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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

The activities of a midwife at a level 3 public sector labour ward in eastern Gauteng

Mukwevho, Moshibudi Florence 16 January 2009 (has links)
No description available.
2

Risks associated with suspected dysphagia in NICU-admitted infants in a South African public hospital : a retrospective study

Schoeman, 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
3

Job satisfaction of nurses in a public hospital with a high number of HIV and AIDS patients

Hennessy, Elaine 22 September 2009 (has links)
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.
4

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.
5

Reasons for high turnover of nursing professionals at public hospitals in Angola

Mateus, Gaspar 25 August 2009 (has links)
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)
6

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 hospital

Sola, Gabryel Lopes 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.
7

'Unsaid’ voices of middle-level women nurses’ experience of Western Australian public hospitals: an integrated feminist postmodern ethnography

Pannowitz, Helen K Unknown Date (has links)
The context for this research was the socio-political, culturally constructed, lived experience of eight women nurses who held middle-level positions in two Western Australian public hospitals. Glass and Davis’ (1998) integrated feminist postmodern model for nursing research framed the design for the ethnographic investigation.The researcher used an innovative self-developed trifocality method: realist; critical feminist; and feminist postmodern to critique ethnographic data against the research aim and objectives and reflexively engaged with the women nurses to reveal unacknowledged individual and collective insights. Participant observation, critical conversation, and reflective field/journaling were used as triangulated data collection methods. The methodology revealed the local, particular, historical, taken-for-granted and traditionally gender-biased subjugated voices of individual women nurses as legitimate sites for the production of knowledge and insights.The trifocal data analysis revealed multiple intersecting layers of meanings and insights. The participants unacknowledged ‘unsaid’ experiences were viewed as exemplar ‘states of being’, or subjectivity positions, of their multiple and temporal realities. Inherent within the subjectivity positions was their personal, professional and corporate efforts, assumed as self-managing strategies and implicit knowledge, to enact work roles.Deeper critique, applying feminist poststructuralism (Lather 1991b) and postmodern notions of power/knowledge networks of relationships (Foucault 1980b) revealed three competing socio-political culturally constructed discourses. Firstly, the participants’ were embedded within an empowering ‘Discourse of Values Attributed to Nursing/Between a Rock and a Hard Place’. Secondly, they were influenced by, and resistant to the patriarchally dominant ‘Discourse of Bureaucratic Managerialism Discourse/Absence of Care’. thirdly, they functioned within the influence of the disempowering ‘Discourse Medical Science/Working the Margins’.This research contributes to the knowledge base of scholarly work that exists about nurses, women nurses specifically, concerning the meaning of the experiences of practicing in the confluence of corporate and professional responsibilities. At the personal participant level the insights contribute to emancipatory consciousness-raising. The insights also positively contribute to the recommendations made in The Report of the Western Australian Study of Nursing and Midwifery (Pinch & Della 2001). The insights may evoke wider awareness of the disempowering influence of managerialism upon professional practice and inter-professional relationships. Finally, the unique trifocal data analysis method contributes to the body of nursing and social science research knowledge.
8

An Investigation into the Relationship between Total Quality Management Practice and Performance in a Taiwan Public Hospital

Lai, Mei-Chiao, res.cand@acu.edu.au January 2003 (has links)
This thesis investigated the relationship between Total Quality Management (TQM) practice and hospital performance from 1997 t0 2001 in a Taiwan public hospital. In Taiwan, previous research focused on TQM practice and hospital performance in the manufacturing sector. Earlier research relevant to hospitals emphasised outcomes, such as hospital efficiency. The current study differs from the previous hospital research by examining comprehensive organisational performance, including financial and non-financial performance. The objective was to gain insights into ways in which the managers of hospitals might use the findings to enhance the hospital performance levels. The Malcolm Baldrige National Quality Award (MBNQA) 2001 health care criteria for performance excellence were used as a research instrument to measure TQM practice and hospital performance. Data were collected using triangulation method, that is a self-assessment questionnaire, focus group interviews and documentation that is Government Annual Reports. Multivariate Analysis of Variance (MANOVA) and Multiple Regression Analysis were utilised to analyse data from questionnaires. Findings from focus group interviews were coded and categorised. Findings from documentation were used to verify and validate the progress of hospital performance. The quantitative findings indicated that the demographic characteristics of employees had no significant impact on TQM practice, nor on hospital performance. Elements of TQM, however, were important determinants of overall hospital performance, the more committed the TQM practice, the better the hospital performance. The qualitative findings indicated that, for Hospital A, effective TQM would be accomplished through incremental organisational change. This research makes a contribution to both academic knowledge and hospital practice. It bridges the research gap in the relationship between TQM practice and hospital performance and also offers a solid foundation for future academic research. The study also provides short and long-term recommendations about quality improvement to both the manager and hospital A.
9

'Unsaid’ voices of middle-level women nurses’ experience of Western Australian public hospitals: an integrated feminist postmodern ethnography

Pannowitz, Helen K Unknown Date (has links)
The context for this research was the socio-political, culturally constructed, lived experience of eight women nurses who held middle-level positions in two Western Australian public hospitals. Glass and Davis’ (1998) integrated feminist postmodern model for nursing research framed the design for the ethnographic investigation.The researcher used an innovative self-developed trifocality method: realist; critical feminist; and feminist postmodern to critique ethnographic data against the research aim and objectives and reflexively engaged with the women nurses to reveal unacknowledged individual and collective insights. Participant observation, critical conversation, and reflective field/journaling were used as triangulated data collection methods. The methodology revealed the local, particular, historical, taken-for-granted and traditionally gender-biased subjugated voices of individual women nurses as legitimate sites for the production of knowledge and insights.The trifocal data analysis revealed multiple intersecting layers of meanings and insights. The participants unacknowledged ‘unsaid’ experiences were viewed as exemplar ‘states of being’, or subjectivity positions, of their multiple and temporal realities. Inherent within the subjectivity positions was their personal, professional and corporate efforts, assumed as self-managing strategies and implicit knowledge, to enact work roles.Deeper critique, applying feminist poststructuralism (Lather 1991b) and postmodern notions of power/knowledge networks of relationships (Foucault 1980b) revealed three competing socio-political culturally constructed discourses. Firstly, the participants’ were embedded within an empowering ‘Discourse of Values Attributed to Nursing/Between a Rock and a Hard Place’. Secondly, they were influenced by, and resistant to the patriarchally dominant ‘Discourse of Bureaucratic Managerialism Discourse/Absence of Care’. thirdly, they functioned within the influence of the disempowering ‘Discourse Medical Science/Working the Margins’.This research contributes to the knowledge base of scholarly work that exists about nurses, women nurses specifically, concerning the meaning of the experiences of practicing in the confluence of corporate and professional responsibilities. At the personal participant level the insights contribute to emancipatory consciousness-raising. The insights also positively contribute to the recommendations made in The Report of the Western Australian Study of Nursing and Midwifery (Pinch & Della 2001). The insights may evoke wider awareness of the disempowering influence of managerialism upon professional practice and inter-professional relationships. Finally, the unique trifocal data analysis method contributes to the body of nursing and social science research knowledge.
10

'Unsaid’ voices of middle-level women nurses’ experience of Western Australian public hospitals: an integrated feminist postmodern ethnography

Pannowitz, Helen K Unknown Date (has links)
The context for this research was the socio-political, culturally constructed, lived experience of eight women nurses who held middle-level positions in two Western Australian public hospitals. Glass and Davis’ (1998) integrated feminist postmodern model for nursing research framed the design for the ethnographic investigation.The researcher used an innovative self-developed trifocality method: realist; critical feminist; and feminist postmodern to critique ethnographic data against the research aim and objectives and reflexively engaged with the women nurses to reveal unacknowledged individual and collective insights. Participant observation, critical conversation, and reflective field/journaling were used as triangulated data collection methods. The methodology revealed the local, particular, historical, taken-for-granted and traditionally gender-biased subjugated voices of individual women nurses as legitimate sites for the production of knowledge and insights.The trifocal data analysis revealed multiple intersecting layers of meanings and insights. The participants unacknowledged ‘unsaid’ experiences were viewed as exemplar ‘states of being’, or subjectivity positions, of their multiple and temporal realities. Inherent within the subjectivity positions was their personal, professional and corporate efforts, assumed as self-managing strategies and implicit knowledge, to enact work roles.Deeper critique, applying feminist poststructuralism (Lather 1991b) and postmodern notions of power/knowledge networks of relationships (Foucault 1980b) revealed three competing socio-political culturally constructed discourses. Firstly, the participants’ were embedded within an empowering ‘Discourse of Values Attributed to Nursing/Between a Rock and a Hard Place’. Secondly, they were influenced by, and resistant to the patriarchally dominant ‘Discourse of Bureaucratic Managerialism Discourse/Absence of Care’. thirdly, they functioned within the influence of the disempowering ‘Discourse Medical Science/Working the Margins’.This research contributes to the knowledge base of scholarly work that exists about nurses, women nurses specifically, concerning the meaning of the experiences of practicing in the confluence of corporate and professional responsibilities. At the personal participant level the insights contribute to emancipatory consciousness-raising. The insights also positively contribute to the recommendations made in The Report of the Western Australian Study of Nursing and Midwifery (Pinch & Della 2001). The insights may evoke wider awareness of the disempowering influence of managerialism upon professional practice and inter-professional relationships. Finally, the unique trifocal data analysis method contributes to the body of nursing and social science research knowledge.

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