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Search Results: 1 - 10 of 36477 matches for " care quality "
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Quality of Antenatal Care: Comparison between Secondary and Tertiary Health Facilities in Ibadan, Nigeria  [PDF]
Oluwasomidoyin Olukemi Bello
Open Journal of Obstetrics and Gynecology (OJOG) , 2018, DOI: 10.4236/ojog.2018.86063
Abstract: Background: Patient satisfaction is related to the quality of services received and the extent to which specific needs are met. Satisfied patients are likely to come back for the health services and recommend it to others. Objective: To assess and compare patients’ satisfaction with the quality of prenatal/antenatal care (QPC) services received at a tertiary and secondary health facility in Ibadan, Nigeria. Methods: A comparative cross sectional study used an interviewer administered questionnaire to assess and compare the quality of antenatal care among women who had antenatal care and delivered live baby in two government health facilities—Adeoyo Maternity Hospital (secondary health facility) and University College Hospital (tertiary health facility). A total of 500 women were interviewed within 48 hours post delivery and data obtained was analyzed with SPSS version 20. Results: The mean age was 29.7 (SD = 4.95) years. About half of the respondents had more than four antenatal visits, almost two-thirds (61.4%) were primipara, and 55.6% delivered per vagina. Almost all (98.4%) the women were very satisfied with the QPC received while a little above half (54.0%) received high QPC. Health facility and mode of delivery were found to be significantly associated with the satisfaction of the QPC. Factors predicting high QPC comparing the tertiary and secondary health facility are “availability” (OR = 0.341, 95%CI = 0.173 - 0.672) and “support and respect” (OR = 5.599, 95%CI = 3.621 - 8.659) of health care
Becoming a culturally competent nurse  [PDF]
Valarie F. Thomas
Open Journal of Nursing (OJN) , 2013, DOI: 10.4236/ojn.2013.38A009
Abstract:

Cultural competence in nursing provides an ideal avenue to meet the various needs of our patients while providing them with safe, competent care. “Racial and ethnic differences in family expectations or preferences for care are not yet well identified and cataloged, but they may uniquely affect individual ratings or experience with care” [1]. The purpose of this article is to enlighten nurses as health care providers about cultural care in an effort to provide that safe, competent care. Many times patients present for care at hospitals and clinics with language barriers and preconceived ideas based on their own cultural beliefs and practices. It is ideal when we, as nurses have the ability to meet those needs in an effort to meet patient’s expectations and healthcare needs. In order to meet the diverse needs of our growing multi-cultural population, it is becoming apparent that we must not only provide care based on the physical needs, but the entire person’s needs relevant to their cultural beliefs regarding healthcare practices and the healing process.

Improving Hospital Utilization and Outcomes: Health Economics at the Community Level  [PDF]
Ronald Lagoe, Shelly Littau
Health (Health) , 2014, DOI: 10.4236/health.2014.69107
Abstract: This study reviewed efforts to improve health care efficiency at the community level from the perspective of the financial impact on provider organizations. It focused on utilization and outcomes programs that address this objective in the metropolitan area of Syracuse, New York and their implications for health economics. The study demonstrated that a range of length of stay initiatives, including programs addressing length of stay reduction between hospitals and nursing homes produced a savings of $12,448,300 - $31,232,900 over a fifteen-year period. These efforts involved community wide costs of $3,128,125 - $4,144,025. The study also demonstrated that efforts to reduce inpatient hospital complications produced a savings of between $1,622,400 - $3,623,400 over a four-year period. These efforts involved community wide costs of $739,200. The study suggested that these savings were enhanced through community wide initiatives that enabled hospitals to save expenses associated with data development and program implementation.
Psychometric properties of the interRAI subjective quality of life Instrument for mental health  [PDF]
Tess E. Naus, John P. Hirdes
Health (Health) , 2013, DOI: 10.4236/health.2013.53A084
Abstract:
A new Subjective Quality of Life (SQoL) Instrument for inpatient and community mental health settings was developed by the interRAI research collaborative to support evaluation of quality in mental health settings from the person’s perspective. Ratings of SQoL provide important information about the quality of service and patient experience with the care they receive. This information can help staff to improve approaches to each person’s plan of care in a manner that is meaningful to the individual. This study examined the reliability of the SQoL-MH. 83 inpatients from several clinical departments in a mental health center in South Western Ontario, Canada were randomly assigned to either be interviewed or complete the assessment on his or her own. Reliability was tested using Cronbach’s Alpha. A preliminary factor analysis points to four SQoL-MH subscales with very good internal consistency, ranging from 0.83 to 0.90. Once finalized, the Subjective Quality of Life instrument will be integral to the interRAI suite of instruments used to assess persons with mental health needs. A reliable and valid SQoL-MH instrument will allow mental health service providers to shape or modify care environments in order to enhance quality of life. In addition, the SQoL-MH instrument could also benefit advocacy groups who use reports on quality of life to influence social policy development and funding decisions.
Association between Caregiver Quality of Life and the Care Provided to Persons with Alzheimer’s Disease: Systematic Review  [PDF]
Afeez Abiola Hazzan, Harry Shannon, Jenny Ploeg, Parminder Raina, Mark Oremus
Advances in Alzheimer's Disease (AAD) , 2014, DOI: 10.4236/aad.2014.31006
Abstract: We reviewed the literature to examine whether an association exists between the quality of life (QoL) of primary informal Alzheimer's disease (AD) caregivers and the level and quality of care that these caregivers provide to their loved ones with AD. We obtained studies focusing on the care that these caregivers provide for their family members with AD. Our outcome of interest was level or quality of care and the independent variable was caregiver QoL. We extracted data in tabular form and used a narrative synthesis approach to describe our findings. Only one relevant study was included in the review. Overall, the evidence was equivocal regarding the associations between caregiver QoL and the level/quality of care in AD.
Hospital inpatient complications and severity of illness  [PDF]
Ronald Lagoe, Anne Marie Czyz, Joseph Bick, Shelly Littau
Open Journal of Nursing (OJN) , 2013, DOI: 10.4236/ojn.2013.38A002
Abstract:

This study evaluated the severity of illness of patients experiencing inpatient hospital complications in two hospitals in the metropolitan area of Syracuse, New York. It involved identification of inpatient complications by All Patients Refined (APR) severity of illness for pneumonia, clostridium difficile colitis, and urinary tract infection. Severity of illness was identified for each patient at the time of admission. The study showed that patients at the two highest levels of severity of illness, Major and Extreme, accounted for 76-93 percent of those with the three complications evaluated. These patients comprised less than 40 percent of the inpatient populations of the hospitals. At the same time, the study showed that only 0-23 percent of patients at Minor or Moderate severity of illness experienced inpatient complications. These low severity of illness categories accounted for 60 percent or more of inpatients in the Syracuse hospitals. Results of the study suggested that efforts to reduce hospital inpatient complications could focus on those patients with high severity of illness. They also suggested that these efforts could largely avoid patients with low severity of illness and, as a result, save clinical and quality assurance resources in hospitals.

Current Attitudes of Anesthesiologists towards Medically Futile Care  [PDF]
Angela Saettele,Joseph Kras
Open Journal of Anesthesiology (OJAnes) , 2013, DOI: 10.4236/ojanes.2013.34048
Abstract: Purpose: To explore anesthesiologists’ perceptions of the reasons underlying why physicians continue to provide care that they consider futile. Methods: A qualitative study was conducted utilizing a grounded theory approach. Four separate focus groups (2 resident physician groups and 2 attending physician groups) were conducted over a three week span. An interview guide was used consisting of a proposed definition of futility and five open-ended questions. Responses to the five open-ended questions were used to guide follow up questions. Transcribed audio recordings were then analyzed. Results: With data reduction, we were able to separate responses into definitions of futility, stories of cases where futile care was provided, and opinions as to the underlying causes of continuing to provide futile care. A variety of opinions was obtained, suggesting the possibility that different groups (surgeons, anesthesiologists, family members) view questions of futility differently. Conclusions: Complete agreement on a definition of futility does not exist. Even when some agreement exists, there is great difficulty in predicting outcomes in individual cases. Future quantitative studies may provide more evidence of trends in underlying reasons for providing futile care. Focused education efforts may then lead to more agreement between all involved.
Current Attitudes of Anesthesiologists towards Medically Futile Care  [PDF]
Angela Saettele, Joseph Kras
Open Journal of Anesthesiology (OJAnes) , 2013, DOI: 10.4236/ojanes.2013.34048
Abstract:

Purpose: To explore anesthesiologists’ perceptions of the reasons underlying why physicians continue to provide care that they consider futile. Methods: A qualitative study was conducted utilizing a grounded theory approach. Four separate focus groups (2 resident physician groups and 2 attending physician groups) were conducted over a three week span. An interview guide was used consisting of a proposed definition of futility and five open-ended questions. Responses to the five open-ended questions were used to guide follow up questions. Transcribed audio recordings were then analyzed. Results: With data reduction, we were able to separate responses into definitions of futility, stories of cases where futile care was provided, and opinions as to the underlying causes of continuing to provide futile care. A variety of opinions was obtained, suggesting the possibility that different groups (surgeons, anesthesiologists, family members) view questions of futility differently. Conclusions: Complete agreement on a definition of futility does not exist. Even when some agreement exists, there is great difficulty in predicting outcomes in individual cases. Future quantitative studies may provide more evidence of trends in underlying reasons for providing futile care. Focused education efforts may then lead to more agreement between all

Post Mid-Staffordshire Inquiries Reaction, in and about the National Health Service (NHS), England. The Missing Pieces: Organizational, Care and Virtue Ethics Perspectives  [PDF]
Albert Coleman
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.516131
Abstract:

The release of the Mid Staffordshire hospital report otherwise called the Francis report once again ignited the debate about the issue of abuse of especially vulnerable patients, while navigating the care pathway as inpatients in hospitals; within the National health service (NHS), England. Once more the official reaction from the NHS directorate is more “standards” to monitor failed standards in patient care. Of interest in the official responses so far, are the unheard voices addressing the issue of healthcare and organizational ethics concerns that need revisiting. This article seeks to revisit practice, systems and care issues leading to incidents of the type of the Staffordshire abuses, and the important but yet unheralded place of organizational and care ethics in helping to curb such abuses from re-occurring.

Incongruence between the Preferred Mode of Delivery and Risk of Childbirth Complications among Antepartum Women in Mulago Hospital, Uganda  [PDF]
Dan Kabonge Kaye, Annettee Nakimuli, Othman Kakaire, Michael Odongo Osinde, Nelson Kakande, Scovia Nalugo Mbalinda
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.414125
Abstract: Objective: Women’s preferences for the mode of delivery provide clues on their knowledge and perceptions of anticipated risk of childbirth complications. The objective was toinvestigate incongruence between preferred mode of delivery and risk of adverse pregnancy outcomes. Methods: Through a cross-sectional study, data were collected from 327 women admitted to Mulago hospital. Data included socio-demographic characteristics, past medical, gynaecological and obstetric history, pregnancy complications, knowledge of pregnancy complications and preferred mode of delivery. The preferred mode of delivery and knowledge of related risks for adverse pregnancy outcomes were compared. Results: The mean age of participants was 24.7 years (±5.9), ranging 14 - 43 years, of whom 41.4% were nulliparous. The preferred mode of delivery was vaginal (84.1%). Incongruence (preference for a mode of delivery that did not correspond to expected or anticipated risks) occurred in 88 (26.9%) of the women, and was associated with having secondary school or higher level of education (OR 2.49, CI 1.52 - 4.08) and history of previous vaginal delivery (OR 3.82, CI 1.94 - 7.49). Conclusion: One in four women had incongruence between preferred mode of delivery and risks of adverse pregnancy outcomes, which called for urgent interventions to improve decision-making about intrapartum care.
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