Health Management Information System (HMIS) in developing countries lags seriously behind as compared to the developed countries; and the existing HMIS in many countries is insufficient to support health management functions. The purpose of this study was to describe the implementation of Anti-retroviral Therapy (ART) pharmacy management information system in public health facilities. Quantitative, descriptive research was conducted at 38 public health facilities. The participants of the study were Pharmacists and Druggists those are working at ART Pharmacy. Data collection was done by using structure questionnaire. 76 respondents were recruited to participate in the study. The participants ages ranged from 26-50 years and all had more than 2 years’ work experience. The study indicated that even if there is a system at most health facilities their utilization of information technology (IT) for pharmacy practice were not appreciated. The findings indicated that the need for creating awareness among professionals in giving more skill oriented and also a formal in-service information technology related trainings for the professionals. To achieve better utilization of information technology at health care delivery system particularly pharmacy practice, government and stakeholder should consider capacity building activities through proper training and it should also viewed as a long term socio-cultural and technical development process. / Health Studies / M.A. (Public Health with specialization in Medical Informatics)

The contribution of Emergency Obstetric Care (EmOC) in reducing maternal mortality in Ethiopia is very minimal as evidenced by poor provision and low utilization of EmOC. Client centred EmOC provision improves the provision and utilization of EmOC; leading to the treatment of the majority of obstetric complications which are the main causes of maternal mortality. This study describes clients’ views and perspectives concerning the quality of EmOC provision in Ethiopian public health facilities. An explorative and descriptive phenomenological qualitative study design was used in the study in order to explore and describe the lived experiences of clients with EmOC services. Key informant interviews with women who had direct obstetric complications and received EmOC at three public health facilities in Addis Ababa generated rich data on their lived experiences. Content analysis was used to analyze the data as it complies with the phenomenological data analysis and Atlas ti version 6.2 qualitative data analysis software was employed. The findings revealed that quality EmOC is a welcoming, life-saving timely care given in a clean environment with humility, respect, equal treatment and encouragement. It is care that is safe for the client, technically sound, responsive and meets clients’ needs and expectations. Accessibility of life saving care at all time and collaborative and coordinated care created good experiences for the clients. The causes of clients’ disappointment with the provision of EmOC were higher expectations from female providers, underestimation by providers, non responsive providers, and ethical misconduct by providers such as mocking, insulting, yelling, advantage taking providers, undelivered promises by providers, expectation with place of delivery, expectation with newborn care and a limited number of health workers attending delivery. Discrimination, high cost of care and asking client to buy drugs and supplies and referrals from centres, are some of the barriers on r the use of EmOC at public health facilities. The provision of EmOC is constrained by overloaded staffs, shortage of space to accommodate clients and inadequate number of beds. In conclusion, clients have expectations and experiences of provision of EmOC that influence their future decision to seek care. Finally, a client centred guideline for the provision of client centred EmOC provision was developed. / Health Studies / D. Litt. et Phil. (Health Studies)

The aim of the study was to explore the perceptions of nurses regarding communication with nurse managers in the workplace. The design of the study was a generic qualitative. The methodology of choice was qualitative, explorative method. The sample was non-probability and the approach or technique used was purposive sampling method. It comprised of thirty nurses, ten of each category. The category was a component of professional nurses, enrolled nurses and enrolled nursing auxiliary nurses. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The findings showed that there were dynamics in communication from all nurse categories and that also indicated that there was a need to conduct a research so that the root cause may be identified and suggestions to be put in place to curb the challenges. In conclusion it showed that communication is the key problem of all and it is a worldwide problem. / Health Studies / M.A. (Health Studies)

A influência das características laborais sobre a saúde mental dos trabalhadores pode decorrer de inúmeros fatores ou formas de organização do trabalho. Na atualidade, verifica-se os crescentes índices de sintomas psíquicos entre determinadas categorias profissionais, com destaque para os trabalhadores de saúde atuantes em ambiente hospitalar Objetivo: Este estudo objetivou identificar a ocorrência de Transtornos Mentais Comuns (TMC), a ocorrência da síndrome de Burnout, e a associação de ambos os transtornos nos trabalhadores de enfermagem, bem como elaborar propostas de intervenção para redução do desgaste psíquico. Metodologia: Trata-se de um estudo exploratório, transversal com abordagem quanti-qualitativa. A pesquisa foi realizada em Hospital Público Universitário especializado em cardiologia, pneumologia e cirurgias cardíacas e torácicas. A amostra foi composta por trabalhadores de enfermagem que atuam em unidades de terapia semi-intensiva e intensiva pediátrica e neonatal, perfazendo um total de 92 participantes. Para a coleta de dados quantitativos foram utilizados: instrumento de caracterização sócio demográfica, Self-Reporting Questionnaire (SRQ-20), e o Maslach Burnout Inventory (MIB). Para os dados qualitativos, optou-se pela técnica de grupo focal, conduzido por questões norteadoras, com uma amostra de 17 trabalhadores de enfermagem. O período de coleta foi nos meses de junho e julho de 2012. Resultados: A análise dos resultados evidenciou a ocorrência de TMC em 44,60%(41) dos trabalhadores e a ocorrência de Burnout em 8,7%(8) trabalhadores. Houve associação estatística entre os TMC e o Burnout p=0,003, considerando nível de significância de 5%. Em relação aos TMC, as respostas dos trabalhadores foram distribuídas de acordo com os quatro grupos de sintomas avaliados pelo SRQ-20: Grupo somático, Decréscimo de energia vital, Humor depressivo-ansioso e Pensamentos depressivos. Em relação à sindrome de Burnout, os trabalhadores foram avaliados considerando-se a ocorrência de escores alto nas três dimensões (Desgaste Emocional, Despersonalização e Reduzida Realização Profissional) ou em uma delas apenas. Não foi constatada associação entre os transtornos e as variáveis sócio-demográficas. Houve associação entre ambos os transtornos. As sessões de grupo focal evidenciaram propostas de intervenção mediante três temas que emergiram das discussões: Aprender a lidar com a criança cardiopata grave, Receber o reconhecimento profissional e Repensar a gestão de pessoas. Conclusão: Os achados, em conjunto, evidenciam necessidade de medidas protetoras à saúde mental do trabalhador que assiste crianças cardiopatas graves. Palavras-chave: Estresse psicológico, Esgotamento profissional, Equipe de enfermagem, Hospitais públicos, Unidades de terapia intensiva pediátrica, Unidade de terapia intensiva neonatal, Saúde do trabalhador. / The influence of work characteristics on mental health workers may be due to numerous factors or forms of work organization. At present, there is the growing rates of psychiatric symptoms among certain professions, especially health workers working in hospitals Objective: This study aimed to identify the occurrence of Common Mental Disorders (CMD), the occurrence of Burnout, and the association of both disorders among nursing staff, as well as elaborate proposals for intervention to reduce wear psychic. Methodology This is an exploratory study, cross-sectional with quantitative and qualitative approach. The research was conducted in a public University Hospital specialized in cardiology, pulmonology, thoracic and cardiac surgery. The sample consisted of nursing workers of care units, semi-intensive and intensive, pediatric and neonatal, making a total of 92 participants. For quantitative data collection was used: instrument of socio demographic, Self-Reporting Questionnaire (SRQ-20), and the Maslach Burnout Inventory (MIB). For qualitative data, we chose the technique of focal group, conducted by leading questions, with a sample of 17 nurse workers. The collection period was between June and July, 2012. Results The result of the analysis revealed the occurrence of CMD in 44.60% (41) of the workers and the occurrence of Burnout in 8.7% (8) of the workers. There was a statistical association between CMD and Burnout p = 0.003, considering level of significance 5%. Regarding CMD, the answer of the workers was distributed according to the four groups of prognostic evaluated by the SRQ-20: Somatic Group, Decrease of vital energy, Anxious-depressive humor and Depressive thoughts. Regarding Burnout syndrome, workers were evaluated considering the occurrence of high scores in all three dimensions (Emotional Exhaustion, Depersonalization, and Reduced Professional Accomplishment) or only in one of them. There was no association between the disorders and sociodemographic variables. There was an association between both disorders. The focal group sessions revealed proposals for intervention through three issues that emerged from the discussions: Learn to deal with severe heart disease children, professional acknowledgment and rethink people management. Conclusion: Findings, during the sessions, highlight the need for protective measures of mental health for workers who assist children with heart disease

Univ., Diss.--Linz, 2006.

PPSUS / A gestão de custos, em qualquer organização, proporciona uma série de benefícios, como a segurança na boa administração dos recursos, porém é pouco utilizada na área hospitalar pública, o que se configura como um paradoxo, frente à complexidade da organização hospitalar e à situação de subfinanciamento da saúde. Sendo assim, a questão de pesquisa que norteia este estudo é: Qual a contribuição de um modelo de custeio para a governança pública nas unidades hospitalares próprias do Estado do Paraná? Este estudo tem como objetivo propor um modelo de custeio para a gestão de custos em hospitais públicos administrados diretamente pelo Estado, como proposta de aprimoramento para controle, transparência, orçamentação e planejamento das ações estratégicas de saúde. Tal estudo mostra-se relevante, uma vez que a área hospitalar é bastante complexa, tornando-se ferramenta útil para tomada de decisão sobre investimentos, alterações de perfil de atendimento, utilização de capacidade ociosa, ampliações de serviços, entre outros. O sistema de saúde público brasileiro necessita de máxima eficiência, tendo em vista os direitos universais garantidos pela Constituição Federal. Assim, justifica-se pela complexidade hospitalar, um cenário de elevada evolução de custos, seja pela mudança do perfil demográfico e epidemiológico, como o envelhecimento da população brasileira e o crescente número de doenças crônicas, bem como pela crescente evolução tecnológica e seu incremento acelerado. Trata-se de uma pesquisa-ação com base no levantamento de resultados de pesquisas similares para análise da aplicação do modelo de custeio para organizações hospitalares, bem como a análise empírica das informações existentes em dois hospitais selecionados. Com base nos conceitos teóricos e empíricos da aplicação da metodologia de custo por absorção, gera elementos para melhor compreensão do problema para desenvolver o modelo de custeio. A avaliação dos resultados se constitui em importante instrumento de gestão dos hospitais e da Secretaria de Estado da Saúde, pois permite aos dirigentes maior segurança diante das dificuldades e desafios impostos nesse segmento, caso contrário há uma restrição ainda maior na gestão, no financiamento e operacionalização dos hospitais públicos. / Cost management brings about several benefits to any type of organization, such as the certainty that resources are well managed, but it is not much used by the public hospital sector, what is a paradox seeing that hospital management is complex and public health faces an under-financing situation. Based on the aforementioned facts, the present study aims at answering the following question: What is the contribution of costing models to public governance in the State of Paraná public hospitals? So, the study objective is to propose a costing management model addressed to improve health strategy control, transparency, budget and planning actions in public hospitals directly managed by the State of Paraná. Since the hospital sector is complex, our study is highly relevant as a helping tool to: investment decision-making processes, changes of healthcare profile, use of spare capacity and service improvement, among others. Considering the universal rights ensured by the Brazilian Federal Constitution, the country public health system needs to show maximum efficiency. In addition to hospital complexity, the sector increased costs are justified by the change of demographic and epidemiological profiles, Brazilian population aging, chronic disease growth, increased technological evolution and development. The research/action is based on the results of similar researches addressed to analyze the application of costing models addressed to hospital organization, as well as on the empiric analysis of data existing in two hospitals selected by the study. By applying the theoretical and empiric costing absorption methodology, our study provides elements to help understanding the problems involved in the costing model development. Result assessment is an important tool which permits Hospital and the State Health Department managers to deal with the sector challenges and difficulties more easily, since it helps lessen the restrictions imposed to public hospital management, financing and operation.

Submitted by Emanuel Varela Cardoso (emanuel.varela@ufcg.edu.br) on 2018-10-15T19:52:56Z No. of bitstreams: 1 JEOVÁ ALVES DE SOUZA - DISERTAÇÃO (PPGRN) 2017.pdf: 1904848 bytes, checksum: f65f584b21aa1e729856464256946cb8 (MD5) / Made available in DSpace on 2018-10-15T19:52:56Z (GMT). No. of bitstreams: 1 JEOVÁ ALVES DE SOUZA - DISERTAÇÃO (PPGRN) 2017.pdf: 1904848 bytes, checksum: f65f584b21aa1e729856464256946cb8 (MD5) Previous issue date: 2017-08 / Os problemas ambientais estão intrinsecamente ligados aos fatores de risco à saúde da população e às necessidades atuais de preservação do meio ambiente, sendo os resíduos sólidos gerados pelos serviços de saúde agentes com alto potencial de contaminação biológica, química ou radioativa, os quais necessitam de tratamento especial quanto à seleção, acondicionamento e destino apropriado, fazendo-se imprescindível a gestão e o gerenciamento conscientes desses resíduos em decorrência dos perigos que propiciam aos seres vivos e ao meio ambiente. Objetivou-se analisar a gestão e o gerenciamento dos resíduos sólidos dos serviços de saúde na cidade de Campina Grande – PB, em cinco unidades hospitalares públicas. A metodologia utilizada tratou de um estudo exploratório, descritivo de corte transverso, bibliográfico e de campo, realizado na cidade de Campina Grande-PB com os sujeitos responsáveis pela gestão e gerenciamento dos resíduos sólidos hospitalares no município. Como parte dos resultados, identificamos que: os gestores sabem da existência da legislação ambiental, mas falta aprimoramento do conteúdo vigente para organização de política institucional de resíduos; os resíduos são identificados e a coleta e acondicionamento ocorrem, parcialmente, dentro das normas ambientais nos serviços hospitalares, existindo, em alguns dos hospitais, politica de reaproveitamento já implementada com destinação adequada dos resíduos; os gestores têm ciência dos riscos ambientais que os resíduos produzem e alegam haver dificuldades de manejo e que há treinamento periódico dos profissionais que lidam com resíduos sólidos nos hospitais estudados. Contudo, há necessidade de mais aprofundamento teórico e prático para gestão e gerenciamento dos resíduos sólidos dos serviços de saúde, destacando-se os seguintes pontos: existe sobrecarga de trabalho para os gerentes dos serviços o que impacta no processo de gestão; a gestão e o gerenciamento ocorrem de forma diferenciada nas instituições analisadas quanto à obediência à legislação ambiental; observou-se que os gestores dos hospitais atendem parcialmente aos critérios de coleta e acondicionamento propostos pelas Resoluções nº 358/05 do CONAMA e a Resolução nº 306/04 da ANVISA; percebeu-se que em algumas das instituições do estudo não há política institucional de reaproveitamento dos resíduos sólidos já implementada e a destinação final é a incineração e o aterro sanitário municipal, sem tratamento prévio dos resíduos na fonte geradora. Recomenda-se: o desenvolvimento de ações frequentes de capacitação e educacional continuada para os profissionais que trabalham com os RSS; a elaboração e implementação de Plano de Gerenciamento dos Resíduos Sólidos dos Serviços de Saúde - PGRSS; a conscientização dos profissionais para seguirem as orientações estabelecidas pela legislação ambiental; implantação de uma política de reaproveitamento dos RSS mais ampla dos reutilizáveis e recicláveis; correto acondicionamento e destino final dos RSS, sobretudo resíduos radioativos, infectantes e perfurocortantes; implantação, na própria instituição, de sistemas de tratamento para os resíduos infectantes e perfurocortantes, tornando-os inertes. / Environmental problems are intrinsically linked to the health risk factors of the population and to the current needs of preservation of the environment, with solid waste being generated by health services agents with high potential for biological, chemical or radioactive contamination, which require treatment especially in terms of selection, packaging and proper destination, making it essential to consciously manage and manage these wastes as a result of the dangers they pose to living beings and the environment. The objective was to analyze the management and management of solid waste from health services in the city of Campina Grande - PB, in five public hospitals. The methodology used was an exploratory, descriptive cross-sectional, bibliographical and field study, carried out in the city of Campina Grande-PB with the subjects responsible for the management and management of hospital solid waste in the municipality. As part of the results, we identified that: managers know of the existence of environmental legislation, but lack of improvement of the current content for organization of institutional waste policy; the waste is identified and the collection and packaging takes place partially within the environmental norms in the hospital services, and in some of the hospitals there is a reuse policy already in place with adequate waste disposal; the managers are aware of the environmental risks that the waste produces and claim there are management difficulties and that there is periodic training of professionals who deal with solid waste in the hospitals studied. However, there is a need for more theoretical and practical deepening for the management and management of solid waste from health services, highlighting the following points: there is work overload for the managers of the services, which impacts on the management process; Management and management occur in a differentiated way in the analyzed institutions regarding compliance with environmental legislation; It was observed that hospital managers partially meet the collection and conditioning criteria proposed by CONAMA Resolutions 358/05 and ANVISA Resolution 306/04; It was noticed that in some of the institutions of the study there is no institutional policy for the reuse of solid waste already implemented and the final destination is the incineration and municipal landfill without previous treatment of the waste in the generating source. It is recommended: the development of frequent training and continuing educational actions for professionals working with RSS; The elaboration and implementation of the Solid Waste Management Plan of the Health Services - PGRSS; The awareness of professionals to follow the guidelines established by environmental legislation; Implementation of a policy of reusing the RSS of reusable and recyclable products; Correct packaging and final destination of RSS, especially radioactive, infectious and sharps-borne waste; Establishment of treatment systems for infectious and piercing-cutting residues, rendering them inert.

Recognising the enormous challenges in South Africa confronting the nursing of the mentally ill, the project was conducted in a public hospital in Gauteng. The purpose of the research was to describe professional nurses' perception of nursing mentally ill people in a general hospital setting and was carried out amongst a sample size of 124 professional nursing staff using a self-administered tool. The study looked at four different types of perceptions guided by categories of conceptual framework proposed by Mavundla (2000:1569-1570), namely perception of self, perception of patients, perception of environment and perceived feelings. The study found that the majority of professional nurses have a predominantly positive self- perception of nursing mentally ill people in a general hospital, although a significant number have a negative perception of patients, the nursing environment and perceived feelings. Lack of knowledge, skill and experience affect the nursing care of mentally ill people in the general hospital. / Health Studies / M.A. (Health Studies)

Text in English / Professional nurses are regarded as the backbone of the health care system and quality patient care is linked to patient safety.The purpose of the study was to describe and explore the perceptions of professional nurses on impact of shortage of resources for quality patient care. The resources include health professionals, equipment and drugs. The study was conducted in Mankweng hospital which is a public hospital in the Capricorn district in Limpopo Province. Qualitative descriptive exploratory design was used which provided the researcher with in-depth information regarding phenomena under study. Data was collected from ten (10) professional nurses who have 5 to 20 years of nursing experience allocated in medical and surgical wards. Unstructured face-to-face interview was conducted using field notes and audio tape. Data was analysed following Creswell (2014) Tesch method. Five themes and eighteen subthemes emerged from data. The findings revealed that the shortage of health professionals and inadequate resources has a negative impact on provision of quality patient care. / Health Studies / M.A. (Health Studies)

The purpose of this study was to explore the level of integration of health promotion and disease prevention services with the curative care provided at hospitals and health centres in Addis Ababa, and to propose recommendations that could improve such an integrated health service. A quantitative approach, using an exploratory and descriptive design was applied at 22 public health facilities in Addis Ababa followed by the Delphi technique to reach consensus on ways to improve the integration of health promotion, preventive and curative care. An integrated health service (IHS) framework was used as the conceptual framework upon which the study was based. Multistage sampling involving stratified simple random sampling was applied to select hospitals and health centres while a systematic sampling technique was used to sample patients from the outpatient and inpatient medical departments. Data was collected by means of two questionnaires from patients and health service managers, respectively, following which two Delphi rounds with experts resulted in agreement on a contextually accepted integrated framework. The findings revealed that promotive and preventive services for chronic diseases were not optimally integrated in the routine health care services of the health facilities. Most health facilities lacked skilled health professionals, adequate medication and equipment to provide a comprehensive integrated service. The study emphasized the need for health service providers to undergo a paradigm shift and additional training in order to provide a comprehensive, patient-centred, integrated health service instead of only treating patients’ complaints. To assist this approach, the study affirmed the Integrated Health Service (IHS) framework as a tool which comprehensively demonstrates the cause, effect and progression of chronic diseases and the appropriate interventions which health professionals can apply in managing diseases or their risk factors. Recommendations for effective, integrated promotive and preventive health care, included the development of guidelines, protocols and policy documents for cultivating a healthy lifestyle, adopting effective disease prevention approaches, re-designing medical school curriculums, and staffing health facilities with trained and specialized staff, capacitating health facilities with the necessary equipment, medication and supplies that would enable the provision of an integrated health care service. / Health Studies / D. Litt. et Phil. (Health Studies)