Dissertations / Theses: 'Hospitals – Medical staff – Botswana'

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Woods, Bernadette M. "Assessment of staff attitudes to patient safety." View thesis, 2004. http://handle.uws.edu.au:8081/1959.7/46693.

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Thesis (M.N. (Hons))--University of Western Sydney, 2004. A thesis presented to the University of Western Sydney, College of Social and Health Sciences, School of Nursing, Family and Community Health, in fulfilment of the requirements for the degree of Masters of Nursing (Honours). Includes bibliographical references and appendices.

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Keorekile, Opelo. "Occupational health hazards encountered by nurses at Letsholathebe II memorial hospital in Maun, Botswana." Thesis, University of Limpopo, 2015. http://hdl.handle.net/10386/1613.

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Thesis (MPH.) -- University of Limpopo, 2015 Nurses are an integral component of the health care delivery system and they encounter occupational health problems classified as biological, chemical, physical, and psychosocial hazards. Nurses also face health hazards such as Hepatitis B, Acquired Immune Deficiency Syndrome, tuberculosis, cytotoxic drugs, anesthetic agents, needle stick injury, back pain, and stress. At Letsholathebe II Memorial Hospital in Maun, nurses and other health professionals face occupational health and safety risks at the workplace. Aim and Objectives The aim of the study was to identify the occupational health hazards encountered by nurses at Letsholathebe II Memorial Hospital in Maun, Botswana. The objectives were to identify occupational health hazards at Letsholathebe II Memorial Hospital; determine organic and inorganic disorders caused by occupational health hazards; determine coping mechanisms of nurses towards occupational health hazards and the compliance of nurses to written protocols that address occupational health hazards. Research Method and Design A quantitative descriptive cross-sectional method was adopted. The population comprised 200 nurses employed at Letsholathebe II Memorial Hospital. Simple random sampling was used to select 132 nurses who participated in the study. A self-administered questionnaire was used for data collection. Descriptive and inferential statistics were used for data analysis. Results The study revealed health hazards namely; back aches, frequent headaches, and persistent tiredness; mercury, solvents and anaesthetic gases; HIV, streptococcus, staphylococcus, Hepatitis B and measles. Nurses also reported fatigue, loss of sleep due to stress, anxiety and persistent tiredness. Conclusion The study concluded that nurses at Letsholathebe ll Memorial hospital experienced physical, chemical, biological and psychological health hazards. Recommendations The study recommends that nurses should have access to OHS information, that OHS awareness should be created at Letsholathebe II Memorial Hospital.

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Benjamin, Valencia. "Experiences of professional nurses with regard to accessing information at the point-of-care via mobile-computing devices at a public hospital." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1020193.

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Mobile computing devices are capable of changing how healthcare is delivered in the future, since they aim to merge and integrate all services into one device that is versatile, customisable, and portable. The aim of this study was to explore and describe the experiences of professional nurses with regard to accessing information at the point-of-care of the patient, in order to develop guidelines that could assist other professional nurses with implementing the mobile computing device for accessing information at the point-of-care of patients. To achieve the purpose of the study, a qualitative, explorative, descriptive, and contextual design was used to conduct this research – to gain an understanding of how the professional nurses experienced accessing information at the point-of-care via mobile computing devices. The study was conducted among the professional nurses employed at the public hospital, who were trained and provided with the mobile computing device for accessing information at the point-of-care for more than two years. In-depth interviewing was conducted to obtain the data. Data analysis was done using Tesch‘s method to make sense out of text and data. Four themes were identified, namely, the professional nurses‘ expression of various experiences regarding the training received; the need for support in implementing the mobile computing device; the accessing of information at the point-of-care as beneficial for educational purposes; and the accessing of information at the point-of-care as beneficial to patient care. Two main guidelines were developed. The study concludes with recommendations made with regard to the areas of nursing practice, education and research. Throughout the study, the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2010:298).

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Duffy, Brianne Michelle. "Identification of stressors related to emergency department employment." Honors in the Major Thesis, University of Central Florida, 2003. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/315.

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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information. Bachelors Health and Public Affairs Nursing

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Kwizera, Alice Stella. "Quality of work and work life: understanding the work ethic of medical professionals in selected hospitals in the Eastern Cape region of South Africa." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1003111.

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This thesis reports a study of work ethic values, beliefs and attitudes held by medical professionals in selected hospitals in the Eastern Cape, South Africa. The study was in response to the public outcry about the declining work ethic and poor service delivery in South Africa’s healthcare sector. Scholarly interest in the work ethic and its role in economic development dates back to Max Weber’s classical work, which was the starting point for my study. The German economic sociologist published his seminal essay on The Protestant Ethic and the Spirit of Capitalism in 1904/1905. Since that time, Weber’s ideas on the Protestant work ethic continue to inform and influence studies of the contemporary work ethic, which is thought to have become secularised. My study was informed by data collected in 2009 through a questionnaire survey and personal interviews. A total of 174 doctors and nurses, working in four urban, periurban and rural hospitals near East London, completed a self-administered questionnaire. The questionnaire replicated the Multi-Dimensional Work Ethic Profile (MWEP) developed by Miller, Woehr and Hudspeth in 2001/2002. The instrument examines seven critical dimensions of the work ethic, namely self-reliance, morality, (foregoing) leisure, hard work, centrality of work in life, not wasting time, and delay of gratification. In addition, I conducted personal interviews in the same four hospitals with 41 hospital managers, doctors, nurses, and patients to discuss their understanding of the work ethic and its practical application. The study found that both doctors’ and nurses’ overall work ethic scores on the MWEP scale were above average. Although there was no significant difference between the overall work ethic scores of the two professions, doctors scored significantly higher than nurses on the ‘hard work’ and ‘self reliance’ dimensions of the work ethic scale. In the qualitative study, the doctors’ work ethic was rated much more highly than the nurses’ by their superiors and patients; and the work ethic of nurses in the urban hospitals was rated much lower than that of their rural colleagues. In contradiction to the idea of the secularization of the contemporary work ethic, religiosity and religious beliefs were influential in the endorsement of work ethic principles. In line with the notion that ‘happy’ workers are more productive, job and life satisfaction were found to be strong correlates of the work ethic of medical professionals.

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Mrara, Msibulele Theophilus. "An investigation of turnover and retention factors of health professional staff within the Eastern Cape Department of Health." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1003875.

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Health Professionals are critical in the provision of health services, more especially when it comes to nurses who are next to the patient most of the time. It is critically important for the Eastern Cape Department of Health to ensure that skilled health professionals such as doctors, pharmacists, nurses and the like are retained and the staff turnover regarding this category of staff is appropriately managed. The difficulty to attract and retain health professionals is negatively affecting service delivery in the Eastern Cape department of Health and leaves the department with an unacceptably high vacancy rate. This often put more of a burden on to the health professionals who remain within the organization. Some of them will end up leaving the organization. There is a great shortage of health professionals in South Africa and it becomes easier for the health professionals to get employment elsewhere, particularly in the private sector which appears to have a competitive advantage as compared to the public sector. In this study, both quantitative and qualitative methods were used to gather information through the utilization of a questionnaire and interviews were conducted mainly to confirm the results obtained. The results of the study have assisted to reflect factors that could be influencing the health professionals to leave health facilities of the Eastern Cape Department of Health. The respondents were drawn from the two areas within the Health Department, and these are, Mthatha and Port Elizabeth areas. One hundred (100) questionnaires were issued to the health professionals and sixty three responded. Documents that were received from the department were helpful in determining the turnover rate. The study has revealed that the Eastern Cape Department of Health may succeed in retaining the health professionals if they can be made to feel that their job is important. It appears that health professionals would like to be given enough opportunity to perform their functions and participate in the decision making processes of the department. Some factors may be contributing to the staff turnover and these are, lack of career opportunities to develop, challenges in the workplace, conflict with the management and colleagues. It is always important for the organizations to recognize its employees by giving them space to practice their profession and create a comfortable workplace that could have an impact in influencing the employee to remain within the organization. Employee turnover can be minimized, if employees can be exposed to a healthy workplace environment that will assist if fostering happiness, and in the process, enhance their motivation. It is imperative for the Eastern Cape Department of Health to focus on the training and development of its employees in order to increase the efficiency and competitiveness. As the employees gain the necessary skills to perform their job, productivity may improve. The performance of the employees should be properly managed, and the resultant incentives and rewards must be fairly distributed. This could promote harmony in the workplace and that could help in building relationships among employees. If employees are satisfied, there is an increased chance that they will stay within the organization and it becomes difficult for other competitors to attract them. Employees must be given adequate space to participate in the decision making processes of the organization, and by doing so, their loyalty to the organization could be increased.

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Galo, Luntu. "A case study describing factors perceived to be impacting staff satisfaction amongst health care professionals at the East London Hospital complex." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1003905.

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This thesis was born from a concern the researcher had with regard to negative reports in the media emanating from 4 babies that died at Cecilia Makiwane Hospital Peadiatric ICU unit due to power supply failure. The most significant of these negative reports was in 2007 when the Daily Dispatch ran a series of articles regarding what they termed avoidable deaths over the last 14 years. The ease with which staff communicated with the media together with the high absenteeism rate and high turnover was a cause for concern. When the researcher analysed the history of the problem, it immerged from the respondents’ responses that the rationalistion process undertaken by the Eastern Cape Department of Health (ECDoH) was a significant root cause to the problem. The literature review focused on three areas viz.: Organisational Culture, Organisational Change, Foundations of Satisfaction. This focus was used to confine the problem to a manageable project but secondly each of the aspects are interwoven. Routledge (2010) notes that culture is the reflection of the values advocated by a founder or leader by way of his/her day to day actions. This is done by the leader creating a perception or viewpoint that assists the employees to achieve the organisation’s mission, vision and goals. In any organisation change is a constant and it needs to be effectively managed. With government institutions like the East London Hospital Complex (ELHC) directives come from the top and are implemented by an unprepared and untrained leadership and management cadre and clear communication of vision and objective of the desired outcomes never happens. The aim of the research was to: describe the existing Organisational Culture present at ELHC (Perform an organisational diagnosis); describe the impact of change (rationalisation) and to analyze why there was such a high staff turnover. It is clear from the results of the survey conducted that significant dissatisfaction prevailed relating to how the institution was managed. Dissatisfaction amongst the health professionals was general but also specific to the following: leadership and management issues, fairness, remuneration and lack of resources. The recommendations therefore focused on developing management and leadership within the proposal of Dubrin’s model (2001).

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Sanders, Carolyn L. "Clinical antecedents of a medical emergency team response as predictors of ICU transfer /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2008.

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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. Typescript. Includes bibliographical references (leaves 100-107). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

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Rutledge, M. Hannah. "Patient Family and Hospital Staff Information Needs at a Pediatric Hospital: an Analysis of Information Requests Received by the Family Resource Libraries." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc801947/.

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This research explored the information needs of patient families and hospital staff at a pediatric hospital system in Dallas, Texas. Library statistics recorded in four hospital libraries from 2011 - 2013 were used to analyze the information requests from patient families and hospital staff. Crosstabulations revealed the extent to which patient families and hospital staff used the libraries to satisfy their information needs. The data showed that patient families used the libraries very differently than hospital staff. Chi-square tests for independence were performed to identify the relationships between the Classification (Patient Family, Hospital Staff) and two descriptors of information needs (Request Type, Resources Used). There were a total of 1,406 information requests analyzed. The data showed that patient families and hospital staff information requests differed greatly in the number of information requests, the type of information requested, the resources used and the time the library staff spent on the requests. Chi-square analyses revealed relationships statistically significant at the p < .05 level; however, the strength of the relationships varied.

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Ward, Gary Ray. "Training the trainer: A manual for Kaiser Permanente educators who teach employees to use computer systems." CSUSB ScholarWorks, 1991. https://scholarworks.lib.csusb.edu/etd-project/758.

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Mnyembane, Adiel. "The experience of hospital management and employees in transforming the public health system in the Western Cape 1996-2001." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/53117.

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Thesis (MPhil)--Stellenbosch University, 2002. ENGLISH ABSTRACT: One of the main objectives of the new South African government who came into power in 1994 was to improve the daily living conditions of its citizens. To what extent did the government succeed in this objective? This is the basic research question informing the present study. In order to keep it within manageable proportions, the study investigated a very specific area of service delivery, namely the delivery of public health services. This was further narrowed down to the Western Cape and more specifically, to the role of public hospitals in the area. The Western Cape promised to be an interesting case, because although the government of national unity was dominated by the ANC, the Western Cape was ruled by a NNP dominated coalition. On the national level, the Province had to follow national policy guidelines, while on the provincial level it had more freedom to formulate and implement its own policies. The study itself consists of two parts. The first concerns policy formulation, the second policy implementation. As far as policy formulation is concerned, a study was made of basic documents articulating the fundamental values, national priorities and main objectives informing government policy. These included the Freedom Charter, the Constitution, and the Reconstruction and Development Program. It was found that these values and priorities were in general well translated into policy options on both the national and provincial level, especially in the various documents aimed at transforming the national health system. The second part of the study investigates the implementation of the broad policy guidelines in the area of public heath in selected public hospitals in the Western Cape. The main method of investigation was the use of structured interviews with representative employees from all different levels. The findings were therefore of a qualitative rather than a quantitative nature. The focal areas selected were personnel management issues, human resource planning, labour relation issues and human resource development issues. The main findings were that the formulation of policy both from basic values to the level of health care policies and from the national to provincial level in general was quite successful. On the other hand, there were serious shortcomings in the implementation of these policies on various levels. The investigation revealed a mixed and often contradictory picture. Although some hospitals made good progress in some respects, there is still a long way before quality health care will be delivered to all patients. A commitment to equity in the health services of the country implies a commitment to correcting the historical gender, class and racial imbalances in the development of human recourses for health care. Of necessity, a compassionate and caring health service will address the issue of corrective action. There is a real need to provide proper planning of those most disadvantaged by apartheid in managerial skills to fill managerial positions in the health sector. It is therefore is necessary to introduce as a matter of urgency new health management programmes, which will promote efficient and effectiveness management at all levels of health care service delivery. Current health managers need to be reoriented from the predominantly bureaucratic, rule-based approach towards a participative approach. The development of managerial capacity in areas such as participative and change management, leadership development, strategic planning, programme management and evaluation, and policy development and implementation is of crucial importance. The study concludes with a series of specific recommendations with regard to affirmative action, managerial and institutional capacity, human resource planning, and training needs for various sectors. AFRIKAANSE OPSOMMING: Een van die hoofdoelstellings van die nuwe Suid-Afrikaanse regering wat in 1994 aan bewind gekom het, was om die leefomstandinghede van al die land se inwoners te verbeter. Tot watter mate het die regering geslaag in hierdie doelwit? Dit is die basiese navorsingsvraag onderliggend aan hierdie studie. Ten einde die ondersoek binne hanteerbare grense te hou, is op slegs een aspek van dienslewering gekonsenteer, naamlik die lewering van gesondheidsdienste. Hierdie terrein is verder vernou tot die Wes-Kaap en meer spesifiek tot die rol van openbare hospitale. Die Wes-Kaap was interessant omdat hoewel die regering op nasionale vlak deur die ANC beheer is, die Wes-Kaap basies deur die NNP in die periode van ondersoek geregeer is. Die provinsie was verplig om nasionale beleidsriglyne te volg, maar op provinsiale vlak het dit 'n sekere speelruimte geniet om eie beleid te formuleer en te implementeer. Die studie bestaan uit twee dele. Die eerste het te doen met beleidsformulering, die tweede met beleidsimplementering. Wat beleidsformulering betref, is 'n studie gemaak van die basisdokumente wat die kernwaardes, nasionale prioriteite en hoof doelstellings van die regering bevat. Dit het ingesluit die Vryheidmanifes, die Konstitusie en die Heropbou- en Ontwikkelingsprogram. Daar is bevind dat hierdie waardes en prioriteite in die algemeen suksesvol vertaal is in beleidsopsies op beide die nasionale en provinsiale vlak, veral in die dokumente wat gerig was op die transformasie van die nasionale gesondheidsektor. Die tweede deel van die studie het die implementering van die breë beleidsriglyne in die area van openbare gesondheid in geselekteerde publike hospitale in die Wes-Kaap ondersoek. Die hoof-ondersoekmetode was gestruktureerde onderhoude met verteenwoordigende werknemers van alle vlakke. Die bevindinge was gevolglik meer van 'n kwalitatiewe as kwantitatiewe aard. Die fokusareas waarop geskonsentreer is, was personeelbestuur, menslike hulpbronbeplanning, arbeidsverhoudinge en die ontwikkeling van menslike potensiaal. Die hoofbevindinge was dat die formulering van beleid beide van basiese waardes na gesondheidsbeleid en van die nasionale na provinsiale vlak in die algemeen suksesvol was. Aan die ander kant het ernstige gebreke aan die lig gekom sover dit die implementering van beleid op verskillende vlakke betref. Die resultaat was 'n gemengde en dikwels kontrasterende prentjie. Hoewel sommige hospitale goeie vordering gemaak het in sekere opsigte, laat die lewering van gehalte-diens aan alle pasiënte nog veel te wense oor. Die verbintenis to gelykheid in gesondheidsdienste veronderstel 'n verbintenis tot die regstelling van geslags-, klas- en rasse-ongelykhede in die ontwikkeling van menslike hulpbronne in die gesondheidsektor. Dienslewering gebaseer op sorg en empatie is van deurslaggewende belang in hierdie opsig. Daar is 'n groot behoefte aan behoorlike beplanning vir die verbetering van bestuur- en ander vaardighede van agtergestelde groepe. Die implementering van behoorlike bestuursopleidingsprogramme is van die uiterste belang, wat kan bydra tot effektiewe en goeie dienslewering. Die huidige oorwegend burokratiese en reëlsgebonde bestuurstyl behoort in 'n deelnemende benadering omgeskakel te word. Die ontwikkeling van bestuurskapasiteit in gebiede soos deelnemende veranderingsbestuur, leierskapsontwikkeling, strategiese beplanning, programbestuur en -evaluering en beleidsformulering is van die grootse belang. Die ondersoek sluit af met 'n reeks konkrete aanbevelings met betrekking tot regstellende aksie, verbetering van bestuurskapasiteit, menslike hulpbronontwikkeling en die opleidingsbehoeftes van die verskillende afdelings.

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Amanambu, Rochelle Aneeta. "An investigation of the intention to leave or stay of health care professionals at St. Andrews Hospital." Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1011091.

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Background: The demand for and retention of talent worldwide is aggravated by revolutionary trends that include global competition, demographic changes and technological advances. In South Africa this phenomenon according to Frost (2002) is further challenged by the emigration of skilled people; the relative scarcity of specialist and managerial employees; employment equity and affirmative action procedures. But the development of strategies first requires an understanding of the factors which influence decisions to leave or stay particularly in rural and remote areas. St. Andrews Hospital is a rural district hospital in Ugu District, KZN. Its remoteness from urban areas and the lack of resources contributes towards challenges of attracting and retaining health care professionals to the area. It is the aim of this study to identify the ten most prevalent turnover and retention factors in a rural district hospital with the intention of making recommendations towards strategies to mitigate turnover and improve retention of health care professionals. This study will not only serve the local Human Resource Department but may also be used to inform district and provincial policies as well as departments’ decisions in the design or the review of current retention strategies aimed at reducing turnover. Method: The survey method was used to collect the primary data by distribution of self-administered questionnaires to Health Care Professionals at St. Andrews Hospital. Of the one hundred and fifty questionnaires distributed, one hundred and seven were returned (71% response rate) and formed the basis of the study. Results: Based on the impact scores, the top three turnover factors identified were, the way the organisation is led by top management (0.934); the size of the workload (0.862); and the way problems are dealt with by managers in the organisation (0.817). No statistically significant relationships were found between turnover factors and biographical variable. Availability of quality health services was ranked as the external factor that had the highest influence (78%) on turnover, while geographical location was ranked the lowest. The main reason given by respondents for leaving their previous employment was promotion, followed by distance and personal/family reasons. The top three retention factors identified from the impact scores were the quality of relationships with colleagues (1.698); the amount of support received from managers and colleagues (1.484); and the level of engagement and involvement with the job (1.390). This demonstrates that the salary package often thought to be a first priority factor Mobley, Horner and Hollingsworth (1978); Mobley (1982) and Herzberg (2003) is far less of a determining factor at St. Andrews Hospital than management support, job involvement and person-organisation fit as well as the social relationships formed in the workplace. A positive relationship was found between leadership and job dimension factors at the 1% level of significance. This supports the strong social bond (person-organisation fit) formed in the work environment between management and colleagues that supports retention and increases level of commitment. An important result of the study was that 46% of the respondents were thinking of leaving the town within the year while 29% were considering resigning from St. Andrews Hospital within the year. Conclusion: The results reveal a complex interaction of factors impacting on turnover and retention. The Human Resource Management function has a pivotal role to play in improving its ability to attract and retain professionals through developing comprehensive strategies based on external and internal and environmental factors. The study conveys to the St. Andrews Hospital management that turnover and retention factors are unique to the location and the working environment and differs amongst Health Care Professionals – this should be deliberated on when formulating Hospital Human Resource retention policies.

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Lauria, Ivone Do Carmo. "Contribution à une méthodologie de l'étude des représentations sociales: une approche des relations structurelles et interpersonnelles en milieu hospitalier." Doctoral thesis, Universite Libre de Bruxelles, 1997. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/212102.

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Forsyth, Rowena Public Health &amp Community Medicine Faculty of Medicine UNSW. "Tricky technology, troubled tribes: a video ethnographic study of the impact of information technology on health care professionals??? practices and relationships." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/30175.

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Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.

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Surtie, Adin Don. "An empirical investigation into the integration of foreign doctors into the public health case system of the Northern Cape in South Africa." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/95690.

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Thesis (MBA)--Stellenbosch University, 2013. The South African Northern Cape Department of Health has many challenges to overcome in order to provide the province with quality public health care. One of these challenges is the recruitment and retention of foreign doctors in order to maintain and improve on the population’s access to physicians. Due to the lack of locally trained physicians willing to work and settle in the Northern Cape Province, the Department of Health in the province have been employing foreign-trained physicians to fill the gap in providing adequate medical care to its population. This study examined how well foreign doctors have integrated into the Northern Cape public health care system. It further identified, described and explored the factors that might influence the integration of these foreign physicians. This was done in order to make recommendations to improve the existing retention strategies of the Northern Cape Department of Health. This research utilised the mixed-method of research by obtaining secondary qualitative as well as primary quantitative data. The qualitative data were obtained through a literature review. Questionnaires informed by the literature review were utilised in order to obtain the primary quantitative data. The data obtained were subjected to a statistical analysis.The results indicated that the needs of the foreign doctors were generally met and the factors pertaining to work, community and family aspects of integration did not have an overtly negative or positive influence on integration. The results pertaining to rurality were not as prominent as expected. The main factors identified related to relational (professional as well as personal) factors. The researcher concluded that relational factors contributed the most as they had an influence on all the categories of possible factors that might influence integration. This finding stressed that the social phenomena that influence integration should not be overlooked. The implementation of interventions to improve integration and retention should be accompanied by a detailed examination of the factors that affect the recruitment, integration and retention of the workforce in a country/region. This research could be an important step towards achieving this goal for the Northern Cape Department of Health.

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Hanson, Bernard. "Le malaise du médecin dans la relation médecin-malade postmoderne." Doctoral thesis, Universite Libre de Bruxelles, 2005. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210989.

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En partant d’une description des nombreux changements de la pratique médicale depuis quelques décennies, la thèse étudie divers aspects constitutifs du malaise du médecin. L’accroissement de la puissance médicale qu’a permis la technoscience est analysée et remise dans un contexte plus large où les technologies de l’information ont une grande place. L’augmentation considérable des connaissances pose un problème de maîtrise de la science médicale. La multiplicité des observations fait qu’il y a discordance de certaines d’entre elles avec les théories médicales largement acceptées. De cette manière, le gain d’efficacité est associé à une perte de la cohérence du discours médical. Le rôle du médecin disparaît derrière la technique, qui semble pouvoir, seule, rendre tous les progrès accessibles. Le médecin devient alors un simple distributeur de services et, à ce titre, développe parfois des offres de pratiques sans fondement, voire dangereuses.Le pouvoir du médecin est évoqué, et se ramène in fine à la fourniture d’un diagnostic et d’une explication de sa maladie au patient. Le rôle des explications particulières que donne le médecin au malade est exploré à la lumière d’une conception narrative et évolutive de la vie humaine. Le rôle du médecin apparaît alors comme d’aider le patient à réécrire a posteriori le fil d’une histoire qui apparaît initialement comme interrompue par la maladie.Le rôle social de maintien de l’ordre de la pratique médicale est alors évoqué. Ensuite, par une approche descriptive du phénomène religieux, on montre que la médecine du XXIe siècle a les caractéristiques d’un tel phénomène. Entités extrahumaines, mythes, rites, tabous, prétention à bâtir une morale, accompagnement de la vie et de la mort, miracles, promesse de salut, temples, officiants sont identifiés dans la médecine « classique » contemporaine. Seule la fonction de divination de l’avenir d’un homme précis est devenue brumeuse, la technoscience permettant régulièrement du « tout ou rien » là où auparavant un pronostic précis (et souvent défavorable) pouvait être affirmé. L’hypothèse que la médecine est devenue une religion du XXIe siècle est confrontée à des textes de S. Freud, M. Gauchet et P. Boyer. Non seulement ces textes n’invalident pas l’hypothèse, mais la renforcent même. Il apparaît que le fonctionnement de l’esprit humain favorise l’éclosion de religions et donc la prise de voile de la médecine. La dynamique générale de la démocratisation de la société montre que la médecine est une forme de religion non seulement compatible avec une société démocratique, mais est peut-être une des formes accomplies de celle-ci, où chaque individu écrit lui-même sa propre histoire.Le danger qu’il y a, pour le patient comme pour le médecin, si ce dernier accepte de jouer un rôle de prêtre, est ensuite développé. Enfin, la remise dans le cadre plus général de l’existence humaine, l’évocation de la dimension de révolte de la médecine, de son essentielle incomplétude, l’acceptation d’une cohérence imparfaite permettent au médecin de retrouver des sources de joie afin de, peut-être, ne tomber ni dans un désinvestissement blasé, ni dans un cynisme blessant.From a description of the many changes medical practice has undergone for a few decades, the work goes on to study many sides of the modern doctor’s malaise. The gain of power made possible by technoscience is put on a larger stage where information technologies play a major role. The abundance of knowledge makes health literacy more difficult. the great number of observations makes discrepancies with general theories more frequent. The gain in power is associated with a loss of coherence of the medical speech. The doctor’s role vanishes behind technology that seems to be the only access to all medical progresses. Doctors becomes mere service providers and go on to offer unvalidated or even harmful services on the market.Modern medical power resumes into the explanations and diagnosis given to the patient. The role of medical explanations is explored through an evolutive and narrative vision of human life. The duty of the doctors then appears to allow a new narration of the self that bridges the gap disease introduced into the patient’s life.The role of medicine in maintaining social order is mentioned. Through a sociological approach of the religious phenomenon, one can see that XXIst century medicine is such a phenomenon. Medicine knows of extrahuman entities, myths, rites, taboos, miracles, temples; priests are present in modern mainstream medicine. Some want to derive objective moral values from medicine, and it brings companionship to man from birth to death. The only departure from old religions was the weakened ability to predict the future of an individual patient: for some diseases for which survival was known to be very poor, the possibilities are now long-term survival with cure, or early death from the treatment. The hypothesis that medicine is a religion is confronted to texts from Freud S. Gauchet M. and Boyer P. Not only do they not invalidate the hypothesis, but they bring enrichment to it. Brain/mind dynamics is such that the appearance of religions is frequent, and makes the transformation of medicine into a religion easier. Society’s democratisation confronted to religion’s history shows that medicine is the most compatible form of religion within a truly democratic society, where each individual writes his own story.To become a priest brings some dangers for the patient, but also for the doctor. These dangers are discussed. This discussion is put into the larger context of human life. The revolt dimension of medicine is discussed, as is its never-ending task. Their acceptance, as that of a lack of total logical coherence can open the possibility for the doctor to enjoy his work, without being neither unfeeling nor cynical. Doctorat en philosophie et lettres, Orientation bioéthique info:eu-repo/semantics/nonPublished

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Yilma, Nebeyou Aberra. "Comparing adherence patterns to standard precautions and infection control amongst health care providers in public and private hospitals in Botswana." Diss., 2013. http://hdl.handle.net/10500/18196.

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This study aimed to provide evidence on knowledge of attitudes toward standard precautions (SPs) and its practice of Healthcare Workers (HCWs) in government and private hospitals in Botswana. It utilised descriptive cross-sectional methodology. A range of significant findings were revealed. Good practice of SPs was noted more amongst the HCWs in government than in private hospitals. Knowledge of SPs amongst HCWs in government hospital was significantly and positively correlated to good practice of SPs. Registered Nurses (RNs) had better knowledge of SPs than HealthcareAssistants (HCAs).There was no significant difference between RNs and HCAs practice of SPS and attitudes toward the same. No significant difference in the knowledge, attitudes and practice of SPs was noted between General Practitioners (GPs) and RNs. No significant difference in the knowledge, attitudes and practice of SPs was observed between GPs and HCAs. The study findings have implications for the application of SPs in practice Health Studies M.A. (Public Health)

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He, Shu An, and 何叔安. "A study on the medical staff worktime allocation at the Taipei municipal hospitals." Thesis, 1994. http://ndltd.ncl.edu.tw/handle/85003780697988763717.

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Shu-YuanHuang and 黃淑媛. "An Analysis of Corruption Factors:A Case Study of Medical Staff in Public Hospitals." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/tb3zfs.

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碩士 國立成功大學 政治經濟研究所碩士在職專班 105 This paper is designed to identify the causes of medical corruption, how such causes interact and the differences between the causes of medical corruption and those of general corruption. This study explores the causes of medical corruption from three levels. Specifically, the system level includes formal and informal systems. In the interpersonal level, the relationship between hospitals and manufacturers is analyzed. The Psychological level includes a sense of relative deprivation, civil servants' identity perceptions and moral mechanism. The factors of different levels are proved to produce an impact on medical corruption by the aforesaid research methods. After the results are sorted out and summarized, judicial decisions of medical corruption cases are cited to prove the results. Then academic theories and practical experience are employed to confirm the findings of this paper and corresponding research recommendations are put forward.

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Shuiqing, Jin. "Work satisfaction of medical staff in China-aided hospitals in Africa: a study of China-aided hospitals in Angola." Doctoral thesis, 2019. http://hdl.handle.net/10071/22843.

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Degree of satisfaction, this measure, particularly applied to the medical staff, explores the content of healthcare professionals for doing their job in medical institutions like hospitals or clinics. But what if the cultural factor is added to this measurement, like the culture differences between the western and eastern worlds? This thesis provides an insight to this problem in the remote location of Angola, a country in Africa, for the Chinese medical staff living there. At the beginning the research provides a close view of the previous and actual situation of the relations between the countries of China and Angola in the medical field. From there it gets straight to the point of evaluating the medical staff working in a Chinese hospital in the capital of Angola, Luanda. Qualitative research was the main method used to gather the principal information needed to make the evaluation of the degree of satisfaction of the Chinese medical staff in the selected hospital; thus getting the personal experiences from them, sometimes affecting their jobs, analysing their actual situation plus adding the data-values to this information provided a solid understanding of the level of satisfaction of them in that hospital. In the end, the information, conclusions and recommendations included in this thesis could be used as a tool for the development of solutions to this topic and/or further research into it, which also can show the contrast between two cultures where healthcare professionals have to put aside those cultural differences in order to fulfil their duties. O grau de satisfação neste trabalho refere-se especificamente aos profissionais médicos, o presente trabalho dedica-se principalmente a explorar o grau do satisfação dos profissionais médicos que trabalham em instituições médicas, e se haverá diferenças de grau de satisfação quando se envolve os fatores culturais? Este trabalho fornece novos conhecimentos para os profissionais médicos chineses estabelecidos em áreas remotas de Angola, África. Em primeiro lugar, este estudo efetuou uma análise mais aprofundada do historial médico e a conjuntura atual da China e Angola, explicando as relações médicas entre os dois países, através da qual se passou diretamente para a avaliação do grau de satisfação dos profissionais médicos que trabalham num hospital chinês em Luanda, Angola. A investigação qualitativa é a maneira principal para a recolha de dados importantes para a avaliação do grau de satisfação dos profissionais médicos chineses no hospital escolhido, através da qual se adquire as experiências pessoais dos médicos, descobrindo os elementos que afetam o trabalho, analisando as situações reais deles, com o objetivo de acrescentar os dados úteis na avaliação de grau de satisfação, o que fornece um conhecimento real sobre o grau de satisfação dos médicos que trabalham nos hospitais estrangeiros. Em fim, os dados recolhidos, as conclusões e sugestões neste trabalho podiam ser os instrumentos para a elaboração de investigação do grau de satisfação dos profissionais médicos estabelecidos em África e para a pesquisa futura sobre o tema, além disso, também demonstra os choques culturais entre os dois países, ou seja, os profissionais médicos têm que deixar ao lado os choques culturais quando cumprem as suas tarefas.

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Johal, Jagdeep K. "Staff Nurses' Perceptions of Rapid Response Teams in Acute Care Hospitals." Thesis, 2008. http://hdl.handle.net/1974/1503.

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The purpose of the present study were to (a) explore the relationship between the frequency of use of Rapid Response Teams (RRTs) by hospital staff nurses and the support received from RRTs; (b) to investigate staff nurses’ perceptions of their individual level, group level and organizational level learning as a result of single or multiple exposures to the RRT; (c) to identify predictors of learning outcomes and (d) to identify overall impressions and advantages and disadvantages of the RRT. A mail survey was used to collect data. The response responses rate was 33%, 131 registered nurses responded to the survey (pre-test = 12, study = 119). The results of Pearson r correlation suggest that a high frequency of access of RRTs was positively related to process support (r = .25, p < .01). Also, perceived content and process support from RRTs was positively related to maintenance and building of staff nurses’ mental models regarding patient deterioration pertaining to self, group and organization. Multiple regression analyses show that sociodemographic and independent variables predict organizational learning outcomes (mental model maintenance and building). Overall impressions of the RRTs were high. A content analysis of nurses’ comments indicated that there were more advantages to having the RRTs than disadvantages. This study suggests that RRTs are influential in changing nurses’ perceptions about managing patient deterioration. Training programs for RRTs should include both content and process support, which may enhance building and maintaining mental models. Thesis (Master, Nursing) -- Queen's University, 2008-09-25 21:27:44.682

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Meyer, Julia. "The knowledge and perceptions of the medical staff about chiropractic at the Kimberly [i.e. Kimberley] Hospital Complex." Thesis, 2009. http://hdl.handle.net/10321/414.

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Dissertation presented to the Faculty of Health Sciences at the Durban University of Technology in partial compliance with the requirements for a Master’s Degree in Technology: Chiropractic, 2009 Background: In order to develop a balanced healthcare system, healthcare integration and inter-professional communication is important and allows for optimum healthcare benefits for a patient and improves cost-effectiveness. The chiropractic profession has been trying to improve inter-professional communication with the medical profession. Kimberly Hospital Complex (KHC) is a tertiary provincial hospital situated in the Northern Cape and since 1998, a permanent chiropractic post exists at this hospital, making it the only state hospital in South Africa with a full-time chiropractic clinic and post. Purpose: To determine the knowledge and perceptions of the medical staff about chiropractic at KHC. Method: This study was achieved by means of a questionnaire, which was modified to suit a South African context by means of a focus group. The questionnaire was personally delivered to 975 medical staff members at KHC. A response rate of 30% (n = 292) was achieved and the data was analysed using SPSS version 15 (SPSS Inc., Chicago, III, USA). Results: The mean age of the respondents was 37.3 years and most were female (78.9%, n = 289). Doctors (62.5%, n = 54) and therapists (61.6%, n = 10) had a higher knowledge percentage score than nurses (48%, n = 213) or other healthcare professions (56.8%, n = 15). Doctors (77.8%, n = 42), therapists (100%, n = 10) and other healthcare professions (69.2%, n = 9) were more inclined to think that chiropractic is an alternative healthcare service, while nurses perceived chiropractic as a primary healthcare service (43.3%, n = 91). Many respondents were unaware of the fact that Diagnostics, Emergency Medical Care, Pharmacology and Radiology are included in the chiropractic curriculum and that chiropractic leads to a Master’s degree. Seventy five percent (n = 203) believed that chiropractors are competent in the general medical iv management of patients, but they would still rather refer patients to physiotherapists and orthopaedic surgeons. Despite the poor level of knowledge of chiropractic, 79.2% (n = 224) believed that it is sufficiently different from physiotherapy to warrant two separate professions and few (24%, n = 69) perceived it as unscientific. A large proportion of the respondents (80.3%, n = 228) believe that chiropractic is not well promoted in South Africa and only 20.8% (n = 59) felt that they know enough about the profession to advise a patient. The majority wanted to learn more about the chiropractic profession (95.8%, n = 277), especially pertaining to the scope and the treatment employed by chiropractors. Seventy-nine percent (n = 212) believed that patients benefit from chiropractic at KHC and 95.4% (n = 268) felt that South African hospitals would benefit from chiropractic care. Conclusion: Due to the poor level of knowledge at KHC, an educational drive should be employed to educate the medical staff in order to increase their understanding of chiropractic and to aid chiropractic integration into the state hospital system of South Africa.

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Mbindyo, Patrick Mutinda. "Roles, norms and incentives influencing the performance of clinical officers in Kenyan rural hospitals." Thesis, 2013. http://hdl.handle.net/10539/12288.

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This work explored perceptions regarding the roles, norms and incentives influencing the performance of Clinical Officers (COs) in rural district hospitals in Kenya. In order to improve access to health care mainly in rural areas, COs are increasingly being used to perform tasks that were previously the preserve of physicians. The assumption underlying their use is that they are a viable option to doctors. Studies have shown with reference to HIV care and obstetric and gynaecological surgical tasks that COs’ performance is comparable to that of physicians. Other studies also show that the care offered by COs is cost effective when compared with the costs associated with physicians and obstetricians care. However, there is emerging work which shows that COs are not happy in their assigned role in the health system. These studies report CO’s dissatisfaction with the low remuneration, poor career progress and limited career options inherent their jobs as compared with those accorded to physicians. As revealed by a systematic review of mid-level worker literature, addressing these issues is at present difficult due to gaps in our understanding of CO functioning. The existence of these gaps is explained by the limited empirical work on COs in general. The aim of this thesis was to address this issue by exploring issues that affect their routine functioning in a typical rural hospital setting going beyond the fact that they are technically competent. To investigate these issues, a conceptual framework was adopted that explores the tension between what institutions demand and what individuals within them feel able to do. Qualitative methods comprising of interviews, participant observation, review of official policy and hospital level documents on COs, and review of hospital statistics were used. A comparative approach was adopted that sought to; (1) examine perceptions regarding influences on the performance of COs from a variety of sources (COs, doctors, nurses, supervisors, hospital managers, policy makers and policy documents); (2) compare perceptions of respondents based in three faith-based hospitals with those in three government facilities; and, (3), explore features of different work settings (outpatient department, specialist clinics and vertically supported clinics) within these hospitals that encouraged good CO performance. Preliminary findings were reported back to respondents in the six study hospitals. Analysis of the data showed three major issues. First, perceptions of CO roles are problematic despite an acknowledgement of the important function performed by COs in the health system. This is revealed by the variety of images regarding their roles that highlights the need for a redefinition of CO roles. An example of this is shown by the inconsistency between their importance as the ‘backbone of the health system’ versus the poor remuneration and career prospects that their position attracts. Second, there were differences in the norms of CO performance that have resulted in variations regarding what is expected of them. While there was much attention paid to norms of performance about technical aspects of work, less attention focussed on non-technical aspects of work. The adoption of a holistic approach to the notion of CO performance is needed that will enable facilities and the system to meet the needs of the CO which should prompt COs to reciprocate by working better. Third was the issue that there were minimal incentives were attached to COs work. In the public sector, there were some incentives but their availability depended on the work settings. For example, while COs in vertical clinics got training their colleagues in the outpatient department had few chances to get training opportunities. Faith-based hospitals did provide performance related bonuses that encouraged health workers to perform better although notably basic salaries in faith-based hospitals were no better than those given in the government sector. However, major incentives such as salary and promotions in the public sector are handled by the central government giving public sector hospital managers little opportunity to utilise such incentive mechanisms. Where hospital managers may have some leeway in implementing actions at the local level to improve performance, for example through improving CO recognition and working conditions, it was observed that public sector managers were generally less engaged in utilising such incentives. Therefore while it is important to consider and address system level factors that influence CO performance such as salaries and promotions, among others, facility managers would also appear to have some scope to improve performance. In discussing these issues, it is becoming clear that the assumption that COs are altruistic and will continue to work flawlessly in their assigned niche presents a naïve view of COs. This thesis shows that COs are also influenced by self–interest and find ways to overcome or work around any perceived barriers to their growth, some of which may work against the institution. This calls for a re-examination of who COs are, what they do and how they should be managed. Ways of resolving the tension that exists between COs and the health institution exist and can be derived from examining the coping mechanisms that COs have adopted to make their lives better. These coping mechanisms show areas that need attention. Further, there should be greater consideration of the important role that facility managers play in mediating and/or modifying system level influences by creating local environments suitable for better staff performance. Underlying all this is the fact that a long term view of COs is needed. The long term view must go beyond the notion of ‘substitute physician’ as Kenya has made huge investments in this cadre over the last 40 years or more and, with other countries, is likely to continue to rely on such a cadre for much clinical care. This thesis therefore concludes with recommendations that seek to address issues identified with the performance of COs in the Kenyan health system focusing on potential hospital level and system level solutions. Also included is a reflection of the relevance of findings for countries similar to Kenya that are currently using or seek to use COs as a physician substitute.

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Abrahamsohn, David Alan. "The dissemination of knowledge between medical and non-medical staff in a hospital setting as a means of preventing AIDS infection of hospital workers." Thesis, 2016. http://hdl.handle.net/10539/20904.

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Knowing about .AIDS and the manner in which it can be contracted in the workplace is essentlal for preventing infection. This thesis attempts to explore whether non-medlcal hospital workers are placed at risk of Infection by virtue of their ignorance of the virus and further seeks to investigate whether "expert" knowledge possessed by professional health workers is disseminated to less-skilled and less-knowledgeable workers. Processes around class and status involved in social closure are investigated to account for the lack of communication concerning AIDS amongst hospital workers. Two research procedures were adopted in this study, namely the intensive interview and participant observation. Findings of the thesis indicate that though all hospital workers are at risk of AIDS infection, unskilled workers remain more vulnerable because they lack knowledge and awareness of the virus. Factors of class, status, educational opportunity and professional elitism striate the hospital workforce and result in exclusionary practices, including the non-dissemination of knowledge about AIDS in the hospital work setting

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Ramarope, Johannah. "Factors contributing to staff turnover among professional nurses in selected hospitals of Vhembe District." Diss., 2015. http://hdl.handle.net/11602/223.

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YIN-HSIEN-CHI and 尹賢琪. "Using the emergency electronic referral system impact on the medical staff- A Case Study in Chiayi area hospitals." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/mpx6hj.

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碩士 國立中正大學 資訊管理學系暨研究所 103 To improve the quality of emergency and referral medical services, the ministry of health and welfare had formulated “The project of improving the quality of emergency and referral medical services” since 2013. This project requires transferring the referral data by using the urgent patients electronic referral system ”Mars “. There is still no conclusion about the effect of this system, and this research aims to explore it. In this research, we use semi-structured questionnaire to conduct in depth Interview of qualitative research method. The interviewee were doctors, registered nurses and nurse practitioners of nine hospital based at Chiayi and its network who had emergency medical services for at least three years and practical use of Mars, or was responsible for promoting the project. To investigate the effect of medical care personnel using “Mars”, data including whether the system made the emergency and referral medical services smoothly or not and the impact on medical care personnel were collected. The results showed that the rate of registration and reply reach the goal in electronic referral system which is useful for improving the medical quality. The impacts on medical care personnel including unstable system, can not raise the referral service (system information insufficient, could not find bed, increase the work load), affect the morale of personnel. The suggestion based on the results of research is to improve the efficiency of the emergency and referral medical service and decrease the system impact on medical care personnel while referral. Meanwhile, the government should enhance the fire station on knowing the emergency ability of every hospital, teach people the medical grading of hospitals, connect Mars and HIS system, clarify the sub specialist of urgent patients, and help dispatch the bed form the EOC.

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Churchill, Brian E. "Perceptions of community hospital physicians on computerized physician order entry." Thesis, 2004. http://hdl.handle.net/1957/30961.

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Objectives: To identify the perceptions of community hospital physicians on computerized physician order entry. Design: Multi-method approach consisting of a mail survey of 659 community hospital physicians with active admitting privileges at three PeaceHealth, Inc., along with follow-up personal interviews with stratified random selection from completed survey. Measurements: Perceptions were assessed by means of a mail survey that asked physicians to rank themselves on a scale that represented the five adopter categories contained in the Diffusion of Innovation (DOI) change theory, along with several questions regarding computer use and attitudes toward potential effects of computers and CPOE on medicine and healthcare. Physicians representing four of the five adopter categories were interviewed to assess general perceptions and perceived attributes of innovations, an another construct within the DOI theory. Results: The response rate was 41%. Medical specialty, years in practice, and gender were found not to influence attitudes toward use of computers or, more specifically CPOE in medicine and healthcare. However, more medical specialists favor CPOE implementation at PeaceHealth than expected. Self-ranking on the DOI five adopter categories appears to influence attitudes toward use of computers in medicine and healthcare with positive trends in improving quality, rapport, and patient satisfaction mainly in the Innovator, Early Adopter, and Early Majority categories. A positive trend was seen in the relationship between CPOE's potential effects on improving patient care, not interfering with communication, and improving patient satisfaction with negative relationships with impact on physician workflow and enjoyment of medical practice. A relationship is seen between the five adopter categories and favoring CPOE implementation at PeaceHealth. The perceived attributes of innovations of Ease of Use, Result Demonstrability, and Visibility were supported by interview responses. Relative Advantage seemed to be supported by other questions. The concept of Compatibility was also supported. No steps of the processes of change construct within the Transtheoretical Model were identified during the interviews. Conclusions: This study appears to refute the suggestion that there might be a difference between medical specialists and surgical specialists, age, or gender in their support of computers and specifically CPOE. These data appear to support the Diffusion of Innovation theory is appropriate to consider in investigating CPOE and its diffusion among community hospital physicians. Implementing CPOE according to adopter categories would provide the option for interested physicians to use CPOE, to use CPOE on certain hospital units or patients, and to expand its use before making mandatory. Communication should be targeted toward the adopter categories rather than mass media and emphasize the perceived attributes of innovation. Graduation date: 2004

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Ackah, Shiroma. "The association of demographics and occupational factors with latent tuberculosis infection in radiology staff at public sector hospitals in the eThekwini health district." Thesis, 2015. http://hdl.handle.net/10321/1422.

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Submitted in fulfillment of the requirements for the degree of Master’s of Technology: Radiography, Durban University of Technology, Durban, South Africa, 2015. Introduction Tuberculosis remains a leading cause of death, second to the Human Immunodeficiency Virus. The risk of latent tuberculosis infection and active tuberculosis disease is a known occupational hazard. In South Africa, a high tuberculosis burden country, the potential of Mycobacterium tuberculosis transmission to health care workers is high. This includes diagnostic radiographers and other radiology staff working in radiology departments. Purpose of the Study This study aimed to investigate the association of demographic and occupational factors with latent tuberculosis infection in radiology staff in public sector hospitals of the eThekwini Health District. Methodology This cross-sectional study was conducted from 26 February 2013 to 07 June 2013. Quantitative methods were used to test for associations of demographic and occupational factors with latent tuberculosis infection in participants. A sample size of 181 participants for an estimated population of 340 radiology staff was recommended at the proposal stage. The study consisted of two phases; the questionnaire survey (phase one) and the administration of a two-step tuberculin skin test (phase two). Data was obtained with regard to demographics, occupational history, social behaviours, medical history; and family and home histories. Demographic and occupational associations with latent tuberculosis infection were made in relation to the size of the first tuberculin skin test induration. Frequency distributions were developed to describe data categories. Pearson’s and Spearman rho’ correlation coefficients were used to test for correlations between the independent variables. The chi-square test was used to determine associations between the categorical independent variables and the dependent variable. Bivariate analyses were performed using these tests. The multivariate analysis was performed using logistic and linear regression on the dependent variable. Results A total of 182 questionnaires were returned from approximately 280 radiology staff. At the outset, all doctors working in the radiology department had to be excluded due to numerous failed attempts to enlist their participation. Fifty-three (29.12 percent) participants were excluded from phase one of the study and a further thirteen participants were excluded from phase two. The total sample was 116 participants. Of the 116 participants, 86.2 percent tested positive for latent tuberculosis infection at the first step of the two-step testing method used. One (0.86 percent) participant went on to convert at the second step, testing positive at this level. Demographic associations with latent tuberculosis infection included age (older) as an associated factor. A significant demographic association with latent tuberculosis infection was the use of alcohol (p-value 0.033 on the multivariate analysis). Occupational associations with latent tuberculosis infection included longer durations of employment. The annual income (higher income earners) displayed significant associations with latent tuberculosis infection (p-value 0.048 on the multivariate analysis). It is necessary in this study to note that participants include support personnel (lower income earners) making up 37.8 percent of the study, diagnostic radiographers making up 48.3 percent; and radiography managers/assistant managers (highest income earners) making up 13.8 percent of the study. Conclusion and recommendations The risk of transmission of Mycobacterium Tuberculosis to health care workers is a known occupational hazard. This study has described the prevalence of latent tuberculosis infection in radiology staff, at district and regional hospitals within the eThekwini Health District. With 23.62 percent of all participants already having active TB disease and 86.2 percent of the tested group displaying positive results for latent tuberculosis infection, using the tuberculin skin tests, the need for tuberculosis screening is essential. The findings of this study will be used as a health improvement mechanism for stakeholders, having identified potential gaps in medical screening in healthcare in Kwa-Zulu Natal. This study makes recommendations for the early detection of active tuberculosis infection and the monitoring of health care workers that are latently infected, thus assisting in reducing the rate of conversion of latent tuberculosis infection to active tuberculosis disease in radiology staff. This reduces long-term exorbitant costs related to health care associated infections, such as tuberculosis. It also reduces rates of transmission and cross infection to both co-workers and already immunocompromised patients, helping to curb the overall epidemic in South Africa.

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Ingraham, Raymond G. "Work excitement among staff nurses on a unit planning to introduce a nurse extender a research [report] submitted in partial fulfillment ... Masters of Science Medical-Surgical Nursing ... /." 1992. http://catalog.hathitrust.org/api/volumes/oclc/68796224.html.

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Katamba, Henry Stanley. "Factors affecting voluntary nursing staff turnover in Mengo Hospital." Diss., 2011. http://hdl.handle.net/10500/5590.

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The purpose of this study was to examine the relationship between perceived availability of opportunities for promotion, training, career progression, existing management style and voluntary staff turnover intention among the nurses working in Mengo Hospital. A quantitative, descriptive correlational design was used. Data collection was done using structured questionnaires. Full time staff nurses (N= 235) were surveyed. The findings revealed that all the four variables were significantly and negatively correlated to the intention to leave and predicted 16.8 percent of the variance in intention to leave scores. Management style was the strongest predictor of intent to leave (14.5%). Nurses perceiving their managers as participatory had lower intention to leave. To retain qualified personnel, hospital administrators should focus on participative management style and career development programs that address the needs of the staff and the hospital Public Health M.A. (Public Health)

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Dolamo, Bethabile Lovely. "The quality of professional conduct by the nursing practitioner in selected public hospitals in the Northern (Limpopo) Province." Thesis, 2012. http://hdl.handle.net/10210/7194.

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D.Cur. The purpose of this study was to evaluate the quality of professional conduct by the nursing practitioner in clinical nursing care as reflected in post laparotomy and respiratory disorders in selected public hospitals in the Northern (Limpopo) Province, and to develop a programme to improve the quality of professional conduct by the nursing practitioner in public hospitals. Professional conduct in this study refers to the level of compliance with the SANC/Muller (1999) practice standards as refined by the researcher. The following dimensions are addressed in relation to post laparotomy patients and patients with respiratory disorders: knowledge, skills/competencies, scientifically-based care, recording, teamwork/networking, health promotion, therapeutic environment and accountability. The hypothesis for this study was that the quality of professional conduct by the nursing practitioner in clinical nursing care as reflected in post laparotomy and respiratory disorders is inadequate and non-compliant with the standards and criteria in selected public hospitals in the Northern (Limpopo) Province. The following research questions were addressed: a) What is the quality of professional conduct by the nursing practitioner in clinical nursing as reflected in practice setting of post laparotomy and respiratory disorders in selected public hospitals in the Northern (Limpopo) Province? b) What professional conduct programme should be developed to improve compliance with the standards and criteria? A quantitative evaluative descriptive and contextual survey was conducted consisting of: 1. Refinement of standards by the researcher 2. Baseline survey to evaluate the quality of professional conduct by the nursing practitioner in clinical nursing care as reflected in post laparotomy and respiratory disorders; 3. The development of a professional conduct programme as a remedial action strategy. The data collection method utilised strategies such as the use of trained evaluators, direct and indirect observations, individual and group interviews, and documentation analysis. Population and samples were selected from public hospitals that offer clinical nursing care to both post laparotomy patients and patients with respiratory disorders. The units that offered clinical nursing care to the same patients and the nursing practitioners who provide clinical nursing care to these patients were selected. A three point rating scale consisting of compliance (C) = 1, partial compliance (PC) = 0.5 and non-compliance (NC) = 0.0 was used to collect data. Statistical analysis system was used by the statistician to analyse the data. Individual items were analysed and percentages calculated. Then mean (M) and standard deviation (SD) on individual standard were determined. The results revealed that for practice standard one the nursing practitioner showed partial compliance (M = 0.375; SD = 0.197); practice standard two, the nursing practitioner showed partial compliance (M = 0.355; SD = 0.267) slightly lower than standard one; practice standard three the nursing practitioner showed non-compliance (M = 0.319; SD = 1.211); practice standard four, the nursing practitioner showed partial compliance (M = 0.552; SD = 0.180); practice standard five, the nursing practitioner showed partial compliance (M = 0.397; SD = 0.220); practice standard six, the nursing practitioner showed non-compliance (M = 0.238; SD .= 0.257), the lowest of all the standards; practice standard seven, the nursing practitioner showed partial compliance (M = 0.396; SD = 0.237); and practice standard eight, the nursing practitioner demonstrated partial compliance (M = 0.530; SD 0.267). The first research question was what is the level of compliance by the nursing practitioner with the standards and criteria in clinical nursing care in public hospitals in the Northern Province? The overall results for the eight standards showed partial compliance (M = 0.380; SD = 0.175). The second research question was what professional conduct programme should be developed to improve compliance with the standards and criteria. The professional conduct programme was developed based on the SANC/Muller practice standards as the theoretical foundation. Further analysis was done on contributory factors. There was a relationship between the recording format (78.9% inadequate) and compliance with practice standard three; scientifically-based recording on patient records rated low at all the selected hospitals (M = 0.319; SD = 0.211). There was also an association between supervision/support (85% inadequate) and practice standard six, indicating non-compliance (M = 0.238; SD = 0.257) and practice standard seven (M = 0.396; SD = 0.237). A relationship between availability of stock and supplies (69.4% inadequate) and practice standard one and two, was observed (M = 0.375; SD = 0.197) and (M = 0.355; SD = 0.269) respectively. There was, however, no relationship between staffing and the practice standards;

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Reddy, Shiksha. "The development of a retention model for scarce-skilled professionals in the health sector." Diss., 2015. http://hdl.handle.net/10500/22204.

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The shortage of skilled professionals in the health sector has been an ongoing problem. This has resulted in poor service delivery and ultimately increased patient deaths. The primary objective of this study was to develop a conceptual model to retain scarce skilled professional workers in the health sector. An exploratory study was conducted which included both professionals and non-professionals in the pathology sector. Recruitment was done from a population of 207 employees. In total 188 employees responded, of which 116 were professionals and a comparator group of 72 being the non-professionals. The study was conducted in three phases. In the first phase, quantitative data collection methods such as the job diagnostic survey, career orientation inventory, organisational commitment questionnaire and intention to quit questionnaire were used to assess the characteristics of the groups of interest. The relationship between the independent and dependent variables were calculated. The results revealed that only a few of the traditional predictors influenced retention in the professional group. The predictors worked much better for the non-professional group. It was concluded that traditional retention strategies are not suitable to retain professionals in the health sector. The second and third phases utilised qualitative methods. The second part of the study related to identifying factors which retain professional staff. Following interviews with 15 professionals, ten themes were identified which relate to the retention of professionals. The third phase of the study consisted of interviews with 3 managers, and this was to determine what the managers can do to influence retention. A retention model for the professionals was then developed. This model not only contributes to the body of knowledge, but is also a useful managerial tool to manage professionals in the health sector Graduate School of Business Leadership (SBL) D.B.L. (Business Leadership)

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Pao, Erh-His, and 鮑爾璽. "A study for the relationship between hospital medical records room directors'' leadership styles and staff pharmacists'' job satisfaction--A case study of regional hospitals in central region hospital department of health." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/22430509460813643901.

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碩士 東海大學 工業工程與經營資訊學系 96 This research was to explore the relationship beween medical records room dirctors” leadership styles and stsff pharmacists”job satisfaction.There were one moderating variables：internal-external control etc. variables. This questionnaire as a tool was to be used to investigate in regional hospital in central region hospital department of health.Date was collected from hospital pharmacists.seven hospital ignored this study and only eight hospital got involved in it. There were 166 validquestionnaires and the response rate was 72.1% Date was analysed by Pearson”s correlation analysis、one-way ANOVA analysis to search the relationship between medical records room dirctors leadership styles and each facet of pharmacists”job satisfaction. The findings of this study were as follows： First,The majority of pharmacy directors use high consideration-high initating structure leadership style. Second, To sort each facet of pharmacists”job satisfaction the conclusion is supervision＞pay＞coworkers＞promotion＞work. Third, There were significant differences between pharmacy directors leadership styles and pharmacists”job satisfaction. Fourth, A significant positive correlation between two dimensions of leadership and each facet of job satifaction except coworks and pay.

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Moola, Sabihah. "A qualitative analysis of the communication process between HIV-positive patients and medical staff : a study at Stanger Regional Hospital's antiretroviral therapy clinic." Diss., 2010. http://hdl.handle.net/10500/4113.

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Health communication is a vital part of health care and treatment. For patients living with HIV, effective health communication is crucial. This study aimed at describing health communication from the perspective of HIV-positive patients by uncovering their experiences as they interacted with various medical staff members at Stanger Hospital. Guided by a review of various health communication models, data were collected via individual interviews and non-participant observation. The findings showed that interactive communication was favoured by all the respondents, especially communication that was patient-centred. Such communication encompassed education on how to live and cope with HIV. Obstacles to effective communication such as power differentials, lack of time and privacy at public health care clinics were identified. The study found that the different medical staff members at the clinic to various degrees addressed distinctive communication needs of HIV-positive patients. This study contributed to effectively understating the communication process as a whole. Sociology M.A. (Social Behaviour Studies in HIV/AIDS)

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"Designing and developing an intervention to maximise the coping resources of doctors working with trauma patients at Johannesburg General Hospital." Thesis, 2008. http://hdl.handle.net/10210/1526.

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M.A. This research aimed to design and develop an intervention that would maximise the coping resources of doctors working with trauma patients at Johannesburg General Hospital. Intervention Research methodology was used in order to achieve this objective. The study was divided in to three phases, namely, Diagnosis, Feedback and Discussion and Evaluation. The initial intervention comprised the Diagnostic as well as the Feedback and Discussion phase. The findings from the Diagnostic phase suggested that the doctors who had been working in the unit for less than three months, as well as the doctors who had less than four years medical practice experience, were most likely to show areas of vulnerability. This vulnerability related to their under-use of coping resources accompanied by elevated negative mood states, as identified by the Coping Resource Inventory and the Profile of Mood States questionnaire respectively. Other groups of doctors that shared this vulnerability included interns, medical officers, females and single doctors. The Feedback and Discussion phase brought to light themes relating to the stressors that the doctors’ experience in their work context. These themes along with the results of the Evaluation phase where used in order to re-design the Intervention for future use with doctors working with trauma patients. The findings from the Evaluation phase also confirmed that the doctors found the intervention to be beneficial.

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Mntambo, Selina Ntombizodwa. "Student nurses' experience of clinical accompaniment in a public hospital in Gauteng Province." Thesis, 2009. http://hdl.handle.net/10500/3897.

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Clinical practice is the core of nursing education during which the student is socialized into the nursing profession. During this period, there is transfer of knowledge and skill from qualified nurses and other members of the multidisciplinary team to student nurses. The purpose of this study is to describe and explore student nurse’s experiences of clinical accompaniment in a public hospital in Gauteng Province by means of a qualitative approach that included the exploratory, descriptive and contextual study. Three focus group interviews were conducted with students and one with clinical accompanists. Qualitative methods included categorizing and coding. The major findings of the research revealed that participants regarded relationships and communication as important for clinical accompaniment. Both student nurses and unit supervisors expected nurse facilitators to accompany students in clinical settings; but some hospital staff members did not perceive clinical accompaniment to be their task. Health Studies M.A. (Public Health)

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Matlala, Mosehle Salome. "Perceptions of midwives on the shortage and retention of staff at a public hospital in Tshwane District, Gauteng Province." Diss., 2017. http://hdl.handle.net/10500/24409.

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Midwifery is the backbone of women and child healthcare. The shortage of staff in maternity units is a crisis faced by many countries worldwide, including South Africa. This study aims to investigate and explore the perceptions of midwives on the shortage and retention of staff in a public institution. An explorative, descriptive generic qualitative design method was followed. Non-probability, purposive sampling technique was used. The study was conducted at one tertiary hospital in the district of Tshwane, Gauteng Province. A total of 11 midwives were interviewed. Thematic coding analysis was followed in analysing data. Midwives are passionate about their job, despite the hurdles related to their day-to-day work environment. They are demoralised by a chronic shortage of staff, and feel overworked. Staff involvement in decision-making processes is a motivational factor for midwives to stay in the profession. Health Studies M.A. (Public Health)

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Mumba, Judith Shadunka. "A description of support services available for nurses who care for patients with HIV/AIDS in Pretoria urban public hospitals." Diss., 2004. http://hdl.handle.net/10500/1404.

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The purpose of the study was to describe the support services available for nurses who care for patients with human immunodeficiency virus / acquired immune-deficiency syndrome (HIV/AIDS) in Pretoria urban pubic hospitals. Problems faced by nurses in HIV/AIDS care support preferences were also investigated. The study was conducted between March and April 2003, using a descriptive design. Respondents comprised eighty-seven (87) nurses who were conveniently selected from five (5) hospitals. Results reveal that support available is inadequate in both quality and coverage of nurses. Other significant findings are inadequate job preparation, shortage of nurses and that nurses prefer to receive support from both within and outside the hospital. It has been recommended that management should work with nurses to design support interventions that match the identified problems/needs. Nurses need to take an active role in caring for themselves and more in-service training opportunities need to be created for nurses. Health Studies MA (Health Studies)

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Ravhura, Grace Tshilidzi. "Experiences of forensic nurses regarding the provision of care to victims of sexual assault in selected public hospitals of Limpopo Province, South Africa." Diss., 2014. http://hdl.handle.net/10500/18917.

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Purpose: The purpose of this study was to explore the experiences of forensic nurses when providing care to victims of sexual assault in selected public hospitals of Limpopo province. Methods: A qualitative, explorative, descriptive and contextual research design was employed in this study. A sample of 7 registered nurses was purposively selected to partake in in-depth unstructured interviews. Results: Four themes associated with the experience of providing care to victims of sexual assaults emerged during data analysis. These included (1) psychological experiences of nursing victims of sexual assault, (2) physical challenges associated with implementing the forensic nursing specialty in a clinical setting, (3) psychological coping strategies to deal with challenges experienced, and (4) the experience of managerial support. Conclusion: Participants reported negative psychological and physical experiences of providing care to victims of sexual assault, which resulted to occupational stress. Recommendations of forensic nurses support guidelines and further research were made. Health Studies M.A. (Health Studies)

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Sehume, Odilia Monica Mamane. "Evidence-based guidelines to promote the health and safety of health care workers in selected public hospitals in the Tshwane health care district in Gauteng, South Africa." Thesis, 2016. http://hdl.handle.net/10500/22602.

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Text in English The purpose of this research was to investigate occupational health and safety challenges and their impact on health care workers (HCWs) in selected public hospitals from the Gauteng Province, South Africa. Method: A quantitative descriptive cross-sectional survey was conducted among HCWs in the study sites. A two-staged sampling that include purposive sampling of study sites and census sampling of 2000 HCWs was used. Self-administered questionnaires were used to obtain data from HCWs. In addition, two different checklists were used to conduct retrospective records reviews to assess occupational health and safety (OHS) policy compliance and occupational injuries and diseases occurrence. The SAS Release 9.3 was used to analyse data. The Fischer Exact test and Chi-square were also used to determine the association of variables and P-value was set at <0.05 to indicate significant association. Results: A total of eight public hospitals and 926 (46.3%) HCWs who were all females nurses participated in this survey. Major occupational health hazards reported by the participants include: needle-stick injuries 275 (54.67%), slips trips and falls 67 (13.32%) and splashes 57 (11.33%). The analysis of open-ended responses indicated increased workloads, long hours of work and shift work as the most reported psychosocial hazards among HCWs. The reviewed records indicated that back injuries 22 (4.37%), tuberculosis (TB) 17 (3.38%) and asthmatic reactions 8 (1.59%) were the commonly reported occupational injuries and diseases among the HCWs. The records review also revealed a lack in the conducting of adequate medical surveillance among participants. The results showed poor compliance with the OHS policy and a negative impact of biological and psychosocial hazards on the HCWs. Conclusion: There was a high risk of exposures to biological hazards whilst providing care to patients, thus warranting the implementation of robust preventive measures. As a result, the guidelines were developed to promote the health and safety of HCWs with a view to promoting policy compliance and preventing the occurrence of occupational injuries and diseases as well as their impact among HCWs. Health Studies D.Litt et Phil. (Health Studies)

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Wagner, J.-D. "Assessing the communication climate focus of professional nurses in selected public hospitals in the Gauteng province through the development of a measuring instrument." Thesis, 2017. http://hdl.handle.net/10500/24783.

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The purpose of this study was to develop and test a measuring instrument based on the Gibb’s Defensive Communication Climate Paradigm (1961) to assess the communication climate focus of professional nurses in selected public hospitals in the Gauteng province. This focus involves the communication behaviour orientation of the professional nurses and their perceptions of the communication behaviour orientation of their operational managers. The Gibb’s model comprises six bipolar conceptual continuums, namely Evaluation-Description, Control-Problem orientation, Strategy-Spontaneity, Neutrality-Empathy, Superiority-Equality and Certainty-Provisionalism Continuums. The study consisted of a non-experimental design, including a developmental phase and a testing phase. During the developmental phase the researcher developed a measuring instrument (a Semantic Differential Scale questionnaire); used a simple, random sample method to pre-test the instrument; analysed the data by applying Cronbach’s Alpha reliability analysis and refined the instrument. Further refinement of this new instrument by future researchers is recommended. During the testing phase the researcher also used a simple, random sample, consisting of professional nurses (N = 270) from three selected public hospitals in Gauteng; tested the items against the biographical data and the three research questions and analysed the obtained data by utilising both descriptive and inferential statistics. A Delphi panel of experts were involved in both phases of the study. The results of the study indicated that although the respondents had a predominantly supportive communication behaviour orientation, they were more focused on the communication behaviour of their operational managers than on their own. Furthermore, the results indicated no significant differences in the influencing factors: age, tenure (periods in hospital), gender, language and institution (public hospital), in terms of the six conceptual continuums. Significant differences were found only in the factor: unit/ward, indicating that the supportiveness of the communication behaviour of professional nurses could be dependent on their specific work environment. Guidelines aimed at the development of a supportive climate were drawn up for the National Department of Health, Gauteng Department of Health, public hospitals, operational managers and professional nurses. It is recommended that implementation of the newly developed guidelines be pivotal for public hospitals, to refocus their communication climates towards supportive communication. Health Studies D. Litt. et Phil. (Health Studies)

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Tomas, Nestor Petrus Namulo. "Factors contributing to the negative behaviours of nurses in a specific public health care facility in Namibia." Diss., 2017. http://hdl.handle.net/10500/24427.

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It is important for nurses to show acceptable behaviour when interacting with the patients. The purpose of this study was to explore and describe the factors that contribute to nurses’ negative behaviour when rendering patient care and to determine the effects of nurses’ behaviour on patient outcomes. The study used a non-experimental explorative and descriptive quantitative design. Data collection was done using a structured questionnaire. The sample comprised of 64 respondents which consisted of 25 registered nurses and 39 enrolled nurses. The study found that besides the known contributing factor, that is, the shortage of nurses, further identified contributing factors to nurses’ negative behaviour when rendering patient care are failure to retrain nurses identified with negative behaviours, poor condition of employment and patients’ behaviours and cultural beliefs. These results suggested a need to train more nurses, improve conditions of employment, as well as support and retrain nurses identified with negative behaviours. Health Studies M.A. (Public Health)

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Malelelo, Hulisani. "Ethical dilemmas experienced by Health Care Professionals working in Intensive Care Unit Tshilidzini Hospital, Vhembe district in Limpopo Province." Diss., 2017. http://hdl.handle.net/11602/1210.

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MCur Department of Advanced Nursing Science Background: Doctors and nurses working in ICU are always confronted with ethical dilemmas when caring for critically ill patients no matter where they practice. The ethical dilemmas experienced by ICU nurses and doctors include amongst other: freedom of choice, truth telling, distribution of resources and confidentiality. Purpose: The study sought to explore the ethical dilemmas experienced by healthcare professionals working in ICU, Vhembe district in Limpopo province. Setting: The setting of the study was Tshilidzini hospital, Vhembe district in Limpopo Province Methodology: A qualitative, explorative, descriptive design was used. The population was nurses and doctors working in ICU, Tshilidzini hospital, Vhembe district in Limpopo province. A purposive sampling was used to select the study sample, and the study hospital. Data was collected by means of Semi-structured, in-depth interviews. Data was analyzed using Tesch`s method. Ethical considerations were adhered to. Findings: Participants expressed ethical dilemmas related to lack of resources, unsuitable infrastructure, hospital policies and patient`s decision making. Recommendations: The study recommends better policies by government and critical care societies to help guide resource allocation for ICU services. The number of ICU beds must be allocated according to the population it serves, in-service trainings to be conducted on regular bases in order to equip ICU health care professionals with knowledge of ethics and skills of decision-making, an active ethics committee to be elected to assist ICU practitioners when they encounter ethically challenging situation. NRF

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Dissertations / Theses on the topic 'Hospitals – Medical staff – Botswana'

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