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2.
Health Sci Rep ; 4(3): e361, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34532595

RESUMO

Background: Professional isolation is viewed as a sense of isolation from ones professional peers and this has contributed to compromised quality of health service delivery as well as quality of life for health professionals in low resource environments. Professional isolation is a multidimensional concept which may be either geographic, social, and/or ideological. However, professional isolation in low resource environments remains poorly defined with a limited body of research focusing on health professionals. Aim: To map and examine available literature on interventions for managing professional isolation among health professionals in low resource environments. Methods: We conducted a scoping review of the published and grey literature to examine the extent, range and nature of existing research studies relevant to professional isolation in health professionals. Results: Of the 10 articles retrieved, 70% were conducted in high income countries where the context may be different if applied to other low-income settings such as in Africa. Only 20% of the studies focused specifically on nurses or the nursing profession and only 10% were conducted on the African continent. Conclusion: There is insufficient research on the definition and origins of professional isolation among health professionals including the interventions that can be employed. Rural, remote and/or isolated settings significantly predispose health professionals to professional isolation but remain poorly defined. Additional research is recommended to explore and determine the interventions for managing professional isolation among health professionals in low resource environments.

3.
Afr J Emerg Med ; 11(3): 372-377, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34367899

RESUMO

A changing climate will have demonstrable effects on health and healthcare systems, with specific and disproportionate effects on communities in Africa. Emergency care systems and providers have an opportunity to be at the forefront of efforts to combat the worst health effects from climate change. The 2020 African Conference on Emergency Medicine, under the auspices of the African Federation for Emergency Medicine, convened its first ever workshop on the topic of climate change and human health. Structured as a full day virtual course, the didactic sections were available for both live and asynchronous learning with more than 100 participants enrolled in the course. The workshop introduced the topic of the health effects of climate as they relate to emergency care in Africa and provided a forum to discuss ideas regarding the way forward. Lectures and focused discussions addressed three broad themes related to: health impacts, health care delivery, and advocacy. To our knowledge, this is the first workshop for health professionals to cover topics specific to emergency care, climate change, and health in Africa. The results of this workshop will help to guide future efforts aimed at advancing emergency care approaches in Africa with regard to medical education, research, and policy. African relevance: •Climate-related extreme weather events are adversely affecting health and health care delivery in African countries.•African organisations, cities, and nations have taken positive steps to adapt and build climate resilience.•There are opportunities for emergency care professionals and scholars to continue to expand, and lead, climate and health education, research, and policy initiatives on the continent.

4.
Int Emerg Nurs ; 58: 101038, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34329826

RESUMO

The aim of this review was to map literature on available tools measuring families experience in the emergency department and to identify domains being measured in the tools. A two-stage screening process was employed to determine eligibility of articles. Articles written in English language were retrieved, and data extracted on design, setting, sample and sampling, tool description and details, as well as data collection point used. From 165 articles initially screened, 8 articles were finally included and three tools identified namely: Critical Care Family Needs Inventory, Critical Care Family Needs Inventory-Emergency Department and one researcher-developed questionnaire. The domains measured, which were common to all tools, were those of communication, comfort, and support. Measuring families experience in the ED appears limited and this might be related to the difficulty around conducting research in an ED environment. This review provides important information for hospitals regarding how they engage with families and how they can influence current practice standards and processes, thus assuring improved quality of care.


Assuntos
Cuidados Críticos , Serviço Hospitalar de Emergência , Comunicação , Hospitais , Humanos , Inquéritos e Questionários
5.
Afr J Emerg Med ; 11(3): 335-338, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34141528

RESUMO

The World Health Assembly declared 2020 as the 'Year of the Nurse and the Midwife' in recognition of the critical contribution of both professions to global health. Nurses globally are having to do more with less and in the already resource deficient African context, significant adaptation and leadership is required in the way emergency nurses work if they are to be effective in reducing mortality and morbidity within emergency populations. In 2011, an emergency nursing group, representing the largest group of nurses in Africa, swiftly engaged with this process by publishing the document 'Developing a framework for emergency nursing practice in Africa' (2012). From this document a strategic plan was devised within a tight timeframe, to operationalise the quest for enhanced emergency nursing in Africa. The purpose of this paper is to describe this development of emergency nursing in Africa and to explain the operational challenges and successes, as well as the lessons learnt in order to assist with future planning.

6.
Intensive Crit Care Nurs ; 66: 103081, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34116886

RESUMO

BACKGROUND: Critical illness is distressing for families, and often results in negative effects on family health that influence a family's ability to support their critically ill family member. Although recent attention has been directed at improving care and outcomes for families of critically ill patients, the manner in which nurses engage with families is not fully understood. OBJECTIVES: To describe nurses' perceptions and practices of family engagement in adult intensive care units from a global perspective. DESIGN: A qualitative-descriptive multi-site design using content analysis. SETTINGS: The study was conducted in 26 intensive care units of 12 urban, metropolitan, academic medical centers in ten countries, spanning five continents. PARTICIPANTS: A total of 65 registered nurses (77% women, age of M = 39.5, SD = 11.4 years) participated. Most held intensive care certification (72%) and had worked on average 10 (SD = 9.6) years in the ICU. METHODS: Semi-structured, individual interviews (M = 38.4 min, SD = 12.0) were held with ICU nurses at the hospital (94%) or their home using an interview guide. Qualitative interview data were analysed using inductive content analysis. RESULTS: We found that nurse-family engagement was an ebb and flow of relational power that needed to be carefully negotiated and balanced, with nurses holding and often exerting more power than families. Constant fluctuations in nurses' practices of engagement occurred in day-to-day practice from shift-to-shift and from nurse-to-nurse. Family engagement was dependent on individual nurses' attitudes and perceptions of family, the patient's condition, and workload. Lastly, family engagement was shaped by the ICU context, with team culture, collaborative relationships, unit structures and organizational resources either enabling or limiting nurses' ability to engage with families. CONCLUSIONS: This global study provides an in-depth understanding of the way nurses engage with families in ICU and reflects many different cultures and health systems. We found that nurse-family engagement was marked by a shifting, yet often unequal power distribution in the nurse-family relationship, inconsistent nurse engagement practices, both of which resulted in variable family engagement in intensive care. Our research contributes a detailed description of engagement as practiced in the everyday delivery of health care. A more concentrated team effort, based on a shared culture and defined framework of family care is needed to ensure that families of critically ill persons are fully engaged in all aspects of intensive care.


Assuntos
Enfermagem de Cuidados Críticos , Enfermeiras e Enfermeiros , Adulto , Cuidados Críticos , Estado Terminal , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva , Masculino , Relações Profissional-Família , Pesquisa Qualitativa
7.
Curationis ; 44(1): e1-e7, 2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33970005

RESUMO

BACKGROUND: Giving birth is one of the most important events in a woman's life and is a highly individualistic and unique experience. OBJECTIVES: The study aimed to describe women's childbirth experiences in two state hospitals in KwaZulu-Natal. METHOD: A non-experimental, quantitative, descriptive survey of low-risk mothers was conducted in two state hospitals by using the Childbirth Experience Questionnaire (CEQ). RESULTS: With a response rate of 96%, 201 questionnaires were completed and returned. The highest mean score of the four dimensions of the CEQ was for the dimension of Professional Support (3.1). The results of the individual dimension items scoring the highest positive response were: I felt that I handled the situation well (147; 74%) (Own Capacity); I felt very well cared for by my midwife (165; 82%) (Professional Support); 151 respondents (76%) scored the item My impression of the team's medical skill made me feel secure as the highest positive experience (Perceived Safety); and I felt I could have a say in the choice of pain relief (105; 52%) (Participation). The relationship between demographic variables (age, level of education, parity, antenatal clinic attendance, induction of labour, augmentation and duration of labour) and respondents' scores of the CEQ dimensions was calculated, and only the dimension of Perceived Safety and duration of labour (≥ 12 hours) were found to be significant (p = 0.026). CONCLUSION: From the women perspectives, the study results described childbirth experience as multi-dimensional experience and subjective. Both positive and negative experiences coexisted in all dimensions of the CEQ, with the dimension of Professional Support scoring the highest positive response. To maintain a positive birth experience, the study suggests that women should be involved and equipped with knowledge on the process of childbirth.


Assuntos
Hospitais Estaduais/normas , Acontecimentos que Mudam a Vida , Parto/psicologia , Satisfação do Paciente , Adulto , Feminino , Hospitais Estaduais/organização & administração , Hospitais Estaduais/estatística & dados numéricos , Humanos , Gravidez , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , África do Sul , Inquéritos e Questionários
8.
J Surg Res ; 262: 47-56, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33548673

RESUMO

BACKGROUND: The trauma burden in South Africa is significant. The objective of this project was to investigate the incidence of posttrauma pulmonary complications (PPCs) and to identify patient, health risks, and hospital factors, which predispose trauma patients to develop PPCs hospital in Pietermaritzburg, South Africa. METHODS: The design was a retrospective secondary data analysis of patients who presented as a trauma admission via the health systems' Hybrid Electronic Medical Registry. The final data set included 6382 trauma admissions. RESULTS: The PPC rate was 9.4% for patients with a surgical intervention versus 1.9% for those without a surgical intervention. Of the total 289 PPCs reported, the most common included pneumonia or atelectasis (46.4%) and prolonged ventilation (36.0%). The risk of developing a PPC was statistically significantly (P < 0.0001) associated with surgical intervention and the number of surgeries. CONCLUSIONS: The trauma burden in South Africa requires complex medical and surgical interventions. The incidence of PPCs is significantly associated with surgical intervention. With the increasing demand to harness data and improve patient care, the Hybrid Electronic Medical Registry proves to be a driver for quality improvement.


Assuntos
Análise de Dados , Pneumopatias/etiologia , Ferimentos e Lesões/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Recuperação Pós-Cirúrgica Melhorada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia/etiologia , Atelectasia Pulmonar/etiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
10.
Afr J Emerg Med ; 10(4): 249-255, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33299758

RESUMO

Introduction: Measuring patients' experience in the emergency department can be an avenue through which the patients are able to evaluate their own care experience, and this may provide guidance for healthcare professionals in addressing quality improvement. This scoping review aimed to identify and examine existing tools that measure patients' experience in the emergency department. Methods: A scoping review was carried out to synthesize evidence from a range of studies in order to describe the characteristics of each study and their sample, and to describe the tools used to measure patients' experience in the emergency department. Results: Out of the 308 articles retrieved, results of the first and second level screening yielded 10 articles for inclusion using 9 different experience tools/questionnaire in the emergency department. Conclusion: Measuring patients' experience in the emergency department is a global concern, however research conducted in low-to-middle-income countries is very limited and such research in Africa appears to be absent. Getting consumers of care to evaluate their experience may help healthcare professionals to identify discrepancies in care and plan possible strategies to address them.

11.
Curationis ; 43(1): e1-e7, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33179946

RESUMO

BACKGROUND: Emergency departments are regarded as stressful working environments, associated with staff shortages, increased patient numbers and long waiting times. Increased organisational demands for performance can compromise genuine interactions between families and healthcare providers working in emergency departments. A relational practice approach in caring for families can enhance the capability of healthcare providers to simultaneously overcome these difficulties and provide emergency healthcare of high quality. OBJECTIVES: The purpose of the study was to describe healthcare providers' perceptions of relational practice with families in three emergency departments in KwaZulu-Natal, South Africa. METHOD: Using a qualitative descriptive approach data were collected through semi-structured interviews with healthcare providers working in emergency departments. The data were analysed and categorised using qualitative content analysis. RESULTS: Four categories emerged from data analysis: (1) families and healthcare providers connecting; (2) recognising the uniqueness of families; (3) caring interactions; and (4) taking charge when necessary. CONCLUSION: The study elicited that healthcare providers working in emergency departments perceived that despite high patient volumes and resource constraints, collaborative relationships with families were important. However, these collaborative relationships cannot be willed into practice, instead training workshops are needed to develop relational skills of healthcare providers which can facilitate family and healthcare professional collaboration.


Assuntos
Pessoal de Saúde/psicologia , Percepção , Relações Profissional-Família , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto/métodos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde/normas , África do Sul
12.
BMC Med Educ ; 20(1): 346, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023590

RESUMO

BACKGROUND: The rapid progression of diseases and the complex, changing landscape of healthcare has increased the awareness that interprofessional collaboration is essential in ensuring safe and effective healthcare delivery. However, to develop a "collaborative practice-ready" workforce, organisations need to invest in the application of alternative approaches to the training of healthcare professionals. PURPOSE OF THE STUDY: To describe the perceptions of healthcare professionals attending an HIV interprofessional collaborative initiative at a non-governmental organization research site in South Africa and to provide suggestions regarding the improvement of this educational programme. METHODS: Focus group discussions (December 2018 to January 2019), were conducted on a purposeful sample (N = 21) consisting of healthcare professionals (clinicians, pharmacists, pharmacy assistants, and nurses), and clinical trial staff (recruiters, administrators, QC officers, psychologists, counsellors) based at a research site, who were invited to attend a continuing medical education initiative on the pathogenesis and treatment of HIV. Qualitative content analysis was carried out to identify meaning units, which were then condensed and labelled with a code. This was further grouped to form categories. RESULTS: Five categories emerged: learning something new, acquiring from each other, promoting company culture, needing company buy-in and teaching methods matter. Interprofessional collaborative learning improved technical capacity, work relationships and company culture. The diversity in learning needs of the different professionals requires a structuring of a curriculum to meet the needs of all. The success of this initiative requires company buy-in/investment and recognition from leaders and higher management with regards to time and resources. Suggestions for improvement included: formalizing the training, introducing more lectures and pitching each topic at different levels i.e. basic, intermediate or advanced, thus ensuring maximum benefit for all. CONCLUSION: Inter-professional learning was perceived as highly valuable. This initiative has the potential to develop further but requires resources and company buy-in. All staff working (clinical and non-clinical) at the NGO site were represented in the interviews, thus ensuring a richer understanding of all perspectives relevant to the study site. The small sample size confined to a single research site, however, prevents these findings from being generalized and limits the applicability of its findings.


Assuntos
Práticas Interdisciplinares , Currículo , Humanos , Relações Interprofissionais , Farmacêuticos , Pesquisa Qualitativa , África do Sul
14.
Sci Total Environ ; 719: 137360, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32114226

RESUMO

With the introduction of the One Health approach to global health advocated by the World Health Organization, the role of the environment as a reservoir and transmission route for diverse microorganisms is increasingly being recognised globally. This study investigated the diversity and functional profiles of bacterial communities using high-throughput metagenomics of the 16S rRNA gene in samples collected from environmental surfaces in different levels of healthcare in South Africa. A total of 150 samples were collected in three public hospitals [District (A), Regional (C) and Central (B)] from intensive care and paediatric wards. Military hospitals were excluded. Swabs were taken from mattresses, drip stands, ward telephones, patient files and sinks. A total of 7,996,346 reads were found, of which 7,319,569 were quality-filtered reads. Unique (and shared) microbial community structures were identified within the different hospital levels, locations and sample source. A total of 11 phyla, 29 classes, 50 orders, 105 families, 190 genera and 288 known species were identified. The primary phyla identified were Proteobacteria, Firmicutes and Actinobacteria. The dominant class identified was Gamma-proteobacteria, followed by Bacilli and Actinobacteria. Acinetobacter (16.08%), Citrobacter (13.64%), Staphylococcus (9.65%) and Corynebacterium (6.15%) were predominant genera. Although the functional profile analysis identified citrate cycle (TCA), signal transduction mechanisms, bisphenol degradation, tyrosine metabolism and transcription-factors as the dominant pathways, human disease functional classes, including involvement in antibiotic resistance, were significantly identified. The drip stands, patient files and ward telephones in all the wards of Hospitals A and C contained a higher number of human diseases functional classes. These findings highlight the potential of different hospital environments to serve as reservoirs and possible sources of bacterial pathogens; thus, the need for better monitoring and hygienic practices within the hospital environment.


Assuntos
Bactérias , Metagenoma , Hospitais Públicos , RNA Bacteriano , RNA Ribossômico 16S , África do Sul
18.
Curationis ; 42(1): e1-e5, 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-31038327

RESUMO

BACKGROUND:  Health care professionals are expected to deliver safe and effective health services; however there is increased realisation that adverse events in the health system are a major cause of preventable morbidity and mortality. OBJECTIVES:  To conduct a retrospective audit of nursing-related morbidities in a state hospital in KwaZulu-Natal, South Africa. METHOD:  A retrospective audit of nursing-related morbidities documented by the surgical service was carried out using the Hybrid Electronic Medical Registry data for a period of 3 years - 01 November 2013 to 31 October 2016. RESULTS:  There were a total of 12 444 admissions to surgical service during the study period, with 461 nursing-related morbidities reported. There was an increase in the number of documented nursing-related morbidities noted during November 2015 to October 2016, with 79% of all reported nursing-related morbidities documented during this period. A total of 54% of nursing-related morbidities were associated with males (n = 248) and 46% (n = 213) with females. The most commonly documented nursing-related morbidity was drugs/medication (n = 167, 36%) with the second most common being adjunct management (n = 130, 28%). CONCLUSION:  The study has identified the most commonly documented nursing-related morbidities in the surgical service of a state hospital. The findings of the study could provide direction for further research and educational initiatives.


Assuntos
Morbidade/tendências , Auditoria de Enfermagem/estatística & dados numéricos , Hospitais Estaduais/organização & administração , Hospitais Estaduais/estatística & dados numéricos , Humanos , Auditoria de Enfermagem/métodos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/enfermagem , Estudos Retrospectivos , África do Sul/epidemiologia
19.
Curationis ; 42(1): e1-e7, 2019 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-30843401

RESUMO

BACKGROUND:  The need to use innovative teaching and learning strategies in the nursing pedagogy is important in the 21st century. The challenges of clinical sites and opportunities for nursing students to gain clinical experience are a growing concern for many nurse educators. High-fidelity human patient simulators (HFHPS) are computerised mannequins that replicate a real-life patient, and when integrated into classroom teaching they allow students to become fully immersed into an almost real-life scenario. OBJECTIVES:  The aim of this study was to describe how HFHPS can promote experiential learning following the management of postpartum haemorrhage as a midwifery clinical emergency. METHOD:  A descriptive qualitative research approach was carried out in this study. The research setting was a local university in KwaZulu-Natal. The total population included all (N = 43) fourth-year baccalaureate of nursing undergraduate student midwives who participated as observers and/or role-players of a scenario role-play. An all-inclusive sampling was performed. There were 43 student midwives involved in the simulation teaching session with 6 of these students actively participating in each role-play at a time, while the remaining 37 observed. This occurred in two separate sessions and all the student midwives were involved in a debriefing session. These student midwives were then followed up and asked to participate in a focus group. The data in this article came from two separate focus groups which comprised 20 student midwives in total. Data were analysed using content analysis. RESULTS:  Four categories emerged from the data, namely HFHPS offers a unique opportunity for student midwives to manage complex real-life emergencies; promotes reflection by allowing student midwives to reflect or review their roles, decisions and skills; allows student midwives to learn from their own experiences and encourages student midwives to try out what they learnt in a real-life situation. CONCLUSION:  High-fidelity human patient simulators can be used in a complex case scenario to promote experiential learning of a clinical emergency.


Assuntos
Tocologia/educação , Simulação de Paciente , Aprendizagem Baseada em Problemas/métodos , Adulto , Competência Clínica/normas , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Avaliação Educacional/métodos , Feminino , Grupos Focais/métodos , Humanos , Masculino , Manequins , Aprendizagem Baseada em Problemas/tendências , Pesquisa Qualitativa , Estudantes de Enfermagem/estatística & dados numéricos
20.
Health SA ; 24: 1279, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31934438

RESUMO

Background: Caring for cancer patients can take a toll on the emotional health of oncology nurses, which may lead to compassion fatigue, resulting in decreased quality of nursing care, absenteeism and decreased retention of staff. Aim: The aim of this study was to describe compassion fatigue from the perspective of oncology nurses. This study is part of a larger mixed-methods action research study to develop an in-facility intervention to manage compassion fatigue in oncology nurses. Setting: This study was conducted at Durban, KwaZulu-Natal, South Africa. Methods: The research setting comprised one state hospital (with oncology clinics and wards), a private hospital (with oncology wards) and a hospice in Durban, KwaZulu-Natal, South Africa. Semi-structured individual interviews (guided by Figley's Compassion Fatigue Process, 2005) were conducted with eight participants. Data were analysed using manifest content analysis. Results: Five categories emerged from the data, namely, emotional connection, emotional fatigue, emotional loss, blurring boundaries and acceptance. Conclusion: The findings revealed that oncology nurses are affected emotionally in caring for their patients, thus making them prone to compassion fatigue. Oncology nurses need to acknowledge compassion fatigue and be able to self-reflect on how they are managing (both positively and negatively) with the stressors encountered in the oncology wards or units.

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