scholarly journals The Influence of Servant Leadership and Motivation on the Service of Health Care Units in Way Kanan Regency

2021 ◽  
Vol 8 (9) ◽  
pp. 582-587
Author(s):  
Eko Agus Fitrianto Samah
Keyword(s):  
Health Care ◽  
Servant Leadership ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Health Department ◽  
Survey Analysis ◽  
District Health ◽  
Cross Sectional ◽  
Health Care Unit ◽  
Under Performing

The results of evaluation program by The Way Kanan Health Department in late 2013 shows 47 cases of death among toddlers, 7 cases of malnutrition, 2 cases of paralysis with withered body. This might have been an indication of the presence of under-performing servants in health care units. Two of the many factors influencing their performance are leadership and motivation. This study aims to analyse the influence of servant leadership and motivation on the general performance of a health care unit in Way Kanan Regency, Lampung, Indonesia. Cross sectional approach and survey analysis method were used. 122 officers of Baradatu Health Care Unit and Pisang Baru Health Care Unit 122 people were taken as the population. The result shows significant relationship between servant leadership and motivation to the performance (p <0.05). The servant leadership variable has got the greatest influence on the accuracy of clinical decision making than the professional knowledge and behaviour with OR = 4,476. It is suggested that the District Health Office of Way Kanan Regency create: a model of servant leadership as an alternative to the existing leadership models, tighten the control on the program, and conduct more training to improve the quality of human resources and their performance at the health care units. Keywords: servant leadership, motivation, performance..

scholarly journals Analysis Relationship Family Support and Health Cadre with Elderly Hypertension Practice in Controlling Health at Primary Health Care Mranggen Demak

2019 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Ninin Irani
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
Family Support ◽  
Health Workers ◽  
Care Home ◽  
The Elderly ◽  
Health Department ◽  
Quantitative Approach ◽  
District Health ◽  
Cross Sectional

Hypertension is a major risk factor for cardiovascular disease which is the leading cause of death in Indonesia. Data Research Department of Health in 2005, showed hypertension and cardiovascular disease is still quite high and even tends to increase with the lifestyle that much of the behavior of healthy and clean life, high cost of treatment of hypertension, erroneous perception of the public accompanied by a lack of safety facilities hypertension , Hypertension is actually a disease that can be prevented if the risk factors can be controlled and healthy behaviors (healthy behavior) which practices or activities related to efforts to maintain, control and improve health. Data from Demak district health department, the incidence of hypertension has increased within the last three years. The aim of this study was to determine the relationship of family support and cadres with elderly Hypertension practices in controlling health in Puskesmas Mranggen, Demak by using a cross-sectional study with a quantitative approach. The sample size for a quantitative approach is 285 respondents (total sampling). The data were analyzed using univariate, bivariate with chi-square. The results showed an association between family support for elderly people who suffer from hypertension with the practice of elderly hypertension in controlling health (p = 0.048), there is a relationship between support for health workers to the elderly who suffer from hypertension with Practice elderly hypertension in controlling health (p = 0.049). Advice to the puskesmas officers in order to improve the quality of health care, home visits, provide health education particularly on controlling health benefits for elderly hypertension and cross-sectoral cooperation in the implementation of an integrated program of coaching post (posbindu) elderly.

scholarly journals Diagnostic accuracy of symptoms as a diagnostic tool for SARS-CoV 2 infection: a cross-sectional study in a cohort of 2,173 patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carlos Alfonso Romero-Gameros ◽  
Tania Colin-Martínez ◽  
Salomón Waizel-Haiat ◽  
Guadalupe Vargas-Ortega ◽  
Eduardo Ferat-Osorio ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Tool ◽  
Clinical Decision Making ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Decision ◽  
Cross Sectional Study ◽  
World Health ◽  
Likelihood Ratios ◽  
Cross Sectional ◽  
Health Organization

Abstract Background The SARS-CoV-2 pandemic continues to be a priority health problem; According to the World Health Organization data from October 13, 2020, 37,704,153 confirmed COVID-19 cases have been reported, including 1,079,029 deaths, since the outbreak. The identification of potential symptoms has been reported to be a useful tool for clinical decision-making in emergency departments to avoid overload and improve the quality of care. The aim of this study was to evaluate the performances of symptoms as a diagnostic tool for SARS -CoV-2 infection. Methods An observational, cross-sectional, prospective and analytical study was carried out, during the period of time from April 14 to July 21, 2020. Data (demographic variables, medical history, respiratory and non-respiratory symptoms) were collected by emergency physicians. The diagnosis of COVID-19 was made using SARS-CoV-2 RT-PCR. The diagnostic accuracy of these characteristics for COVID-19 was evaluated by calculating the positive and negative likelihood ratios. A Mantel-Haenszel and multivariate logistic regression analysis was performed to assess the association of symptoms with COVID-19. Results A prevalence of 53.72% of SARS-CoV-2 infection was observed. The symptom with the highest sensitivity was cough 71%, and a specificity of 52.68%. The symptomatological scale, constructed from 6 symptoms, obtained a sensitivity of 83.45% and a specificity of 32.86%, taking ≥2 symptoms as a cut-off point. The symptoms with the greatest association with SARS-CoV-2 were: anosmia odds ratio (OR) 3.2 (95% CI; 2.52–4.17), fever OR 2.98 (95% CI; 2.47–3.58), dyspnea OR 2.9 (95% CI; 2.39–3.51]) and cough OR 2.73 (95% CI: 2.27–3.28). Conclusion The combination of ≥2 symptoms / signs (fever, cough, anosmia, dyspnea and oxygen saturation < 93%, and headache) results in a highly sensitivity model for a quick and accurate diagnosis of COVID-19, and should be used in the absence of ancillary diagnostic studies. Symptomatology, alone and in combination, may be an appropriate strategy to use in the emergency department to guide the behaviors to respond to the disease. Trial registration Institutional registration R-2020-3601-145, Federal Commission for the Protection against Sanitary Risks 17 CI-09-015-034, National Bioethics Commission: 09 CEI-023-2017082.

What Is Medical Ethics Consultation?

2008 ◽  
Vol 36 (1) ◽  
pp. 95-118 ◽  
Author(s):  
Giles R. Scofield
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Medical Ethics ◽  
Medical Technology ◽  
Clinical Decision Making ◽  
Ethics Consultation ◽  
Clinical Decision ◽  
Law Students ◽  
Medical Ethicist ◽  
Care Decision

As everybody knows, advances in medicine and medical technology have brought enormous benefits to, and created vexing choices for, us all – choices that can, and occasionally do, test the very limits of thinking itself. As everyone also knows, we live in the age of consultants, i.e., of professional experts who are ready, willing, and able to give us advice on any and every conceivable question. One such consultant is the medical ethics consultant, or the medical ethicist who consults.Medical ethics consultants involve themselves in just about every aspect of health care decision making. They help legislators and judges determine law, hospitals formulate policies, medical schools develop curricula, etc. In addition to educating physicians, nurses, and lawyers, amongst others, including medical, nursing, and law students, they participate in clinical decision making at the bedside.

Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice

2016 ◽  
Vol 25 (4) ◽  
pp. 453-469 ◽  
Author(s):  
Jennifer Horner ◽  
Maria Modayil ◽  
Laura Roche Chapman ◽  
An Dinh
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Legal Advice ◽  
Medical Context

PurposeWhen patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice.MethodThe authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient–practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy.ConclusionsSpeech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.

scholarly journals The situation of nursing education in Latin America and the Caribbean towards universal health

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Silvia Helena De Bortoli Cassiani ◽  
Lynda Law Wilson ◽  
Sabrina de Souza Elias Mikael ◽  
Laura Morán Peña ◽  
Rosa Amarilis Zarate Grajales ◽  
...  
Keyword(s):  
Health Care ◽  
Latin America ◽  
Primary Health Care ◽  
Nursing Education ◽  
Clinical Decision Making ◽  
Clinical Experiences ◽  
Cross Sectional ◽  
Primary Health ◽  
The Caribbean ◽  
Universal Health

Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion: there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.

HEALTH TECHNOLOGY ASSESSMENT AND CLINICAL DECISION MAKING:

1999 ◽  
Vol 15 (3) ◽  
pp. 585-592 ◽  
Author(s):  
Alicia Granados
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Case Studies ◽  
Technology Assessment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Health Technology ◽  
Evidence Based ◽  
Systematic Process

This paper examines the rationality of the concepts underlying evidence—based medicineand health technology assessment (HTA), which are part of a new current aimed at promoting the use of the results of scientific studies for decision making in health care. It describes the different approaches and purposes of this worldwide movement, in relation to clinical decision making, through a summarized set of specific HTA case studies from Catalonia, Spain. The examples illustrate how the systematic process of HTA can help in several types of uncertainties related to clinical decision making.

Standardized Synoptic Cancer Pathology Reports — So What and Who Cares?: A Population-Based Satisfaction Survey of 970 Pathologists, Surgeons, and Oncologists

2013 ◽  
Vol 137 (11) ◽  
pp. 1599-1602 ◽  
Author(s):  
Sara Lankshear ◽  
John Srigley ◽  
Thomas McGowan ◽  
Marta Yurcan ◽  
Carol Sawka
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Physician Satisfaction ◽  
Cross Sectional ◽  
Cancer Pathology ◽  
Report Turnaround Time ◽  
Significant Difference ◽  
Pathology Reporting ◽  
The Impact

Context.—Cancer Care Ontario implemented synoptic pathology reporting across Ontario, impacting the practice of pathologists, surgeons, and medical and radiation oncologists. The benefits of standardized synoptic pathology reporting include enhanced completeness and improved consistency in comparison with narrative reports, with reported challenges including increased workload and report turnaround time. Objective.—To determine the impact of synoptic pathology reporting on physician satisfaction specific to practice and process. Design.—A descriptive, cross-sectional design was utilized involving 970 clinicians across 27 hospitals. An 11-item survey was developed to obtain information regarding timeliness, completeness, clarity, and usability. Open-ended questions were also employed to obtain qualitative comments. Results.—A 51% response rate was obtained, with descriptive statistics reporting that physicians perceive synoptic reports as significantly better than narrative reports. Correlation analysis revealed a moderately strong, positive relationship between respondents' perceptions of overall satisfaction with the level of information provided and perceptions of completeness for clinical decision making (r = 0.750, P &lt; .001) and ease of finding information for clinical decision making (r = 0.663, P &lt; .001). Dependent t tests showed a statistically significant difference in the satisfaction scores of pathologists and oncologists (t169 = 3.044, P = .003). Qualitative comments revealed technology-related issues as the most frequently cited factor impacting timeliness of report completion. Conclusion.—This study provides evidence of strong physician satisfaction with synoptic cancer pathology reporting as a clinical decision support tool in the diagnosis, prognosis, and treatment of cancer patients.

scholarly journals Analysis of job satisfaction of the nursing staff of a primary health care unit

2014 ◽  
Vol 35 (4) ◽  
pp. 20-27 ◽  
Author(s):  
Ione Carvalho Pinto ◽  
Carla Santa Maria Marciliano Panobianco ◽  
Fabiana Costa Machado Zacharias ◽  
Alexandre Fávero Bulgarelli ◽  
Tânia Silva Gomes Carneiro ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Nursing Staff ◽  
Work Satisfaction ◽  
Professional Status ◽  
District Health ◽  
Cross Sectional ◽  
Organizational Policies ◽  
Health Care Unit ◽  
The City ◽  
Validated Instrument

This was a cross-sectional, observational study conducted in an outpatient specialty district health unit in the city of Ribeirão Preto, in the southeastern Brazilian state of São Paulo, with the aim to analyze the job satisfaction of the nursing staff. Data were collected using the Index of Work Satisfaction (IWS), a validated instrument which was applied to 23 members of the nursing team in January 2012. Among the components of job satisfaction, participants considered Interaction to be most important, followed by Professional Status, Job Requirements, Organizational Policies, Remuneration and Autonomy. The combined mean Index of Work Satisfaction obtained was 8.29, corresponding to poor job satisfaction among the studied population, as most of the studies in the literature that used the same instrument had scores between 12 and 37.

scholarly journals Factors Influencing Physicians' Clinical Decision-making at Upazila Health Complexes in Bangladesh

2020 ◽  
Vol 3 (4) ◽  
pp. 125-133
Author(s):  
M. Aminul Islam ◽  
M. Abdul Awal
Keyword(s):  
Decision Making ◽  
Social Networks ◽  
Clinical Decision Making ◽  
Average Length ◽  
Clinical Decision ◽  
Primary Data ◽  
Decision Making Process ◽  
Cross Sectional ◽  
The Right ◽  
Consultation Session

ABSTRACT Introduction Selecting the most appropriate treatment for each patient is the key activity in patient-physician encounters and providing healthcare services. Achieving desirable clinical goals mostly depends on making the right decision at the right time in any healthcare setting. But little is known about physicians' clinical decision-making in the primary care setting in Bangladesh. Therefore, this study explored the factors that influence decisions about prescribing medications, ordering pathologic tests, counseling patients, average length of patient visits in a consultation session, and referral of patients to other physicians or hospitals by physicians at Upazila Health Complexes (UHCs) in the country. It also explored the structure of physicians' social networks and their association with the decision-making process. Methods This was a cross-sectional descriptive study that used primary data collected from 85 physicians. The respondents, who work at UHCs in the Rajshahi Division, were selected purposively. The collected data were analyzed with descriptive statistics including frequency, percentage, one-way analysis of variance, and linear regression to understand relationships among the variables. Results The results of the study reveal that multiple factors influence physicians' decisions about prescribing medications, ordering pathologic tests, length of visits, counseling patients, and referring patients to other physicians or hospitals at the UHCs. Most physicians prescribe drugs to their patients, keeping in mind their purchasing capacity. Risk of violence by patients' relatives and better management are the two key factors that influence physicians' referral decisions. The physicians' professional and personal social networks also play an influential role in the decision-making process. It was found that physicians dedicate on average 16.17 minutes to a patient in a consultation session. The length of visits is influenced by various factors including the distance between the physicians' residence and their workplace, their level of education, and the number of colleagues with whom they have regular contact and from whom they can seek help. Conclusion The results of the study have yielded some novel insights about the complexity of physicians' everyday tasks at the UHCs in Bangladesh. The results would be of interest to public health researchers and policy makers.

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