scholarly journals The neonatal transfer process through the lens of neonatologists at public hospitals in South Africa

2021 ◽  
Vol 26 ◽  
Author(s):  
Pradeep Ashokcoomar† ◽  
Raisuyah Bhagwan
Keyword(s):  
South Africa ◽  
Transfer Process ◽  
Public Hospitals

scholarly journals The neonatal transfer process through the lens of neonatologists at public hospitals in South Africa

2022 ◽  
Vol 27 ◽  
Author(s):  
Pradeep Ashokcoomar ◽  
Raisuyah Bhagwan
Keyword(s):  
South Africa ◽  
Critically Ill ◽  
Transfer Process ◽  
Life Support ◽  
Advanced Life Support ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Team Members ◽  
Healthcare Facilities ◽  
Tertiary Hospitals

Background: Neonatal care is provided by various levels of healthcare facilities in South Africa. Intensive care for neonates is only provided at the higher levels, hence the need for transfers from lower-level to higher-level facilities (e.g. primary hospitals to tertiary hospitals) or across levels of facilities, particularly when life-threatening situations arise (e.g. cardiac deterioration, respiratory deterioration and desaturation).Aim: The aim of the study was to explore neonatologists’ views regarding the neonatal transfer process and to describe the preparedness of advanced life support (ALS) paramedics to undertake such transfers.Setting: The setting consisted of neonatologists from three provinces i.e. KwaZulu-Natal, Gauteng and Western cape.Method: A qualitative descriptive design was utilised in this study. Semistructured interviews were conducted on the public health hospitals in three provinces (N = 9; n = 3) with neonatologists (N = 7; n = 7) who were involved in the transfers of critically ill neonates. The process of thematic analysis was used.Results: The themes that emerged in this study were: an awareness of local contextual realities related to neonatal transfers, challenges evident within the context of neonatal transfers, decision-making around the transfer of ill neonates, ALS paramedic preparedness for transfers and good clinical governanceConclusion: The study found that there was a need to be aware of local contextual realities confronting neonatal transfers, a need for greater preparedness for paramedics to undertake these transfers, a need for a sound referral processes and a need for coordinated transfer effort between paramedics, hospital staff and transport team members for the successful transfer of critically ill neonates.Contribution: The findings highlight the challenges confronting the neonatal transfer process in South Africa through the lens of neonatologist at public hospitals. Hence, the study reinforces the preparedness and coordination of the transfer process, along with more efficient communication between paramedics, hospital staff and the transfer team.

Assessing the Appraisal, Disposal and Transfer of Records from 1994 to 2014: The Case of Mpumalanga Provincial Government in South Africa

Mousaion ◽  
2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Nkholedzeni Sidney Netshakhuma
Keyword(s):  
South Africa ◽  
Transfer Process ◽  
Qualitative Method ◽  
Document Analysis ◽  
Provincial Government ◽  
Specific Objective

This study was conceptualised in order to assess the appraisal, disposal and transfer of archival records from the Mpumalanga Provincial Government (MPG) to the Mpumalanga Provincial Archives (MPA) for the period from 1994 to 2013. The study’s specific objective was to investigate the transfer process of archival records in terms of the Mpumalanga Archives Act, No. 14 of 1998. The study used a qualitative method through document analysis, interviews and observation. The sample for the study comprised the MPG and municipality records managers. The Mpumalanga provincial archivists were also interviewed as the custodians of the MPA. The key findings revealed that the MPG and the municipality did not comply with the Mpumalanga Archives Act, No. 14 of 1998 in terms of transferring records with archival value to the MPA as stipulated by the act. This has adverse implications for efficient administration of records in the country.  

scholarly journals Quality of recovery after total hip and knee arthroplasty in South Africa: a national prospective observational cohort study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ulla Plenge ◽  
Romy Parker ◽  
Shamiela Davids ◽  
Gareth L. Davies ◽  
Zahnne Fullerton ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Knee Arthroplasty ◽  
Patient Characteristics ◽  
Public Hospitals ◽  
Morbidly Obese ◽  
Total Hip ◽  
Quality Of Recovery ◽  
Hip And Knee Arthroplasty

Abstract Background Encouraged by the widespread adoption of enhanced recovery protocols (ERPs) for elective total hip and knee arthroplasty (THA/TKA) in high-income countries, our nationwide multidisciplinary research group first performed a Delphi study to establish the framework for a unified ERP for THA/TKA in South Africa. The objectives of this second phase of changing practice were to document quality of patient recovery, record patient characteristics and audit standard perioperative practice. Methods From May to December 2018, nine South African public hospitals conducted a 10-week prospective observational study of patients undergoing THA/TKA. The primary outcome was ‘days alive and at home up to 30 days after surgery’ (DAH30) as a patient-centred measure of quality of recovery incorporating early death, hospital length of stay (LOS), discharge destination and readmission during the first 30 days after surgery. Preoperative patient characteristics and perioperative care were documented to audit practice. Results Twenty-one (10.1%) out of 207 enrolled patients had their surgery cancelled or postponed resulting in 186 study patients. No fatalities were recorded, median LOS was 4 (inter-quartile-range (IQR), 3–5) days and 30-day readmission rate was 3.8%, leading to a median DAH30 of 26 (25–27) days. Forty patients (21.5%) had pre-existing anaemia and 24 (12.9%) were morbidly obese. In the preoperative period, standard care involved assessment in an optimisation clinic, multidisciplinary education and full-body antiseptic wash for 67 (36.2%), 74 (40.0%) and 55 (30.1%) patients, respectively. On the first postoperative day, out-of-bed mobilisation was achieved by 69 (38.1%) patients while multimodal analgesic regimens (paracetamol and Non-Steroid-Anti-Inflammatory-Drugs) were administered to 29 patients (16.0%). Conclusion Quality of recovery measured by a median DAH30 of 26 days justifies performance of THA/TKA in South African public hospitals. That said, perioperative practice, including optimisation of modifiable risk factors, lacked standardisation suggesting that quality of patient care and postoperative recovery may improve with implementation of ERP principles. Notwithstanding the limited resources available, we anticipate that a change of practice for THA/TKA is feasible if ‘buy-in’ from the involved multidisciplinary units is obtained in the next phase of our nationwide ERP initiative. Trial registration The study was registered with ClinicalTrials.gov (NCT03540667).

scholarly journals Challenges in implementing continuous support during childbirth in selected public hospitals in the North West Province of South Africa

2018 ◽  
Vol 23 ◽  
Author(s):  
Nobelungu S. Spencer ◽  
Antoinette Du Preez ◽  
Catharina S. Minnie
Keyword(s):  
South Africa ◽  
Negative Impact ◽  
Cochrane Review ◽  
Public Hospitals ◽  
North West ◽  
The North ◽  
North West Province ◽  
Continuous Support ◽  
Group Interviews ◽  
Personal Challenges

Background: According to a Cochrane review, continuous support during childbirth increases the mother’s chances of a vaginal birth without identified adverse effects. However, this evidence-based practice is not universally implemented. The objective of the study was to identify challenges encountered in implementing continuous support during childbirth in public hospitals in the North West Province of South Africa. Method: An explorative, descriptive and contextual qualitative approach was used. The data were collected during 2013 by conducting focus group interviews with 33 registered midwives who had worked in maternity units in three selected public hospitals in the North West Province for at least two years. Results: Midwives identified challenges that negatively impacted the implementation of continuous support during childbirth at organisational and interpersonal levels. At the organisational level, challenges included human resources, policies and guidelines as well as the architectural outlay of the maternity units. The personal challenges related to communication and attitudes of nurses, patients and their families.  Conclusions: Organisational and personal challenges had a negative impact on the provision of continuous care during childbirth.

scholarly journals Feasibility of using point prevalence surveys to assess antimicrobial utilisation in public hospitals in South Africa: a pilot study and implications

2019 ◽  
Vol 47 (2) ◽  
pp. 88-95 ◽  
Author(s):  
Nokuthula N. Dlamini ◽  
Johanna C. Meyer ◽  
Danie Kruger ◽  
Amanj Kurdi ◽  
Brian Godman ◽  
...  
Keyword(s):  
South Africa ◽  
Pilot Study ◽  
Public Hospitals ◽  
Point Prevalence
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