forms and to recognize who may be the most potential victims; find out the reasons of abuse by health care providers; and know the role of  ethical guidelines and institutional policy in confronting abuse in health care.Methods: Literatures and publications on the subject were searched in order to identify research studies investigating abuse in health care that were studied, analyzed and presented.  Results: Abuse in health care today is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated. Medical professionals and institutions are being targeted worldwide today for negligence and the medical litigation has become a huge challenge. Throughout history, health care professionals have been trusted because of their competency and caring abilities. However, the disturbing reality is that physical and psychological maltreatment of patients do occur in the health care settings throughout the world. The abuse can vary from treating someone with disrespect in a way which significantly affects the person's quality of life, to causing actual physical suffering. Differently able and dependent people are more susceptible to such abuse. Work overload, Staff burnout, lack of information and instructions were also indicated to underlie instances of abuse in health care.Conclusions: We in the healthcare facility should first accept that abuse in health care does occur and causes distress. This change needs to occur at individual, cultural and structural level. Next step will be for the staffs to be aware of abuse in health care when it happens and recognize it as such. It is always better to create a situation where we could prevent abuse from happening at health centers. Hospital personnel must implement a change in workplace culture to stop abusive behaviors wherever they occur. Each and every health care facility should be client friendly and respecting their rights. Effective ethical guidelines were needed to minimize abuse as existing ethical codes were found to be ineffective and above all there was a lack of awareness of the contents of the relevant ethical documents.


Author(s):  
Mayadhar Panda ◽  
Sikata Nanda

Background: As a part of “Swachh Bharat Abhiyaan” campaign, the Ministry of Health and Family welfare, Govt. of India had launched “Kayakalp” in 2015, an initiative to promote cleanliness and enhance the quality of public health facilities. Our aim was to study the situational analysis of the health institution using Kayakalp tool; to assess the level of cleanliness, hygiene and infection control practices in the facility and to assess the status of Bio-medical waste management in the health care facility and to suggest remedial measures based on the study finding.Methods: It is a hospital based snapshot study done during a period of one year from April 2016 to March 2017. Kayakalp assessment tool was used for analysis.Results: The total scores for upkeep maintenance obtained in 2016-17 was 69 and for the year 2017-18 was 81. There was an increase of total score in the year 2017-18 and it was found to be statistically significant. On assessment in the year 2016-17, for BMW the total score obtained was 58 and in the year 2017-18 it was 81. There was a statistically significant increase in the scores (p=0.001) obtained in the year (2017-18).Conclusions: Improvements in Biomedical waste management can be made by increasing the knowledge, awareness and practices of the health care providers as well as the beneficiaries with regular periodic monitoring. 


2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Hesham S. Taha ◽  
Mirna M. Shaker ◽  
Mohamed M. Abdelghany

Abstract Background The COVID-19 pandemic poses a major burden to the healthcare system in Egypt, and in the face of a highly infective disease which can prove fatal, healthcare systems need to change their management protocols to meet these new challenges. Main body This scientific statement, developed by the cardiology department at Cairo University, emphasized 6 different aspects that are intended to guide healthcare providers during cardiopulmonary resuscitation (CPR) in the era of the COVID-19 pandemic. It highlighted the importance of dealing with all cardiac arrest victims, during the pandemic, as potential COVID-19 cases, and the use of appropriate personal protective equipment (PPE) by health care providers during the procedure. It also stated that the CPR procedure should be done in a separate room with the door closed and that the number of providers present during the procedure should be limited to only those who are essential for patient resuscitation. It also stressed that family members and accompanying personnel of patients with possible COVID-19 should not be in the vicinity of CPR site. The statement also pointed out that CPR procedure should be done in the standard manner with precautions to minimize spread of infection to the staff and accompanying people. Early intubation was prioritized, and the use of rapid sequence intubation with appropriate PPE was recommended. For delivery of CPR for the prone ventilated patient, delivery of chest compressions by pressing the patient’s back, while a team prepares to turn the patient supine, was recommended. During intra-hospital transport, it was emphasized that the receiving intensive care unit (ICU) should be notified about the possibility of the patient being COVID-19 positive, so that appropriate infection control precautions are taken. Conclusion Cardiopulmonary resuscitation of cardiac arrest patients in the COVID-19 era poses a significant challenge, and all health care providers should deal with any cardiac arrest victim presenting to the emergency department as potential COVID-19 suspects and should use the appropriate PPE.


2020 ◽  
Vol 7 (6) ◽  
pp. 1627-1633
Author(s):  
Courtney Caminiti ◽  
Lily Deng ◽  
Patricia Greenberg ◽  
Anthony Scolpino ◽  
Catherine Chen ◽  
...  

Objective: To evaluate perceptions regarding cell phone use in a teaching hospital setting among health care providers, residents, medical students, and patients. Methods: Fifty-three medical students, 41 resident physicians, 32 attending physicians, and 46 nurses working at University Hospital completed a questionnaire about cell phone use practices and their perceptions of cell phone use in the hospital. Forty-three inpatients admitted to medical/surgical units at University Hospital were surveyed at bedside about their perceptions regarding physicians’ cell phone use. Results: All health care providers identified cell phones as a risk to patient confidentiality with no specific group significantly more likely to attribute risk than another. Practitioners were identified as either primarily as inpatient or outpatient practitioners. Inpatient practitioners were significantly more likely to rate cell phones as beneficial to patient care than outpatient practitioners. Physicians were statistically more likely to rate mobile phones as beneficial to patient care as compared to nurses. Among the patient population surveyed, one quarter noted that their physician had used a cell phone in their presence. The majority of those patients observing practitioner cell phone use had reported a beneficial or neutral impact on their care. Significance: Perceived risk of cell phones to patient confidentiality was equal across health care providers surveyed. Physician and medical students were significantly more likely to rate cell phones as beneficial to patients’ care than nurse providers. Patients indicated that their physicians used cell phones in their presence at low rates and reported that the use was either neutral or beneficial to the care they received.


2008 ◽  
Vol 18 (5) ◽  
pp. 921-928 ◽  
Author(s):  
N. Reis ◽  
R. Engin ◽  
M. Ingec ◽  
B. Bag

The study was designed as a descriptive one to reveal the beliefs and attitudes of the women undergoing abdominal hysterectomy. It was carried out at the university hospital in Erzurum between July 2005 and March 2006. The data were collected through semistructured in-depth interviews with 31 women undergoing abdominal hysterectomy. The data obtained were evaluated by content analysis. These evaluations revealed five themes concerning the beliefs and attitudes of the women undergoing abdominal hysterectomy: (1) feminine identity, (2) husband/family relationships, (3) sexual life, (4) menopause, and (5) relatives' opinions. These findings about cultural beliefs and attitudes of the women undergoing hysterectomy will enable health care providers to provide culturally sensitive and comprehensive care to women; it is also expected to enable health care providers to instruct women to avoid unnecessary delay of hysterectomy


2021 ◽  
Vol 9 ◽  
pp. 251513552110325
Author(s):  
Juny Sebastian ◽  
Gurumurthy Parthasarathi ◽  
Mandyam Dhati Ravi

Background and Aims: Maintaining the quality and safety of immunization is as important as the efficacy of vaccines in vaccine-preventable diseases (VPD) programs. The aim of this study was to determine the problems associated with different stages of vaccine use and to assess the outcome of an educational intervention on safety and quality use of vaccines among health care providers. Methods: A pilot prospective interventional study was conducted over a period of 2 years at 271 sites in Mysuru, India. The study population was health care professionals (HCPs) involved in immunization and a sample of parents (one per site). A validated questionnaire was used as a study tool. An educational intervention on best immunization practice was conducted for the enrolled HCPs and the impact of the educational intervention was assessed using the study tool after 3 weeks. Results: The total number of the study population was 594 (323 HCPs and 271 parents). Of these, 41.49% were working at community health care facility and 33.13% were enrolled from primary care centers. There were statistically significant improvements in post interventional assessment of all stages of the immunization process including storage ( p −0.001), transportation ( p −0.001), administration ( p 0.001), monitoring and reporting of adverse events following immunization (AEFIs) ( p −0.001), knowledge of AEFIs ( p 0.001), and HCP-parent communication ( p 0.001). AEFI reporting improved by 30% in the post education phase. Conclusion: Continuous education and motivation can result in positive behavioral changes on best immunization practices amongst HCPs involved in immunization, which may help to improve and maintain the safety and quality use of vaccines in immunization centers irrespective of the type of facility.


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