Hospital In Gauteng Research Articles

Range of movement, power and pinch grip strength post flexor tendon repair

Background: Flexor tendon injuries (FTI) are common hand injuries that pose a challenge to the multi-disciplinary team. Despite being the most researched topic in hand literature, the optimal surgical and post-operative treatment of FTI remains unclear and results after flexor tendon repair (FTR) continue to be unpredictable.Purpose: The purpose of this study was to determine the range of movement (ROM), power and pinch grip strength post FTR and to establish factors that may affect these.Method: The study was conducted at an academic hospital in Gauteng, South Africa, between January 2013 and September 2015. At one, three and six months post FTR, the ROM of the injured and contralateral finger(s) were measured. At three and six months post FTR the participants’ bilateral power and pinch grip strength were also measured.Results: One hundred and twenty-six participants (n=126) enrolled in the study. There was a drop-out rate of 48%, leaving 65 participants that completed six months’ follow-up: 41 males (63%) and 24 females (37%) with mean age of 32 years (SD±10, n=65). Out of 65 participants, 2% (n=1) had an excellent outcome, 32% (n=21) a good outcome, 32% (n=21) a fair outcome and 34% (n=22) a poor outcome with regard to ROM. At six months post FTR the average power grip was 60% (SD±25, n=65) of the unaffected hand, while the average pinch grip was 52% (SD±42, n=65) of the unaffected hand. Sixty-eight per cent (n=44) of patients had post-operative complications: the most common complication was tenodesis/adhesions (25%, n=16), followed by contracture (22%, n=14). Four patients (6%) had ruptures and 11 (17%) underwent further surgery. Factors that had a positive effect on outcome at six months post FTR were: younger age, no associated injury, less duration between injury and surgery, having controlled active motion instead of passive motion occupational therapy protocol, and not having a language barrier. Injury in zone IV was associated with worse ROM and power grip strength than other zones.Conclusion: Although there were some promising outcomes, during this period participants did not consistently achieve the good or excellent outcomes that are achieved in some developed countries.Level of evidence: Level 4

Suture material use and procurement: an audit of a public hospital surgical system in Gauteng, South Africa

Surgical systems are integral to successful, safe and cost effective clinical practice and must balance surgical demands on consumable items and their costs. Suture material is a key consumable resource, and was evaluated in an audit of consumable use and cost as well as the procurement systems within the South African Gauteng public health care sector. To determine suture use and cost in the four commonest general surgical procedures - abdominal wall closure, mastectomy, appendicectomy and inguinal hernia repair - in three academic Gauteng hospitals. Performance and availability were evaluated as a secondary aim in suture material use. A prospective observational study. Suture use was documented by the surgeon at the time of the procedure and qualitative investigation at relevant hospital departments determined suture material procurement and expenditure. The surgeons in three facilities documented consistent material type and average number of units used; however, in some cases there was a lack of availability of appropriate material and breakage of generic material intraoperatively. There is no consistent and consolidated electronic record-keeping of suture stock and cost in all three hospitals, therefore cost of suture material used was not obtainable. Clinical deficiencies in availability and quality of material may have adverse implications for patient health, healthcare costs and budgets through procedure-related complications and should be investigated. There is a lack of communication between the financial management, procurement officers, hospital and theatre stores and theatre staff. It is suggested that clinical protocols and system-based strategies be put in place to manage surgical consumables.

Nurses experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng South Africa

Background: Staffing patterns refers to the number and types or categories of staff assigned to the particular wards in a hospital. Staffing patterns that accommodate imbalanced patient to nurse ratios can affect nursing staff negatively. The negative experiences increased emotional stress, physical exhaustion, high nurse turnover and consequences of poor patient outcomes. The high patient to nurse ratios and the profitability factor of private hospitals virtually dictates the type of staffing patterns that are used in these wards. As such, the current staffing patterns appear to require nursing staff to work longer shifts as well as overtime work without a choice, the consequences of which are the effects highlighted above.Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards.Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study.Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns.Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively.

Nurses experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng South Africa

BackgroundStaffing patterns refers to the number and types or categories of staff assigned to the particular wards in a hospital. Staffing patterns that accommodate imbalanced patient to nurse ratios can affect nursing staff negatively. The negative experiences increased emotional stress, physical exhaustion, high nurse turnover and consequences of poor patient outcomes. The high patient to nurse ratios and the profitability factor of private hospitals virtually dictates the type of staffing patterns that are used in these wards. As such, the current staffing patterns appear to require nursing staff to work longer shifts as well as overtime work without a choice, the consequences of which are the effects highlighted above. PurposeThe purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards. MethodologyA qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study. ResultsThe findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns. ConclusionIt is evident from the findings of the study that nurses are experiencing staffing patterns negatively.

Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals.

IntroductionHospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa.MethodsWe used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA.ResultsOf the 9971 patients with positive blood cultures, 7.7% (772) had S. aureus bacteraemia (SAB). The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%– 34.3%). HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%– 31.7%). Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7–34.4), age ≤1 month (aOR 8.7; 95% CI 3.0–24.6), residency at a long-term care facility (aOR 5.2; 95% CI, 1.5–17.4), antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8–9.1), hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3–5.6) and mechanical ventilation (aOR 2.2; 95% CI 1.07–4.6), were independent risk factors for HA-MRSA infection.ConclusionThe prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients.

Experiences of registered nurses caring for patients with an open abdomen in an intensive care unit in Gauteng

The researcher observed that nurses prefer not to nurse patients with an open abdomen as they fear that the abdominal contents will protrude. The purpose of the study was to explore and describe the experiences of registered nurses taking care of patients with an open abdomen in intensive care in an academic hospital in Gauteng, and to provide recommendations for registered nurses when taking care of patients with an open abdomen. The research design used was a qualitative, exploratory, descriptive and contextual design. Focus group interviews were conducted with each group comprising six participants. The research question was: What are the experiences of registered nurses caring for patients with an open abdomen in an intensive care unit? What recommendations can be made to assist registered nurses in taking care of patients with an open abdomen in an intensive care unit? The data was analysed using Tesch's method. Three themes emerged: Difficulty in nursing care, complications such as fistula and infections, and poor hospital administration. Recommendations for assisting registered nurses in taking care of patients with an open abdomen were then made based on the findings of the four focus group interviews. Ethical principles and measures of trustworthiness were adhered to throughout the research study.

Identifying medication errors in the neonatal intensive care unit and paediatric wards using a medication error checklist at a tertiary academic hospital in Gauteng, South Africa

Background. Paediatric patients are particularly prone to medication errors as they are classified as the most fragile population in a hospital setting. Paediatric medication errors in the South African healthcare setting are comparatively understudied. Objectives. To determine the incidence of medication errors in neonatal and paediatric inpatients, investigate the origin of medication errors that occurred and describe and categorise the types of medication errors made in both the neonatal intensive care unit (NICU) and paediatric wards. Methods. The study followed a prospective, quantitative design with a descriptive approach. A prospective record review of inpatients’ medication charts was undertaken to determine what was prescribed by the physician, dispensed by the pharmacy and administered by the nurses. The researcher also directly observed the preparation and administration techniques as performed by the nurses. A medication error checklist was used to collect the data. Results. A total of 663 medication errors were detected in 227 patients over the study period of 16 weeks, of which 177 (78%) patients had one or more error(s). There were 338 (51%) administration errors and 309 (47%) prescribing errors. Incorrect dosing was the most frequent type of error (34%), followed by omission of medication (18.5%) and medication given at the incorrect time (12%). The causes of these medication errors were mostly due to miscalculation (26%), failure to monitor (15%) and procedures not followed (15%). Anti-infectives (43%) and analgesics (25%) had the most errors. In 118 (67%) patients the errors resulted in no harm to the patient, whereas in 59 (33%) patients the medication error resulted in some level of harm. Conclusion. The incidence of medication errors in the NICU and paediatric wards at the teaching hospital was higher than values reported elsewhere globally. Most errors occur during prescribing and administration of medication. Dosing errors are a common problem in paediatrics. Therefore, a formalised system to record these errors should be introduced alongside regular discussions on preventive measures among the multidisciplinary team.

The Influence of Socio-Cultural Beliefs in Chris Hani Baragwanath Academic Hospital (Chbah): A Social Work Perspective

Background: Socio-cultural beliefs play a significant role in healthcare as they influence perceptions of health and illness for both the client and the healthcare provider. These beliefs may influence the need to use a variety of health care providers. By understanding the belief system of patients, clinical social workers can effectively meet the needs of the hospital patients. The aim of this paper was to explore the role of patients’ socio-cultural beliefs in a healthcare setting. Methodology: By means of an exploratory investigation with 24 patients at an academic hospital in Gauteng, this paper identifies some beliefs that patients bring with them into the healthcare institution. Herskovits in-depth relativist approach was used to analyze the data. This paper examines how beliefs contradict, enhance or complement clients’ experiences of health care within a hospital setting. The results illustrate that African traditional and cultural beliefs were reported to be affordable and enable people to connect with their ancestral spirits. Close relatives and traditional healers played an important role during illness and recovery. It is recommended that social workers should always engage with patients and other members of multi-disciplinary team for a holistic patient care approach. Social workers should communicate to holistically understand their patients.

Experiences of women receiving high dose rate brachytherapy for cervical cancer at an academic hospital

The objective of this study was to present a descriptive summary of the experiences of women treated with high dose rate brachytherapy for cervical cancer. A qualitative descriptive design was used and 16 women treated at an academic hospital in Gauteng were purposively selected. Qualitative interviews were conducted and thematic analysis was used to analyse the data, from which two themes arose: the treatment experience and experiencing emotional distress. Being treated with brachytherapy was a negative experience causing fear, pain and humiliation. The participants feared the procedure, before receiving the first treatment and even after having had one. Pain was a major problem, as the preventative medication participants received did not protect them from experiencing pain. Having to open and hang their legs was a humiliating experience aggravated by the presence of observers and the rotation of doctors. Their belief in God comforted them and gave them courage to endure the treatment, whilst caring sta...

FACTORS CONTRIBUTING TO RELAPSE OF MENTAL HEALTH CARE USERS TREATED FOR SUBSTANCEINDUCED PSYCHOTIC DISORDER IN A PSYCHIATRIC HOSPITAL IN GAUTENG, SOUTH AFRICA

This study explored the factors contributing to relapse of mental health care users (MHCUs) treated for substance-induced psychotic disorder in a public psychiatric hospital in Gauteng, South Africa. A qualitative, explorative, descriptive and contextual research design was followed. The study was conducted at the outpatient department of the hospital. Participants were selected purposefully from MHCUs visiting the outpatient department for follow-up. Ten semistructured interviews were used to collect data until data saturation occurred. The transcribed interviews and field notes were analysed using Tesch's method of qualitative data analysis. The researcher and an independent coder reached consensus on the categories, sub-categories and themes. Trustworthiness was ensured through application of the strategies of dependability, transferability, conformability, credibility and authenticity. The findings explicated the factors contributing to relapse of MHCUs treated for substanceinduced psychotic disorder in a psychiatric hospital. These factors included psychological, physical and social factors. Recommendations were provided for psychiatric nurses in terms of therapeutic programme planning and involvement of the community and family in the management of MHCUs treated for substance-induced psychotic disorder.

Inequities in resources and preparedness for surgical complications of caesarean section in southern Gauteng hospitals

Background. The number of maternal deaths from bleeding during and after caesarean section (BDACS) has increased in South Africa. Health-worker training and health-system strengthening are considered important prerequisites for improving maternal health outcomes. Objectives. To determine preparedness for, and health-system constraints to, safe caesarean section in southern Gauteng hospitals. Methods. This was a cross-sectional study in 15 hospitals. Data were collected by questionnaire from clinical heads of department in each hospital. Results. The 15 hospitals included 5 district hospitals, 7 regional hospitals and 3 central (university academic) hospitals. The number of deliveries per hospital ranged from 893 to 44 256 for 2013 - 2014, with a total of 201 314 births and 70 095 caesarean sections (34.8%). Despite similar numbers of births, there were 20 deaths from BDACS at regional hospitals and 6 at central hospitals ( p =0.008). Service delivery constraints included an unequal staff distribution between central hospitals and lower levels of care, as well as non-availability of essential drugs and a lack of surgical capacity to arrest severe haemorrhage at district and regional hospitals. Conclusion. The findings of this study reflect inequity in maternity services. Compared with central academic hospitals, district and regional hospitals are inadequately prepared for the management of complications from BDACS.

Assessing the usefulness of electroencephalography in psychiatry: Outcome of referrals at a psychiatric hospital.

This retrospective study was conducted at Sterkfontein psychiatric hospital in Gauteng. The objectives included investigating reasons for referral to conduct an electroencephalography (EEG) and to determine whether EEG findings have impact on clinical management. Source data included EEG reports over an 18-month period and clinical records. The total sample was 85 adult inpatients (53 males; 32 females). Seizure disorder exclusion was the main reason for EEG referral (69.0%). Seventy-four (87.0%) records were normal, 7 (8.2%) were abnormal, 2 (2.4%) were inconclusive and 2 (2.4%) EEG reports were unavailable. There was no statistically significant correlation between abnormal EEG results and demographic variables, symptoms, admission diagnosis and medications. EEG recording demonstrated a low yield of abnormal results. In this study, EEG results did not appear to influence the treating psychiatrists regarding management, but this could be as a result of the small sample size. As interactions between psychiatric conditions and epilepsy are important and well established, negative EEGs are indeed useful and it is recommended that clinicians should carefully consider which patients should be referred for EEGs.

Audiological testing for ototoxicity monitoring in adults with tuberculosis in state hospitals in Gauteng, South Africa

Background: Ototoxicity monitoring during treatment of medical conditions, where the medications used are known to be toxic to the ear, is an important scope of practice of the audiologist; and, is an important clinical service aimed at enhancing patients’ quality of life.Aim: The aim of the current study was to determine audiological testing practices for ototoxicity monitoring in adults with tuberculosis in State Hospitals in Gauteng, South Africa. Specific objectives included establishing if ototoxicity (cochleotoxicity) monitoring occurs; determining the timing as well as frequency of monitoring; and, establishing what management protocols are followed once ototoxicity is established.Methodology: A retrospective data record review design was adopted where hospital records from tuberculosis treatment units were reviewed. A total of 191 participant files comprised the research sample. Data obtained was analysed using descriptive statistics.Results: Findings indicated that out of 5 hospitals recruited, only one had an ototoxicity monitoring programme in place. At this programme only 66% of participants were enrolled in an ototoxicity monitoring program in which baseline audiological measures were only conducted one month post treatment in 41% of the samples monitored. The majority of those monitored had repeat measures conducted once monthly. No clear and systematic medical management of ototoxicity, once identified, was found in the current sample. A small number of participants’ medication was adjusted as an intervention measure.Conclusion: Findings demonstrate the need for systematic and integrated ototoxicity monitoring programs in tuberculosis treatment centres in South Africa; as well as highlight the need for the development of evidence-based management protocols for ototoxicity within state hospitals in this South African context.

The needs of families accompanying injured patients into the emergency department in a tertiary hospital in Gauteng.

BackgroundFamilies are not prepared for traumatic injuries of loved ones. Emergency nurses have the important role of caring for patients and families in this time of crisis. Family needs in the critical care setting have been explored using the Critical Care Family Needs Inventory (CCFNI), however little is known about family needs in the emergency department.ObjectivesThis study sought to determine the needs of family members accompanying injured patients into the emergency department, and if these needs were met.MethodsA quantitative, descriptive, study was conducted in a level 1 trauma facility in Johannesburg, South Africa. The population included families of patients admitted to the emergency department, sampling 100 participants. The instrument, based on the CCFNI, was validated in a pilot study in Melbourne, Australia and re-evaluated using the Cronbach Alpha validity test to ensure internal consistency.Five themes were explored: ‘meaning’, ‘proximity’, ‘communication’, ‘comfort’ and ‘support’ and data were analysed using descriptive statistics. Responses to open-ended questions were analysed using content analysis. Permission from the Human Research Ethics Committee was granted and participants were ensured confidentiality and the option for counselling if required.ResultsThemes ranked highly important were ‘meaning’ and ‘communication’. Satisfaction was highest for ‘meaning’. Low satisfaction levels for ‘communication’ were found. Issues regarding prolonged time spent in the emergency department and discrimination were raised.ConclusionThese findings have a negative impact on the family’s satisfaction with care and it is recommended that the nurse’s role in family care be further explored and emphasised.

Implementing oral care to reduce aspiration pneumonia amongst patients with dysphagia in a South African setting.

Oral care is a crucial routine for patients with dysphagia that, when completed routinely, can prevent the development of aspiration pneumonia. There is no standardised protocol for oral care within government hospitals in South Africa. This study aimed to investigate the outcome of an oral care protocol. Participants were patients with oropharyngeal dysphagia, with either stroke or traumatic brain injury as the underlying medical pathology, and nurses. All participants were recruited from one tertiary level government hospital in Gauteng, South Africa. 139 nurses participated in the study and received training on the oral care protocol. There were two groups of participants with oropharyngeal dysphagia. Group one (study group, n = 23) was recruited by consecutive sampling, received regular oral care and were not restricted from drinking water; however, all other liquids were restricted. Group two (comparison group, n = 23) was recruited via a retrospective record review, received inconsistent oral care and were placed on thickened liquids or liquid restricted diets. Results showed that a regimen of regular oral care and free water provision when combined with dysphagia intervention did prevent aspiration pneumonia in patients with oropharyngeal dysphagia. The article highlights two key findings: that regular and routine oral care is manageable within an acute government hospital context and a strict routine of oral care can reduce aspiration pneumonia in patients with oropharyngeal dysphagia. An implication from these findings is confirmation that teamwork in acute care settings in developing contexts must be prioritised to improve dysphagia management and patient prognosis.

Audiological testing for ototoxicity monitoring in adults with tuberculosis in state hospitals in Gauteng, South Africa

Background: Ototoxicity monitoring during treatment of medical conditions, where the medications used are known to be toxic to the ear, is an important scope of practice of the audiologist; and, is an important clinical service aimed at enhancing patients’ quality of life.Aim: The aim of the current study was to determine audiological testing practices for ototoxicity monitoring in adults with tuberculosis in State Hospitals in Gauteng, South Africa. Specific objectives included establishing if ototoxicity (cochleotoxicity) monitoring occurs; determining the timing as well as frequency of monitoring; and, establishing what management protocols are followed once ototoxicity is established.Methodology: A retrospective data record review design was adopted where hospital records from tuberculosis treatment units were reviewed. A total of 191 participant files comprised the research sample. Data obtained was analysed using descriptive statistics.Results: Findings indicated that out of 5 hospitals recruited, o...

Audit of feeding practices in the neonatal wards at the Charlotte Maxeke Johannesburg Academic Hospital

Background. Breastfeeding is the preferred choice of infant feeding. The Baby Friendly Hospital Initiative (BFHI) is a ten-step plan to help establish successful breastfeeding and is adapted by public sector hospitals in Gauteng. Despite this, rates of breastfeeding in sick and preterm neonates remain low. Objective. To determine feeding practices of neonates in the neonatal wards of the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) on discharge. Methods. A retrospective review of the CMJAH neonatal database of feeding choices of neonates discharged from the CMJAH neonatal unit between 1 January 2013 and 30 April 2013 was conducted. Results. The records of 404 neonates were studied. A total of 98 (24%) were very low birth weight (VLBW) ( 1 500 g or more. Only 94 (23.2%) were discharged on exclusive breastmilk, 232 (57.4%) were discharged on exclusive formula milk and 78 (19.3%) babies were discharged on mixed feeds (both formula milk and breastmilk). Significant variables associated with feeding choices were HIV exposure, perinatal asphyxia and resuscitation at birth and, particularly in the VLBW group, necrotising enterocolitis was found to be statistically significant. Conclusion. Despite the fact that the CMJAH was involved in the BFHI, rates of exclusive breastfeeding were still low. This needs to be urgently addressed with employment of lactation consultants and improved counselling of mothers exposed to HIV on the importance and benefits of breastfeeding.

Nurses' perceptions of facilitating genuineness in a nurseepatient relationship

Background: Genuineness was highlighted as an important concept when nurses' perceptions of facilitating a therapeutic relationship were assessed in a study conducted in private general hospital wards. Training courses are mainly professionally orientated and little attention is given to genuineness, which is underpinned by values and influenced by culture and self-awareness. Reflection on patients' feelings enables mindfulness in the nurse—patient relationship, but nurses often act on instinct or rely on learned knowledge and skills. Despite the increased emphasis on virtue ethics and honest disclosure, hope is offered but nurses are often not honest with themselves or in their response to patients.This poses a challenge when genuineness is facilitated. In this article, nurses' perceptions of facilitating genuineness will be discussed.Method: To assess nurses' genuineness, a quantitative, contextual, deductive and descriptive study was conducted. A purposive sample of nurses was taken from private general hospitals in Gauteng, South Africa. Nurses' (n = 181) perceptions of facilitating genuineness in a nurse—patient relationship were self-assessed on a five-point scale in a questionnaire.Data analysis: Descriptive statistics and non-parametric statistical techniques were used. Specific hypotheses were tested to identify whether statistically significant differences in perceptions of facilitating genuineness existed between two or more groups.Results: When groups were compared, statistically significant differences were identified in nurses' perceptions of facilitating genuineness with respect to age, years' experience as a nurse and qualifications. It is recommended that nurses' awareness of genuineness and its facilitation should involve learning through socialisation and self-awareness.

Baseline patient profiling and three-year outcome data after metabolic surgery at a South African centre of excellence

The bariatric team at Waterfall City Hospital in Gauteng has performed 820 metabolic surgeries under the guidance of an extended team, and with comprehensive recordkeeping. Baseline profiling on more than 50 variables afforded insight into patients undergoing surgery. The available outcome data over three years were comparable with those in the documented literature. The attempted weight loss period prior to agreeing to surgery was 16-18 years. Weight loss in the overall cohort was 29% at three years, with a two-year outcome as follows: diabetes mellitus remission of 81.6% in males and 83.1% in females, full and part-hypertension resolution of 84.8% in males and 74.6% in females, hyperlipidaemia on no treatment of 76.8% in males and 72.1% in females, and sleep apnoea of 75.5% in males and 76.8% in females. Separating out the diabetic group indicated a diabetes mellitus remission of 73.9% in males and 75.1% in females at one year. Improvement in the components of metabolic syndrome was demonstrated in the ...

Investigating Employee Perceptions of Performance Management at the Department of Radiology in a Public Hospital in Gauteng

The South African Department of Public Administration has been utilizing the Performance Management and Development System (PMDS) to ensure accountability of performance in the public sector for the last twelve years. However, challenges of poor performance remain rife. Since perception, notably influences successful implementation of any system, this study evaluates employee perception of performance management in an attempt to evaluate the effectiveness of the system. The Department of Radiology at a Gauteng Public Hospital was chosen as the research site. No known research on PMDS had been conducted at the site since the implementation of PMDS. A quantitative study method utilized purposive sampling to obtain data from the Department of Radiology at the Gauteng Public Hospital. The target population consisted of forty three employees of the Department and forty of these employees made up the sample population. A pilot study was conducted on ten percent of the population. A questionnaire was then administered to the sample population. The questionnaire consisted of two sections having a total of twenty five closed statements Participants were required to rate the statements according to a five point Likert scale. The response rate was ninety percent with only thirty six participants returning completed questionnaires. The data was analyzed using the Statistical Program for Social Science (SPSS) version 22. The findings indicated that support staff had a positive perception of PMDS compared to clinical staff. This correlated to a congruent perceived effectiveness of PMDS. In addition both support and clinical staff viewed PMDS as not working well, demotivating and needing change. Results showed that 41.67% of participants disagreed to feeling motivated after PMDS reviews, 50% disagreed that PMDS works well, 44.44% disagreed that PMDS did not need to change, 58.33% disagreed that participating in PMDS for the money while 66.67% of participants agreed that the expected outcomes are aligned to the organizations vision, mission and core values, 55.56% agreed that PMDS helps achieve the organization’s goal and 69.45% agreed that PMDS informs areas for development. Recommendations included providing of non-financial rewards and measures to increase interpersonal relationships were therefore recommended.