Factors influencing patient falls in a private hospital group in the Cape Metropole of the Western Cape

Background: The fall rate of patients in hospitals is a worldwide concern due to the impact falls have on patients, the family or relatives, as well as the healthcare setting. Factors influencing patient falls are categorised as intrinsic and extrinsic. Intrinsic factors refers to physical conditions and the extrinsic factors include the environment of the patient, nursing staffing levels and skill mix.Aim: The study aimed to determine the factors that influence patient falls.Setting: A private hospital group in the Cape Metropole of the Western Cape.Methods: A quantitative retrospective descriptive research approach was used by analysing 134 records of patients that have fallen from October 2016 to February 2018. Data was collected using a data extraction sheet and analysed using the Statistical Package for the Social Sciences (SPSS).Results: Intrinsic factors contributing to patient falls includedthe patient's age, hypertension, co-morbidities and the use of benzodiazepines as a sedative. Extrinsic factors were the incorrect use of bed rails and the skill mix of the staff. In over half of the cases (n = 68; 50.7%), risk assessments were not performed according to the protocol. Only 5 (3.7%) patients sustained major injuries due to the falls. However, the risk of more severe falls increased 2.4 times with the lack of risk assessment.Conclusion: The lack of accurate and consistent patient fall risk assessments, use of benzodiazepines as a sedative and the staff skill mix were contributors to the fall rate in these hospitals

Anxiety experience and preoperative nursing care evaluation among postoperative emergency caesarian section patients in two selected hospitals, Nairobi, Kenya

Emergency caesarean section poses obstetric, anesthetic and surgical risks to the mother and the unborn baby and exacerbates anxiety which is deleterious. Preoperative nursing care rendered during this period greatly influence patient's care perception, a concept underpinned in this study. Patients' pre-and postoperative anxiety levels and demographics informed by literature reviewed were evaluated. Demographics included age, the level of education, mode of hospital bill payment, history of major illness, previous surgeries, current medication, smoking and the condition of the newborn. A descriptive cross-sectional survey was conducted in a private and a public hospital among patients undergoing emergency caesarean section. Sixty participants were purposively and systematically sampled from the postnatal ward admission registers using inclusion criteria. A structured questionnaire was used to assess participants' demographics and care satisfaction. Anxiety levels were evaluated using Form Y-6. Ethical approval was obtained from the respective ethical review boards. Multivariate nonparametric statistical analyses using Statistical Package for Social Sciences (SPSS) version 17 computer software was used to analyze data Alongside descriptive statistics. Significant finding observed regarding demographics were on the level of education and mode of hospital hill payment. The highest level of education attained was tertiary 22(73.3%) in private compared to secondary level 14 (46.7%) in the public hospital. The mode of hospital bill payment was through companies' medical schemes 24(80%) in private hospital and through National Health Insurance Fund (NHIF) 22(73.3%) in public. Mann-Whitney U test showed statistically significant differences in only two out of the six anxiety defining statements assessed postoperatively. Participants at the public hospital felt calmer (z=-2.071, p=0.038<0.05) and more relaxed (z=-2.85, p=0.004<0.05) than those at the private hospital. Wilcoxon rank test yielded significant results for only one out of the six care satisfaction defining statements. Participants at the public hospital were more satisfied with the information given by the nurse about what is expected before and after surgery (z=-2.61, p=0.009<0.05) compared to private. This study evidences nurses' ability to render satisfactory care to patients in emergency situations regardless of socio-patients' demographic profile and type of hospital. There is need to initiate and sustain such care surveillance for quality auditing

Determinants of patient satisfaction with outpatient health services at public and private hospitals in Addis Ababa, Ethiopia

Background: Patients have explicit desires or requests for services when they visit hospitals. However; inadequate discovery of their needs may result in patient dissatisfaction. This study aimed to determine the levels and determinants of patient satisfaction with outpatient health services provided at public and private hospitals in Addis Ababa; Central Ethiopia. Methods: A comparative cross-sectional study was conducted from 27 March to 30 April 2010. The study included 5 private and 5 public hospitals. Participants were selected using systematic random sampling. A pre-tested and contextually prepared structured questionnaire was used to conduct interviews. Descriptive statistics; analysis of variance; factor analysis and multiple linear regressions were performed using computer software (SPSS 16.0). Results: About 18.0of the patients at the public hospitals were very satisfied whilst 47.9were just satisfied with the corresponding proportions a bit higher at private hospitals. Selfjudged health status; expectation about the services; perceived adequacy of consultation duration; perceived providers' technical competency; perceived welcoming approach and perceived body signalling were determinants of satisfaction at both public and private hospitals. Conclusions: Although patients at the private hospitals were more satisfied than those at the public hospitals with the health care they received; five of the predictors of patient satisfaction in this study were common to both settings. Thus; hospitals in both categories should work to improve the competencies of their employees; particularly health professionals; to win the interests of the clients and have a physical structure that better fits the expectations of the patients

Retrospective review of antiretroviral therapy program data in accredited private hospitals in Addis Ababa City Administration, Ethiopia

Background: Ethiopia is committed to improving access to human immunodeficiency virus (HIV) care and antiretroviral therapy (ART) service. In May 2005; some private hospitals in Addis Ababa City Administration received accreditation to provide ART services to eligible patients. Objective: To examine and describe the achievements of the ART Program in accredited private hospitals. Methods: Descriptive retrospective analyses of reported ART Program Data from accredited private hospitals; between May 2005 and 31st December 2009. The aggregate data was obtained from Addis Ababa Regional Health Bureau and consisted of information about patients enrolled for care; those who started ART; and those presently are on ART. Results: During the study period; 10;849 patients were enrolled for care; 9;442 who had just started ART and 5;608 already on it across the study private facilities. In general close to 75of the total patients enrolled for care at five facilities. Although the majority (87) had started treatment in the past; only 59.4were currently on treatment. Overall; the program retained 66.4of the patients (n=6;270) and attrition was 32(n=3;021). Conclusions: Differences in patient enrollment for care; ART initiation and retention were observed across facilities. A significant number of patients discontinued treatment and their outcome status was unclear. A better monitoring and reporting of ART Program Data will improve program quality. An effective strategy is needed to enhance patient retention and tracing in the accredited private hospitals in Addis Ababa City Administration