Audit of Bloemfontein Primary Healthcare Clinics' Emergency Preparedness

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Dirk T Hagemeister ◽  
Molibeli Makhoathi ◽  
Lerato Sekhutsoanyane ◽  
Nqobile Dladla ◽  
Sinenhlanhla Mbongo ◽  
...  

Primary health clinic staff must be prepared to manage medical emergencies until an ambulance arrives. This study aimed to determine how well prepared clinics in Bloemfontein, South Africa, are to manage common emergencies regarding consumables, equipment and medication, secondarily to identify common emergencies. This was an observational descriptive study and included all 16 public primary health clinics in the Bloemfontein sub-district. Data were collected using a walk-through audit tool based on current provincial equipment lists. Mean compliance was 45 per cent (range 32–67%) for consumables, 53 per cent (range 46–63%) for equipment, and 58 per cent (range 36–77%) for medication. None of the clinics achieved a level of above 90 per cent in any of these three categories. Six clinics (38%) scored below 40 per cent for consumables, one (6%) for equipment and two (13%) for medication. Items not found in any of the clinics were paediatric or neonatal Magill forceps, size 6.5 cuffed and 4.5 uncuffed endotracheal tubes, and 14 g intravenous cannulas. Two clinics had an automated external defibrillator. Respiratory (asthma), metabolic (hypo- and hyperglycaemia) and cardio circulatory (hypertension) were the most common emergencies. Almost half of all the clinics scored less than 40 per cent in at least one of the three categories, suggesting a general “poor culture” of maintaining emergency trolleys. The utilisation of an easy-to-use audit tool to monitor the emergency preparedness of clinics appears essential. Identified challenges with such a tool need to be dealt with and clear audit rules must accompany such a tool. Audit results should be used in the performance assessment of responsible managers.

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3487 ◽  
Author(s):  
Philip M. Giffard ◽  
Jiunn-Yih Su ◽  
Patiyan Andersson ◽  
Deborah C. Holt

Background The microbiome of built environment surfaces is impacted by the presence of humans. In this study, we tested the hypothesis that analysis of surface swabs from clinic toilet/bathroom yields results correlated with sexually transmitted infection (STI) notifications from corresponding human populations. We extended a previously reported study in which surfaces in toilet/bathroom facilities in primary health clinics in the Australian Northern Territory (NT) were swabbed then tested for nucleic acid from the STI agents Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. This was in the context of assessing the potential for such nucleic acid to contaminate specimens collected in such facilities. STIs are notifiable in the NT, thus allowing comparison of swab and notification data. Methods An assumption in the design was that while absolute built environment loads of STI nucleic acids will be a function of patient traffic density and facility cleaning protocols, the relative loads of STI nucleic acids from different species will be largely unaffected by these processes. Another assumption was that the proportion of swabs testing positive for STIs provides a measure of surface contamination. Accordingly, “STI profiles” were calculated. These were the proportions that each of the three STIs of interest contributed to the summed STI positive swabs or notifications. Three comparisons were performed, using swab data from clinics in remote Indigenous communities, clinics in small-medium towns, and a single urban sexual health clinic. These data were compared with time and place-matched STI notifications. Results There were significant correlations between swab and notifications data for the both the remote Indigenous and regional data. For the remote Indigenous clinics the p values ranged from 0.041 to 0.0089, depending on data transformation and p value inference method. Further, the swab data appeared to strongly indicate known higher relative prevalence of gonorrhoeae in central Australia than in northern Australia. Similarly, the regional clinics yielded p values from 0.0088–0.0022. In contrast, swab and notifications data from the sexual health clinic were not correlated. Discussion Strong correlations between swab and notifications were observed. However, there was evidence for limitations of this approach. Despite the correlation observed with the regional clinics data, one clinic yielded zero positive swabs for C. trachomatis, although this STI constituted 25.1% of the corresponding notifications. This could be ascribed to stochastic effects. The lack of correlation observed for sexual health clinic data was also likely due to stochastic effects. It was concluded that toilet/bathroom surface swab sampling has considerable potential for public health surveillance. The approach may be applicable in situations other than primary health clinics, and for targets other than STIs.


2018 ◽  
Vol 28 (3) ◽  
pp. 104-123 ◽  
Author(s):  
Mahmood Othman ◽  
Zachary Steel ◽  
Catalina Lawsin ◽  
Ruth Wells

Introduction: Syrian medical staff working in non-government controlled areas of Syria operate in situations that expose them to great personal danger, while they must often face the same challenges as the people they help. Supporting the wellbeing of these staff is crucial to the operation of health services for internally displaced Syrians given the large-scale destruction of healthcare infrastructure. Methods: Findings from a staffcare programme designed by a grassroots Syrian psychosocial organisation in Southern Turkey and implemented in a medical nongovernment organisation in Idlib in Northern Syria are presented. An iterative and collaborative process employed individual, team and organisational level consultation to identify occupational stresses within the workplace. A six-month programme involved group sessions across eight sites with 56 staff working in three primary health clinics, two mobile teams and one sexual and reproductive health clinic, serving eight internally displaced persons camps in Idlib. Results: Following the programme, staff reported significant reductions in role ambiguity, and improvements in the nature of their work, personal relationships with colleagues and superiors and physical conditions in the workplace. There were no significant differences in reported organisational structure or job satisfaction. Discussion: This evaluation of a grassroots programme, designed to address the expressed needs of displaced staff, suggests that reductions in daily living stresses can be achieved even in the context of ongoing crisis.


2021 ◽  
Vol 107 (10) ◽  
pp. 455-459
Author(s):  
Sigríður Óladóttir ◽  
◽  
Jón Steinar Jónsson ◽  
Margrét Ólafía Tómasdóttir ◽  
Hannes Hrafnkelsson ◽  
...  

INTRODUCTION: In recent decades there has been a notable increase in the prescription of opioids in western countries. With this rise in use of opioids the risk of side effects, opioid abuse and deaths linked to opioids have become more apparent. The increase in opioid prescription may partly stem from a change in attitude in relation to pain management. Research has shown that pain is among the most common reasons people seek medical care and chronic pain is prevalent. Iceland is leading the Nordic countries in opioid prescriptions. OBJECTIVE: To examine prescriptions of opioids in primary car in Iceland for all age group from 2008 to 2017. METHODS: The research included all opioid prescription in every health clinic in the capital area in Iceland the between 2008 and 2017. Population in the capital area in this time period was between 201 and 222 thousand people. Data was collected from medical records database of the primary health care and approximatley 68.000 individuals had received a prescription for opioids during the research period. RESULTS: During the research period there was a 17,2% (p<0,01) increase in DDD/1000 inhabitants/day (Defined daily dose) for opioids. About a third of those who got the prescription were men and that ratio did not change during the period. proportionately, the biggest change in DDD/1000 inhabitants/day was in the age group made of people 90 years old and older, about 40,5% (p<0,01). The biggest increase in number of people getting a prescription for opioids was in the age group 30-39, about 25,5% (p<0,01). Number of prescriptions increased in every category of opioids, measured in DDD/1000 inhabitants/day,15,3% (p<0,01) in parkódin, 20,7% (p<0,01) in parkódín forte, 4,7% (p<0,01) in tramadol and 85,6% (p<0,01) in the strongest opioids. Discussion: the evolution of prescriptions for every type of opioid to the clients of the health clinics in the capital area that occured in the years from 2008 to 2017, proportionately highest for the strongest opioids, should encourage a review of pain treatment within the health clinics and development within that field.


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Hope Padayachee ◽  
Muhammad E Hoque ◽  
Emmanuel Mutambara

This study was conducted to evaluate Patient Experience in primary health clinics in the province of KwaZulu-Natal (KZN). A quantitative study approach included 280 participants. The descriptive cross sectional study utilised a self-administered questionnaire as the research instrument, which was distributed to the target population of primary health care (PHC) users. The overall Patient Experience-Satisfaction showed that more than half of the respondents were not satisfied with the current Patient Experience in the primary health clinic. There was a significant association with age and the overall Patient Experience-Satisfaction (p<0.05). Older patients indicate a favourable Patient Experience when compared to younger patients, who are more critical of the Patient Experience elicited in primary health clinics. The results showed that gender did not significantly affect the overall Patient Experience-Satisfaction (p=0.957). Race significantly affected Patient Experience (p value = 0.011) with black respondents having a significantly lower mean rank of Patient Experience when compared to Indian respondents. There was an overall negative perception toward the Patient Experience elicited in users. There is an urgent need to review the service delivery of clinics. The need for a Patient Experience Model is highlighted for the health sector in South Africa.


Author(s):  
Selvakumari Selvadurai ◽  
Kit Yee Cheah ◽  
Min Wei Ching ◽  
Hanisah Kamaruddin ◽  
Xiao You Lee ◽  
...  

2017 ◽  
Vol 18 (03) ◽  
pp. 261-269 ◽  
Author(s):  
Nour A. Obeidat ◽  
Feras I. Hawari ◽  
Malek A. Habashneh ◽  
Rawan A. Shihab

AimTo measure the knowledge, perceptions, and practices of Jordanian primary healthcare practitioners (PHCPs) (physicians, nurses, midwives, and nurse aids) employed in Jordanian Ministry of Health (MoH) primary health clinics with respect to counseling on cancer (cancer screening, the signs and symptoms of cancer, and referral for specialized care).BackgroundIntegration of oncology services within primary care is a means of enhancing cancer early detection, and requires involvement of skilled. In the Middle East, little is known about PHCPs’ potential to be providers of such services.MethodsA questionnaire measuring PHCP perceptions and practices related to counseling on cancer screening and diagnosis was distributed to PHCPs across MoH clinics covering the main regions of Jordan.FindingsA total of 322 practitioners responded (75.1% response). Across most activities involving cancer detection, no more than 30% reported performing activities. Roughly half of PHCPs expressed discomfort at providing cancer-related counseling and at least 43% of non-physicians expressed limited confidence in cancer-related counseling. Confidence was a consistent predictor of provision of counseling and confidence in turn was associated with having greater knowledge, having positive a valuation of counseling, and being a physician. Results reveal points where educational efforts can strengthen PHCPs’ provision of cancer control-related services.


2018 ◽  
Vol 2 (3) ◽  
pp. 1-10
Author(s):  
Lim Shiang Cheng ◽  
Jens Aagaard-Hansen ◽  
Feisul Idzwan Mustapha ◽  
Ulla Bjerre-Christensen

Introduction: Studies from many parts of the world have explored factors associated with poor diabetes self-management including Diabetes Self-Management Education (DSME). Research Methodology: This study was conducted among 162 diabetes patients at primary healthcare clinics in Malaysia using semi-structured exit-interviews to explore their perceptions, attitudes and practices in relation to self-care and encounters with primary health care providers. Results and Discussion: Generally, the patients had limited knowledge, lack of motivation and encountered difficulties in diabetes self-management. The DSME was inadequate due to limited time allocated for consultations with doctors, language barriers and the lack of interpersonal and communication skills of HCPs. Conclusion: In view of the positive effects of quality DSME on the health outcomes and quality of life among diabetes patients, it is important for the primary healthcare clinics in Malaysia to strengthen the diabetes services through training in communication of all HCPs, awareness of language difference and task shifting.


Author(s):  
Fatima Aslam ◽  
Karimah Hanim Abd Aziz ◽  
Nurjasmine Aida Jamani ◽  
Razman Mohd Rus

Introduction: Co-morbidities such as obesity, gestational diabetes and pregnancy induced hypertension during pregnancy can be dangerous to the mother and foetus. Regular physical activity during pregnancy not only maintains maternal and foetal wellbeing, but it also maintains physical fitness and brings various health benefits. However, many women reduce their physical activity levels during pregnancy.Objectives: Thus, this study aimed to identify the barriers that could prevent pregnant mothers from doing physical activities.Methods: This is a cross-sectional study involving 168 pregnant women aged 18 to 35 years between gestational age 12 to 35 weeks in a primary health clinic in Kuantan, Pahang. Their socio-demographic characteristics were recorded, and barriers for physical activity assessed through a set of pre-tested questionnaire.Descriptive statisticswere used to describe the sociodemographiccharacteristics and the barriers.Results: The mean (SD) age was 28.0 (3.6) and majority of them were of Malay ethnicity from B40 group. Two thirds (74.4%) had tertiary education and 66.7% were working mothers. More than half (53.0%) of the participants wereoverweight and obese.Moreover, 58% of the participants had leg cramp and 63.1% felt fatigue. Almost 80.4% had backache and 46.4% had epigastric discomfort.Conclusion: Barriers such as leg cramp, backache, fatigue and epigastric discomfort could prevent pregnant women from conducting physical activities. Opportunistic recommendation by physician and concerns on the physical activity should be addressed.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S23


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