Completeness and Readability of Health Information in Hospitals Records – North Kordofan State-Sudan 2015

Documentation of patients` information in the hospital registry is crucial for efficient quality of care. The objective was to assess the completeness and readability of patients` information in the inpatients files of internal medicine and pediatric departments. A descriptive audit study carried out in four hospitals in North Kordofan State. A total of 549 and 555 inpatients` files were reviewed from the internal medicine and pediatric departments respectively. A structured review checklist was used for the audit.  Data was managed by SPSS version 20. Comprehensiveness proportions were calculated manually. Chi square test at 95% CL was used for comparison. Complete and readable full names of patients were shown in 6.2% and 34.2% of internal medicine and pediatric files respectively. Patients` full contact address was complete and readable in 11.3% and 4.5% respectively. Only 0.5% of pediatric files had recorded age. Completeness of basic information in inpatients` files was significantly different in favor to the internal medicine department, P- value=0.01. Documentation of clinical assessment items was complete in internal medicine files (65.6%) and pediatric files (62.5%). Pediatric files had complete readable vaccination history (55.7%), complete readable perinatal, natal and postnatal history (40%) and complete readable milestones history(29.9%). The summary discharge pages had comprehensiveness scores, 13% and 18.7% in internal medicine and pediatric files respectively, P-value 0.01. Date of discharge was adequately complete in 74.1% and 77.5% of the internal medicine and pediatric files respectively. Information in hospital inpatients` files was not complete.Two thirds of inpatients` files were complete and readable for clinical assessment items. The childhood developmental history was under-documented. The summary discharge pages were not completely documented except the date of discharge.  A reform plan and computerization of the data base is recommended.

Knowledge, Attitude and Practice of Village Midwives Regarding HCV in Khartoum State, Sudan; 2014

Hepatitis is a disease of liver that can be caused by chemicals or viruses. The objective of this study is to study level of knowledge, attitude and practice among village midwives regarding HCV, Khartoum State, Sudan, 2014. This study was a descriptive study. Three hundred thirty five village midwives were surveyed. Data was collected through questionaire which was composed of 20 questions; 11 for knowledge, 6 for attitude and 3 for practice. Variables were computed using SPSS version 20. The results shows that most of respondents were in age group less than 49 years (68.4%). Seventy seven percent were educated. About half of them had duration of work for more than twenty years. They had poor knowledge (33.7%) and attitude (42.4%); but they had moderate level of positive practice (61.2%). There was no significant statistical association between knowledge and age, education, or duration of work; no significant statistical association between attitude and age or duration of work, while there was significant statistical association of attitude with education; and no statistical association between practice and age, while there was significant statistical association between practice and education and duration of work. There was a poor level of knowledge and attitude; but there was moderate level of positive practice.There was significant statistical association between attitude and education; between practice and education and duration of work. Health education is highly recommended

Nurses` Perception Regarding Diabetic Wound Care at Primary Health Care Level

One of the challenges regarding quality of care at primary care level is diabetic wound services; where the nurses are the pillar in wound care. The study objective was to determine the perception of nurses regarding the diabetic wound services in the health centers.  A descriptive qualitative study carried in Khartoum State Sudan targeted nurses at the health centers. Focus Group Discussion (FGD) was carried out using semi-structured open ended questions. Saturation of information was obtained after four FGD sessions resulted in 26 nurses. Informed consent was signed and obtained from each nurse. Two independent qualified researchers carried out content analysis of the recorded information. The results show that female to male ratio was 2:1. Most of nurses were holders of Technical Nursing Certificate. Almost all nurses have not received in-service training about diabetes and diabetic wound care. Factors affecting diabetic wound services were lack of guidelines for services and follow-up registry, insufficient consumables and dressing materials and negative patients` attitudes. In-service training on diabetic wound care was absent. Guidelines and follow up registry for diabetic wound care were not available at the health centers.  Health centers were lacking sufficient dressing and surgical materials. Strengthening the capacity of nurses and availing adequate resources and services` guidelines are recommended.

Tutors, The Valuable Resource to Enhance Medical Students’ Motivation.

Background: Students’ academic performance is largely affected by their motivation. Moreover, health professions’ education needs motivated students who are keen to tolerate the burden of clinical work along with the academic excellence to graduate competently. This study assessed the effect of tutors on students’ motivation. Method: A cross-sectional, institution-based study of the first-year medical students at University of Khartoum, Sudan was conducted. A self-administered questionnaire was used comprising a modified Motivated Strategies for Learning Questionnaire (MSLQ) with students’ evaluation of their tutors after semester one community medicine course. A total of 237 out of 324 students responded. Pearson productmoment correlation coefficient was used to test the relationship between motivation and evaluation. Hierarchical multiple regression model tested the ability of evaluation factors to predict motivation score. Results: There was a significant association between tutor’s characteristics regarding creativity in conducting the sessions, igniting discussion, and adequacy of knowledge about the course contents and the motivation score (p-value = 0.001). There was a strong, positive correlation between the perceived evaluation score and perceived motivation score (r = 0.505, n = 206, p < 0.0005). After controlling age, gender, paternal educational levels, and scores of Sudanese certificate upon entry, R squared change = 0.28, F change (9.181) = 8.416, p <0.001. In the final model, the content of the course was statistically significant, standardized Beta = 0.285, indicating that content uniquely explains 5.7% of the variance in total perceived motivation score. Conclusion: The evaluation score explained 28% of the variance in student motivation. Students’ motivation issignificantly associated with tutor’s teaching skills concerning knowledge, creativity, students’ involvement, and attractiveness in conducting the tutorials. Improving course content can enhance students’ motivation toward community medicine

Overuse of Radiological Imaging in National Health Insurance Fund Centres, Khartoum Sudan 201

Background: Overuse of radiological imaging contributed to risk of radiation. Objective: To identify causes of overuse and unnecessary radiological imaging and the responses of radiologist towards doubtful imaging requests. Methods: A cross sectional study carried out in four reference diagnostic centres accepting insured patients. Self-administered questionnaire was testing the perception of radiologists by Likert scale. Eleven and five causes were listed for overuse and unnecessary imaging respectively. Factor analysis was used to extract the domain causes. Cronbach's Alpha was used for reliability at >0.7.  Fisher exact test was used at 95% confidence level to test the association of the cause, insufficient clinical examination, with time being working in NHIF and the working years.  Results: Females accounted to 71.4%, 48.4% were specialists of Computed tomographic scan and paediatric radiology. Perceived causes of overuse were new radiological technology (71.4%), availability of radiological resources (57.1%), larger payment from NHIF (57.1%) and patients` demands (57.1%). Factor analysis yielded five causes of overuse. Insufficient clinical examination (90.4%) and give comfort to the patients (61.9%) were causes of unnecessary imaging. Doubtful imaging request was not performed because of serious complications of radiation (71.4%). The cause, insufficient clinical examination was not significantly associated with time being working in NHIF and the working years P-value > 0.05.  Conclusion: Insufficient clinical examination and comfort the patients were the causes of unnecessary radiology imaging .Radiologists did not respond to doubtful imaging request for the serious complications of radiation

Ebola hemorrhagic fever under scope, view of knowledge, attitude and practice from rural Sudan in 2015

Summary: Ebola hemorrhagic fever (EHF) is an emerging threat to public health. The last epidemic in West Africa had a great effect on the affected communities. Timely and effective interventions were necessary in addition to community participation to control the epidemic. The knowledge, attitude and practices of vulnerable communities remain unknown, particularly in Sudan.The aim of this study was to explore the knowledge, attitude and practices of rural residents in Sudan regarding Ebola hemorrhagic fever.We conducted a cross sectional, community-based large-scale study in Al Gaziera state in rural Sudan in eight localities. In total, 1500 random adult participants were selected. The participants were assessed by a predesigned pretested questionnaire regarding their knowledge, attitude and practices regarding Ebola. Their sources of information were determined, and we assessed demographic factors as predictors of knowledge.We found poor knowledge, a fair attitude and suboptimal practices among the participants. The main sources of information were the press and media. Education was the only predictor of knowledge regarding Ebola.A lack of knowledge and suboptimal preventive practices mandates orientation and education programs to raise public awareness. Health care providers are advised to engage more in educating the community. Keywords: Ebola knowledge, Attitude, Practice, Health care providers, Educatio