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1
Van, Huyssteen Nina. "A legal analysis of the emergency medical services in South Africa." Diss., University of Pretoria, 2016. http://hdl.handle.net/2263/60108.
Full textAbstract:
The purpose of this dissertation is to analyse the Emergency Medical Services (EMS) in South Africa from a legal point of view. The researcher has practical experience in the EMS and this has given her insight as to how the EMS operates, the grey areas in this unique profession and how the EMS is regulated by the South African law.
A brief background of the EMS is given as well as how the system operates now and what EMS providers deal with on a day-to-day basis. This provides a clear picture of how diverse and unpredictable the EMS profession truly is. How the law regulates the EMS is discussed and all the grey areas from a medico-legal point of view are pointed out and analysed. During this discussion, the researcher makes use of her practical experience to explain why certain situations EMS providers have to deal with on a regular basis are so complex and why the EMS is in need of a better regulatory framework. The grounds of justification in medical law are also discussed and applied to the pre-hospital environment.
The researcher made use of the EMS of the United States of America (USA) and the EMS of Australia in the comparative section, analysed how their respective EMS systems operates and how it is regulated by the law. This is ultimately compared to the EMS of South Africa and recommendations were made as to how the regulation of the EMS system, as a whole, can improve in the future.<br>Dissertation (LLM)--University of Pretoria, 2016.<br>Public Law<br>LLM<br>Unrestricted
2
Cimona-Malua, T. C. "“Waiting time of patients who present at Emergency department of Saint Rita’s hospital, Limpopo Province, South Africa.”." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/539.
Full textAbstract:
Thesis (M. Med. (Family Medicine)) -- University of Limpopo (Medunsa Campus), 2010.<br>Title: Waiting time of patients who present at Saint Rita’s hospital Emergency Department (ED), Limpopo province, South Africa.
Objective: To determine the waiting time for stable patients who present at Saint Rita’s hospital ED, to determine where the longest time is spent by patients in ED and to identify the area of inefficient patients flow.
Methods: A descriptive cross-sectional study was conducted in the ED of Saint Rita’s Regional hospital in the province of Limpopo, South Africa. During a one week period, Monday to Friday in July 2010, a daily random sample of 30 patients was monitored. The time In and Out of each step in the process of care was recorded. Waiting time was defined as the time from arrival of the patient in the ED until the start of the consultation by the Medical Officer. Time elapsed was calculated for various steps in care. Demographic data, diagnosis and acuity based on the SATS were obtained from patient’s record. Data capturing was done in window excel and data analysis done using the statistical software SPSS 17.
Results: The mean waiting time for stable patients was 252.3 minutes. The mean EDLOS was 360 minutes for stable patients. Result show that 80% of patient attending Saint Rita’s ED are non-urgent (SATS: Green) cases. There was fluctuation of waiting times from Monday to Friday; with Monday having the longest waiting time and Tuesday the shortest waiting time. The waiting time for unstable patients (SATS: Red or Orange) is Zero minute. Patients spent the longest time waiting for registration (60 minutes) and for triage (57 min waiting for vitals and 28 minutes waiting for history taking). Interestingly the extremity of age: the youngest and oldest had lowest waiting time in ED. Areas of inefficient patient flow were registration and triage.
Conclusion: This study has determined the waiting time for stable patients attending Saint Rita’s Regional Hospital ED. It has shown that waiting time in ED fluctuates with the day of the week. It has also shown that waiting time in ED varies with age of the patient and volume of patients in ED. Registration and triage have been identified as areas of inefficiency patients flow and recommendations for improvement have been formulated. Sustainability of the performance requires regular follow up from the hospital management.
3
Barley, Kim Wayne. "The development of a marketing plan for an emergency medical service." Thesis, Port Elizabeth Technikon, 2002. http://hdl.handle.net/10948/120.
Full textAbstract:
The research problem addressed in this study was to develop a comprehensive marketing plan that would help an emergency medical service (EMS) in the Nelson Mandela Metropolitan Municipality (NMMM), capture a significant market share and gain a competitive advantage over competitors. To achieve this object, a literature study to determine the key components of a marketing plan was undertaken and used as a theoretical model in developing an actual marketing plan. In addition to the literature study, an empirical study was conducted to identify the key issues critical to the development of a marketing plan for the EMS. The survey method used, based on the key components gained from the literature study, consisted of an in-depth scan of the macro-environment and thorough market investigation of the target industry. The investigation involved the general management and senior personnel from the local emergency medical industry, medical aid schemes and private hospitals and clinics delimited in the study. The results of the above literature study were finally combined with the results of the empirical study and a marketing plan for an emergency medical service was developed. This study concludes with recommendations applicable for the implementation of the actual marketing plan.
4
Buchana, Yasser. "Generative mechanisms of IT-enabled organisational performance in resource-constrained Emergency Medical Services organisations in South Africa." Doctoral thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29545.
Full textAbstract:
Problem Statement: Emergency medical services (EMS) organisations have one of the highest levels of dependence on and use of information technology (IT) to support delivery of emergency medical services. The need for EMS organisations to provide efficient and effective emergency medical services has emphasised the importance of performance management. Organisational performance which is monitored and evaluated through key performance indicators (KPIs) plays an important role in EMS organisations. Organisational performance helps to monitor, evaluate and communicate outcomes in the form of KPIs. Empirical evidence shows that quantitative KPIs have been designed with little in-depth understanding of the underlying IT usage mechanisms that influence organisational performance. Unfortunately, such quantitative KPI reports have been limited in explaining organisational performance underpinned by IT. Purpose / rationale of the research: The purpose of this research study was to identify the generative mechanisms associated with IT-enabled organisational performance and to explain how these mechanisms interact. In the context of resource-constrained EMS organisations, quantitatively defined KPIs are not suitable for explaining the underlying causes of performance variations and outcomes. The lack of empirical evidence on IT-enabled organisational performance as well as the lack of theoretical explanations of the underlying mechanisms provided the primary rationale for this study. In addition, this study sought to provide answers to the following research question: What generative mechanisms explain IT-enabled organisational performance in resource-constrained EMS organisations? Theoretical approach/methodology/design: This study was informed by the critical realist philosophy of science and used the complex adaptive systems theory together with institutional theory as the theoretical lenses to investigate the research question in a manner that jointly explained the generative mechanisms. Using interviews, participant observation, organisational performance data and documents collected from a single case study, the study used abduction and retroduction techniques to explicate the mechanisms of IT-enabled organisational performance. Findings: Findings indicate that the IT-enabled organisational performance mechanisms can be categorised into two types of generative mechanisms. These are structural and coordination mechanisms. The explanation of the mechanisms developed in this study take into consideration three important elements: (1) the technological, cultural and structural mechanisms that influence IT-enabled organisational performance; (2) the unpredictable, non-linear, adaptive nature of emergency medical services environments; and (3) the complexities that arise in the interactions between EMS organisations and their environments. Originality/contribution: In respect of IT-enabled organisational performance this study contributes to both organisational and health information systems literature by developing a multi-level research framework that is informed by the realist philosophical stance. The framework plays an explanatory role which relates to its inherent ability to offer explanatory insights into the necessary mechanisms that give rise to organisational performance. This framework has the potential to guide empirical research and provide theoretical explanations of different domains or disciplines that are concerned with identifying IT usage mechanisms which influence organisational performance. These include the significance of the coordination and structural mechanisms which, under differing conditions of uncertainty, produce variations in performance outcomes. Implications: Findings from this study can be integrated into broader emergency medical policy planning and health programme management. The model developed by the study provides a fresh understanding of the underpinning mechanisms enabling performance in resource-constrained EMS organisations. It can be used to assist emergency medical institutions and practitioners in South Africa and other sub-Saharan African countries, especially Southern African Development Community (SADC) countries to improve emergency medical service delivery to the public. The findings provide a guide for improving management of emergency medical situations and resources in their respective resource-constrained contexts. Furthermore, findings from the study can also guide improved design and implementation strategies and policies of EMS systems initiatives in South Africa and sub-Saharan developing countries.
5
Howard, Ian. "Current practice in the air medical services for the inter-facility transfer of paediatric patients in the Western Cape, South Africa." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/2862.
Full text
6
Veronese, Jean-Paul Tyrone. "An assessment of theoretical knowledge and psychomotor skills of Basic Life Support Cardio-Pulmonary Resuscitation provision by Emergency Medical Services in a province in South Africa." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16524.
Full textAbstract:
Includes bibliographical references<br>Introduction: When high quality cardiopulmonary resuscitation (CPR) is performed, survival rates can approach 50% following witnessed out-of-hospital cardiac arrest. However, survival rates are more commonly much worse in both the in-hospital and out-of-hospital context and range from 0% to 18%. There is a paucity of evidence surrounding the competency at which basic life support (BLS) CPR is provided among Emergency Medical Services (EMS) personnel in South Africa, and quality assurance mechanisms are generally scarce or do not exist. Methods: A descriptive analytical study design was used to assess theoretical knowledge and psychomotor skills of BLS CPR provision by EMS personnel in a province in South Africa. An assessment questionnaire from a 'BLS for healthcare providers' course was used to determine theoretical knowledge. Cardiac arrest simulations were video recorded to assess psychomotor skills. BLS instructors independently scored the latter. Results: Overall competency of BLS CPR among the participants (n=115) was poor. The median knowledge assessment was 50% and the median skills 22%. Only 25% of the items tested showed that the participants applied the relevant knowledge to the equivalent skill and the nature and strength of theory influencing skills was small. However, certain demographic and circumstantial variables such as sector of employment, guidelines they were trained according to, age, and location where trained had a significant effect (p<0.05) on knowledge and skills. Discussion: This study suggests that theoretical knowledge has a small but notable role to play in psychomotor skills performance of BLS CPR. Demographic and circumstantial variables that were shown to affect knowledge and skill may be used to improve training and therefore competency. The results of this study highlight the need for continuous, and perhaps tailored BLS CPR instruction to bring the diverse set of EMS personnel currently practicing in South Africa up to international competency standards.
7
Buthelezi, Jabulani Khulikani Ancon. "Implementation of customer care at the Casualty Department of Edenvale Regional Hospital in Gauteng Province." Diss., 2017. http://hdl.handle.net/10500/22992.
Full textAbstract:
The study aimed to investigate the implementation of customer care at the Casualty Department
of Edenvale Regional Hospital in Gauteng Province. The research was conducted using a
qualitative case study approach, which sought to gain deeper understanding of the impact of
customer care in the hospital’s Casualty Department from the employees’ point of view. Data was
collected from 16 purposively selected respondents using semi-structured interviews and
document analyses were interpreted by the researcher to give voice and meaning to the assessment
topic. Data was analysed using the Content Analysis framework and six themes emerged from the
data analysis: (1) High expectation levels from the community; (2) Quality of patient care; (3)
Lack of resources; (4) Malfunctioning equipment; (5) Compromised safety and security; (5)
Strategies to improve customer care; and (6) The effect of policies and guidelines on the quality
of services rendered. The study revealed that the surrounding community that is served by the
Edenvale Hospital’s Casualty Department had high expectations which the hospital was unable to
meet because of the many limitations, especially resource constraints. The issues and difficulties
associated with overcrowding in the emergency section were raised by respondents, who reported
several challenges experienced in the hospital. These included patients sleeping on floor mattresses
and even on stretchers, inadequate beds, shortage of staff, malfunctioning equipment and lack of
sufficient infrastructure. These challenges resulted in long waiting periods for patients to be given
open beds in the wards, bad attitudes from both patients and employees alike, poor communication
among staff and patients and their families, and an unsafe environment for the staff and customers
(patients). There is hence a need for the Gauteng Health Department together with the hospital
management to review resources allocated to the Edenvale Regional Hospital and to increase
awareness among the community about the operations of the level 2 hospitals such as this.<br>Public Administration<br>M. P. A.
8
Finlayson, Melissa Joy. "An analysis of emergency response times within the public sector emergency medical services in KwaZulu-Natal." Thesis, 2017. http://hdl.handle.net/10321/2922.
Full textAbstract:
Submitted in fulfillment of the requirements for the degree of Master of Health Sciences in Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2017.<br>Introduction: Response times are considered to be one of the oldest and most popular indicators which are used to measure the efficiency of Emergency Medical Services (EMS), particularly to cases in which the patient’s condition is deemed to be life threatening.
Purpose: To analyse emergency response times within the public sector Emergency Medical Services in KwaZulu-Natal and to compare these to the national norms.
Methods: Using a mixed method approach, the study was conducted in two phases. The first phase involved collecting quantitative data for all the cases logged in the Umgungundlovu Health District Communications Centre over a period of one week (seven days). Phase Two involved the collection of qualitative data from focus group discussions which were conducted with three groups which had been identified. These groups included the communications centre staff, operational staff and supervisory staff. The aim of these focus group discussions was to identify factors that influenced response times as well as to propose strategies which would improve these response times. Content analysis was utilised to interpret the qualitative data which had been collected.
Results: Quantitative data was collected from a total of 1 503 cases of which 680 were categorised as priority 1 (P1), 270 as priority 2 (P2) and 553 as inter facility transfer (IFT). The majority of the cases (895) had occurred in urban areas. A total of 406 cases were exempted as no patient was transported. The number of these cases was greater on days when the total case load was higher as compared to days with a lower total case load. The mean response time to cases in rural areas was 129 minutes and 110 minutes to cases in urban areas. All the time intervals were found to be longer for cases in rural areas as compared to those for cases in urban areas but with the exception of the EMD response interval. P1 cases had the shortest mean response times for both urban area cases (33 minutes) and rural area cases (95 minutes) as compared to the other case categories. Nevertheless, the national norm of 15 minutes in urban areas and 40 minutes in rural areas was not achieved in the majority of the cases. The mean Emergency Medical Dispatch (EMD) response interval was 41 minutes for P1 cases, 56 minutes for P2 cases and 96 minutes for IFT cases.
The qualitative data revealed factors that impacted on the response times and helped to explain and account for the quantitative data results. Challenges regarding the availability of resources, including vehicles, staff and equipment, as well as the way in which such resources are managed, were highlighted. The high demand for services compared to the available resources was raised by the focus group participants with this high demand resulting in extended EMD response intervals. This was exacerbated by the overwhelming demand for IFT cases which are serviced by the same resources as emergency cases and which have a much longer mission time, thus delaying response times continuously. Exempt cases were also found to impact negatively on response times as, although operational vehicles are committed to these cases, services are not required. Inconsistencies with regards to case prioritisation and dispatch triage also emerged. External factors, including poor road infrastructure, lack of road names and house numbers, weather conditions and long distances between EMS bases, the patient or incident location and health care facilities were also identified as factors that resulted in extended response times. Strategies to improve the situation were explored. These strategies included the effective management of resources in order to ensure optimal availability, the introduction of a formal, computer aided, dispatch system, the adoption of demand pattern analysis and dynamic location/relocation models, standardised processes and procedures to guide all areas of EMS operations and the education of both the public and staff.
Conclusion: South African EMS response time national norms for both rural and urban areas are unachievable under the majority of circumstances and, thus, they may be said to be unrealistic. Until these national norms, against which the efficiency of EMS in South Africa is measured, are revised, the service will be deemed to be incompetent.<br>M
9
Binks, Faisal. "Retention strategy of paramedics in South Africa." Thesis, 2011. http://hdl.handle.net/10500/4445.
Full textAbstract:
The pre-hospital industry is faced with many challenges, one of which is the skills shortage of advanced life support paramedics in the country. The industry has naturally dictated competition both nationally and internationally for the recruitment of these advanced life support paramedics. Staff turnover has increased as a result of this issue which also has financial implications on the individual business of constant recruitment and turnover. The purpose of this study is to investigate problems that currently exist in the industry with regards to the advanced life support paramedic employment which will provide valuable information on retention strategies and reduce staff turnover.
10
Muhlbauer, Dagmar. "An analysis of patients transported by a private helicopter emergency service within South Africa." Thesis, 2015. http://hdl.handle.net/10321/1326.
Full textAbstract:
Submitted in fulfillment of the requirements for the degree of Master of Technology: Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2015.<br>Introduction:
A Helicopter Emergency Medical Service (HEMS) is a specialist flying emergency service where on-board medical personnel have both the knowledge and equipment to perform complicated medical procedures. There is an absence of literature describing the types of patients treated and the clinical outcome of these patients flown by Helicopter Emergency Medical Services within South Africa. The paucity of literature on this topic poses a challenge for current aeromedical services as there is no baseline information on which to base flight criteria, staffing and policy documents. This has the potential to hamper the advancement of HEMS within South Africa.
Purpose of the study:
The purpose of this study was to undertake a descriptive analysis of the patients flown by the Netcare 911 HEMS over a 12 month period in both Gauteng and KwaZulu-Natal and to assess the patients’ outcomes. The objectives of the study were to analyse the clinical demographics of patients transported by the Netcare 911 HEMS operation, determine the time frames from dispatch of the helicopter to delivery of the patient to the receiving hospital and undertake a correlational analysis of crew qualifications, clinical procedures performed and their outcomes at 24 hours and 72 hours. A further objective was to make recommendations regarding the refinement of current aeromedical policies as well as the education and training requirements.
Methodology:
The research study was conducted utilizing a retrospective quantitative, descriptive design to undertake an analysis of patients transported by a private helicopter emergency medical service within South Africa. The records of all patients transported by the Netcare 911 HEMS operations between 01 January 2011 and 31 December 2011 were included.
Results:
In the 12 month study period there were a total of 547 cases. However, the final study population was made up of 537 cases as 10 cases had to be excluded due to incomplete documentation. Of the 537 cases, 82 (15.3%) were managed by the KwaZulu-Natal HEMS and 455 (84.7%) were managed by the Gauteng HEMS. Findings revealed that the majority of patients flown in both Gauteng and KwaZulu-Natal were adult males: males (n=398; 74.1%) and adults (n=437; 81.4%).
Motor vehicle accidents were the most common incident type for both operations (n=193; 36%). At the 24-hour follow up, 339 (63.1%) patients were alive and stable and at the 72-hour follow up, 404 (75.3%) were alive and stable.
Conclusion and recommendations
The findings of this study provide valuable information that may have an impact on the current staffing and authorization criteria of South African HEMS operations.
11
Newton, Paul Richard. "An evaluation of the appropriateness of emergency medical service (EMS) responses in the eThekwini health district of KwaZulu-Natal." Thesis, 2014. http://hdl.handle.net/10321/1105.
Full textAbstract:
Submitted in fulfilment of the requirements for the Degree of Master of Technology: Emergency Medical Care, Durban University of Technology, 2014.<br>Introduction: The Emergency Medical Service (EMS) is required to respond to cases of life threatening illness or injury which may later be found to be non-emergent thus creating a mismatch between the dispatch of limited EMS resources and actual patient need. This study proposed that such a mismatch presently exists among South African urban EMS systems resulting in unacceptably high levels of inappropriate emergency responses. The purpose of this study therefore, was to evaluate the appropriateness of EMS responses in comparison to patient needs in a South African urban EMS system.
Methods: All emergency cases dispatched over a 72 hour period at the Emergency Medical Communication Centre (EMCC) of the eThekwini Emergency Medical and Rescue Service (EMRS), a public sector urban EMS system, were prospectively enrolled in a quantitative study employing a descriptive, comparative design. Computer generated Vehicle Control Forms (VCF) containing dispatch data were matched and compared with Patient Report Forms (PRF) containing epidemiological and clinical data to describe the nature and extent of inappropriate responses based on patient need. Data were subjected to simple descriptive analysis and comparisons were analysed with correlations and chi-square. The Pearson's г and Spearman's rho were used to establish significance between more than two variables.
Results : A total of 1689 cases were enrolled in the study of which 1385 met the inclusion criteria; 304 cases were excluded due to incomplete or duplicated data. The demand for EMS resources fluctuated widely throughout the day with levels peaking at midday and declining sharply after midnight. The median response time across all priorities was 56 minutes (IQR 59min) with just under half (46.4%) of all cases having a response time of more than an hour and almost one in ten (9.5%) exceeding 2½ hours. Significant variations existed between dispatch and on-scene priority settings and category descriptors most notable of which was seen in the highest priority ‘red code’ category which constituted more than 56% of all cases dispatched yet accounted for less than 2% on-scene (p <0.001). Conversely, over 80% of ‘red code’ responses actually required a lower priority response. Similarly, significant discrepancies were seen in the allocation of resources compared to the interventional needs of patients where it was shown that more than 58% of all cases required no interventions and just under 36% required only basic life support (BLS) level interventions (p <0.001). Of those patients triaged as ‘red code’ on-scene, less than 12% were initially allocated an appropriate Advanced Life Support (ALS) level of response and, of particular concern, only 7% of patients found to be dead or ‘blue code’ on-scene were initially dedicated a ‘red code’ response.
Conclusion: South African urban EMS systems are presently unable to meet the needs of patients in terms of demand and matching resources to patient needs with evidently high levels of inconsistent and inappropriate responses resulting in sub-optimal use of limited resources.
12
Ngwenya, Nakanani. "Management of medical records in support of primary health care services of Diepsloot clinics in Gauteng Province of South Africa." Diss., 2019. http://hdl.handle.net/10500/27007.
Full textAbstract:
Text in English with summaries in English, Afrikaans and Zulu<br>Bibliography: leaves 102-115<br>The study investigated the management of medical records in the Primary Health Care services
(PHCs) of Diepsloot. The study investigated the regulatory framework, records infrastructure,
records security, records management staff skills and the filing system. A qualitative design guided
by the interpretive paradigm was used to guide the case study. Interviews, focus groups, and
observations generated data from 50 participants.
The study revealed that the regulatory instruments used to manage records lack implementation and
compliance. There was a lack of security measures, a shortage of records management
infrastructure and inconsistency in the filing system. There is a low level of skill in the records
management staff. The study recommended the implementation of a regulatory policy that will
guide and ensure effective governance of records in PHCs. Records should be secure from misuse
by unscrupulous individuals. PHC records need to be managed by experienced professionals. The
filing system should be easily accessible.<br>Die studie het ondersoek ingestel na die bestuur van mediese rekords in die Primêre
Gesondheidsorgdienste (PHC's) van Diepsloot. Die studie het ondersoek ingestel na die
regulatoriese raamwerk, rekord van infrastruktuur, rekord sekuriteit, vaardighede vir
rekordbestuur en die liasseerstelsel. 'n Kwalitatiewe ontwerp gelei deur die interpretatiewe
paradigma is gebruik om die gevallestudie te lei. Onderhoude, fokusgroepe en waarnemings het
gegewens van 50 deelnemers gegenereer.
Die regulatoriese instrumente wat gebruik word om rekords te bestuur, het geen implementering en
nakoming nie. Die studie het aan die lig gebring dat daar 'n gebrek aan veiligheidsmaatreëls was,
'n tekort aan infrastruktuur vir rekordbestuur en teenstrydigheid in die liasseringstelsel. Die
personeel in rekordbestuur het 'n lae vlak van vaardigheid. Die studie het die implementering van
'n regulatoriese beleid aanbeveel wat die doeltreffende bestuur van rekords in PHC's sal lei en
verseker. Rekords moet beskerm word teen misbruik deur gewetenlose individue. PHC-rekords
moet deur ervare professionele persone uitgevoer word. Die liasseerstelsel moet maklik toeganklik
wees.<br>Lolu cwaningo luphenywe ngokuphathwa kwamarekhodi ezokwelashwa emnyangweni
Wezokunakekelwa kwempilo okuyisisekelo (i-PHCs) eDiepsloot. Ucwaningo luphenywe ngohlaka
lokulawula, ingqalasizinda yamarekhodi, ukuphepha kwamarekhodi, amakhono okuphathwa
kwamarekhodi nohlelo lokufayila. Umklamo olungaqanjwa uqondiswa yi-paradigm yokutolika
wasetshenziselwa ukuqondisa ucwaningo lwesigameko. Izingxoxo, amaqembu okugxila kanye
nokubukwa kukhiqize idatha evela kubahlanganyeli abangu 50.
Izinsizakusebenza zokulawula ezisetshenziselwa ukuphatha amarekhodi zingenakho ukusebenza
nokuhambisana. Ucwaningo luveze ukuthi bekukhona ukuntuleka kwezindlela zokuphepha,
ukushoda kwengqalasizinda yokuphathwa kwamarekhodi kanye nokungahambelani ohlelweni
lokugcwalisa. Kunezinga eliphansi lekhono kubasebenzi bokuphathwa kwamarekhodi. Ucwaningo
lincome ukusetshenziswa kwenqubomgomo yokulawula ezohola futhi iqinisekise ukuphathwa
kwamarekhodi kuma-PHCs ngendlela efanele. Amarekhodi kufanele avikeleke ekusetshenzisweni
kabi ngabantu abangathembekile. Amarekhodi we-PHC adinga ukuqhutshwa ngochwepheshe
abanolwazi. Uhlelo lokufayila kufanele lutholakale kalula.<br>Information Science<br>M. Inf.
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Du, Toit Renee Elsie. "A systemic analysis of the perception of stress within the emergency services." Thesis, 2012. http://hdl.handle.net/10210/5885.
Full textAbstract:
D. Litt. et Phil.<br>This report presents the findings of a study conducted in February-March 1995, involving 109 members of different emergency services from three regions: Pretoria, Durban and Cape Town. The emergency services included in the study were three units of the South African Police Service (Visible Policing, the Internal Stability Unit and the Flying Squad), provincial fire and ambulance services, and municipal traffic services. The aims of the study were to: (1) describe the underlying causes of stress in the emergency services; (2) establish how stress is currently being dealt with by members and identify the structures and support systems available to assist members with stress-related problems; (3) identify constructive and destructive, effective and ineffective mechanisms used by members to cope with their stress, and (4) suggest solutions to problems experienced in managing stress in the emergency services. The study investigated stressors of SAPS members under the following themes: (1) public image of the SAPS, (2) management style in the SAPS, (3) communication in the SAPS, (4) working environment in the SAPS, (5) working conditions and remuneration packages, (6) distinct characteristics of the work of SAPS members, and (7) the priorities set by SAPS members that need to be addressed in order to reduce their level of stress. The stressors of members of the fire and ambulance services were dealt with under the following themes: (1) utilisation of manpower in the organisation, (2) training provided to members, (3) management style in the fire and ambulance services, (4) distinct characteristics of the work of members of the fire and ambulance services, (5) remuneration packages, and (6) the priorities set by members that need to be addressed in order to reduce their level of stress. The stressors of members of the traffic services were dealt with under the following themes: (1) the public image of the traffic services, (2) distinct characteristics of the work of traffic officials, (3) communication in the traffic services, (4) working conditions and remuneration packages and (5) the priorities set by members that need to be addressed in order to reduce their level of stress. Regarding the support members of the emergency services receive within their organisations for managing stress, a number of sources of support were mentioned, such as social workers, psychologists and chaplains in the SAPS, support by supervisors, debriefing after traumatic events, stress management training, nursing sisters at ambulance stations, drinking and socialising, with the biggest form of support being "buddies". Regarding the co-operation between members of the different emergency services, the perception was that there was a very good relationship and good co-operation. Number of problems experienced in their day-to-day contact with each other were however mentioned.
14
Govender, Pregalathan. "The development of a framework to retain migrating South African undergraduate Advanced Life Support paramedics." Thesis, 2010. http://hdl.handle.net/10321/599.
Full textAbstract:
Dissertation submitted in fulfilment of the requirements for the Degree of Master in Technology: Emergency Medical Care, Durban University of Technology, 2010.<br>South Africa currently has 1631 registered Advanced Life Support (ALS) paramedics
to tend to the pre-hospital advanced life support needs of just under 50 million
people. Compared to the globally accepted ratio of 1:10 000, the number of ALS
paramedics in South Africa is grossly inadequate. The current shortage of South
African ALS paramedics may be ascribed to migration. However, although literature
on health worker migration in general abounds, there is a marked lack of national or
international statistics and information on migration of ALS paramedics and their
migration. Current measures to manage migration appear to be ineffective. The
success of future strategies is dependent on an understanding of the migration of
South African ALS paramedics - an understanding that presently does not exist.
Purpose
The purpose of this study was to describe the migration of South African
undergraduate Advanced Life Support paramedics who qualified between 2001 and
2006, and to then develop a framework of retention strategies. In particular, it
determined the extent and nature of their migration, identified the factors that have
contributed to their decision to work outside South Africa and identified strategies to
retain or encourage the return of ALS paramedics to practice exclusively in South
Africa.
Methods
The study consisted of a two-phase mixed method descriptive survey. Paramedics
with ALS undergraduate diplomas who qualified in South Africa between 2001 and
2006 made up the study population. Quantitative data (Phase One) was obtained
from a web-based survey distributed to the accessible population (N=97). Thereafter,
qualitative data (Phase Two) was gathered through in-depth interviews with selected
information rich participants (n=10) also from within the accessible population.
Through methodological triangulation, data from Phase One and Phase Two were
Page vi
integrated to obtain an in-depth understanding of South African ALS paramedic
migration.
Results
Significant differences existed in the distribution of age (p=0.035), and years of
experience post-graduation (p=0.007) and the ALS paramedic deemed most likely to
migrate were individuals between the ages of 21 – 30. 15 (55%) of the participants
working outside the country were engaged in short term contracts while all 24 (100%)
of participants working inside South Africa were permanently employed. 18 (75%) of
respondents working inside South Africa intended migrating, 12 (67%) of which
intended to do so within 0 to 2 years. Nine major factors or reasons for migration
were identified by participants. Working conditions, physical security and economic
considerations were ranked as the top three major factors most likely to contribute to
the decision or intended decision to migrate.
This study also found five primary decisions that likely emerge during the life of a
South African ALS Paramedic. The outcome of each decision is a result of facilitators
weighted against barriers. Facilitators are factors that supported each of the primary
decisions while barriers weakened or rejected them. Findings indicated that many
barriers existed which rejected or weakened the decision of ALS paramedics to work
inside South Africa, return to South Africa or remain in South Africa. On the
converse, a vast number of facilitators existed which spurred continued migration.
Conclusions
As the decision to migrate may be conceptualised as early on as when individuals
decide to become ALS paramedics, the constructs of return and retention strategies
have to extend as far as revising recruitment policies. Preference or places into
training programmes should be given to individuals who are less inclined to migrate,
these include: military personnel; those already employed in the EMS, older mature
candidates; candidates with families that have already settled in SA; and recognition
of prior learning (RPL) candidates who are predominately obligated by contract to
remain in South African EMSs.
15
Magwentshu, Beatrice Makgoale. "Critical analysis of adolescent reproductive health services in Gauteng Province." Thesis, 2000. http://hdl.handle.net/10500/17290.
Full textAbstract:
Adolescent reproductive health services (ARHS) in Gauteng Province are not meeting the reproductive health
needs of adolescents. There is also no formalised adolescent/youth policy laid down to assess the quality of
care given to adolescents attending these clinics although the policy is currently in the process of being
finalised.
The purpose of the study therefore was to critically analyse the ARHS in Gauteng Province to determine which
adolescents attended the clinics, whether the clinics were accessible and available and whether they provided
comprehensive care, gave information and counselling to the adolescent and whether the clinics \\·ere
adolescent-friendly.
Using the quality care model as the conceptual framework for the study, the following research questions were
asked to determine the quality of care in terms of the adolescent's needs at these clinics:
Who is the adolescent using ARHS in Gauteng Province')
Are the ARHS in Gauteng Province accessible and available to adolescents?
Do the ARHS in Gauteng Province provide comprehensive care to adolescents?
Are adolescents receiving information and counselling from the ARHS in Gauteng Province? Are the
ARHS in Gauteng Province adolescent-friendly?
A quantitative cross-sectional exploratory, descriptive research design using a
self-administered, researcher designed questionnaire was used to collect data from a 203
nonprobability convenient sample, at selected ARHS in Gauteng Province.
The analysed data indicated that females in the older age group. ie 18-19 years used the ARHS more
than the female adolescents in the younger age group and males. Findings also indicated that
the ARHS in Gauteng Province are geographically accessible and available to adolescents.
However, there appeared to be a need to
extend the days and hours of functioning of the ARHS so as to make them more accessible and
available to
adolescents. Comprehensive care is not given to adolescents attending ARHS. Adolescent gave
contradictory mformation especially with regard to the attitudes of service providers.
Recommendations made include management strategies that will attract the adolescent in the younger
age group and in particular the male adolescent. This necessitated that service providers at ARHS
be equipped with the appropriate information given in an outcome-based format in adolescent care.<br>Health Studies<br>D. Litt. et Phil. (Advanced Nursing Science)
16
Bowen, James Marcus. "Development of a tool to define the population of emergency medical care users in South Africa." Thesis, 2008. http://hdl.handle.net/10321/335.
Full textAbstract:
Thesis (M.Tech.: Emergency Medical Care)-
Dept. of Emergency Medical Care and Rescue,
Durban University of Technology, 2008.
xii, 149 leaves, Appendices A-I.<br>Prehospital emergency medical service (EMS) data is essential for understanding the functioning of the services as well as the community's health. Being able to clearly and accurately define the patient population in terms of demographics and clinical condition may guide the EMS in resource management, clinical governance, research, education and political decisions. However, such data is limited in South Africa. This research, therefore, aimed to develop a data collection tool to determine the population of prehospital emergency medical care patients in South Africa. The objectives were: (i) determination of what data needed to be collected, (ii) development of a tool to collect the data, and (iii) testing the tool for ease and appropriateness of use and completeness of data collection in an authentic environment. A mixed-method, predominantly qualitative methodological design was used, with some elements of grounded theory. There were three phases corresponding to the objectives. The first two were qualitative and the third was both qualitative and quantitative. In the first phase expert consensus was sought, using a focus group discussion and Delphi study, to develop a minimum data set (MDS) to describe the patient population. The resultant MDS consisted of 18 data elements which could be categorised into demographics, time and location of EMS use, the clinical reasons for EMS use, and the actual use of the EMS. A tool and associated user instructions, based on the findings of Phase One, were developed and refined during Phase Two. Phase Three was used for testing the tool in an authentic environment. The tool was found to be acceptable and user-friendly. Further testing of the tool for accuracy and reliability is recommended.
17
Neel, Sheryl. "It's a two way street : striking the balance between routinisation and responsiveness in emergency calls." Thesis, 2014. http://hdl.handle.net/10539/14918.
Full textAbstract:
A call taker is the first point of contact in the emergency service system and thus the interface
between the caller and ambulance dispatch. Misunderstandings in an emergency call have
implications for the survival of patients. Using an applied conversation analytic approach this study
examined participants’ use of conversational repair as an interactional strategy. Data included 101
calls from a South African emergency medical services call centre. The data set was comprised of
two distinct subsets, namely: the 107 and public corpora. The 107 corpus (53 calls) contained calls
from a general emergency call centre. The 107 caller thus served as a mediating party on behalf of
the public caller. The public corpus (48 calls) comprised calls received directly from members of the
public. The data subsets afforded a unique opportunity to analyse ways in which participants to an
emergency call manage asymmetries of knowledge. Differential patterns of the type and purpose of
repair were tracked across both data sets and similarities and differences were explored. Both data
sets showed that participants’ choice of interactional strategies was customized based on an
ongoing assessment of knowledge asymmetries. However, whilst knowledge asymmetries posed
some constraints an overriding interactional constraint, inherent within the institutional nature of
the emergency call, was a rigid adherence to routinized protocols. The call taker’s dilemma was thus
identified as the management of these constraints through the frequent use of conversational
repair. Although a level of responsiveness is required to glean quality information from callers, high
volumes of emergency calls would not be possible without routinized protocols. However, increased
orientation to routinized protocols led to a decreased orientation to responsiveness. This research
therefore showed that knowledge symmetry is not necessarily more advantageous but that
successful call trajectory is reliant on the call taker’s ability to maximize the collaborative nature of
the interaction and effectively negotiate through the judicious use of repair and other relevant
interactional strategies. This has important implications for call taker training.
18
Williams-Claassen, Natalee Jean. "Development of a disinfection protocol for the public sector Emergency Medical Services in the eThekwini District of KwaZulu-Natal." Thesis, 2013. http://hdl.handle.net/10321/1688.
Full textAbstract:
Submitted in fulfillment of the requirements for the degree of Master of Technology: Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2013.<br>Background
In the Emergency Medical Services (EMS), paramedics play a vital role in the treatment of critically ill or injured patients, as they are often the first link or point of contact for the patient in the healthcare setting. They may therefore also play a vital role in the prevention and control of the transmission of communicable diseases, provided that proper infection control measures are in place.
The objectives of the study
There is presently no national policy on communicable diseases and infection control that is specifically designed for use in the South African prehospital environment. Given the paucity of research in the area, qualitative multiple case studies were conducted to develop an ambulance specific disinfection protocol and to evaluate its effectiveness in the public sector EMS in the eThekwini District of KwaZulu-Natal.
Methodology
The study comprised of three phases. In the first phase focus group discussions were conducted to identify the factors needed to develop a disinfection protocol. The study population consisted of both operational and management staff from the EMS under study. The first four focus groups consisted of eight to ten EMS operational staff each and the fifth focus group consisted of five EMS management staff. Thereafter, the information gathered was used in conjunction with internationally accepted guidelines to develop an ambulance specific disinfection protocol (Phase Two). The third phase entailed the implementation of the protocol at seven ambulance bases in the eThekwini health district and the evaluation of the protocol with the use of an open-ended questionnaire at two weeks and four weeks after implementation. A single ambulance crew and their immediate supervisor from each base were utilized in this phase.
Conclusion and recommendations
An ambulance specific disinfection protocol was developed and implemented in the EMS under study. During the development, implementation and evaluation of the protocol, many themes with regard to infection control in EMS were identified. These themes were used to better understand the present situation in EMS in relation to infection control and in the formulation of recommendations to assist in the improvement of the present situation.
The researcher recommended that all EMS staff require training and education with regard to infection control and prevention. The development and implementation of a protocol and policy document for infection control specifically for EMS is required. There is a need for the deployment of more ambulances and the employment of more operational EMS staff together with the appointment of Infection Control Supervisors at all ambulance bases. Without adequate infrastructure needed to meet infection control and prevention requirements, there may be a serious risk to both staff and the patients they serve.<br>M
19
Mahlo, Shongy Joyce. "A strategy to enhance positive working relationships among the role players within the managed healthcare context in Gauteng." Thesis, 2012. http://hdl.handle.net/10210/7516.
Full textAbstract:
M.Cur.<br>Managed healthcare was introduced in South Africa largely in order to control the rampant increase of medical costs, more especially in the private healthcare industry. Managed healthcare is a system of healthcare delivery, which ensures that cost effective quality care is provided to patients without jeopardising the health of the patient. Positive working relationships are necessary among the role players in the provision of cost effective quality care within the managed healthcare context. Role players experience problems in the delivery of healthcare, affecting their working relationships, which in turn affects the quality of care provided to patients. Because managed healthcare is a new concept in South Africa, little is known about the problems. As a result, there are no guidelines for the formulation of a strategy to enhance positive working relationships among the role players within the context of managed healthcare. Understanding the problems experienced by the role players will provide guidelines to the researcher to formulate a strategy to enhance positive working relationships, hence the reseacher sought to explore and describe these problems in the study. The purpose of the study is to formulate a strategy to enhance positive working relationships among the role players within the managed healthcare context in Gauteng. The specific objective is to explore and describe the problems experienced by the role players, as well as the possible solutions within the managed healthcare context in Gauteng. The relevant research questions are: * What are the problems experienced by the role players within the managed healthcare context in Gauteng, and what are the recommended solutions to counteract these problems? * What strategy can be formulated to enhance positive working relationships among the role players within the managed healthcare context in Gauteng? A qualitative, exploratory, descriptive and contextual design was followed to answer the research questions. Focus group interviews and a workshop were conducted to collect data and a content analysis was conducted as described by Tesch (1990). The results were analysed in two phases: the problems experienced and the suggested solutions to counteract these problems. A strategy to enhance positive working realtionships was suggested. The strategy, which is based on role player empowerment, staff development, staff recruitment and selection, use of advanced information technology and standardisation of methods across managed healthcare industry, was derived from a synthesis of solutions suggested by the participants. Guba and Lincoln's (1983:290) principles of trustworthiness were employed by the researcher and the ethical standards as set by DENOSA (1998) were adhered to by the researcher to facilitate the quality of the study. It was recommended that the strategy be implemented and evaluated for its effectiveness by evaluating the quality of working relationships among the role players and that ethical standards be formulated in managed healthcare.
20
Otieno, Florence Awino. "Patient perception of quality of care and service delivery in emergency departments in Gauteng: a case study of one public hospital." Thesis, 2008. http://hdl.handle.net/10210/715.
Full textAbstract:
Quality of health care delivered in the public sector remains a major challenge with diminishing resources to meet the increasing health care demands. Improvements in quality health care are identified in the Department of Health’s strategic framework as a key challenge. In order to improve quality, one needs to measure it. The patients’ views are important in identifying what is important to them. Inexpensive, easy to collect metrics need to be developed to measure quality of care. The study investigated perceptions of patients as a reflection of quality of care provided. The study also determined the key success factors in quality care in emergency departments and priorities of quality of care for improvement. A prospective study was conducted using one of Gauteng hospitals’ emergency departments as a case study. A structured questionnaire based on an overall care index focusing on specific dimensions of patients’ experience with health care was used to collect the data. Quantitative analysis was done using the Epi Info statistical package and the results summarised in frequency diagrams and tables. The findings indicate that waiting time is a major factor in perception of quality of health care. Although other hospitality issues in health care are important to patients, the degree to which they affect perception of quality of health care is difficult to determine because of the overwhelming influence of waiting time. It is recommended that priorities in addressing what users really want from health care should concentrate on strategies to shorten the waiting time. It is further recommended that a similar study be carried out in future once the waiting times have been improved considerably thus eliminating its excessive influence. This may highlight other variables important to the patients that may need to be improved in order to improve quality of care.<br>Dr. Susan Jennifer Armstrong
21
Van, der Walt Renske. "Characteristics of patients (expatriates and long-term travellers) with suspected malaria, being evacuated by fixed-wing air ambulances out of Sub-Saharan Africa to Johannesburg, South Africa. a retrospective case review, for the period July 2006 through June 2009." Thesis, 2012. http://hdl.handle.net/10539/11029.
Full textAbstract:
Background Promotion of job opportunities and tourism in African countries has led to an
increase in expatriates in malaria endemic areas. A paucity of data exist on characteristics
and numbers of expatriates and long-term travellers being evacuated from sub-Saharan
Africa for suspected malaria infections diagnosed while still in Africa.
Methods A retrospective flight record review of a South African fixed-wing air-ambulance
provider from June 2006 through July 2009 was performed. Adult expatriates and long-term
travellers with suspected malaria being evacuated from sub-Saharan African countries to
Johannesburg, South Africa were included.
Results Suspected malaria was the single most common diagnosis for dispatching airambulances
with 81 (11.9%) of the 679 flights. Accuracy of the initial diagnosis, based on
confirmation of malaria at the receiving facility was 78.4% for blood smears, 92.3% for rapid
detection tests and 42.8% for clinical signs alone. P. falciparum (alone, or in combination
with other Plasmodium species) was the most frequently isolated species at both the
referring (100%) and receiving (88.2%) facilities in cases where the species was
documented. The suspected malaria patients were predominantly male 69 (84.1%), with a
mean age of 42.1 ±12.8 years, and were in sub-Saharan Africa for occupational reasons 65
(79.3%). Angola, the Democratic Republic of Congo and Mozambique were the countries of
origin in 48 (58.5%) of the suspected malaria flights. Compliance on appropriate malaria
chemoprophylaxis was documented in two (2.4%) suspected malaria patients. Intubation as
a marker of severity was required for 15 (18.3%) patients, and one (1.2%) patient died inflight.
No statistically significant difference (p=0.50) was shown for intubation requirements
when comparing patients who had utilised malaria chemoprophylaxis with the patients who
had not utilised chemoprophylaxis.
Conclusions Patients presented in advanced stages of severe/complicated malaria with
concurrent poor chemoprophylaxis utilisation and compliance. Appropriate
chemoprophylaxis did not decrease the severity of presentation (based on intubation
requirements) and did not guarantee complete malaria protection.
22
Malimabe, Keneuwe Joyce. "A study on the utilisation of integrated management of childhood illnesses (IMCI) in primary health care facilities." Diss., 2007. http://hdl.handle.net/10500/2278.
Full textAbstract:
This explorative, descriptive quantitative survey attempted to determine whether the reduced number of consultations and admissions of sick children less than five years in Emfuleni sub- district clinics is due to the utilisation of the IMCI strategy or other health services. The research population comprised of all the mothers/caretakers of children less than five years who utilised the clinics and those who consulted the private medical doctor. The convenient sample consisted of 169 candidates. Data was collected by means of a questionnaire and analysed using the SAS/Basic computer statistical software package. Findings of the study revealed a need to address the major concern about the waiting time and operational times in all the three clinics. Recommendations were made that staff allocation procedures and policies be reviewed in order to abate long waiting periods at the clinics where children with childhood illnesses are treated.<br>Health Studies<br>M.A. (Health Studies)
23
Richter, Roxane. "Medical outcasts: voices of undocumented Zimbabwean and Mexican women fighting gendered and institutionalized xenophobia in American and South African emergency health care." Thesis, 2016. http://hdl.handle.net/10539/20804.
Full textAbstract:
A Thesis Submitted to the School of Social Sciences, in the Faculty of Humanities, in Fulfilment of the Requirement for the Degree of
Doctor of Philosophy in Political Studies
THE UNIVERSITY OF THE WITWATERSRAND
JOHANNESBURG, SOUTH AFRICA
NOVEMBER 2014<br>This thesis is the culmination of medical aid work and 24 one-on-one interviews with undocumented Mexican women in the U.S.A. and Zimbabwean women in South Africa seeking lifesaving emergency healthcare access. The theoretical research combined with practitioner-based fieldwork, shows the direct and deplorable effects of xenophobic policies coupled with a demonstrable failure to enforce healthcare access rights.
24
Kotze, Shane. "A clinical audit of responses by an emergency department: medical emergency team, within a 469 bed private hospital in Gauteng, South Africa, from 1st January 2010 to 31st December 2010." Thesis, 2016. http://hdl.handle.net/10539/19491.
Full textAbstract:
A research report presented to the
Faculty of Health Sciences, University of the Witwatersrand
in partial fulfilment for the degree
of
Master in Science in Medicine: Emergency Medicine.
Johannesburg, November 2015.<br>Introduction
Patients often deteriorate when in hospital, which may result in unscheduled
admission to Intensive Care Units, cardiac arrest and possibly death. Medical
Emergency Teams (MET) have been instituted in hospitals to mitigate these patient
critical events.
Aim
The aim of this clinical audit was to appraise the practices of a MET in a large,
private South African hospital.
Method
A retrospective, transverse, observational analysis of 278 MET responses (which
occurred in 2010) was undertaken.
Results
Males accounted for 57.2% of MET responses. Males further accounted for 60.9% of
cardiac arrests. Females had a higher mortality compared to males.
Age analysis showed a multimodal age distribution. A mean overall age of 56.2
years was observed. A paediatric median of 0.583 years was found whilst a mean of
60.432 years was found in the adult category. An increase in frequency of MET
responses was observed with advancing age with associated poor outcome.
The MET functioned hospital-wide. Intensive care unit (ICU) and high care unit
(HCU) areas accounted for the majority of MET responses and cardiac arrest
prevalence. Similarly, ICU and HCU areas had a high mortality at the end of MET
responses – 33% to 80% mortality.
No statistically significant difference in activation frequency occurred between days
of the week. No “weekend effect” could be immediately demonstrated. Public
holidays proved to be difficult to objectively analyse with regards to prevalence of
MET responses.
A peak in MET response frequency was demonstrated between 03h00 to 03h59. A
minimal increased night-time prevalence was found but was not statistically
significant. An increase in mortality was noted for cardiac arrest occurring at night.
The prevalence of cardiac arrest was 0.324 per 100 admissions. The return of
spontaneous circulation (ROSC) rate for the MET was 62.7%. The cardiopulmonary
resuscitation (CPR) survival rate at the end of MET responses was 58.2%.
A total of 596 man-hours were expended on MET responses. The average MET
response duration was 26 minutes.
Conclusion
The MET in operation at the Hospital in this audit is a combined MET and Heart
Arrest Team. The MET operates hospital-wide, 24 hours a day and is internationally
comparable.
25
Malatjie, Kgwathamane Andronicus. "The assessment and impact of job satisfaction on the service delivery of City of Tshwane Emergency Management Services (COT EMS) employees." 2012. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1000229.
Full text
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Sethakha, Tshepo Paul. "Factors that affect adherence to ISO Code 9001 of 2008 in the emergency and rescue services of the city of Tshwane." 2016. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1002010.
Full textAbstract:
M. Tech. Business Administration<br>The city of Tshwane Emergency Services is the first in South Africa to be certified ISO 9001:2008 in 2013. This saw the department leading the course of quality management both in the city and throughout the country. As a service rendering undertaking their efficiency and effectiveness requires evaluation from a quality management perspective. The city seeks to roll-out certification throughout all city departments so as to enable a quality driven municipal entity. This study was conducted to identify the factors that affect adherence to ISO 9001:2008 within the city. The results of this study can be used by managers throughout the Emergency Services and related services around the world to evaluate the importance of the implementation of the management system. The study is descriptive and cross-sectional. A quantitative method was used to collect data and analyse it. A stratified random sampling techniques was used with sample size of n=121 on employees within the Emergency Services of the city of Tshwane. Frequency tables, pie-chart, histograms and tables were used to present and analyse the data collected. The study identified qualification, effective communication and proper record keeping (documentation) as key factors affecting adherence to ISO 9001:2008.
27
Moodley, Kubendhren. "An investigation into the clinical practicum experience of als paramedic students and their preparedness for professional practice." Thesis, 2016. http://hdl.handle.net/10321/1551.
Full textAbstract:
Submitted in fulfillment of the requirements for the Degree Masters of Health Sciences in Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2016.<br>Clinical practicum remains an integral part of training and a vital component of the emergency medical care curriculum that takes place in a realistic and complex emergency care environment. Clinical practicum should provide students with the opportunity to combine cognitive, psychomotor and affective skills to develop competencies to prepare the qualifying practitioner for demands of pre-hospital emergency care in the real world.
The aim of this study was to explore the multidimensional aspects of the clinical practicum experience of ALS paramedic students in the Western Cape through the lens of a qualitative research design. The study involved exploring the experience of paramedic students in the clinical practice placement. In addition, the views of paramedic graduates were also explored, to ascertain whether the placement experience adequately prepared them for practice. An analysis of the clinical practice documents utilised in the training of ALS paramedic students was conducted with particular reference to identify correlations with relevant literature. In addition, it was necessary to identify how clinical practice manifested itself, not only in what students and graduates express but also how it was coordinated and conveyed in a professional work related context, against the backdrop of the work integrated learning framework.
Using a case study design, focus group interviews were conducted with final year EMC students from CPUT and CCA students from the Western Cape CEC. This was followed with one on one interview with paramedic graduates. Further to this, clinical practice documents were analysed to triangulate the data.
This study revealed that the clinical practice learning objectives for paramedic students were not adequately achieved and paramedic graduates felt ill prepared for independent practice. These discrepancies were attributed to the complex issues both in theory and practice. The study provided a number of recommendations for improving the clinical training experience, such that paramedic graduates who enter the complex and challenging world of EMC are better prepared.<br>M
28
Cermak, Radomir. "An investigation into recognition of prior learning within the National Certificate: Emergency Care Programme in the Western Cape." Thesis, 2016. http://hdl.handle.net/10321/1741.
Full textAbstract:
Submitted in fulfillment of the requirements for the Degree of Master of Health Sciences in Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2016.<br>Purpose
Emergency care education and training in South Africa is experiencing an important transformation period, involving migration from short course based training to a newly proposed, formalised, three-tier qualification system, aligned with the Higher Education Sub-framework. Many existing and experienced holders of short course emergency care certificates face the challenge of gaining access to formal emergency care programmes without meeting the minimum entry requirements. Recognition of Prior Learning (RPL) will therefore become one of the key strategies for planned migration of short course graduates into professional learning programmes. However, the research reports on RPL practice in the field of emergency care are scarce. Hence, valuable lessons about RPL in emergency care programmes are missed. The purpose of this study is to explore the efficacy of RPL practice within the National Certificate: Emergency Care (NCEC) Programme in the Western Cape, through the experience of ambulance emergency assistants, who applied for RPL on the Programme and the paramedic educators involved in the facilitation and RPL assessment on the NCEC Programme.
Methodology
The design of this descriptive exploratory study was qualitative, and was set in the interpretative paradigm using a case study mode of inquiry. The qualitative data was collected through semi-structured focus groups, individual interviews, and document analysis. The participants were from Cape Peninsula University of Technology (CPUT), Department of Emergency Medical Sciences, and the Western Cape Government College of Emergency Care (WCCEC). Collected data was interpreted by means of thematic analysis, set against the context of the study objectives and the theoretical framework.
Finding
The study revealed three main themes related to RPL efficacy in the NCEC Programme. These included the need for RPL training for educators involved in RPL, lack of support and guidance for RPL assessors and participants, and the need for careful selection of RPL assessment methods. The document analysis highlighted the gap between a comprehensive and sound RPL policy document and the practical implementation of these policies.
Conclusion and Recommendations
The emergency care field requires greater awareness and information on RPL processes, principles, assessments, and requirements. The higher education institutions, as the sole providers of the newly proposed formal emergency care programmes need to consider building capacity for RPL by means of training and dedicating academic staff to RPL, and developing comprehensive RPL policies, in collaboration with relevant stakeholders in the field. RPL assessment methods need to be more diverse and tailored to the individual RPL claimants. Further research on RPL will ensure a fair, social inclusive and redressing process during the planned migration of emergency care education and training.<br>M
29
Kriek, Helena Catharina. "An investigation into the needs of emergency medical workers and how these could inform management practices." Diss., 2008. http://hdl.handle.net/10500/1942.
Full textAbstract:
Literature on the Emergency Medical Services (EMS) has paid much attention to stressors, stress and symptoms, coping, and support of Emergency Medical Workers (EMWs). However, it has paid little attention to the needs of EMWs, and the satisfaction thereof, which should result in their improved well-being and motivation.
In an attempt to rectify this imbalance, this study investigated the needs of EMWs as suggested by descriptions of their experiences within the EMS. Interviews were conducted with EMWs employed by a private EMS company. The interviews were analysed for emerging needs by means of interpretive analysis. These needs comprised the Need for Freedom, the Need for Competence, the Need for Recognition, the Need for a Challenge, and the Need to be Understood. The findings were linked with theory and it is proposed that the relevant EMS company incorporates participative management into its management approach. In addition suggestions are made for future research.<br>Psychology<br>M. A.(Psychology)
30
Pillay, Bernard Christopher. "A needs assessment for continuous professional development for South African advanced life support providers." Thesis, 2011. http://hdl.handle.net/10321/728.
Full textAbstract:
Dissertation submitted in fulfilment of the requirements for the Degree of Master of Technology: Emergency Medical Care, Durban University of Technology, 2011.<br>South African Advanced Life Support (ALS) providers follow an autonomous practice model of care. This advanced role profile is characterized by clinical skill competence and autonomous decision making whilst demonstrating a high level of awareness of their own ethical attitudes, values and beliefs. It is through a professional commitment that ALS providers deliver an advanced evidence based practice that should be maintained constantly within a dynamic environment. Continuous Professional Development (CPD) is seen as an instrument for this. CPD should also serve as a means to acquire professional excellence and going beyond the boundaries of meeting the base level standard with the aim of providing the finest quality of care in the interest of patient safety.
Purpose of the research
The purpose of this research is to identify gaps in the professional development of out-of-hospital ALS providers trained in South Africa by assessing frequency of performance of ALS clinical skills, by determining perceived level of competence and predictors of confidence, and by sourcing information on attendance of CPD activities and training needs.
vi
Methodology
This study used a quantitative non-experimental design. Data was attained from an e-mail based descriptive survey that was limited to a precise and concise questionnaire. The data from 140 (N) ALS providers was subjected to a descriptive statistical analysis using the PASW statistics version 18.0 to systematically show patterns and trends. Frequency distributions were generated to describe data categories. Bivariate analysis was conducted using Chi-square and Pearson correlation tests.
Results
Results indicated that ALS providers performed clinical skills infrequently. Of the total number of respondents 140 (N), the average ALS clinical skills performance was 6 (4.8%) daily. In the 2-6 times a week category 8 (6.4%) ALS clinical skills were performed. ALS clinical skills performance in the once a week category showed an average of 7 (5.6%) and the once a month category, an average of 17 (13.7%) ALS skills were performed. An average of 31 (25%) ALS skills were performed in the once in six months category whilst an average of 54 (43.5%) were performed in the greater than six months category. CPD activities that are appropriate to ensuring the maintenance of competence for these clinical skills were not adequately undertaken. Medical updates were mostly attended by ALS providers, 52 (42.9%) whilst CPD events that addressed clinical skills, was mostly limited
vii
to the ACLS course 42 (34.7%). The needs assessment for CPD showed that 56 (53%) of respondents expressed a need for paediatric and obstetric simulated skill sessions, whilst 43 (40.9%) requested clinical skills workshops and 39 (37.1%) expressed a need for clinical practice in theatre and coronary care units.
Conclusions and recommendations
This study shows that ALS clinical skill competence is maintained by frequent practice and appropriateness of CPD activities. The infrequent performance of ALS skills coupled with the lack of appropriate and diverse CPD activity attendance results in poor maintenance of competence. The loss of competence can be related to poor reported levels of confidence which consequently places patient safety at risk. To safeguard against medical error and ensure patient safety, it is strongly recommended that CPD audits be undertaken on all ALS providers for appropriate CPD compliance related to clinical skills performance. In addition to a clinical skills audit, it is recommended that a national clinical skills registry be established with the intention of facilitating clinical skill surveillance, to determine a notifiable, high risk skill set. To safeguard against knowledge and clinical skill attrition and loss of competence, the delivery of CPD activities should be assessed for effectiveness and appropriateness.
31
Makombe, Tsisi Nyasha. "The experiences of women living with HIV and Aids in Centurion, Gauteng province." Thesis, 2014. http://hdl.handle.net/10500/14326.
Full textAbstract:
This qualitative study aimed to explore and describe the experiences of women living with HIV and Aids in Centurion, Gauteng Province. The study was conducted at Lyttleton clinic and 12 women living with HIV and Aids were selected for the study using a non-probability, purposive sampling technique. In-depth, individual semi-structured interviews were used during data collection. A thematic content approach in data analysis yielded the following main themes: experience of being diagnosed HIV positive, disclosure of an HIV positive status, physical signs and symptoms of HIV and Aids, stigma/ emotional stress well experiences in services rendered. The study highlighted the need for a well-established health system, assisting women living with HIV and Aids on how to cope and to raise awareness on HIV and Aids.<br>Health Studies<br>M. A. (Public Health)
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Mahomed, Ozayr Haroon. "A review of the communicable diseases and infection control policy for emergency medical services in the pre-hospital environment in the public health sector in South Africa - 2005." Thesis, 2006. http://hdl.handle.net/10413/2382.
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Augustyn, Jean Elisabeth. "An investigation into the implementation of an emergency unit triage system in a selected private hospital." Diss., 2006. http://hdl.handle.net/10500/2194.
Full textAbstract:
Triage assessment of patients on arrival at the emergency unit is an essential function in quality emergency care provision. Triage is the process of sorting and prioritising patients according to their level of acuity. This study was performed within an emergency unit that experienced serious problems with the sorting of patients on their arrival. After implementation of the Cape Triage Score, a questionnaire was distributed amongst staff utilising the new triage system. The investigation sought to answer specific questions concerning the triage nurse's roles, competencies required and strengths and weaknesses of the implemented system. The study also suggests guidelines to improve the triage system within the unit.
The triage system was received well by participants. The roles of the triage nurse are multifaceted and extensive competencies are required. The strengths of the implemented triage system outweighed the weaknesses as perceived by the respondents. Guidelines for implementing triage in emergency units are provided.<br>Health Studies<br>M.A. (Health Studies)