Effect of a staffing strategy based on voluntary increase in working hours on quality of patient care in a hospital in KwaZulu-Natal

Two of the issues facing the South African Health Care System are the shortage of nursing staff and a lack of adequate skills to provide quality patient care. The hospital under study experienced a critical shortage of applications from professional registered nurses, consequently a staffing strategy was implemented to overcome the shortage of nurses and to maintain quality patient care. The strategy introduced encouraged nurses to voluntarily work an additional ten hours per week with remuneration. A non-experimental, descriptive design with a quantitative approach was applied to investigate the effect of a staffing strategy aimed at improving the quality of care in a hospital in Kwa-Zulu Natal based on voluntarily increasing staff working hours. The investigation compared the quality of nursing care before and after the implementation of the staffing strategy through retrospective audits of randomly selected patient files 372 (11%) of the total population of 400 files were audited. A random sample of 4 boxes each containing a 100 patient files, of a total of 34 boxes, was selected from the hospital filing system. Descriptive statistical analyses were performed and correlations between various variables using the Chi-square test. No statistically significant differences (p<0.05) were found between the quality of nursing care before and after the implementation of the management strategy, even though deterioration of results after the implementation was observed. The study shows that the quality of nursing care in most wards deteriorated after implementation. The staffing strategy failed to improve or maintain the quality of nursing care

Knowledge of community care workers about key family practices in a rural community in South Africa

CITATION: Stellenberg, E., Van Zyl, M. & Eygelaar, J. 2015. Knowledge of community care workers about key family practices in a rural community in South Africa. African Journal of Primary Health Care & Family Medicine, 7(1):1-7, doi:10.4102/phcfm.v7i1.892The original publication is available at http://www.phcfm.orgBackground: Interventions by community care workers within the context of communitybased integrated management of childhood illness (CIMCI) may have a positive effect on child health if the health workers have adequate knowledge about key family practices. Setting: The study was conducted in rural areas of the West Coast district in the Western Cape, South Africa. Objectives: The objective of this study was to determine the knowledge of community care workers about five of the 16 key family practices of CIMCI. Methods: A descriptive survey collected a self-administered questionnaire from 257 community care workers out of a possible total of 270 (95.2% response rate). Descriptive and inferential statistical analysis was applied. Results: Only 25 of the respondents (10%) obtained a score higher than 70% on the knowledgebased items of the questionnaire. Less than 25% of respondents answered questions in these key areas correctly (pneumonia [17%], tuberculosis [13%], HIV/AIDS [9%] immunisation [3%] and recommendations for a child with fever [21%]). Statistically significant correlations were found between the total score a respondent achieved and the highest level of education obtained (p < 0.01), the level of in-service training (p < 0.01), attendance of a CIMCI five-day training course (p < 0.01), and completing a subsequent refresher course (p < 0.01). Conclusion: The knowledge of CCWs was inadequate to provide safe, quality CIMCI. CIMCI refresher courses should be offered annually to improve CCWs’ knowledge and the quality of care that they render. Regular update courses could contribute to building competence.http://www.phcfm.org/index.php/phcfm/article/view/892Publisher's versio

Accessibility, affordability and use of health services in an urban area in South Africa

Background: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. Objectives: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. Method: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. Results: The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ²) test. Conclusion: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly

A new approach to Professional Practice

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Investigation into the relationship between the socio-economic and health status of the Coloured people of the Western Cape in an urban setting

A descriptive non-experimental approach was applied to investigate and describe the prevalence of factors influencing the health status of the Coloured people of the Western Cape in an urban setting as a dissertation for a doctorate degree. For the purpose of this article the relationship between the socio-economic and health status of the Coloured people of the Western Cape in an urban setting are described. The study only included economically active persons < 21 ^ 50 years. The objective was to determine the relationship between the health status and the socio-economic status of economically active Coloured people in an urban area as defined. The objectives set for the study were reached through a cross sectional study. The hypothesis, an association between the health status and the socio-economic status of the Coloured people of an urban area in the Western Cape was tested using the chi square statistical test. A purposeful stratified sample of 353 participants was drawn from the residential areas as defined for the purpose of the study. All social classes were well represented in the suburbs. Statistical associations on a 95% confidence interval were shown between the socio-economic status (i.e. educational level, income and occupation) social habits, diet, and money available for food, exercise and the health status of the respondents. Recommendations were made based on the scientific evidence obtained through the study

The Patient With Burns

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HIV/AIDS peer education initiative for learners in Kuils River Western Cape South Africa.

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Nursing students’ perception of simulation as a clinical teaching method in the Cape Town Metropole South Africa

Background. Given the pivotal role that simulation plays in teaching students clinical skills, it is important to understand the students’ perception of using simulation laboratories. Objectives. A descriptive qualitative research design was used to determine whether participants ‘believe’ they have gained competence and confidence to assess a patient holistically. Methods. Purposive sampling of 10 individual interviews and a focus group of 7 participants was drawn from primary healthcare students who successfully completed the programme the preceding year. Data were collected by 2 trained fieldworkers and transcribed by the researcher (NN). Ethical approval was obtained from the Health Research Ethics Committee, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa, and informed consent from the participants. Results. The data that emerged from the data analysis were coded and categorised into themes and subthemes. The following 5 themes emerged: simulation as a teaching method; a manikin offering effective learning; confidence in clinical practice; structure of the course; and a support system. The researcher compiled a written account of the interpretations that emerged from the data analysis and verified these with the fieldworkers. Furthermore, member checking was done on 2 of the participants from the focus group and 2 of those from the individual interviews to validate the transcribed data. The findings suggest that the manikin should be upgraded regularly and be able to register a response. Data showed that the students are in favour of simulation as a foundation phase in their programme, but preferred to be introduced to a human being. Conclusion. Simulation as a clinical teaching method ensured a good foundation phase, but students felt more competent and confident after practising on humans

Opvoeding tot menseregte : die dienste van die staat en die verpligting van die indiwidu teenoor die staat

M.Ed. (Sociology of Education)This study is part of a broader research project that deals with educating towards human rights. The purpose of this study was to determine the matriculants' perception of the duty of the State and the responsibility of the individual towards the State. It is also aimed at informing readers about the rights and duties of the State and individuals as far as education is concerned

The Effects of Computerized Electronic Prompts in Influencing Dental Hygiene Students’ Compliance with Infection Control Protocols

University of Minnesota M.S. thesis. April 2018. Major: Dentistry. Advisor: Joy Osborn. 1 computer file (PDF); 153 pages.Background: In a health care setting, infection control protocols are established to ensure patient and provider safety. Research suggests provider compliance with infection control protocols decreases over time and that frequent training interventions are needed to sustain and improve compliance. The success of computerized prompts in medicine suggests investigation in the dental environment is warranted. Purpose: The purpose of this study was to investigate the effect of computerized prompts on the cross-contamination in a dental school clinic. Methods: A convenience sample of twenty-two senior dental hygiene students participated in the study. Microbial samples were collected after initial patient treatment and after students had completed cubicle disinfection. Computerized prompts were then introduced and, after students completed three rounds of computerized prompts, final microbial samples were collected and counted. Results: No statistically significance was found after the computerized prompt intervention was implemented. Conclusion: The keyboard was the most contaminated surface after disinfection and the most irregular object in the operatory with deep grooves and consistent use. Students appeared to be compliant with infection control protocol. No statistically significance differences in initial or residual contamination was reported after prompt intervention