Thesis (M.S.)--Boston University / The chronically ill patient in a general hospital designated for the treatment of the acutely ill presents serious problems to the medical team. With the advancements made in the medical profession, together with improved hospital facilities, more people today can benefit from hospitalization. Because of this fact, more people utilize hospital facilities today than in the past, with the results that hospitals are often overcrowded and cannot accommodate all who require treatment. Consequently, it is extremely important that the period of hospitalization be as short as possible, and consistent with the patient's condition, both for the chronically and the acutely ill if these services are to be available to all.

No description available.

The medical records of 263 patients hospitalized between 14 and 28 days in a 405-bed, acute care, community hospital were reviewed before 100 records were obtained with complete data to determine percent recommended body weight (RBW), serum albumin, total lymphocyte count (TLC), and hematocrit on admission and near discharge. Serum albumin and hematocrit were the only indicators that changed significantly during hospitalization, with both decreasing from admission to discharge. Considering the four indicators together, changes in nutritional status of the patients during hospitalization were determined. Eighty three patients were found to be at least at moderate potential for nutritional risk on admission, and 95 were found to be at least at moderate potential for nutritional risk near discharge. No patients who were judged to be potentially at severe nutritional risk on admission improved their nutritional status during hospitalization. Paired comparisons of the four parameters indicated that hematocrit and serum albumin seemed to be measuring changes in potential nutritional status more similarly than any other pair of assessment indicators. Sixty-three of the patients did not receive what was judged to be adequate kilocalories and protein during hospitalization. Twelve of these patients were found to have an increase in potential nutritional risk status. Of the 163 medical records that were reviewed but did not have all indicators recorded, height was most often missing on admission, and weight and serum albumin were most often missing near discharge. / Master of Science

In this thesis the applicability of a hospital patient flow model is used in addressing hospital resource allocation problems. Three separate but interrelated models are presented. First, the hospital patient flow model is discussed. The main feature of the hospital patient flow model is the matrix of technical coefficients, which gives the probability of patient transfers throughout the hospital. Given the hospital system's daily patient input, the model provides the patient demands upon the different hospital services. Results from the patient flow model are used in the development of a staff allocation model. The staffing model involves the minimization of a weighted quadratic penalty function. The weighting factors are based on the proportion of patients in each of three carelevels in the wards. The weights are also dependent upon whether overstaffing or understaffing is the situation. Constraints to the model include a desirable mix and number of the available nursing staff. Solution of the allocation model is obtained by using SUMT with a pattern search. A third model concerned with predicting hospital revenues is presented. Again, results from the hospital patient flow model are used to present estimates of the expected values and variance of a hospital's revenue. To illustrate the use of the models, results from a two-week study period of the Montgomery County Hospital are presented and discussed. / Master of Science

No / Introduction Patients represent an important and as yet untapped source of information about the factors that contribute to the safety of their care. The aim of the current study is to test the reliability and validity of the Patient Measure of Safety (PMOS), a brief patient-completed questionnaire that allows hospitals to proactively identify areas of safety concern and vulnerability, and to intervene before incidents occur. Methods 297 patients from 11 hospital wards completed the PMOS questionnaire during their stay; 25 completed a second 1 week later. The Agency for Healthcare Research and Quality (AHRQ) safety culture survey was completed by 190 staff on 10 of these wards. Factor structure, internal reliability, test-retest reliability, discriminant validity and convergent validity were assessed. Results Factor analyses revealed 8 key domains of safety (eg, communication and team work, access to resources, staff roles and responsibilities) explaining 58% variance of the original questionnaire. Cronbach’s α (range 0.66–0.89) and test-retest reliability (r=0.75) were good. The PMOS positive index significantly correlated with staff reported ‘perceptions of patient safety’ (r=0.79) and ‘patient safety grade’ (r=−0.81) outcomes from the AHRQ (demonstrating convergent validity). A multivariate analysis of variance (MAMOVA) revealed that three PMOS factors and one retained single item discriminated significantly across the 11 wards. Discussion The PMOS is the first patient questionnaire used to assess factors contributing to safety in hospital settings from a patient perspective. It has demonstrated acceptable reliability and validity. Such information is useful to help hospitals/units proactively improve the safety of their care.

No / Many studies have highlighted the problems associated with different aspects of medicines reconciliation (MR). These have been followed by numerous recommendations of good practice shown in published studies to decrease error; however, there is little to suggest that practice has significantly changed. The study reported here was conducted to review local medicines reconciliation practice and compare it to data within previously published evidence. To determine current medicines reconciliation practice in four acute hospitals (A–D) in one region of the United Kingdom and compare it to published best practices. Quantitative data on key indicators were collected prospectively from medical wards in the four hospitals using a proforma compiled from existing literature and previous, validated audits. Data were collected on: i) time between admission and MR being undertaken; ii) time to conduct MR; iii) number and type of sources used to ascertain current medication; and iv) number, type and potential severity of unintended discrepancies. The potential severity of the discrepancies was retrospectively dually rated in 10% of the sample using a professional panel. Of the 250 charts reviewed (54 Hospital A, 61 Hospital B, 69 Hospital C, 66 Hospital D), 37.6% (92/245) of patients experienced at least one discrepancy on their drug chart, with the majority of these being omissions (237/413, 57.1%). A total of 413 discrepancies were discovered, an overall mean of 1.69 (413/245) discrepancies per patient. The number of sources used to reconcile medicines varied with 36.8% (91/247) only using one source of information and the patient being used as a source in less than half of all medicines reconciliations (45.7%, 113/247). In three out of the four hospitals the discrepancies were most frequently categorized as potentially requiring increased monitoring or intervention. This study shows higher rates of unintended discrepancies per patient than those in previous studies, with omission being the most frequently occurring type of discrepancy. None of the four centers adhered to current UK guidance on medicines reconciliation. All four centers demonstrated a strong reliance on General Practitioner (GP)-based sources. A minority of discrepancies had the potential to cause injury to patients and to increase utilization of health care resources. There is a need to review current practice and procedures at transitions in care to improve the accuracy of medication history-taking at admission by doctors and to encourage pharmacy staff to use an increased number of sources to validate the medication history. Although early research indicates that safety can be improved through patient involvement, this study found that patients were not involved in the majority of reconciliation encounters.

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.

No description available.

The purpose of this study was to describe the relationships among perceptions of privacy, powerlessness, and subjective sleep characteristics in hospitalized adults with coronary heart disease. Thirty subjects, 48 to 92 years old who were hospitalized for suspected or confirmed coronary heart disease, completed three questionnaires. Negative relationships were found between patient privacy and powerlessness (r = -.44) and between powerlessness and the subjective sleep characteristics of sleep effectiveness (r = -.30). Feelings of powerlessness were negatively related to total number of days of (r = -.50) and number of days in the Coronary Care Unit (CCU) (r = -.41). The number of days in the CCU was positively related to sleep disturbance (r =.30). Age was negatively related to patient privacy (r = -31) but positively related to powerlessness (r =.33) and sleep supplementation (r =.35). A better understanding of the hospital environment enhances the planning of nursing care for hospitalized patients.