Search results for: interprofessional health care team

Authors: L. José, S. Vieira, E. Melo, A. R. Pinheiro

Abstract:

Objectives: This study aims to characterize the stroke profile and the health care provided for people with a stroke in Luanda, Angola. Methods: A prospective longitudinal study was conducted at two Health centers, from March to November 2023, enrolling stroke patients. Data was gathered using a survey created by the researchers and validated by a health panel of experts from Angola. The analysis focused on demographic and stroke characteristics, as well as the care provided. Ethical approval and informed consent were obtained. Results: Preliminary results of a total of 186 patients are described, 122 from a Central Acute Care Hospital, with a mean age of 51.3±14.35 years old, a BMI of 26.7±4.15 kg/m2, 41% male, and 64 patients from a Rehabilitation Center, with 55.6±11.55 years old, a BMI of 27.0±3.8 kg/m2, 53% male. Ischemic stroke was reported as the most representative type in both centers (71.3% and 70.3%, respectively), though 100% of patients had no imaging diagnosis confirmation, neither data about the subtype was given. For patients admitted to the Hospital, discharge occurred before rehabilitation, and no follow-up was possible. No rehabilitation care was delivered in the first 7 days after the stroke. In the Rehabilitation Center, patient’s rehabilitation started in the late subacute phase, after a mean of 171.8±11.5 days. Conclusions: Stroke diagnosis lacks imaging confirmation, which is decisive for proper treatment, and rehabilitation starts during the late subacute phase, which is too late considering the international guidelines and the best window of opportunity for neuroplasticity and recovery. These results highlight the urgent need for the definition of Stroke-directed Health Care Policies in Angola.

Keywords: stroke, personalized health care, functional recovery, quality of life, health policies

Procedia PDF Downloads 24

Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

Abstract:

Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

Procedia PDF Downloads 319

Authors: Aditya Manna

Abstract:

Introduction: As in any developing countries state of West Bengal in India has a huge burden of cancer patients in advanced stage coming from rural area where awareness regarding the usefulness of palliative care in rather poor. Objective: Our goal is to give a pain free good quality of life in these advanced stage cancer patients. Objective of this study is to identify the main difficulties in achieving the above goal in a rural village setting in India. Method: Advanced cancer patients in need of palliative care in various villages in of rural India were selected for this study. Their symptoms and managements in that rural surroundings were evaluated by an NGO (under the guidance of a senior palliative care specialist) working in that area. An attempt was made to identify the main obstacles in getting proper palliative care in a rural setting. Results: Pain, fatigue are the main symptoms effecting these patients. In most patients pain and other symptoms control were grossly inadequate due to lack of properly trained manpower in the rural India. However regular homecare visits by a group of social workers were of immense help in the last few months of life. NGO team was well guided by a palliative care specialist. Conclusion: There is a wide gap of trained manpower in this filled in rural areas of India. Dedicated groups from rural area itself need encouragement and proper training, so that difficult symptoms can be managed locally along with necessary social and psychological support to these patients.

Keywords: palliative care, NGO, rural India, home care

Procedia PDF Downloads 295

Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

Abstract:

Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

Procedia PDF Downloads 374

Authors: Pei-Shan Liang

Abstract:

Objective: This article explores the nursing experience of caring for a patient with terminal gastric cancer complicated by an abdominal aortic aneurysm. The patient experienced physical discomfort due to the disease, initially unable to accept the situation, leading to anxiety, and eventually accepting the need for surgery. Methods: The nursing period was from June 6 to June 10, 2024. Through observation, direct care, conversations, and physical assessments, and using Gordon's eleven functional health patterns for a one-on-one holistic assessment, interdisciplinary team meetings were held with the critical care team and family. Three nursing health issues were identified: pain related to the disease and invasive procedures, anxiety related to uncertainty about disease recovery, and decreased cardiac tissue perfusion related to hemodynamic instability. Results: Open communication techniques and empathetic care were employed to establish a trusting nurse-patient relationship, and patient-centered nursing interventions were developed. Pain was assessed using a 10-point pain scale, and pain medications were adjusted by a pharmacist. Initially, Fentanyl 500mcg with pump run at 1ml/hr was administered, later changed to Ultracet 37.5mg/325mg, 1 tablet every 6 hours orally, reducing the pain score to 3. Lavender aromatherapy and listening to crystal music were used as distractions to alleviate pain, allowing the patient to sleep uninterrupted for at least 7 hours. The patient was encouraged to express feelings and fears through LINE messages or drawings, and a psychologist was invited to provide support. Family members were present at least twice a day for over an hour each time, reducing psychological distress and uncertainty about the prognosis. According to the Beck Anxiety Inventory, the anxiety score dropped from 17 (moderate anxiety) to 6 (no anxiety). Focused nursing care was implemented with close monitoring of vital signs maintaining systolic blood pressure between 112-118 mmHg to ensure adequate myocardial perfusion. The patient was encouraged to get out of bed for postoperative rehabilitation and to strengthen cardiopulmonary function. A chest X-ray showed no abnormalities, and breathing was smooth with Triflow use, maintaining at least 5 seconds with 2 balls four times a day, and SpO2 >96%. Conclusion: The care process highlighted the importance of addressing psychological care in addition to maintaining life when the patient’s condition changes. The presence of family often provided the greatest source of comfort for the patient, helping to reduce anxiety and pain. Nurses must play multiple roles, including advocate, coordinator, educator, and consultant, using various communication techniques and fostering hope by listening to and accepting the patient’s emotional responses. It is hoped that this report will provide a reference for clinical nursing staff and contribute to improving the quality of care.

Keywords: intensive care, gastric cancer, aortic aneurysm, quality of care

Procedia PDF Downloads 24

Authors: Nasra Idilbi, Jalal Tarabeia, Layalleh Masalha, Heiam Shoufani Kassis, Gizell Green

Abstract:

Background: Healthcare professionals working in underground facilities face unique challenges affecting their physical and mental health and team effectiveness. We aimed to examine how an underground work environment affects the physical and mental health and effectiveness of a multi-professional medical team in a medical center under continuous war threats and the contribution of various demographic and professional characteristics. Methods: A cross-sectional survey was disseminated electronically. The questionnaire assessed team effectiveness, the quality of the work, and the health symptoms reported by the team while working in the underground complex. Results: In total, 270 healthcare workers (mean age 40 years, 75.6% females, 88.4% nurses) completed the questionnaire. Women reported statistically significantly higher mean scores of physical strain, fatigue, and eye irritation associated with the work environment compared to men. Multiple regression analysis revealed that psychological distress, noise, and lighting in the underground compound significantly influenced team effectiveness. The qualitative analysis revealed two key themes: the mental health impact of working in an underground environment and the effects of noise and lighting on staff performance. Nurses reported feelings of suffocation, claustrophobia, and difficulty concentrating due to the enclosed space, with some expressing heightened stress levels that impaired their ability to work effectively and safely. Female staff reported more pronounced symptoms of physical strain, fatigue, and eye irritation. Additionally, the underground complex’s poor noise absorption created a highly disruptive work environment, while inadequate lighting hindered accurate patient assessments, leading to potential errors. These challenges were exacerbated by physical symptoms like headaches and nausea, which further impacted job performance. The findings underscore the significant role of environmental factors in influencing both mental health and operational effectiveness, aligning with quantitative data on the predictors of team performance. Conclusions: The underground work environment is crucial in influencing healthcare team effectiveness, with psychological distress, noise, and lighting as key factors. The study highlights the importance of creating a comfortable work environment to foster team efficiency. The findings provide valuable insights for managers in underground healthcare facilities to optimize team performance and well-being.

Keywords: team effectiveness, underground settings, healthcare, environmental factors, a mixed-methods study

Procedia PDF Downloads 1

Authors: C. Puangsawat, C. Limotai, P. Srikhachin

Abstract:

Bio-psycho-social caring was required for promoting the quality of life of the patients with epilepsy (PWE), despite controlled seizures. Multifaceted issues emerge at the epilepsy clinic. Unpredicted seizures, antiepileptic drug compliance problems/adverse effects, psychiatric, and social problems are all needed to be explored and managed. The Nursing Service System (NSS) at the tertiary epilepsy clinic (TEC) was consequently developed for improving the clinical care for PWE. Case manager concept was integrated as the framework guiding the processes and strategies used for developing the NSS as well as the roles of the multidisciplinary team at the clinic. This study aimed to report the outcomes of the developed NSS integrated case manager concept. The processes of our developed NSS program included 1) screening for patient’s problems using questionnaire prior to seeing epileptologists i.e., assessing the patient’s risk to develop acute seizures at the clinic, issues related to medication use, and uncovered psychiatric and social problems; and 2) assigning the patients at risk to be evaluated and managed by appropriate team. Nurses specializing in epilepsy in coordination with the multidisciplinary team implemented the NSS to promote coordinated work among the team which consists of epileptologists, nurses, pharmacists, psychologists, and social workers. Determination of the role of each person and their responsibilities along with joint care plan were clearly established. One year after implementation, the rate of acute seizure occurrence at the clinic was decreased, and satisfactory feedback from the patients was received. In order to achieve an optimal goal to promote self-management behaviors in PWE, continuing the NSS and systematic assessment of its effectiveness is required.

Keywords: case manager concept, nursing service system, patients with epilepsy, quality of life

Procedia PDF Downloads 124

Authors: Jevonte Abioye, Dylan Savary

Abstract:

The aim of this research is to present a disaggregated geostatistical analysis of the subnational provincial trends of child mortality variation in Zimbabwe from a child health policy perspective. Soon after gaining independence in 1980, the government embarked on efforts towards promoting equitable health care, namely through the provision of primary health care. Government intervention programmes brought hope and promise, but achieving equity in primary health care coverage was hindered by previous existing disparities in maternal health care disproportionately concentrated in urban settings to the detriment of rural communities. The article highlights policies and programs adopted by the government during the millennium development goals period between 1990-2015 as a response to the inequities that characterised the country’s maternal health care. A longitudinal comparative method for a spatial variation on child mortality rates across provinces is developed based on geostatistical analysis. Cross-sectional and time-series data was extracted from the World Health Organisation (WHO) global health observatory data repository, demographic health survey reports, and previous academic and technical publications. Results suggest that although health care policy was uniform across provinces, not all provinces received the same antenatal and perinatal services. Accordingly, provincial rates of child mortality growth between 1994 and 2015 varied significantly. Evidence on the trends of child mortality rates and maternal health policies in Zimbabwe can be valuable for public child health policy planning and public service delivery design both in Zimbabwe and across developing countries pursuing the sustainable development agenda.

Keywords: antenatal care, perinatal care, infant mortality rate, neonatal mortality rate, under-five mortality rate, millennium development goals, sustainable development agenda

Procedia PDF Downloads 203

Authors: Yeshanew Ayele Tiruneh, L. M. Modiba, S. M. Zuma

Abstract:

Introduction- Healthcare waste is any waste generated by health care facilities, considered potentially hazardous to health. Solid health care waste is categorised into infectious and non-infectious wastes. Infectious waste is material suspected to contain pathogens. The non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances. The purpose is to assess solid health care waste (SHCW) management practice toward developing guidelines. The setting is all health facilities found in Hossaena town. A mixed-method study design used. For the qualitative part, small purposeful samples were considered and large samples for the quantitative phase. Both samples were taken from the same population. Result - 17(3.1%) of health facility workers have hand washing facilities. 392 (72.6%) of the participants agree on the availability of one or more of personal protective equipment (PPE) in the facility ‘’the reason for the absence of some of the PPEs like boots, goggles, and shortage of disposable gloves are owing to cost inflation from time to time and sometimes absent from the market’’. The observational finding shows that colour coded waste bins are available at 23 (9.6%) of the rooms. Majority of the sharp container used in the health facility are reusable in the contrary to the health care waste management standards and most of them are plastic buckets and easily cleanable. All of the health facility infectious waste are collected transported and deposed daily. Regarding the preventive vaccination nearly half of the the fahealth facility workers wer vaccinated for Hep B virus. Conclusion- Hand washing facilities, personal protective equipment’s and preventive vaccinations are not easily available for health workers. Solid waste segregation practices are poor and these practices showed that SWMP is below the acceptable level.

Keywords: health care waste, waste management, disposal, private health facilities

Procedia PDF Downloads 73

Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

Abstract:

Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

Procedia PDF Downloads 300

Authors: Alex Hughes

Abstract:

Patients with advanced heart failure develop specific palliative care needs due to the progressive symptom burden and unpredictable disease trajectory. NICE guidance advises that palliative care should be provided to patients with both cancer and non-cancer conditions as and when required. However, there is some way to go before this guidance is consistently and effectively implemented nationwide in conditions such as heart failure. The Ambitions for Palliative and End of Life Care: A national framework for local action in England provides a set of foundations and ambitions which outline a vision for what high-quality palliative and end-of-life care look like in England. This poster aims to critically consider how to improve access to palliative care for heart failure patients in England by analysing the foundations taken from this framework to generate specific recommendations using Soft Systems Methodology (SSM). The eight foundations analysed are: ‘Personalised care planning’, ‘Shared records’, ‘Evidence and information’, ‘Involving, supporting and caring for those important to the dying Person’, ‘Education and training’, ‘24/7 access’, ‘Co-design’ and ‘Leadership.’ A number of specific recommendations have been generated which highlight a need to close the evidence-policy gap and implement policy with sufficient evidence. These recommendations, alongside the creation of an evidence-based national strategy for palliative care and heart failure, should improve access to palliative care for heart failure patients in England. Once implemented, it will be necessary to evaluate the effect of these proposals to understand if access to palliative care for heart failure patients actually improves.

Keywords: access, health systems, heart failure, palliative care

Procedia PDF Downloads 128

Authors: Leoba Nyathi, Augustine K. Tugli, Takalani G. Tshitangano

Abstract:

Use of health care services is an effective way of improving maternal and child health outcomes, especially in the rural areas. The study aimed to find out the perceptions of women on factors that affect the utilisation of antenatal care services (ANC) in Mangwe Rural District, Zimbabwe. The study was conducted in Mabunga village which is situated in Mangwe Rural District, Matabeleland South Province, Zimbabwe. A qualitative approach using explorative and descriptive design was adopted for the study. A sample of ten women were chosen from the target population by means of convenience sampling and data was collected through semi-structured interviews. Interviews and discussions were audio-taped, transcribed and coded into themes and subthemes. The study results showed that access factors, socio-cultural factors, demographic factors, quality of care and knowledge about antenatal care services were the major factors affecting utilisation of ANC services in Mangwe Rural District. It was discovered that the geographical location of the village to the health care centres has a great impact on utilisation of services. All the women did not initiate ANC services as recommended and they also did not adhere to the number of times they were supposed to visit the health care centres. The findings concluded that women have the knowledge about ANC and they all attended at least once during their last pregnancy. However, inconsistencies in attendance were shown due to access, socio-cultural and demographic factors.

Keywords: antenatal care services, women, utilisation, affect, factors, perceptions

Procedia PDF Downloads 378

Authors: Hsiu-Chuan Hsueh, Kuei-Feng Shen Jr., Chia-Ling Chao, Hui-Chuan Pan

Abstract:

This article described a 75 years old woman who has suffered from intestinal perforation and accepted surgery with temporary enterostomy, the operation makes her depressed, refused relatives and friend's care, facing low willingness to participate in various activities due to fear of changing body appearance caused by surgery and leave enterostomy. The author collected information through observation talks, physical evaluation, and medical records during the period of care from November 14 to November 30, 2016, we used the four aspects of physiology, psychology, society and spirituality as a whole sexual assessment to establish the nursing problems of patient, included of acute pain, disturbance of body image,coping ineffective individual. For patient care issues, to encouraged case to express their inner feelings and take part in self-care programs through providing good therapeutic interpersonal relationships with their families. However, it provided clear information about the disease and follow-up treatment plan, give compliments in a timely manner, enhanced self-confidence of individual cases and their motivation to participate in self-care of stoma, further face the disease in a positive manner. At the same time, cross-section team care model and individual care measures were developed to enhance the care skills after returning home and at the same time assist the individual in facing the psychological impact caused by stoma. Hope to provide this experience, as a reference for the future care of the disease.

Keywords: enterostomy, intestinal perforation, nursing experience, ostomy

Procedia PDF Downloads 139

Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

Abstract:

West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: elder care settings, family caregiver, home care, geriatric hospital care, long term care facility

Procedia PDF Downloads 287

Authors: Vera Lúcia Raposo

Abstract:

The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

Procedia PDF Downloads 385

Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

Abstract:

Background: Health care providers have been identified as an at-risk group for obesity. Mobile health technology can be used to motivate lifestyle behavioral changes. The aim of this study was to investigate hospital-based health care providers’ perceptions of mHealth Workplace Nutrition Wellness Program. Methods: This qualitative study was conducted at a regional hospital in Hong Kong. Ten health care providers were purposively selected for the study. Qualitative data was collected by individual face-to-face semi-structured interviews which were audio-taped, transcribed verbatim and analyzed by thematic analysis. Results: Four themes were identified: (1) mobile health technology motivates lifestyle changes, (2) self-perceived body weight initiates health behavioral changes, (3) organizational support promotes healthy behavior, (4) lack of self-confidence hinders lifestyle modification. The health care providers’ perceptions of mobile health technology, barriers, and facilitators to participation in the mHealth Workplace Nutrition Wellness Program were discussed in the study. Conclusions: Barriers, facilitators, self-perceived body weight and experiences of mobile health technology were associated with intention of participation in mHealth Workplace Nutrition Wellness Program. The knowledge generated from the study could be used to guide the design and implementation of effective interventions, strategies and policies of workplace wellness programs to promote participation for hospital’s employees.

Keywords: workplace wellness program, mobile health, barriers, facilitators, qualitative

Procedia PDF Downloads 259

Authors: Saradiya Mukherjee

Abstract:

Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

Procedia PDF Downloads 336

Authors: Giuliana Murfet, Heidi Behrens

Abstract:

Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

Procedia PDF Downloads 228

Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

Abstract:

Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

Procedia PDF Downloads 213

Authors: Carmen Silvia Gabriel, Dsniele Bernardi da Costa, Andrea Bernardes, Sabrina Elias Mikael, Daniele da Silva Ramos

Abstract:

The goal of this quantitative study is to investigate patient safety culture from the perspective of professional from the hospital nursing team.It was conducted in two Brazilian hospitals,.The sample included 282 nurses Data collection occurred in 2013, through the questionnaire Hospital Survey on Patient Safety Culture.Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor overlooks patient safety problems.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.On hospital management support for patient safety, 52.8% refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.On frequency of event reporting, 64.7% said often and always notify events with no damages to patients..About teamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8 % disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6 % classified it as very good. it is concluded that there are positive points in the safety culture, and some weaknesses as a punitive culture and impaired patient safety due to work overload .

Keywords: quality of health care, health services evaluation, safety culture, patient safety, nursing team

Procedia PDF Downloads 299

Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

Abstract:

Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

Procedia PDF Downloads 112

Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

Abstract:

Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: disposal, healthcare waste, management, Montserrado County, Monrovia

Procedia PDF Downloads 345

Authors: Beatrice Adeoye

Abstract:

Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

Procedia PDF Downloads 385

Authors: Narges Solaymani

Abstract:

Definition of Nurse: Nurse: A person who is educated and skilled in the field of scientific principles and professional skills of health care, treatment, and medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.

Keywords: nurse, intensive care, CPR, bandage

Procedia PDF Downloads 68

Authors: Theodorus Holtzhausen

Abstract:

With a growing number of professionals in healthcare moving freely between countries and also in general a more mobile global workforce, awareness of cultural differences have become more urgent for health care workers to apply proper care. There is a slowly emerging trend in health care due to globalisation that may create a more uniform cultural base for administering healthcare, but it is still very vulnerable to being hijacked and misdirected by major commercial interests. Veterinary clinics and medical clinics promoting alternative remedies lacking evidence based support and simultaneously practicing medicine as a science have become more common. Such ‘holistic’ clinics see these remedies more as a belief system causing no harm with minimal impact but with added financial benefit to the facility. With the inarguable acceptance and realisation of the interconnection between evolutionary aspects of cognition, knowledge and culture as a global but vulnerable cognition-gaining process affecting us all, we can see the enormous responsibility we carry. Such a responsibility for creating global well-being calling for an universally applicable ethic. Such an ethic with the potential of having significant impact on our cognition gaining process.

Keywords: veterinary health care, ethics, wellbeing, veterinary clinics

Procedia PDF Downloads 641

Authors: Vichai Tienthavorn

Abstract:

Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.

Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care

Procedia PDF Downloads 250

Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria

Abstract:

In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.

Keywords: e-health for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device

Procedia PDF Downloads 193

Authors: Mirzaii Khadigeh

Abstract:

Background and objectives: Sexual health education is an important part of health promotion services. The major role of sex education is on mothers’ shoulders. So, they have to be equipped with enough knowledge, attitude and self-efficacy for teens’ education. The present study aimed to determine the effect of team-learning and multimedia software on mothers’ knowledge, attitudes and self-efficacy in sexual health education to 12-14-year-old sons in Mashhad in 1395. Materials and methods: In this research, two experimental and one control group were employed using random sampling, which was done on 132 mothers of high school pupils. They were randomly assigned into experimental and control groups. The data were collected using demographic information and a researcher-constructed questionnaire to investigate the mothers’ knowledge, attitude, and self-efficacy and DASS21(The Depression, Anxiety and Stress Scale). They were run after confirming their reliability and validity. Intervention for the multimedia group was in the form of four CDs- each for 45 minutes- that were given to the mothers each week. At the end of the fourth week, a question-and-answer session was administered for 60 minutes. The team-learning group received intervention once a week (totally four weeks). Two weeks later, the data were collected and analyzed via Chi-square, Fisher, Kruskal-Wallis and ANOVA. Findings: Knowledge, attitude and self-efficacy of mothers in sexual health before the intervention did not have any significant differences (p >0.05). At the end of the study, the difference between the scores of the knowledge, attitude and self-efficacy in the three groups was meaningfully different (p < 0/001), but the difference between the two groups of multimedia and team-learning was not significant (p> 0.05 ). Discussion and conclusion: The result reported the efficacy of both team-leaning and multimedia software, which implies that the multimedia software training method was as effective as team-learning training one on the knowledge, attitude and self-efficacy of mothers. But, the multimedia training method is highly advised due to its availability, flexibility, and interest.

Keywords: training one on the knowledge, attitude, self-efficacy of mothers, boys

Procedia PDF Downloads 176

Authors: K. Malak, A. Nourah, S.Liyakathunisa

Abstract:

Nowadays, healthcare services are facing many challenges since they are becoming more complex and more needed. Every detail of a patient’s interactions with health care providers is maintained in Electronic Health Records (ECR) and Healthcare information systems (HIS). However, most of the existing systems are often focused on documenting what happens in manual health care process, rather than providing the highest quality patient care. Healthcare business processes and stakeholders can no longer rely on manual processes, to provide better patient care and efficient utilization of resources, Healthcare processes must be automated wherever it is possible. In this research, a detail survey and analysis is performed on the existing health care systems in Saudi Arabia, and an automated smart medical healthcare business process model is proposed. The business process management methods and rules are followed in discovering, collecting information, analysis, redesign, implementation and performance improvement analysis in terms of time and cost. From the simulation results, it is evident that our proposed smart medical records system can improve the quality of the service by reducing the time and cost and increasing efficiency

Keywords: business process management, electronic health records, efficiency, cost, time

Procedia PDF Downloads 341

Authors: Reem Al-Garni

Abstract:

Malnutrition is a global epidemic, but the under-weight or Failure-To-Thrive risk is increasing in rehabilitation setting and considered one of the contribution factor for developmental delay. Beside the consequences of malnutrition on children growth and development, there are other side-effects that might delay or hold the progress of rehabilitation. The awareness for malnutrition must be raised and discussed by the rehabilitation team, to promote the treatment and to optimize the client care. The solution can start from food supplements intake and / or Enteral Nutrition plan, depending on the malnutrition level and to reach the goal, the medical team should to work together in order to provide comprehensive treatment and to help the family to be able to manage their child condition. We have explore the outcomes of rehabilitation between the children with CP whose diagnosed with malnutrition and children with normal body Wight Over a period of 4 months who received 4-6 weeks of rehabilitation two hours daily by using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings reported that children with normal body Wight has better outcomes and improvement comparing with children with malnutrition for the entire study sample.

Keywords: Cerebral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, malnutrition

Procedia PDF Downloads 318