scholarly journals Reorganisation of primary care services during COVID-19 in the Western Cape, South Africa: Perspectives of primary care nurses

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Talitha Crowley ◽  
Danine Kitshoff ◽  
Frances De Lange-Cloete ◽  
Justine Baron ◽  
Santel De Lange ◽  
...  
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Online Survey ◽  
Healthcare Providers ◽  
Western Cape ◽  
Healthcare Facilities ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Nurses ◽  
Postgraduate Diploma

Background: Primary care nurses play a pivotal role in the response to disasters and pandemics. The coronavirus diseases 2019 (COVID-19) pandemic required preventative, diagnostic, and curative measures for persons presenting with symptoms of COVID-19 by healthcare providers, whilst continuing other essential services. We aimed to investigate the reorganisation of primary care services during COVID-19 from the perspectives of primary care nurses in the Western Cape province of South Africa.Methods: We administered an online survey with closed and open-ended questions to professional nurses enrolled for a Postgraduate Diploma in Primary Care Nursing at Stellenbosch University (2020) and alumni (2017–2019) working in the Western Cape. Eighty-three participants completed the questionnaire.Results: The majority of the participants (74.4%) reported that they were reorganising services using a multitude of initiatives in response to the diverse infrastructure, logistics and services of the various healthcare facilities. Despite this, 48.2% of the participants expressed concerns, which mainly related to possible non-adherence of patients with chronic conditions, the lack of promotive and preventative services, challenges with facility infrastructure, and staff time devoted to triage and screening. More than half of the participants (57.8%) indicated that other services were affected by COVID-19, whilst 44.6% indicated that these services were worse than before.Conclusion: Our findings suggest that the very necessary reorganisation of services that took place at the start of the COVID-19 pandemic in South Africa enabled effective management of patients infected with COVID-19. However, the reorganisation of services may have longer-term consequences for primary care services in terms of lack of care for patients with other conditions, as well as preventive and promotive care.

scholarly journals Health-Care Waste: Knowledge of Primary Care nurses

2018 ◽  
Vol 71 (5) ◽  
pp. 2367-2375 ◽  
Author(s):  
Ana Paula Mhirdaui Sanches ◽  
Karen Sayuri Mekaro ◽  
Rosely Moralez de Figueiredo ◽  
Silvia Carla da Silva André
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Family Health ◽  
Chemical Waste ◽  
Know How ◽  
Paulo State ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Nurses ◽  
Health Care Waste

ABSTRACT Objective: to describe the knowledge of nurses on Health-Care Waste Management (HCW) in Family Health Units (FHU) of São Carlos city, São Paulo State. Method: exploratory, descriptive and quantitative approach. The research was carried out with nurses of 16 FHU of the municipality of São Carlos-SP. Data were collected through an interview using a tool validated and analyzed using descriptive statistics. Results: it is noteworthy that 68.7% (11) of the nurses did not know how to describe how chemical waste was sorted. In addition, regarding the treatment of HCW, 50.0% (8) of the nurses did not know if the general waste were subjected to some type of treatment. Conclusion: the HCW management can be considered a challenge in the nurses' agenda inserted in the Primary Care services, which refers to the need to implement periodic training on the management of this waste.

scholarly journals Integrating HIV Care into Primary Care Services: Quantifying Progress of an Intervention in South Africa

PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e54266 ◽  
Author(s):  
Kerry E. Uebel ◽  
Gina Joubert ◽  
Edwin Wouters ◽  
Willie F. Mollentze ◽  
Dingie H. C. J. van Rensburg
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Hiv Care ◽  
Care Services ◽  
Primary Care Services

scholarly journals Psychiatry Residents' Perceptions and Reported Practices in Providing Primary Care

2017 ◽  
Vol 9 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Lisa M. Wehr ◽  
Erik R. Vanderlip ◽  
Patrick H. Gibbons ◽  
Jess G. Fiedorowicz
Keyword(s):  
Primary Care ◽  
Online Survey ◽  
Psychiatry Residents ◽  
Medical Conditions ◽  
Residency Programs ◽  
Care Services ◽  
Preventive Counseling ◽  
Primary Care Services ◽  
Primary Care Specialty ◽  
Improve Health

ABSTRACT Background Patients with psychiatric disorders have higher rates of chronic medical conditions and decreased life expectancy. Integrating medical and psychiatric care is likely to improve health outcomes for these patients. Objective This study examined what proportion of psychiatry residents viewed psychiatry as a primary care specialty, how important they felt it was to provide primary care to patients, and how this perception altered self-reported comfort and practice patterns in providing screening and treatment for select general medical conditions. Methods An online survey was sent to current psychiatry residents of US residency programs. Results A total of 268 residents from 40 programs completed the survey (25% response rate), with 55% (147 of 265) of respondents considering psychiatry to be a primary care specialty. Residents who held this opinion gave higher ratings for the importance of providing preventive counseling and reported counseling a higher percentage of patients on a variety of topics. They also reported screening more patients for several medical conditions. Residents who considered psychiatry to be primary care did not report greater comfort with treating these conditions, with the exception of dyslipidemia. The most commonly cited barrier to integrating primary care services was lack of time. Conclusions Residents' perceptions of psychiatry as a primary care field appears to be associated with a higher reported likelihood of counseling about, and screening for, medical conditions in their patients.

scholarly journals Seeking Healthcare During Lockdown: Challenges, Opportunities and Lessons for the Future

2021 ◽  
Author(s):  
Fiona Imlach ◽  
Eileen McKinlay ◽  
Jonathan Kennedy ◽  
Megan Pledger ◽  
Lesley Middleton ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Health Services ◽  
Online Survey ◽  
Influential Factors ◽  
System Level ◽  
Practice Environment ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Practices

Background: In Aotearoa/New Zealand, the first nation-wide coronavirus disease 2019 (COVID-19) lockdown occurred from March 23, 2020 to May 13, 2020, requiring most people to stay at home. Health services had to suddenly change how they delivered healthcare and some services were limited or postponed. This study investigated access to healthcare during this lockdown period, whether patients delayed seeking healthcare and reasons for these delays, focusing on the accessibility of primary care services. Methods: Adults (aged 18 years or older) who had contact with primary care services were invited through social media and email lists to participate in an online survey (n = 1010) and 38 people were recruited for in-depth interviews. We thematically analysed qualitative data from the survey and interviews, reported alongside relevant descriptive survey results. Results: More than half (55%) of survey respondents delayed seeking healthcare during lockdown. Factors at a national or health system-level that could influence delay were changing public service messages, an excessive focus on COVID-19 and urgent issues, and poor service integration. Influential factors at a primary care-level were communication and outreach, use of technology, gatekeeping, staff manner and the safety of the clinical practice environment. Factors that influenced patients’ individual decisions to seek healthcare were the ability to self-manage and self-triage, consciousness of perceived pressure on health services and fear of infection. Conclusion: In future pandemic lockdowns or crises, appropriate access to primary care services can be improved by unambiguous national messages and better integration of services. Primary care practices should adopt rapid proactive outreach to patients, fostering a calm but safe clinical practice environment. More support for patients to self-manage and self-triage appropriately could benefit over-burdened health systems during lockdowns and as part of business as usual in less extraordinary times.

scholarly journals 191 A classification of primary care pathways in emergency departments: a multi-methods study comprising cross-sectional survey; site visits with observations; semi-structured and informal interviews

2020 ◽  
Vol 37 (12) ◽  
pp. 841.2-842
Author(s):  
Michelle Edwards ◽  
Alison Cooper ◽  
Davies Freya ◽  
Andrew Carson-Stevens ◽  
Thomas Hughes ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Departments ◽  
Online Survey ◽  
Local Context ◽  
Framework Analysis ◽  
Front Door ◽  
Care Services ◽  
Primary Care Services

Aims/Objectives/BackgroundWe aim to describe and classify the predominant streaming pathways on arrival in Emergency Departments (EDs) in England and Wales and explain how they operate in different models of emergency department primary care services. Recent policy has encouraged a method whereby nurses stream from the emergency department front door to GPs working in a separate GP service operating within or alongside an ED. However, there is variation in methods of assessing and streaming patients on arrival at EDs. Conflated terminology causes difficulties in assessing relative performance, improving quality or gathering evidence about safety, clinical effectiveness. Our findings present a new classification of current streaming pathways from emergency departments to primary care services.Methods/DesignWe used a multi-stage method approach, including an online survey completed by 77 EDs across England & Wales, interviews with 21 clinical leads, and finally, undertaking case studies of 13 EDs. Qualitative data were triangulated and analysed using a framework analysis approach.Results/ConclusionsThe most common ED pathways to primary care services were: front door streaming before ED registration; streaming inside the ED; or without streaming but GPs selecting patients. Pathways were often adapted, to suit local circumstances such as department layout, patient demand levels, skill mix and interests of GPs practitioners and the accessibility of community primary care services. Pathways to redirect patients with non-urgent primary care problems to community primary care services were also used, with local variation in protocols based on staffing, patient demand and links to community primary care services. Local clinical leads and managers need to consider which pathway(s) may best suit their local context and needs. Consistency of terminology used to describe pathways between EDs and primary care services is necessary for multi-site evaluation, quality improvement and performance measurement.

scholarly journals Adapting primary care for new migrants: a formative assessment

BJGP Open ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. bjgpopen17X100701 ◽  
Author(s):  
Elizabeth Such ◽  
Elizabeth Walton ◽  
Brigitte Delaney ◽  
Janet Harris ◽  
Sarah Salway
Keyword(s):  
Primary Care ◽  
Case Studies ◽  
Online Survey ◽  
Resource Constraints ◽  
Sample Survey ◽  
Service Development ◽  
Care Provision ◽  
Care Services ◽  
Primary Care Services ◽  
The Uk

BackgroundImmigration rates have increased recently in the UK. Migrant patients may have particular needs that are inadequately met by existing primary care provision. In the absence of national guidance, local adaptations are emerging in response to these new demands.AimTo formatively assess the primary care services offered to new migrants and the ways in which practitioners and practices are adapting to meet need.Design & settingOnline survey and case studies of current practice across primary care in the UK. Case studies were selected from mainstream and specialist general practice as well as primary care provision in the third sector.MethodNon-probability sample survey of primary care practitioners (n = 70) with descriptive statistical analysis. Qualitative case studies (n = 8) selected purposively; in-depth exploration of organisational and practitioner adaptations to services. Analysis is structured around the principles of equitable care.ResultsSurvey results indicated that practitioners focused on working with communities and external agencies and adapting processes of, for example, screening, vaccination, and health checks. Lack of funding was cited most frequently as a barrier to service development (n = 51; 73%). Case studies highlighted the prominence partnership working and of an organisational and practitioner focus on equitable care. Adaptations centred on addressing wider social determinants, trauma, and violence, and additional individual needs; and on delivering culturally-competent care.ConclusionDespite significant resource constraints, some primary care services are adapting to the needs of new migrants. Many adapted approaches can be characterised as equity-oriented.

scholarly journals Primary care nurses’ preparedness for COVID-19 in the Western Cape province, South Africa

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Talitha Crowley ◽  
Danine Kitshoff ◽  
Frances De Lange-Cloete ◽  
Justine Baron ◽  
Santel De Lange ◽  
...  
Keyword(s):  
Primary Care ◽  
Personal Protective Equipment ◽  
Online Survey ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Western Cape ◽  
Global Public Health ◽  
Western Cape Province ◽  
Health Crisis ◽  
Primary Care Nurses

Introduction: The novel coronavirus 2019 or COVID-19 pandemic has brought about a global public health crisis. Primary care (PC) nurses render first line care, or refer for more specialised services.Aim: To investigate the preparedness of PC nurses for COVID-19 in the Western Cape.Setting: The Western Cape province of South Africa.Methods: We administered an online survey, with closed and open-ended questions, to 83 Stellenbosch University postgraduate PC nursing students and alumni working in the Western Cape, between 03 July and 01 September 2020.Results: The results indicated that 43.3% of participants were confident about the infection, prevention, and control (IPC) training they received and 56.7% felt prepared to provide direct care to suspected cases of COVID-19. Primary care nurses were more comfortable to triage (78.3%) than to manage persons with COVID-19 (42.2%), indicating that they may not be functioning to the full capacity of their education and training. Adequate infrastructure was reported by less than a third of the participants (30.1%) and 59.1% reported that personal protective equipment (PPE) was always available. Primary care nurses needed support in coping with stress (57.8%) although few (14.5%) reported access to mental health services.Conclusion: Primary care nurses were not prepared optimally for the COVID-19 pandemic. Challenges included adequate training, infrastructure, the availability of personal protective equipment, COVID-19 testing of health care workers and management support. Primary care nurses need comprehensive support to manage stress and anxiety.

scholarly journals Patient and public perception and experience of community pharmacy services post-discharge in the UK: a rapid review and qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043344
Author(s):  
Sarah Khayyat ◽  
Philippa Walters ◽  
Cate Whittlesea ◽  
Hamde Nazar
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Community Pharmacy ◽  
Healthcare Providers ◽  
Pharmacy Practice ◽  
Rapid Review ◽  
Post Discharge ◽  
Care Services ◽  
Primary Care Services ◽  
The Uk

ObjectivesTo investigate the perception and experience of patients and the public (PP) about community pharmacy (CP) services and other primary care services after hospital discharge back home.Design and settingA rapid review and qualitative study exploring PP perceptions of primary care, focusing on CP services in the UK.MethodsA mixed-methods approach was adopted including a rapid review undertaken between 24 April and 8 May 2019 across four databases (MEDLINE, EMBASE, PsycINFO and CINAHL). Semistructured interviews were then conducted investigating for shifts in current PP perception, but also nuanced opinion pertaining to CP services. A convenience sampling technique was used through two online PP groups for recruitment. Thematic framework analysis was applied to interview transcripts.ParticipantsAny consenting adults ≥18 years old were invited regardless of their medical condition, and whether they had used post-discharge services or not.ResultsTwenty-five studies met the inclusion criteria. Patients were generally supportive and satisfied with primary care services. However, some barriers to the use of these services included: resource limitations; poor communication between healthcare providers or between patient and healthcare providers; and patients’ lack of awareness of available services. From the 11 interviewees, there was a lack of awareness of CP post-discharge services. Nevertheless, there was general appreciation of the benefit of CP services to patients, professionals and wider healthcare system. Potential barriers to uptake and use included: accessibility, resource availability, lack of awareness, and privacy and confidentiality issues related to information-sharing. Several participants felt the uptake of such services should be improved.ConclusionThere was alignment between the review and qualitative study about high patient acceptance, appreciation and satisfaction with primary care services post-discharge. Barriers to the use of CP post-discharge services identified from interviews resonated with the existing literature; this is despite developments in pharmacy practice in recent times towards clinical and public health services.

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