Thesis (MCur (Nursing Science))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Nursing documentation is the written evidence of nursing practice and reflects the accountability of nurses to patients. Accurate documentation is an important prerequisite for individual and safe nursing care. It is a severe threat for the individuality and safety of patient care if important aspects of nursing care remain undocumented. Nursing staff cannot rely on information that is not documented. Every patient is important and unique hence every patient’s care is individualised and different according to his/her needs. This is why important aspects of his/her care need to be documented. Ultimately, the documentation practices reflect the values of the nursing personnel (Isola, Muurinen and Voutilainen, 2004:79-80). The goal of this study was to investigate documentation of nursing care with reference to current practices and perceptions of nurses in a teaching hospital in Saudi Arabia Specific objectives of the study were:  to identify whether the hospital policies are being carried out  to identify whether the procedures regarding current documentation are being carried out and  to explore the perceptions of the nurses regarding the current documentation practices. Research Methodology For the purpose of this study, a non-experimental descriptive design with a quantitative approach was used. The study was carried out at King Faisal Specialist Hospital in Jeddah in Saudi Arabia. The total population of 90 registered nurses were used in this study. Questionnaires were distributed to the participants and they were answered with no identities written on the questionnaires. After the questionnaires were completed, it was posted in a box and was collected by the researcher. The questions are straightforward, easily understood, unambiguous, non-leading, objectively set and aimed at obtaining views, experiences and perceptions of documentation of nursing care. . Involvement of participants was voluntary and non-coercive. Data analysis were carried out with the support of a statistician, expressed in tables, frequencies and statistical associations were done between various variables based on a 95% confidence interval. The study revealed that:  Hospital policies are being carried out N=76 (95%)  Procedures pertaining to documentation of nursing care are being carried out N=67(83,7%).  Nurses N=45(56,3%) indicated that paper documentation included a lot of paperwork.  The Cerner (computer system) is regarded as the best system ever used for documentation of nursing care N=44(55%)  The Mycare system (medication ordering system) is regarded as the most reliable, user-friendly system and nurses are happy with it N=68(85%) Recommendations are:  Nurses still need to be taught about the hospital policies  Nurses should be taught the correct procedure on documenting the patient data  Nurse clinicians and managers should check the Cerner for compliance with regard to documentation of physical assessment when conducting audits  Use of paper for nursing documentation should be minimized by shifting some of the nursing documentation procedures from paperwork to electronic version  Continuous updating, in-service training and monitoring to keep nurses abreast with the dynamic nature of computer usage  Reviewing of the system, troubleshooting and suggestions from users need to be attended to on a continuous basis  It is recommended that a backup system (generator) is in place to ensure continuity of documentation. / AFRIKAANSE OPSOMMING: Die dokumentering van verpleegsorg is die skriftelike bewys van die verpleegpraktyk en weerspieël die toerekenbaarheid van verpleegsters teenoor pasiënte. Noukeurige dokumentering is ’n belangrike voorvereiste vir individuele en veilige verpleegsorg. Dit is ’n ernstige bedreiging vir die individualiteit en veiligheid van pasiënte-sorg, indien belangrike aspekte van verpleegsorg nie gedokumenteer word nie. ’n Mens kan nie inligting vertrou wat nie gedokumenteer is nie. Die versorging van elke pasiënt is belangrik en uniek. Dit is waarom belangrike aspekte aangaande haar/sy versorging gedokumenteer behoort te word. Uiteindelik weerspieël die dokumenteringspraktyke, die waardes van die verpleegpersoneel (Isola, Muurinen en Voutilainen, 2004: 79-80). Die doel van die studie was om dokumentasie van verpleegsorg met verwysing na huidige praktyke en persepsies van verpleegkundiges in ‘n opleidingshospitaal in Saudi Arabia te ondersopek. Spesifieke doelwitte was  om vas te stel of die hospitaal se beleidsrigtings toegepas word  om vas te stel of die prosedure t.o.v die huidige dokumentering uitgevoer is  en’n ondersoek na die persepsies van verpleegsters aangaande die huidige dokumenteringspraktyke Vir die doel van hierdie studie is ’n nie-eksperimentele beskrywingsontwerp met ’n kwantitatiewe benadering gevolg. Hierdie studie was in King Faisal Specialist Hospital in Jeddah, in Saudia Arabia gedoen. ’n Totale bevolking van 90 geregistreerde verpleegsters was betrokke. Vraelyste was versprei na die deelnemers en is naamloos beantwoord, sonder dat hulle identiteite op die vraelys aangebring is. Na voltooiing van die vraelyste, is dit in ’n houer geplaas en deur die navorser afgehaal. Die vrae is direk, eenvoudig, maklik verstaanbaar, ondubbelsinnig, nie-afleibaar, objektief opgestel en is daarop gemik om gesigspunte, ervaringe en persepsies oor dokumentering van verpleegsters te verkry. Betrokkenheid van deelnemers was vrywillig en nie afdwingbaar nie. Data is getabuleer en in histogramme en frekwensies voorgestel. Deur die Chi-square- toets te gebruik, is statisties betekenisvolle assosiasies tussen veranderlikes bepaal. Bevindinge sluit die volgende in:  Die hospitaalbeleid word toegepas N= 76(95%)  Prosedure t.o.v. dokumentering aangaande verpleegsorg word uitgedra N=67(83,7%)  Verpleegsters het aangedui dat dokumentering op papier, baie papierwerk behels N=45(56,3%)  Die Cerner (rekenaarstelsel) word beskou as die beste stelsel ooit in gebruik vir die dokumentering van verpleegsorg N==44(55%)  Die Mycare stelsel (medisyne bestellingstelsel) word beskou as betroubaar en gebruikersvriendelik, en een waarmee verpleegsters gelukkig is N=68(85%). Aanbevelings is gemaak, gebaseer op die volgende bevindinge:  Dit is steeds nodig dat verpleegsters die hospitaal se beleidsrigtinge geleer moet word  Verpleegsters moet die korrekte prosedure aangaande die dokumentering van die pasiënt se data geleer word  Verpleegklinici en bestuurders moet die Cerner nagaan ter voldoening van die dokumentering van fisiese waardebepalinge tydens ouditeringe  Die gebruik van papier vir verpleegdokumentering behoort afgeskaal te word deur van die praktyk van papierwerk na elektroniese dokumentering te skuif  Voortdurende bywerking van data, indiensopleiding en monitering van verpleegsters om hulle op die hoogte te hou van die dinamiese aard van rekenaargebruik  Hersiening van die stelsel, foutspeurdery en voorstelle van gebruikers moet op ’n voortdurende basis aandag geniet.

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

Bakgrund: Ett av sjuksköterskans ansvarsområden är omvårdnaden för nutrition till äldre i särskilt eller ordinärt boende. Flera studier visar att det råder risk för undernäring bland äldre vilket bland annat orsakas av bristande födointag, sämre munstatus, flertal mediciner. För att utreda nutritionstatus hos de äldre kan sjuksköterskan eller annan hälso- och sjukvårdspersonal använda ett bedömningsinstrument. För att de äldre ska bibehålla god nutritionsstatus bör bland annat ett välfungerande samarbete mellan olika professioner finnas. Syfte: Var att undersöka hur sjuksköterskan bedömer, åtgärdar och följer upp nutritionsstatus hos äldre i särskilt och ordinärt boende. Metod: Studien är en tvärsnittsstudie som redovisas med beskrivande statisstik. Populationen var sjuksköterskor som arbetade mot särskilt och ordinärt boend. Enkäter lämnades ut till 112 sjuksköterskor varav 65 besvarades.   Resultat: Studien visade att få av respondenterna var specialist mot distrikt eller äldresköterska. Det förekom bristfälligt utbildning inom nutrition, och en stor andel av sjuksköterskorna beskrev att chefen inte arbetar tillräckligt avseende nutritionsfrågor. Bedömningsinstumentet MNA användes i de flesta fall. Det saknades rutiner för överrapportering av risken för undernäring. Samarbete mellan sjuksköteskorna i studien och dietist ansågs vara litet. Slutsats: Det finns ett behov av att hälso- och sjukvårdspersonal erbjuds utbildning i ämnet nutrition. Det framkommer att det finns ett behov av mer stöd ifrån organisationen vad gäller bland annat rutiner för överrapportering mellan olika vårdinstanser vid risk för undernäring. För att behålla god nutritionstatus hos de äldre är det viktigt med ett gott samarbete mellan de olika professionerna. / Abstract   Background: One of the nurse's responsibilities include the care of nutrition for older people in special or regular housing. Several studies show that there is a risk of malnutrition among older people, due to for example, lack of food intake, poor oral status, multiple medications. To investigate the nutritional status in older people, nurses or other health professionals should use an assessment instrument. In order to maintain good nutritional status among older people, a well-functioning cooperation between different professions is necessary. Aim: Was to investigate how the nurse assesses, addresses and monitors the nutritional status of older people living in particular and ordinary housing. Method: The study is cross-sectional and is reported by descriptive statistics. The population was nurses who worked in special and regular housing. Questionnaires were sent to 112 nurses of which 65 were answered. Results: The study showed that few of the respondents were district nurses. There was inadequate training in nutrition, and a large proportion of the nurses described that their managers did not work enough with nutrition issues. The assessment instrument MNA is used in most cases. Lack of procedures regarding reporting of risk of malnutrition was described. Cooperation between nurses and dietitians was considered small by respondents. Conclusion: There is a need of education in nutrition for health care professionals.  There is a need for more support from the organization such as procedures/guidelines of how risk of malnutrition should be reported between different care institutions. To maintain good nutritional status in older people  it is important to have a good cooperation between various professional categories.

No description available.

From February to September of 2001, a significant body of qualitive data was collected to investigate barriers for Hispanic participation in Oregon's managed care Medicaid program. As a means to investigate this topic, comments were solicited from physicians, hospital administrators, social service agencies, and low-income Hispanics through semi-structured focus groups and individual interviews. This methodology presents the reader with a rich enthnohistoric and cultural context to the local issues surrounding Hispanic under-participation in Oregon's managed care Medicaid program. Finally, through an analytical framework of critical medical anthropology, connections are drawn from local barriers to state and corporate policies. / Graduation date: 2002

Purpose: The Purpose of this research was to design, implement and evaluate a patient centered asthma intervention pilot program directed by physicians and administered by community pharmacists to a group of Managed Care contracted Oregon Health Plan asthmatics. The evaluation was to determine if the proposed intervention could improve the enrolled asthma patient's related education and quality of life while simultaneously creating economic benefit for the sponsoring health plan. Methods: The study was designed to be a prospective, six month pre and posttest quasi-experimental evaluation combined with a Solomon-like two-control group comparison. All patients in the sponsoring health plan twelve years of age and older who had six months of continuous enrollment were eligible. Enrollment of the target patients was voluntary and the time period of the evaluation (November, 1997 to May, 1998) was purposely conducted to capture the notoriously difficult asthma trigger cold and allergy seasons. Information regarding the cost and frequency of pre and post emergency room visits, hospitalizations, physician's office and medications use and Health Related Quality of Life (HRQL) was collected for the intervention group and control group. Satisfaction information for the major actors was collected and analyzed at posttest. Within group comparisons were conducted using the paired T-test and the unpaired T-test was used for between group comparison. Results: Patients in the intervention group who had their physician and pharmacist fully participate in respectively directing and administering the study protocol showed associated improvements in their quality of life measures. Economic benefit to the health plan is suggested by a cost benefit ratio of 1:5.71 resulting from favorable decreases in health care related resources and improved asthma related medication utilization. Analysis of the satisfaction measures suggests that all the major participants were very satisfied with the intervention. Conclusion: Even though the sample size in this pilot study was relatively small, the resulting information should not be immediately discounted. The evidence suggests that in those cases where the study protocol was followed, favorable economic, HRQL and satisfaction is comparable to larger, previously conducted studies. / Graduation date: 2000

Thesis (Ph. D.)--University of Adelaide, Dept. of Clinical Nursing, 2003. / "March 2003." Includes bibliographical references (leaves 340-350). Available in print format and electronically. http://web4.library.adelaide.edu.au/theses/09PH/09phw746.pdf Title page, contents and abstract only.

No description available.

Thesis (Ph.D.)--University of Adelaide, Dept. of Clinical Nursing, 2003. / Includes bibliographical references. Also available in a print form.

Thesis (Ph.D.)--University of Adelaide, Dept. of Clinical Nursing, 2003. / "March 2003." Includes bibliographical references (leaves 340-350). Also available electronically.