During the twentieth century, Nursing Education in South Africa was traditionally provided by the public sector and religious orders. Sr Henriëtta Stockdale played a major role in the development of nursing education and the governing thereof. In 1914, the establishment of the South African Trained Nurses’ Association (SATNA) marked the drive for an improved system of education for professional nurses. Medical practitioners and members of the Colonial Medical Council supported this initiative. The Provincial Medical Councils recommended a uniform system of education, to abolish the apprenticeship system of training and that students should be supernumerary. However, it was difficult to persuade authorities to accept the recommendations. The apprenticeship system prevailed, except for Groote Schuur Hospital where a block system was introduced (Searle, 1965b:287). Nursing training at university level has been advocated by SATNA since 1914. Due to financial responsibilities and the limited number of recruits that met the entry requirements of tertiary institutions, it was unsuccessful. Furthermore, university training of nurses restricted the placement of student nurses at large hospitals linked to universities. In 1933, the University of Cape Town and the University of the Witwatersrand became the first two universities in South Africa to have nurses on campus (Potgieter, 1984:1). In 1916, the training of male nurses in the mining industry was allowed for the first time. All training interventions were funded by mining houses and could therefore be regarded as the first Private Nursing Education Institution (PNEI). In 1946, a small nursing school was established on the East Rand under the Simmer and Jack Native Hospital. The purpose was to train white male orderlies for medical stations at mines. This was the beginning of PNEI in South Africa. PNEI are still functioning presently. The role and contribution of these institutions to nursing education in South Africa are often ignored. The researcher strove to answer the following question: What is the history and development of PNEI and their contribution with regard to nursing education in South Africa from a historical perspective? The objectives of the study were to explore, describe and record the history of the development of PNEI and their contribution to nursing education in South Africa. The motivation for the private health care industry to embark on the establishment of Nursing Education Institution (NEI) was investigated and described. A qualitative research design and an explorative, descriptive, contextual, historical research approach were applied. Explorative research involves the exploration of the phenomenon to divulge its core components. A descriptive study design aimed to find more information on the topic within this particular field of study was also used. The topic and context of this study is PNEI in South Africa between 1946 and 2006. The purpose of the study is to preserve the history of the development and contribution of PNEI including Gold Fields Nursing College, Netcare Training Academy, Life Nursing College, Medi-Clinic Learning Centres and Gandhi Mandela Nursing Academy between 1946 and 2006. This research study is presented as a chronological narrative report (Objective 1). Data collection was done by individual oral history semi-structured interviews with information-rich individuals as well as document analysis. Oral history semi-structured interviews had been recorded after which each interview was transcribed verbatim. Data analysis was done by narrative and document analysis. Scientific rigour was ensured throughout the study. Objective 2 and Objective 3 were achieved through data collection and analysis. Recommendations based on the findings are made for nursing research, nursing education and nursing practice. / Thesis (PhD (Nursing))--North-West University, Potchefstroom Campus, 2012

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The aim of the thesis is to explore pregnant women's decision-making and major influences on their preferences for a place of delivery. The study was prompted by the UK government's policy of a woman centred maternity service (Department of Health 1993b), and the observation that studies had concentrated on professionals' rather than women's views about the place of delivery. Two factors were considered to have potential influence in decision making, one being the individual woman's risk perception related to the process of childbirth, and the other, knowledge about available options for place of birth. First, a systematic review was conducted, looking at available studies on women's views about the place of delivery. Only 9 studies were found, suggesting a need for more studies. Secondly, a primary study was conducted using in-depth interviews with 20 women planning a hospital birth, and 13 planning a home birth to explore factors that led to their respective choices. Results from the primary study indicate that women were not offered information about the availability of home birth. Consequently, 90% of those planning a hospital birth did not give thought to where they were going to have their babies, but assumed they were going to go to hospital. On the other hand, those planning a home birth found information privately and discussed the options with their husbands before making a decision. Additionally, results exposed differences in perception of safety concerning childbirth for subsequent deliveries according to planned place of delivery. Control of the birth process and environment was also found to be important for women planning a home birth. Risk perception and information about available options were found to influence decision-making about the place of birth, thus supporting the hypotheses of the thesis.

Class of 2010 Abstract / OBJECTIVES: To assess disease-related and resource consumption characteristics of esophageal cancer mortality within hospital inpatient settings in the United States from 2002 to 2006. METHODS: This retrospective investigation of adults aged 18 years or older with diagnoses of malignant neoplasms of the esophagus (ICD-9: 150.x) utilized nationally-representative hospital discharge records from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample. Cases resulting in inpatient death were analyzed with respect to patient demographics, payer, hospital characteristics, number of procedures and diagnoses, Deyo-Charlson disease-based case-mix risk adjustor, and predominant comorbidities. RESULTS: Overall, 168,450 inpatient admissions for esophageal cancer were observed between 2002 and 2006, averaging 66.3 + or - 11.9 years, length of stay of 10.3 + or - 15.2 days, and charge of $51,600 + or _ 92,377. Predominant comorbidities within these persons included: secondary malignant neoplasms; disorders of fluid, electrolyte, and acid-base balance; pneumonia; respiratory failure/collapse or insufficiency; sepsis; anemia; hypertension; cardiac arrhythmias; obstructive pulmonary disease; acute or chronic renal disease; and heart failure. Significant predictors of increased charges included longer lengths of stay, higher numbers of diagnoses and procedures, median annual family income over $45k, urban hospital location, and presence of heart failure, chronic pulmonary disease, fluid and electrolyte disorders, or metastatic cancers (P< or = 0.05). Longer lengths of stay were associated with higher total charges, female sex, larger number of diagnoses and procedures, Medicaid, black race, increased case-mix severities, and fluid and electolyte disorders (P< or = 0.05). CONCLUSIONS: Patient mortality occurs in over one-tenth of esophageal cancer hospital admission cases. Further research is warranted to understand the impact of various comorbidities or treatment approaches and to assess potential disparities in lengths of stay.

Trabajo final de los alumnos de la Carrera Diseño Profesional de Interiores de la Universidad Peruana de Ciencias Aplicadas (UPC). Curso Taller 7, ciclo 2015-2, alumnos: Vargas Acuña, Candy Claudia y Larrea León, Alejandra Karina. / El curso de especialidad Patrimonio Histórico de la carrera Diseño Profesional de Interiores, de carácter teórico, está dirigido a los alumnos de séptimo ciclo y busca desarrollar la competencia general de Ciudadanía y la competencia específica de Diseño Multidisciplinario. El curso está orientado al desarrollo de un proyecto de intervención en un espacio patrimonial, el estudiante experimenta con patologías de deterioro en edificaciones antiguas y aprende técnicas de conservación a fin de que pueda utilizarlas en su desempeño profesional recuperando el valor de un inmueble. Como competencia de ciudadanía el alumno adquiere su compromiso con la historia y el patrimonio de su ciudad. El Perú tiene un importante Patrimonio cultural edificado y requiere profesionales con formación en temas de puesta en valor y adecuación a un nuevo uso.

This study compares selected social characteristics of first admissions to a private psychiatric hospital in the calendar years 1940 and 1960 with the white populations of Texas and Dallas County. In addition, this study compares selected background characteristics of first admissions to determine what, if any, change occurred in these characteristics between 1940 and 1960.

The primary purposes of the present study were (1) to see in which way, if any, the measured attitudes of psychiatric aides employed on geriatric wards differed from those of aides employed on non-geriatric wards at the same hospital; and (2) to explore the relationships between measured attitudes and other variables such as age, education, amount of experience as an aide, amount of experience on either geriatric or non-geriatric wards, and the number of patients per aide on each ward.

The role of marketing and marketing communication in hospitals has grown in the last decade. The need for hospitals to make careful decisions about their marketing communication efforts is mandated, given the changes taking place in the hospital industry. The purpose of this dissertation was to conduct empirical research to determine whether for-profit and non-profit hospitals perceive and utilize promotion as a marketing strategy element. The two steps taken included: identifying important factors considered by hospital administrators and marketing staff in the development of communication messages designed for patients, hospital staff and medical staff; and testing the factors developed and studying the attitudes of hospital personnel toward promotion using a national sample of hospitals. In phase 1, focus group interviews were conducted in a surrogate for-profit hospital and a surrogate non-profit hospital. In phase 2, an original mail questionnaire was used to collect data from a sample of 80 hospitals. A total of 38 hospitals participated, providing 114 usable responses. Test statistics included content analysis, Chi-Square, Pearson correlation coefficient and Analysis of Variance. The results of the focus group study indicated the practice of marketing in hospitals is in its early growth stages and marketing is viewed as nothing more than advertising and public relations. The results of the mail survey indicated that respondents in small for-profit hospitals with 20 to 30 years of experience as professionals, with key decision making authority, are favorably disposed to marketing and marketing communication. It was also found that respondents in large non-profit hospitals are very positive towards marketing. In contrast, respondents in medium and large for-profit hospitals, who are not directly involved in decision making, tend to be less positive towards marketing. The study serves as a basis for future research which may involve, (1) a larger sample frame, (2) hospitals in inner-city and rural areas, (3) investigation of the association between hospital ownership and hospital efficiency, and (4) development of a profile of respondents by title held, in hospitals.

Class of 2007 Abstract / Objectives: The purpose of this study is to determine the direct costs of scorpion envenomation events in the acute care setting for patients treated in a southern Arizona hospital. Methods: A chart review analysis of documented treatment of scorpion envenomations at a university hospital was conducted to compile demographic, drug use, and resource utilization information. Patients were selected based on an ICD-9 code diagnosis of scorpion envenomation within the years 1993 to 2001. Results: 103 patient charts were reviewed. The average length of stay was 1.21 days (range 0.5-6.5 days), the average age was 4.7 years (range 0.2-53 years old). Males comprised 54% of the patients, 51.9% Caucasian, 41.6% Hispanic, and 60.2% were from an urban setting. The average drug cost was $51.82 (SD=53.22). The total average cost in the entire population was $6,764.54, (SD= $3,866.55). The average cost of rural versus urban was $7,535.74 and $6,254.55, respectively (p=0.100). The average cost for male versus female was $6,949.64 and $6,520.90 (p= 0.581), and the average cost for the 0-3 years group was $6,721.10, the >3 years to 14 years group’s average cost was $6,643.33, and the >14 years of age group’s average cost was $8,578.42. None of the comparisons between age groups were statistically significant, with p values ranging from 0.274 to 0.922. Conclusions: Although scorpion envenomations were costly, there were no statistically significant differences noted between any of the comparison groups. Transportation, including air transport in the rural setting, did not account for a significant change in cost. Many of the patients that were envenomated in the rural setting were seen at a regional hospital and then transported as necessary.

Class of 2007 Abstract / Objectives: Medication reconciliation is a formal process of obtaining a complete and accurate list of each patient’s current home medications. This process is done to prevent errors of omission, therapeutic duplication, dosing/frequency errors, or drug-drug/drug-disease interactions. As of January 1, 2006, University Medical Center (UMC) implemented a new, comprehensive medication reconciliation form which was intended to prevent medication-related discrepancies upon admission. The purpose of this study was to compare the percent of missing required prescription information upon hospital admission before and after the implementation of the medication reconciliation form. Methods: This study was an inferential retrospective chart review of patients admitted to UMC in Tucson, Arizona, between January 1, 2005 and August 1, 2006. While the overall goal was to measure the impact of a new medication reconciliation form on the completeness of a patient's medication history, the specific study objectives were to: (1) evaluate medication reconciliation form utilization and compliance and (2) compare the completeness of medication information upon hospital admission before and after the implementation of the comprehensive medication reconciliation form. Patients were included in the study if they were over 18 years of age and admitted to UMC at least once in 2005, and at least once between January 1, 2006 and August 1, 2006. The following patients were excluded: patients that were institutionalized in an assisted living facility or nursing home, admitted to the emergency room, intubated, transferred to the hospital from a nursing home or a long term care facility, and discharged from the hospital within 24 hours of admit. Two hundred and thirty-four patients, who met the inclusion criteria, were randomly selected from a UMC hospital census. The researchers reviewed each medical chart and recorded the physician-reported medication history, reason for admit, length of stay, and demographic information. Descriptive and inferential statistical analysis was completed using SPSS Version 11.0 (SPSS Inc., Chicago, IL). After collecting the data, counts were taken on missing prescription information, such as missing medication names, dose, route, and frequencies. If the collected data were normally distributed and were interval/ratio level data, a paired t- test was used for analysis. If the data were not normally distributed or were of nominal/ordinal level, a McNemar test was used. An a priori alpha level of 0.05 was used for all statistical tests. Results: A total of 234 patients were included in both the pre and post analysis. Approximately 53.8% of the sample was male. Fifty-one percent of the population was categorized as white in the patient’s chart. The average age at time of first admit was 50.3 years. Fifty-three percent of the population had a past medical history that included cardiovascular disease. Over 28% of the patients in the sample had diabetes and over 18% had pulmonary disease. The most common admit diagnoses for the population included shortness of breath, chest pain, and abdominal pain. Medication reconciliation forms were found in the chart 71.4% of the time. Of the 71.4% of the forms present in the patient’s medical chart, the form was utilized 66.6% of the time. The percentage of allergies recorded in the patient’s chart decreased from 89.3% before implementation of the form to 65.9% after implementation. This movement repeated itself with the recording of social history, which fell from 92.3% recorded before the form to 52.6% after implementation. Introduction of the new medication reconciliation form at UMC resulted in significantly fewer drug names missing, incorrect, or illegible from the patient’s medication history between pre and post (p=0.034), as well as a greater amount of medications recorded in the patient’s medication history (p=0.006). However, the use of the form did not result in significant differences between pre and post in the route, frequency, and dosing information being recorded. It also did not result in a significantly greater amount of non- prescription drugs recorded. Conclusions: The results of this study indicate the need for a systematic approach to ensure the process of obtaining accurate medication histories at the time of hospital admission. Utilization of a new comprehensive medication reconciliation form in this academic institution is far from optimal, and could have significant healthcare implications. Better methods of ensuring medication reconciliation at the time of hospital admission are needed.