Nigeria implemented a National Health Insurance Scheme (NHIS) in 2005, introducing monumental changes to the health care delivery system. This study assessed physicians’ understanding of the objectives of the NHIS as well as their perceptions of the scheme, to identify their level of acceptance and support of the health policy reform. A convenient sample of 134 physicians residing in South-East Nigeria were surveyed via a self-administered questionnaire. Descriptive statistics were used to summarize study data. Aggregate knowledge scores regarding health insurance and the NHIS objectives were assessed. Measures of consensus (Cns) of physicians’ perceptions of the health reform were also obtained. Study results show a high level of awareness and support for the NHIS among participants. However, there were deviations between awareness of the NHIS and knowledge of the program’s objectives. Aggregate knowledge scores differed significantly by age group, length of years of practice, place of employment and location. Further, consensus measures of physician’s perceptions of NHIS (Cns index = 0.69) and the introduction of Health Maintenance Organizations (HMOs) as intermediary operators of the scheme (Cns index = 0.68) were positive and considered strong while perceptions on associations between HMOs and corruption in the country was moderate (Cns index = 0.56) and slightly negative. This study demonstrates physicians’ support for the NHIS program in Nigeria and an acceptance of changes implemented with the health policy reform. Knowledge gaps were identified, highlighting the need forincreased awareness of the reform and its objectives.
{"title":"Awareness, knowledge and perceptions of physicians of the National Health Insurance Scheme in Nigeria: An exploratory study","authors":"Nene Okunna, N. Ezeama, C. Ezeama, Leso Munala","doi":"10.5430/ijh.v8n1p51","DOIUrl":"https://doi.org/10.5430/ijh.v8n1p51","url":null,"abstract":"Nigeria implemented a National Health Insurance Scheme (NHIS) in 2005, introducing monumental changes to the health care delivery system. This study assessed physicians’ understanding of the objectives of the NHIS as well as their perceptions of the scheme, to identify their level of acceptance and support of the health policy reform. A convenient sample of 134 physicians residing in South-East Nigeria were surveyed via a self-administered questionnaire. Descriptive statistics were used to summarize study data. Aggregate knowledge scores regarding health insurance and the NHIS objectives were assessed. Measures of consensus (Cns) of physicians’ perceptions of the health reform were also obtained. Study results show a high level of awareness and support for the NHIS among participants. However, there were deviations between awareness of the NHIS and knowledge of the program’s objectives. Aggregate knowledge scores differed significantly by age group, length of years of practice, place of employment and location. Further, consensus measures of physician’s perceptions of NHIS (Cns index = 0.69) and the introduction of Health Maintenance Organizations (HMOs) as intermediary operators of the scheme (Cns index = 0.68) were positive and considered strong while perceptions on associations between HMOs and corruption in the country was moderate (Cns index = 0.56) and slightly negative. This study demonstrates physicians’ support for the NHIS program in Nigeria and an acceptance of changes implemented with the health policy reform. Knowledge gaps were identified, highlighting the need forincreased awareness of the reform and its objectives.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84040765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-27DOI: 10.1101/2022.04.24.22274232
Barro Abibata, P. Ngangue, N. Bationo, D. Soubeiga, Yacouba Pafadnam, Safiata S Kabore, Arzouma Hermann Pilabré, Doulaye Traore
Background: Mobile health (mHealth) interventions are being tested to improve contraceptive uptake in SubSaharan Africa (SSA). However, few attempts have systematically reviewed the mHealth programs aiming to improve family planning (FP) services among women in SSA. This review identifies and highlights facilitators and barriers to implementing cell phone interventions designed to target women FP services. Methods: Databases including PubMed, CINAHL, Epistemonikos, Embase, and Global Health were systematically searched for studies from January 01, 2010, to December 31, 2020, to identify various mHealth interventions used to improve the use of FP services among women in SSA. Two authors independently selected eligible publications based on inclusion/exclusion criteria, assessed study quality and extracted data using a pre-defined data extraction sheet. In addition, a content analysis was conducted using a validated extraction grid with a pre-established categorization of barriers and facilitators. Results: The search strategy led to a total of 8,188 potentially relevant papers, of which 16 met the inclusion criteria. The majority of included studies evaluated the impact of mHealth interventions on FP services; access (n = 9) and use of FP outcomes (n = 6). The most- reported cell phone use was for women reproductive health education, contraceptive knowledge and use. Barriers and facilitators of the use of mhealth were categorized into three main outcomes: behavioral outcomes, data collection and reporting, and health outcomes. mHealth interventions addressed barriers related to provider prejudice, stigmatization, discrimination, lack of privacy, and confidentiality. The studies also identified barriers to uptake of mHealth interventions for FP services, including decreased technological literacy and lower linguistic competency. Conclusion: The review provides detailed information about the implementation of mobile phones at different healthcare system levels to improve FP services; outcomes. Barriers to uptake mHealth interventions must be adequately addressed to increase the potential use of mobile phones to improve access to sexual reproductive health awareness and family planning services. Systematic review registration: PROSPERO CRD42020220669 (December 14, 2020) Keywords: Cell phone, mHealth, Women, SubSaharan Africa, Systematic review, Facilitators, Barriers
{"title":"Barriers and facilitators to the implementation of cell phone interventions to improve the use of family planning services among women in Sub-Saharan Africa: a systematic review","authors":"Barro Abibata, P. Ngangue, N. Bationo, D. Soubeiga, Yacouba Pafadnam, Safiata S Kabore, Arzouma Hermann Pilabré, Doulaye Traore","doi":"10.1101/2022.04.24.22274232","DOIUrl":"https://doi.org/10.1101/2022.04.24.22274232","url":null,"abstract":"Background: Mobile health (mHealth) interventions are being tested to improve contraceptive uptake in SubSaharan Africa (SSA). However, few attempts have systematically reviewed the mHealth programs aiming to improve family planning (FP) services among women in SSA. This review identifies and highlights facilitators and barriers to implementing cell phone interventions designed to target women FP services. Methods: Databases including PubMed, CINAHL, Epistemonikos, Embase, and Global Health were systematically searched for studies from January 01, 2010, to December 31, 2020, to identify various mHealth interventions used to improve the use of FP services among women in SSA. Two authors independently selected eligible publications based on inclusion/exclusion criteria, assessed study quality and extracted data using a pre-defined data extraction sheet. In addition, a content analysis was conducted using a validated extraction grid with a pre-established categorization of barriers and facilitators. Results: The search strategy led to a total of 8,188 potentially relevant papers, of which 16 met the inclusion criteria. The majority of included studies evaluated the impact of mHealth interventions on FP services; access (n = 9) and use of FP outcomes (n = 6). The most- reported cell phone use was for women reproductive health education, contraceptive knowledge and use. Barriers and facilitators of the use of mhealth were categorized into three main outcomes: behavioral outcomes, data collection and reporting, and health outcomes. mHealth interventions addressed barriers related to provider prejudice, stigmatization, discrimination, lack of privacy, and confidentiality. The studies also identified barriers to uptake of mHealth interventions for FP services, including decreased technological literacy and lower linguistic competency. Conclusion: The review provides detailed information about the implementation of mobile phones at different healthcare system levels to improve FP services; outcomes. Barriers to uptake mHealth interventions must be adequately addressed to increase the potential use of mobile phones to improve access to sexual reproductive health awareness and family planning services. Systematic review registration: PROSPERO CRD42020220669 (December 14, 2020) Keywords: Cell phone, mHealth, Women, SubSaharan Africa, Systematic review, Facilitators, Barriers","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91099540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu Chen, S. Park, Xinning Gui, Steven C. Cramer, Kai Zheng, Yunan Chen
Objective: Previous healthcare informatics research identifies a critical need for information technologies to support the selfmanagement of chronic illness by patients and caregivers. However, little is known about their experiences and challenges in seeking health services.Methods: We present a qualitative study with chronic stroke patients and their caregivers. Among them the 13 patients who participated in the study, 9 patients also participated together with a caregiver, who played a major role in helping the patients seek health services and the other 4 stroke patients, who dealt with stroke management independently, participated in the study by themselves. We used a grounded theory approach to analyze the interview data.Results: Our findings revealed three main barriers that stroke patients and their caregivers faced in utilizing affordable, accessible, and satisfactory health services and the corresponding strategies they adopted to cope with these challenges.Conclusions: We discussed that these strategies reflect patients’ creative appropriation in making services affordable and could inform technology design that builds around patients’ creation. In addition, patients’ collaborative and yet onerous strategies to access health services imply the opportunities of designing technologies that leverage local social resources. Moreover, to offer satisfactory health services, it is valuable to provide individualized treatment plans that consider patients’ treatment goals, symptoms, and home environment. The findings could apply to similar neurological diseases that require long-term rehabilitation.
{"title":"Challenges and patient strategies in seeking health services for chronic stroke: A qualitative study","authors":"Yu Chen, S. Park, Xinning Gui, Steven C. Cramer, Kai Zheng, Yunan Chen","doi":"10.5430/ijh.v8n1p36","DOIUrl":"https://doi.org/10.5430/ijh.v8n1p36","url":null,"abstract":"Objective: Previous healthcare informatics research identifies a critical need for information technologies to support the selfmanagement of chronic illness by patients and caregivers. However, little is known about their experiences and challenges in seeking health services.Methods: We present a qualitative study with chronic stroke patients and their caregivers. Among them the 13 patients who participated in the study, 9 patients also participated together with a caregiver, who played a major role in helping the patients seek health services and the other 4 stroke patients, who dealt with stroke management independently, participated in the study by themselves. We used a grounded theory approach to analyze the interview data.Results: Our findings revealed three main barriers that stroke patients and their caregivers faced in utilizing affordable, accessible, and satisfactory health services and the corresponding strategies they adopted to cope with these challenges.Conclusions: We discussed that these strategies reflect patients’ creative appropriation in making services affordable and could inform technology design that builds around patients’ creation. In addition, patients’ collaborative and yet onerous strategies to access health services imply the opportunities of designing technologies that leverage local social resources. Moreover, to offer satisfactory health services, it is valuable to provide individualized treatment plans that consider patients’ treatment goals, symptoms, and home environment. The findings could apply to similar neurological diseases that require long-term rehabilitation.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90906187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Exposure to environmental factors before conception or in the very early stage of the embryonic period, can cause permanent changes in an individual life that can result in the development of chronic illness later in life or be transferred to progeny and hence future generations. Diverse effects of poor diet, alcohol, tobacco consumption, infectious diseases, obesity, anxiety, and depression in pregnancy and fetal origin of adult diseases all are well documented and known. Many of these are preventable or can be modified or treated. The general provision of prepregnancy interventions, however, are neglected by current health system policy. According to the World Health Organization (WHO), 50% of pregnancies worldwide are unintentional. The consequences of this is that embryo exposure to the teratogens can occur weeks before the pregnancy has been detected. Most women modify their risky behavior, such as smoking cessation, reducing alcohol consumption and even alter their lifestyle to a healthier one, such as consuming folic acid and multivitamins, when they learn about their pregnancy, typically around 8-10 weeks of gestational age. By this time, however, women have missed the opportunity of providing a healthy uterine environment for their fetus through the critical stage of the embryonic period. Preconception care is a relatively new concept and provides a unique opportunity to improve maternal health and pregnancy outcomes before pregnancy, through pregnancy, and after birth. Despite the general acknowledgment of the potential valuable impact of preconception care, there are various impediments to implementation of preconception care as part of routine practice in the health system.
{"title":"A case for preconceptual education programs for women: Integrative review","authors":"Azita Keytash, L. Jones, A. Kimpton","doi":"10.5430/ijh.v8n1p28","DOIUrl":"https://doi.org/10.5430/ijh.v8n1p28","url":null,"abstract":"Exposure to environmental factors before conception or in the very early stage of the embryonic period, can cause permanent changes in an individual life that can result in the development of chronic illness later in life or be transferred to progeny and hence future generations. Diverse effects of poor diet, alcohol, tobacco consumption, infectious diseases, obesity, anxiety, and depression in pregnancy and fetal origin of adult diseases all are well documented and known. Many of these are preventable or can be modified or treated. The general provision of prepregnancy interventions, however, are neglected by current health system policy. According to the World Health Organization (WHO), 50% of pregnancies worldwide are unintentional. The consequences of this is that embryo exposure to the teratogens can occur weeks before the pregnancy has been detected. Most women modify their risky behavior, such as smoking cessation, reducing alcohol consumption and even alter their lifestyle to a healthier one, such as consuming folic acid and multivitamins, when they learn about their pregnancy, typically around 8-10 weeks of gestational age. By this time, however, women have missed the opportunity of providing a healthy uterine environment for their fetus through the critical stage of the embryonic period. Preconception care is a relatively new concept and provides a unique opportunity to improve maternal health and pregnancy outcomes before pregnancy, through pregnancy, and after birth. Despite the general acknowledgment of the potential valuable impact of preconception care, there are various impediments to implementation of preconception care as part of routine practice in the health system.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73925814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This paper assesses hospital costs associated with sinonasal cancer (SNC) in Italy and evaluates related time trends.Methods: All Italian hospitalizations treating patients with a diagnosis of SNC (N = 29,355) were extracted from the National Hospital Discharge Registry. Data refer to patients discharged from public and private hospitals between 2001 and 2018. Hospitalization cost, admission rate, length of stay and other hospitalization-level variables were used as the main outcome variables. Information on the relative disease intensity per hospitalization was used to specifically allocate total hospitalization costs to SNC medical resources.Results: Over the 2001-2018 period, Italian hospitals have treated 1,631 admissions with SNC every year, on average. The mean annual hospitalization cost across all hospitals was 5,502,909 €, or 3,374 € per admission, and 60.0% of these costs were attributable to SNC only. Patient age at discharge (from 62 to 63 years), percentage of surgical procedures (from 29.3% to 46.8%) and of urgent cases (from 13.5% to 16.5%) increased over time. The percentage of costs attributable to SNC followed an inverted U-shaped pattern reaching the minimum level in 2006; conversely, mortality rose until 2007 then decreased steadily.Conclusions: Good progress has been made in SNC treatments. Endoscopic techniques represent one of the most important advances in this field, reducing morbidity and hospital length of stay while keeping similar survival rates. Policies aimed at monitoring workers most exposed to SNC risk and at standardizing hospital treatments could help Public Health Institutions to plan optimal prevention policies.
{"title":"Hospitalisation costs of sinonasal cancer: Results from the Italian hospital discharge registry (2001–2018)","authors":"P. Ferrante, F. Mazzola","doi":"10.5430/ijh.v8n1p19","DOIUrl":"https://doi.org/10.5430/ijh.v8n1p19","url":null,"abstract":"Objective: This paper assesses hospital costs associated with sinonasal cancer (SNC) in Italy and evaluates related time trends.Methods: All Italian hospitalizations treating patients with a diagnosis of SNC (N = 29,355) were extracted from the National Hospital Discharge Registry. Data refer to patients discharged from public and private hospitals between 2001 and 2018. Hospitalization cost, admission rate, length of stay and other hospitalization-level variables were used as the main outcome variables. Information on the relative disease intensity per hospitalization was used to specifically allocate total hospitalization costs to SNC medical resources.Results: Over the 2001-2018 period, Italian hospitals have treated 1,631 admissions with SNC every year, on average. The mean annual hospitalization cost across all hospitals was 5,502,909 €, or 3,374 € per admission, and 60.0% of these costs were attributable to SNC only. Patient age at discharge (from 62 to 63 years), percentage of surgical procedures (from 29.3% to 46.8%) and of urgent cases (from 13.5% to 16.5%) increased over time. The percentage of costs attributable to SNC followed an inverted U-shaped pattern reaching the minimum level in 2006; conversely, mortality rose until 2007 then decreased steadily.Conclusions: Good progress has been made in SNC treatments. Endoscopic techniques represent one of the most important advances in this field, reducing morbidity and hospital length of stay while keeping similar survival rates. Policies aimed at monitoring workers most exposed to SNC risk and at standardizing hospital treatments could help Public Health Institutions to plan optimal prevention policies.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73522845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roqaia Ahmad Dorri, Tam Truong Donnelly, E. McKiel, S. R. Bouchal
Breastfeeding is known to provide health benefits for newborns and breastfeeding mothers. The World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of an infant’s life. However, the rates of exclusive breastfeeding practices among Arab immigrant mothers are lower when compared with rates for non-immigrant Canadian mothers and mothers in the immigrants’ countries of origin. Critical ethnography was used to explore the breastfeeding practices among immigrant Arab mothers in Alberta, Canada, and factors influencing their decision or ability to breastfeed exclusively. Face-to-face interviews were conducted with 10 participants, followed by thematic analysis of the qualitative narrative data. The results indicated that family and religion are the sociocultural factors that primarily influenced the mothers’ initiation and exclusive breastfeeding practices. The findings from this study can facilitate culturally safe and sensitive interventions to address Arab mothers’ breastfeeding needs and promote exclusive breastfeeding within this population in Canada.
{"title":"Family and religion’s influence on Arab immigrant mothers’ initiation and exclusive breastfeeding","authors":"Roqaia Ahmad Dorri, Tam Truong Donnelly, E. McKiel, S. R. Bouchal","doi":"10.5430/ijh.v8n1p1","DOIUrl":"https://doi.org/10.5430/ijh.v8n1p1","url":null,"abstract":"Breastfeeding is known to provide health benefits for newborns and breastfeeding mothers. The World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of an infant’s life. However, the rates of exclusive breastfeeding practices among Arab immigrant mothers are lower when compared with rates for non-immigrant Canadian mothers and mothers in the immigrants’ countries of origin. Critical ethnography was used to explore the breastfeeding practices among immigrant Arab mothers in Alberta, Canada, and factors influencing their decision or ability to breastfeed exclusively. Face-to-face interviews were conducted with 10 participants, followed by thematic analysis of the qualitative narrative data. The results indicated that family and religion are the sociocultural factors that primarily influenced the mothers’ initiation and exclusive breastfeeding practices. The findings from this study can facilitate culturally safe and sensitive interventions to address Arab mothers’ breastfeeding needs and promote exclusive breastfeeding within this population in Canada.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85011858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Racial and ethnic minority women experience more maternal deaths and comorbid illnesses than non-Hispanic White women. The purpose of the current study was to identify if maternal health disparities exist at an urban academic health center.Methods: A retrospective chart review was conducted of a systematic random sample of women who delivered a child in 2017. The study setting was an urban academic health center Level III neonatal intensive care unit serving a high percentage of racial minority patients. Data were analyzed using relative risks (RR) with 95% confidence intervals.Results: Findings reflect an increased risk for maternal complications for minority and older aged women. Specifically, risk was higher for Black (RR: 3.818) and Hispanic/Latino (RR: 2.354) women compared to non-Hispanic White women for cesarean section and for older women (age 35 years or older) compared to younger women for cesarean section (RR: 2.671) and preeclampsia (RR: 3.422). While White, non-Hispanic women did not incur pre-eclampsia or hemorrhage with intervention, minority women did experience these maternal complications.Conclusions: Maternal health inequities exist within this sample of women giving birth at an academic health center. Healthcare providers can conduct self-assessments to determine their implicit biases that may be contributing to health disparities.
{"title":"Racial, age, and community level maternal disparities at an academic health center","authors":"Candace N Holloway, G. Gillespie, B. Clayton","doi":"10.5430/ijh.v7n2p42","DOIUrl":"https://doi.org/10.5430/ijh.v7n2p42","url":null,"abstract":"Objective: Racial and ethnic minority women experience more maternal deaths and comorbid illnesses than non-Hispanic White women. The purpose of the current study was to identify if maternal health disparities exist at an urban academic health center.Methods: A retrospective chart review was conducted of a systematic random sample of women who delivered a child in 2017. The study setting was an urban academic health center Level III neonatal intensive care unit serving a high percentage of racial minority patients. Data were analyzed using relative risks (RR) with 95% confidence intervals.Results: Findings reflect an increased risk for maternal complications for minority and older aged women. Specifically, risk was higher for Black (RR: 3.818) and Hispanic/Latino (RR: 2.354) women compared to non-Hispanic White women for cesarean section and for older women (age 35 years or older) compared to younger women for cesarean section (RR: 2.671) and preeclampsia (RR: 3.422). While White, non-Hispanic women did not incur pre-eclampsia or hemorrhage with intervention, minority women did experience these maternal complications.Conclusions: Maternal health inequities exist within this sample of women giving birth at an academic health center. Healthcare providers can conduct self-assessments to determine their implicit biases that may be contributing to health disparities.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76760056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahdhir Bin Amat Tugiman, Xiao-dong Tan, J. Chia, G. Lim
Objective: To expound on the implementation of the clinical risk management framework in an acute care hospital to minimise clinical risks and improve patient safety on account of systemic and human risk factors and patterns.Methods: The clinical risk management framework involves a 2-pronged approach through retrospective and prospective methods. The 5 stages of the retrospective approach include data collection, data aggregation, risk assessment and prioritisation, risk mitigation, and lastly, risk monitoring. The prospective approach entails horizon scanning which aims to detect risks early and ensure controls are swiftly implemented to prevent harm from arising. When combined, the framework seeks to be responsive to reduce the possibility and severity of patient harm. The number of incidents and risk scores for top clinical risks from 2016 to 2019 were monitored and studied to assess the effectiveness of the newly implemented clinical risk management framework.Results: When the clinical risk management framework was implemented in 2017, the number of incidents as well as corresponding risk scores for many of the identified clinical incident types and root causes decreased over the years. Most notably, two top clinical risks, results not being reviewed or delayed, and staff inadequate skills and knowledge, saw major improvements in risk scores.Conclusions: The systematic workflow of the 2-pronged clinical risk management framework allows the campus to manage risks comprehensively and efficiently. While retrospective risk analysis examines and reacts to reported clinical incidents, amidst volatile circumstances and advancements of technology exposing unprecedented risks in healthcare, prospective risk analysis conducted through horizon scanning is useful in anticipating and acting before harm arises, ultimately resulting in improved patient safety.
{"title":"Managing clinical risk retrospectively and prospectively with a risk management framework in an acute care hospital in Singapore","authors":"Mahdhir Bin Amat Tugiman, Xiao-dong Tan, J. Chia, G. Lim","doi":"10.5430/ijh.v7n2p22","DOIUrl":"https://doi.org/10.5430/ijh.v7n2p22","url":null,"abstract":"Objective: To expound on the implementation of the clinical risk management framework in an acute care hospital to minimise clinical risks and improve patient safety on account of systemic and human risk factors and patterns.Methods: The clinical risk management framework involves a 2-pronged approach through retrospective and prospective methods. The 5 stages of the retrospective approach include data collection, data aggregation, risk assessment and prioritisation, risk mitigation, and lastly, risk monitoring. The prospective approach entails horizon scanning which aims to detect risks early and ensure controls are swiftly implemented to prevent harm from arising. When combined, the framework seeks to be responsive to reduce the possibility and severity of patient harm. The number of incidents and risk scores for top clinical risks from 2016 to 2019 were monitored and studied to assess the effectiveness of the newly implemented clinical risk management framework.Results: When the clinical risk management framework was implemented in 2017, the number of incidents as well as corresponding risk scores for many of the identified clinical incident types and root causes decreased over the years. Most notably, two top clinical risks, results not being reviewed or delayed, and staff inadequate skills and knowledge, saw major improvements in risk scores.Conclusions: The systematic workflow of the 2-pronged clinical risk management framework allows the campus to manage risks comprehensively and efficiently. While retrospective risk analysis examines and reacts to reported clinical incidents, amidst volatile circumstances and advancements of technology exposing unprecedented risks in healthcare, prospective risk analysis conducted through horizon scanning is useful in anticipating and acting before harm arises, ultimately resulting in improved patient safety.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86950580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study explored the level of occupational stress experienced by healthcare and human service professionals during COVID-19 pandemic and assessed if their personal characteristics, occupational stressors, job satisfaction, and their satisfaction with diversity of staff composition, salary, and compensation influenced their perceived stress, and their physical and psychological well-being.Methods: A total of 227 healthcare and human service professionals participated in an online survey from March to August 2020. Participants provided background and job-related information and completed several measures to explore their perceived stress, job experiences, occupational stressors, as well as their physical and psychological problems. Bivariate analyses were used to assess the relationships between perceived stress, occupational stressors, satisfaction with job salary and compensation, satisfaction with diversity of staff composition, overall job satisfaction, and physical and psychological problems. Stepwise multiple regression analyses were performed to identify predictors of perceived stress and physical and psychological problems.Results: The study found a significant correlation between level of job satisfaction, satisfaction with diversity of staff composition, and satisfaction with job salary and compensation. Perceived stress was related positively with occupational stressors and physical and psychological problems, but negatively with overall job satisfaction, satisfaction with diversity of staff composition, and satisfaction with job salary and compensation. The findings found occupational stressors and being younger as significant predicators of perceived stress. Occupational stressors and female gender were significant predicators of experience of physical and psychological problems.Conclusions: This study provides understanding on critical factors that have impacted healthcare and human service professionals’ stress and wellbeing during outbreak of COVID-19 pandemic. These factors should be further investigated to inform public policy and interventions that mitigate health and mental health problems among these professionals during this and future outbreaks.
{"title":"Work, stress, and well-being of healthcare and human service professionals during outbreak of COVID-19","authors":"K. Kwong","doi":"10.5430/ijh.v7n2p15","DOIUrl":"https://doi.org/10.5430/ijh.v7n2p15","url":null,"abstract":"Objective: This study explored the level of occupational stress experienced by healthcare and human service professionals during COVID-19 pandemic and assessed if their personal characteristics, occupational stressors, job satisfaction, and their satisfaction with diversity of staff composition, salary, and compensation influenced their perceived stress, and their physical and psychological well-being.Methods: A total of 227 healthcare and human service professionals participated in an online survey from March to August 2020. Participants provided background and job-related information and completed several measures to explore their perceived stress, job experiences, occupational stressors, as well as their physical and psychological problems. Bivariate analyses were used to assess the relationships between perceived stress, occupational stressors, satisfaction with job salary and compensation, satisfaction with diversity of staff composition, overall job satisfaction, and physical and psychological problems. Stepwise multiple regression analyses were performed to identify predictors of perceived stress and physical and psychological problems.Results: The study found a significant correlation between level of job satisfaction, satisfaction with diversity of staff composition, and satisfaction with job salary and compensation. Perceived stress was related positively with occupational stressors and physical and psychological problems, but negatively with overall job satisfaction, satisfaction with diversity of staff composition, and satisfaction with job salary and compensation. The findings found occupational stressors and being younger as significant predicators of perceived stress. Occupational stressors and female gender were significant predicators of experience of physical and psychological problems.Conclusions: This study provides understanding on critical factors that have impacted healthcare and human service professionals’ stress and wellbeing during outbreak of COVID-19 pandemic. These factors should be further investigated to inform public policy and interventions that mitigate health and mental health problems among these professionals during this and future outbreaks.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82223139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-16DOI: 10.21203/RS.3.RS-426672/V1
Robert K. Basaza, Emmanuel D Otieno, C. Haddock
Background: The Ugandan military medical services work together with the civilian public health system to deliver quality healthcare. This Partnership is the mainstay of health service delivery in Uganda. The burden of needle stick injuries (NSIs) is increasing in Uganda’s larger health industry; however, data on needle stick injury in military and public health facilities is lacking. No published data exist on comparative studies for a mix of facilities both military and civilian health settings. This study represents the first time this issue has been studied in a military or public health hospital in Uganda.Methods: A hospital-based, cross-sectional study was conducted in July 2018 to September 2019 in Kakiri Military and SOS Hospitals in Uganda using a structured questionnaire. Respondents were purposively selected based on the objectives of study, occupation status and department (N = 310). Results: The overall prevalence of NSIs among respondents was 27.2% and prevalence rates for the two facilities was nearly identical. The largest percentage of NSIs occurred during drawing venous blood samples (49.4%). Significant predictors of NSI were gender, occupational status, age, poor knowledge on prevention and post exposure of NSI, and less professional experience. Infection control practices were lacking in both selected health facilities. Conclusion: Over a quarter of HCWs in Uganda reported NSIs, which places them at significant health risk. Fostering the practice of universal precautions, best infection control practices and training of healthcare workers on bio-safety measures can reduce the prevalence of NSIs.Trial Registration: Not Applicable
{"title":"Assessment of needle stick injuries among healthcare workers: a cross-sectional study from Kakiri military and SOS hospitals, Uganda","authors":"Robert K. Basaza, Emmanuel D Otieno, C. Haddock","doi":"10.21203/RS.3.RS-426672/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-426672/V1","url":null,"abstract":"\u0000 Background: The Ugandan military medical services work together with the civilian public health system to deliver quality healthcare. This Partnership is the mainstay of health service delivery in Uganda. The burden of needle stick injuries (NSIs) is increasing in Uganda’s larger health industry; however, data on needle stick injury in military and public health facilities is lacking. No published data exist on comparative studies for a mix of facilities both military and civilian health settings. This study represents the first time this issue has been studied in a military or public health hospital in Uganda.Methods: A hospital-based, cross-sectional study was conducted in July 2018 to September 2019 in Kakiri Military and SOS Hospitals in Uganda using a structured questionnaire. Respondents were purposively selected based on the objectives of study, occupation status and department (N = 310). Results: The overall prevalence of NSIs among respondents was 27.2% and prevalence rates for the two facilities was nearly identical. The largest percentage of NSIs occurred during drawing venous blood samples (49.4%). Significant predictors of NSI were gender, occupational status, age, poor knowledge on prevention and post exposure of NSI, and less professional experience. Infection control practices were lacking in both selected health facilities. Conclusion: Over a quarter of HCWs in Uganda reported NSIs, which places them at significant health risk. Fostering the practice of universal precautions, best infection control practices and training of healthcare workers on bio-safety measures can reduce the prevalence of NSIs.Trial Registration: Not Applicable","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88096792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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