Magister Administrationis - MAdmin / The shift from an ethnocentric, monocultural society to a more inclusive and democratic society should be accompanied by a national policy providing equal access to resources in a proactive, affirmative manner. This can be achieved in one of the two ways, either through equal employment opportunity or Affirmative Action. Affirmative Action is a specific intervention directed toward ensuring that employment opportunities are created by actively correcting imbalances caused by past discrimination and achieving employment targets. Equal employment opportunity implies an absence of discrimination, whereas Affirmative Action denotes compensatory discrimination in favour of disadvantaged groups. Affirmative Action is a supplement to, rather than equivalent to equal employment opportunities in that equality cannot be a genuine option where the effects of previous discriminatory practices have not been redressed. In an equal opportunities system, not all persons have the same chance of achieving the desired goal, but all are provided with equal means to achieve it. The unequal outcome of such a system is caused by the unequal skills for talents of the past discrimination, especially in terms of education and experience. All the Directors of Tygerberg Administration who responded to the questionnaires supported this and all of them agreed that training is necessary for all employees, especially the previously discriminated groups. The primary objective of Affirmative Action can therefore said to be the adequate advancement of disadvantaged groups for the purpose of securing equal rights, freedom and opportunities.Equal employment opportunity is seen as a passive agreement on the part of the employer not to discriminate against any particular group. Employers adhering to the principle of equal employment opportunity evaluates candidates for employment according to performance criteria which relates directly to the requirements of a particular position. Affirmative Action seeks to go beyond equal employment opportunity in that it recognises that, when members of disadvantaged groups constitute only a small percentage of the labour pool, passively providing equality of opportunity will not suffice in overcoming the effects of previous discriminatory employment practices. Affirmative Action employers are therefore given the mandate to identify and remove the barriers to the employment of those under-represented in the workplace. Merely removing the present obstacles to equality does not necessarily ensure equality between groups since the effects of previous discrimination need to be actively redressed. It can be noted that equal employment and Affirmative Action programmes should not be equated with each other as they imply different approaches to overcoming the effects of previous discrimination. Affirmative Action is said to be a supplement to, rather than the equivalent of equal employment opportunity, in that it is required to eliminate the barriers to real equality in the workplace. In this regard, it is essential to point out that Affirmative Action programmes are a means to an end, namely equal employment opportunity, and should not continue after this end has been achieved. Due to the similarity between the two terms, Affirmative Action and equal employment opportunity are often equated with one another when, in essence, they have different meanings. From the information gathered for this research it was clear that not many Blacks were employed in management and supervisory positions of the City of Tygerberg. The research revealed that despite adopting the Agreement on Affirmative Action and equal employment practice of the National Labour Relations Forum for Local Government as its policy framework, the Tygerberg Administration had not succeeded in meeting most of its obligations in terms of the above mentioned policy framework. This is largely ascribed to problems experienced with the implementation of equal employment and Affirmative Action programmes within the local authority. The methods of communicating these programmes to especially its lower category of disadvantaged employees to participate in training opportunities to improve their working skills, were not capitalised on. There was an unequal distribution of skills due to the effects of past discrimination, especially in terms of education. Active steps therefore need to be taken to ensure that the intentions of the local authority with repect to equal employment and Affirmative Action are implemented efficiently and effectively. / South Africa

Magister Scientiae Dentium - MSc(Dent) / This study analyzed the dental surgical implant therapy in the past 5 years at Tygerberg Oral Health Centre, UWC Dental School, Cape Town, South Africa. The findings of this study serve as a guideline for the estimation of the prevalence in this dental hospital. The importance of this study was to aid in the establishment of the formalized electronic database for dental implant therapy. The data generated will form a foundational basis for future studies that may be conducted in the field of implantology.

Magister Scientiae Dentium - MSc(Dent) / Purpose This study analyzed the dental surgical implant therapy in the past 5 years at Tygerberg Oral Health Centre, UWC Dental School, Cape Town, South Africa. The findings of this study serve as a guideline for the estimation of the prevalence in this dental hospital. The importance of this study was to aid in the establishment of the formalized electronic database for dental implant therapy. The data generated will form a foundational basis for future studies that may be conducted in the field of implantology. Methodology A retrospective cross-sectional study was conducted at the Tygerberg Oral Health Centre. The data was collected from the implant dental records for the years 2012-2017. Variables measured included the patient demographics such as age, gender, an implant placed by type, length, width, and anatomical location. Frequencies and means of data were generated using IBM SPSS v20.

Magister Chirurgiae Dentium (MChD) / Periodontal disease is one of the most common diseases worldwide. Periodontal treatment aims to prevent disease progression and restore functional and aesthetic dentition. The purpose of studying periodontal treatment outcome is to assess treatment efficacy. Treatment outcome of periodontal disease is affected by multiple patient-related factors, the type of treatment provided, and the expertise of the clinician.

Magister Scientiae Dentium - MSc(Dent) / Oral epithelial dysplasia (OED) is a growth anomaly which occurs as a result of atypical, abnormal proliferation and a change in the architecture and cytological features of cells of epithelial origin, which ultimately results in the formation of a lesion with disturbed differentiation and maturation The purpose of this study was to describe the OED cases diagnosed at Tygerberg Oral health centre in a 7-year period between 2012 and 2019. The patients’ medical records from Tygerberg Oral Health Centre and National Health Laboratory Service (NHLS) were reviewed. All diagnosed cases of OED were identified and the data retrieved for further assessment and comparison. The individual medical records and follow up data were assessed. Seventy cases of OED were diagnosed in the period assessed. Of those 70 cases, the median age was 58 and the interquartile range was from 48 – 62. Thirty-six of the diagnosed patients were female and thirty-four were males. The majority of lesions diagnosed with OED were found on the tongue, floor of the mouth (FOM) and buccal mucosa. Majority of the lesions were found in non-smokers and non-alcohol consumers. These two categories both presented with mild cases of OED. From the results, it was derived that OED has no intra-oral location predilection. Moreover, OED is not directly associated with smoking.

Magister Chirurgiae Dentium (MChD) / MChD (Oral Pathology) minithesis, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, University of Western Cape Among malignant lesions, lymphoma ranks second only to squamous cell carcinoma in frequency of occurrence in the head and neck. Lymphomas in HIV patients' are second in frequency to Kaposi's sarcoma as AIDS-defining tumours. About 50% of lymphomas in HIV patients are extranodal and more than half of these occur in the head and neck area. The number, variety and diagnostic complexity of lymphoma cases that have primarily arisen in the head and neck region has steadily increased in the surgical pathology service of the National Health Laboratory Services (NHLS) - Tygerberg. This observation is particularly relevant in the context of increasing HIV infection rates in the population of South Africa as demonstrated by a study in 2006 conducted by the Medical Research Council of South Africa. This is a retrospective study using the records of cases of head and neck lymphomas diagnosed at NHLS-Tygerberg over the last five years. The aim of this study is to investigate the prevalence of head and neck lymphomas (HNL) at NHLS-Tygerberg from January 2002 to December 2006. The objective of this study is to determine the frequency and types of HNL and to determine, if possible, an association between the incidence of HNL and the HIV status of the patients. Trends of prevalence in terms of gender, referral centres, HIV status, age of patients and site of presentation are also examined. The results of this study show an increase in the number of patients with HNL from January 2002 to December 2006. A significant increase is noted in the number of HIV positive patients documented each year, from 17% in 2002 to 33% in 2006. Western Cape- urban (WC-U) remains the largest referral center. A notable increase is seen, each year, in the number of patients referred to Tygerberg-NHLS from the Eastern Cape (EC) and Western Cape- rural (WC-R) areas. A significant number of HIV positive patients are referred from the Eastern Cape and Western Cape rural areas. The average age of disease presentation in the HIV positive group of patients is 35 years with the unknown group being 46 years and the HIV negative group being 54 years. The main categories of lymphoma that presented in HIV positive patients are plasmablastic lymphoma (PBL) and diffuse large B-celllymphoma (DLBCL), which together form 56% of cases. 26% of cases are Hodgkin's lymphoma (HL); the second largest group of HNL cases. Burkitt's lymphoma (BL) consists of 8% of cases. 7% of cases are T-cell lymphomas. 3% of cases are Mantle zone lymphomas. No cases of SLL and Follicular lymphomas (FL) are described in this group of patients. DLBCL and HL form 27% each of the cases in patients with a negative HIV status. A significant number of Follicular lymphomas (15%), small lymphocytic lymphoma (SLL) (9%), MALT (7%), and T-cell lymphomas (8%) are identified. No PBL are seen in this group of patients. The incidence of HNL at NHLS-Tygerberg has increased over the last five years. This trend parallels that seen in other developing countries such as Tanzania, Nigeria, Thailand and India. This increase is possibly due to an increase in the number of referrals to our center, an increase in the overall population of the Western Cape, an increase in the number of HIV positive patients and the high incidence of EBV infection in the general population of the Western Cape. Social issues, such as poverty, lack of adequate education, female dependence on partners, rural communities and the non-availability of anti-retroviral drugs (ARV) and highly active anti-retroviral therapy (HAART) to most of the population that require these drugs, are considered major contributing factors. A trend is noted in the increased number of female patients diagnosed each year with HNL. A predominance of DLBCL was identified in our series. This is consistent with previous reports and studies on HNL. The number of biologically aggressive lymphomas, such as DLBCL, Plasmablastic and Burkitt's lymphomas diagnosed each year, has also significantly increased. These were prevalent mainly in the HIV positive group of patients who were also younger compared to the HIV negative patients. The documented findings of this study will serve as a guideline for the estimation of head & neck lymphoma burden and risk assessment at NHLS- Tygerberg.

Thesis (MSc (Medical Virology )--University of Stellenbosch, 2004. / 150 leaves printed on single pages, preliminary pages i-vii and numberd pages 1-143. Includes bibliography and figures digitized at 300 dpi grayscale and 300 dpi 24-bit Color to pdf format (OCR), using a Hp Scanjet 8250 Scanner and digitized at 600 dpi grayscale to pdf format (OCR), using a Bizhub 250 Konica Minolta Scanner. / ENGLISH ABSTRACT: The first episode of HIV-1 in South Africa was documented in 1982. Homosexual transmission of the virus was the predominate mode of transmission in an epidemic of mainly HIV-1 subtype Band D infections. To date, no full-length sequences of Subtype D strains from South Africa has been reported. Here we describe the characterization and some of the unique features of the Tygerberg HIV-1 subtype D strains. A near full-length 9 kb fragment was obtained through a one step PCR using high molecular weight DNA. Cloning was done successfully with the pCR-XLTapa cloning kit. Large quantities of plasmid DNA was grown and sequenced on both strands of the DNA. ORF determination and subtyping was followed by standard phylogenetic methods to construct evolutionary phylogenetic trees. Subtyping and similarity plots revealed that the sequences from Tygerberg are pure subtype D. All the Tygerberg strains had intact genes with no premature stop codons. At the tip of the V3 loop, the Tygerberg strains have the GOGO motif. R214 has a more variable vpu gene than the rest of the Tygerberg strains, but is still subtype D in this region. No premature stop codons have been observed in the tat gene and the glycosilation of the strains are less than the subtype D consensus. We are the first to report full-length sequences of HIV-1 subtype D strains from South Africa. The sequences represent non-mosaic genomes of subtype D. Our results confirm that the subtype D sequences from the beginning of the HIV-1 epidemic differ from the Subtype D sequences from recent isolates. / AFRIKAANSE OPSOMMING: Die eerste episode van HIV-1 infeksie in Suid Afrika is in 1982 gedokumenteer. Die epidemie het hoofsaaklik uit subtipe B en D bestaan en was deur homoseksuele kontak oorgedra. Geen vollengte subtipe D DNS volgordes van Suid-Afrika is tans beskryf nie. Hier beskryf ons die karakterisering van vollengte subtipe D stamme asook sommige van die unieke eienskappe van die virusse. Die vollengte 9 kb genoom volgorde was verkry deur 'n eenstap PKR reaksie met hoë molekulêre gewig DNS uit te voer. Die 9 kb fragment was suksesvol gekloneer met behulp van die peR-Xl-TOPO klonerings toetsstel. Groot hoeveelhede plasmied DNS was opgegroei en die nukleotied volgorde bepaal op beide stringe van die genoom. Die stamme was gesubtipeer en filogenetiese analise was uitgevoer met standaard metodes. Die volledige DNS volgordes was bepaal en subtipering het daarop gedui dat die stamme van Tygerberg suiwer subtipe D is. Geen premature stop kodons is in die nukleotied volgordes van die Tygerberg stamme gevind nie. By die draai van die varieerbare deel (V3) het al die Tygerberg stamme die GQGQ motief gehad. R214 het 'n meer varieerbare vpu geen, maar behoort steeds tot die subtipe D groep in die gedeelte. Daar was geen premature stop kodons in die tat geen gevind nie en die glikosilasie van die stamme is minder as die van die konsensus subtipe D stam. Ons is die eerste groep om vollengte subtipe D stamme van Suid-Afrika te karakteriseer. Die DNS volgordes verteenwoordig suiwer subtipe D genome. Ons resultate bevestig die van ander dat die nukleotied volgordes van die ouer subtipe D stamme verskil van die nuwer stamme.

Thesis (MScMedSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Setting This study was conducted in the Tygerberg district, Cape Town, in the Western Cape, South Africa Background The evaluation of early tuberculosis (TB) treatment response is based on month 2 sputum culture status. This method of evaluation has a number of limitations: the test requires relatively advanced laboratory infrastructure and procedures, it takes several weeks to obtain results and is a relatively a poor marker at predicting treatment response. The discovery of potential host markers which reflect the efficacy of early treatment would be of great importance for clinical management of individual patients. The treatment failure would be detectable earlier than at week 8 of treatment. The duration of clinical trials of new anti-tuberculosis drugs may also be substantially reduced by such markers if these would be measurable earlier than at week 8 of therapy. Objectives 1) To evaluate diluted, 7-day whole blood cultures stimulated with live Mycobacterium tuberculosis (M.tb) for the presence of host markers of early TB treatment response 2) To evaluate an overnight, undiluted, M.tb antigen stimulated whole blood culture Quantiferon Gold In Tube (QFT-GIT) supernatants for host markers of early TB treatment response The study designs were as follows: In study one, baseline samples and samples from week 1, week 2 and week 4 of treatment from 30 cured TB patients were selected from a larger biomarker study, in which whole blood was stimulated with live M.tb or left unstimulated. Fifty seven host markers were measured in supernatants by multiplex cytokine arrays. In study two, baseline samples and samples from week 2 and week 8 of treatment from 19 cured TB patients were randomly selected from the placebo group in a micronutrient supplement study. QFT-GIT supernatants from these participants were assessed through multiplex cytokine arrays for levels of fifty seven host markers. All of the participants in both studies were Human Immunodeficiency Virus (HIV) negative. Changes in marker expression over time and between fast and slow responders to treatment were evaluated. Comparability between the two culture methods was assessed for markers that were evaluated in both studies. Results In study one, the majority of host markers showed significant changes over time in the unstimulated supernatants. Only GRO and IL-1beta changed significantly in an antigen-specific manner (background levels subtracted). No significant changes were observed between fast and slow responders. In study two, the majority of host markers showed significant changes over time in the unstimulated supernatants whereas only MDC and IL-4 changed during the observation period in antigen stimulated levels. Significant differences were observed between fast and slow responders at pre-treatment for IL-13 Ag-Nil and IL-1betaAg-Nil . Conclusion This study revealed, antigen-specific responses showed only limited potential for early TB treatment response monitoring, but may have potential in differentiating between treatment outcomes. Future investigations may have to include later time points during treatment as these were not included in the present assessment. The QFT-GIT samples do not appear to be equivalent to live M.tb stimulated 7-day whole blood assays. / AFRIKAANSE OPSOMMING: Instelling Die studie is uitgevoer in die Tygerbergdistrik, Kaapstad, Wes-Kaap, Suid-Afrika. Agtergrond Die evaluering van die respons op vroeë tuberkulose (TB) behandeling word gebaseer op die status van maand 2 sputum kulture. Hierdie evalueringsmetode het ‘n paar beperkinge: die toets benodig relatief gevorderde laboratorium infrastruktuur en prosedures, die toetsuitslae is eers na ‘n paar weke beskikbaar en dit is n relatiewe swak merker om repons op behandeling te voorspel. Die ontdekking van potensiële selfmerkers wat die doeltreffendheid van vroeë behandeling weerspieël sal van groot belang wees vir die kliniese bestuur van individuele pasiënte. Mislukking van die behandeling sal sodoende voor week 8 van behandeling waargeneem kan word. Die tydsduur van kliniese proewe van nuwe anti-tuberkulose medikasie mag ook baie verkort word met sulke merkers as dit voor week 8 van behandeling gemeet kan word. Doelwitte 1) Om verdunde, 7-dae oue volbloedkulture, met lewende Mikobakterium tuberkulosis (M.tb) gestimuleer, te evalueer vir die teenwoordigheid van vroeë TB behandeling respons selfmerkers. 2) Om die supernatant van oornag, onverdunde, M.tb antigeen gestimuleerde volbloedkulture Quantiferon Gold In Tube (QFT-GIT) vir vroeë behandeling respons selfmerkers te evalueer. Die studie-ontwerpe was soos volg: Met studie een is basislynmonsters en monsters verkry na week 1, week 2 en week 4 van behandeling van 30 geneesde TB-pasiënte geselekteer uit ‘n groter biomerkerstudie waarin die volbloed met lewende M.tb gestimuleer is of ongestimuleer gelaat is. Sewe-en-vyftig selfmerkers is in die supernatante gemeet deur middel van multipleks sitokine arrays. Met studie twee is basislynmonsters en monsters verkry na week 2 en week 8 van behandeling van 19 geneesde TB-pasiënte lukraak uit die plasebo-groep in ‘n mikrovoedingstowwe-aanvullingstudie geselekteer. Vlakke van 57 selfmerkers is in die QFT-GIT supernatante van hierdie deelnemers, deur middel van die multipleks sitokine arrays, bepaal. Al die deelnemers van beide studies was HIV negatief. Veranderinge in merker-uitdrukking oor tyd, asook tussen vinnige en stadige respons tot behandeling, is ge-evalueer. Die vergelykbaarheid van die twee kultuurmetodes is geassesseer ten opsigte van die ge-evalueerde merkers in albei studies. Resultate Met studie een het die meerderheid van die selfmerkers in die ongestimuleerde supernatante kenmerkende verandering oor tyd gewys. Slegs GRO en IL-1beta het aansienlik verander in die antigeenspesifieke wyse (agtergrond vlakke afgetrek). Geen kenmerkende veranderinge was waargeneem tussen die vinnige en stadige respons pasiënte nie. Met studie twee het die meerderheid van die selfmerkers aansienlike veranderinge oor tyd in die ongestimuleerde supernatante gewys, in vergelyking waar net die MDC en IL-4 veranderinge gedurende die observasie periode in antigeen gestimuleerde vlakke getoon het. Kenmerkende verskille is tussen die vinnige en stadige respons pasiënte in voorbehandeling vir IL-13 Ag-Nil en IL-1betaAg-Nil waargeneem. Gevolgtrekking Die studie bewys dat antigeenspesifieke response slegs beperkte potensiaal vir vroeë TB behandeling respons monitering het, maar mag die potensiaall vir onderskeidende behandeling uitkomste hê. Toekomstige ondersoeke sal dalk latere tydpunte gedurende die behandeling moet insluit aangesien dit nie in hierdie evaluasie ingesluit is nie. Die QFT-IT monsters verskyn nie as gelykwaardig met die lewendig M.tb gestimuleerde 7-dae volbloed toetse nie.

Thesis (MTh)--Stellenbosch University, 2001 / ENGLISH ABSTRACT: The basic premise of this study is that when a comprehensive analysis is made of the Vineyard Christian Fellowship Tygerberg's current status and growth, it will provide a sound basis for discerning that growth. This will in some measure open the way for the leadership of the congregation to be able to make decisions for the future that are better informed and more aware of the way God has worked with the congregation thus far. This in turn will hopefully keep the congregation on the path to further growth toward maturity. The research has been structured in such a way, that it conforms to a practical theological framework and attempts a description of the current reality of the congregation by means of a mechanical, cultural and leadership analysis. A practical theological ecclesiology follows in order to provide the basis for a correlational hermeneutic. After analysis and reflection, possibilities for future strategies are proposed. / AFRIKAANSE OPSOMMING: Die basiese uitgangspunt van hierdie studie is dat wanneer In goed gefundeerde gemeente analise van die 'Vineyard Christian Fellowship Tygerberg' se huidige status en groei gedoen word, dit 'n gesonde basis vir oordeel oor die groei van die gemeente sal gee. Dit behoort tot ' n mate die weg te baan vir die leierskap van die gemeente om beter ingeligte besluite rakende die toekoms van die gemeente te neem omdat daar dan ' n bewustheid is van God se werking in die gemeente tot dusver. Hopelik sal dit ook die gemeente help om voorts op die pad van groei tot volwassenheid te bly. Die navorsing is so gestruktureer dat dit 'n praktiese teologiese raamwerk gebruik en poog om die huidige realiteite van die gemeente deur 'n meganiese, kulturele en leierskap analise te beskryf. 'n Praktiese teologiese ekklesiologiese uiteensetting volg wat moet dien as die beginpunt van 'n korrelatiewe hermeneutiese proses. Moontlike strategice vir die toekoms word voorgestel nadat analise en refleksie gedoen is.

Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: BACKGROUND Post anesthesia discharge criteria scoring systems have been used successfully to aid discharge from the post anesthetic care unit (PACU) for over 40 years. They do not replace, but rather act in conjunction with good clinical judgment, and provide concise, standardized documentation of a patient’s readiness for discharge. 1,2,3,4,5 In order to improve patient safety, provide clear documentation and to aid future audit, a discharge criteria scoring system was developed for use in our PACU (Addendum A). It is a modification of the Aldrete Scoring System and the modified Post Anesthetic Discharge Scoring System (PADSS) proposed by Chung.1 There is a steadily increasing patient burden on the existing medical infrastructure in South Africa. Tygerberg Academic Hospital is no exception, and because of the high demand on our theatre services, optimal efficiency is essential. We speculated that our discharge criteria scoring system might increase the efficiency of our PACU when compared to the traditional time based system. The more healthy patients, undergoing minor procedures, could potentially spend less time in PACU, allowing the nurses to focus on problem cases. Increasing the speed of transit might also help prevent delays in theatre due to lack of bed space in PACU. Our primary endpoint was to compare the duration of time spent by patients in the PACU at Tygerberg Academic Hospital, from the moment they are admitted, to the time they are discharged to the ward, before and after the introduction of a discharge criteria scoring system. While planning the audit, one of the factors that staff identified as contributing to delayed discharge from PACU, was the time it took for the wards to collect their patients. A secondary objective, therefore, was to assess the amount of time that elapsed between calling the ward to collect the patient, and the patient leaving PACU. METHODS AND MATERIALS Prior to commencing the audit, approval was obtained from the Human Research Ethics Committee of the Faculty of Health Sciences of the University of Stellenbosch and Tygerberg Academic Hospital. The Audit, its purpose and possible benefits, was discussed with representatives of the nurses working in PACU, and written consent was obtained from those who would be involved in the data collection (Addendum B). Audit forms (Addendum C), collection boxes, and posters reminding staff to participate in the audit were prepared. Our first audit was performed over approximately a week in August 2012. During this period, the traditional time-based discharge system was still in operation. Data was captured from 327 patients. Audit forms were placed in a collection box, which was cleared daily by the primary investigator. The discharge criteria scoring system was introduced to the PACU staff in January 2013. The nurses were trained in its use, and a one month period was allowed for all involved to become accustomed to the new system. A second audit was performed in February 2013, again over a week, during which we gathered data from 313 patients. RESULTS The median value of the time spent by patients in the PACU decreased from 1 hour 25 minutes, to 1 hour 15 minutes, after introduction of the discharge criteria scoring system. This was statistically significant (p-value = 0.003). The median time between calling the ward to collect a patient, and the patient leaving recovery, was 15 minutes. CONCLUSION The main finding of the study was that the introduction of a discharge criteria scoring system decreased the median duration of time spent by patients in the post anesthetic care unit at Tygerberg Academic Hospital. / AFRIKAANSE OPSOMMING: AGTERGROND Puntestelsels as ontslag kriteria na narkose, word vir die afgelope 40 jaar suksesvol gebruik as maatstaf om pasiënte uit die herstelkamer te ontslaan. Hierdie kriteria vervang nie goeie kliniese oordeel nie, maar is ’n addisionele hulpmiddel om te bepaal of die pasiënt gereed is vir ontslag en om noukeurige, gestandardiseerde dokumentasie te verseker. 1,2,3,4,5 'n Nuwe puntestelsel vir ontslag is vir die herstelkamer van Tygerberg Akademiese Hospitaal ontwikkel om pasiëntesorg en dokumentasie te verbeter, asook om ouditering in die toekoms te vergemaklik (Addendum A). Hiervoor is die Aldrete Scoring System en die gemodifiseerde PADSS, voorgestel deur Chung, aangepas. 1 Die bestaande mediese infrastruktuur in Suid-Afrika beleef tans ‘n geleidelike toename in die getal pasiënte. Tygerberg Akademiese Hospitaal is geen uitsondering nie en as gevolg van die hoë aanvraag na ons teaterdienste, is uiterste doeltreffendheid noodsaaklik. Ons vermoede was dat hierdie aangepaste puntestelsel doeltreffendheid in die herstelkamer sou verbeter in vergelyking met die meer tradisionele tyd-gebaseerde sisteem. Gesonde pasiënte wat kleiner prosedures ondergaan, sal waarskynlik na ’n korter periode ontslaan kan word wat die verpleegpersoneel in staat sal stel om meer aandag aan probleem gevalle te gee. Bespoediging van die pasiëntvloei behoort onnodige vertragings van teatergevalle weens 'n tekort aan beddens in die herstelkamer, te beperk. Die primêre doel van die studie was om te bepaal of die gebruik van die aangepaste puntestelsel as ontslag kriteria in Tygerberg Akademiese Hospitaal, die tydperk wat die pasiënt in die herstelkamer deurbring, verkort. Die herstelkamer verpleegsters het beweer dat die saal personeel ‘n lang tyd gevat het om hulle pasiente in herstelkamer te kom haal. Vervolgens is 'n sekondêre doelwit ingesluit om die tydperk te bepaal vandat die saalpersoneel in kennis gestel word, totdat die pasiënt die herstelkamer verlaat. METODE Goedkeuring is verkry van die Menslike Navorsing en Etiese Komitee van die Gesondheidswetenskap Fakulteit van die Universiteit van Stellenbosch en Tygerberg Akademiese Hospitaal voor die aanvang van die studie. Die studie, asook die doel en moontlike voordele daarvan is vooraf bepsreek met verteenwoordigers van die herstelkamer verpleegpersoneel en skriftelike toestemming is verkry van al die deelnemers wat betrokke sou wees by die data versameling (Addendum B). Oudit vorms (Addendum C), versamelhouers en inligtingsplakkate vir die betrokke personeel is voorberei. Die aanvanklike oudit is in Augustus 2012 oor 'n periode van ongeveer een week uitgevoer. Tydens hierdie oudit is die tradisionele tydgebaseerde sisteem gebruik. Inligting van 327 pasiёnte is versamel. Die oudit vorms is in die versamelbokse geplaas en is daagliks deur die primêre navorser verwyder. Die aangepaste puntestelsel as ontslag kriteria, is in Januarie 2013 in die herstelkamer geïmplementeer. Die verpleegpersoneel het opleiding ontvang waarna die aangepaste puntestelsel vir een maand gebruik is om te verseker dat die personeel vertroud is daarmee. In Februarie 2013, is ‘n tweede oudit oor ‘n tydperk van een week uitgevoer, waartydens inligting van 313 pasiёnte versamel is. RESULTATE Na die implementering van die aangepaste puntestelsel as ontslag kriteria, het die mediane tyd wat pasiënte in die herstelkamer deurbring afgeneem van 1 uur en 25 minute tot 1 uur en 15 minute. Hierdie afname is statities betekenisvol (p-waarde = 0.003) Die mediane tyd vandat die saal in kennis gestel is totdat die pasiënt die herstelkamer verlaat, was 15 minute. GEVOLGTREKKING Die hoof bevinding van die studie is dat die mediane tydperk wat die pasiënte in die herstelkamer deurbring verminder is deur die implementering van die aangepaste puntestelsel as ontslag kriteria in Tygerberg Akademiese Hospitaal.