Implementation Of Quality Assurance Measures Research Articles

Challenges Encountered by Teachers in the Implementation of Quality Assurance Measures

The study investigated the challenges encountered by teachers in the implementation of quality assurance measures. The research designed for the study was a survey method. The sample for this study was fifty-two people who are faculty members of the School of General Studies in Xianning Vocational and Technical College. A semi-structured interview and a structured questionnaire were used for data collection in the study. The reliability of the instrument was determined by testing and retesting. The data were analyzed using frequency counting and simple percentage. The result of the study showed: inadequate understanding of learning conditions, insufficient participation in the formulation of quality assurance policies, inadequate educational quality assurance training, imperfect teacher performance appraisal system, inadequate funding support for online teaching activities (during the pandemic) and a shortage of having the qualification certificate of the related profession are the challenges encountered by teachers in the implementation of quality assurance measures in Xianning Vocational and Technical College.

Investigating the Benefits and Barriers of Quality Assurance Management for Adequate Housing Delivery in Nigeria: An Empirical Overview

Abstract Purpose: The process of housing delivery all over the world is confronted by multiple barriers resulting in houses that are short of clients’ expectations in terms of quality and overall standards. The inability of the house builders (contractors) to deliver quality housing normally occurs due to non-conformance to quality assurance principles and non-adherence to the key quality indicators. An assessment of recent developments and actions in the building industry that might help mitigate the identified barriers has been made in this study. Hence, skilful application of quality assurance principles to overcome quality barriers in housing delivery is essential. Methodology: The study has employed quantitative methods of data collection. Closed-ended questionnaires have been prepared and administered to building contractors in Akure, Nigeria. The collected quantitative data have been analysed with the aid of SPSS software, version 27. The results have been accordingly reported to ascertain the level of commitment made by building contractors on ensuring quality in housing delivery in Akure. Findings: Findings have revealed that building contractors are well conversant and knowledgeable about the probable benefits of implementing quality assurance in the housing delivery process. There are, however, obvious challenges and serious barriers that are militating against effective implementation of quality assurance measures in the housing delivery process such as engaging unskilled labour force. Recommendation: The study recommends that a pre-assessment of the workforce be made to establish their level of knowledge and competencies on quality assurance management principles. Originality and value: Creation of “quality assurance consciousness” for the housing industry will result in quality housing delivery to the satisfaction of all end users and the general public.

COVID-19 coronavirus: Aseguramiento de la calidad en servicio de distribución a domicilio de carne procesada en la ciudad de Ambato

Esta investigación realiza un estudio de factibilidad para la implementación de medidas de aseguramiento de la calidad en la producción, comercialización y logística de distribución de carne en la ciudad de Ambato, utilizando transporte motorizado puerta a puerta en período de pandemia por COVID-19.  Para establecer los cambios en el flujo de proceso inicial se inició determinando las actividades, siclos, participantes y tiempos de ejecución de tareas realizando un estudio de trabajo. Luego se realizó un análisis de aseguramiento de la calidad para determinar las actividades necesarias para cubrir la satisfacción del cliente, considerando como aspectos prioritarios la trazabilidad, medidas básicas de bioseguridad por la exposición de los trabajadores a ambientes contaminados por COVID-19 determinados por la norma INEN 1338:2012 y el reglamento ARCSA-DE-067-2015-GGG. Seguidamente se estructuró un diagrama de flujo de proceso considerando: macroproceso, proceso, entradas, salidas y responsables con la lista de los registros necesarios para lograr la mejora competitiva y finalmente evaluarlo con los requisitos de la norma ISO 9001:2015. Se consiguió un crecimiento en los aspectos: contexto de organización en un 7%, liderazgo un 8%, planificación un 12%, Apoyo un 6%, operación 13% evaluación del desempeño 6% y mejora 11%según la norma ISO 9001:2015 en condiciones extremas de trabajo en Ambato por COVID-19. Se observa valores más altos en los items relacionados a la planificación de la producción.  

Assessing the Implementation of American College of Surgeons Quality Indicators for Pancreatic Cancer Across an Integrated Health System.

The American College of Surgeons (ACS) recently published quality assurance (QA) indicators for pancreatic cancer care. Implementing quality indicators in a newly formed health system may lead to better patient selection and standardized cancer care. Select ACS and internal quality indicators were implemented system wide in 2014. We compared compliance with these measures before and after their implementation at the main hospital and two new affiliate institutions. A total of 506 patients with pancreatic cancer were included. At the main hospital in the pre-QA period, 11 (12.6%) of 87 patients were discussed at our institutional multidisciplinary tumor board meeting; this number rose to 89 (49.7%) of 179 patients (P < .001) after the implementation. Clinical TNM stage was documented in the electronic medical record in 75 patients (86.2%) in the pre-QA group; this number rose to 170 (94.9%; P = .026) in the post-QA era. External imaging of patients undergoing resection was uploaded in 10 (66.7%) of 15 patient cases in the pre-QA period; this number rose to 33 (93.4%) of 35 (P = .020). Rates of time from diagnosis to treatment initiation shorter than 60 days were similar between eras (n = 26, 96.3% v n = 57, 95%). Implementation of QA measures at the affiliate institutions did not result in measurable differences. There were no differences in margin-negative resection rate, lymph node yield, or perioperative mortality after QA implementation at any site. The implementation of ACS quality indicators at our main hospital was feasible and effective for several measures, without delaying treatment. Instituting these indicators at lower-volume affiliates was more challenging.

HIV point of care diagnosis: preventing misdiagnosis experience from a pilot of rapid test algorithm implementation in selected communes in Vietnam.

Introduction: In Vietnam, HIV testing services had been available only at provincial and district health facilities, but not at the primary health facilities. Consequently, access to HIV testing services had been limited especially in rural areas. In 2012, Vietnam piloted decentralization and integration of HIV services at commune health stations (CHSs). As a part of this pilot, a three-rapid test algorithm was introduced at CHSs. The objective of this study was to assess the performance of a three-rapid test algorithm and the implementation of quality assurance measures to prevent misdiagnosis, at primary health facilities. Methods: The three-rapid test algorithm (Determine HIV-1/2, followed by ACON HIV 1/2 and DoubleCheckGold HIV 1&2 in parallel) was piloted at CHSs from August 2012 to December 2013. Commune health staff were trained to perform HIV testing. Specimens from CHSs were sent to the provincial confirmatory laboratory (PCL) for confirmatory and validation testing. Quality assurance measures were undertaken including training, competency assessment, field technical assistance, supervision and monitoring and external quality assessment (EQA). Data on HIV testing were collected from the testing logbooks at commune and provincial facilities. Descriptive analysis was conducted. Sensitivity and specificity of the rapid testing algorithm were calculated. Results: A total of 1,373 people received HIV testing and counselling (HTC) at CHSs. Eighty people were diagnosed with HIV infection (5.8%). The 755/1244 specimens reported as HIV negative at the CHS were sent to PCL and confirmed as negative, and all 80 specimens reported as HIV positive at CHS were confirmed as positive at the PCL. Forty-nine specimens that were reactive with Determine but negative with ACON and DoubleCheckGold at the CHSs were confirmed negative at the PCL. The results show this rapid test algorithm to be 100% sensitive and 100% specific. Of 21 CHSs that received two rounds of EQA panels, 20 CHSs submitted accurate results. Conclusions: Decentralization of HIV confirmatory testing to CHS is feasible in Vietnam. The results obtained from this pilot provided strong evidence of the feasibility of HIV testing at primary health facilities. Quality assurance measures including training, competency assessment, regular monitoring and supervision and an EQA scheme are essential for prevention of misdiagnosis.

Misdiagnosis of HIV infection during a South African community‐based survey: implications for rapid HIV testing

Introduction: We describe the overall accuracy and performance of a serial rapid HIV testing algorithm used in community-based HIV testing in the context of a population-based household survey conducted in two sub-districts of uMgungundlovu district, KwaZulu-Natal, South Africa, against reference fourth-generation HIV-1/2 antibody and p24 antigen combination immunoassays. We discuss implications of the findings on rapid HIV testing programmes. Methods: Cross-sectional design: Following enrolment into the survey, questionnaires were administered to eligible and consenting participants in order to obtain demographic and HIV-related data. Peripheral blood samples were collected for HIV-related testing. Participants were offered community-based HIV testing in the home by trained field workers using a serial algorithm with two rapid diagnostic tests (RDTs) in series. In the laboratory, reference HIV testing was conducted using two fourth-generation immunoassays with all positives in the confirmatory test considered true positives. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value and false-positive and false-negative rates were determined. Results: Of 10,236 individuals enrolled in the survey, 3740 were tested in the home (median age 24 years (interquartile range 19–31 years), 42.1% males and HIV positivity on RDT algorithm 8.0%). From those tested, 3729 (99.7%) had a definitive RDT result as well as a laboratory immunoassay result. The overall accuracy of the RDT when compared to the fourth-generation immunoassays was 98.8% (95% confidence interval (CI) 98.5–99.2). The sensitivity, specificity, positive predictive value and negative predictive value were 91.1% (95% CI 87.5–93.7), 99.9% (95% CI 99.8–100), 99.3% (95% CI 97.4–99.8) and 99.1% (95% CI 98.8–99.4) respectively. The false-positive and false-negative rates were 0.06% (95% CI 0.01–0.24) and 8.9% (95% CI 6.3–12.53). Compared to true positives, false negatives were more likely to be recently infected on limited antigen avidity assay and to report antiretroviral therapy (ART) use. Conclusions: The overall accuracy of the RDT algorithm was high. However, there were few false positives, and the sensitivity was lower than expected with high false negatives, despite implementation of quality assurance measures. False negatives were associated with recent (early) infection and ART exposure. The RDT algorithm was able to correctly identify the majority of HIV infections in community-based HIV testing. Messaging on the potential for false positives and false negatives should be included in these programmes.

Abstract: Implementing Infection Control Measures in Neonatology at Muhima Hospital

Abstract Background Neonatal infection is a primary cause of morbidity and mortality globally. Objective The project’s objective is to facilitate quality improvement by reduction of hospital-acquired infection (HAI) in hospitalized neonates. Methods Current infection control practices were surveyed and three main areas were identified for quality improvement: hand hygiene, parental compliance with infection control and reducing non-clinical visitors to the unit. Over 3 months, several initiatives were implemented to reduce risk of HAI. 1. Hand Hygiene: The unit manager established a consistent source for liquid hand soap and hand sanitizer manufactured by the pharmacy. Broken bottles were replaced and a continued supply of these planned for. Additionally, a staff person was assigned to assure liquid hand soap and hand sanitizers were always available. 2. Parental Compliance with Infection Control: Two gowns per patient bed were procured, labelled and hung on corresponding hooks on the wall for parent use. Twice weekly parent educational sessions were implemented. Infection control measures discussed included the use of gowns, hand washing and proper cleaning as well as questions solicited. This teaching role rotated between staff over the course of the month. 3. Reduction of non-clinical visitors: Non-clinical staff visited for social reasons frequently and used the neonatology unit as a hallway during bad weather. Neonatal staff discouraged non-clinical visiting and use of the unit as a hallway. Lessons Learned The unit initially struggled to find the resources needed. In working with the hospital-wide infection control initiative, neonatal staff, and parents, the resources were available for a sustainable improvement project. The unit manager sought consensus that these interventions were possible and important as well as soliciting staff ideas. Soap and hand sanitizer were consistently available, parents reminded each other of infection control measures, and non-clinical staff in the unit has decreased significantly. Conclusions In resource-poor settings, assuring sustainability is critical as waste and infection risk have a larger impact than in resource-rich settings. The development and implementation of quality assurance measures and evidence based interventions included gathering administrative support for reduction of waste and infection risk staff and parents who supported infection control measures within the Neonatal Intensive Care Unit at Muhima Hospital. Key words : hospital-acquired infection, hand hygiene, hand sanitizer, quality assurance, infection control initiative, parent education

Differentiation by quality: (re)defining social role of the school

European trends promote the students' and academic staff mobility and international cooperation in Higher education. These hugely depend on international transparency, consistency and common rules in defining policies and implementation of quality assurance measures. Reforms in the framework of the Bologna process and the vision of the creation of the European Higher Education Area (EHEA) means not only harmonisation of the duration of study cycles and compatibility of credit transfer systems, but also the harmonisation of the methods of quality improvement. The intention of this paper is to show possible implementation of quality standards demands of ISO 9001:2008 and Bologna standards defined by EHEA imposed at School of Economics and Business in Sarajevo (SEBS). The paper will include comparative analysis of ISO standards and EHEA criteria for quality assurance through use of EQUAL model of business excellence and organisation of the SEBS.

AIDS-Prävention – ein Erfolgsmodell in der Krise

The rising number of new HIV infections in Germany, particularly among men who have sex with men, raises the question whether the previously successful prevention strategy should be revised. This strategy has been based on a New Public Health approach which arose from the specific historical context in Europe at the start of the epidemic. The hallmarks of this approach are: the active involvement of the target groups; the central role of non-governmental organizations; the combination of population level and targeted, context specific interventions; and an emphasis on social integration and voluntary participation in the work with target group members. Current challenges include: changes in risk perception (at least in part due to the availability of more effective treatments); a diversification of prevention behavioral strategies among target group members; the formation of new sexual subcultures and target groups; as well as changes in hard-to-reach populations such as immigrants and people of lower socioeconomic status. In order to meet these challenges the following measures are necessary: an increased investment in prevention research (with a particular focus on interventions specific to social contexts in which risk behavior is increasing); further development of the institutional infrastructure for prevention, including the full implementation of UNAIDS guidelines for national prevention strategies; and improving the prevention work of local AIDS service organizations and public health authorities through an increase in funding and the implementation of quality assurance measures based on participatory action research.

Substitution treatment for opioid addicts in Germany

BackgroundAfter a long and controversial debate methadone maintenance treatment (MMT) was first introduced in Germany in 1987. The number of patients in MMT – first low because of strict admission criteria – increased considerably since the 1990s up to some 65,000 at the end of 2006. In Germany each general practitioner (GP), who has completed an additional training in addiction medicine, is allowed to prescribe substitution drugs to opioid dependent patients. Currently 2,700 GPs prescribe substitution drugs. Psychosocial care should be made available to all MMT patients.ResultsThe results of research studies and practical experiences clearly indicate that patients benefit substantially from MMT with improvements in physical and psychological health. MMT proves successful in attaining high retention rates (65 % to 85 % in the first years, up to 50 % after more than seven years) and plays a major role in accessing and maintaining ongoing medical treatment for HIV and hepatitis. MMT is also seen as a vital factor in the process of social re-integration and it contributes to the reduction of drug related harms such as mortality and morbidity and to the prevention of infectious diseases. Some 10 % of MMT patients become drug-free in the long run. Methadone is the most commonly prescribed substitution medication in Germany, although buprenorphine is attaining rising importance. Access to MMT in rural areas is very patchy and still constitutes a problem. There are only few employment opportunities for patients participating in MMT, although regular employment is considered unanimously as a positive factor of treatment success. Substitution treatment in German prisons is heterogeneous in access and treatment modalities. Access is very patchy and the number of inmates in treatment is limited. Nevertheless, substitution treatment plays a substantial part in the health care system provided to drug users in Germany.ConclusionIn Germany, a history of substitution treatment spanning 20 years has meanwhile accumulated a wealth of experience, e.g. in the development of research on health care services, guidelines and the implementation of quality assurance measures. Implementing substitution treatment with concomitant effects and treatment elements such as drug history-taking, dosage setting, co-use of other psychoactive substances (alcohol, benzodiazepines, cocaine), management of 'difficult patient populations', and integration into the social environment has been arranged successfully. Also psychosocial counseling programmes adjuvant to substitution treatment have been established and, in the framework of a pilot project on heroin-based treatment, standardised manuals were developed. Research on allocating opioid users to the 'right' form of therapy at the 'right' point in time is still a challenge, though the pilot project 'heroin-based treatment' brought experience with patients who do not benefit from methadone treatment. There is also expertise in the treatment of specific co-morbidity such as HIV/AIDS, hepatitis and psychiatric disorders. The promotion and involvement of self-help groups plays an important part in the process of successful substitution treatment.

12 Towards a new legal framework for radiotherapy in the EU member states: Is there a scope for harmonisation? Can ESTRO contribute?

On 30 June 2997 the official journal of the European Communities published the “Council Directive 97/43/Euratom on health protection of individuals against the dangers of ionising radiation in relation to medical exposure and repealing Directive 84/466/Euratom”. Since radiation protection issues are generally not the concern and responsibility of the clinical radiotherapy community, this directive escaped attention until ESTRO was invited to contribute to a conference scheduled from 28 to 30 April of this year in Luxembourg, on the transposition af the directive into national law, a requirement the member states have to comply with betore 13 May 2000. A quick analysis of the text revealed that, in the context of this directive, the term radiation protection needed to be interpreted in the broadest possible sense: not only the physical conditions preventing occupational hazards and environmental contamination, but the protection of the patient against undue exposure and, as far as radiotherapy is concerned: the delivery of the appropriate dose to the patient. The directive touches upon format education and training requirements, accreditation of individuals and departments, minimal infrastructural requirements, staffing, recommendations for continued medical education and the implementation of quality assurance measures. Is the European Radiation Oncology ready for this? Did we do our homework? Whereas some other medical associations were pressing for European examinations and diplomas ESTRO has chosen for bottom-up approach by patiently and carefully working at a grassroots level on a convergence of European standards through its quality assurance, education, exchange and mobility programmes. Besides, the newly created European Board of Radiotherapy in which the scientific community (ESTRO) and the professional bodies (UEMS) are represented on a parity basis, started tackling the issues the profession needs to face up to in order to provide a solid basis for the guaranteed freedom of movementot of its members within the European space: the harmonisation of basic and continued education, guidelines for the length and content of the practical training in radiotherapy (logbook system), and minimum standards for the accreditation of teaching departments. A European examination and diploma were only envisaged to come at the end of the road. However, with the European directive in mind these long term objectives have now gained momentum and. If ESTRO is to play a role in building a European consensus around the legal framework which will govern the future functioning of Radiation Oncology in Europe, it will have to come up quickly with solid data and creative and thorough discussion documents for entering the debate at the national level.