Thesis (M.Dev) --University of Limpopo, 2011

The primary motivation of this PhD by publication has been the apparent disconnect between the metrics of hospital quality of care at national and board level and patients’ experiences. Exploration of the gap led to the realisation of two key points. Firstly, the concept of healthcare quality continually evolves. Secondly, the NHS Scotland Measurement Framework does not include a measure of patient experience at the microsystem level (e.g. hospital ward). This is needed to counterbalance easier to obtain metrics of quality (e.g. waiting times). Resource tends to follow measurement. Papers 1 and 2 were exploratory, investigating theoretical and practical aspects of measuring quality of hospital care at the clinical microsystem level. With the associated Chapters, they highlighted both the necessity and the possibility of measuring the patient experience at the micro level of the healthcare system. They also drew attention to the inadequacy of “satisfaction” as a metric, leading to closer examination of “experience” as the decisive metric. This required the development of a systematic review protocol (Paper Three), then a systematic review (Paper Four). The review (Paper Four) examined the utility (validity, reliability, cost efficiency, acceptability and educational impact) of questionnaires to measure the patient experience of hospital quality of care, with a newly devised matrix tool. Findings highlighted a gap for an instrument with high utility for use at the clinical microsystem level of healthcare. Paper Five presents the development and preliminary psychometric testing of such an instrument; the Care Experience Feedback Improvement Tool (CEFIT). The thesis provides, as well as the matrix tool and CEFIT, theoretical and methodological contributions in the field of healthcare quality. It contributes to an aspiration that the patient’s voice can be heard and acknowledged, in order to direct improvements in the quality of hospital care.

A patient monitoring system for cardiopulmonary bypass surgery has been developed. This monitoring system uses a SWAN 286-10 computer (fully IBM PC/AT compatible) and a DT280l-A Input/Output board to monitor seven surgical parameters. This system monitors six temperatures, the hemoglobin content, the arterial oxygen saturation, the venous oxygen saturation, the oxygen consumption, and the blood flow rate through the cardiopulmonary bypass circuit. Additionally, there are three individual timers available. Details and the evaluation of the hardware and software design of this monitoring system are presented. Also, recommendations for clinical use are discussed. / Master of Science / incomplete_metadata

Thesis (M.A. (Nursing Science)) -- University of Limpopo, 2016 / The purpose of the study was to develop a protocol to enhance patient satisfaction with regard to nursing care at Health Centres and to determine factors leading to patient dissatisfaction. A quantitative, descriptive and cross-sectional research design was used for this study. The population of the study for the two Health Centres was: Agincourt Health Centre= 5697 while Thulamahashe Health Centres= 5696. Systemic random sampling method was used to select 400 respondents from each Health Centre. Data were collected through self-developed questionnaire. The questionnaire was pre-tested at Cunningmoore clinic. Reliability was ensured through conducting of a pre-test. Validity was ensured through undertaking extensive literature review. The questionnaire was also given to the supervisor for content validity. Data analysis was done through descriptive and inferential statistics using SPSS version 22 programme of data analysis. The findings indicated that factors leading to patient dissatisfaction with regard to nursing are: long waiting time, poor communication and information between nurses and patients, shortage of nurses, poor service and environmental condition and shortage of treatment (medication). The study recommends that waiting time should be reduced to less than 3 hours, shortage of nurses should be addressed, workshops and inservice training should be implemented and treatment should be monitored.

Thesis (MPH.) -- University of Limpopo, 2021 / Background:Patient satisfaction is an important means of measuring the effectiveness of health care delivery and medical care. Patient satisfaction provides a picture of the extent to which the general health care needs of the patient provided by health care professionals are met to the satisfaction of the patient. Administration of patient satisfaction surveys provide an opportunity to identify and resolve potential problems before they become serious. Enhancing quality of service delivery in public health facilities is a prerequisite for the increased utilisation and sustainability of health care services to the population. The aim of the study was to investigate the level of patient satisfaction regarding service delivery provided by the doctors and nurses at a hospital in Botswana. Purpose:The study’s aim was to investigate the level of patient satisfaction regarding service delivery at a hospital in Botswana. Methods:Aquantitative approach using a self-administered structured questionnaire to collect data regarding patient satisfaction regarding service delivery at hospital was used.A consecutive sampling technique was used to select patients who fulfilled the study’s inclusion criteria. A sample size of 360 patients was required for the study, which was calculated based on the Taro Yamane formula. Data was analysed using SPSS version V.21.0. Results:The mean age of the outpatients was 38.5(SD ±15.6) years while,for the inpatients, the mean agewas 33.3(SD±12.4) years. The greater proportion of respondents in both groups was females. Nearly half (47%) of the outpatients were employed, whereas more than half (53%) of the inpatients were unemployed. The majority of the participants had a low level of education. The mean satisfaction level was 58.9 (SD±7.9)for outpatients, while for in patients, the mean satisfaction level was 70.3 (SD±12.5). A large proportion (65%) of the outpatients were satisfied compared to the inpatients (54%), however, the results were not statistically significant (p>0.05). There was no statistically significant relationship between the age, gender, employment status, level of education of the outpatients and their level of satisfaction. For inpatient variables, age, gender, and level of education were not associated with level of satisfaction (p>0.05). Conclusion: Inconclusion, regardless of the fact that certain aspects of care provided a t this hospital were unsatisfactory, the results of the present study revealed that, overall,more than half of the patients were satisfied with the inpatients and outpatient aspects of the xiv care they were provided.

This study addresses the specific barriers related to time delays in the treatment of patients who suffered acute myocardial infarction at the Al Ain Hospital accident and emergency unit in the United Arab Emirates. A comprehensive background of the UAE is given for the benefit of students who have limited access to the background and challenges facing medical and nursing personnel in providing thrombolythic therapy to patients who suffered from acute myocardial infarction. The study will contribute to the continuous quality management and improvement of overall nursing and medical care of the AMI patient who is eligible for thrombolysis. An extensive literature review addresses the clinical manifestations and treatment of the patient suffering from AMI as well as the adverse effects of time delays in treatment during the acute phase of the disease. The researcher selected a quantitative, non-experimental descriptive and retrospective study. Data was collected by a structured instrument to gather the desired responses from the files of 457 selected patients admitted to the Al Ain Hospital. This study emphasizes the need to improve patient care by all health care personnel in an accident and emergency unit to prevent the delays in treatment in life threatening conditions such as myocardial infarction ensuring optimal and prompt time to thrombolyse. The improvement of awareness and commitment by health care providers such as nurses, doctors and ambulance personnel, can be achieved through education and training, commitment and dedication, absolute cooperation, collaboration and constant update on performance. Regular audits are essential with regard to door-to-needle time and performance of all health care providers. This study ultimately show that time constrains in attending to patients presenting with myocardial infarction should be addressed in utmost urgency. / Health Studies / M. A. (Health Studies)

This study addresses the specific barriers related to time delays in the treatment of patients who suffered acute myocardial infarction at the Al Ain Hospital accident and emergency unit in the United Arab Emirates. A comprehensive background of the UAE is given for the benefit of students who have limited access to the background and challenges facing medical and nursing personnel in providing thrombolythic therapy to patients who suffered from acute myocardial infarction. The study will contribute to the continuous quality management and improvement of overall nursing and medical care of the AMI patient who is eligible for thrombolysis. An extensive literature review addresses the clinical manifestations and treatment of the patient suffering from AMI as well as the adverse effects of time delays in treatment during the acute phase of the disease. The researcher selected a quantitative, non-experimental descriptive and retrospective study. Data was collected by a structured instrument to gather the desired responses from the files of 457 selected patients admitted to the Al Ain Hospital. This study emphasizes the need to improve patient care by all health care personnel in an accident and emergency unit to prevent the delays in treatment in life threatening conditions such as myocardial infarction ensuring optimal and prompt time to thrombolyse. The improvement of awareness and commitment by health care providers such as nurses, doctors and ambulance personnel, can be achieved through education and training, commitment and dedication, absolute cooperation, collaboration and constant update on performance. Regular audits are essential with regard to door-to-needle time and performance of all health care providers. This study ultimately show that time constrains in attending to patients presenting with myocardial infarction should be addressed in utmost urgency. / Health Studies / M. A. (Health Studies)