Mobile computing devices are capable of changing how healthcare is delivered in the future, since they aim to merge and integrate all services into one device that is versatile, customisable, and portable. The aim of this study was to explore and describe the experiences of professional nurses with regard to accessing information at the point-of-care of the patient, in order to develop guidelines that could assist other professional nurses with implementing the mobile computing device for accessing information at the point-of-care of patients. To achieve the purpose of the study, a qualitative, explorative, descriptive, and contextual design was used to conduct this research – to gain an understanding of how the professional nurses experienced accessing information at the point-of-care via mobile computing devices. The study was conducted among the professional nurses employed at the public hospital, who were trained and provided with the mobile computing device for accessing information at the point-of-care for more than two years. In-depth interviewing was conducted to obtain the data. Data analysis was done using Tesch‘s method to make sense out of text and data. Four themes were identified, namely, the professional nurses‘ expression of various experiences regarding the training received; the need for support in implementing the mobile computing device; the accessing of information at the point-of-care as beneficial for educational purposes; and the accessing of information at the point-of-care as beneficial to patient care. Two main guidelines were developed. The study concludes with recommendations made with regard to the areas of nursing practice, education and research. Throughout the study, the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2010:298).

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-03-30T17:31:27Z No. of bitstreams: 1 Nendy Temistocles Ribeiro.pdf: 1014260 bytes, checksum: d60b9cd2859b602eb8c06e6dcfb61173 (MD5) / Made available in DSpace on 2016-03-30T17:31:27Z (GMT). No. of bitstreams: 1 Nendy Temistocles Ribeiro.pdf: 1014260 bytes, checksum: d60b9cd2859b602eb8c06e6dcfb61173 (MD5) Previous issue date: 2015-11-11 / This research evaluates the adherence to organizational competencies that are linked to the universe of ERP systems management in the public hospital sector in its prospect of post-implementation. For this, use the theoretical framework associated with both the literature focused on the study of organizational skills as well as the literature on the ERP systems management, focusing on the public hospital sector. From the bibliographic review, study proposals were prepared that served as the basis for the development of a matrix of competencies with three public hospitals in the direct administration of the State of São Paulo. The methodology of the study predicted the development of multiple case study method by which the information gathered in organizations were analyzed together and in crosswise way, making possible the identification of the organizational competencies and their respective adhesions to the problem of research. Empirical evidence suggests that in fact there is a set of organizational competencies related to post-implementation of ERP applications, related to the quality of use and quality of information extracted; full IT management; technological innovation and safety requirements, confidentiality and reliability required by law specifically when it comes to health information. The results allowed defining strengths and weaknesses of which resulted in a contribution proposition to practice by means of a guide of best practices. / Este projeto de pesquisa avalia a adesão às competências organizacionais que estão vinculadas ao universo de gestão dos sistemas ERP no setor hospitalar público, em sua perspectiva de pós-implementação. Para isso, utiliza o referencial teórico associado tanto à literatura voltada para o estudo das competências organizacionais como também à literatura voltada para o a gestão dos sistemas ERP, com foco no setor hospitalar público. A partir do levantamento bibliográfico, foram elaboradas proposições de estudo que serviram de base para o desenvolvimento de uma matriz de competências junto a três hospitais públicos de administração direta na Zona Norte do Estado de São Paulo. A metodologia utilizada no estudo previu o desenvolvimento do método de estudo de caso múltiplo, através do qual as informações colhidas nas organizações foram analisadas em conjunto e de forma cruzada, possibilitando a identificação das competências organizacionais e de suas respectivas aderências ao problema da pesquisa. As evidências empíricas sugerem que de fato existe um conjunto de competências organizacionais ligadas à pós-implementação dos aplicativos ERP, relacionadas à qualidade de uso e qualidade das informações extraídas; gestão plena de TI; inovação tecnológica e requisitos de segurança, sigilo e confiabilidade legalmente exigidos especificamente quando se trata de informações em saúde. A análise dos resultados permitiu delinear pontos fortes e fracos dos quais resultou uma proposição de contribuição para prática por meio de um roteiro de boas práticas.

Accidents related to medical devices are a worldwide problem and result in many deaths each year. It affects patients, relatives, health care workers and society. Due to the complexity of intensive care units (ICUs), such accidents lead to particularly serious consequences. The aim of this thesis was to identify patient safety aspects at ICUs in public and private hospitals in Bangladesh, in order to provide a basis for improving the quality of performance of devices as well as personnel, care and cost effectiveness. The objectives were to a)      compare the conditions of medical devices at ICUs in private and public hospitals, b)      increase understanding of errors, risks and accidents related to medical devices, c)      study reporting systems and communication between staff at ICUs and d)      find ways to minimize hazards related to medical equipment to ensure effective and safe use of devices. Data was collected through interviews during field visits to six hospitals in Dhaka, Bangladesh. Interviews were held with the chiefs of the ICUs, physicians, nurses and technicians. It was noticed that the admission fees to the public hospitals were lower and had more limited resources. Differences between public and private hospitals could be seen in the aspects of finance, the existence of a Biomedical Engineering Department, maintenance and calibration of medical equipment, further education of staff, working environment and infection control. The reporting systems for adverse events and communication about patients’ conditions between coworkers were weak at all hospitals. The procurement process was lengthy at all hospitals. Access to disposable items was limited at several hospitals. The lower admission fee at the government hospitals results in the patients of these hospitals often having a lower income and status, thus less inclined to be critical of the received care. A number of suggestions have been proposed in order to improve the work in the ICU. These include a)      following up rules made by the authorities to ensure they are implemented at each hospital, b)      increasing documentation of malfunctioning devices and adverse events, c)      nurses and physicians taking part in the procurement process, d)      establishing a Biomedical Engineering Department at all hospitals, e)      organizing workshops for health care workers, f)       developing biomedical products adapted for multiple time use and with less need for calibration, g)      providing more education for health care workers in infection control, management of specific devices, solutions to common technical problems, patient safety and user safety, for example using Information and Communication Technology tools (audio and audiovisual material) and discussion platforms as well as h)      constructing an internet forum for consultation on the abovementioned subjects for technicians. / Olyckor relaterade till medicinteknisk utrustning är ett globalt problem som leder till många dödsfall varje år. Det påverkar patienter, anhöriga, sjukvårdspersonal och samhället. Den komplexa miljön på intensivvårdsavdelningar gör att olyckorna leder till allvarliga konsekvenser. Uppsatsen syftade till att identifiera patientsäkerhetsaspekter på intensivvårdsavdelningar i Bangladesh för att skapa en grund för prestandaförbättring, både gällande utrustning och gällande personal. Det ska också öka vård- och konstandseffektiviteten. Målet uppnåddes genom att a)      jämföra användandemiljön för medicinteknisk utrustning på intensivvårdsavdelningar på statliga och privata sjukhus, b)      öka förståelsen för fel, risker och olyckor relaterade till medicinteknisk utrustning, c)      studera rapporteringssystem samt kommunikation mellan personal på intensivvårdsavdelningar och d)      hitta sätt att minimera faror relaterade till medicinteknisk utrustning för att försäkra en effektiv och säker användning av utrustningen. Data samlades in genom intervjuer under en fältstudie på sex sjukhus i Dhaka, Bangladesh. Intervjuer hölls med cheferna på intensivvårdsavdelningarna, läkare, sjuksköterskor och tekniker. Det upptäcktes att patientavgiften på de statliga sjukhusen var lägre och resurserna var mer begränsade. Skillnader mellan statliga och privata sjukhus kunde ses inom ekonomiska resurser, förekomsten av medicintekniskavdelning, underhåll och kalibrering av medicinteknisk utrustning, vidareutbildning av personal, arbetsmiljö och infektionskontroll. Rapporteringssystemen för olyckor samt kommunikationen om patienters tillstånd mellan medarbetare var bristfällig på alla sjukhus. Upphandlingsprocesserna av ny medicintekniskutrustning var lång på alla sjukhus. Tillgången på engångsartiklar var begränsad på flera utav sjukhusen. Den lägre avgiften på de statliga sjukhusen resulterar i att patienterna på dessa sjukhus ofta har lägre inkomst samt status i samhället och är därför mindre benägna att vara kritiska till den mottagna vården. Ett antal ändringar föreslogs för att förbättra arbetet på intensivvårdsavdelningarna. Dessa inkluderar att a)      följa upp de av myndigheterna satta reglerna för att försäkra att de är implementerade på varje sjukhus, b)      öka dokumentationen av icke fungerande utrustning tillika olyckor, c)      sjuksköterskor och läkare skall delta i upphandlingsprocesserna, d)      starta medicintekniska avdelningar på alla sjukhus, e)      organisera workshops för vårdpersonal, f)       utveckla medicintekniska produkter som är anpassade för att användas flera gånger och som behöver kalibreras mer sällan, g)      ge mer utbildning till sjukvårdspersonal om infektionskontroll, hantering av specifika maskiner, lösningar till vanligt förekommande tekniska problem, patientsäkerhet och användarsäkerhet till exempel genom att använda information- och kommunikationsteknik-verktyg (audio och audiovisuellt material) och diskussionsplattformar samt h)      konstruera ett internetforum där tekniker kan få konsultation angående ovannämnda ämnen. / To develop patient safety system to improve the safety and quality of patient care at the Intensive Care Units

Yes / Purpose Previous research (Bandoophanit et al, 2017) has shown that pharmaceuticals are a key input into effective healthcare operations but other equally important inputs are medical supplies, food, utilities, equipment and linen. As stated by the Twelfth National Economic and Social Development Plan (2017-2021) of Thailand, to attempt to deliver national Sustainable Development Goals (SDGs) organisations should preserve resources and minimize waste-generation in all aspects. The principal aim of this research project was to identify green practices and develop a model which supported and promoted healthcare efficiencies. Research Approach This was a mixed methods multi-site study using both qualitative and quantitative data collection and analysis methods. Six public hospitals were selected as case organizations, covering different types/sizes, locations, and environmental performance expertise. The data collection methods included interviews, documentation reviews and in situ observations. Respondents’ selection was purposive and a bespoke form of content analysis was used for the data review before further cross-case analysis, resulting in the identification of best practices using key indicators. Findings and Originality In spite of facing financial crisis, by reviewing key logistical processes and lifecycle, the overuse of healthcare resources and the poor management of waste, were clearly identified within in this study. This had a negative effect on personnel and patient hygiene. The result of identifying effective GL practices were reported as: (i) promoting the usage of multiple-use medical devices that can minimize inputs, waste, and cost, and (ii) producing/selecting organic food materials and fruits and reusing these waste byproducts to create secondary products e.g. fertilizer, biogas and electricity and cleaning/sterilizing liquid. The results also indicated that there was a drive from leaders to introduce green and efficient systems to improve staff personnel awareness and engagement in this area. The output of this study presents a model for GL implementation guidance, grounded in Thailand’s Sufficiency Economy Philosophy (SEP) concept. Research Impacts Currently, healthcare green logistics has received limited attention in developing nations and this study contributes to the reduction of these gaps. The SEP concept promotes sustainable health standards and underpins the focus and the originality/impact of this study. Practical Impacts This study recommends that staff in Thai hospitals focus on effective resource and waste management to contribute to sustainable sufficiency. This allows Thailand to offer an effective healthcare service to its patients. The study presents guidance and support to do this.

Interactive version of the thesis is filed with the printed copy in the UNISA archives / The study investigated and described public hospitals in terms of management processes with reference to financial planning, organizing, leading and control in order to identify deficiencies in the financial management of public hospitals. The aim was to identify gaps in the management of financial processes and to provide guidelines and strategies to improve these. The purpose of the research was addressed within a quantitative approach applying exploratory and descriptive designs. A self-administered questionnaire was used to collect the data that fit the objectives of the research. The study population compassed all 27 public hospitals as study units in a specific geographic area, namely Mpumalanga Province with the following inclusion criteria: active patient capacity of 100 beds and more, which employ personnel such as (1) medical, (2) paramedical and (3) administrative and a working application of the BAS as financial accounting system since its interception in the year 2000. Nine public hospitals were randomly selected as the sample hospitals. Within the nine hospitals, four groups of staff were selected by means of stratified random sampling, namely management, health professionals, and financial and administrative staff. The number of staff selected within each hospital differed, from 15 to 50, amounting to a sample size of three hundred (n=300). A response rate of 66.66% v (n=182) was achieved. The sample consisted of 4 (2.27%) chief executive officers, 3 (1.70%) financial managers, 84 (47.72%) unit managers and 91 (50.00%) subordinates. The response rate of 66.66% in this study was an indication of the unavailability of the health care professionals (which include management, health professionals and financial and administrative staff) within the nine public hospitals. The major inferences drawn from this study are that the different health care professions have a poor perception of the scope of financial management in terms of financial needs, utilization of resources, the scope and function of leading and delegation, and applying appropriate financial control methods. / Health Studies / D. Litt. et Phil. (Health Services Management)

Abstract not available

Interactive version of the thesis is filed with the printed copy in the UNISA archives / The study investigated and described public hospitals in terms of management processes with reference to financial planning, organizing, leading and control in order to identify deficiencies in the financial management of public hospitals. The aim was to identify gaps in the management of financial processes and to provide guidelines and strategies to improve these. The purpose of the research was addressed within a quantitative approach applying exploratory and descriptive designs. A self-administered questionnaire was used to collect the data that fit the objectives of the research. The study population compassed all 27 public hospitals as study units in a specific geographic area, namely Mpumalanga Province with the following inclusion criteria: active patient capacity of 100 beds and more, which employ personnel such as (1) medical, (2) paramedical and (3) administrative and a working application of the BAS as financial accounting system since its interception in the year 2000. Nine public hospitals were randomly selected as the sample hospitals. Within the nine hospitals, four groups of staff were selected by means of stratified random sampling, namely management, health professionals, and financial and administrative staff. The number of staff selected within each hospital differed, from 15 to 50, amounting to a sample size of three hundred (n=300). A response rate of 66.66% v (n=182) was achieved. The sample consisted of 4 (2.27%) chief executive officers, 3 (1.70%) financial managers, 84 (47.72%) unit managers and 91 (50.00%) subordinates. The response rate of 66.66% in this study was an indication of the unavailability of the health care professionals (which include management, health professionals and financial and administrative staff) within the nine public hospitals. The major inferences drawn from this study are that the different health care professions have a poor perception of the scope of financial management in terms of financial needs, utilization of resources, the scope and function of leading and delegation, and applying appropriate financial control methods. / Health Studies / D. Litt. et Phil. (Health Services Management)

Submitted in fulfillment of the requirements for the Degree Mast in Technology: Public Management, Durban University of Technology, Durban, South Africa, 2017. / The South African healthcare sector stands at the threshold of major restructuring in an attempt to address inadequacies as a result of fragmentation of health services in apartheid South Africa. The level of health services, particularly in rural areas, has decreased and has led to reduced quality and productivity of health services. For individuals residing in rural communities, access to health services can be arduous. Delivery of essential services has to meet the needs of marginalised people who live in remote areas. In light of the above, the department of health is faced with growing expectations from citizens to use resources efficiently and effectively and to ensure that healthcare is affordable and accessible to all. National Health Insurance (NHI) is intended to bring about reform that will improve service provision. The researcher undertook this study to explore healthcare challenges faced by South Africa and its people and how far progressive realisation of access to healthcare, as enshrined in the 1996 Constitution, is being implemented. A case study using a mixed method approach was adopted. The literature reviewed indicated that issues of remuneration, ageing infrastructure and general management challenges, including financial management, are among the challenges that continue to hamper the public health system in South Africa. In addition, the HIV/AIDS epidemic has created more demand for healthcare as many more people become sick. The Green Paper outlining the government’s broad policy proposals for NHI, released in August 2011, makes it clear that NHI is a long-term project that will be rolled out over 14 years. It aims to promote efficiency and equity to ensure that all South Africans have access to affordable, quality healthcare. The findings of this study are useful not only to the case study institution, but to all District Hospitals, especially the department of health and the public management sector and may assist in taking the NHI forward. / M

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

M.A. / This research aimed to design and develop an intervention that would maximise the coping resources of doctors working with trauma patients at Johannesburg General Hospital. Intervention Research methodology was used in order to achieve this objective. The study was divided in to three phases, namely, Diagnosis, Feedback and Discussion and Evaluation. The initial intervention comprised the Diagnostic as well as the Feedback and Discussion phase. The findings from the Diagnostic phase suggested that the doctors who had been working in the unit for less than three months, as well as the doctors who had less than four years medical practice experience, were most likely to show areas of vulnerability. This vulnerability related to their under-use of coping resources accompanied by elevated negative mood states, as identified by the Coping Resource Inventory and the Profile of Mood States questionnaire respectively. Other groups of doctors that shared this vulnerability included interns, medical officers, females and single doctors. The Feedback and Discussion phase brought to light themes relating to the stressors that the doctors’ experience in their work context. These themes along with the results of the Evaluation phase where used in order to re-design the Intervention for future use with doctors working with trauma patients. The findings from the Evaluation phase also confirmed that the doctors found the intervention to be beneficial.