scholarly journals Fenomenologi : Caring Perawat Terhadap Klien Dengan Kondisi Kritis Di Instalasi Gawat Darurat – Rumah Sakit Dr. Saiful Anwar Malang

2017 ◽  
Vol 2 (1) ◽  
pp. 17
Author(s):  
Janes Jainurakhma ◽  
Indah Winarni ◽  
Setyoadi Setyoadi
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Critical Condition ◽  
Care Providers ◽  
Emergency Nurses ◽  
Nursing Experience ◽  
Nursing Services ◽  
Nurse Caring ◽  
Critical Patients

Caring is an important part of nursing process that difficult to be apart. Emergency nursing is a profession that required health care providers with fast performance, accurate, and quality of complicated and holistic problems. A lot of patients with critical condition at emergency department, they ask a quality of nursing services and it is affected by the quality of a nurse caring. Without caring passion, a nurse vulnerable to act that violate ethical of nursing, no exception nursing profession at emergency installations of RSSA Malang. The purpose of this study is to explore the experience of nurse caring for clients with critical condition at emergency installations of RSSA Malang. This study used a qualitative approach, with interpretive phenomenological method. Purposive sampling is a method used in this study, the criteria of experience as nurse in the emergency installations of RSSA Malang at least 5 years, still working in the emergency installations of RSSA Malang, and willing as participant. Using semi-structure interviews technique, and analyzed by Miles and Huberman model approach. The results led to three themes, namely: the resque of critically ill patients, improve patient and family confidence,  desire to do the best for crical patients. Based on the results of the study are expected to follow up with the theme of the next study of emergency nurses caring of the perpective of patient and families, and needs to be improved further for the training of emergency skill of nurses in the emergency department, so thet skills and knowledge of nurses in handling critical patients better.; Key words: caring, nursing experience, critical patient.

scholarly journals RELATIONSHIP BETWEEN SHARIA-BASED NURSING SERVICES AND PATIENT LOYALITY AT ISLAMIC HOSPITAL

2018 ◽  
Vol 4 (2) ◽  
pp. 109
Author(s):  
Dyah Wiji Puspita Sari ◽  
Muhammad Abdurrouf ◽  
Rismawati Rismawati
Keyword(s):  
Health Services ◽  
Health Care Providers ◽  
Sampling Technique ◽  
Good Health ◽  
P Value ◽  
Care Providers ◽  
Cross Sectional ◽  
Nursing Services ◽  
Patient Loyalty

Introduction: Sharia labeled hospitals have more responsibility in providing health services to patients. This challenge requires health care providers to compete by improving the quality of services so that patient loyalty is formed. The purpose of this study was to identify the relationship between sharia-based nursing services and patient loyalty in Semarang Hospital. Methodology: This research is a quantitative type with a cross sectional approach. Data collection using a questionnaire with the number of respondents 105 patients with total sampling technique. Results: the characteristics of respondents mostly consisted of age 36-45 (24.8%), last education elementary school 69 people (65.7%), length of stay that is 4 days a number of 35 people (33.3%), there is a relationship between services sharia-based nursing with patient loyalty at RSISA Semarang with pvalue 0.002 (p-value <0.05) with an R value (0.305). Discussion: This study can be used as a reference in improving good health services by implementing services in accordance with sharia principles so that patient loyalty is achieved.

scholarly journals Referrals to a Pediatric Emergency Department of a Tertiary Care Teaching Hospital Before and After Introduction of a Referral Education Module - a Quality Improvement Study

2020 ◽  
Author(s):  
Gopalakrishnan Ezhumalai ◽  
Muralidharan Jayashree ◽  
Karthi Nallasamy ◽  
Arun Bansal ◽  
Bhavneet Bharti
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Critically Ill Children ◽  
Referral Letter ◽  
Care Providers ◽  
Post Intervention ◽  
Intervention Phase ◽  
Before And After ◽  
Referral Letters

Abstract Background: Provision of timely care to critically ill children is essential for good outcome. Referral from smaller peripheral hospitals to higher centers for intensive care is common. However, lack of an organized referral and feedback system compromises optimal care. We studied the quality of referral letters coming to our Emergency Department (ED) with respect to their demography, association with severity of illness and mortality before and after referral education. Methods: Our study was completed in three phases in the Pediatric ED; Pre-intervention, Intervention and Post intervention phases. Quality of referral letter was matched with a quality checklist proforma and graded as ‘good’, ‘fair’ and ‘poor’ if it scored >7, 5 –7 and < 5 points respectively. A peer reviewed referral education module was prepared using case studies, expert opinions, and lacunae observed in the first phase and administered to health care providers (HCP’s) of referring hospitals. Quality of referral letter was compared between pre and post intervention phases. Results: Most referrals belonged to the neighboring states of Punjab (48.2%) and Haryana (22.4%). Major referring hospitals were from public sector (80.9%), of which the teaching hospitals topped the list (53.6%). Government run ambulance services (85.5%) was commonest mode of transport used and need for a PICU bed and/or mechanical ventilation (50.4%) was the commonest reason for referral. The post intervention phase saw a significant decline in the proportion of poor (93.2 vs.78.2%; p=0.001) and a significant increase in the proportion of fair (6.1 vs 18%; p=0.001) and good referral letters (0.7 vs 18%; p=0.001). The proportion of children with physiological decompensation at triage had reduced significantly in the post intervention phase [513 out of 1403 (36.5%) vs. 310 out of 957 (32.3%); p= 0.001]. Conclusion: Referral education had significantly improved the quality of referral letters. Proportion of children with physiological decompensation at triage had decreased significantly after referral module. This change suggests sensitization of the peripheral hospitals towards a better referral process. Continued multifaceted approach will be required for sustained and increased benefits

scholarly journals Referrals to a Pediatric Emergency Department of a Tertiary Care Teaching Hospital Before and After Introduction of a Referral Education Module - A Quality Improvement Study

2020 ◽  
Author(s):  
Gopalakrishnan Ezhumalai ◽  
Muralidharan Jayashree ◽  
Karthi Nallasamy ◽  
Arun Bansal ◽  
Bhavneet Bharti
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Critically Ill Children ◽  
Referral Letter ◽  
Care Providers ◽  
Post Intervention ◽  
Intervention Phase ◽  
Before And After ◽  
Referral Letters

Abstract Background: Provision of timely care to critically ill children is essential for good outcome. Referral from smaller peripheral hospitals to higher centers for intensive care is common. However, lack of an organized referral and feedback system compromises optimal care. We studied the quality of referral letters coming to our Emergency Department (ED) with respect to their demography, association with severity of illness and mortality before and after referral education. Methods: Our study was completed in three phases in the Pediatric ED; Pre-intervention, Intervention and Post intervention phases. Quality of referral letter was matched with a quality checklist proforma and graded as ‘good’, ‘fair’ and ‘poor’ if it scored >7, 5 –7 and < 5 points respectively. A peer reviewed referral education module was prepared using case studies, expert opinions, and lacunae observed in the first phase and administered to health care providers (HCP’s) of referring hospitals. Quality of referral letter was compared between pre and post intervention phases.Results: Most referrals belonged to the neighboring states of Punjab (48.2%) and Haryana (22.4%). Major referring hospitals were from public sector (80.9%), of which the teaching hospitals topped the list (53.6%). Government run ambulance services (85.5%) was commonest mode of transport used and need for a PICU bed and/or mechanical ventilation (50.4%) was the commonest reason for referral. The post intervention phase saw a significant decline in the proportion of poor (93.2 vs.78.2%; p=0.001) and a significant increase in the proportion of fair (6.1 vs 18%; p=0.001) and good referral letters (0.7 vs 18%; p=0.001). The proportion of children with physiological decompensation at triage had reduced significantly in the post intervention phase [513 out of 1403 (36.5%) vs. 310 out of 957 (32.3%); p= 0.001]. Conclusion: Referral education had significantly improved the quality of referral letters. Proportion of children with physiological decompensation at triage had decreased significantly after referral module. This change suggests sensitization of the peripheral hospitals towards a better referral process. Continued multifaceted approach will be required for sustained and increased benefits.

scholarly journals Nurses Perceptions of Family Presence during Resuscitation in the Emergency Department

2014 ◽  
Author(s):  
Jennifer Jennings
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Heart Association ◽  
Advanced Practice Nursing ◽  
Future Research ◽  
Advanced Practice ◽  
Care Providers ◽  
Emergency Nurses ◽  
Family Presence ◽  
Nurses Perceptions

<p>Family presence during resuscitation has been a controversial and much debated topic for many years. In the past decade, the movement toward family presence has steadily grown. The Emergency Nurses Association (ENA) and the American Heart Association (AHA) have endorsed family presence and incorporated guidelines for its implementation. Although becoming more accepted in practice, there are still many hospitals without family presence policies, and some nurses and other health care providers continue to identify concerns about its’ use. The purpose of this project was to survey nurses’ perceptions of family presence during resuscitation in the Emergency Department. A researcher developed a survey which was left in the study site’s Emergency Department break room for a period of two weeks. The target samples were Registered Nurses (RNs) employed in the ED. Thirteen out of 59 RNs completed the survey. More than half of the respondents believed in general that family should be present, that family presence encouraged increased professional behavior from the RN, and families being present can facilitate closure. Recommendations and implications for advanced practice nursing and the need for future research are discussed.</p>

scholarly journals LO23: Reducing time to disposition for treat & release patients in the emergency department

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S14-S14
Author(s):  
V. Woolner ◽  
S. Ensafi ◽  
J. De Leon ◽  
L. George ◽  
L. Chartier
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Providers ◽  
Initial Assessment ◽  
Teaching Hospitals ◽  
Care Providers ◽  
Patient Disposition ◽  
Forcing Function

Introduction: Treat and Release (T&R) patients are seen and discharged home from the emergency department (ED), and asked to return within 12-72 hours for follow-up care (e.g., ultrasound, repeat blood work). Our two academic teaching hospitals see approximately 2,000 T&R patients per year. Handover of care for T&R patientsdone through charting only and therefore dependent on the charts adequacy and completenessis crucial to the safety and quality of care they receive. An 18-month retrospective chart audit at our sites identified quality gaps, including suboptimal documentation that ultimately impedes patient disposition. Our projects aim was to reduce the time-to-disposition (TTD; time spent by patients between provider initial assessment and discharge from the ED) by a third (from 70min) in 6-months time (March 2017), a target felt to be both meaningful and realistic by our stakeholder team. Methods: Our primary outcome measure was the TTD (in minutes). Our process measure was the quality of documentation, using a modified version of QNOTE, a validated tool used to assess the quality of health-care documentation. PDSA cycles included: 1) Involvement of stakeholders for the creation and refinement of an improved T&R handover tool to cue more specific documentation; 2) Education of health-care providers (HCPs) about T&R patients; 3) Replacement of the previous T&R handover tool with a newly designed and mandatory tool (i.e. a forcing function); 4) Refinement of the process for T&R patients and chart hold-over. Results: Run charts for both the median TTD and median modified QNOTE scores over time demonstrate a shift (i.e., run chart rule) associated with the second and third clustered PDSA cycles. After the first three clusters of PDSA cycles (i.e., before-and-after), mean TTD was reduced by 40% (70min to 42min, p=0.005). The quality of documentation (mean modified QNOTE scores) was also significantly improved (all results p<0.0001): patient assessment from 81% to 92%, plan of care from 58% to 85% and follow-up plan from 67% to 90%. Conclusion: We reduced the time-to-disposition for T&R patients by identifying gaps in the quality of documentation of their chart. Using iterative PDSA cycles, we improved their time-to-disposition through improved communication between health-care providers and a new T&R handover tool working as a forcing function. Other centers could use similar assessment methods and interventions to improve the care of T&R patients.

scholarly journals P102: Perspectives surrounding paediatric procedural sedation using intranasal ketamine administration: a qualitative study of emergency nurses

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S100-S101
Author(s):  
D. Wonnacott ◽  
S. Scott ◽  
R. Flynn ◽  
S. Ali ◽  
N. Poonai
Keyword(s):  
Health Care Providers ◽  
Resistance To Change ◽  
Implementation Strategies ◽  
Structured Interview ◽  
Pediatric Emergency ◽  
Procedural Sedation ◽  
Care Providers ◽  
Emergency Nurses ◽  
Nursing Experience ◽  
Physician Resistance

Introduction: Intranasal ketamine (INK) has an emerging role for procedural sedation (PSA) in children in the emergency department (ED). While INK is less invasive and requires fewer personnel than IV ketamine, widespread adoption in the paediatric ED would require strong nursing acceptance. To inform INK implementation strategies, we explored nursing perspectives surrounding INK, including perceived barriers to its adoption. Methods: Nurses in the paediatric ED of London Health Sciences Centre, London, Ontario were recruited by email. Two, one-hour, in-person focus groups were conducted on January 26 and February 2, 2018 using a semi-structured interview format. Transcription was performed by a professional medical transcription service and analyzed using an inductive qualitative approach involving code words corresponding to recurring topics. Thematic analysis was used to group similar codes into themes. The analytic process was managed using the NVivo 11 software package. Results: Results: Eight nurses participated. All nurses were female and had a mean of 8.9 (range: 2.5 - 26) years of pediatric emergency nursing experience. Seven nurses had experience monitoring and administering INK to children for PSA. Five themes emerged: 1) attributes of INK, 2) INK effects on patients and families, 3) INK effects on health care providers, 4) INK effects on the ED environment, and 5) uncertainty regarding INK's effectiveness, predictability, and fit into institutional sedation protocols. Subthemes included 1) perceptions that INK produced a relatively shallower, slower-onset, and/or less titratable sedation, 2) the importance of patient cooperation (i.e. INK may be preferred by providers for older patients undergoing relatively painful or long procedures), 3) belief that INK was an effective anxiolytic and sedative with the potential to improve nursing resource utilization, and 4) belief that physician resistance to change and lack of personal familiarity were barriers to adoption. Conclusion: Conclusions: We identified clinical advantages to using INK in children, the importance of selecting appropriate patients, and barriers to widespread INK adoption. Importantly, our findings highlighted uncertainty about INK's effectiveness and incorporation into sedation protocols. Our findings will inform future knowledge translation strategies when implementing INK in the clinical setting.

scholarly journals FACTORS INFLUENCING COMPETENCY DEVELOPMENT OF NURSES AS PERCEIVED BY STAKEHOLDERS IN VIETNAM

2020 ◽  
Vol 6 (4) ◽  
pp. 103-110
Author(s):  
Do Thi Ha ◽  
Khanitta Nuntaboot
Keyword(s):  
Health Care ◽  
Nursing Education ◽  
Health Care Providers ◽  
Nursing Profession ◽  
Public Image ◽  
Care Providers ◽  
Competency Development ◽  
Nursing Services ◽  
Quality Of Nursing

Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. Competency development is a continuous process of improving knowledge, attitudes and skills, and is influenced by a numerous of factors.Purposes: This study aims to explore factors that influence the development of competencies of nurses working in clinical settings in Vietnam.Methods: A descriptive qualitative research was conducted in Ho Chi Minh City, Vietnam with a purposive sample of twenty-seven participants including nurses, nurse managers, administrators, nurse teachers, medical doctors, and other health care providers.  Data collection was by in-depth interviews and focus group discussions. Content analysis was used to analyze the data.Findings: The research participants described numerous of factors that influence the journey of developing nurses’ competencies. The identified factors were relevant to nursing education and training system in Vietnam; working environments of nurses; public image and values of nursing profession; characteristics of nurses themselves; Vietnamese nursing profession; sociocultural-economic and political aspects in Vietnam; and global contexts.Conclusion: The derived knowledge would greatly benefit clinical nurses, administrators, nursing educators, health care services managers, policy makers as well as other relevant health care stakeholders in proposing of solutions to promote nursing education, nursing workplace environments, and the appropriate regulations in order to enhance the nursing competency and quality of nursing services in Vietnam. 

Client characteristics and satisfaction with the quality of primary health-care services in Calabar, Nigeria

2020 ◽  
Vol 3 ◽  
pp. 1-8
Author(s):  
H. C. Okeke ◽  
P. Bassey ◽  
O. A. Oduwole ◽  
A. Adindu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Client Satisfaction ◽  
Demographic Characteristics ◽  
Care Providers ◽  
Client Characteristics ◽  
Study Objective ◽  
Primary Health

Different mix of clients visit primary health care (PHC) facilities, and the quality of services is critical even in rural communities. The study objective was to determine the relationship between socio-demographic characteristics and client satisfaction with the quality of PHC services in Calabar Municipality, Cross River State, Nigeria. Specifically to describe aspects of the health facilities that affect client satisfaction; determine the health-care providers’ attitude that influences client satisfaction; and determine the socio-demographic characteristics that influence client satisfaction with PHC services. A cross-sectional survey was adopted. Ten PHCs and 500 clients utilizing services in PHC centers in Calabar Municipality were randomly selected. Clients overall satisfaction with PHC services was high (80.8%). Divorced clients were less (75.0%) satisfied than the singles and the married counterparts (81%), respectively. Clients that were more literate as well as those with higher income were less satisfied, 68.0% and 50.0%, respectively, compared to the less educated and lower-income clients, 92.0% and 85.0% respectively. These differences in satisfaction were statistically significant (P = 0.001). Hence, it was shown that client characteristics such as income and literacy level show a significant negative relationship with the clients satisfaction with the quality of PHC services in Calabar Municipality.

Medical Informatics and the Quality of Health: New Approaches to Support Patient Care

2003 ◽  
Vol 42 (02) ◽  
pp. 185-189 ◽  
Author(s):  
R. Haux ◽  
C. Kulikowski ◽  
A. Bohne ◽  
R. Brandner ◽  
B. Brigl ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Informatics ◽  
Health Care Providers ◽  
Medical Knowledge ◽  
Lessons Learned ◽  
Care Providers ◽  
Access To Health Services ◽  
Leading Role ◽  
Future Challenges

Summary Objectives: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of excellent papers on medical informatics research which have been recently published (www.yearbook.uni-hd.de). The 2003 Yearbook of Medical Informatics took as its theme the role of medical informatics for the quality of health care. In this paper, we will discuss challenges for health care, and the lessons learned from editing IMIA Yearbook 2003. Results and Conclusions: Modern information processing methodology and information and communication technology have strongly influenced our societies and health care. As a consequence of this, medical informatics as a discipline has taken a leading role in the further development of health care. This involves developing information systems that enhance opportunities for global access to health services and medical knowledge. Informatics methodology and technology will facilitate high quality of care in aging societies, and will decrease the possibilities of health care errors. It will also enable the dissemination of the latest medical and health information on the web to consumers and health care providers alike. The selected papers of the IMIA Yearbook 2003 present clear examples and future challenges, and they highlight how various sub-disciplines of medical informatics can contribute to this.

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