Healthcare Delivery In Hospitals Research Articles

Portfolio on Web-Based Medical Record Identification system for Nigerian public Hospitals

Patient record management is an important aspect of healthcare delivery in hospitals. It involves the creation, maintenance, and retrieval of patient records, which contain vital information about a patient's medical history, diagnosis, treatment, and outcomes. Effective patient record management ensures that healthcare professionals have access to the right information at the right time, which is critical for making informed decisions about patient care. In Nigerian public hospitals, identifying patients’ records poses a challenge as there is no automated method of record management. Files are being carried from one table to another during treatments, thereby causing delays in attending to patients, which sometimes leads to worst conditions as death. To the best of our knowledge, there is no study targeting this problem of public hospitals or any that addressed this problem hitherto. To cover this gap, we designed a web-based medical record identification system for Nigerian public hospitals. Much novelty of the system lies on empowering patients with a prompt of their access codes when they are registered with the system. Qualitative approach and agile methodology were adopted for this study. A user study was done to confirm the functionality of the system and feedback concerns were handled appropriately. While this work contributes to the scientific body of IT knowledge and highlights the steps of preparing portfolio of evidence in computing, it addresses the record management issues in Nigerian public health system.

Perceived Impact of University Education on Practices of Graduate Nurses at Federal Medical Centre, Owo, Nigeria

Introduction: Nurses globally have made giant strides in the development of nursing, which has moved nurses' education from hospital-affiliated schools into Universities and colleges. The study determined the impact of the knowledge of the University level of education on nursing practices at Federal Medical Center, Owo. Method: A descriptive research design was adopted. Using a convenient sampling technique, a total of 133 nurses were accessed. Data were collected using a self-designed structured questionnaire which consists of five sections and a checklist to observe the practice of both graduate and diploma nurses. Data collected were analyzed with SPSS software using both descriptive and inferential statistics. Result: There are many benefits of university education as identified by the respondents as follows: it brings job satisfaction (89.5%), it helps to give the best care (86.3%), it gives room for competitiveness (89.5%), it encourages leadership role (92.6%), it increases the degree of autonomy in the nursing profession (90.5%), it helps to give best care (86.3%), and so on. The factors affecting the practices of graduate nurses include understaffing (86.4%), unavailability of necessary equipment (88.4%), Lack of role differentiation (86.3%), and Hospital policy (92.6%) and poor working condition of equipment and instruments (100.0%). There is a significantly higher degree of expertise in health care delivered by graduate nurses over diploma nurses; and their ability to plan, implement and evaluate patient care outcomes (P=0.009). In addition, a significant relationship exists between knowledge acquired by graduate nurses and their nursing care practices determines to be P= 0.004. In Conclusion, graduate nurses have a greater impact on healthcare delivery than diploma nurses. Therefore, they should be employed in larger numbers for better healthcare delivery in hospitals.

Impact of the COVID-19 pandemic on the mental health of professionals in 77 hospitals in France.

The COVID-19 pandemic has led to significant re-organisation of healthcare delivery in hospitals, with repercussions on all professionals working in healthcare. We aimed to assess the impact of the pandemic on the mental health of professionals working in health care institutions and to identify individual and environmental factors influencing the risk of mental health disorders. From 4 June to 22 September 2020, a total of 4370 professionals responded to an online questionnaire evaluating psychological distress, severity of post-traumatic stress symptoms, stress factors, and coping strategies. About 57% of the professionals suffered from psychological distress, and 21% showed symptoms of potential post-traumatic stress. Professionals working in radiology, those working in quality/hygiene/security and nurses' aides were the most affected groups. The media focus on the crisis, and a high workload were the most prevalent stress factors, followed by uncertainty regarding the possibility of containing the epidemic, the constantly changing hygiene recommendations/protocols, and the lack of personal protective equipment. The use of coping strategies, notably positive thinking, helped to mitigate the relation between perceived stress and mental health disorders. The COVID-19 pandemic has had far-reaching negative repercussions for all professionals, with some sectors more markedly affected. To prevent mental health disorders in professionals during a public health crisis, support services and management strategies within hospitals should take account of the importance of positive thinking and social support.

Perioperative Nurses' Perceptions Pre-Implementation of an Electronic Medical Record System.

The use of electronic medical record (EMR) systems is transforming health care delivery in hospitals. Perioperative nurses work in a unique high-risk health setting, hence require specific considerations for EMR implementation. This research explored perioperative nurses' perceptions of facilitators and barriers to the implementation of an EMR in their workplace to make context-specific recommendations about strategies to optimise EMR adoption. Using a qualitative exploratory descriptive design, focus group data were collected from 27 perioperative nurses across three hospital sites. Thematic analyses revealed three themes: 1) The world is going to change; 2) What does it mean for me? and 3) We can do it, but we have some reservations. Mapping coded data to the Theoretical Domains Framework identified prominent facilitators and barriers, and informed recommended implementation strategies for EMR adoption by perioperative nurses.

Investigate knowledge management technology implementation for supporting decision making in Ethiopian health sectors

IntroductionKnowledge management technology is a key tool for facilitating and improving the quality of health care delivery in hospitals. However, the use and implementation of this technology is not an easy task. This study aims to investigate a knowledge management technology implementation and use in Ethiopian hospitals, with a particular reference to Jimma University Specialized Hospital.MethodologyInformation about challenges of knowledge management technology implementation was gathered using qualitative research methods, through conducting semi-structured interviews. Purposive sampling method was applied to select fifty-four participants from a well-defined population. Findings were first validated, according to published literature and research works, and then sorted into three main areas, such as current usage of KM technology to enhance and improve decision-making, factors affecting the implementation of KM technologyResultsThis study revealed that the overall level of KM technology implementation in Jimma University Specialized hospital is still low.ConclusionImplementation and use of KM technology to improve the quality of hospital health services is needed. Thus, it suggested that hospital managers should make much more effort to develop a strategy and policy on the implementation and use of KM technology so that the hospital could improve the quality of healthcare services.

Factors affecting sustainable adoption of e-health technology in developing countries: an exploratory survey of Nigerian hospitals from the perspective of healthcare professionals.

BackgroundE-health technology applications are essential tools of modern information technology that improve quality of healthcare delivery in hospitals of both developed and developing countries. However, despite its positive benefits, studies indicate that the rate of the e-health adoption in some developing countries is either low or underutilized. This is due in part, to barriers such as resistance from healthcare professionals, poor infrastructure, and low technical expertise among others.ObjectiveThe aim of this study is to investigate, identify and analyze the underlying factors that affect healthcare professionals decision to adopt and use e-health technology applications in developing countries, with particular reference to hospitals in Nigeria.MethodsThe study used a cross sectional approach in the form of a close-ended questionnaire to collect quantitative data from a sample of 465 healthcare professionals randomly selected from 15 hospitals in Nigeria. We used the modified Technology Acceptance Model (TAM) as the dependent variable and external factors as independent variables. The collected data was then analyzed using SPSS statistical analysis such as frequency test, reliability analysis, and correlation coefficient analysis.ResultsThe results obtained, which correspond with findings from other researches published, indicate that perceived usefulness, belief, willingness, as well as attitude of healthcare professionals have significant influence on their intention to adopt and use the e-health technology applications. Other strategic factors identified include low literacy level and experience in using the e-health technology applications, lack of motivation, poor organizational and management policies.ConclusionThe study contributes to the literature by pinpointing significant areas where findings can positively affect, or be found useful by, healthcare policy decision makers in Nigeria and other developing countries. This can help them understand their areas of priorities and weaknesses when planning for e-health technology adoption and implementation.

Evaluation of Appropriateness Admission and Hospital Stay at Educational Hospital.

Appropriate admissions and patients' length of stay are two of the most important indicators of efficient health care delivery in hospitals. Paying due attention to these indicators may lead to optimal use of hospital resources as well as provision of ambulatory services to a larger population of patients. The purpose of the current study is to quantify the rate of inappropriate hospital admissions and days of hospital stay to identify factors affecting them. Data were collected regarding admissions and length of stay of 1815 patients admitted to an educational hospital in Tehran, Iran, with a total 12,629 days of hospitalization using the Appropriateness Evaluation Protocol. A qualitative study was conducted using content analysis method by analyzing data from interviews with the hospital personnel about the factors affecting patients' length of stay. The results indicated that the average length of stay in medical and surgical wards was 9.4 to 6.3 days, and 8.5% of admissions and 3.4% of stays were inappropriate. The necessity to receive nursing care and/or to receive medical services and/or the patients' conditions accounted for 57.6% of total hospitalization days, followed by the need to receive nursing care alone (36.6%). Planning/Procedures/ Personnel factors were responsible for 77.3% of inappropriate stays. The qualitative study revealed that in addition to sound in house policy setting, abundance of suitable equipment and facilities at the hospital site had positively affected the appropriateness of hospital stay while incoordination of health care delivery groups, rotation of residents and other wards personnel and lack of a proper complementary patient follow-up system, had a negative impact on the same indicator. Inappropriate admissions and inappropriate stays are influenced by numerous factors, both inside and outside of the hospitals; the results of the current study indicate that structural factors such as techniques adopted in the studied hospital, contributed significantly to decreasing inappropriate stays. Improving and upgrading these techniques will make optimal use of hospital beds possible.

Understanding barriers to the provision of hand hygiene products in Africa – a WHO POPS/APPS project

The availability of alcohol-based handrub (ABHR) and its component parts to enable reliable use in health care are variable around the globe. Three initiatives from the World Health Organisation (WHO) have addressed this inequity. The WHO guidelines on hand hygiene (2009) promote the use of ABHR as an easy and effective way to ensure clean safe hands at the point of care. WHO Private Organisations for Patient Safety (POPS) harnesses industry strengths to align and improve implementation of WHO recommendations, to hand hygiene in the first instance. WHO African Partnerships for Patient Safety (APPS) focuses on supporting safer healthcare delivery in hospitals with hand hygiene as a linchpin for safe quality care. In 2013, a one-off project was launched through POPS to provide empty bottles to APPS hospitals so that operational barriers to implementation of locally produced ABHR could be addressed.

Hospital organizational behaviour and management ethos: a gandhian perspective

Any modern hospital needs to have high quality patient care, efficient medical and nursing services, a very cordial and friendly hospital staff that control stress, for which behavioural sciences including organizational behaviour, flexibility and management ethos are relevant for effective healthcare delivery in hospitals. Curing begins with caring which is the basic premise of nursing care and accordingly it makes several related disciplines like organizational behaviour, psychology and other behavioural sciences very relevant for several areas of hospital administration such as patient care management, nursing administration, stress management, patient safety, etc. The paper discusses how organizational behaviour related fields like hospital leadership, organizational culture, hospital hierarchy, organizational flexibility and management ethos are relevant for effective healthcare delivery in select hospital disciplines, namely, patient care management, nursing administration, patient safety and stress management.

Developing a Reproducible Non-Line-of-Sight Experimental Setup for Testing Wireless Medical Device Coexistence Utilizing ZigBee

The integration of heterogeneous wireless technologies is believed to aid revolutionary healthcare delivery in hospitals and residential care. Wireless medical device coexistence is a growing concern given the ubiquity of wireless technology. In spite of this, a consensus standard that addresses risks associated with wireless heterogeneous networks has not been adopted. This paper serves as a starting point by recommending a practice for assessing the coexistence of a wireless medical device in a non-line-of-sight environment utilizing 802.15.4 in a practical, versatile, and reproducible test setup. This paper provides an extensive survey of other coexistence studies concerning 802.15.4 and 802.11 and reports on the authors' coexistence testing inside and outside an anechoic chamber. Results are compared against a non-line-of-sight test setup. Findings relative to co-channel and adjacent channel interference were consistent with results reported in the literature.

The Impact of Noneconomic Damages Cap on Health Care Delivery in Hospitals

Previous literature focused on narrowly defined treatments reached conflicting conclusions about the association between tort reforms and treatment intensity. Using county-level panel data, I evaluate the impact of noneconomic damages caps on broadly defined measures of health care delivery in hospitals. Caps adoption leads to a 3.5% decrease in surgeries, a 2.5% decrease in admissions, a 4.5% decrease in outpatient visits but has no significant effect on emergency care. These results are not driven by spillovers across state borders or by improvements in health and are accompanied by an increase in mortality from complications of medical and surgical care.

Stage implementation of RFID in hospitals

The use of radio frequency identification device (RFID) technology within the healthcare industry was researched and specific instances of implementation of this technology in the hospital environment were examined. The study primarily makes use of ideas from operations and supply chain management, such as work flow diagrams, value stream mapping, and poka-yokes (mistake proofing measures) for investigations of processes, failures, and solutions. This study presents a step-by-step approach of how to implement the use of RFID tracking systems within the entire hospital. A number of poka-yokes were also devised for improving the safety of the patient and cost effectiveness of the hospital to insure the success of the hospital health care delivery system. Many players in the hospital environment may be impacted. This includes patients, doctors, nurses, technicians, administrators, and other hospital personnel. Insurance and government agencies may be impacted as well. Different levels of training of hospital personnel will be required based on the degree of interaction with the RFID system. References to costs, Return On Investment, change management, ethical and legal considerations are also made to help the reader understand the benefits and implications of the technology in the hospital environment.

The impact of computerization of the nutrition support process on the nutrition support program in a tertiary care hospital in the Philippines: Report for the years 2000–2003

To improve hospital health care delivery by identifying malnutrition in all admitted patients and following up those identified to be malnourished and "at risk of developing malnutrition" a hospital nutrition support program based on the JCAHO system was initiated in 1999. Two major problems were encountered: first, the inability to perform a nutrition surveillance process due to failure by the staff to implement existing nutrition screening tools and second, the lack of awareness and support from the medical staff in this initiative. Two solutions were implemented in 2000: computerization of the nutrition screening and nutrition support process and synchronizing this with the whole nutrition support program. A computer program was developed which performs BMI-based nutrition screening, produces lists of all malnourished patients, and computes the different formulas for either nutritional requirement or parenteral and/or enteral formulation. It also generates patient status reports based on encoded data from the nutrition support team, which prioritized these patients for management based on the data output. From 2000 to 2003, improvement was seen in these areas: entry of height and weight in the patient record increased from 30% to 90%; nutrition surveillance shows nutritional status distribution to be: normal (58%), underweight (9%), overweight (25%), and obese (8%), referrals to the nutrition support team based on the screen notification increased from 37% to 100%, patient coverage by nutrition support services increased from 7374 (38.8%) in 2000 to 11,369 (83%) in 2003, and critical care patients seen increased from 10% in 2000 to 99% in 2003. More improvement is needed in physician response to nutrition support recommendations, which still remains low (11.2-24%). Computerization helps to improve nutrition support delivery in the hospital, but more cooperation and support from the medical staff is still needed for better results.

Observations From a Maternal and Infant Hospital in Kabul, Afghanistan—2003

Afghanistan is believed to have one of the highest infant and maternal mortality rates in the world. As a result of decades of war and civil unrest, Afghan women and children suffer from poor access to health services, harsh living conditions, and insufficient food and micronutrient security. To address the disproportionately high infant and maternal mortality rates in Afghanistan, the US Department of Health and Human Services pledged support to establish a maternal health facility and training center. Rabia Balkhi Hospital in Kabul, Afghanistan, was selected because this hospital admits approximately 36,000 patients and delivers more than 14,000 babies annually. This article reports the initial observations at Rabia Balkhi Hospital and describes factors that influenced women's access, the quality of care, and the evaluation health care services. This observational investigation examined areas of obstetric, laboratory and pharmacy, and ancillary services. The investigators concluded that profound changes were needed in the hospital's health care delivery system to make the hospital a safe and effective health care facility for Afghan women and children and an appropriate facility in which to establish an Afghan provider training program for updating obstetric skills and knowledge.

A Case Study Using The Discipline with a Clinical Team

SUMMARY Health care delivery in hospitals and clinics promotes an interdisciplinary team approach. This article presents the use of The Discipline though the involvements of the chaplain as part of the Infectious Disease team as together they addressed the inherent spirituality of one HIV/AIDS patient. This narrative recounts the unfolding events of the patient's life and describes the use of The Discipline during a very difficult time period for the patient and the staff. The experience can serve as a model for other health care teams who must manage difficult, deteriorating patients.

Hospital design and the temporal and spatial organization of nursing activity

Abstract The effectiveness of health care delivery in hospitals is determined, in part, by the design of the physical environment and by the spatial organization of work. This paper presents an analysis of the spatial and temporal organization of the work of nurses in the medical and surgical units of French hospitals. In both cases the units were designed around a ‘U’ shaped configuration. The data from these analyses focused on the number of trips undertaken by nurses in completing the various aspects of their work. The results, it is argued, are useful towards the redesign of the units.

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A health care program for hospital staff

This paper illustrates the significance of one aspect of psychiatric consultation to questions of general hospital health care delivery. The contractual arrangements, implementation, and evaluation of a health care delivery program for nonprofessional hospital employees are presented. Changes in patients' perception of treatment were evaluated by random surveys of representative clinic and ward populations before and after this program was implemented. The program was evaluated by precourse-postcourse questionnaires completed anonymously by the hospital personnel group. The program was found to be successful in generating lists of major health care delivery problems and some possible solutions. The majority of personnel enjoyed and benefited from this program. A conceptual framework and implications of psychiatric consultation for problems of general health care delivery are discussed.