Frontline Of Healthcare Delivery Research Articles

Literacy-related factors and knowledge of patient rights charter: evidence from nurses in selected hospitals in Ghana.

Systems of across the world have developed and implemented patient rights policies to protect and improve the provider-patient relationship. The Patient Charter of Ghana was developed in 2002 to improve service quality and protect patients' rights. However, it is not yet known whether those at the frontline of healthcare delivery can read and understand the contents of the charter. While studies have explored the socioeconomic and institutional level factors related to awareness and knowledge of the Patient Rights Charter, there is a lack of literature on its readability and comprehensibility among nurses. This study assesses nurses' knowledge of the Patient Rights Charter and associated literacy-related factors. An exploratory cross-sectional design and quantitative methods were used to collect data on knowledge, comprehension, and readability of the Patient Rights Charter. 205 nurses from four district hospitals in the Central Region were recruited using proportional and total enumeration sampling. Data were collected using structured questionnaires and were processed using SPSS (version 26) and an online text readability consensus calculator (version 2.0). Descriptive and inferential statistical analyses were performed, and data were presented using simple frequencies, readability statistics, and regression output. The results show the charter is written at a higher reading grade level; Flesch-Kincaid Grade Level (13.36), Simple Measure of Gobbledygook (11.57), and Coleman-Liau Readability Index (14.2). The average reading grade level score was 14. The Gunning Fox Index (15.40) and the Flesch Reading Ease Score (34%) show the patient charter is difficult to read and will require at least 14 years of education to be able to read. 87.3% of nurses were able to read and comprehend the charter. Very few (8.3%) read at frustration level. Nurses' actual comprehension of the charter was the only significant predictor of knowledge of the charter. Comprehension of the patient charter is an important predictor of its knowledge. The results emphasize the need to enhance the readability and comprehensibility of the charter for providers. Hospitals can stimulate nurses' knowledge of the charter by simplifying the charter's language and deliberately educating nurses on its content.

Self-reported knowledge, attitudes, practices and barriers in use of evidence-based medicine among resident physicians in Kenya: a mixed methods study

BackgroundEvidence based medicine (EBM) helps clinicians to integrate latest research evidence into their daily clinical practice. There is a need for all healthcare professions to adopt it in order to provide safe and most cost-effective care. Postgraduate doctors are at the frontline of healthcare delivery and all medical institutions should strive to produce practitioners of EBM. Studies have shown that physicians are still struggling to adapt to this paradigm shift in the practice of medicine but very few studies have been done in Sub Saharan Africa. This study explored the self-reported knowledge, attitudes, practices and barriers of evidence-based practice among resident physicians in a tertiary teaching hospital.MethodsA mixed methods cross-sectional study that used convergent parallel design was conducted. The quantitative arm was conducted among all residents enrolled in the Master of Medicine programme at Aga Khan University Hospital Nairobi (AKUHN). It included an online survey exploring self-reported knowledge, attitudes, practices and barriers of EBM among all residents. Simultaneously, semi-structured In-Depth Interviews were carried out among 18 purposefully selected residents in order to explore the same themes in more depth.ResultsOne hundred and one residents (99%) responded to the survey. The mean scores for self-reported knowledge, attitude and practice of EBM among residents were 73.88, 66.96 and 63.19% respectively, which were generally higher than in comparable studies. There was a significant association between year of residency and practice of EBM. The most common barriers faced by residents were lack of time, lack of EBM skills and patients’ unawareness about EBM.From the qualitative study, residents demonstrated good knowledge and support of EBM but practice remained relatively poor. Barriers to EBM were characterized by lack of motivation, time, skills and resources, patient overload and fear of challenging consultants.ConclusionThere was good understanding and support of EBM among residents at AKUHN, though challenges were experienced in regards to practice of EBM because of lack of time and skills. Therefore resources should be allocated towards integrating EBM into undergraduate medical curricula to cultivate critical thinking skills at an early stage before transition into residency.

Patient safety education for undergraduate nursing students: a scoping review protocol.

The objective of the review is to examine the literature on patient safety and the teaching and learning strategies required to help students learn about patient safety in undergraduate nursing curricula in prelicensure nursing education programs. Patient safety is a global concern, and health care professionals, including nurses who are on the frontline of health care delivery, should be equipped with the knowledge to enhance patient safety. Undergraduate nursing curricula should include the relevant patient safety content and supply nurse educators with teaching and learning strategies to help students acquire these skills. Based on the Participants, Concept, and Context (PCC) framework, the eligible population will include nursing students who are enrolled in undergraduate nursing programs and nurse educators who teach in undergraduate nursing programs. The concept of interest is patient safety education, namely, the curricular content and teaching and learning strategies used to help nursing students learn the content. The context is prelicensure nursing education programs at college or university level. Eligible studies will include, but not be limited to, quantitative studies, observational, qualitative, and mixed-methods studies, systematic reviews, and opinion papers. Online databases will be searched across MEDLINE, CINAHL, and Web of Science. JBI methodology for scoping reviews will be used to conduct the review. Pre-determined inclusion and exclusion criteria will be used to select relevant studies. Data will be extracted and synthesized from studies that describe patient safety content and teaching and learning strategies in prelicensure nursing education.

Paramedic use of PPE and testing during the COVID-19 pandemic

COVID-19 is the disease caused by the SARS-CoV-2 virus. Paramedics are at the frontline of healthcare delivery, including during the SARS-CoV-2 pandemic. The virus poses specific problems for paramedics. These involve treating and transporting infected patients, as well as considerations around decontamination and disinfection of ambulances and medical equipment. All respiratory infections should be considered COVID-19 until proven otherwise so paramedics should wear personal protective equipment (PPE). PPE consists of gloves, gowns, aprons, surgical face masks, protective eyewear and face shields. Paramedics should receive training and guidance on PPE so they can select and use it properly. The type and level of PPE used will depend on the level of protection required, and risk should be assessed. Widespread testing will give a clearer picture of the incidence and distribution of the virus.

Paramedics and pneumonia associated with COVID-19

Paramedics are at the frontline of healthcare delivery and this includes during the current coronavirus pandemic. This pandemic poses specific problems for paramedics, which include not only treating and transporting infected patients, but also issues around decontamination and disinfection of ambulances and medical equipment. Of particular concern is the pneumonia associated with the 2019 novel coronavirus. Data on COVID-19 pneumonia are developing. Ongoing research demonstrates that almost all serious consequences of COVID-19 feature pneumonia, especially in older people and those with comorbidities. Paramedics can have a profound effect on the care of patients with pneumonia. Effective management of COVID-19 pneumonia by the paramedic should centre around prompt recognition, early administration of oxygen and intravenous fluids and transfer to hospital. In some situations, paramedics may need to be involved in the delivery and maintenance of airway adjuncts in patients with COVID-19 pneumonia.

Personal protective equipment and testing during the COVID-19 pandemic

COVID-19 is caused by the severe acute respiratory syndrom coronavirus 2 (SARS-CoV-2) virus. The virus poses specific problems for cardiac nurses, with nurses being at the frontline of healthcare delivery. These issues not only involve treating and caring for cardiac patients with the virus, but also include the need to continue routine cardiac interventions during the pandemic. Many cardiac interventions are invasive, requiring close patient contact. As such, these interventions pose significant infection risks. To mitigate against these risks, cardiac nurses should follow established infection control guidelines and wear personal protective equipment where appropriate. Ongoing research is also demonstrating the usefulness of COVID-19 testing, the results of which will aid in the detection of the virus and enable any self-isolating nurses to return to work, where appropriate.

Distinguishing the novel coronavirus from influenza

Distinguishing the novel coronavirus from influenza

Enhancing primary care services for diverse sexual and gender minority populations: a developmental study protocol

IntroductionCompared with heterosexual, cisgender populations, sexual and gender minority (SGM) people are more likely to suffer from serious health conditions and insufficient access to health services. Primary care is at...

Impact of the quality of management on the general improvement of the healthcare system.

Health professionals are on the front lines of healthcare delivery, due to the current shortage, and ageing of medical staff, their recruitment and retention are crucial challenges for health policy-makers and managers. To get the opinions of decision-makers and practitioners concerning importance of the quality of management to improve the healthcare system we conducted interviews with selected stakeholders. According to our respondents, the main challenge for the Polish healthcare system is an employment of an adequate number of medical staff. Adequate funding and proper fund allocation are indispensable. Respondents stressed that only properly trained and highly skilled managers are able to meet the current challenges of the healthcare system.

Supporting colleagues to improve care: educating for quality improvement

Clinicians at the front line of healthcare delivery are very well positioned to identify and improve the system in which they work. Training curricula, however, have not always equipped them...

Perinatal mortality in Indonesia: an unfinished agenda

Perinatal mortality is a profound issue in maternal and child health due to its close relation with the maternal condition. There exist Millennium Development Goals (MDGs) which are to be achieved by 2015. These are coupled with a continuing need for comprehensively monitoring and identifying factors associated with perinatal mortality, which is a primary concern for developing countries inclusive of Indonesia. Previous and on-going health programs could have brought about strategic interventions but as different attributes can emerge due to epidemiological transition, and given the fact that associated factors may remain persistent, forward thinking strategies in public health are forever in need of renewal. Results from our research show that educational variables, poor awareness towards proper antenatal care visits and weak services at the front-line of healthcare delivery (community outreach) worsen the condition of childbearing women, raising the question of biological risk factors in line with socio-economic variables.

Nurses Create a Culture of Patient Safety: It Takes More Than Projects

Healthcare organizations are embracing the sciences of safety, improvement, human factors, and complexity to transform their culture into a culture of safety and high reliability. Nurses are the front lines of healthcare delivery, and as such, the front lines of safety and quality processes and outcomes. Nurses are required to both understand and develop the skills needed to improve care processes and to own the work of improvement as a professional responsibility. These changes demand that nurses understand both the complex demands of providing harm-free care and the system dynamics needed to create the conditions for improved outcomes, organizational, and system performance, and intraprofessional development and teamwork. The author presents the challenge of maintaining a safe patient care environment and describes a model that can detect and mitigate the migration of safe nursing care into at-risk and unsafe nursing care. She emphasizes the importance of healthcare organizations performing as high reliability organizations and outlines 'planned practices' steps to introduce new technology and innovation, and concludes by considering the interaction between individual practice and system performance.

Leading Change for Sustainability

Nurse leaders are key drivers for the creation of quality work environments and quality patient care outcomes at the frontline of healthcare delivery. Their charge has been to provide leadership to assure quality nursing care, and ensure the satisfaction of their patients, families, staff, physicians, and hospital executives at each and every clinical care site. In this era of transparency and with the onset of accountable care organizations, the charge is now broader—outcomes must be sustained.

Empowering the frontline of healthcare delivery

The pledge to empower clinicians, particularly those at the frontline of healthcare delivery, remains an enduring feature of successive waves of healthcare policy reform since the Labour landslide of 1997. The current Conservative/Liberal coalition proposals for health care reform are no different and indeed are more radically ‘empowering’ in ambition and scope. This article looks at empowerment through the lenses of organisational culture and human resources management in an attempt to understand why empowerment as a strategic objective remains difficult to deliver at the frontline.

Delivering Health Care Through Community Pharmacies: Are Working Conditions Deterring Female Pharmacists’ Participation?

Recent UK government policy has placed community pharmacists at the frontline of health care delivery in order to improve patient access. Community pharmacy has been beset by recruitment and retention problems which potentially threaten health service delivery. This is largely a consequence of an increased demand for pharmacists. Additionally, the proportion of female pharmacists in the profession has risen. Consequently, interrupted career patterns and part-time working practices have increased, shrinking the pool of available workers. This study aimed to examine the importance of factors influencing female community pharmacists' work patterns. Q methodology was used in a sample of 40 female UK-based community pharmacists. Nine distinct factors emerged from a factor analysis of Q sorts: fulfilled pharmacists; family first or pharmacy shelved; low stress altruist; permanent part-time employees; focused on free time and finances; pressurized modernizers; wandering wage slaves; overloaded and under resourced for the new contract; and pin money part-timers. Female community pharmacists often worked below their potential and part-time at a practitioner level in response to a combination of domestic commitments and intensifying work place pressures. Family-friendly flexible work environments, adequate staffing levels and improved management support, might be more effective in increasing workforce participation than enhanced salary levels in this group of workers.

The Genetic Information Nondiscrimination Act (GINA): What it Means for Your Patients and Families

Human genome research is creating new opportunities for a more individualized approach to the screening, diagnosis, and treatment of rare and common diseases. Concerns about insurance discrimination, however, have led many people who could benefit from genetic testing to choose not to have it. Other individuals have chosen to pay for genetic testing on their own. In May 2008, the Genetic Information Nondiscrimination Act, known as GINA, was signed into law. GINA is a federal law that protects United States citizens from health insurance and employment discrimination based on their genetic information. Nurses, who are on the frontlines of healthcare delivery, need to become familiar with the scope and limitations of GINA. This article describes the need for GINA, the scope and limitations of this law, and health provider resources relating to this law. Case studies that illustrate typical situations nurses and their clients may face with regard to genetic and genomic information are provided. Activities that nurses can carry out in their own institutions to facilitate GINA compliance are outlined.

On the case

In this new era of patient safety, the case manager, as an advocate and facilitator of care, has a pivotal role on the front line of healthcare delivery.

Case Managers Optimize Patient Safety by Facilitating Effective Care Transitions

In this new era of patient safety, the case manager, as an advocate and facilitator of care, has a pivotal role on the front line of healthcare delivery. Effective communication and collaboration between disciplines is key to the promotion of patient safety, and ultimately the avoidance of life-threatening medical errors. Across the healthcare continuum and within hospitals in particular, patients are routinely transferred from one service to another, from one level of care to another, or from one provider to another. As patients are stabilized and transitioned through the hospital system, there are multiple hand-offs of care or care transitions that can often expose the patient to fragmented service and increase the risk of communication breakdown. Ineffective hand-offs can result in a disruption of continuity between one level of care and the next. In a culture that places a strong emphasis on patient safety, case managers can facilitate opportunities that ease care transitions whereby a change in venue is no longer perceived as a disruption in the flow of care but rather is viewed as a coordinated changeover where cautious and comprehensive communication sets the tone for the continued delivery of safe and effective healthcare.