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   Table of Contents - Current issue
July-December 2019
Volume 1 | Issue 2
Page Nos. 21-38

Online since Tuesday, April 28, 2020

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Analysis of incidents of fall in the patients receiving home healthcare services p. 21
Ridhima Pahwa, Punitha Singh, Gagan Kapoor, Gaurav Thukral, Prativa Talukdar, PC Joseph
Background: Incidents of fall remains the major cause of accidental and unintended injury in health care setups. Caring for patients at homecare setting comes with its own challenges and concerns. Methods: The incidents of fall reported over past 18 months in patients availing home care services from Healthcare at home from February 2018 to August 2019 was analysed to identify various risk factors involved in fall and suggestions for fall prevention were laid out in the study. Results: The fall percentage reported was 1.29% of patients served by HCAH during this tenure. The incident of fall was higher in rehabilitation services and lower in nursing services. The results show that prevalence of falling was higher among women than men between the age of 65-84 years. The highest number of falls was reported in patients suffering from neuro disorders, most of the incidents resulted due to external factors where more emphasis needs to be given on creating safe environment in the patient's home. Conclusion: Providing clinical care at home environment even makes it more difficult to control certain factors such as adequate space in the room for safe mobilization or unavailability of grab bars or presence of slippery floors or poor lightening are the majorly contributing to incidents like falls. Thus, identifying underlying risk while admitting the patient in homecare becomes the primary responsibility of the care provider.
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Caregiver satisfaction with quality of care in the pediatric medical ward of a large hospital in Botswana p. 26
Mbaakanyi Masikara, Alemayehu Mekonnen Gezmu, Merrian Brooks, Lesego Gabaitiri, Tonya Arscott-Mills
Context: Few studies in developing settings seek to determine caregivers' level of satisfaction with medical services provided for their children. High-quality medical care is associated with improved health outcomes and higher health-care utilization. Aims: We sought to understand caregiver satisfaction in the pediatric ward of a large hospital in Botswana. Settings and Design: A cross-sectional, descriptive survey was conducted in the pediatrics medical ward at a referral hospital in Gaborone, Botswana, between September and October 2017. Subjects and Methods: A cross-sectional survey was conducted on caregivers admitted with their children in the pediatric ward of a large multispecialty hospital in Botswana. A total of 250 caregivers took a modified Service Quality Instrument from September to October 2017. The quality service instrument provides expectation and perception data in two subscales and assesses the difference between expectation and perception score, or gap score, for five dimensions of medical care. Statistical Analysis Used: All data were analyzed using Statistical Package for Social Science software. Results: The mean gap scores for the cohort were all negative, showing poor satisfaction and discrepancies between expectations and perceptions. The overall mean gap score was at − 0.315 (P < 0.001). The gap scores were as follows: for tangibles, –0.372; reliability, –0.1656; responsiveness, –0.210; assurance, −0.137; and empathy, −0.198. There was a statistically significant difference between the mean gap scores of caregivers in the oncology (−0.08) and medical cohort (−0.35) (P < 0.005). Conclusions: Caregivers in the hospital with their children were dissatisfied with the quality of care their children received in each quality domain measured. Hospital and government leaders of growing health systems have an opportunity to create environments and communication that are responsive to the needs of caregivers who are partners in the care of children.
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Improvement of platelet supply by the project research quality control circle and win-win team model in a hematological department p. 32
Qianli Jiang, Chengpu Yu, Leyi Chen, Xiaorui Cui, Yanyan Chai, Zhengyuan Wang, Quanfeng Chen, Maoyu Qin, Maoyuan Wang, Wenyuan Li, Tingfang Liu
Objective: Platelet is a crucial medical resource to ensure the quality and patient safety in healthcare. A project research Quality Control Circle (prQCC) was applied to this platelet shortage challenge in a level 3 Grade A hospital of South China. Materials and Methods: (1) A prQCC team was established based on the win-win team model. (2) By system diagram analyzing, the prQCC focused on improving the donation of the society. (3) The differences between regular donors and ordinary volunteers were analyzed using questionnaires, and four strategies were integrated and implemented according to the analysis of the requirements from donors and volunteers. (4) The platelet supply as well as tangible and intangible achievements were collected and evaluated. Results: More donors were recruited, including 313 ordinary volunteers and 76 regular donors, 226 units of platelets were donated directly. The platelet supply in the department of hematology has increased to 121.95% (from 4792 to 5844 units) versus 105.56% (from 9488.5 to 10016 units) in the hospital. Each participant of this prQCC benefited from tangible and intangible achievements, with a closed win-win loop formed. Conclusions: The prQCC is an efficient tool to improve platelet supply; and the win-win team model is also potentially useful in other areas of quality in healthcare, and thereafter worth spreading.
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