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Awareness, knowledge and perceptions of physicians of the National Health Insurance Scheme in Nigeria: An exploratory study 尼日利亚医生对国家健康保险计划的认识、知识和看法:一项探索性研究
Pub Date : 2022-05-13 DOI: 10.5430/ijh.v8n1p51
Nene Okunna, N. Ezeama, C. Ezeama, Leso Munala
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.
尼日利亚于2005年实施了国家健康保险计划(NHIS),对卫生保健提供系统进行了重大改革。本研究评估了医生对国家卫生健康计划目标的理解以及他们对该计划的看法,以确定他们对卫生政策改革的接受和支持程度。通过自行填写的问卷调查了居住在尼日利亚东南部的134名医生。采用描述性统计对研究数据进行汇总。评估了有关健康保险和国家卫生保健系统目标的总体知识得分。还获得了医生对医疗改革看法的共识测量(Cns)。研究结果显示,参与者对国家卫生保健系统的认识和支持程度很高。然而,在对国家健康信息系统的认识和对项目目标的了解之间存在偏差。总知识得分因年龄组、实习年数、工作地点和地点而有显著差异。此外,医生对国家卫生健康系统(Cns指数= 0.69)和引入健康维护组织(HMOs)作为该计划的中介运营商(Cns指数= 0.68)的共识测量是积极的,并且被认为是强烈的,而对HMOs与该国腐败之间的关联的看法是温和的(Cns指数= 0.56),略微消极。本研究表明,医生对尼日利亚国家医疗卫生系统项目的支持,以及对卫生政策改革实施的变化的接受程度。确定了知识差距,强调需要提高对改革及其目标的认识。
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引用次数: 2
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 实施手机干预措施以改善撒哈拉以南非洲妇女计划生育服务使用的障碍和促进因素:系统审查
Pub Date : 2022-04-27 DOI: 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
背景:正在测试移动保健(mHealth)干预措施,以改善撒哈拉以南非洲(SSA)的避孕措施。然而,很少有人尝试系统地审查旨在改善SSA妇女计划生育服务的移动医疗方案。本综述确定并强调了实施针对妇女计划生育服务的手机干预措施的促进因素和障碍。方法:系统检索PubMed、CINAHL、Epistemonikos、Embase和Global Health等数据库,检索2010年1月1日至2020年12月31日期间的研究,以确定用于改善SSA妇女计划生育服务使用的各种移动健康干预措施。两位作者根据纳入/排除标准独立选择符合条件的出版物,评估研究质量,并使用预先定义的数据提取表提取数据。此外,使用经过验证的提取网格进行了内容分析,并预先建立了障碍和促进因素的分类。结果:通过搜索策略共获得8188篇潜在相关论文,其中16篇符合纳入标准。纳入的大多数研究评估了移动医疗干预措施对计划生育服务的影响;获取(n = 9)和使用计划生育结果(n = 6)。报告最多的手机使用是用于妇女生殖健康教育、避孕知识和使用。使用移动医疗的障碍和促进因素分为三个主要结果:行为结果、数据收集和报告以及健康结果。移动医疗干预措施解决了与提供者偏见、污名化、歧视、缺乏隐私和保密性相关的障碍。这些研究还确定了计划生育服务采用移动医疗干预措施的障碍,包括技术素养下降和语言能力下降。结论:本综述提供了在不同级别卫生保健系统实施移动电话以改善计划生育服务的详细信息;结果。必须充分解决采取移动保健干预措施的障碍,增加移动电话的潜在使用,以改善获得性生殖健康认识和计划生育服务的机会。关键词:手机,移动医疗,妇女,撒哈拉以南非洲,系统评价,促进者,障碍
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引用次数: 0
Challenges and patient strategies in seeking health services for chronic stroke: A qualitative study 慢性中风患者寻求医疗服务的挑战和策略:一项定性研究
Pub Date : 2022-03-25 DOI: 10.5430/ijh.v8n1p36
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.
目的:先前的医疗信息学研究确定了对信息技术的迫切需求,以支持慢性疾病患者和护理人员的自我管理。然而,人们对她们在寻求保健服务方面的经历和面临的挑战知之甚少。方法:对慢性脑卒中患者及其护理人员进行定性研究。在13例参与研究的患者中,9例患者与护理人员一起参与研究,护理人员在帮助患者寻求健康服务方面发挥主要作用,另外4例卒中患者独立处理卒中管理,自行参与研究。我们使用扎根理论的方法来分析访谈数据。结果:我们的研究结果揭示了中风患者及其护理人员在利用负担得起的、可获得的和令人满意的卫生服务方面面临的三个主要障碍,以及他们采取的应对这些挑战的相应策略。结论:我们讨论了这些策略反映了患者在使服务负担得起方面的创造性挪用,并可以为围绕患者创造的技术设计提供信息。此外,患者获得医疗服务的协作性和繁重的策略意味着设计利用当地社会资源的技术的机会。此外,为了提供满意的健康服务,提供个性化的治疗方案,考虑患者的治疗目标、症状和家庭环境是有价值的。这一发现可能适用于需要长期康复的类似神经系统疾病。
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引用次数: 0
A case for preconceptual education programs for women: Integrative review 妇女孕前教育项目的案例:综合评价
Pub Date : 2022-03-24 DOI: 10.5430/ijh.v8n1p28
Azita Keytash, L. Jones, A. Kimpton
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.
在受孕前或胚胎期的早期阶段,暴露于环境因素可能会对个人生活造成永久性的变化,从而导致以后生活中慢性疾病的发展或转移到后代,从而转移到后代。不良饮食、酒精、烟草消费、传染病、肥胖、焦虑和抑郁在怀孕期间的各种影响以及成人疾病的胎儿来源都有充分的记录和了解。其中许多是可以预防的,或者可以改变或治疗的。然而,目前的卫生系统政策忽视了孕前干预措施的一般规定。根据世界卫生组织(WHO)的数据,全世界50%的怀孕是无意的。这样做的后果是,胚胎暴露于致畸物可能发生在怀孕前几周被发现。大多数女性在得知自己怀孕后(通常在8-10周左右),会改变自己的危险行为,如戒烟、减少饮酒,甚至改变自己的生活方式,使其变得更健康,如摄入叶酸和多种维生素。然而,到这个时候,妇女已经错过了在胚胎期的关键阶段为胎儿提供健康子宫环境的机会。孕前护理是一个相对较新的概念,为改善孕前、孕期和产后孕产妇健康和妊娠结局提供了独特的机会。尽管人们普遍认识到孕前保健的潜在价值影响,但在卫生系统中,将孕前保健作为常规做法的一部分,仍存在各种障碍。
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引用次数: 0
Hospitalisation costs of sinonasal cancer: Results from the Italian hospital discharge registry (2001–2018) 鼻窦癌的住院费用:意大利医院出院登记的结果(2001-2018)
Pub Date : 2022-02-28 DOI: 10.5430/ijh.v8n1p19
P. Ferrante, F. Mazzola
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.
目的:评估意大利鼻窦癌(SNC)相关的医院费用并评价相关的时间趋势。方法:所有意大利住院治疗的SNC诊断患者(N = 29,355)从国家医院出院登记处提取。数据指的是2001年至2018年间公立和私立医院的出院患者。以住院费用、住院率、住院时间等住院水平变量作为主要结局变量。每次住院的相对疾病强度信息被用于具体分配SNC医疗资源的总住院费用。结果:2001年至2018年期间,意大利医院平均每年收治1631例SNC患者。所有医院的平均年住院费用为5,502,909欧元,即每次住院费用为3,374欧元,其中60.0%仅归因于SNC。出院时患者的年龄(从62岁到63岁)、外科手术的百分比(从29.3%到46.8%)和紧急病例的百分比(从13.5%到16.5%)随着时间的推移而增加。可归因于SNC的成本百分比呈倒u型趋势,在2006年达到最低水平;相反,死亡率一直上升到2007年,然后稳步下降。结论:SNC治疗已取得良好进展。内窥镜技术代表了这一领域最重要的进步之一,减少了发病率和住院时间,同时保持了相似的生存率。旨在监测最容易受到SNC风险的工作人员和使医院治疗标准化的政策可以帮助公共卫生机构规划最佳预防政策。
{"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":"29 1","pages":""},"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}
引用次数: 0
Family and religion’s influence on Arab immigrant mothers’ initiation and exclusive breastfeeding 家庭和宗教对阿拉伯移民母亲启蒙和纯母乳喂养的影响
Pub Date : 2021-11-02 DOI: 10.5430/ijh.v8n1p1
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.
母乳喂养对新生儿和母乳喂养母亲的健康有益。世界卫生组织和加拿大卫生部建议在婴儿出生后的头六个月完全采用母乳喂养。然而,与非移民加拿大母亲和移民原籍国母亲的比率相比,阿拉伯移民母亲的纯母乳喂养率较低。采用关键人种学方法探讨加拿大阿尔伯塔省阿拉伯移民母亲的母乳喂养行为,以及影响其决定或能力的因素。对10名参与者进行面对面访谈,然后对定性叙事数据进行专题分析。结果表明,家庭和宗教是影响母亲开始和纯母乳喂养行为的主要社会文化因素。这项研究的结果可以促进文化上安全和敏感的干预措施,以解决阿拉伯母亲的母乳喂养需求,并促进加拿大这一人群的纯母乳喂养。
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引用次数: 2
Racial, age, and community level maternal disparities at an academic health center 学术保健中心的种族、年龄和社区层面的产妇差异
Pub Date : 2021-10-28 DOI: 10.5430/ijh.v7n2p42
Candace N Holloway, G. Gillespie, B. Clayton
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.
目的:种族和少数民族妇女比非西班牙裔白人妇女经历更多的孕产妇死亡和合并症。本研究的目的是确定在城市学术保健中心是否存在孕产妇保健差异。方法:对2017年分娩妇女进行系统随机抽样的回顾性图表分析。研究设置在一个城市学术卫生中心三级新生儿重症监护室,为高比例的少数种族患者提供服务。数据分析采用相对危险度(RR),置信区间为95%。结果:研究结果反映了少数民族和老年妇女发生产妇并发症的风险增加。具体而言,与非西班牙裔白人女性相比,黑人(RR: 3.818)和西班牙裔/拉丁裔(RR: 2.354)女性剖宫产的风险更高;与年轻女性相比,年龄较大的女性(35岁或以上)剖宫产(RR: 2.671)和先兆子痫(RR: 3.422)。虽然白人和非西班牙裔妇女在干预中没有发生先兆子痫或出血,但少数民族妇女确实经历了这些产妇并发症。结论:在这个在学术卫生中心分娩的妇女样本中存在孕产妇保健不平等。医疗保健提供者可以进行自我评估,以确定他们可能导致健康差异的内隐偏见。
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引用次数: 0
Managing clinical risk retrospectively and prospectively with a risk management framework in an acute care hospital in Singapore 新加坡一家急症护理医院的风险管理框架对临床风险进行回顾性和前瞻性管理
Pub Date : 2021-09-09 DOI: 10.5430/ijh.v7n2p22
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.
目的:阐述在某急症医院实施临床风险管理框架,以最大限度地降低临床风险,提高患者安全,考虑到系统和人为的风险因素和模式。方法:临床风险管理框架包括回顾性和前瞻性双管齐下的方法。回顾性方法的5个阶段包括数据收集、数据汇总、风险评估和确定优先顺序、风险缓解以及最后的风险监测。前瞻性方法需要水平扫描,其目的是及早发现风险,并确保迅速实施控制措施,以防止产生危害。结合起来,该框架寻求对减少患者伤害的可能性和严重程度作出反应。对2016 - 2019年最高临床风险事件数和风险评分进行监测和研究,以评估新实施的临床风险管理框架的有效性。结果:2017年实施临床风险管理框架时,已确定的许多临床事件类型和根本原因的事件数量和相应的风险评分逐年下降。最值得注意的是,两个最大的临床风险,即未审查或延迟结果,以及工作人员技能和知识不足,在风险评分方面有了重大改善。结论:双管齐下的临床风险管理框架系统的工作流程,使校园能够全面、高效地管理风险。虽然回顾性风险分析检查并对报告的临床事件作出反应,但在不稳定的环境和技术进步暴露出医疗保健领域前所未有的风险的情况下,通过水平扫描进行的前瞻性风险分析有助于在伤害发生之前预测和采取行动,最终提高患者的安全性。
{"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":"33 1","pages":""},"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}
引用次数: 0
Work, stress, and well-being of healthcare and human service professionals during outbreak of COVID-19 COVID-19爆发期间医疗保健和人类服务专业人员的工作、压力和福祉
Pub Date : 2021-09-09 DOI: 10.5430/ijh.v7n2p15
K. Kwong
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.
目的:探讨2019冠状病毒病(COVID-19)大流行期间卫生保健和人类服务专业人员的职业压力水平,评估其个人特征、职业压力源、工作满意度以及对员工组成、薪酬和补偿多样性的满意度是否影响其感知压力和身心健康。方法:2020年3月至8月,共有227名医疗保健和人力服务专业人员参与了在线调查。参与者提供了背景和工作相关的信息,并完成了几个测试,以探讨他们的感知压力、工作经历、职业压力源以及他们的身体和心理问题。采用双变量分析评估感知压力、职业压力源、工作薪酬满意度、员工构成多样性满意度、总体工作满意度和身心问题之间的关系。采用逐步多元回归分析来确定感知压力与生理和心理问题的预测因子。结果:研究发现工作满意度水平、员工构成多样性满意度与工作薪酬满意度之间存在显著相关。感知压力与职业压力源、身心问题正相关,与整体工作满意度、员工构成多样性满意度、工作薪酬满意度负相关。研究发现,职业压力因素和年龄是感知压力的重要预测因素。职业压力源和女性性别是生理和心理问题经历的显著预测因子。结论:本研究提供了对COVID-19大流行期间影响医疗保健和人类服务专业人员压力和福祉的关键因素的理解。应进一步调查这些因素,以便为公共政策和干预措施提供信息,在本次和未来疫情期间减轻这些专业人员的健康和精神健康问题。
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引用次数: 0
Assessment of needle stick injuries among healthcare workers: a cross-sectional study from Kakiri military and SOS hospitals, Uganda 卫生保健工作者针刺伤评估:来自乌干达Kakiri军事医院和SOS医院的横断面研究
Pub Date : 2021-04-16 DOI: 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
背景:乌干达军事医疗服务与民用公共卫生系统一起提供高质量的医疗保健。这一伙伴关系是乌干达提供保健服务的支柱。在乌干达较大的卫生产业中,针头刺伤的负担正在增加;然而,缺乏军事和公共卫生设施中针头刺伤的数据。没有关于军事和民用卫生机构混合设施的比较研究的公开数据。这项研究是第一次在乌干达的军事或公共卫生医院研究这个问题。方法:2018年7月至2019年9月,在乌干达Kakiri军事医院和SOS医院使用结构化问卷进行了一项以医院为基础的横断面研究。根据学习目标、职业状况和院系有目的地选择调查对象(N = 310)。结果:受访者中nsi的总体患病率为27.2%,两家医院的患病率几乎相同。nsi发生率最高的是静脉血采集(49.4%)。性别、职业状况、年龄、对自伤预防和暴露后知识的缺乏以及缺乏专业经验是自伤发生的显著预测因素。这两个选定的卫生设施都缺乏感染控制措施。结论:乌干达超过四分之一的卫生保健工作者报告了nsi,这使他们面临重大的健康风险。促进普遍预防措施、最佳感染控制做法和对卫生保健工作者进行生物安全措施培训,可减少国家传染病的流行。试验注册:不适用
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International journal of healthcare
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