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An investigation into the effect of a staffing strategy on patient care in a selected hospital in Kwazulu-NatalMcIntosh, Jane 03 1900 (has links)
Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2008. / The South African Nursing Council believes that “quality nursing practice is based on
adequate knowledge, skills or competencies, ethically and scientifically based
comprehensive and holistic patient care, timely, accurate and complete or comprehensive
recording” (SANC, n.d.). The aim of professional regulation is to protect the public from
unsafe practices and to ensure quality services (SANC, n.d.).
A shortage of nursing staff resulted in the implementation of a staffing strategy of increasing
the work hours of nurses by ten hours a week. Patient complaints and unacceptable patient
incidences resulted in it becoming essential to evaluate the effect of this strategy on patient
care. As a goal of this study, the researcher decided to investigate the quality of patient care
before the implementation of the strategy and the effect of the strategy on patient care after
the implementation.
The objectives of the study were set to determine whether
• The patients were assessed according to activities of daily living and psychosocial
data;
• The nursing diagnosis was done
• Nursing interventions are prescribed for each problem identified
• The patients’ records were utilised to enhance individualised patient care and to
ensure responsibility and accountability for patient care
• The evaluation of patient progress was done according to the different prescriptions
and interventions at least twice in 24 hours
• A written final report for discharge criteria and health education was provided
• A comparison of the quality of nursing care delivered before and after the
implementation of the staffing strategy exist
Research question
What is the effect of an implemented staffing strategy in a selected hospital in KwaZulu-Natal
on the quality of care delivered?
Research methodology A non-experimental, descriptive design with a quantitative approach was applied.
Population and sampling
The target population for the study was patient care records of patients who were
hospitalised during 2003.
A non-probability convenience sample for a retrospective audit of a total of 372 patient care
records over a period of 12 months was audited. An evaluation of the records was done and
a comparison was drawn between the results obtained before and after the implementation
of the staffing strategy. For both periods, 186 patient records were audited. The pilot study
included the audit of 40 files.
Reliability and validity were assured with a pilot study and the use of experts in nursing
management, quality assurance, research methodology and statistics. The researcher
audited the patient files personally.
Ethical approval was obtained from Stellenbosch University and the ethics committee of the
hospital. All principles related to ethics, such as confidentiality and anonymity, were
maintained. Neither patient names were used nor the name of the hospital or wards from
which the records were used. Codes were used to identify the hospital wards. The hospital
was informed in the letter requesting consent to conduct the research, that the researcher
intends publishing the findings of the research.
Data analysis and interpretation
Statistical associations using Chi-square tests were carried out to determine the significance
between the various variables. The results of this study were presented in percentages,
tables and histograms. Findings obtained showed that the quality of nursing declined after
the strategy. Documentation of patient records was incomplete and did not meet legal
requirements.
Recommendations
The implementation and maintenance of a quality assurance programme, human resource
management, the on-going use of the nursing process and record keeping should be
emphasised in the clinical practice environment and in the formal education environment.
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Quality in palliative care from the patient perspective : Instrument development, perceptions of care received and the importance of careSandsdalen, Tuva January 2016 (has links)
The overall aim was to investigate the quality of palliative care from the patient perspective, to adapt and psychometrically evaluate the Quality from Patients’ Perspective instrument specific to palliative care (QPP-PC) and investigate the relationship between the combination of person- and organization-related conditions and patients’ perceptions of care quality. Methods: In the systematic literature review (I), 23 studies from 6 databases and reference lists in 2014 were synthesized by integrative thematic analysis. The quantitative studies (II–IV) had cross-sectional designs including 191 patients (73% RR) from hospice inpatient care, hospice day care, palliative units in nursing homes and home care in 2013–2014. A modified version of QPP was used. Additionally, person- and organization-related conditions were assessed. Psychometric evaluation, descriptive and inferential statistics were used. Main findings: Patients’ preferences for palliative care included living a meaningful life and responsive healthcare personnel, care environment and organization of care (I). The QPP-PC was developed, comprising 12 factors (49 items), 3 single items and 4 dimensions: medical–technical competence, physical–technical conditions, identity–oriented approach, and socio-cultural atmosphere (II). QPP-PC measured patients’ perceived reality (PR) and subjective importance (SI) of care quality. PR differed across settings, but SI did not (III). All settings exhibited areas of strength and for improvement (II, III). Person-related conditions seemed to be related to SI, and person- and organization-related conditions to PR, explaining 18–30 and 22-29% respectively of the variance (IV). Conclusions: The patient perspective of care quality (SI and PR) should be integrated into daily care and improvement initiatives in palliative care. The QPP-PC can measure patients’ perceptions of care quality. Registered nurses and other healthcare personnel need awareness of person- and organization-related conditions to provide high-quality person-centred care. / Knowledge about patients’ perceptions of palliative care is limited and valid instruments are needed. The aim of this thesis was to investigate quality of palliative care from the patient perspective, adapt and evaluate an instrument to measure patients’ perceptions of quality in palliative care (QPP-PC), and investigate the relationship between the combination of person- and organization-related conditions and patients’ perceptions of care quality. A systematic literature review and quantitative methods were used. Patients’ preferences in palliative care included help living a meaningful life and responsive personnel, care environment and organization of care. The QPP-PC was developed and identified patients’ perceptions of areas of strength and for improvement in hospice inpatient and day care, palliative units in nursing homes and home care settings. Perceptions of care quality seemed to be related to person- and organization-related conditions, and differed across settings, although subjective importance did not. The patient perspective of care quality should be integrated into daily care and quality work, and QPP-PC can be used in such work. Registered nurses and other healthcare personnel need awareness of person- and organization-related conditions to provide high-quality person-centred palliative care. / Den overordnede hensikten var å undersøke kvalitet i palliativ behandling og omsorg fra pasientens perspektiv, å utvikle og psykometrisk evaluere spørreskjemaet Kvalitet ut fra Pasientens Perspektiv (KUPP) for palliativ omsorg (KUPP-PO), samt å undersøke sammenhengen mellom person- og organisasjonsrelaterte forhold og pasientenes erfaringer av kvalitet. Metode. I den systematiske oversiktsartikkelen (I) ble 23 studier fra seks databaser og referanselister syntetisert i 2014 med integrativ tematisk analyse. De kvantitative studiene (II-IV) hadde et tverrsnittsdesign som inkluderte 191 pasienter (svarprosent: 73) fra hospice-døgnavdeling, hospice-dagavdeling, lindrende enheter i sykehjem og hjemmetjeneste i 2013 til 2014. En modifisert versjon av KUPP ble brukt. I tillegg ble person- og organisasjonsorienterte forhold kartlagt. Deskriptiv og inferensiell statistikk, samt psykometrisk evaluering ble anvendt. Hovedfunn. Pasientene ønsket at palliativ behandling og omsorg skulle omfatte hjelp til å leve et meningsfullt liv og at helsepersonell, omsorgsmiljø og organisering av omsorgen var lydhør for og handlet eller var tilrettelagt i samsvar med deres preferanser (I). KUPP-PO ble utviklet og omfattet 12 faktorer (49 spørsmål), 3 enkeltstående spørsmål og fire dimensjoner; medisinsk-teknisk kompetanse, fysisk-tekniske forhold, identitetsorientert tilnærmingsmåte og sosiokulturell atmosfære (II). KUPP-PO målte pasientenes erfaringer og subjektiv betydning av kvalitet. Pasientens erfaringer av kvaliteten med palliativ behandling og omsorg varierte utfra kontekst, men subjektiv betydning varierte ikke. Alle omsorgskontekstene viste styrker og forbedringsområder (II, III). Personrelaterte forhold så ut til å være forbundet med subjektiv betydning mens person- og organisasjonsorienterte forhold så ut til å være forbundet med erfaring med behandling og omsorg, og forklarte respektivt 18–30/22-29% av variansen (IV). Konklusjon: Kvalitet fra pasientens perspektiv (subjektiv betydning og erfaring) bør integreres i daglig behandling og omsorg og i forbedringstiltak i palliativ omsorg. KUPP-PO kan måle pasientenes erfaringer i kvalitetsutviklingsarbeid. Sykepleiere og annet helsepersonell trenger å være bevisst person- og organisasjonsrelaterte forhold for å utføre personsentrert behandling og omsorg av høy kvalitet.
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Analyse des facteurs institutionnels associés à la mortalité maternelle : Une étude nationale dans les maternités chirurgicales au SénégalKoucoï, Muriel Sêdo 07 1900 (has links)
Résumé
Objectif : Identifier les facteurs institutionnels qui influencent la mortalité maternelle (MM) hospitalière dans les maternités chirurgicales au Sénégal. Méthode : cette étude est une analyse secondaire des données de la troisième Enquête Nationale sur la Couverture Obstétrico-chirurgicale au Sénégal en 2001. Les données analysées, issues des fiches d'activité des maternités, comptaient pour 38,239 admissions en obstétrique dans 19 hôpitaux et 450 décès maternels. Les taux de mortalité maternelle hospitalière (TMMH) brut et ajusté ont été utilisés comme variables dépendantes. Le TMMH ajusté sur les caractéristiques de la clientèle ('cases-mix') a été estimé pour chaque établissement de santé par la méthode de standardisation directe. Les indicateurs de la qualité des structures, de la gestion des ressources, et un score de qualité ont été utilisés comme variables indépendantes pour prédire la MM hospitalière. Les tests de Mann-Whitney et de Kruskal-Wallis ont été utilisés pour analyser l’association entre les variables indépendantes, le score de qualité et la MM. Une analyse multivariée a été utilisée pour estimer l’impact du score de qualité sur la MM, en tenant compte de la situation géographique (Dakar versus autre région).Résultats: En analyse bivariée, la présence d'anesthésiste, la disponibilité de boîtes de césarienne complète et la supervision de tous les accouchements par du personnel qualifié sont les facteurs institutionnels associés significativement à une réduction du TMMH brut. Quant au TMMH ajusté ce sont la présence de scialytique, la disponibilité du sulfate de magnésium, l'utilisation des guides de pratiques cliniques (GPC) pour la prise en charge des complications obstétricales. Le score de qualité est associé significativement au TMMH brut, y compris en analyse multivariée, mais pas au TMMH ajusté. Conclusion : La disponibilité du Sulfate de magnésium, et du scialytique pourrait contribuer à la réduction de la MM. En complément, une réorganisation adéquate des ressources pour réduire la disparité géographique rurale/urbaine est essentielle ainsi qu’une sensibilisation du personnel à l’usage des GPC. De plus, l’assistance par un personnel qualifié de tous les accouchements est nécessaire pour améliorer la qualité des soins et la prise en charge des complications obstétricales. / Abstract
Objective: To identify which institutional factors are associated to the hospital maternal mortality in surgical maternities in Senegal.
Method: This study is a secondary data analysis of the third National survey of the Surgical-Obstetric Coverage in Senegal in 2001. The hospital statistics data analyzed represent 38,239 admissions in obstetrics in 19 hospitals and 450 maternal deaths. The hospital maternal death rates (TMMH) crude and adjusted were used as dependent variables. The TMMH adjusted on the characteristics of the customers (`cases-mix') was estimated for each health structure by the direct standardization method. The indicators of the structure, resources management’s complexity score quality were used as independent variables to predict hospital MM. The Mann-Whitney and Kruskal-Wallis tests were used to analyze the association between independent variables, the complexity score of quality and MM. A multivariate analysis was used to estimate the impact of quality score on the MM, taking into account the geographical location (Dakar versus other region).
Results: In bivariate analysis, the presence of anaesthetist, the availability of Caesarean kit and supervision of all births by trained personnel are the institutional factors significantly associated with the crude TMMH decreased. For the adjusted TMMH, the presence of Scialytic, the availability of Magnesium Sulphate, the use of clinical guidelines of good practice (GPC) for obstetrical complications are the institutional factors associated to his decreased. The complexity score quality is significantly associated with the crude TMMH, including multivariate analysis, but not with adjusted TMMH.
Conclusion: The availability of the Magnesium Sulphate, and the Scialytic could contribute to the reduction of maternal mortality. In addition, an adequate reorganization of the resources to reduce the geographical rural/urban disparity is essential, as well as a developing the personnel’s awareness for the use of GPC. Moreover, qualified assistance at birth for all women is necessary to improve the quality of care and the treatment obstetrical complications.
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Assessing waiting times in the clinical trajectory of patients with lung cancerDobson, Sarah 08 1900 (has links)
Le cancer du poumon a une incidence et une létalité parmi les plus hautes de tous les
cancers diagnostiqués au Canada. En considérant la gravité du pronostic et des
symptômes de la maladie, l’accès au traitement dans les plus brefs de délais est
essentiel. Malgré l’engagement du gouvernement fédéral et les gouvernements
provinciaux de réduire les délais de temps d’attente, des balises pour les temps d’attente pour le traitement d’un cancer ne sont toujours pas établis. En outre, le
compte-rendu des indicateurs des temps d’attente n’est pas uniforme à travers les
provinces. Une des solutions proposées pour la réduction des temps d’attente pour le traitement du cancer est les équipes interdisciplinaires. J’ai complété un audit du programme interdisciplinaire traitant le cancer du poumon à l’Hôpital général juif
(l’HGJ) de 2004 à 2007. Les objectifs primaires de l’étude étaient : (1) de faire un audit de la performance de l’équipe interdisciplinaire à l’HGJ en ce qui concerne les temps d’attente pour les intervalles critiques et les sous-groupes de patients ; (2) de comparer les temps d’attente dans la trajectoire clinique des patients traités à l’HGJ avec les balises qui existent ; (3) de déterminer les facteurs associés aux délais plus
longs dans cette population. Un objectif secondaire de l’étude était de suggérer des
mesures visant à réduire les temps d’attente. Le service clinique à l’HGJ a été
évalué selon les balises proposées par le British Thoracic Society, Cancer Care
Ontario, et la balise pan-canadienne pour la radiothérapie. Les patients de l’HGJ ont
subi un délai médian de 9 jours pour l’intervalle «Ready to treat to first treatment», et un délai médian de 30 jours pour l’intervalle entre le premier contact avec l’hôpital et le premier traitement. Les patients âgés de plus de 65 ans, les patients
avec une capacité physique diminuée, et les patients avec un stade de tumeur limité
étaient plus à risque d’échouer les balises pour les temps d’attente. / Lung cancer is among the most lethal and the most diagnosed cancers in Canada. Given the poor prognosis and symptom burden of the disease, timely access to treatment and quality care are essential. In spite of government commitments to reduce waiting times in cancer care, national clinical benchmarks for cancer care have yet to be established, and waiting time reporting by provinces is inconsistent. One of the proposed strategies for reducing waiting times in cancer care is the use of interdisciplinary teams. I undertook an audit of the interdisciplinary pulmonary
oncology program at the Jewish General Hospital from 2004 to 2007. The primary
objectives of this study were: (1) to audit the performance of the interdisciplinary
pulmonary oncology service at the Jewish General Hospital with respect to waiting
times for key intervals and subgroups of patients; (2) to compare waiting times in the
clinical trajectory of lung cancer patients seen at the Jewish General Hospital with
existing waiting time guidelines; (3) to determine those factors associated with
longer waiting times in this population. A secondary objective was to suggest measures to be considered in order to reduce waiting times. The JGH’s lung cancer service was compared against benchmarks developed by the British Thoracic Society, Cancer Care Ontario, and the pan-Canadian waiting time benchmarks for radiation oncology. Patients waited a median of 9 days from the time they were ready to treat until their first treatment, and a median of 30 days from their first contact with the pulmonary service until their first treatment. Patients over age 65, those with early-stage disease and those with good performance status were less likely to meet the recommended guidelines.
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L'évolution des infirmières de la pratique avancée et leur rôle dans le système de santé français : perspective internationale / (The evolution of advanced practice nurses and their role in the French health care system : international perspective)Bonnel, Galadriel 14 December 2012 (has links)
Objectifs: Etudier l'évolution de l'introduction du rôle de l'IPA et proposer des recommandations pour les études ultérieures.Méthodes: Une revue de la littérature française et internationale concernant l'IPA. Participation à un groupe de travail national concernant l'avancement de ce rôle et les réformes éducationnelles. Une étude rétrospective comparant la prise en charge de patients hypoglycémiques en milieu pré-hospitalier par infirmiers et physiciens. Un questionnaire étudiant les perceptions des premiers étudiants en cursus IPA.Résultats: Différents niveaux de transferts de compétence et de collaboration médecin/infirmière existent déjà en France. Dans l'étude rétrospective, la qualité de soin des infirmières a été similaire à celle des médecins. Dans l'étude sur l'IPA, la majorité des étudiants a indiqué que les autres infirmières et docteurs ne sont pas au courant du rôle de l'IPA, et que des barrières bloquent son développement.Conclusions: La création du rôle d'IPA et le développement de la formation des infirmières en France peuvent répondre aux défis de santé publique, telle l'incidence croissante des maladies chroniques et la pénurie de médecins. Les recommandations suivantes furent proposées pour le développement du rôle de l'IPA : définir et faire reconnaître le rôle de la pratique infirmière avancée et ses compétences, promouvoir le rôle plus largement dans les disciplines médicales, soutenir les efforts de communication entre l'état et les professionnels de santé, développer des programmes au niveau master et doctorat, et promouvoir des travaux de recherche infirmiers et interdisciplinaires. / Background: In the context of public health challenges and health care reforms in France, the evolving advanced practice nurse (APN) role may be a solution. Objectives: To study the introduction of the ANP role and provide evidence-based recommendations for future research.Methods: A review of the international and French APN literature was performed. Participation in a national task force concerned advancement of the role and education reforms. In a retrospective study, nurses and physicians were compared in the pre-hospital management of hypoglycemic patients. Finally, a survey was administered to the first French APN Master's students to identify their perceptions of the APN role.Results: Variables levels of skill transfer and doctor-nurse collaboration currently exist in France. In the retrospective study, the pre-hospital quality of care of nurses was comparable to that of doctors. In the APN student survey, the majority indicated that other nurses and doctors were not aware of the APN role, and that barriers exist in role development. Conclusions: Creation of the APN role and advancement of nursing education in France can respond to public health challenges including the rising incidence of chronic diseases and an impending physician shortage. The following recommendations were proposed for APN role development: to define and recognize the advanced practice nurse role and related competencies, promote the role in a wider range of medical disciplines, facilitate clear communication between government and health care professionals, develop nursing Master's and Doctorate programs, and promote nursing and interdisciplinary research.
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Reforma péče o duševní zdraví v České republice / Reform of mental healthcare in Czech RepublicŠilhanová, Andrea January 2019 (has links)
In the thesis I examine current legislative anchoring of healthcare and social care of mental health. In the second chapter of theoretical part I write about classification of mental illnesses. Third chapter, which is very important from my point of view, describe transformation of healthcare and social care in the foreign countries. Practical part contains pilot survey for the Ministry of Health. The purpose was to find out the satisfaction of the clients with social and health services, which are part of the treatment of mental health. Satisfaction was detected by questionnaires, which patients had available with their ambulant psychiatrist. Those questionnaires were created at round tables by experts, patients and service providers in a hospital. Social care and healthcare do not connect. Experts do not communicate with each other. Tragical finding was that ambulant psychiatrist has in average thirteen minutes for examination of a client. Definitely Czech Republic need Centre for Mental Healthcare for complex care of the patient.
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Avaliação do evento queda de paciente no âmbito hospitalar: um estudo de caso / Assessment of patient fall event in hospital environment: a case studyBianchini, Suzana Maria 31 August 2015 (has links)
Introdução: A adoção e a implementação de medidas de prevenção de quedas de paciente no ambiente hospitalar são indissociáveis dos atributos qualidade e segurança nos serviços de saúde, pressupondo uma abordagem sistêmica, na qual o êxito depende do compromisso e da responsabilidade da organização, dos profissionais, dos pacientes e de seus acompanhantes. Objetivos: Compreender a vivência dos pacientes acometidos pelo evento queda e dos enfermeiros acerca do processo de implementação de medidas preventivas e do monitoramento do evento queda de paciente em um hospital privado do Município de São Paulo. Caminho Metodológico: Estudo qualitativo, exploratório, descritivo na modalidade estudo de caso. O cenário foi o Hospital Alemão Oswaldo Cruz. Os participantes corresponderam a dez pacientes e 11 enfermeiras. A coleta de dados foi realizada no período entre maio de 2014 e março de 2015, empregando-se a entrevista semiestruturada gravada para os pacientes acometidos pelo evento queda, que foi transformada em narrativas, e as do grupo focal, para as enfermeiras. As narrativas oriundas das entrevistas e o material produzido nas três sessões do grupo focal foram submetidos à análise de conteúdo de Bardin, emergindo duas categorias e três subcategorias. Achados: As categorias foram: a singularidade do evento queda: da expressão do fato à manifestação de sentimentos; o olhar do paciente e familiar para os recursos institucionais: elementos da estrutura, processo e resultado; a vulnerabilidade e os determinantes no evento queda; a implementação de medidas para a prevenção de queda à luz da tríade Donabediana e o modo de ser: reflexões atitudinais acerca da interface enfermeiro-paciente. Para a análise interpretativa dos achados foram adotados os referenciais de qualidade em saúde, segurança do paciente e de autoeficácia, preconizado por Bandura. Considerações Finais: Esta investigação propiciou compreender a percepção dos pacientes e enfermeiros frente ao evento queda, interpretar e revisitar os processos assistenciais e gerenciais na prevenção e monitoramento das quedas. Por conseguinte, permitiu elaborar propostas, visando a aprimorar os componentes de estrutura, processo e resultado para dirimir as quedas, bem como reconstruir o material instrucional e aprimorar os protocolos e planos de ação, com vistas a qualificar o cuidado na Instituição. / Introduction: The spiritual aspect is very important and is becoming increasingly necessary in the practice of health care. S Introduction: The adoption and the implementation of measures to prevent patients fall in hospital are inseparable from quality and safety dimensions in health care services, assuming a systemic approach in which success depends on the commitment and on the responsibility of the organization, of the professionals, of patients and their escorts. Objectives: Understand the experience of patients affected by fall events and nurses about the process of implementation of preventive measures and the monitoring of the event of fall at a private hospital in the city of São Paulo. Methodology: Qualitative, exploratory, descriptive study, a case study. The scenario was Hospital Alemão Oswaldo Cruz. Participants corresponded to ten patients and 11 nurses. Data collection was made from May 2014 to March 2015, by applying semi structured interview recorded to patients affected by fall event, which was converted into narratives, and the focus group for the nurses. The narratives from the interviews and the material produced in the three sessions of the focus group were submitted to Bardin content analysis, emerging two categories and three subcategories. Findings: The categories were, the singularity of fall event: from the fact itself to the manifestation of feeling; the perception of the patient and family regarding the institutional resources: elements of structure, process and outcome; the vulnerability and major factors in the fall event; the implementation of measures to prevent fall according to the Donabedian triad and the way of being: attitudinal reflections on the nurse-patient interaction. For an interpretative analysis of findings, guidelines of health care quality, patient safety and self-efficacy as called for Bandura were adopted. Final comments: this research made possible the understanding of patients and nurses perception regarding the event of fall, the interpretation and revisit of health care and management processes in the prevention and monitoring of falls. Consequently, it allowed the creation of proposals in order to better the components of structure, process and result to reduce falls and also to rebuild the instructional material and improve the protocols and plans of education with the aim of qualifying care in the institution.
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Impact of hospital accreditation on patients' safety and quality indicatorsAl-Awa, Bahjat 18 May 2011 (has links)
Ecole de Santé Publique <p>Université Libre de Bruxelles <p>Academic Year 2010-2011<p><p>Al-Awa, Bahjat<p><p>Impact of Hospital Accreditation on Patients' Safety and Quality Indicators<p><p>Dissertation Summary <p><p>I.\ / Doctorat en Sciences / info:eu-repo/semantics/nonPublished
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Resident-centered care and work satisfaction of health care aides working with personal care home residents living with dementiaMarcotte, Anita 14 April 2009 (has links)
Resident-centered care has been the standard philosophy in accredited personal care homes (PCHs) across Canada since 1990. Health care aides (HCAs) are the primary health care providers in PCHs and key to residents' quality of care and quality of life. However, studies have not examined HCA work satisfaction in relation to the four elements of resident-centered care: providing flexible scheduling, following residents' preferences, promoting a home-like environment and offering permanent assignment to promote consistency of care. This cross-sectional, ethnographic study was conducted using face-to-face interviews with nine HCAs working in four PCHs in Winnipeg, Manitoba, Canada. The results indicate that HCAs' work satisfaction was highly related to their caring relationships with residents and their working relationships with other HCAs and staff. The implementation of resident-centered care depended on institutional and managerial support. Lack of this support created stressful situations for HCAs and caused them concern about the quality of care and quality of life of residents. / May 2009
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Patients' rights to quality in health care and health damage compensation / Paciento teisės į kokybišką sveikatos priežiūros paslaugą ir žalos sveikatai atlyginimąBrogienė, Daiva 07 May 2010 (has links)
Objects of dissertation: the quality in health care inpatient institutions and health damage compensation in medical malpractice litigation cases. This work is a scientific assessment of the implementation of the patients‘ rights to quality in health care and health damage compensation in Lithuania, where the functioning of two patients' rights is assessed in a systematic and integrated manner, both in the medical and the legal aspect. Research: the modified Picker Institute‘s questionnaire was used for the scientific research of 1917 patients treated in hospitals in order to examine and assess their opinions on the quality of health care provided to them and evaluate the opportunities to realize their right to health care of good quality. The study analyzed 32 medical malpractice lawsuit cases of general jurisdiction courts in terms of the principles of health damage compensation, procedural characteristics and efficiency. Conclusions: statutory regulation of patients 'rights to quality in health care services and health damage compensation in Lithuania meets international and European patients' rights protection principles. The research showed that the vast majority of surveyed patients (nine out of ten) realized their right to quality in health care service in the hospital. However, six out of ten plaintiffs received the health damage compensation, plaintiffs were awarded only nearly a fifth of the requested overall pecuniary and non-pecuniary damages. / Disertacijos objektai: sveikatos priežiūros paslaugų kokybė stacionarinėse asmens sveikatos priežiūros įstaigose ir žalos sveikatai atlyginimas gydytojų civilinės atsakomybės bylose.
Šis darbas - pacientų teisių į kokybišką sveikatos priežiūros paslaugą ir žalos sveikatai atlyginimą įgyvendinimo mokslinis vertinimas Lietuvoje. Iki šiolei paciento teisė į kokybišką sveikatos priežiūros paslaugą nacionaliniuose moksliniuose darbuose buvo analizuojama kokybės vadybos aspektu, o teisė į žalos sveikatai atlyginimą buvo vertinama pagal galiojančius teisės aktus ir Lietuvos teismų praktiką. Tai pirmasis mokslinis darbas, kuomet dviejų pacientų teisių funkcionavimas vertinamas sistemiškai ir integruotai, kartu tiek medicininiu, tiek teisiniu požiūriais.
Tyrimai. Pritaikius Europos Picker instituto modifikuotą klausimyną tirta 1917 stacionarinėse asmens sveikatos priežiūros įstaigose gydytų pacientų nuomonė apie jiems suteiktų sveikatos priežiūros paslaugų kokybę ir vertintos pacientų galimybės realizuoti teisę į kokybišką sveikatos priežiūros paslaugą. Analizuotos 32 LR bendrosios kompetencijos teismų civilinės bylos dėl žalos sveikatai atlyginimo, vertinant patirtos žalos sveikatai kompensavimo principus, procesinius ypatumus bei efektyvumą, atskleidžiant probleminius paciento teisės į žalos sveikatai atlyginimą įgyvendinimo aspektus.
Disertacijos išvadose konstatuojama, kad paciento teisių į kokybišką sveikatos priežiūros paslaugą ir žalos sveikatai atlyginimą įstatyminis... [toliau žr. visą tekstą]
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