Mukwevho, Moshibudi Florence
16 January 2009
No description available.
Risks associated with suspected dysphagia in NICU-admitted infants in a South African public hospital : a retrospective studySchoeman, Jacoline January 2016 (has links)
Background: The prevalence of neonatal dysphagia is increasing, as medical advances contribute to the survival of critically ill and preterm infants. Additional factors such as low birth weight (LBW), gastroesoephageal reflux disorder (GERD), failure to thrive (FTT) and exposure to HIV may increase the complexity of dysphagia symptoms. Knowledge of context-specific risk factors for dysphagia in the neonatal intensive care unit (NICU) may lead to an effective pathway of diagnosis and management in vulnerable neonates. Objective: The objective was to describe the feeding characteristics and categories of underlying medical conditions in 24 to 42 week gestational age infants while still in the NICU and who were referred for feeding and swallowing assessment. Method: The study was a retrospective investigation of 231 purposively selected medical and speech-language therapy records. Participants had a mean stay of 28.5 days in the NICU of a peri-urban public hospital and all had feeding concerns. An existing seven-category framework for the classification of suspected dysphagia was used. Results: Feeding characteristics of the participants demonstrated that 65.0% had previous enteral tube (NGT/OGT) feeding, and only 15.6% were referred for instrumental assessments such as a VFSS by doctors or speech-language therapists (SLTs). The majority of participants used a mixed manner of feeding such as cup and breastfeeding, or cup and syringe feeding. Only 29.7% of participants was able to breastfeed exclusively which was an indication of feeding difficulties as the hospital where the study was conducted promotes exclusive breastfeeding. Results indicated that the majority of participants (90.04%) presented with multiple medical conditions. Underlying neurological conditions (48.48%) and feeding difficulties secondary to systemic illness (65.80%) contributed mostly to suspected dysphagia in the sample. It was found that 70.99% of infants presented with feeding difficulties secondary to other conditions such as LBW and prematurity, highlighting the need for an expanded dysphagia classification framework. Conclusion: The results are in agreement with the outcomes of previous research and confirm the need for a unique classification framework for dysphagia in South Africa. Neonatal dysphagia is a complex condition and frequently associated with multiple risk factors. / Dissertation (M Communication Pathology)--University of Pretoria, 2016. / Speech-Language Pathology and Audiology / MCommunication Pathology / Unrestricted
22 September 2009
M.Sc.(Nursing), Faculty of Health Sciences, University of the Witwatersrand, 2009 / The purpose of this research was to investigate job satisfaction and the impact of HIV and AIDS on nurses in a public hospital in Gauteng. The problems that generated this study included absenteeism, low morale and negativity of nurses working with patients in the presence of the HIV/AIDS crisis. A quantitative research method was used. The sample size comprised 248 nurses from all categories. The Measure of Job Satisfaction was the framework used which covers issues such as remuneration, security, growth, social and supervisory aspects. The framework for the HIV/AIDS section of the research was the Government policy on HIV/AIDS. Results showed job satisfaction was adversely affected by staff shortages, workload, frustrations with management, remuneration, lack of developmental opportunities and equipment. Analysis of the open-ended responses showed ambivalence amongst nurses towards nursing HIV/AIDS patients. Some expressed sadness and fear while others found their caring role fulfilled. The study indicated that facilitating development of staff, improving management skills, providing staff and equipment will all impact positively on job satisfaction. In addition, a deliberate effort needs to be made to plan debriefing/counselling services for nurses as well as ongoing HIV training.
Investigating the laundry logistics system of small-sized public hospital: Can the efficiency of operations be improved under the constraints of Thailand’s administrative culture?Bandoophanit, Thianthip, Breen, Liz, Naipinit, A., Pila-Ngarm, P., Permwanichagun, P., Saenchaiyathon, K. January 2017 (has links)
yes / Purpose All internal logistics systems contribute to the overall success of healthcare service delivery; laundry management (as a closed loop logistics system) is a critical system which facilitates patient recovery and rehabilitation. Studies indicate that applying efficiency measures/improvement tools in such systems, can deliver financial savings and strengthening of in-house competencies (Banerjea-Brodeur et al. 1998; Golden et al. 2008). This study focuses on the review and improvement of laundry management systems in a Thailand Hospital and the organizational culture underpinning this. This hospital was awarded the highest level of hospital accreditation (high level of quality and environmental compliance within this site). Despite this, problems existed at a very basic level with the laundry management, which can undermine patient dignity and respect and increase risk infection and health complications. This study contributes to the Thai healthcare agenda, a core mission of which is to “Develop efficient and equitable integrated health service system for both normal situation and emergency with emphasis on basic rights, specialized service and emergency medicine, surveillance system, disease prevention and control and health threats” (MOPH 2003). Research Approach The key research methods employed include literature review, in-depth interview, observation, documentation and content analysis. A mixed methods methodology was considered appropriate for this study for a number of reasons including a lack of previous insight into this system and the number of actors involved. To this end a triangulated view of the laundry management system was realized. Findings and Originality Delays in the provision of linen and patient clothing (1-4 days bottleneck) were adversely affected by unstructured laundry operations, insufficient personnel, poor job design and worn-out equipment. As a result of this analysis several solutions were steadily implemented which led to: (i) linen shortage was reduced by 12.12% - 28.48%, and (ii) the total cleaning time per cycle was reduced by 130 minutes (45.12%). The impact of the improvement practices in place were perceived to be undermined by cultural factors such as very high internal conflict, the new hospital Director with relatively low power, and limited budget allocated to purchasing linen. Research Impacts Very few studies have explored a closed-loop supply chain of hospital laundry management systems, fewer collected data from key users using a mixed methods methodology. Reverse Exchanges (RE), a new theoretical framework, was adopted to examine the laundry processes. This study attempts to this study fill these gaps. Although this research studied one district hospital; the practices can be greatly generalized; and the diagram of laundry operations and this research design can be replicated. Practical Impacts Improvement measures have been identified which directly impact on the effectiveness and efficiency of this operation. Whilst this is once case study site analysis, this can offer a positive contribution to the healthcare agenda within this country.
Exploring the experiences of caregivers with a child receiving hospital treatment for a chronic illnessSheriffs, Rachael January 2010 (has links)
Magister Psychologiae - MPsych
O processo orçamentário e a tomada de decisão dos gestores em um hospital público / The budgeting and the decision making process of managers in a public hospitalGabryel Lopes Sola 13 November 2014 (has links)
Hospitais são instituições complexas e fundamentais na vida do ser humano. Eles consomem quase a metade das despesas destinadas à saúde no Brasil. Devido à especificidade dessas instituições há a genuína dificuldade em adaptar a atividade médica a controles administrativos. No entanto, é possível encontrar hospitais que utilizam o processo orçamentário como ferramenta de gestão. Esse processo pode ser utilizado para alinhar os objetivos entre os gestores e a organização, para estruturação e alocação de esforços, mensuração de desempenho/performance do gestor, atrelando metas a incentivos. Ao deparar-se com um hospital público em que há a presença dessa ferramenta e que conta com ausência de incentivos financeiros para o alcance de metas orçamentárias, com a complexidade da gestão comum a estas instituições, incerteza da tarefa e do embate entre profissionais da área médica e da administração, há o interesse do entendimento de como é a utilização, pelos gestores clínicos, do processo orçamentário para a tomada de decisão. Portanto, este trabalho aplicou um estudo de caso, utilizando entrevistas semiestruturadas, no Hospital das Clínicas de Ribeirão Preto para esse entendimento. Os resultados demonstram que a interação dos gestores com o orçamento se dá predominantemente via planejamento de materiais e incorporação de novas tecnologias. Os instrumentos de gestão utilizados auxiliam nesse planejamento e acompanhamento das atividades que impactam em consumo de recursos. Também foi demonstrado que há a percepção, pelos gestores, de conflitos entre as lógicas administrativa e médica. / Hospitals are complex institutions and fundamental in human life. They consume almost half of the spending on health in Brazil. Because of the specificity of these institutions there is genuine difficulty in adapting to the medical activity management controls. However, it is possible to find hospitals that use the budget process as a management tool. This process can be used to align the goals of managers and the organization for structuring and allocation of effort, performance measurement manager tying goals to incentives. When faced with a public hospital where there is the presence of this tool and it has no financial incentives for achieving budget targets, the complexity of the joint management of these institutions, job uncertainty and the clash between medical professionals and administration, there is interest in understanding how to use the clinical management of the budgeting process for decision making. This study applied a case study using semi-structured interviews, the University Hospital of Ribeirão Preto to this understanding. The results demonstrate that the interaction of managers with budget occurs predominantly through materials planning and incorporation of new technologies. Management tools used to assist in planning the mapping of activities that impact on resource consumption. It was also shown that there is a perception by managers of conflict between administrative and medical logic.
PERFIL EPIDEMIOLÓGICO DOS PACIENTES COM CÂNCER DE PRÓSTATA ENCAMINHADOS A UM HOSPITAL PÚBLICO E DE ATENÇÃO TERCIÁRIA NO SUL DO BRASIL / EPIDEMIOLOGIC PROFILE OF PATIENTS WITH PROSTATE CANCER SUBMITTED TO A PUBLIC HOSPITAL AND TERTIARY CARE IN SOUTHERN BRAZILLöbler, Ricardo 11 July 2013 (has links)
Introduction: Prostate cancer is the most diagnosed cancer in males in Brazil. As it has a relatively indolent evolution and effective screening, patients with localized disease should be referred to the referral centers to perform treatment with curative intent. This study aimed to determine at what stage of the disease patients with prostate cancer are referred to tertiary care and regional referral public hospital for cancer treatment and how these cases were conducted. Methodology: This study included patients diagnosed with prostate cancer from the year 2000 to 2006. They were referred to the University Hospital of Santa Maria (HUSM). The data were described in prevalence percent, being used the Chi Square and Fisher tests, according to application; logistic regression was used to describe potential risk factors, the prevalence ratio was calculated by a non-parametric generalized regression model, using the Poisson distribution, significant statistical difference was considered when p <0.05. Excel 2007 was used to tabulate the data and the analysis was performed using version 18.0 IBM statistical program SPSS for Windows. Results (Article 1): 240 patients with prostate cancer were referred to HUSM during the years 2000 and 2006, of which 59.6% had localized disease, 25% had metastatic disease, and 15.4% had biochemical recurrence. Considering the 143 patients with localized disease, 34.3% were treated with radical prostatectomy, 33.6% with radiotherapy, 20.2% underwent palliative treatments, and 11.9% were under observation. The causes associated with not performing curative treatment of patients with localized disease were: undetermined in 32.6% of the cases, problems due to delay in hospital care in 30.4% of the cases, locally advanced disease in 21.7% of the cases, high surgical risk in 13.1% of the cases, and other reasons in 2.2% of the cases. Of the patients who were referred with localized disease, 20.2% underwent palliative treatments and 11.9% were under observation; in this situation, approximately, one third of the patients with localized disease did not undergo curative treatment due to delay in the waiting list for surgery and, in one third of the cases, the cause was not defined in the medical charts, showing that medical reports were not adequately filled in. Results (Article 2): In patients with localized prostate cancer treated with radical prostatectomy, biochemical recurrence occurred in 34 of 47 patients (72.3%). In this sample, unlike what is described in the literature, there was no correlation between risk ratings and possible risk factors (age, Gleason score, PSA level at diagnosis, T stage) with biochemical recurrence. Conclusions: In comparison with the Medical Literature, there were a greater number of patients referred to a referral hospital with metastatic disease, a lower proportion of patients undergoing curative treatment and less use of radical prostatectomy as a curative treatment. Regarding patients who were treated with radical prostatectomy, there was a higher prevalence of biochemical recurrence. / Introdução: O câncer de próstata é o mais diagnosticado em homens no Brasil. Como tem evolução relativamente indolente e rastreamento efetivo, os pacientes deveriam ser encaminhados, aos centros de referência, com doença localizada para realização de tratamento com intenção curativa. Este estudo objetivou determinar em que estágio da doença os pacientes com câncer de próstata são encaminhados a um hospital público, de atenção terciária e referência regional para tratamento oncológico e como estes casos foram conduzidos. Metodologia: Foram incluídos pacientes com diagnóstico de câncer de próstata confirmados histologicamente entre os anos 2000 e 2006 e que foram encaminhados ao Hospital Universitário de Santa Maria (HUSM). Os dados foram descritos em prevalência por cento, sendo utilizados os testes de Chi Quadrado e Fisher, conforme aplicabilidade; regressão de logística foi utilizada para descrever possíveis fatores de risco; a razão de prevalências foi calculada por um modelo de regressão generalizado não paramétrico, utilizando-se a distribuição de Poisson; foi considerada diferença estatisticamente significativa quando valor de p <0,05. O Excel 2007 foi usado para tabelar os dados e a análise foi realizada utilizando-se a versão 18.0 do programa estatístico IBM SPSS para Windows. Resultados (artigo 1): Foram encaminhados 240 pacientes com câncer de próstata ao HUSM entre os anos 2000 e 2006, sendo que 59,6% com doença localizada, 25% com doença metastática e 15,4% com recorrência bioquímica. Dos 143 pacientes com doença localizada, 34,3% foram tratados com prostatectomia radical; 33,6%, com radioterapia; 20,2% foram submetidos a tratamentos paliativos, e 11,9% ficaram em observação. As causas associadas a não realização de tratamento curativo em pacientes encaminhados com doença localizada foram em: 32,6% dos casos indeterminada, 30,4% por problemas relacionados ao atraso na assistência hospitalar, 21,7% doença localmente avançada, 13,1% alto risco cirúrgico e 2,2% outros motivos. Dos pacientes que foram encaminhados com doença localizada, 20,2% foram submetidos a tratamentos paliativos e 11,9% ficaram em observação; nesta situação, aproximadamente 1/3 dos pacientes com doença localizada não foram submetidos a tratamento curativo por atraso em lista de espera para cirurgia e em 1/3 dos casos a causa não estava definida nos prontuários, mostrando um preenchimento inadequado destes. Resultados (artigo 2): Nos pacientes com câncer de próstata localizado tratados com prostatectomia radical, a recorrência bioquímica ocorreu em 34 dos 47 pacientes (72,3%). Nessa amostra, ao contrário do que descrito na Literatura, não houve correlação entre classificação de risco e dos possíveis fatores de risco (idade, Escore de Gleason, valor do PSA ao diagnóstico, estadiamento T) com recorrência bioquímica. Conclusões: Comparado com a Literatura Médica, obteve-se um maior número de pacientes encaminhados ao hospital de referência com doença metastática, uma menor proporção de pacientes tratados de forma curativa e uma menor utilização de prostatectomia radical como tratamento curativo. E, em relação aos pacientes que foram tratados com prostatectomia radical, houve uma maior prevalência de recorrência bioquímica.
25 August 2009
The observed high turnover of nursing staff in some public hospitals in Luanda was assumed to give rise to staff shortages, resulting in work overload for the remaining nurses and poor service delivery. The aim of this study was to determine the reasons for the high turnover of nurses in public hospitals in the city of Luanda, and to determine the actual turnover over a two-year period. The researcher adopted a quantitative approach with an exploratory and descriptive design, using a questionnaire for data collection from a sample of 100 respondents consisting of the Directors of Nursing, Directors of Human Resources and Heads of Departments (ward/units) in seven public hospitals. The study found that the most common reasons for the resignation of nurses were retirement, ill health, and better remuneration and working conditions elsewhere. Lack of motivation could be ascribed to the perceived low remuneration, insufficient supplies and equipment, being overworked due to staff shortages, unsafe working environment and poor conditions of service. Recommendations were made to tackle these issues. It was however not possible to determine the actual extent of nurses resigning from the public hospitals. / Health Studies / M.A. (Health Studies)
Medidas de asociación en estudios transversales: a propósito del estudio “elevada frecuencia de dislipidemia en pacientes infectados por VIH en un hospital público peruano” / Association measures in crosssectional studies: Concerning the study “high frequency of dyslipidemia in HIV-infected patients in a peruvian public hospital”Farfán-García, Reyna C., Ulloque, Jorge L., Araujo-Castillo, Roger V. January 2018 (has links)
Carta al editor / Revisión por pares
Estilos de liderança e sua relação com comprometimento e clima organizacional - estudo de caso em um hospital público e de ensino / Leadership styles and their relationship with commitment and organizational climate - case study in a public training hospitalFeitosa, Raquel Libório January 2008 (has links)
FEITOSA, Raquel Libório. Estilos de liderança e sua relação com comprometimento e clima organizacional - estudo de caso em um hospital público e de ensino. 2008. 140f. – Dissertação (Mestrado) – Universidade Federal do Ceará, Programa de Pós-Graduação em Psicologia, Fortaleza (CE), 2008. / Submitted by Gustavo Daher (email@example.com) on 2017-06-16T17:40:25Z No. of bitstreams: 1 2008_dis_rlfeitosa.pdf: 85777846 bytes, checksum: 744b8f3e907fa24e9fa08a20775a41ab (MD5) / Approved for entry into archive by Márcia Araújo (firstname.lastname@example.org) on 2017-06-16T18:03:38Z (GMT) No. of bitstreams: 1 2008_dis_rlfeitosa.pdf: 85777846 bytes, checksum: 744b8f3e907fa24e9fa08a20775a41ab (MD5) / Made available in DSpace on 2017-06-16T18:03:38Z (GMT). No. of bitstreams: 1 2008_dis_rlfeitosa.pdf: 85777846 bytes, checksum: 744b8f3e907fa24e9fa08a20775a41ab (MD5) Previous issue date: 2008 / This study aims to analyze the relationship between leadership and commitment styles and the organizational climate in a public training hospital in the State of Ceará. A turning point that directed the research to this type of hospital was the scope and importance of acts performed by such organizations. They carry on practice-theory teaching to a wide extent and develop social welfare by offering a great deal of health assistance. Other important and equally decisive issues in the research were the following aspects in such organizations: the decision-makers are in the highest ranks and either the infrastructure is precarious or resources are often scarce at work. Work psychodynamics and French psychosociology were the theoretical references employed. The qualitative approach was used in the research on leadership styles. Analysis of data and their respective interrelationship was supported by another comprehensive study previously produced during a quantitative-qualitative research on organizational climate and commitment at the same hospital. / O presente estudo tem por finalidade analisar as relações entre estilos de liderança e comprometimento e clima organizacional no contexto de um hospital público e de ensino do estado do Ceará. Um fator decisivo para direcionar a pesquisa para esse tipo de hospital foi a importância e a dimensão dos atos praticados por essas organizações, que desenvolvem um amplo exercício do ensino teórico-prático e realizam, em caráter de missão social, elevado volume de assistência à saúde. Outros fatores igualmente decisivos na escolha foram os seguintes aspectos das referidas organizações: os sujeitos decisórios se encontram em esferas superiores e as infra-estruturas são marcadas pela precarização ou falta constante de recursos para o trabalho. Os principais referenciais teóricos foram a Psicodinâmica do Trabalho e a Psicossociologia francesa. Na pesquisa sobre estilos de liderança, foi utilizada a abordagem qualitativa. Para a análise dos dados, com suas respectivas correlações, considerou-se importante utilizar vasto material produzido anteriormente, por meio de uma pesquisa quanti-qualitativa sobre clima e comprometimento organizacional, realizada no mesmo hospital.
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