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A three-day food intake was recorded for 100 elderly patients who were subsequently interviewed to determine the relationship of income level, educational level completed, and sex of the person with the nutrient intakes of these patients. Three-day caloric and nutrient intakes were recorded and compared to the 1974 Reconmended Daily Allowances (RDA). Mean intake for a three-day period of seven nutrients showed patient averages met at least 100 percent of the RDA for all nutrients except calcium. The females had a mean intake of ninety-six percent of the RDA for calcium. The patients with the lower incomes had dietary patterns that were less adequate than the patterns for those with higher incomes, and these patients ate more carbohydrate and less protein than did the patients with higher income. Nutrient intake was increased for the patients as their level of education increased. There were no significant differences in the nutrient intakes between sexes. The males had a higher nutrient intake and had a higher percentage of protein in their diets than did the females, however, the differences were slight. It was concluded from the above results that certain beneficial changes in the study menu could be made. Especially important areas such as calcium and fat intake may need modification at some time in the future as more light is shed on these areas. / Master of Science

Bakgrund Bristande handhygien hos hälso-och sjukvårdspersonal bidrar till smittspridning och ökade kostnader för hälso-och sjukvården. Hälso- och sjukvårdspersonalen har en avgörande roll i att minska smittspridningen med hjälp av noggrant genomförd handhygien. Trots att kunskap i ämnet finns så brister handhygienen och patienterna beroende av sjukvård drabbas av vårdskador i samband med vård och behandling. Syfte Syftet är att beskriva faktorer som påverkar vårdpersonalens följsamhet av hygienrutiner på sjukhus. Metod En litteraturöversikt har genomförts med 13 vetenskapliga artiklar som publicerats under tidsperioden 2012–2024 i databaserna CINAHL och PubMed. Resultat I litteraturöversiktens resultats del kunde tre huvudkategorier hittas: verksamhetsfaktorer, arbetsfaktorer och personliga faktorer. Utifrån dessa tre huvudkategorier kunde åtta underkategorier identifieras. Kategorierna präglas av alltifrån personliga faktorer som glömska och preferenser. Till organisationsfaktorer där bland annat resursbrist och bristande rutiner beskrivs. Slutsats Det breda spektrumet av påverkande faktorer kan förebyggas och åtgärdas genom kunskap och strukturimplementering. På så vis skulle följsamheten till hygienrutiner öka och patientsäkerheten främjas. / Background Insufficient hand hygiene in healthcare contributes to the spread of infection and increased costs for the healthcare system. Healthcare professionals have a decisive role in reducing the spread of infection with the help of carefully implemented hand hygiene, even though there is knowledge on the subject, hand hygiene is lacking and patients dependent on medical care suffer from health care related injuries. Aim The aim is to describe factors that influence healthcare staff's adherence to hygiene routines in hospitals. Method A literature review has been carried out with 13 scientific articles published during theperiod 2012–2024 in the databases CINAHL and PubMed. Results In the results section of the literature review, three main categories could be found: institutional factors, work factors and personal factors. Based on these three main categories, eight subcategories could be identified. The categories are characterized by everything from personal factors such as forgetfulness and preferences. To organizational factors where,among other things, lack of resources and inadequate routines are described. Conclusions The broad spectrum of factors can be prevented and solved with knowledge and implementation of structures. With that the adherence to hygiene routines could increase and the patient safety would be promoted.

Yes / Purpose The 999 ambulance call handler is critical in responding to emergency patient treatment; however, the call handlers are often a hidden component of the healthcare workforce and an under-researched group. The objective of this study is to understand stress triggers experienced by 999 ambulance call handlers that could lead to burnout and examine personal and organisational mechanisms and strategies which reduced the risk of burnout. Design/methodology/approach A single interview case study approach applying qualitative methods was undertaken. Participants were identified through a purposive sample of 999 ambulance call handlers with the Yorkshire Ambulance Service National Health Service Trust (UK). Participants were interviewed via telephone between July 2019 and September 2019. Findings In total, 18 staff participated in this study. Societal factors including public incivility and media representation and organisational factors, such as a demanding environment, lack of appreciation and career progression, training issues and protocols were key stressors. Organisational well-being services were helpful for some, but for others lacked accessibility and appropriateness. Positive public feedback and speaking with peers bolstered well-being. 999 ambulance call handlers suggested that sufficient breaks, co-design or feeding back on training and protocols and creating more informal opportunities to discuss ongoing everyday stressors as methods to reduce stress and burnout. Originality/value This paper explores a previously under researched area on stressors and potential burnout in 999 call handlers. This paper highlights the need for improved organisational support services and appropriate public and sector peer recognition of the role of ambulance 999 ambulance call handlers. / This research was funded by the University of Bradford Research Development Fund. This research was supported by Yorkshire Ambulance Service NHS Trust, and the National Institute for Health Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC).

published_or_final_version / Social Work / Master / Master of Social Work

Project (B.S.)--James Madison University, 2009. / Includes bibliographical references.

Text in English / This study investigated practices, motivations, perceived benefits and barriers to outsourcing of support services by general hospitals in Uganda. The aim was to contribute to the evidence base to increase adoption and effectiveness of outsourcing by hospitals in Uganda. An explanatory sequential mixed methods design was used. Quantitative data was collected from hospital managers in 32 randomly selected hospitals using a self-administered questionnaire. Qualitative data was collected through in-depth interviews from 8 purposively selected hospital managers using an interview guide. Quantitative data was statistical analysed (frequencies, contingency tables and Wilcoxon-Mann-Whitney tests) using SAS 9.3. Qualitative data was managed using ATLAS ti 7, coded manually and content analysis conducted to identify emerging themes, subthemes and categories. A cost benefit analysis was conducted for outsourcing cleaning services in a selected hospital using financial data provided by the managers. Quantitative findings indicate that many (72%) hospitals were outsourcing some of their support services; many were satisfied with their outsourcing (>60%). The key motivation for outsourcing was to gain access to quality service (68%). Most hospitals have a system for monitoring outsourcing (71%). Managers perceive improved productivity and better services as the main benefit from outsourcing (90%). The main barrier to outsourcing is limited financing. A key challenge encountered during outsourcing was limited number of service providers (57%). Managers perceive regulatory violations as a key risk during outsourcing (87%). Hospital location is a determinant of outsourcing (p=0.0033). Managers’ perceptions towards outsourcing have no impact on outsourcing (p>0.05). These findings were confirmed and explained by the qualitative data. Qualitative findings reveal masquerading, impersonation and extortion of patients by outsourced staff as an outsourcing risk. They reveal a concern that outsourcing may lead to job loss for community members. The cost benefit analysis indicates that outsourcing in the studied hospital for the year considered was cheaper than insourcing by UGX 669,575.00. The savings increase to UGX 48,753,689.94 when adjusted for quality differences between insourced and outsourced services. Sensitivity analysis shows that the assumptions used in the analysis were robust. Recommendations, interventions and guidelines are proposed for increasing outsourcing and its effectiveness. / Health Studies / D. Litt. et Phil. (Health Studies)

This case study was undertaken from mid 2003 to December 2005. It investigates the influence of the Corporate Services Centre (CSC) on customer (patient) service quality in the East London Hospital Complex (ELHC). This approach was justified on the basis that even though most patients do not have enough knowledge of clinical practices in order to make an accurate assessment on their quality, the same patients would readily appreciate factors such as faster turnaround times, drug availability and cleanliness. The study focuses on both service providers and end users for a quality health service delivery by looking at the potential of the shared corporate services centre. This was done by identifying important areas for improvements, such as response times, waiting periods and other aspects of the various services. The ELHC was formed from the merger of Frere and Cecilia Makiwane Hospitals, with a distance of 26km between the two institutions. The complex itself was in its infancy stages, having had to go through a process of re-engineering, rationalisation and standardisation of the two hospitals. The study seeks to answer the following key question: What has been the contribution of the corporate service centres in relation to health care service quality? The study examines the impediments to the realization of full potential of the Corporate Services Centre (CSC) through expedited decision-making and improved turnaround times. The main functions of the CSC were Procurement and Asset Management; General Administration (including but not limited to Transport, Office equipment, Patient Administration, Office Support, and Professional Secretariat Support); Financial Management and Administration; and Human Resource Management and Human Resources Administration. The study recommends that the CSC, to justify its existence, needs to consult with the clinicians and the patients to better understand what their needs and aspirations are. The study also emphasizes that the CSC is there purely to remove the administrative load and ease the processes and the biggest mistake is to make it an authority over the hospital, instead of being a support. Finally, it was realized that a lot of structural changes, business processes and organisational cultural changes are essential if one wants to create an impact through shared corporate services.

The purpose of this project is to develop a self-administered developmental care program that will be utilized by the staff of the neonatal ICU at Arrowhead Regional Medical Center, Colton, CA.

Within the framework of ethnography, an inquiry was made into the many dimensions of psychological treatment and training in a psychiatric hospital, with particular reference to State Patients. Ethnography is the study of an intact cultural or social group based mainly on observations over a prolonged period of time in which the researcher is a participant. The multicultural aspects of the therapeutic community were also inquired into. Ethnographic data was collected and processed over a period of 16 years in three psychiatric hospitals, the main source of data gathered from Weskoppies Hospital in Pretoria. The ecosystemic psychotherapeutic perspective was used as a meta-model to describe eight therapeutic approaches in which intern-psychologists were trained. The hospital is described as a therapeutic community in which rehabilitation is a multi-professional responsibility. Each profession, or sub-culture, has its own framework and culture in which it works within the broader system of the psychiatric hospital. Ethical considerations and recommendations are levelled at the academic and practical aspects of clinical psychology, hospital management, and different levels of government. / Psychology / D.Litt. et Phil.