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Feb 2025 DOI 10.14302/issn.2641-4538.jphi-25-5436
High rates of workplace psychological stress and burnout have been chronic among Healthcare Practitioners. Research shows that Healthcare Practitioner psychological stress / burnout is related to poor quality of care and a high probability of making medical errors and mishaps resulting in harm to patients and even workers themselves. In response, relatively impactful programs have been developed to address Practitioner burnout. To derive a better understanding of the subject and inform best practices and policy regarding the problem and its fixes, this article reports findings from a novel study of a systematic (PRISMA-based) literature review of current (circa ~10 years <) literature reviews; or a distillation of reviews already at 100 proof then undergoing a further distillation into a review of 200 proof.* This study employed a grounded theoretic qualitative methodology to iteratively generate and enumerate descriptive themes from the study’s literature review articles. This article reports on what is currently known regarding the precipitants of Health Practitioner Burnout, Burnout itself, its relationship to Safety lapses and mishaps, and Programmatic Interventions (i.e., Fixes). The primary conclusion is that Health Practitioners are the foundation of healthcare organizations and key to quality care and management / leadership should be concerned for their wellbeing; and this article provides a general blueprint in terms of addressing burnout and safety. Study Limitations and Future research are also discussed.
Feb 2024 DOI 10.14302/issn.2641-4538.jphi-23-4871
Background This study evaluates the effectiveness of quality improvement (QI) strategies in mid-level private healthcare facilities in Lagos State, with a focus on the structural components, healthcare processes, and healthcare outcomes. Employing the Donabedian model, the research aims to comprehensively assess and enhance healthcare service quality in these facilities. Methods A before-and-after study design was employed, involving a baseline assessment of 321 health facilities and endline assessment of 239 healthcare facilities, and a subsequent 10 - 12-month quality improvement intervention. Data were collected using facility assessments, client exit interviews, and interviews with key stakeholders. The analysis included a before and after analysis of the structural components, healthcare processes, and healthcare outcomes. Results The study demonstrates positive outcomes in mid-level private healthcare facilities in Lagos State following quality improvement (QI) interventions. Structural components, including, improved equipment availability, and enhanced compliance with standards, showcased significant improvements. Renovations and heightened registration compliance further underscored commitment to regulatory standards. Challenges in service availability, particularly in family planning and laboratory services, were identified. Importantly, the implementation of a QI scoring system revealed an overall positive impact, with the average score rising from 69% to 74%, signifying enhanced quality across diverse priority areas. Implications These findings highlight the success of QI interventions in transforming healthcare processes and structural components. Despite notable progress, persistent challenges in specific services call for targeted interventions. The substantial increase in patient satisfaction and overall QI scores underscores the transformative potential of sustained efforts and tailored interventions in mid-level private healthcare facilities in Lagos State. Conclusions This research comprehensively evaluates the effectiveness of quality improvement strategies implemented in mid-level private healthcare facilities in Lagos State, Nigeria, utilizing the Donabedian Model as a guiding framework. The findings provide valuable insights for policy recommendations, with the aim of aligning healthcare services with the Donabedian model to ensure the provision of high-quality care in mid-level private healthcare facilities in Lagos State. This study contributes to the ongoing efforts to improve healthcare quality in Lagos State. Contribution to Knowledge The research provides empirical insights into the effectiveness of quality improvement strategies in mid-level private healthcare facilities, particularly within the context of Lagos State, Nigeria. It highlights the significance of addressing structural components, optimizing healthcare processes, and monitoring healthcare outcomes to enhance the quality of care provided, aligning with the Donabedian model. These findings offer a valuable basis for policy recommendations and further research efforts aimed at improving healthcare quality in similar settings.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3439
Background Pregnancy and parturition are events of considerable significance in the life cycle of women. Though it is supposed that the quality of care during labor, birth, and postpartum period plays a great role for adverse outcomes of birth, various reports claimed that cesarean delivery carries a higher maternal and fetal morbidity and mortality compared to vaginal delivery. Therefore, this study assessed the Rate, Maternal and Fetal Outcome of Cesarean delivery performed by IESO at Shenen Gibe General Hospital, Jimma south west Ethiopia. Integrated Emergency surgical officer is a health professional qualified and authorized to perform emergency obstetrical-gynecological and emergency general surgical procedures. The training has started in 2010 in 3 universities and 10 affiliated sites with intake of 43 students. The MSc program in integrated emergency surgery is intended to achieve one of the millennium development goals (MDG): reducing the overwhelming maternal mortality ratio and perinatal mortality rate at the local and national level. (1) Methods Hospital based two-year retrospective descriptive cross-sectional study design was employed and data collected from November to December 2019 in shenen Gibe General Hospital ,Jimma south west Ethiopia. A total of 185 mothers who delivered by cesarean delivery from December 2017 to December 2018 and complete data were included in the study. Data were extracted using structured data collection format and cleaned, and entered into Epi data software version 3.1 and exported into SPSS version 26 for further descriptive analysis. Result Among 2115 deliveries in the two years of retrospective data, a total of 186 mothers were delivered by cesarean section, giving cesarean delivery rate 8.8 %. The leading indication for cesarean delivery was fetal distress (24.2%). Among the total cesarean delivery, 22 neonates were died, giving the proportion of neonate mortality rate 16.8%. One mothers were died following cesarean delivery, giving maternal mortality rate following cesarean delivery 12 per 1000 live births. The leading cause for maternal mortality was hemorrhagic shock Conclusion However, cesarean delivery rate in this study was within the WHO recommended range, the health outcome of mothers and neonates’ following cesarean delivery was not acceptable. The neonatal and maternal mortality following cesarean delivery was 16.8% and12 per 1000 live births respectively. The main cause of neonatal death was birth asphyxia.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-19-2608
In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.
Dec 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1811
Homecare is very important in oncology care since cancer patients are discharged more and more earlier from the hospital and receiving ambulatory treatments. Homecare nurses have a more general broad educational background, with less specialization regarding specific care, like oncology care. The aim of this study is to develop and test a cross-platform application (named Oncopunt) for homecare nurses involved in oncology care to provide specific nurse-centred information via digital media about skill guidelines specific for oncology care. This study was set-up as a non-experimental feasibility and satisfaction study with one measurement moment to collect information about usability, user-experience and added value of Oncopunt using the System Usability Scale (SUS) and an additional questionnaire. The cross-platform application Oncopunt was build using Drupal and Vimeo and consists of a homescreen, filter/search function and watch-function (full video panel, chapter panel and FAQ). Seventeen homecare nurses completed all questionnaires. The mean SUS score was 83,8 (stdev 11,6) and Oncopunt was rated positively regarding video content, technical issues, website layout, quality of care and user satisfaction. Oncopunt is developed to provide homecare nurses specific nurse-centred information about skills specific for oncology care via digital media . It was rated good on usability, user-experiences and added value for clinical practice.
Aug 2017
Aim: To assess the extent and directions of internal hospital turnover of registered nurses and to examine the associated factors and stressors. Background: Internal turnover of hospital nurses is mainly horizontal. Occurring on a large scale, it could lead to dropout of skilled personnel, burdening hospitals both financially and in terms of human resources, affecting the quality of care. Methods: A secondary analysis based on data from the national study on "Patterns and trends of the nursing workforce in Israel". A structured telephone interview was conducted of 2,098 hospital nurses (October 2008-February 2009). Results: The rate of internal turnover between hospital departments was 29.7%. The main departments from which nurses moved were medical and surgical. The main departments from which nurses moved were oncology departments, Intensive Care Units, nursing administration. The major work-related stressor concerned salary (59%), two predictors of internal turnover were nurses with children under the age of 18 and academic degree nurses. Conclusions and Implications for Health Policy: Internal turnover rate in Israeli hospitals is moderate, with high rates in medical and surgical departments. It is vital to identify the main factors associated with high turnover rates and implement focused managerial retention strategies and other intervention programs.
Jun 2017 DOI 10.14302/issn.3070-5835.jcpn-17-1580
Objective. To describe the attitudes and behavior of registered nurses in their professional interaction toward unlicensed assistive personnel (UAPs) and to identify areas to develop policy for an effective nursing development and workforce planning. Background: One of the challenges health care systems have been addressing is the integration of the UAPs into the nursing care delivery systems. Study Design: Aphenomenological study involving registered nurses, staff and managerial positions. Data were collected using an in-depth semi-structured interview. Findings: Nurses report an increased task management workload which may lead to a decline in the quality of nursing care. Structural factors that are related to nurses and to UAPs were mentioned as affecting the quality of their professional and collaborative interaction. Conclusions: Training nurses to work with UAPs while developing their communication and managerial skills may improve the quality of care and increase their level of satisfaction.
Mar 2017 DOI 10.14302/issn.2474-7785.jarh-17-1461
Given the aging of the population, an increase in the number of persons in need of long-term care and end-of-life care can be expected in the coming years. The scientific literature underlines the lack of end-of-life care for elderly people in long-term care centres. The aim of this study is to explore needs in terms of new knowledge and research on end-of-life care for elderly persons in long-term care settings, from the perspective not only of the scientific and international community, but also of Quebec professionals concerned by the issue. An online survey using the LimeSurvey® tool was conducted in 2015 among health professionals involved in end-of-life care for elderly persons in long-term care settings in Quebec. 208 professionals rated the priority of new knowledge and research needs related to 1) health professionals; 2) delivery and quality of care; 3) residents and their loved ones; and 4) organization and management of care. The results show that the statements collected in scientific literature resonate with health professionals. The most important need is to identify the symptoms of distress in residents in the final stages of their lives, as well as their causes and treatments. This study also shows professionals’ concerns about attitudes, beliefs, and values of practitioners and the related impacts on end-of-life care in long-term care settings. This study shows that there is a significant need for new knowledge and research. It revealed that there are few studies on end-of-life care for elderly persons in long-term care settings and that there is much more to be discovered in this field.