Inadequate Number Of Staff Research Articles

Missed nursing care in surgical care– a hazard to patient safety: a quantitative study within the inCHARGE programme

BackgroundMissed nursing care occurs globally, and the consequences are severe for the patients when fundamental care needs are not fulfilled, nor delivered in a person-centred way. This study aimed to investigate the occurrence and cause of missed nursing care, and the relationship between registered nurses’ and nursing assistants’ perceptions of missed nursing care, in a surgical care context.MethodsA quantitative study was performed using the MISSCARE survey, measuring missed nursing care and associated reasons, in three surgical wards with registered nurses and nursing assistants as the participants (n = 118), during May-November in 2022. The MISSCARE survey also covers background data such as job satisfaction and intention to leave. The survey was distributed paper-based and the response rate was 88%.ResultsAspects of nursing care rated to be missed the most were ‘attending interdisciplinary care conferences’, ‘turning patient every 2 h’, ‘ambulation 3 times per day or as ordered’, and ‘mouth care’. Differences between registered nurse and nursing assistant ratings were detected for eight out of 24 items, where registered nurses rated more missed nursing care. The uppermost reasons for missed nursing care were ‘inadequate number of staff’ and ‘unexpected rise in patient volume and/or acuity on the unit’. Registered nurses and nursing assistants rated differently regarding six of 17 items. Almost every fourth staff member (24.6%, n = 29) had the intention to leave within a year in the present department.ConclusionsThe occurrence of missed nursing care is frequent in the surgical context, and in combination with a high number of staff members intending to leave their employment, poses a hazard to patient safety. Registered nurses, holding higher educational levels, reported more missed care compared with the nursing assistants. The main reason for missed nursing care was an inadequate number of staff. These findings support a warranted investment in nursing within the organisation. The results can be used to form strategies and interventions, to reduce nurse attrition and optimise competence utilisation, and to achieve safe person-centered fundamental care.

Original Research: Nurse-Reported Missed Care and Its Association with Staff Demographics and the Work Environment.

Nurses have primary responsibility for many of the care processes and interventions intended to improve patients' health during hospital stays. Accordingly, missed nursing care can negatively impact patient safety and lead to negative clinical outcomes. Missed nursing care is standard care that is not completed, incomplete, or seriously delayed. There is scant literature on nurse-reported missed care (NRMC) in Singapore. Identifying the prevalence of, types of, and reasons for missed care, including staff-related factors, is imperative to understanding the implications of missed care and identifying opportunities for improvement. Ours is a correlation study of NRMC using convenience sampling. Nurses working on all inpatient units in an acute care hospital in Singapore were recruited to complete the MISSCARE survey, a quantitative tool measuring missed nursing care and the reasons for it. Descriptive statistics was applied to analyze demographics, types of NRMC, and reasons for NRMC. The Pearson χ2 test was used to analyze the correlation between demographics and satisfaction variables and NRMC. A total of 314 participants out of 1,944 eligible nurses (response rate, 16%) were recruited. The most commonly reported missed care activities were setting up meals for patients who can feed themselves (87.3%), ambulation (70.1%), attending interdisciplinary conferences (64.3%), providing emotional support to patients and/or family (58%), and turning patients every two hours (56.7%). The most cited reasons for missed care were inadequate number of staff (84.4%), caregiver not in unit or unavailable (76.1%), heavy admission and discharge activity (75.5%), urgent patient situations (74.2%), and unexpected rise in patient volume and/or acuity (73.2%). Younger age, greater experience in role and current unit, inadequate staffing and teamwork, low satisfaction with current role and with being a nurse, and planning to leave the current position were factors significantly associated with greater levels of missed care. This study demonstrated evidence of NRMC and its associated factors within the local setting. In addition to expanding nursing resources, analyzing nursing work processes, providing support for younger nurses, and improving nursing satisfaction are possible mitigating factors in preventing missed care. Strategies targeting workforce and resource management, greater support for new and younger nurses, and job satisfaction should be considered to address missed care.

EFFECTIVENESS OF AUTOMATED DISPENSING MACHINE (ADM) TO REDUCE THE EVENTS OF DISPENSING ERROR ON MEDICATION ERROR IN INCREASING PATIENT SAFETY: Literature Review

Background: patient safety is one of the main things in providing health services in hospitals. Medication error is one frequent incidents that could harm the patient. Dispensing error is one of the stages in medication errors that can be caused due to high workload, inadequate number of staff, LASA medication, drug packaging that is similar or almost the same, LASA drug storage system, and environmental factors such as distractions and interruptions. Aim: to determine the effectiveness of the Automated Dispensing Machine (ADM) for reduce the incidence of dispensing errors in medication errors to improve patient safety. Methods: this study uses a literature review study by using various journal databases, such as Google Scholar, Science Direct and ProQuest, with journal spanning the last five years. Results: study was shows that the implementation of the Automated Dispensing Machine (ADM) is effective reduce the incidence of dispensing errors in medication errors by being integrated with barcode system and hospital information system. This article can used a refrence in research on the effectiveness of ADM for reduce the incidence of dispensing errors in medication errors.

Inadequate number of staff and other reasons for implicit rationing of nursing care across hospital types and units.

The aim of the study was to find differences in perceived reasons for implicit rationing of nursing care across hospital types and units. A descriptive multicentre study. The study in 14 Czech acute care hospitals was conducted from September 2019 to October 2020. The sample consisted of 8316 nurses working in medical and surgical units. Items for rating the reasons for implicit rationing of nursing care were selected from the MISSCARE Survey. Nurses were asked to rate each item on a scale from 0 (a not significant reason) to 10 (the most significant reason). The most significant reasons for implicit rationing of nursing care were 'Inadequate number of staff', 'Inadequate number of assistive personnel' and 'Unexpected patient admission and discharge'. Most reasons were rated as more significant by nurses from non-university hospitals. Nurses from medical units perceived all reasons for implicit rationing of nursing care as more significant.

Quality of health care around the time of childbirth during the COVID‐19 pandemic: Results from the IMAgiNE EURO study in Norway and trends over time

To describe maternal perception of the quality of maternal and newborn care (QMNC) in facilities in Norway during the first year of COVID-19 pandemic. Women who gave birth in a Norwegian facility from March 1, 2020, to October 28, 2021, filled out a structured online questionnaire based on 40 WHO standards-based quality measures. Quantile regression analysis was performed to assess changes in QMNC index over time. Among 3326 women included, 3085 experienced labor. Of those, 1799 (58.3%) reported that their partner could not be present as much as needed, 918 (29.8%) noted inadequate staff numbers, 183 (43.6%) lacked a consent request for instrumental vaginal birth (IVB), 1067 (34.6%) reported inadequate communication from staff, 78 (18.6%) reported fundal pressure during IVB, 670 (21.7%) reported that they were not treated with dignity, and 249 (8.1%) reported experiencing abuse. The QMNC index increased gradually over time (3.68 points per month, 95% CI, 2.83-4.53 for the median), with the domains of COVID-19 reorganizational changes and experience of care displaying the greatest increases, while provision of care was stable over time. Although several measures showed high QMNC in Norway during the first year of the COVID-19 pandemic, and a gradual improvement over time, several findings suggest that gaps in QMNC exist. These gaps should be addressed and monitored.

Factors Influencing Turnover Intention among Nurses and Midwives in Ghana.

Nurse turnover intention, defined as a measure of nurses' desire to leave their positions, is a global public health issue with a grave impact on the healthcare workforce. However, literature on it is limited in sub-Saharan Africa, an at-risk region. This study aimed to determine the predictors of turnover intention among nursing staff at a tertiary hospital in Kumasi, Ghana. This was an institution-basedcross-sectional study conducted among 226 randomly selected nurses and midwives working at a tertiary healthcare center in Kumasi, Ghana. Data were collected by using a structured questionnaire. Significant predictors of turnover intention were analyzed by using multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p value <0.05 was used. The prevalence of turnover intention among study participants was 87.2% (197/226). About two-thirds (61.5%, 139/226) of the participants were exposed to a high level of workplace hazards. Management support (AOR = 3.09, 95% CI = 1.09-8.75), salary (AOR = 0.07, 95% CI = 0.01-0.46), inadequate number of staff on duty per shift (AOR = 3.36, 95% CI = 1.08-10.47) and participants' rank (AOR = 6.81, 95% CI = 1.18-39.16) were significantly associated with turnover intention. Overall, the turnover intention was high. Hence, there is a need for policymakers, health administrators, and nurse managers to implement strategies such as increasing staff strength, providing adequate support, incentives, and other forms of motivation for nurses and midwives to help reduce the rate of turnover intention.

Determinants of burnout among nurses and midwives at a tertiary hospital in Ghana: A cross-sectional study.

This study determined the prevalence and key determinants of burnout among nurses and midwives in Kumasi, Ghana. Hospital-based cross-sectional study. A questionnaire was used to obtain data from 391 nurses and midwives at a tertiary hospital in Kumasi, Ghana using simple random sampling. About 84.4% of the participants were females. The majority of the study participants experienced low burnout for all dimensions (58% in emotional exhaustion, 55.5% poor personal accomplishment and 38.3% depersonalization). Multiple regression analysis revealed that high emotional exhaustion was independently predicted by post-graduate education (β=6.42, p=.003), lack of support from management (β=2.07, p=.024), dislike for leadership style, (β=3.54, p < .001) and inadequate number of staff (β=2.93, p=.005). Age (β=0.35, p=.004), lack of support from management (β=1.60, p=.012), and inadequate number of staff (β=1.49, p=.034) independently predicted high depersonalisation. Female sex (β=4.36, p < .001) and years of practice (β=-0.26, p < .001) independently predicted low personal accomplishment.

The Determinants of Partograph Utilisation among Obstetric Care Providers at Primary Healthcare Level in South-East Nigeria: A Mixed-Methods Study

BACKGROUND Prolonged and obstructed labour is responsible for 8% of maternal deaths can be prevented by using partograph during labour since complications can be discovered early and avoided. The goal of this study was to determine the factors that influence partograph utilisation (barriers and facilitators) among Obstetric caregivers in primary healthcare centres, Orlu local government area of Imo State, southeast Nigeria. METHOD A mixed method design was adopted for the study. For quantitative and qualitative data collection, a semi-structured questionnaire and an interview guide were utilised. A structured validated proforma was also used to collect data from patient records in all the health centres. The qualitative study consisted of oral interviews conducted among 22-unit heads in the 22 health centres. The data were analysed using simple descriptive statistics such as frequency and percentages, and the results were presented in tables. RESULTS According to the findings, the use of partograph among Obstetric caregivers in primary Healthcare centres in Orlu L.G.A was determined by personal factors such as skill incompetency in carrying out an assessment with the partograph (2.6±0.87); time constraint (2.8±0.55), institutional factors influencing the use of partograph included, non-availability of partograph (2.9±0.92), Lack of adequate orientation (3.4±0.58), Lack of training (3.3±0.47). The qualitative data revealed barriers to the use of the partograph to include unavailability of partograph, inadequate number of staff, increased workload and poor supervision. For partograph utilisation to improve among obstetric caregivers, further training and employment of more staff are needed, provision of partograph forms are also important factors to consider.

Examining the reasons for missed nursing care from the viewpoints of nurses in public, private, and university hospitals in Jordan: A cross-sectional research

BackgroundMissed nursing care is an indicator of quality nursing care. It is a significant healthcare delivery problem, especially given increased demand and limited resources worldwide, including in Jordan. It is paramount to identify the reasons for missed care in hospital settings. AimTo identify the perceptions of registered nurses for missed nursing care in medical and surgical wards in Jordanian hospitals. We also aimed to identify differences in the reported reasons for missed nursing care across three healthcare sectors: public, private, and university. MethodsA quantitative approach utilising a cross-sectional design was conducted by surveying registered nurses at 10 hospitals in Jordan. This study employed the MISSCARE Survey tool. The data collection was performed between March and July 2021. Descriptive statistics and analysis of variance were used to address the objectives. FindingsA sample of 672 registered nurses working in medical and surgical wards in 10 acute care hospitals in Jordan were recruited. The major reason for missed nursing care was inadequate number of staff. Communication issues were more important to missed nursing care in university hospitals than public and private hospitals. ConclusionA study of Jordanian registered nurses revealed that a perceived shortage of human resources is the principal reason for missed nursing care in medical and surgical wards. Comparing the reasons for missed nursing care between the three hospital sectors could help nursing administrators to tailor operational interventions to mitigate the effect of these causes. Therefore, reducing missed nursing care.

Losses in the Sputum Specimen Referral Cascade in Mpulungu District, Zambia: A Cross-Sectional Study.

Sputum specimen referral cascades in resource-limited settings are characterized by losses of specimens, resulting in delays in tuberculosis (TB) diagnosis. Mpulungu District Health Office in Zambia conducted a quantitative based cross-sectional study using both primary and secondary data to identify points at which loss of specimens occurred in the sputum referral cascade. Primary data were collected through observations and interviews with 22 TB service providers. Secondary data were collected through examination of patient files and presumptive TB and laboratory registers to retrospectively track sputum specimens referred by ten health centers from April to September 2018. Proportions of specimens/laboratory results at every stage of the referral cascade were calculated using Epi Info v7. Only 49 (23%) out of 209 sputum specimens completed the referral cascade. The remaining 160 (76%) were lost at various stages of the referral cascade. The largest loss (51%) occurred between the release of laboratory results by the diagnostic facility and their receipt at referring facilities. Barriers included an inadequate number of staff oriented in sputum specimen referral, negative staff attitudes, and lack of specimen packaging material and specimen transportation. The district health office should strengthen the sputum specimen referral system by providing transport and specimen packaging material and by training staff in sputum collection transportation and tracking.

Constraints to Optimising Revenue Potential in Subnational Governments in Kenya: Lessons from Nairobi City County

Optimisation of revenue potential in the subnational governments in Kenya is core to meeting the their recurrent and development expenditure needs without overrelying on national government transfers. However, the subnational governments face constraints that limit their potential to enhance their revenue collections. Therefore, this study examines the constraints to own source revenue (OSR) collections in Nairobi City County (NCC), assesses challenges to optimal collection of parking fees, and identifies measures to address the challenges inherent to the collection of single business permits (SBPs) debts in the county. The study employed desk review and survey design targeting 170 key informants from the NCC Government and the Kenya Revenue Authority distributed across the 17 sub-counties. The study found that the major constraints to OSR collection in the NCC are inadequate revenue collection tools, equipment and machines (82%); inadequate capacity of the debt collection unit to follow taxpayers who default or delay in making payments (68%); poor tax education/awareness within the county (63%); below par adoption of information and communications technology systems combined with the prevalence of manual revenue collection in making payments (58%); inadequate staff numbers to collect the fees and charges (53%); and lack of legal framework (policies, rules and regulations) for collection of all the revenue streams (51%). The study also found that the main challenges to optimal collection of parking fees in the NCC are high parking fees; system failure; insecurity; unmarked parking lots; interference by parking boys; lack of parking spaces, among others. The study makes suggestions for addressing the challenges in the collection of SBPs debts and provides comprehensive recommendations on dealing with the identified constraints to revenue optimisation in the NCC, applicable to other subnational governments across sub-Saharan Africa.

Exploration of non-pharmacological interventions in the management of behavioural and psychological symptoms of dementia.

Behavioural and psychological symptoms of dementia (BPSD) are considered integral parts of dementia. While pharmacotherapy is reserved for severe symptoms of BPSD, the associated adverse effects can be detrimental. Therefore, non-pharmacological intervention is recommended as the first line of treatment in the management of BPSD. This study aimed to explore the non-pharmacological approaches for the management of BPSD and the strategies and barriers to implementing them in secondary care facilities in Malaysia. A qualitative study design was employed. Data were collected through observations and semi-structured interviews of 12 caregivers and 11 people with dementia (PWD) at seven secondary care facilities. Observations were written in the field notes, and interviews were audio-recorded and transcribed. All data were subjected to thematic analysis. Some personalised non-pharmacological interventions, such as physical exercise, music therapy, reminiscence therapy and pet therapy, were conducted in several nursing care centres. Collaborative care from the care providers and family members was found to be an important facilitating factor. The lack of family support led to care providers carrying additional workload beyond their job scope. Other barriers to non-pharmacological interventions were cultural and language differences between the care providers and PWD, inadequate staff numbers and training, and time constraints. Although non-pharmacological approaches have been used to some extent in Malaysia, continuous education and training of healthcare providers and the family members of PWD is needed to overcome the challenges to their successful implementation.

Omission of nursing care, professional practice environment and workload in intensive care units.

The present study aimed to characterize the omission of nursing care according to the nurses' perception, the professional practice environment and the nursing workload of intensive care units (ICU) in Brazil. Additionally, the influence of the practice environment and nursing workload on such omission was assessed, as well as the type of care omitted regarding priority classification. In order to ensure patient safety and quality of care, it is necessary to invest in improvements in nursing care practices. The present cross-sectional study was performed in three large ICU in Brazil. The omission of nursing care was identified using the MISSCARE-BRASIL instrument, and the environment and duration of professional nursing practice were analysed using the Practice Environment Scale (PES) and Nursing Activities Score (NAS), respectively. "Ambulation three times a day or as prescribed" was the form of care reported as the most omitted in the three studied units. The reasons for not performing care included the following: inadequate number of staff, inadequate physical blueprint of the unit/sector and the professional having more than one employment relationship. Upon characterizing the work environment in the ICU according to the PES, ICU 1 and 3 were considered "mixed" environments, whereas ICU 2 was considered a "favourable" environment. The professional practice environment, as well as the workload, may constitute predictive factors for the omission of care. The nursing workload and practice environment influence the omission of care. Moreover, the establishment of criteria for the prioritization of care when faced with adverse work conditions is necessary.

Fetal heart rate monitoring practices at a public hospital in Northern Uganda – what health workers document, do and say

ABSTRACT Background: In Uganda, perinatal mortality is 38 per 1000 pregnancies. One-third of these deaths are due to birth asphyxia. Adequate fetal heart rate (FHR) monitoring during labor may detect birth asphyxia but little is known about monitoring practices in low resource settings. Objective: To explore FHR monitoring practices among health workers at a public hospital in Northern Uganda. Methods: A sequential explanatory mixed methods study was conducted by reviewing 251 maternal records and conducting 11 interviews and two focus group discussions with health workers complemented by observations of 42 women in labor until delivery. Quantitative data were summarized using frequencies and percentages. Content analysis was used for qualitative data. Results: FHR was assessed in 235/251 (93.6%) of records at admission. Health workers documented the FHR at least once in 175/228 (76.8%) of cases during the first stage of labor compared to observed 17/25 (68.0%) cases. Median intervals between FHR monitoring were 30 (IQR 30–120) minutes in patients’ records versus 139 (IQR 87–662) minutes according to observations. Observations suggested no monitoring of FHR during the second stage of labor but records indicated monitoring in 3.2% of cases. Reported barriers to adequate FHR monitoring were inadequate number of staff and monitoring devices, institutional challenges such as few beds, documentation problems and perceived non-compliant women not reporting for repeated checks during the first stage of labor. Health workers demonstrated knowledge of national FHR monitoring guidelines and acknowledged that practice was different. Conclusions: When compared to national and international guidelines, FHR monitoring is sub-optimal in the studied setting. Approximately one in four women was not monitored during the first stage of labor. Barriers to appropriate FHR monitoring included shortage of staff and devices, institutional challenges and mother’s negative attitudes. These barriers need to be addressed in order to reduce neonatal mortality.

Strategic Plan as a Tool for Performance Management in the Tanzanian Public Sector

The study empirically examined the effectiveness of the implementation of strategic plan in Tanzanian public sector specifically in Ilala Municipality. The study employed case study design and mixed research approaches of qualitative and quantitative. Data was collected using interview, questionnaire and documentary review and was analyzed using qualitative and quantitative analysis. The findings revealed that there is poor involvement of staff in the formulation of strategic plan, inadequate financial ability, inadequate number of staff, lack of expertise in some fields, lack of autonomy in revenue collection and recruitment of staff, inconducive working environment, and budgetary deficit in the implementation of the strategic plan. To enhance effective implementation of strategic plan the study recommends involving more staff in the planning process especially at the stage of identifying strength, weaknesses, opportunities and challenges of the municipality. With respect to lack of autonomy in revenue collection and recruitment of staff it is recommended that the Ilala municipality should be given more autonomy rather than being interfered by the central government. The intergovernmental transfers of funds to Ilala municipality should be made on time without delay for effective implementation of strategic plan. The study argues that unless the obstacles to the implementation of strategic plan are addressed, its implementation will remain ineffective.

Omission of nursing care in hospitalization units.

Objective:to describe the prevalence and reasons for omission of nursing care, according to the perception of nursing professionals working in a teaching hospital.Method:a cross-sectional study was carried out with 267 professionals from ten hospitalization units. Data were collected by the MISSCARE-Brasil instrument. Descriptive statistics and Pearson’s Chi-square or Fisher’s exact tests were used to compare differences in the prevalence of omission among professional categories. Results:among the elements of nursing care, the highest prevalence of omission consisted in: to sit up the patient out of bed (70.3%), ambulation three times a day (69.1%), and participation in the discussion of the interdisciplinary team on patient’s health care (67.2%). The most frequent reasons were: inadequate number of staff (85.4%), inadequate number of staff for providing care or in administrative tasks (81.6%), and unexpected increase in the number and/or greater severity of patients (79.8%). Nurses reported major omission than nursing technicians/auxiliaries in four elements of care (p<0.05). Conclusion:according to our study, there is high prevalence of omission of nursing care elements from the professionals’ perspective. Factors related to human and material resources were more reported as causes for such omission.

Attitudes towards, facilitators and barriers to the provision of diabetes self-care support: A qualitative study among healthcare providers in Ghana

Statement of the problemSelf-care support provided by healthcare providers (HCPs) is critical to diabetes self-care. However, a number of barriers prevent HCPs from providing self-care support to people with diabetes. We explored attitudes towards, barriers and facilitators of the provision of diabetes self-care support among Ghanaian HCPs. MethodsFourteen semi-structured interviews were conducted among HCPs recruited from three diabetes clinics in Tamale, Ghana. All interviews were digitally recorded and transcribed verbatim. Transcripts were coded and analysed thematically. ResultsHCPs reported a sense of responsibility and urgency to provide self-care education to diabetes patients; while believing it was the patients' responsibility to self-care for their diabetes condition. Accordingly, HCPs perceived their role to be limited to information sharing rather than behaviour change interventions. Facilitators to the provision of self-care support included patients’ motivation, and team work among healthcare professionals. Barriers that hindered self-care support included language barriers and poor inter-professional collaboration. Furthermore, HCPs discussed that they felt inadequately trained to provide self-care support. Healthcare-system-related barriers were inadequate office space, lack of professional development programmes, high patient numbers, inadequate staff numbers, inadequate health insurance and a lack of sufficient supplies and equipment in the hospital. ConclusionHCPs attitudes were generally favourable towards supporting self-care, albeit with a focus on information provision rather than behaviour change. Training in effective strategies for providing self-care support are needed, and better use of the resources that are available.

Women's perspective of facility-based childbirth services in Ghana: A qualitative study.

BackgroundMany policy makers at country level in both medium and low to middle-income countries still have great difficulty deciding which quality intervention would have the greatest impact on the health outcomes delivered by their health systems.AimTo investigate women’s perceptions about the factors that hinders or facilitates the provision of quality childbirth services in Ghana’s health care services to guide improvement efforts.SettingThe study was conducted in the greater Accra region of Ghana in two primary level hospitals (district hospitals).MethodsA qualitative study design, which is exploratory, descriptive and contextual in nature, was used. Semi-structured interviews were used to examine the perspectives of 15 women on the factors that influence the quality of childbirth services and how services could be improved in Ghana. Data were analysed through data reduction, data display and generation of themes.ResultsThe findings in this study revealed two major themes, firstly, barriers to quality childbirth with five subthemes: high workload, shortage of health workers, non-availability of some services, as well as poor coordination, unacceptable staff behaviour and lack of cooperation from some clients, were identified by the participants as the major causes of poor quality. Secondly, ways to improve care reported, were encouraging health workers to be patient with clients, promoting open communication, friendliness and attentiveness. The need to reorganise service provision to make it more client centred, was also highlighted.ConclusionThe study findings highlight the importance of paying attention to factors such as service organisation and coordination, high workload, inadequate number of staff, as well as limitations in infrastructure and logistics for quality services delivery. Equally important are institutionalisation of systems to continuously assess and improve staff competence and attitudes and the creation of an environment that can foster good interpersonal relationship between health care providers and patients.

Implementing the medicines reconciliation tool in practice: challenges and opportunities for pharmacists in Kuwait

BackgroundUsing the medicines reconciliation tool which involves preparing an updated list of patient’s medications at each transition of care can significantly enhance patient safety. The pharmacist has been leading this process in western healthcare systems. Little is known about pharmacists’ role in medicines reconciliation in Middle Eastern Countries. ObjectivesTo explore the implementation of medicines reconciliation in Kuwait hospitals, pharmacists’ role in this process and perceptions of the challenges in implementing it in practice. MethodsThis was an exploratory descriptive study of medicines reconciliation practices at eleven secondary/tertiary hospitals in Kuwait. A mixed-methods research design was used whereby 110 hospital pharmacists participated in 11 focus groups and 88 of them completed self-administered surveys. ResultsParticipants reported that medicines reconciliation is poorly applied in hospitals and that they had limited role in the process. The current medicines reconciliation policy does not assign any responsibilities for pharmacists in this process. The most significant barriers to applying medicines reconciliation by pharmacists were inadequate staff numbers, lack of time, difficult access to patient information, lack of policy to support pharmacist role and patients’ poor knowledge about their medications. ConclusionsHospital pharmacists in Kuwait advocate implementing medicines reconciliation but report significant strategic/operational barriers to its application. Efforts are needed in policy reform and team training to enable pharmacists provide effective patient care services including medicines reconciliation.

Constraints faced by animal husbandry officials in the implementation of integrated murrah development scheme (IMDS) in Haryana Sta

A study has been conducted in Haryana to analyze the various constraints faced by animal husbandry officials in implementation of “Integrated Murrah Development Scheme” (IMDS). Data were collected from 40 animal husbandry officials from four districts namely Kurukshetra, Mahendragarh, Bhiwani and Jhajjar. Garett’s ranking technique was used to prioritize the different sets of constraints. “Heavy work-load due to multidimensional activities of the project during peak season” and “Inadequacy of staff in the scheme” were the major administrative constraints in order of severity. Under technical constraints “lack of mass media approach” followed by “No provision for the refresher courses for the programme functionaries” were the most severe. “Inadequate number of staff at field level and large area of operation under a single supervisor” followed by “lack of involvement of NGO and PRIs in enhancing community participation” were important infrastructural and operational constraints. Untimely release of fund by the parent department and misguidance of farmers by the middlemen/ Brokers were the economic and socio-psychological constraints, respectively. Lack of technical expertise in the field of extension, lack of emphasis on educating the dairy farmers were other important miscellaneous constraints faced by animal husbandry officials. Removal of these constraints should receive priority over the considerable focus on the implementation of such scheme.