Syfte. Vårdrelaterade infektioner är ett stort problem inom hälso- och sjukvård. Dessa infektioner drabbar patienten och dess anhöriga samt bidrar till stora kostnader för samhället. Studier har visat att god följsamhet till de basala hygienrutinerna är ett effektivt sätt att minska förekomsten av vårdrelaterade infektioner. Syftet med denna studie var att studera två mottagningars följsamhet till basala hygienrutiner, varav den ena deltar i kvalitetsprojektet VRISS – Vårdrelaterade Infektioner Ska Stoppas. Syftet var även att jämföra mottagningen som deltar i VRISS-projektet med den som inte deltagit, för att undersöka om det förekommer någon skillnad mellan dem. Metod. Sjukvårdspersonal i tjänst på en mottagning som deltar, samt på en mottagning som inte deltar i VRISS-projektet observerades gällande följsamhet till basala hygienrutiner. Observationstillfällena gjordes under en veckas tid på varje mottagning. Resultat. Den mottagning som deltar i VRISS-projektet hade högre följsamhet gällande spritning av händer samt helt korrekt utförande i alla tre stegen. Ingen signifikant skillnad mellan mottagningarna avseende följsamhet till någon annan studievariabel förekom. Slutsats. Den mottagning som deltar i VRISS-projektet visar på en bättre följsamhet av bland annat spritning av händer än den mottagning som inte deltagit. För att uppnå följsamhet till 100 procent krävs utbildningsprogram som kontinuerligt uppmanar och påminner personalen om riktlinjerna för de basala hygienrutinerna och deras effekt mot vårdrelaterade infektioner. / Aim. Hospital-related infections are a major problem in healthcare. These infections occur among patients and their relatives, contributing to high costs for society. Studies have shown that good adherence to basic hygiene routines are an effective way to reduce the incidence of the infections. The purpose of this study was to examine adherence to basic hygiene routines among healthcare staff, and compare a healthcare reception which was included in the VRISS-project (healthcare-related infections shall be stopped) with a reception that did not participate, in order to investigate whether there is any difference in the adherence to basic hygiene routines between them. Method. Healthcare staff at service within a healthcare reception that participated, and a reception that did not participate in the VRISS-project was observed. Data observations were accounted during a week within each reception. Results. The healthcare reception involved in the VRISS-project had a higher compliance current shelling of hands and accomplish to the routines properly in all three steps. No difference between the receptions in adherence to any other of the variable that were studied was shown. Conclusion. The healthcare reception that participates in the VRISS-project shows a higher adherence to the basic hygiene routines including shelling of hands. Although, for a higher compliance, training is required to continually remind the healthcare staff about the guidelines for basic hygiene routines and its impact on hospital-related infections.

No description available.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 x, 65 leaves, Annexures A-H / Patient satisfaction is an important, desired measure of quality of care and has a significant influence on the perceived quality of care and outcome of treatment, and for this reason, it holds great value to the treating clinician. Satisfied patients are more likely to comply with treatment instructions and advice, remain with their service provider and refer others. Dissatisfaction, in the event of an unfavourable outcome, can result in legal action and complaints to regulatory bodies. Studies have indicated a high level of satisfaction with chiropractic care; however, none have been in a student clinic setting even in view of the suggested importance in the literature. In view of this significance and lack of understanding of the patients’ satisfaction / dissatisfaction in the history of DIT’s clinic operation the question remains as to what extent the students at the DIT Chiropractic Day Clinic satisfy their patients. This study evaluated the patient satisfaction at the DIT Chiropractic Day Clinic in order to establish a baseline for future comparison. Cronbach’s alpha scores were used to determine questionnaire reliability in a South African student context.

Submitted in fulfilment of the requirements for D.Tech: Nursing in the Faculty of Health Sciences, Durban University of Technology, 2009. / BACKGROUND In South Africa, Integration of Services Policy was enacted in 1996 with the aim of increasing health service utilization by increasing the accessibility of all services at Primary Health Care (PHC) level. However, the problem with the policy arises in the implementation of integrated PHC (IPHC) as there is no agreed upon understanding of what this phenomenon means in the South African context. Hence, there is a need for shared views on this phenomenon. METHODS A cross-sectional study, using a qualitative approach was employed in this study in order to analyze IPHC in KwaZulu-Natal (KZN). A grounded theory approach was selected as it is a method known for its ability to make the greatest contribution in areas where little research has been done and when new viewpoints are needed to describe the familiar phenomenon that is not clearly understood. Policy makers and co-ordinators of PHC at national, provincial and district levels as well as PHC nurses at functional level participated in the study. The data was collected by means of observations and interviews. The sample size for interviews was comprised of 38 participants. RESULTS It emerged that there were three core categories that were used by the participants as discriminatory dimensions of IPHC in South Africa. These core categories were (a) comprehensive health care, (b) supermarket approach and (c) one stop shop. Based on the findings of the study, it was concluded that the phenomenon, IPHC meant different things in different contexts.

Submitted in partial compliance with the requirements for a Master Degree in Technology: Chiropractic at the Durban University of Technology, 2009. / Background: Research has indicated the majority of bacteria on chiropractic adjustment beds (beds), can persist on dry inanimate surfaces for months. Thus, insufficient disinfection procedures create continuous sources of pathogens endangering patients and healthcare workers alike. This research study aimed to assess the beds as reservoirs for micro-organisms, at a chiropractic teaching clinic (clinic) in South Africa. Method: A selection of samples obtained from the headrests and armrests of the beds were serially diluted, plated in duplicate (using the spread plate technique) and incubated for 24-48 hours at 37°C. After inspection for the presence of micro-organisms, those present were enumerated to determine their quantities, the microbial build-up throughout the day, as well as the degree of the transmission from the patients to the beds during treatment. The incidence of the micro-organisms was established, along with their identities, using microscopic and macroscopic characteristics. These micro-organisms were also used to assess the efficacy of the disinfectant currently in use by the clinic. Results: Microbial growth was present on 89.4% of the beds sampled. The quantities of the micro-organisms increased significantly (p=0,027) from 7:30 am to 16:30 pm, with the median increasing from 25 colony forming units (cfu) / cm2 to 714 792 cfu/ cm2. The microbial build-up was highly significant (p<0.001), with a median of 346 cfu/ cm2 at 7:30 am and 10:30 am; increasing to 162 291 cfu/ cm2 by 13:30 pm and 250 million cfu/ cm2 by 16:30 pm. There was also a significant increase (p<0.001) in the quantity of micro-organisms during treatment with a median of 0 cfu/ cm2 before treatment that rose to 23 479 cfu/cm2 after treatment, indicating that the micro-organisms present on the beds were being deposited by the patient`s skin during the treatment. The most prevalent micro-organisms identified were Staphylococci and Serratia, with an average of 59% and 40% of colonies; while Micrococci and Bacilli were relatively uncommon. No growth was evident after 5 minutes of exposure to the disinfectant during the growth inhibition test. For the Kirby Bauer test, the average size of the zone of inhibition increased as the dilution decreased. The disinfectant is effective but more so against the Gram-positive than the Gram-negative bacteria. The disinfectant was 5,0, 5,5 and 5,6 times more effective than phenol in eradicating Staphylococci, Serratia and Bacilli, respectively. Conclusions and Recommendations: This study showed that micro-organisms were present on the beds. Staphylococci and Serratia have been implicated in many healthcare associated infections. The present disinfectant is effective, but should be used in between every patient. A different or additional disinfectant that is more effective against the Gram-negative bacteria should be considered for future use.

Since the 1994 International Conference on Population and Development there has been a shift away from meeting demographic targets towards meeting the reproductive goals of individual men and women. Partially as a response to the increase in the level of HIV infection, and the associated high levels of STIs, there has been an increasing focus on integrating HIV/STI services within mainstream Maternal Child Health and Family Planning programmes. Thus clients attending clinics that provide integrated services have the opportunity to receive multiple services during a single visit to a facility. The aim of this research was to evaluate the process of integrating FPIMCH and STI/HIV services in urban and rural areas within KwaZulu-Natal, using data gathered form semi structured interviews with clients leaving the health facilities. The research also examined the overall quality of care received within the integrated clinics. The results show that clients rarely receive a range of services on a single visit, despite the integration of services. In most cases, clients do receive the services for which they attended the health facility. However the study found that providers are missing important opportunities to inform, educate and counsel clients on a variety of reproductive health matters. This is important if we are to avoid the negative consequences of an unwanted pregnancy and STIs (including HIV/AIDS). It was also found that the overall quality of care within integrated clinics was low amongst all clients attending the facility. / Thesis (M.Dev.Studies)-University of Natal, Durban, 2003.

The objective of this study was to explore clients' perceptions and expectations of therapeutic interaction with nurses at Escoval House Community Psychiatric Clinic in Durban. Following the shift of psychiatric care from institutionalised care to community based psychiatric care, it was anticipated that the findings of the study would help to sensitise the primary health care nurses and community psychiatric nurses on how clients perceive the way nurses interact with them. This would help the nurses to ensure satisfactory interactions that would be therapeutic and enhances clients' recovery and well -being. The study utilized Human Relations Counselling Model in exploring the clients' perceptions. An exploratory descriptive survey was used to conduct the study, The study combined both qualitative and quantitative methods for the purpose of triangulation. Ten participants were involved in a focus group and one-hundred and sixty clients participated by filling in questionnaires. Simple random sampling method was used to select participants for both the focus group interview and those who filled in the questionnaires. Data from the focus group was analysed manually using content analysis. Data was presented by participants' direct quotes. Data from the questionnaires was analysed using Statistical Package for Social Sciences (SPSS). For the quantitative data analysis, frequencies and percentages were used to analyse the data. Findings of the study were presented in tables and graphs. Although previous studies on clients' satisfaction have reported clients' satisfaction with mental health service delivery, the findings of this study have revealed that gaps still exist in quality of care delivered to these clients. Findings show that there were mixed perceptions on the way nurse interact with clients during clients' monthly attendances. / Thesis (M.N.)-University of Natal, Durban, 2003.

An audit of Couples attending the Infertility Unit at Inkosi Albert Luthuli Central Hospital (IALCH), Durban Objectives To determine the patient profile, causes of infertility and the success rates of medical and surgical treatment of infertility thus emphasizing the need for assisted reproductive treatment Methods Data was obtained retrospectively from the medical records of 281 couples that presented to Inkosi Albert Luthuli Central Hospital Infertility Unit between January 2004 and December 2006. Information was recorded on a structured proforma and data analysed using SPSS version 15.0 Results The causes of infertility were anovulation (32.7%), tubal factor (30.3%), male factor (11.7%), endometriosis (7.8%), uterine factor (4.3%) and unexplained infertility in 7.1% of cases. Couples with both male and female factors contributed to 6.1% of infertility cases. Twenty two percent of patients with severe male factor and tubal infertility could not be offered any treatment because of the unavailability of assisted reproductive technology (ART). The pregnancy rate was 24.3% after medical treatment and 14.3% after surgery. When both modalities were employed, the pregnancy rate was 26%. The overall pregnancy rate was 16% with 84% of couples requiring further treatment. Conclusion Anovulation and tubal factors were the major causes of infertility. This audit illustrates that the majority of couples (84%) require gonadotrophins and / or assisted reproductive services to achieve conception. A dedicated infertility unit should provide a full range of services including ART. A significant proportion of couples are denied this health service in the public sector in KwaZulu Natal. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.

The study was designed to examine and describe mental health care provided by the nurses in the primary health care settings of Swaziland. The study sought to answer one main questions namely: • what was the nature of mental health care provided by nurses in the primary health care clinics? A sample of 31 primary health care clinic nurses was used to generate data for the study. The sample consisted of registered nurses with only one having a mental health qualification. The study used both qualitative and quantitative methods for data collection. Data analysis involved simple frequency and percentage counts using SPSSmanual as well as descriptive narratives using NVIVO computer analysis methods. Findings revealed that mental health care in the primary health care clinics was mainly traditional involving immunizations, family planning and antenatal services, Limited mental health care was provided by the only mental health nurse involved in the study, Nurses stated that the care they provided was in line with their job descriptions, The study concluded that the mental health care provided at the primary health care clinics was based on the traditional approach that did no encompass mental health care, Recommendations made were related to the promotion of the integration of mental health care into the services provided in the primary health care scttings with nurses being prepared for the role. / Thesis (M.Cur.)-University of Natal, Durban, 2000.

The aim of this study was to investigate noise levels in the New Zealand health industry. The goal was to investigate the room acoustics and the characteristics of the noise sources along with noise exposure of health care workers, in New Zealand, in dental clinics and orthopaedic cast clinics and assess whether they are at risk of noise-induced hearing loss (NIHL). A literature review was conducted to determine the definition, cause, and ways to prevent NIHL in relation to the dental clinics and orthopaedic cast clinics. Also determined from a review of the literature were ways to assess and monitor the acoustics of these spaces. Initially room acoustic measurements of background noise levels as well as reverberation times were made and frequency information on the major noise sources was obtained. This was followed by measurement of the daily noise dose exposure of staff working in the participating dental clinics and orthopaedic cast clinics. It was found that noise dose levels did not exceed the damage risk criterion set by The New Zealand Occupational Safety and Health Service of Leq8h of 85 dBA and therefore staff were considered to not be at risk of NIHL. However, the background noise levels measured may be putting healthcare workers at risk of non-auditory related effects of noise exposure, affecting work performance, cognitive abilities and vital communication between staff and patients. Healthcare workers may also be at risk of non-auditory health effects due to increased noise annoyance leading to raised stress levels, which may ultimately lead to pathophysiological changes in the myocardium. Future research in the area of noise levels in the New Zealand health industry should be performed to obtain noise data on a larger sample and look further at the non-auditory health effects of exposure to noise in the health industry.