To see the other types of publications on this topic, follow the link: Healthcare assessment.
Dissertations / Theses on the topic 'Healthcare assessment'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Healthcare assessment.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Tabladillo, Mark Z. "Quality management climate assessment in healthcare." Diss., Georgia Institute of Technology, 1996. http://hdl.handle.net/1853/24162.
Full text
2
Townend, William King. "Assessment and delivery of sustainable healthcare wastes management." Thesis, Imperial College London, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429172.
Full text
3
Talice, Kerlie W. "An Assessment of Veterans Affairs Healthcare Leadership Competencies." Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10604903.
Full textAbstract:
The purpose of this study was to collaborate with one of the New England VA Healthcare Systems to conduct research to evaluate the current leadership competencies at the Department of Veterans Affairs (VA) to identified competencies essential for leadership by the VA. The researcher also assessed how VA front-line staff, first-line supervisors, mid-level managers, and senior/executive leadership rate their performance and that of their supervisors. Lastly, the researcher evaluated how these leaders are trained to assume their important roles at the VA and how much of a role are executive coaching and mentoring play in this training process. The research is a quantitative research study, and the competencies and specific behavior indicators were assessed using a web-based survey via a self-administered competency instrument designated to determine employee’s perceptions. The data collected comprised data from four different surveys/questionnaires for each position level within the organization including the demographic data. A total of 143 VA employees participated in the research study and completed surveys to measure the frequency of behaviors on a 10-point scale to answer the research questions. The results answered the key research questions asked in this study to measure leaders and emerging leader competence.
4
Hidalgo, Stevan. "Healthcare expenditure vs healthcare outcomes a comparison of 25 world health organization member countries /." [Denver, Colo.] : Regis University, 2008. http://165.236.235.140/lib/SHidalgo2008.pdf.
Full text
5
Marine, Jeremey, and Jeremey Marine. "Self-Assessment of Medical-Surgical Nurses’ Behavioral Healthcare Competency." Diss., The University of Arizona, 2018. http://hdl.handle.net/10150/626668.
Full textAbstract:
Millions of people in the United States are living with a serious mental illness or substance abuse disorder. These individuals suffer from a high rate of medical co-morbidities. Because of this, patients hospitalized on medical-surgical units for medical reasons often are living with psychiatric/substance abuse co-morbidities, which are not addressed during their medical hospital admission. These patients can be perceived as difficult and even dangerous by nurses who have not received training or education in mental health care. The purpose of this project is to measure medical-surgical nurse’s perceptions of their abilities to recognize psychiatric/substance abuse symptoms and their perception of self-competency to provide appropriate interventions. This project utilized the Behavioral Health Care Competency (BHCC) instrument to measure hospital nurse perceptions of behavioral healthcare competency to determine if additional education and training are needed. The BHCC tool was administered to 19 nurses working on two medical-surgical units in Southern Arizona. Findings support the need for educational intervention, especially in the areas of psychotropic medication recommendation and intervention for patients experiencing hallucinations.
6
Singprasong, Rachanee. "A framework for rapid problem assessment in healthcare delivery systems." Thesis, Brunel University, 2012. http://bura.brunel.ac.uk/handle/2438/7617.
Full textAbstract:
Problems in healthcare are difficult to comprehend due to complexity, involvement of multiple stakeholders in decision making and fragmented structure of delivery systems. Major Problem Structuring Methods (PSMs) have been used to aid problem understanding which, in principle, can provide greater clarity to strategic problems and engage diverse decision makers using transparent representation that capture differing perceptions of problems. In reality, PSMs can be difficult in accurately representing problems, limited in highlighting improvement opportunities due to non-intuitive visual representations and requirements for facilitators and stakeholders to be experts in tools used. This research aims to address this gap by developing a framework, taking into account characteristics of healthcare delivery systems, advantages and limitations of PSMs with an aim of providing accurate and holistic representation of delivery workflow, so as to promote problem understanding in a rapid manner. The framework, termed CARE, first establishes nature of problem and a commonly agreed problem statement along with an understanding of stakeholder involvement and operating regulations. It then sets specific guidelines for data collection, representation, verification and validation from stakeholders and provides methodology for data analysis which allows facilitator insight into possible flaws in workflow. A case study approach is used to test effectiveness of CARE across two different healthcare settings, each involving a different nature of problem. Implementation of CARE leads to improved participation and ownership amongst stakeholders, ease of facilitation during individual or multidisciplinary meetings, intuitive and informative representation of workflow, minimized time and effort for implementation and minimized dependencies on learning new tools and terminologies. A post mortem indicates the positive impact of CARE on services rendered to the patients, leading to an increase in patient satisfaction and workflow efficiencies. The research concludes by noting the contributions and lessons learnt from this research for healthcare practitioners and possible future work.
7
Addico, Henry. "A process driven quality assessment model for electronic healthcare records." Thesis, University of Sheffield, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.575452.
Full textAbstract:
Electronic Healthcare Records (EHRs) are valuable resources, shared across all three subdomains of healthcare: research, policy and practice. The content of these EHRs need to be fit for making critical decisions required for effective and high quality clinical care. The management of the fitness for the purposes of EHR is a well known problem referred to as 'the data quality problem'. within the health care domain, Information Quality (IQ) forms an indirect relation with the quality of service or has a direct impact on decision making. One of the approaches to the management of this problem and its adverse effect on clinical care is through continuous assessment, monitoring and review of its fitness for required purposes. A key challenge to the management of the IQ problem in the health care setting, is having to deal with both objective and subjective determinants of quality in a uniform way on large amount of heterogeneous data and information with complex interdependencies. Whilst the objective determinants like accuracy, completeness, etc. has been well formulated, the subjective determinants like accessibility, confidentiality, privacy, etc. have not been logically formulated. The work presented in this thesis form a step towards a unified logical way to the assessment of the fitness for purpose of data and information from the healthcare context for the activities performed as part of the work flow followed by clinicians during patient care. This thesis makes two main contribution to the assessment of the data and information quality problem for EHRS. First, a model named LOgical Quality (LOQ), which models IQ assessment using fuzzy set and fuzzy logic and thus enables a logical formulation and quantification of both objective and subjective quality. The other contribution, a framework called Process-centric framework for IQ (PROF), builds on the logical model to create a process centric framework using clinical pathways as the source for deriving and generating disease specific IQ rules for the assessment. The clinical pathways, which are disease centric, are also used to determine the evaluation order of the derived quality rules. Given an appropriate domain knowledge representation of the care context and workflow, the two contributions form a road map towards the development of automated online IQ assessment techniques.
8
Coleman, Alfred. "Developing an e-health framework through electronic healthcare readiness assessment." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1519.
Full textAbstract:
The major socio-economic development challenges facing most African countries include economic diversification, poverty, unemployment, diseases and the unsustainable use of natural resources. The challenge of quality healthcare provisioning is compounded by the HIV/AIDS pandemic in Sub Saharan Africa. However, there is a great potential in using electronic healthcare (e-health) as one of the supportive systems within the healthcare sector to address these pressing challenges facing healthcare systems in developing countries, including solving inequalities in healthcare delivery between rural and urban hospitals/clinics. The purpose of this study was to compile a Provincial E-health Framework (PEHF) based on the feedback from electronic healthcare readiness assessments conducted in selected rural and urban hospitals/clinics in the North West Province in South Africa. The e-healthcare readiness assessment was conducted in the light of effective use of ICT in patient healthcare record system, consultation among healthcare professionals, prescription of medication, referral of patients and training of healthcare professionals in ICT usage. The study was divided into two phases which were phases 1 and 2 and a qualitative design supported by a case study approach was used. Data were collected using different techniques to enhance triangulation of data. The techniques included group interviews, qualitative questionnaires, photographs, document analysis and expert opinions. The outcome of the assessment led to the compilation of the PEHF which was based on Service Oriented Architecture (SOA). SOA was chosen to integrate the hospitals/clinics‟ ICT infrastructure yet allowing each hospital/clinic the autonomy to control its own ICT environment. To assist hospitals/clinics integrate their ICT resources, this research study proposed an Infrastructure Network Architecture which clustered hospitals/clinics to share common ICT infrastructure instead of duplicating these resources. Furthermore, processes of the e-health services (e-patient health IV record system, e-consultation system, e-prescription system, e-referral system and e-training system) were provided to assist in the implementation of the PEHF. Finally, a set of guidelines were provided by the research study to aid the implementation of the PEHF.
9
Clarkson, D. M. "Modelling risk in healthcare based on simulation of episodes of interactions relating to patient care." Thesis, Coventry University, 2009. http://curve.coventry.ac.uk/open/items/63d24681-dd61-4896-0c8a-56c04e02c3ec/1.
Full textAbstract:
Risk reduction processes in healthcare remain at the core of 21st century health care provision, though the continuing scale of the problem gives little room for complacency. While other areas of complex technological activity such as air transportation can demonstrate improvements in safety performance, comparable progress eludes modern healthcare. A review of risk reduction techniques within healthcare identifies that there exists a lack of tools involving simulation of risk. It has been necessary in the context of the research to establish many wholly original information structures representing healthcare activity and associated risk related interactions This Thesis describes a new risk simulation environment for the Critical Care Unit of University Hospital, Coventry which is a 1200 bed modern acute hospital which fully opened in 2006. Available sets of patient admission/discharge information and records of patient treatment records used for cost charging together with extensive direct observation of clinical activity are used to create simulated patient episodes within the Critical Care environment. Specific patient interventions are sub divided into a series of up to 7 sub tasks which are associated with sub competencies and a linked adverse effect. Such sub competencies can be coded to reflect three levels of task complexity. Separate codes can be allocated to identify sub competencies which are supervised and sub competencies for which additional competency can be requested from other team members. A fuzzy logic framework has been adopted to combine empirically derived mathematical functions which for a specific sub task, translate values of individual effectiveness, distraction, competency mismatch of individual/team together with the level of supervision to a specific risk value for each adverse effect. This fuzzy logic framework, referenced as the ‘risk engine’ has specific responses for levels of sub task complexity and can be modified by indicators relating to sub task supervision and competency sharing. In addition, each sub task/competency is associated with an adverse effect whose probability of occurrence can be reduced through identified safe working practices which are referenced as ‘preventive measures’. Individual effectiveness is identified as being influenced by cirdadian rhythm, physical effort, emotional/stress effort, intellectual effort, sleep deficit and long term factors. Organisational factors influencing individual effectiveness are identified as patient admission and shift handover. The risk simulation process is implemented within a 10 bed Critical Care Unit which utilises a specifically designed nurse rostering process for 12 hour shift periods. Sub grades of nurse skills (1 to 15) are used to structure skill mix within each rostered group and which are based on representative nurse grades (band 5, 6 and 7). Available competencies of nursing staff for a specific sub task are allocated on the basis of sub grade value and the parameter of individual competency mismatch is derived from values of required competency and available competency for each sub task. The team competency mismatch for a specific sub task linked to a specific individual is derived from the maximum available competency within the active nursing team. Nursing staff are allocated to patients on the basis of clinical need at the start of each shift. A novel feature of the model identifies modes of interaction between nursing individuals on a ‘bed to bed’ basis as relating to parameters of distraction, supervision and competency sharing and which are related to the physical layout of the active clinical area. A fuzzy logic sub system for determining values of such interaction coefficients and which uses the same design methodology as the ‘risk engine’ is described.
10
Martin, Sarah Elizabeth. "Digitisation of healthcare : Barthel Index Assessment, Kardex Management and ECG analysis." Thesis, Ulster University, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.694235.
Full textAbstract:
We are now living in a world where the adoption of mobile computing technologies within healthcare is becoming more prevalent. Digitisation within hospitals and clinical settings have increased due to smaller, powerful and cost effective devices. The National Health Service has a target to be "completely paperless by 2018" and this Thesis presents work highlighting issues involving the lack of paperless across three key areas: (1) occupational therapists: assessment of occupants' general health and wellbeing, (2) nurses: documentation of patient's status, (3) physicians: interpretation of diagnostic tools. A study assessing the digitisation of a social care assessment chart has been undertaken. An online tool was created in an effort to reduce the amount of miscalculations when compared to the paper assessment chart. As a result, there were no miscalculations when using the online tool, compared to 40% when using the traditional paper-based assessment. In a subsequent study, an evaluation of paperless observations recordings in the form of a digital drug chart displayed on a tablet device are explored. The study established that although the digital drug chart took slightly longer for participants to use, it was the method of assessment that the user correctly noticed the patient's drug allergy to penicillin. The penultimate study involved the design, development and evaluation of an online ECG visualisation tool. Along with the traditional 12-Lead ECG, alternative formats (BSPM and ST-Vector Map) were included to allow comparisons between the most effective method of diagnosis. Work within this study showed that the BSPM was proven to be just as useful as the 12-Lead ECG in identifying myocardial infarctions. The final study aimed to evaluate whether an accurate ECG diagnosis could be made using a smartphone. A clinician was sent 15 ECGs as picture messages before providing a diagnosis for each image. Findings illustrate that all 15 ECGs were diagnosed correctly with the clinician stating that there was no key disadvantage in comparison to paper based ECGs. These studies represent each of the three key areas of healthcare discussed previously, and endeavour to bridge the gap in relation to providing sustainable digital healthcare.
11
Tong, Yuxin. "Multiphysics Modeling Of Devices For Whole Organ Healthcare Applications." Thesis, Virginia Tech, 2017. http://hdl.handle.net/10919/86227.
Full textAbstract:
In order to fully understand the functionality of conformal devices, it is critical to develop computational models built from engineered models of 3-dimensional objects. This thesis established a scanning procedure to engineering 3D digital model for whole organs, known as template engineering. The resultant scanning data enabled designing, manufacturing, and modeling of novel organ healthcare devices. Specifically, we applied template engineering and structured-light scanning techniques to capture the 3D topographical information for whole organ systems. Sequentially, we developed multiphysics models for understanding the device functionality, including the function of devices for microfluidic interface and whole organ mechanical stabilization.Master of Science
12
Arushanyan, Elena. "Relationship Between the U.S. Air Force Physical Fitness Assessment And Healthcare Utilization." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4957.
Full textAbstract:
Escalating health care costs in the military health system are not sustainable long term. Regular physical activity has been shown to improve health and reduce health care costs. Military members serving in the United States Air Force (USAF) are encouraged to maintain physical fitness year-round and undergo mandatory physical fitness assessments (PFAs) annually. The purpose of this quantitative correlational study was to determine the nature of the relationship between the timing of the PFA and health care utilization (HU) by active duty service members assigned to the United Kingdom's USAF military treatment facility. Donabedian's framework and the logic process model were used to design the study. Archived fitness and health care utilization data were obtained on 361 military members. Findings indicated a strong, positive correlation between the timing of the PFA and HU, which was strongest during the PFA month. Monthly HU 6 months prior to PFA was compared using a 1-way repeated measures ANOVA. Findings indicated a significant difference between T-1 (PFA month), T-2 (1 month prior to PFA), and T-5 (5 months prior to PFA). Paired-samples t tests demonstrated a statistically significant increase in HU from T-5 to T-2. Although findings are not generalizable, they signal a need for further study to evaluate HU variability between populations, to identify at-risk groups, and to inform health and fitness policies that affect the readiness and retention of military members. The DNP project may promote interdisciplinary collaboration between health care providers and senior military leadership, innovation in health care delivery, and evidence-based and cost-conscious policies.
13
Arushanyan, Elena E. "Relationship Between the U.S. Air Force Physical Fitness Assessment and Healthcare Utilization." Thesis, Walden University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10749499.
Full textAbstract:
Escalating health care costs in the military health system are not sustainable long term. Regular physical activity has been shown to improve health and reduce health care costs. Military members serving in the United States Air Force (USAF) are encouraged to maintain physical fitness year-round and undergo mandatory physical fitness assessments (PFAs) annually. The purpose of this quantitative correlational study was to determine the nature of the relationship between the timing of the PFA and health care utilization (HU) by active duty service members assigned to the United Kingdom's USAF military treatment facility. Donabedian's framework and the logic process model were used to design the study. Archived fitness and health care utilization data were obtained on 361 military members. Findings indicated a strong, positive correlation between the timing of the PFA and HU, which was strongest during the PFA month. Monthly HU 6 months prior to PFA was compared using a 1-way repeated measures ANOVA. Findings indicated a significant difference between T-1 (PFA month), T-2 (1 month prior to PFA), and T-5 (5 months prior to PFA). Paired-samples t tests demonstrated a statistically significant increase in HU from T-5 to T-2. Although findings are not generalizable, they signal a need for further study to evaluate HU variability between populations, to identify at-risk groups, and to inform health and fitness policies that affect the readiness and retention of military members. The DNP project may promote interdisciplinary collaboration between health care providers and senior military leadership, innovation in health care delivery, and evidence-based and cost-conscious policies.
14
Morice, Tura. "Patient falls and hospital consumer assessment of healthcare providers and systems staff responsiveness." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1524142.
Full textAbstract:
The purpose of this study is to establish a relationship between responsiveness of hospital staff to a patient's call for help and the hospital fall rate. Patient falls are a very serious matter so data that furthers understanding in this area may be of help for hospitals trying to raise patient satisfaction scores, improve patient outcomes, and improve financial impact. The data utilized in this project are datasets downloaded from the Centers for Medicare and Medicaid Services (CMS) website.
Two hypotheses were tested from each extreme end of the responsiveness spectrum. The final conclusion is that the hospital fall rate is strongly associated with the high ("Always") but not the lower end ("Sometimes or Never").
Further research in this area is recommended to account for casual factors. The limitations of the study may be the collection and manipulation of the data by CMS.
15
Beaumont, Corrine Ellsworth. "Design thinking in healthcare : developing patient-centred communication materials for breast cancer detection." Thesis, Bucks New University, 2011. http://bucks.collections.crest.ac.uk/9623/.
Full textAbstract:
This thesis is the culmination of five years of communication design research (2006 – 2010) on a specific area of healthcare—breast cancer detection and screening. It is a project-‐based doctoral work, underpinned by a practice-‐led research journey of a graphic designer. The result is this written thesis with an accompanying set of uniquely designed objects: • a series of posters on breast cancer detection • an educational leaflet and risk assessment form • a series of working website prototypes (see worldwidebreastcancer.com) This thesis offers an in-‐depth case study that demonstrates and contextualises the need for using communication design in patient engagement and education efforts in order to create a more patient-‐centred experience in breast cancer detection. The significant contributions of this thesis are: • the development of a human-‐centred design thinking methodology, known as the ‘USER’ model, which helps a designer develop a product for use within a system in an iterative, intuitive and analytical way. This is the first design thinking model of its kind to embed a framework for analysing objects within a systems framework; • the production and testing of visual metaphor, which was found to improve patient literacy and confidence. The significance of this has been to increase the potential for symptoms to be reported early and decrease mortality rates; • a map illustrating the patient journey of breast cancer screening that illustrates roles, communications and detection activities. This has been developed for general practices and imaging centres in a visually clear and distinct way; • a risk assessment tool that encourages doctors and patients to engage in collaborative decision-‐making in the planning of breast cancer screening activities. Finally, the work presented here has profound implications for future studies of patient engagement and health literacy in breast cancer detection. The research journey, findings and objects in this thesis may lead to improved patient communication experiences and decreased mortality in breast cancer. This thesis also acts as a model for exploring and developing design solutions for other health causes.
16
Tholen, David, and Aaron Dix. "Needs Assessment for Patient Focused Healthcare Education in the Over-the-Road Professional Truck Driver and Survey of Intern’s view of Retail Pharmacy Involvement in Healthcare Education." The University of Arizona, 2009. http://hdl.handle.net/10150/623998.
Full textAbstract:
Class of 2009 AbstractOBJECTIVES: Truck drivers one of the most vital components of a country’s economy, and also one of the most medically underserved populations. To date, few studies have explored the healthcare needs of over the road truck drivers. The objective of this study is to determine if a need exists for the creation of a healthcare education program for over the road truck drivers and if retail pharmacy could be an effective setting for such a program. METHODS: A needs assessment analysis was used to examine available literature concerning the healthcare of over the road truck drivers. A multi-question survey was designed to illicit the feasibility of initiating a healthcare education program to over the road truck drivers in a retail pharmacy setting. This survey was administered to third year pharmacy interns, and 67 completed surveys were collected. RESULTS: Statistics from the selected literature showed over the road truck drivers had increased health risks and barriers to receive proper healthcare. Sixty-two percent of the pharmacy interns felt they could help provide healthcare education to over the road truck drivers, but 71% of interns felt that management wanted to have as little time as possible expended providing education and counseling. CONCLUSIONS: Over the road truck drivers are at increased risk of healthcare problems due to the demands of the profession and a healthcare education program is warranted to help
17
George, Taylor A., and Taylor A. George. "2016 Arizona Statewide Emergency Medical Services Needs Assessment (ASENA)." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626310.
Full textAbstract:
Emergency Medical Services (EMS) is an institution and product of public health, health care, and public safety that is chopped and scattered across multiple jurisdictional deployment methodologies throughout Arizona. To fully-asses the EMS needs of the state, those jurisdictions are considered as a whole; for it is the whole that makes a system, and a system is what truly impacts patient outcomes. Evaluating the ""whole"" is the genesis and driver of the 2016 Arizona Statewide EMS Needs Assessment (ASENA).
The primary objective of ASENA is to establish a current ""snap-shot"" of EMS in the state while simultaneously identifying needs and/or areas that can be targeted for further analysis and/or improvement as part of Population Health Management and Emergency Medical Services Integration under the AZ Flex Grant funded by the U.S. Health Resources and Services Administration (HRSA). In addition, the secondary objective of ASENA is to compare and contrast this current ""snap-shot"" with data obtained in a more narrow needs assessment conducted in 2001, allowing comparison of changes in Arizona's critical access EMS system over 15 years.
To accomplish this, a 105-question needs assessment survey tool was developed and distributed to EMS agencies throughout the state. The fully-vetted survey tool collected information pertaining to sixteen core functional sections. Eighty-six agencies fully-completed the needs assessment survey tool, with respondents evenly distributed across the state's four EMS coordinating regions and representative of the various service-delivery methodologies. The combined service areas of the respondents cover over 85% of the state's population.
Arizona's statewide EMS system is well organized and positioned to deliver advanced levels of prehospital care for the vast majority of its citizens and visitors, with some variation between urban and rural regions. Key needs identified relate to: patient care reporting between EMS providers, emergency departments and receiving hospitals; quality assurance activities; education and skills training programs; dispatch system capabilities; mass casualty and public health preparedness; equipment and supplies; and more robust use of data and analyses to inform continuous EMS system improvement.
18
Ishau, Simileoluwa O. "Dermal Exposure and Risk to Aerosolized Pharmaceuticals in Home Healthcare Workers." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1581333497402733.
Full text
19
Ng, Mei-ni, and 吳美妮. "High-risk insurance pool : a systematic review and assessment on efficiency and equity in healthcare." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206946.
Full textAbstract:
To enable high-risk individuals to have access to private health insurance, the Hong Kong government has announced the establishment of a high-risk pool reinsurance mechanism. Under the voluntary and government-regulated insurance program, “Health Protection Scheme”, the high-risk pool will accept individuals with pre-existing medical conditions or higher health risks. Critics have long expressed their concerns regarding the financial sustainability of Hong Kong’s healthcare system due to its heavy reliance on government subsidies and publicly funded services. Patients with pre-existing conditions are denied coverage by the private insurance sector, and have to rely heavily on the overburdened public healthcare system. Following the United States, the Hong Kong government suggests that a high-risk pool proposal will offer a relatively simpler approach compared to other alternatives. However, little is known about its applicability in Hong Kong or potential problems. Therefore, the objective of this study is to evaluate the effectiveness of high-risk pool in promoting healthcare efficiency, equity, and to make recommendations for the operations in Hong Kong.
A systematic literature review was conducted on the MEDLINE database to study the overseas experience of high-risk insurance pools. Of the 52 articles included in the systematic review, the majority of the studies cover the operations in the United States. Results are analysed from the following eight perspectives. For efficiency, the studied areas include (1) fiscal sustainability, (2) adverse selection, (3) risk sharing and (4) cost containment. For equity, (5) insurance premium, (6) out-of-pocket expense, (7) enrolment barrier and (8) program awareness of the high-risk pools are analysed.
Results of the systematic review show the inadequacies of the high-risk pool mechanisms in all of the above studied areas. In the United States, while industry assessment and government subsidization intend to facilitate risk sharing for high-risk population, insufficient funding and the industry’s deteriorated risk sharing capabilities undermine system efficiency. In addition, adverse selection and cost containment add to the already lengthy list of problems that high-risk pools have yet to address. Limited subsidies, high out-of-pocket payments, strict eligibility rules, and insufficient program awareness remain the four major barriers to health equity for the uninsurable.
While studies on the overseas healthcare system have revealed several inadequacies regarding the high-risk pool mechanism, these uncertainties have to be resolved before Hong Kong can move forward to improve its healthcare efficiency and equity. More thoughts should be given on how the risk sharing capability can be enhanced within the insurance industry. Without a clear definition or a standardized underwriting rule that clearly defines “high-risk”, the high-risk pool could become a platform to practice adverse selection and further deteriorate the already limited risk sharing among the population. For addressing the issue of cost containment, the DRG charging system and chronic disease management programs are pivotal components to be incorporated. The government should perform a concrete assessment to justify how the spending on high-risk pool can essentially promote a more equitable system in Hong Kong. By considering the impact on both private insurance market and the public healthcare system, the government should further consider how to implement a high-risk pool that can effectively improve the healthcare efficiency and equity in Hong Kong.published_or_final_version
Public Health
Master
Master of Public Health
20
Henawi, Mohammed Khaled. "Healthcare financing reform in the Kingdom of Saudi Arabia : an assessment of willingness to pay." Thesis, Aston University, 2017. http://publications.aston.ac.uk/33345/.
Full text
21
Benjamin, Michael L. "Cleaning Product Chemical Exposures Measured in a Simulated Home Healthcare Work Environment." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1573224213774289.
Full text
22
Azadeh, Fard Nasibeh. "Essays on Risk Indicators and Assessment: Theoretical, Empirical, and Engineering Approaches." Diss., Virginia Tech, 2016. http://hdl.handle.net/10919/78323.
Full textAbstract:
Risk indicators are metrics that are widely used in risk management to indicate how risky an activity is. Among different types of risk indicators, early warning systems are designed to help decision makers predict and be prepared for catastrophic events. Especially, in complex systems where outcomes are often difficult to predict, early warnings can help decision makers manage possible risks and take a proactive approach. Early prediction of catastrophic events and outcomes are at the heart of risk management, and help decision makers take appropriate actions in order to mitigate possible effects of such events. For example, physicians would like to prevent any adverse events for their patients and like to use all pieces of information that help accurate early diagnosis and interventions.
In this research, first we study risk assessment for occupational injuries using accident severity grade as an early warning indicator. We develop a new severity scoring system which considers multiple injury severity factors, and can be used as a part of a novel three-dimensional risk assessment matrix which includes an incident's severity, frequency, and preventability. Then we study the predictability of health outcome based on early risk indicators. A systems model of patient health outcomes and hospital length of stay is presented based on initial health risk and physician assessment of risk. The model elaborates on the interdependent effects of hospital service and a physician's subjective risk assessment on length of stay and mortality. Finally, we extend our research to study the predictive power of early warning systems and prognostic risk indicators in predicting different outcomes in health such as mortality, disease diagnosis, adverse outcomes, care intensity, and survival. This study provides a theoretical framework on why risk indicators can or cannot predict healthcare outcomes, and how better predictors can be designed. Overall, these three essays shed light on complexities of risk assessments, especially in health domain, and in the contexts where individuals continuously observe and react to the risk indicators. Furthermore, our multi-method research approach provides new insights into improving the design and use of the risk measures.Ph. D.
23
Jiang, Chuan. "A Smart and Minimally Intrusive Monitoring Framework Design for Health Assessment of the Elderly." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1439294464.
Full text
24
Vigenschow, Anja [Verfasser], and Ayola Akim [Akademischer Betreuer] Adegnika. "Structured assessment of healthcare facilities and knowledge, attitudes and practices of healthcare workers regarding tuberculosis infection control in Moyen-Ogooué, Gabon / Anja Vigenschow ; Betreuer: Ayola Akim Adegnika." Tübingen : Universitätsbibliothek Tübingen, 2019. http://d-nb.info/1201644496/34.
Full text
25
Crane, Jeffrey S. "Assessment of the community healthcare providers' ability and willingness to respond to a bioterrorist attack in Florida." [Tampa, Fla.] : University of South Florida, 2005. http://purl.fcla.edu/fcla/etd/SFE0001034.
Full text
26
Beverungen, Henrike [Verfasser], and Christoph [Akademischer Betreuer] Gutenbrunner. "Worldwide assessment of healthcare personnel dealing with lymphoedema / Henrike Beverungen ; Akademischer Betreuer: Christoph Gutenbrunner ; Klinik für Rehabilitationsmedizin." Hannover : Bibliothek der Medizinischen Hochschule Hannover, 2020. http://d-nb.info/1218170522/34.
Full text
27
Ruddock, Steven. "Assessment of the built environment for healthcare : a case study in the development of an evaluation framework." Thesis, University of Salford, 2009. http://usir.salford.ac.uk/26883/.
Full textAbstract:
A number of studies (CABE, 2002; Lawson and Phiri, 2005) have shown that good design of healthcare facilities can both benefit patients and raise staff morale. This research focuses on an investigation of patient and staff perceptions of healthcare facilities, particularly with respect to the development of a framework for the evaluation of patient and staff satisfaction with such facilities. Following a comprehensive literature review, two different but interrelated areas of literature, comprising firstly the interrelationship between health and the built environment and secondly the appraisal of healthcare facilities, led to the formation of the research aim, objectives and questions. At the data collection stage, the researcher focused on two existing health centres within Salford PCT as case studies. Existing questionnaires, such as Achieving Excellence Design Evaluation Toolkit (AEDET), were assessed and bespoke questionnaires based on seven groups of features for patients and six groups for staff were developed and piloted. The researcher employed a mixed method approach in the research technique as the data collection process involved two tools: questionnaire and interview. The results of the surveys showed the issues, which most affected users' levels of satisfaction and allowed cross-centre and cross-user group comparisons to be made. Based on the results of the questionnaire surveys, a post-questionnaire factor analysis was undertaken to evaluate and validate the patient questionnaire itself. This resulted in the recommendation, from the findings, that a reconfigured patient questionnaire, based on four factors would best capture the correlated features.
28
Sasane, Rahul Madhukar. "Assessment of the effectiveness of a non-steroidal anti-inflammatory drug (NSAID) algorithm in an integrated healthcare system /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.
Full text
29
Mattord, Herbert J. "Assessment of Web-Based Authentication Methods in the U.S.: Comparing E-Learning Systems to Internet Healthcare Information Systems." NSUWorks, 2012. http://nsuworks.nova.edu/gscis_etd/235.
Full textAbstract:
Organizations continue to rely on password-based authentication methods to control access to many Web-based systems. This research study developed a benchmarking instrument intended to assess authentication methods used in Web-based information systems (IS). It developed an Authentication Method System Index (AMSI) to analyze collected data from representative samples of e-learning systems in the U.S. and from healthcare ISs, also in the U.S. This data were used to compare authentication methods used by those systems. The AMSI measured 1) password strength requirements, 2) password usage methods, and 3) password reset requirements. Those measures were combined into the single index that represents the current authentication methods. This study revealed that there is no significant difference in the ways that authentication methods are employed between the two groups of ISs.
This research validated the criteria proposed for the AMSI using a panel of experts drawn from industry and academia. Simultaneously, the same panel provided preferences for the relative weight of specific criteria within some measures. The panel of experts also assessed the relative weight of each measure within the AMSI. Once the criteria were verified and the elicited weights were computed, an opportunity sample of Web-based ISs in the two groups identified earlier were assessed to ascertain the values for the criteria that comprise the AMSI. After completion of pre-analysis data screening, the collected data were assessed using the results of the AMSI benchmarking tool. Results of the comparison within and between the two sample groups are presented.
This research found that the AMSI can be used as a mechanism to measure some aspects of the authentication methods used by Web-based systems. There was no measurable significance in the differences between the samples groups. However, IS designers, quality assurance teams, and information security practitioners charged with validating ISs methods may choose to use it to measure the effectiveness of such authentication methods. This can enable continuous improvement of authentication methods employed in such Web-based systems.
30
Santillan, Saldivar Jair. "Integrated assessment of selected materials for criticality and environmental sustainability : application to the healthcare sector and methodological enhancements." Thesis, Bordeaux, 2021. http://www.theses.fr/2021BORD0084.
Full textAbstract:
Les activités nécessaires pour fournir des services de santé posent plusieurs défis en termes de durabilité. Le secteur de la santé repose sur divers produits, services et installations, notamment des produits jetables, équipements complexes et moyens de transport. Ce domaine a été peu exploré sous l'angle de la durabilité et le niveau de sensibilisation à ce sujet est faible. Les méthodologies basées sur le cycle de vie ont le potentiel de caractériser la durabilité liée au secteur de la santé et à bien d'autres; toutefois, ces méthodes sont principalement - sinon exclusivement - liées à une voie inside-out pour évaluer les impacts. D'un point de vue outside-in, la criticité des ressources a le potentiel de répondre aux préoccupations relatives à la disponibilité des ressources pour le secteur de la santé, en particulier après son intégration dans le cadre de l'évaluation de la durabilité du cycle de vie (LCSA).Une tâche en suspens autour de cette voie méthodologique proposée est d'explorer l'applicabilité et l'état de préparation des approches de risque d'approvisionnement, en particulier la méthode de risque géopolitique d'approvisionnement (GeoPolRisk), proposée pour évaluer les impacts liés aux ressources. Cette recherche fournit et intègre des techniques d'évaluation de la durabilité environnementale dans une perspective de cycle de vie, en particulier sur l'amélioration des indicateurs de criticité en tant que voie d'impact outside-in associée au domaine de protection "Ressources naturelles" dans l'analyse du cycle de vie (ACV); en outre, leur applicabilité est validée par de multiples études de cas, dont l'une fait partie du secteur de la santé.La thèse est divisée en 9 chapitres et suit deux branches: "Durabilité des soins de santé" et "Criticité des ressources dans l'ACV". Le premier chapitre fournit une introduction au manuscrit et présente la question de recherche et les objectifs de la thèse ; il est suivi par l'état de l'art dans le chapitre 2. Le chapitre 3 présente le développement d'un nouveau cadre pour relever les défis de la durabilité dans le secteur de la santé par le biais de la pensée cycle de vie. Les chapitres 4 et 5 proposent et testent des développements méthodologiques pour évaluer le risque d'approvisionnement géopolitique. Ces aspects sont nécessaires pour mieux aborder les impacts liés aux ressources en ACV. Le chapitre 6 présente une évaluation intégrée de la criticité des ressources avec les catégories d'impact environnemental traditionnellement utilisées en ACV. Dans le chapitre 7, la méthode GeoPolRisk est utilisée pour mieux comprendre la pertinence de l'évaluation des impacts outside-in associés à un élément utilisé dans le secteur de la santé. Le chapitre 8 intègre les développements méthodologiques présentées précédemment pour étudier les impacts inside-out et outside-in dans le cadre d'une étude de cas associée à l'imagerie médicale. Enfin, les perspectives de développement sur le terrain sont examinées dans le dernier chapitre du manuscrit.Dans la branche " Durabilité des soins de santé", ce travail contribue à l'élaboration d'un cadre intégré pour soutenir la recherche dans ce domaine et à la première application à une étude de cas dans le secteur de la santé d'une analyse intégrée du cycle de vie intégrant des indicateurs environnementaux et la méthode GeoPolRisk. Dans la branche "Criticité des ressources dans l'ACV", la thése développe de nouvelles approches et propose des améliorations méthodologiques pour faire progresser l'évaluation de l'utilisation des ressources dans l'ACVThe activities required to provide healthcare services bring challenges to environmental sustainability. The sector relies on diverse products, services and facilities, including disposable products, complex equipment and transportation. This domain has not been well explored from a sustainability lens and the level of awareness around healthcare sustainability is low. Life-cycle based methods have the potential to characterize systems related to the healthcare sector and many others; however, these methods are mostly – if not exclusively – related to an inside-out pathway to assess impacts. From an outside-in perspective, there is potential for raw material criticality to assess resource availability in the healthcare sector, especially after the proposal to integrate it into the Life Cycle Sustainability Assessment (LCSA) framework.A pending task around this proposed methodological pathway is to explore the applicability and readiness of supply risk methods, specifically the geopolitical supply risk (GeoPolRisk) method has been proposed to assess resource related impacts. This research provides and integrates methods to assess environmental sustainability from a life cycle perspective with focus on enhancing criticality indicators as an outside-in impact pathway associated with the Area of Protection “Natural Resources” in Life Cycle Assessment (LCA); moreover, their applicability is validated with multiple case studies, being one of those a part of the healthcare sector.The thesis is divided in 9 chapters along two branches: “Healthcare Sustainability” and “Raw Material Criticality in Life Cycle Assessment”. The first chapter provides an introduction to the manuscript and presents the research question and objectives of the thesis; it is followed by the state of the art in chapter 2. Chapter 3 presents the development of a novel framework to help address sustainability challenges in the healthcare sector through life cycle thinking. Chapter 4 and Chapter 5 propose and test methodological enhancements to the geopolitical supply risk method required to better address resource related impacts in life cycle assessment. Chapter 6 presents an integrated assessment taking into account the enhanced method and its relation to more traditionally used environmental impact categories in LCA. In chapter 7, the GeoPolRisk method is used to better understand the relevance of assessing outside-in impacts associated to an element used in the healthcare sector. Chapter 8 integrates the methodological enhancements previously presented to study inside-out and outside-in impacts for a case study associated with medical imaging. Finally, accomplishments and future opportunities for development on the field are discussed as part of the last chapter of the manuscript.Along the branch of “Healthcare Sustainability” this work contributes to the development of an integrated framework to support research in this domain and the first application to a case study in the healthcare sector of an integrated life cycle assessment incorporating environmental indicators and the GeoPolRisk method. Along the branch of “Raw Material Criticality in LCA”, the PhD develops new approaches and proposes methodological enhancements to advance the assessment of resource use in LCA
31
Bien, Elizabeth A. "Occupational Exposure Assessment of Home Healthcare Workers: Development, Content Validity, and Piloting the Use of an Observation Tool." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin159584568462432.
Full text
32
Balasa, Rebecca A. "Patients’ and Parents’ Perceptions of their Role in the Assessment of Nursing Students’ Pediatric Clinical Practice." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39689.
Full textAbstract:
Background and objective: Patients’ and parents’ involvement in nursing students’ pediatric clinical practice assessment is informal. This study explored patients’ and parents’ perceptions of their role in students’ formative assessment. Approach: Interviews were conducted with patients and parents admitted at the study setting who received care from a nursing student. They were transcribed verbatim. Data was analyzed using a qualitative content analysis while Lincoln and Guba’s criteria of rigor and trustworthiness were upheld. Findings: Three categories emerged from the data: 1) Patients’ and parents’ current involvement in the assessment of nursing students’ pediatric clinical practice; 2) How they would like to be involved; and 3) The benefits and challenges of their involvement. Conclusion: This study has provided an understanding of patients’ and parents’ past encounters with nursing students, the elements of care that they would want to assess, and their perceived benefits and challenges of their involvement.
33
Tokosi, Oluwatoyin Iyabode Abiola. "An assessment of current practice patterns of TB/HIV at primary healthcare clinics in the Western Cape and a needs assessment for clinic-based training among final year Pharmacy students." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6836_1378888818.
Full textAbstract:
Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual
TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death
amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload
due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may
not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy.
Clinicbased training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored.
34
Salcedo, Maria Victoria Trinidad. "Needs Assessment for a Nurse Practitioner-Led Transitional Care Program." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1450.
Full textAbstract:
The rising cost of health care and changes in healthcare delivery have prompted a need to improve continuity from the hospital to home. This scholarly project was initiated to assess the impact on patient outcomes related to initiation of a nurse practitioner-led transitional care program (TCP). Using the Diffusion of Innovations and Health Belief Models, the purpose of this study was to identify the impact of a TCP on improving the health of patients with congestive heart failure (CHF), diabetes mellitus Type II (DM II), and chronic obstructive pulmonary disorder (COPD). The impact of the TCP was evaluated by a review of patient satisfaction results, reduction in patient readmission rate, and emergency room consults. Two years of data from a community-based health care program were collated from a sample of 819 individuals with chronic disease between 65- and 85-years-old who had a 30-day hospital readmission after a nurse practitioner home visit and a 30- day readmission for an exacerbation of their CHF, DM II, or COPD. The secondary data were analyzed, using SPSS, to determine changes in rates of readmission. Descriptive statistics were used to represent and compare changes in rates. After implementation of the nurse practitioner home visit program, the 30-day readmission demonstrated an 81.07% reduction and the 30-day readmission for exacerbation of COPD, CHF, and DM II was reduced by 36.77%. The project findings contribute to social change by identifying how a reduction in the frequency of hospitalizations could contribute to decreased health care expenses and improved health outcomes. Home care and chronic health care organizations, as well as advanced-practice nurses working in home care settings, may use the results of the study to establish effective community interventions that reduce health care costs.
35
Bogel, Marianne. "Closing the Gaps in Rural Healthcare in Texas: A Formative Bounded Case Study." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7601.
Full textAbstract:
Maldistribution of healthcare professionals persists in remote and rural communities throughout the world. Adoption of a Community Paramedic (CP) program could improve access to quality healthcare for rural communities. The conceptual framework defined rural communities by their distinct characteristics — community efficacy, weaknesses, attitudes, assets, deficits, local culture, and the driving and restraining forces — and not defined by their small populations or distances to cities. The theoretical foundation was a synthesis of theories of Bandura, Rogers, and Lewin. This study assessed community characteristics that may influence the likelihood of success, sustainability, or program failure of the Australian CP model in a single remote Texas border community. In this qualitative formative bounded case study, 3 bounded groups were examined; data collection was by in-person interviews. Group members were purposively selected: 5 residents and 3 EMS members. The 3rd group consisted of 4 randomly self-selected resident interviews, field observations, news articles, and local social media. Data transcripts were coded using theoretical coding based on the conceptual framework and theoretical foundation. Strong individual and group efficacy, efficacy resilience, adaptability, strong communications, overlapping groups, and a strong sense of community program ownership were evident in this study. The probability of establishing an effective CP program based on the Australian model is high based on study findings. Improved access to quality healthcare in remote and rural communities could result in improved health of community members and significant social change.
36
Hensley, Vicki. "CHIILDHOOD BULLYING: ASSESSMENT PRACTICES AND PREDICTIVE FACTORS ASSOCIATED WITH ASSESSING FOR BULLYING BY HEALTH CARE PROVIDERS." UKnowledge, 2015. http://uknowledge.uky.edu/nursing_etds/25.
Full textAbstract:
Childhood bullying affects over 25% of today’s youth and causes up to 160,000 missed school days per year. Bullying causes short and long term adverse effects to both mental and physical health. Many organizations encourage healthcare providers to take an active role in bullying prevention. However, there has been little research into the role of primary healthcare providers regarding childhood bullying and the effectiveness of different approaches to screening and management.
Therefore the purposes of this dissertation were to a) explore childhood bullying and the role of the healthcare provider in bullying prevention, b) develop and evaluate the psychometric properties of Hensley’s Healthcare Provider’s Practices, Attitudes, Self-confidence, & Knowledge Regarding Bullying Questionnaire. Pediatric healthcare providers were asked to participate in this study if they conducted well-child exams on a weekly basis. Information on the provider’s current bullying assessment practices, attitudes, self-confidence, and knowledge regarding bullying was gathered. Results indicated that approximately one-half (46.6%, n=55) of the healthcare providers reported assessing their patients for bullying behaviors during well-child exams. The strongest predictor of positively assessing for bullying was attitudes, recording an odds ratio of 1.24. This indicated for every one-unit increase in attitudes score, the odds of assessing for bullying will be 24% higher. The odds ratio of self-efficacy or self-confidence was 1.18, indicating that for every one-unit increase in self-efficacy score, the odds of assessing for bullying will be 18% higher.
37
Wikström, Lotta. "The clinical utility of patients’ self-rated postoperative pain after major surgery – the perspective of healthcare professionals'." Doctoral thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. ADULT, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-35361.
Full textAbstract:
The Numeric Rating Scale (NRS) is suitable in postoperative settings, yet, the implementation has shown varying results. This has raised issues about the pain scales contribution to the identifying and understanding of pain. The aim of this thesis was to describe the clinical utility of patients’ self-rated postoperative pain after major surgery from a healthcare professional perspective. The aim of study I and II was to describe healthcare professionals’ perceptions of the use of pain scales, and to through considering critical incidents describe care experiences and actions taken by healthcare professionals’ when assessing pain. Participants in study I (N=25) and II (N=24) were enrolled- registered nurses and physicians with clinical experiences of pain scales. The aims of study III and IV were to determine the clinical applicability of NRS mode- and maximum- measures, and the NRS mode- and median measures at rest and during activity based on patients self-rated pain. The aim in study IV was additionally to determine the number of NRS ratings needed for the calculation of these measures. The number of surgical and orthopedic patients who completed study III were: n=157 and study IV: n=479. Study I and II confirmed earlier findings of patients’ self-reported pain scores as a facilitator in the understanding of their postoperative pain. Organizational routines, documentation devices, clinical competence, continuity in care, collaborative actions, time, and individual routines were healthcare related factors affecting the use of pain scales (I, II). Patient-related facilitating factors were patients’ ability and willingness to communicate pain, while disability and unwillingness to communicate or inconsistency in verbal communication with observed behaviors were barriers (II). Time and multidimensional communication approaches could bridge these barriers (I, II). Study III and IV showed acceptable reliability for the mode, median and maximum measures. Rank correlations for individual median scores, based on four ratings, versus patients’ retrospective self-rated average pain, were moderate and strengthened with increased numbers of ratings. The Svensson method showed an individual variation within the expected outcome and a significant systematic group change towards a higher level of reported retrospective pain. The calculated pain measures, particularly concerning pain at rest, generally were lower than patients’ recall of pain. The findings described beneficial effects of patient self-reported pain, however present healthcare did not fully support the utilization of pain scales. Because of the simple measurement characteristics, the use of daily NRS average pain measures, patients’ pain can be followed until resolved. The measures could additionally become important patient reported outcome measures and thus constitute new motivators to increase the utilization of pain scales.
38
Mikusinska, Martyna. "Comparative Life Cycle Assessment of Surgical Scrub Suits : The Case of Reusable and Disposable Scrubs used in Swedish Healthcare." Thesis, KTH, Miljöstrategisk analys, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-118234.
Full textAbstract:
Within the healthcare sector, large quantities of different materials and products are consumed on a daily basis. Recurrently growing awareness about humanity’s negative impacts on the environment have initiated for environmental aspects to be considered on several levels within the healthcare sector. Introducing environmental guidelines within procurement is one example of such an initiative. However, in order to take such aspects into consideration, availability of environmental information concerning the products to be procured is necessary. This thesis was conducted to evaluate and compare the environmental impacts, in a life cycle perspective, of a single-use and a multi-use surgical scrub suit. Accordingly, the main purpose has been to give the County Councils of Örebro and Uppsala decision support and thereby enable them to take environmental impact into account in future procurement of surgical scrub suits. The evaluation is based on certain environmental aspects, assessed to be relevant and of interest for the given case. To ensure a methodical structure and high credibility, this LCA has been conducted in accordance with the ISO 14040-standard. The studied products are two types of surgical scrub suits, one reusable for 100 uses, and one disposable. Besides the lifespan, the material composition of the two products differs. Results showed that that the reusable scrubs have considerably lower environmental impact within the studied categories. The main reason for this is the longer lifespan of the reusable garments, which results in substantially decreased environmental impacts per use within all phases of the lifecycle except usage. Further, the results indicated that farming/production of cotton and usage of fossil fuel-based energy are important contributing factors within a majority of the assessed environmental impact categories. Currently available alternatives exist, which could possibly substitute these factors, and thus decrease the total environmental burden of the garments substantially.Varje dag konsumeras stora mängder material och produkter inom vårdsektorn. Samtidigt har den ständigt växande medvetenheten om mänsklighetens negativa påverkan på miljön medfört ett ökat hänsynstagande inom olika delar av vårdsektorn. Införande av riktlinjer för miljö-anpassad upphandling är ett exempel på ett sådant initiativ. Men för att kunna använda miljömässiga aspekter i upphandling är tillgången till miljödata för produkterna nödvändig. Denna uppsats utfördes för att ur ett livscykelperspektiv utreda och jämföra miljöpåverkan av två typer operationsarbetskläder, en engångs- och en flergångsmodell. Huvudsyftet med studien var att ge landstingen i Örebro och Uppsala län ett beslutsunderlag, och därmed underlätta för dem att ta hänsyn till miljöaspekter i framtida upphandlingar av operations-arbetskläder. Miljöbedömningen av plaggen är baserad på utvalda miljöpåverkanskategorier som bedömts som relevanta och av intresse för denna undersökning. För att försäkra en god metodologisk struktur och hög trovärdighet, har denna Livscykelanalys (LCA) utförts i enighet med riktlinjerna i ISO 14040-standarden. De studerade produkterna är två typer av operationsarbetskläder, en som kan återanvändas 100 gånger, och en för engångsbruk. Utöver plaggens livslängd skiljer även materialsamman-sättningen dem åt. Resultaten visade att de återanvändningsbara kläderna har betydligt lägre miljöpåverkan inom alla studerade kategorier.Den huvudsakliga orsaken till detta är flergångsplaggens betydligt längre livscykel, vilken resulterar i en avsevärd minskning i miljöpåverkan per användning inom alla dess livscykel-faser förutom användningen. Vidare indikerade resultaten att odling och tillverkning av bomull, samt användningen av energi från fossila bränslen, hör till viktiga bidragande faktorer till miljöpåverkan inom flertalet undersökta miljöpåverkanskategorier. Redan idag finns alternativ som skulle kunna ersätta dessa faktorer och därmed minska plaggens totala miljöbelastning avsevärt.
39
Burström, Gustavsson Ingela, and Agnes Fogelberg. "Att mäta vårdpersonals kunskap om afasi : Framtagande av items till bedömningsinstrument." Thesis, Uppsala universitet, Logopedi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-196665.
Full textAbstract:
För att språket ska fungera normalt krävs ett samspel mellan uttrycksförmåga och förståelse av språk. Afasi är en språkstörning som kommer sig av en skada i de delar av hjärnan som påverkar språket. Att få afasi kan innebära en stor omställning i livet och ofta uppstår ett behov av anpassning av kommunikationen både för personen som fått afasi och personer i dess omgivning. Detta inkluderar även den vårdpersonal som arbetar nära personen med afasi. För att nå förståelse och kunna ge vård och omsorg av god kvalitet, måste tillräcklig kunskap om afasi finnas hos vårdpersonalen. Tidigare forskning visar att det finns brister hos vårdpersonal i deras kunskap om afasi. Utifrån detta kan det anses viktigt att kunna mäta vårdpersonals kunskap om afasi. Denna studies syfte har varit att ta fram relevanta frågor (items) som kan mäta kunskapsnivån hos vårdpersonal. För att besvara frågeställningarna användes kvalitativ metod för materialinsamling. För att samla erfarenheter av hur vårdpersonalens kunskap om afasi upplevs vara idag, genomfördes intervjuer med tre separata grupper: fem personer med afasi, fem anhöriga till personer med afasi och tre logopeder med erfarenhet av arbete med personer med afasi. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. Resultatet visade att informanternas erfarenheter var att det hos vårdpersonal existerar kunskapsbrister om afasi, varför studien ansågs vara motiverad. Utifrån det analyserade materialet togs 32 items fram, med syfte att mäta vårdpersonals kunskap om afasi. Som alltid vid kvalitativ forskning finns det risker att olika faktorer, exempelvis forskarnas förförståelse, påverkar informanterna. Största möjliga hänsyn har tagits till detta. Framtida nytta med studien är att de framtagna items kan användas i ett bedömningsinstrument för att mäta vårdpersonals kunskap om afasi. Därmed ges nya möjligheter att kvalitetssäkra vård av personer med afasi, att motivera utbildning för vårdpersonal och att exempelvis mäta vårdpersonals kunskap i relation till rehabilitering. Nyckelord: afasi, kunskap, vårdpersonal, items, bedömningsinstrument, kommunikationIn order for the language to function normally, the expression- and comprehension of language must work together. Aphasia is a language impairment caused by damage to the language areas of the brain. Getting aphasia can mean a big change in life and often requires adaptation regarding communication both for the person with aphasia and the persons around them. Adaptation regarding communication also includes healthcare staff working close to the person with aphasia. In order to reach understanding and to give care of good quality, knowledge about aphasia is necessary. Previous research shows that health care staff lacks efficient understanding about aphasia. Considering that, a tool for measuring knowledge about aphasia would be desirable. This study's aim has been to produce questions (items) which can measure the level of knowledge in healthcare personnel. Qualitative research method was used in order to find material for the production of items. In order to gather experiences of how the health care staff's understanding of aphasia are experienced by interested people today, interviews with three separate groups were performed: five persons with aphasia, five relatives to persons with aphasia and three speech and language pathologists with experience of working with persons with aphasia. The interviews were analyzed through qualitative content analysis. The result showed that all the participants' had various experiences of knowledge deficiencies regarding aphasia within the healthcare staff. The analyzed material resulted in 32 items, with the purpose of measuring the understanding of aphasia in healthcare staff. Since the material indicated that a deficiency in knowledge of aphasia exists in healthcare staff, the study was considered to be justified. Within qualitative research method, there are always risks that different elements, for example the researcher´s viewpoint, can affect the participants. Maximum consideration regarding this issue has been considered. Future benefits of this study could be an assessment instrument containing the items produced in this study. The purpose of an assessment instrument could be to measure health care staff´s knowledge about aphasia. Thereby, new opportunities are given to assure the quality of care for persons with aphasia, to justify education for healthcare staff and to evaluate the health care staff´s understanding in relation to the results of rehabilitation. Keywords: aphasia, knowledge, understanding, healthcare staff, items, assessment instruments, communication, healthcare personnel
40
Larsson, Sebastian, and Leif Sulaiman. "EnterMedic, an E-health application for telemonitoring and health status feedback : Development of a mobile healthcare tool and research about its usage in the field of E-health." Thesis, Högskolan i Halmstad, Akademin för informationsteknologi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-43022.
Full textAbstract:
Digital tools are being implemented in every area of society. Digital healthcare, or E-health, is an area that is increasing in popularity with various mobile applications and online services available. Entergate, a company based in Halmstad, has developed a service called EnterMedic. It is a cloud service that collects data from patients through online questionnaires. Once submitted, the service can directly forward data from these questionnaires to patient journals. EnterMedic also helps researchers with data to develop effective work methods in healthcare. The service was however limited to the web. This thesis consists of developing a mobile version of the service as it is more convenient to use compared to a web-based one and research contributing to what E-health applications can be used for. Interactivity is a desired feature for applications. EnterMedic will provide the users with feedback after questionnaire submissions, to help them track their state of health.Digitala verktyg blir implementerade i alla områden av samhället. Digital hälsovård, eller E-hälsa, är ett område som ökar i populäritet med olika mobiltelefon applikationer och on-line tjänster tillgängliga. Entergate, ett företag baserat i Halmstad, har utvecklat en tjänst som heter EnterMedic. Det ar en moln-tjänst som samlar data från patienter genom online formulär. När dessa skickas in kan tjänsten direkt vidarebefodra datan från formulären till patient journaler. EnterMedic hjälper även forskare med data för att utveckla mer effektiva arbetsmetoder inom hälsovården. Tjänsten är dock begränsad till webben. Det här examensarbetet består av att utveckla en mobil version av tjänsten då det är mer bekvämt att använda jämfört med en webb-baserad tjänst och forskning som bidrar till vad E-hälsa applikationer kan användas för. Interaktivitet är en önskad funktion för applikationer. EnterMedic kommer förse användare med återkoppling efter att ett formulär har skickats in, som i sin tur hjälper dem följa sitt hälsotillstånd.
41
Everhart, Chichi Kate. "Strategies for Measuring Quality Care in Healthcare Organizations in the United States." ScholarWorks, 2018. http://scholarworks.waldenu.edu/dissertations/4851.
Full textAbstract:
Abstract
According to members of the Institute of Medicine, about 98,000 hospitalized
patients in the United States die each year because of poor quality care. The problem of
poor healthcare quality may exist in part due to limited information on effective
performance measurement processes. A multiple case study design was used to gain
broad insight into possible solutions to the problems of determining the quality of
healthcare services using performance measurements. Hospital/healthcare organization
leaders in North Carolina who had implemented optimal performance measurements for
quality care were interviewed. The conceptual frameworks that served as a proposition
for the study were Goldratt's theory of constraint, Deming's 14 point model and Lewin's
model of the change process in human systems. The data collection process involved
semistructured interviews of 12 individuals. Data sources and conceptual framework
triangulations were used in the data analysis process(coding approaches, study
dependability, credibility, transferability methods and case study protocol use) . The
themes that emerged from the study were strategies for performance measurement and
strategies to enhance service quality in healthcare organizations etc. Results might
contribute to social change by helping healthcare leaders and patients improve their
knowledge and understanding of optimal performance measurement strategies, which
may effect positive organizational changes.
42
Al, Essa Fares Mohammed. "Approaches and solutions to hospital emergency department overcrowding including failure mode and effect analysis as a risk assessment technique of real-time locating system." Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/16063.
Full textAbstract:
Emergency Departments (ED) are highly dynamic environments comprising complex multi-dimensional patient-care processes. In recent decades, there has been increased pressure to improve ED services, while taking into account various aspects such as clinical quality, operational efficiency, and cost performance. Overcrowding has become a major barrier to receiving a proper and timely emergency care in many acute hospitals throughout the world. Patients often face long waiting times to be seen and treated. Those who require admission may even wait longer. The scope of this research is to focus on ED factors that lead to overcrowding and their management. Technology is being cited as one of the management tools, specifically the utilization of Radio Frequency Identification (RFID) for tracking patients as their journey progresses through an ED. Like any technology, RFID has potential and pitfalls. The author chose to use Failure Mode and Effect Analysis (FMEA) as a tool to explore the possible failures of RFID technology as it is utilized in one of the ED in Riyadh Military Hospital (RMH). This particular ED has been used as a case study to explore those failures and, with the use of FMEA, propose a set of recommendations to address those failures and improve the design and implementation of RFID. The experience of RMH-ED was explored through interviews and a survey in which 100 participants took part. The survey touched upon various aspects of this experience. This was due to the various roles of the surveyed staff who were involved with this technology. These roles ranged from front line clinical staff to administrative staff, management staff and technical support staff. Data analysis showed convincing evidence of the positive impact RFID had on managing ED overcrowding. However, and as expected, there are some pitfalls and failures that FMEA helped identifying and suggested potential solutions to them. RFID is a small link in the chain of other technological innovations and solutions. It is by no means capable of solving the problems associated with ED overcrowding by itself. Most of the search carried out by the author identified large variation in approaches to dealing with the issue of ED overcrowding. Those ranged from applying more human resources to altering the pathways of managing patients journey through healthcare system to applying more intermediate layers of management to ease the pressure of the Emergency departments. Other approaches included some aspects of technology such as development of early warning systems that have not been widely adopted and remained as isolated efforts.
43
Furnival, Joy. "Regulation for improvement? : a study of how improvement capability is conceptualised by healthcare regulatory agencies in the United Kingdom." Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/regulation-for-improvement-a-study-of-how-improvement-capability-is-conceptualised-by-healthcare-regulatory-agencies-in-the-united-kingdom(1aab8248-e486-4d12-a7ff-fa5523ac7c20).html.
Full textAbstract:
Unexplained variations in organisational performance in healthcare are a continued focus of research, political, and public interest. Regulatory agencies are always seeking new ways to reduce variation and improve performance, and the use of approaches to develop improvement capability is increasingly encouraged. However, the regulatory perspective on improvement capability is under researched. This research study seeks to understand how regulatory agencies in the United Kingdom (UK) assess improvement capability within healthcare organisations. It explores how improvement capability is conceptualised, compares the regulatory arrangements across the UK, and examines assessment and enforcement policies and practices, before developing a conceptual framework for improvement capability. The research study uses data from 48 interviews, 90 regulatory policy documents and 30 assessment reports. Regulatory conceptualisations of improvement capability are explored through cross-case comparison and qualitative analysis. A review of 70 instruments and frameworks for the assessment of improvement capability from the literature identifies that there are plural conceptualisations of improvement capability. The findings from the review are synthesised into eight dimensions of improvement capability which are used to analyse the empirical data and to develop a conceptual framework. The analysis finds an emergent trend towards responsive regulatory models which aim to develop improvement capability. However, the analysis identifies ambiguity in regulatory agencies' conceptualisation of improvement capability with two dimensions of improvement capability used more frequently than others in regulatory assessments. Regulatory agencies need to clarify their conceptualisation of improvement capability and supplement their assessment processes to further understand local circumstances. This can be used to inform more flexible regulatory responses, including the tailored provision of improvement support to develop improvement capability. This requires greater regulatory effort and resources, and the analysis finds there are three areas of tension, linked to regulatory roles, resources and relationships. The research study proposes a conceptual framework of improvement capability that can be used to clarify regulatory conceptualisation and assessment of improvement capability. Greater conceptual clarity will strengthen regulatory agencies' assessment, diagnosis and prediction of organisational performance trajectories, and support the advancement of more appropriate, effective and responsive regulatory interventions, including the development of improvement capability.
44
O'Connor, Matthew S. "Assessment of the Measurement Properties of the NHCAHPS Family Survey: A Rasch Scaling Approach." University of Toledo / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1364386948.
Full text
45
Powell, John Antony. "Consumers and information : an assessment of the health information needs of mental healthcare users and the role of the Internet." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2004. http://researchonline.lshtm.ac.uk/682324/.
Full textAbstract:
Background Significant resources are used to produce health information but little is known about consumer information needs, particularly in mental healthcare. The Internet is increasingly being used, particularly for mental health topics. Methods Literature reviews in the areas of health information needs and the role of the Internet in healthcare; in-depth interviews to explore the experience of mental health users with health information and with the Internet; and a population survey to investigate the interview findings and provide generalisable data on information needs. Results There is very little existing research in the area of mental health information needs. Much of the literature around consumer use of the Internet for health information focuses on issues of quality and access. The most common information needs were: what the problem is; what treatments are available; how to help oneself; where to get help from; what has caused the problem; and the future course of the problem. The sources of information considered most accurate and most likely to be used were general practitioners and mental health professionals. The Internet was not ranked highly for accuracy, but was one of the sources likely to be used. The presence of mental health distress was significantly associated with the use of the Internet for mental health information, after adjustment for age, sex and educational level. Another need is to hear about the experience of others, and this was a particular role for the Internet. This need can be subdivided into 'universality', 'installation of hope', and 'empathy and understanding'. Conclusions and implications Mental healthcare users are poorly served by current health information provision. The results provide support for a stronger practitioner-patient partnership. Policymakers should address the needs identified in this work, including the need to hear about other people's experience. Further research investigating health-related use of the Internet is required.
46
Scheer, Darren. "Respiratory Infections and Risk for Development of Narcolepsy: Analysis of the Truven Health MarketScan Database (2008 to 2010) with Additional Assessment of Incidence and Prevalence." Scholar Commons, 2019. https://scholarcommons.usf.edu/etd/7927.
Full textAbstract:
Background and Significance: Narcolepsy is a chronic neurological disorder. These patients experience various psychiatric and physical comorbid diseases and mortality at an increased rate compared to the general population. Additionally, patients with narcolepsy experience approximately a doubling of various annual healthcare related facility visits, transactions, and costs comparatively. Narcolepsy with cataplexy is generally believed to be more prevalent than narcolepsy without cataplexy. However, incidence and prevalence estimates of narcolepsy (with or without cataplexy) vary widely with few large epidemiological studies conducted worldwide and none in the U.S evaluating these proportions in both children and adults utilizing a large health care claims database.
One of the main mechanisms underlying narcolepsy, the destruction of hypocretin neurons, is not clear. Two of the more noted hypotheses for this pathology are autoimmune and infection based triggers in allele carrier patients. These have been highlighted since narcolepsy diagnoses increased following the late 2000s influenza vaccinations, especially across Europe. Specific influenza and streptococcal infections have also been considered. Large U.S. healthcare claims database investigations of the association between specific infections and development of narcolepsy were not found in the published scientific literature. Our goals were to enhance the knowledge regarding the epidemiology and possible infection triggers of narcolepsy. The information gained may aid in the overall understanding of the condition, the possible vulnerable populations, and lead to hypotheses regarding which subpopulations research should be focused upon and those triggers that may be avoided or reduced in exposure.
Methods: The Truven Health MarketScan Commercial Dissertation Database (THMCDD) was used to estimate prevalence and incidence of narcolepsy, with and without cataplexy, by age groups, gender, and region among patients under age 66 with continuous enrollment for years 2008-2010. THMCDD contains health claims information for over 18 million people. Prevalence was expressed as cases/100,000 persons. Average annual incidence (using varying criteria for latency between the diagnostic tests, polysomnograph coupled with MSLT, and the diagnosis) was expressed as new cases/100,000 persons/year. Subsequently, we conducted a case-control study to assess the differences in respiratory infections between patients with incident narcolepsy diagnosis and controls. Continuously enrolled patients under age 66 were included. Cases of narcolepsy occurring from July 1, 2009 through December 31, 2010 were included based on two diagnosis criteria (using varying criteria for latency between diagnosis and the diagnostic tests). Non-narcolepsy controls were frequency matched on look-back time by assigning an index date equal to a case diagnosis date. Occurrence of prior respiratory infections was compared between cases and controls based on narcolepsy criteria and four different time periods pre-index date. Infections were grouped into 9 types based on pathogen and clinical manifestation.
Results: From 2008 through 2010, there were 8,444,517 continuously enrolled patients and 6,703 diagnosed with narcolepsy (prevalence overall:79.4/100,000; without cataplexy:65.4/100,000; with cataplexy: 14.0/100,000). Based on the 3 definitions of incidence, overall average annual incidence was 7.67, 7.13, and 4.87/100,000 persons/year. Incidence for narcolepsy without cataplexy was generally several times higher than narcolepsy with cataplexy. Prevalence and incidence were approximately 50% greater for females compared to males across most age groups. Prevalence was highest among the 21-30 age group, with incidence highest among enrollees in their early 20s and late teens. Regionally, the North Central U.S. had the highest prevalence and incidence, while the West was the lowest. For the case-control study, Adjusted odds ratio (aOR) increases were statistically significant for Group 5 (acute respiratory infections), Group 8 (other pneumonias, bronchopneumonia, etc.) and Group 9 (influenzas) across various time periods pre-index date and for both narcolepsy criteria. Overall, the most significant aORs were for acute respiratory infections during the 3 to 15 months pre-index date for both narcolepsy diagnosis criteria (aOR=1.73, 95% 1.52 to 1.98 and aOR=1.83, 95% CI 1.57 to 2.19). The aORs for acute respiratory infections were approximately 50% greater among females than males.
Conclusion: We observed higher prevalence and incidence of narcolepsy compared to most previous studies. Females were associated with approximately 50% increased proportions compared to males. We also found that the greatest prevalence and incidence of narcolepsy occurred in patients in their early 20s, and those residing in the North Central region of the U.S. Perhaps most striking was the observation of much greater proportions of narcolepsy without cataplexy compared to narcolepsy with cataplexy. In the case-control assessment, we found increased occurrences of acute respiratory infections, pneumonias, and influenza prior to incident narcolepsy diagnosis, compared to controls. Generally, these rates appeared higher for females than males and occurred for both narcolepsy diagnosis criteria. Additionally, these associations were observed in the infection assessment periods 3 to 15 months and 6 to 18 months prior to incident narcolepsy diagnosis. Increased awareness and early notification among healthcare providers for signs and symptoms of narcolepsy is critical in helping this population of patients manage this burdensome condition. Also, the identification of potential narcolepsy triggers by certain infections may aid in the understanding of the disease. These findings may have implications in the understanding of mechanisms and causation of other acute onset neurological disorders. Our observations of consistently increased risk of incident narcolepsy related to recent previous viral respiratory infections and the inconsistent results for bacterial infections require additional study to confirm these findings.
47
Pukk, Härenstam Karin. "Learning from patient injury claims : an assessment of the potential of patient injury claims to a safety information system in healthcare /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-153-1/.
Full text
48
Dolatabadi, Mjid Davari. "Does the Iranian health system need a health technology assessment programme to improve effectiveness, efficiency and equity of its healthcare services?" Thesis, University of Liverpool, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.501580.
Full textAbstract:
Health Technology Assessment (HTA) is increasingly being utilized on a global scale to Improve the clinical and cost-effectiveness of healthcare resource utilization. This thesis addresses the potential application and implications underlying the development of a structure of HTA specifically designed to fit in with the culture and healthcare system in Iran.
49
Alshehri, Abdullah. "Assessment of diabetes care in Saudi Arabia : by analysis of routine healthcare data, patient case notes and interviews with key stakeholders." Thesis, University of Dundee, 2014. https://discovery.dundee.ac.uk/en/studentTheses/98b4a50e-db5d-4344-b479-a6e4ccd330af.
Full textAbstract:
Background:Diabetes is a major public health problem in Saudi Arabia. One fifth (20%) of the Saudi population has diabetes and their healthcare takes almost a quarter (23%) of the total healthcare expenditure. A few sporadic small studies showed some evidence of suboptimal diabetes care. Aims:The aim of this study was to identify the deficiencies in diabetes care and the potential areas for quality improvement of service provision in Abha, a city representative of Saudi Arabia. Methods:A programme of research was undertaken using multiple research methods: semi-structured interviews with key stakeholders encompassing patients, healthcare professionals, managers and pharmacists; standard checklist for evaluating available resources; analysis of routine healthcare data; questionnaires to medical directors and healthcare leaders; and examination of the case notes of patients with diabetes. Results:The local registered diabetes prevalence was found to be lower than the national estimate (3.75% versus 14-25%). Almost three quarters (73%) of people with diabetes in Abha city have not been diagnosed. The vast majority (85%) of adult people with diabetes were either overweight or obese. Reviewing case notes of patients with diabetes at the primary health care centres (PHCCs) showed that only 4% had a record of HbA1c test and most patients (77%) did not achieve the recommended target of FBG of = 130 mg/dl (=7.2 mmol/l). Almost half the patients exceeded (47%) the recommended level of total cholesterol of = 195 mg/dl (5 mmol/l). Screening for diabetes complications is inadequate: foot examination was done for only 5.5%, neuro-examination for 37% and eye examination for 52%. Some medications e.g. mixed insulin and statins were not consistently available and inadequacies were identified in the provision of healthcare staff (e.g. dieticians and podiatrists) and laboratory resources (e.g. HbA1c test). Limited attention was given to health education and concerns were expressed about patient compliance. These findings were consistent across the multiple methods used. Conclusion:This study in Abha city found that a large number of Saudi patients with diabetes are not achieving recommended levels of glycemic, lipid and body mass index (BMI) control and are therefore at high risk of diabetes complications. Inadequate provision of laboratory facilities, drugs and patient education programmes compound these problems. Recommendations are made for strategies to improve both the structure and processes of diabetes care and the healthy behaviours of people with diabetes.
50
Chulu, Chrissy M. W. "Pharmacovigilance: An Assessment of Knowledge, Attitude and Practice of Healthcare Professionals towards Adverse Drug Reactions Reporting In Central Region of Malawi." University of the Western Cape, 2017. http://hdl.handle.net/11394/6310.
Full textAbstract:
Magister Scientiae - MSc (Pharmacy Administration and Policy Regulation)AIM OF THE STUDY: To assess level of knowledge, attitude and practices of dispensing healthcare professionals towards adverse drug reactions (ADR) reporting and to determine if there are any differences in knowledge, attitude and practices among dispensing healthcare professionals METHODOLOGY: A descriptive cross-sectional survey using stratified random sampling technique was employed to draw 114 health facilities using categories of public hospitals, private clinics/hospitals and community pharmacies as strata. Every dispensing healthcare professional found in the main pharmacy of the sampled facilities was targeted. RESULTS: Dispensing healthcare professionals have positive attitude but limited knowledge and poor practice towards ADR reporting. There is significant difference on knowledge towards ADR reporting among healthcare professionals as more of pharmaceutical personnel and medical doctors indicated having knowledge than the other dispensing cadres but there is no significant difference in attitude and practice towards ADR reporting. CONCLUSION: Healthcare professionals in central region of Malawi have limited knowledge and poor practice but positive attitude towards ADR reporting. Lack of training, unavailability of reporting tools and lack of information on how to report has greatly influenced the poor practice of ADR reporting. Educational and awareness interventions on pharmacovigilance, use of appropriately trained personnel and provision of required support to healthcare professionals would greatly improve ADR reporting.