Faith-based Hospitals Research Articles

How to engage patients in achieving patient safety: A qualitative study from healthcare professionals’ perspective

All parties involved in health care, including patients and their families/caregivers play a significant role to achieve patient safety. Furthermore, patient engagement (PE) has not been adequately implemented to achieve safe healthcare in Indonesia, despite the introduction of the patient-centered care paradigm. This study aims to explore healthcare professionals' (HCPs) perspectives on PE and its application technique. A qualitative study was conducted in the chronic wards of a faith-based private hospital in Yogyakarta Province, Indonesia. Four focus group discussions among 46 HCPs, followed by 16 in-depth interviews, were carried out. Furthermore, the verbatim transcripts were subjected to thematic analysis. The result showed four main themes, including PE as a strategy for achieving safe healthcare, factors affecting its implementation, the need for comprehensive strategies to engage the patients, and their roles in safety efforts. Furthermore, the implementation of PE can be enhanced by encouraging healthcare professionals (HCPs) to play proactive roles in empowering recipients. To achieve PE, “partnership culture” and the removal of potential barriers as well as determining factors, must be established. This requires a high-level commitment, organizational support with a top-down approach, and integration into healthcare systems. In conclusion, PE is essential for patient safety and can be enhanced by strengthening organization support, integrating into the healthcare system, improving HCPs’ roles, and empowering patients and caregivers to overcome potential barriers.

Effect of a Nurse-Led Intervention on Knowledge of the Modifiable Risk Behaviors of Cardiovascular Disease: A Randomized Controlled Trial.

Cardiovascular disease (CVD) has disproportionately burdened the low- and middle-income countries where awareness and detection rates remain very low. Interventions directed to promote the community's awareness of CVD may help reduce the public's exposure to behavioral risk factors. However, the effectiveness of interventions implemented through a nurse on knowledge of the modifiable behavioral risk factors and preventive measures of CVD has not been determined in Kenya. To establish the effect of a nurse-led intervention on knowledge of the modifiable risk behaviors of CVD in adults with metabolic syndrome (MetS) attending a mission-based hospital in Kenya. A two-armed parallel-group randomized controlled trial design was conducted among 352 adults aged 18-64 years with MetS. The participants were recruited from a faith-based hospital in Nairobi, Kenya and randomly allocated to either a nurse-led lifestyle intervention or a control group. The intervention group received a comprehensive health education intervention using the World Health Organization (WHO) guideline recommendations for CVD control and prevention. Individuals in the control group were exposed to the usual CVD care according to hospital protocol. The duration of the intervention was 12 months. The primary outcome measure was a change in levels of knowledge on the modifiable risk factors and preventive measures of CVD. Outcome measures were assessed at baseline and at 15 months postintervention. Pre- and postintervention difference in the level of knowledge between the two groups was determined using the chi-square test of independence. The knowledge level of CVD risk factors and preventive measures was very low in both groups at baseline without significant difference. A significant improvement in the level of knowledge on CVD risk factors (78.2% vs. 30.4%, p < .001) and preventive measures (74.4% vs. 29.0%, p < .001) was observed in the intervention group relative to the control at the end-line. The nurse-led lifestyle intervention significantly improved participants' level of knowledge on CVD risk factors and preventive measures. It is highly recommended that nurses incorporate routine health education interventions for patients with cardio-metabolic abnormalities.

Health Care Providers' Attitude and Satisfaction Toward Patient-Oriented Services Provided by Pharmacy Technicians at Three Faith-Based Hospitals.

Pharmacists and pharmacy technicians often work together to provide optimal pharmacy services, however, some low-middle-income countries lack strong regulatory mechanisms and have an inadequate number of pharmacists, necessitating some hospitals to rely on pharmacy technicians providing direct patient care services. This study sort to investigate health care providers' attitudes and satisfaction toward patient-oriented pharmacy services offered by pharmacy technicians at 3 faith-based hospitals in Cameroon. A cross-sectional study was conducted from February to April 2021. Self-administered questionnaires were distributed to 159 health care providers (HCPs) in 3 institutions of the Cameroon Baptist Convention Health Services. The questionnaire was made up of 3 parts evaluating HCPs' attitudes and satisfaction. A total of 140 questionnaires were completed (88.1%) response rate. The majority of respondents were female (70%) and <35 years (60.7%). Almost all respondents showed a positive attitude toward pharmacy technicians' role in patient education (90%) and provision of medication information (93.6%). However, only 46% agreed that pharmacy technicians should take medication histories. The majority of respondents were satisfied with overall pharmacy services (80.7%). Only 25% were satisfied with pharmacy technicians' participation in ward rounds. Gender was associated with attitude of respondents (P = 0.02). Factors associated with satisfaction of respondents included profession (P = 0.047) and work experience (P = 0.008). Our results revealed a positive attitude and overall satisfaction with technician-led patient-oriented pharmacy services. Additional training, clear job descriptions, and direct pharmacist supervision could ensure the quality and safety of these services.

488-P: Diabetes-Related Major and Minor Amputation Risk Increased during the COVID-Pandemic

Background: Along with significant case transmission, hospitalizations, and mortality experienced during the global COVID-pandemic, there existed a disruption in the delivery of health care across multiple specialties. Objective: The aim of our review was to analyse the possible relationship between COVID-infection and amputations. Methods We conducted a 2-year retrospective cohort study with prospective long-term follow-up of all diabetic patients admitted for a foot lesion at 353-bed, nonprofit, faith-based teaching hospital. Study variables included patient demographics and clinical parameters related to infection and diabetes. The average follow-up after hospital discharge was 2 years. Failure of conservative treatment was the main outcome measure. Independent predictor variables were selected by logistic regression analysis. Results: A total of 849 consults were identified for use in the study, 356 consults for 20 and 493 consults for 2021. We excluded trauma/noninfectious consults. This represents a 38% increase in the number of podiatric consults over the time frame. On average, 42% of consults required podiatric surgical intervention for management/prevention of infection in 2021 compared to 44% in 2019. Amputation rates have fallen from 37.08% to 32.45% from 20to 2021. Rates of minor amputations decreased from 22.75% to 19.07%, rates of moderate amputations decreased from 5.06% to 4.87%, rates of major amputations decreased from 9.27% to 8.52% from 20to 2021, respectively. Conclusion: The effect of the pandemic on the health-care system has had a deleterious effect on people with diabetes-related foot problems resulting in more severe infections, more emergencies, and necessitating more amputations. Disclosure J.Banks: None.

Factors associated with hospital length of stay in patients admitted with suspected malaria in Kenya: secondary analysis of a cross-sectional survey

ObjectivesTo investigate factors associated with hospital length of stay (LOS) in patients admitted with suspected malaria using a competing risk approach.SettingCounty government referrals and major faith-based hospitals in Kenya in...

Job Satisfaction and Turnover Intentions in Faith-Based Hospitals in Uganda: The Mediation Role of Organizational Commitment

This paper examines job satisfaction, organizational commitment and turnover intentions among health workers in faith-based hospitals in Uganda. The study surveyed 125 nurses from three catholic faith-based hospitals. Hierarchical regression analysis confirmed that job satisfaction has a negative effect on turnover intentions, while affective and normative commitments partially mediate the relationship between job satisfaction and turnover intentions. Female gender, and organizational tenure— 3-9 years, each negatively contributes to turnover intentions, while Registered Comprehensive Nursing positively predicts turnover intentions. The importance of job satisfaction, emotional attachment, and a sense of obligation is emphasised, but the ambiguity and thus negative effect of Registered Comprehensive Nursing is noted.

Direct patient costs of maternal care and birth-related complications at faith-based hospitals in Madagascar: a secondary analysis of programme data using patient invoices

ObjectivesWe aimed to determine the rate of catastrophic health expenditure incurred by women using maternal healthcare services at faith-based hospitals in Madagascar.DesignThis was a secondary analysis of programmatic data obtained...

The Role of Organizational Culture in Moderating Corporate Governance Practice Influence on Faith-Based Hospitals Performance in Kenya

The Role of Organizational Culture in Moderating Corporate Governance Practice Influence on Faith-Based Hospitals Performance in Kenya

Influence of Competencies, Resources, and Competitive Orientation on the Performance of Faith-Based Hospitals in Kenya

Influence of Competencies, Resources, and Competitive Orientation on the Performance of Faith-Based Hospitals in Kenya

Cross-sectional study to predict subnational levels of health workers’ knowledge about severe malaria treatment in Kenya

ObjectivesThis study applied a Bayesian hierarchical ecological spatial model beyond predictor analysis to test for the best fitting spatial effects model to predict subnational levels of health workers’ knowledge of...

Influence of Corporate Governance Practices on Performance of Faith-Based Hospitals: A Systematic Review

Influence of Corporate Governance Practices on Performance of Faith-Based Hospitals: A Systematic Review

Delays to essential surgery at four faith based hospitals in rural Sub-Saharan Africa.

Data regarding delays for emergency surgery in Sub-Saharan Africa is limited. We have therefore decided to undertake an evaluation of delays in patients seeking care, reaching care and receiving care for emergency surgery at four rural faith-based hospitals in this region over a 3 month period. This is a cross-sectional, multi-center, international study at four rural faith-based hospitals in Madagascar, Gabon, Cameroon and Burundi. All patients presenting at these hospitals between 10 February and 1 May 2020 for one of the three Bellwether procedures (caesarean delivery, emergency laparotomy, management of open fracture) were to be enrolled in this study. Data was collected in the form of a questionnaire administered to the patient or the patient's caregiver within 24 h of admission to the hospital. After analysis of data for 148 patients, we found that the median [quartiles] delay in seeking care overall was 3.5 [0.5, 17.6] h, in reaching care 7.6 [2.3, 33.6] h and in receiving care 3.6 [1.7, 6.8] h. In 72% (107/148) of cases, the second delay was more than 2h. Sixty-five percent of patients who were delayed reported that their delay was because care was sought elsewhere before arrival at one of our Bellwether-capable sites. Our results suggest that the majority of patients needing emergency surgical care in the rural areas of Sub-Saharan Africa where our study was conducted are frequently delayed, with the largest delay being in reaching care. Further investigations into the reasons for these delays should be conducted.

Does disrespect and abuse during childbirth differ between public and private hospitals in Southeast Nigeria

BackgroundDisrespect and Abuse (D&A) during childbirth represents an important barrier to skilled birth utilization, indicating a problem with quality of care and a violation of women‘s human rights. This study compared prevalence of D&A during childbirth in a public and a private hospital in Southeast Nigeria.MethodsThis study was a cross-sectional study among women who gave birth in two specialized health facilities: a public teaching and a private-for-profit faith-based hospital in Southeast Nigeria. In each facility, systematic random sampling was used to select 310 mothers who had given birth in the facility and were between 0-14 weeks after birth. Study participants were recruited through the immunization clinics. Semi-structured, interviewer-administered questionnaires using the Bowser and Hills classification of D&A during childbirth were used for data collection. Data were analyzed using SPSS version 20 at 95% significance level.ResultsMean age of the participants in the public hospital was 30.41 ± 4.4 and 29.31 ± 4.4 in the private hospital. Over three-fifths (191; 61.6%) in the public and 156 women (50.3%) in the private hospital had experienced at least one form of D&A during childbirth [cOR1.58; 95% CI 1.15, 2.18]. Abandonment and neglect [Public153 (49.4%) vs. Private: 91 (29.4%); cOR2.35; 95% CI. 1.69, 3.26] and non-consented care [Public 45 (14.5%) vs. Private 67(21.6%): cOR0.62; 95% CI. 0.41, 0.93] were the major types of D&A during childbirth. Denial of companionship was the most reported subtype of D&A during childbirth in both facilities [Public 135 (43.5%) vs. Private66 (21.3%); cOR2.85; 95% CI. 2.00, 4.06]. Rural residents were less likely to report at least one form of D&A during childbirth (aOR 0.53; CI 0.35-0.79).ConclusionAlthough prevalence was high in both facilities, overall prevalence of D&A during childbirth and most subtypes were higher in the public health facility. There is a need to identify contextual factors enabling D&A during childbirth in public and private health care settings.

Organizational Leadership and Quality Service Delivery in Faith Based Hospitals in Kiambu County, Kenya

Organizations operates in a fairly dynamic macro and micro business environment having a lot of unpredictability and in many ways marred with pressure for competition making them adopt and institute changes to gain competitive advantage. Quality service delivery is a vital element and a crucial objective and goal for every organization. The reason is that, it is solely through quality service delivery that a firm is has the ability to tell whether there is any progress and growth. This study sought to assess the relationship between organizational leadership and quality service delivery in Faith-Based Hospitals in Kiambu County. The study was anchored on three-step change theory and employed descriptive research design. The researcher targeted senior, middle and lower-level managers at the Faith-Based Hospitals and the respondents filled the questionnaire as the research instrument. The collected data was entered into SPSS version 25.0 where descriptive analysis and regression analysis was conducted. The study established that organizational leadership had moderate effect to quality of service delivery basing it on the R values. The adjusted coefficient of determination was at 0.628, meaning that 62.8% of quality service delivery was as a result of organizational leadership. The study concluded that organizational leadership with elements such as voting on areas of disagreements, getting input and suggestions from staff, leadership style and leaders that nurture and mentor juniors led to improvement in the quality of services delivery. Thus, the study recommends that for organizations to improve quality of service delivery they should look towards the leadership of the firm

Referral patterns at a regional faith-based hospital in Western Kenya

Aim: To assess the pattern and quality of patient referral at a regional faith-based hospital in Western Kenya. Methods: A prospective non-randomized study of patients referred into and out of Litein hospital from 1st June through 31st December 2016. Results: A total of 4,683 patients were admitted during the study period, with 147 `received referral' cases and 106 `sent referral' cases noted, with a referral rate of 3.1%. The majority of the received referrals were formal in nature (76%), initiated by doctors or clinical officers (74%), and had patient/relative input regarding the hospital to refer to (70%). The referral notes were mostly structured (90%) and legible (83%). Advice from the health care professional in the referring facility (36%, n=53), perceived good quality of care (21%, n=31), and presence of a valid insurance cover (8%, n=12) were the main reasons indicated by the patients for choosing our facility. The “sent referrals” were mainly due to need for specialized care (89%) or for proximity to family members/home (6%, n=6). Only 9% of the patients/relatives indicated that there was a significant delay in the initiation and execution of their referral from AIC Litein hospital. The referrals were initiated, predominantly, from the surgical departments (62%, n=66). Conclusion: The referrals to Litein Hospital, while comprising a minority of the patients admitted, were predominantly formal in nature, mostly initiated by medical personnel with the family members involved in decision making regarding the facility to be referred to.

Coping with COVID: Developing a Rapid-cycle Frontline Quality-improvement Process to Support Employee Well-being and Drive Institutional Responsiveness in a Tertiary Care Faith-based Hospital in Rural Kenya.

ABSTRACT.The coronavirus disease 2019 (COVID-19) pandemic has demanded rapid institutional responses to meet the needs of patients and employees in the face of a serious new disease. To support the well-being of frontline staff, a series of debriefing sessions was used to drive a rapid-cycle quality-improvement process. The goals were to confidentially determine personal coping strategies used by staff, provide an opportunity for staff cross-learning, identify what staff needed most, and provide a real-time feedback loop for decision-makers to create rapid changes to support staff safety and coping. Data were collected via sticky notes on flip charts to protect confidentiality. Management reviewed the data daily. Institutional responses to problems identified during debrief sessions were tracked, visualized, addressed, and shared with staff. More than 10% of staff participated over a 2-week period. Feedback influenced institutional decisions to improve staff schedules, transportation, and COVID-19 training.

Dedication in a Difficult Context: Faith-Based Nursing in Haiti.

Haitian nurses live in a precarious environment, with healthcare disparity and low wages. In the presence of significant politico-social-economic disparities, adverse effects of natural disasters, deleterious infrastructure, challenged self-boundaries, and the burden of caring for high-need patients, the authors sought a better understanding of nurses' perspective of the situation. During qualitative interviews, Haitian nurses in two faith-based hospitals (N = 17) reported feeling powerless yet exhibited resilience and dedication to nursing as a calling. These conditions cry out for support of nurses' self-care needs. Future interventions may help nurses identify better resources to care for themselves and guide their practice.

Quality of Caesarean Sections in Rural Sub-Saharan Africa: A Prospective Study in Cameroon

Introduction: Caesarean section (CS) is a major reproductive health intervention to improve maternal and foetal outcomes if appropriately performed. This study aimed to assess the quality of Caesarean sections (CS) in a rural setting in Cameroon. Materials and Methods: A prospective study conducted in 3 hospitals from February 1st 2020 to April 30th 2020. One hundred and twenty women who had a CS were included. Data were grouped into 5 categories: 1) Sociodemographic and obstetrical characteristics, 2) Geographic and financial access, 3) Diagnostic procedures, 4) Operative parameters and 5) Post-operative parameters. The Dujardin’s model and context-relevant criteria served to construct the quality score. The scale was 0 - 20 and scores ≤ 15 were considered as unacceptable quality while those >15 were considered as acceptable quality CS. Logistic regressions permitted to measure associations. Results: There were 538 deliveries and 120 (22.3%) CS. The mean (SD) gestational age was 38.7 (2.6) weeks with extremes of 31 and 43 weeks. Group 5 of the Robson’s classification was predominant (35.0%). Motorbikes were the mode of transport to the maternity for 72.5% (87/120) of women. No referral was made by ambulance. Only 44 (36.7%) women had paid the full cost of the CS prior to surgery. In addition, 26 (21.6%) women had a complete clinical examination on admission. The surgical team was not complete ( Sixty six of the 120 (55.3%) caesarean sections had unacceptable quality CS. Mean (SD) QS was significantly higher in faith-based hospitals than in public hospitals (18.00 (0.91) versus 15.59 (1.24); P 0.001). Immediate postoperative clinical monitoring was effective only in 66 (55%) of cases. Apgar score was below 7 over 10 in 17 (14.2%) cases of which 6 freshes still births. No maternal death was recorded and maternal complications were recorded in 14 (11.7%) cases. Conclusion: The quality of CS is generally poor in rural settings in West-Cameroon. The quantity and quality of staffs required for Caesarean sections in the hospitals are sometimes insufficient. The poor quality of CS in this region could be addressed using the faith-based hospitals: St Vincent de Paul’s Hospital as a model.

An assessment of hospital maternal health services in northern Ghana: a cross-sectional survey

BackgroundAccess to and delivery of comprehensive emergency obstetric and neonatal care (CEmONC) services are often weak in low and middle-income countries affecting maternal and infant health outcomes. There are no studies on resources for maternal healthcare in the Northern region of Ghana. This knowledge is vital for health service planning and mobilising funding to address identified gaps. We investigated the available resources for managing CEmONC and referral services in the region.MethodsThis study involved a cross-sectional survey of maternity facilities in ten hospitals in the Northern region of Ghana, serving a population of 2,479,461, including 582,897 women aged 15–49. Public and faith-based hospitals were included in the study. We used the Service Provision Assessment tool to gather data for this study between October and December 2019. Given the small sample size, we used descriptive statistics to summarise the data using SPSS version 25 and Excel 2016.ResultsA total of 22,271 ANC visits from women to these hospitals occurred in the past 3 months preceding the study; however, 6072 birth events (cases) occurred within the same period. All the hospitals had less than one general medical doctor per 10,000 population (range 0.02–0.30). The number of midwives per 10,000 population ranged from 0.00 (facility H and J) to 1.87 (facility E), and none of the hospitals had a university-trained nurse designated for maternity care. Only one hospital had complete equipment for emergency obstetric and newborn care, while four others had adequate emergency obstetric care equipment. The number of maternity and delivery beds per 10,000 population was low, ranging from 0.40 to 2.13.ConclusionsThe management of emergency obstetric care and referrals are likely to be affected by the limited human resources and equipment in hospitals in Northern Ghana. Financial and non-financial incentives to entice midwives, obstetricians and medical officers to the Northern region should be implemented. Resources should be mobilised to improve the availability of essential equipment such as vacuum extractors and reliable ambulances to enhance referral services. Considerable health system strengthening efforts are required to achieve the required standards.

Sanctification of work and hospital nurse employment outcomes: An observational study.

AimTo explore nurse ascriptions of sacredness to work and measure its association with the employment outcomes of job satisfaction, burnout, organisational commitment, employee engagement and turnover intention.BackgroundHigh portions of hospital nurses experience burnout. Many factors contributing to burnout also contribute to job dissatisfaction and other negative employment outcomes. Personal factors, such as religiosity, help nurses to cope with work.MethodsQuestionnaires measuring study variables were distributed to all nursing personnel at a faith‐based hospital in Los Angeles; 463 responded. Regression analyses allowed measurement of how sacredness ascribed to work (measured by Sanctification of Work Scale) and religiosity (measured by Duke Religiosity Index) were associated with the various employment outcomes.ResultsSanctification of work consistently was found to be associated with less burnout and intention to leave, and more job satisfaction, employee engagement and organisational commitment.ConclusionThe sacredness with which a nurse views work explains, in part, positive employment outcomes.Implications for Nursing ManagementNurturing a sense of sacredness for work in nurses may provide them with an internal buffer against negative employment outcomes. Suggestions for creating rituals and educating nurses are offered.