ABSTRACT
La gestion du malade dans l?univers hospitalier implique non seulement le personnel soignant, mais aussi d?autres acteurs sociaux encore moins connus des gestionnaires des structures hospitalières et des catégories socio professionnelles y évoluant. Parmi ces acteurs encore moins connu, il y a le garde-malade faisant partie du personnel hospitalier en charge de la prise en charge des patients en milieu hospitalier. Cependant au Centre Hospitalier et Universitaire de Brazzaville en République du Congo, les garde-malades sont constitués des parents, amis et connaissances dont la représentation est importante dans cet univers hospitalier. Cette représentation aussi remarquable soit elle, interpelle plus d?un observateur au point de s?interroger sur les raisons à l?origine de cette présence. Notre étude répond à la logique qui est celle de tenter de comprendre et d?analyser ce phénomène devenu très inquiétant. Ce phénomène est donc à lire dans la perspective de la complexité des réalités sociales qui s?expliquent à partir des déterminants socio culturels, fondements de la vie sociale. Aussi, la faiblesse des services sous tutelle du C.H.U-B et la culture bantoue, laquelle repose sur la solidarité mécanique qui, appelle à la cohésion sociale, constituent des facteurs qui expliquent ce phénomène. A cet effet, une observation participante a été effectuée dans cette structure hospitalière. Celle-ci a permis de relever une influence importante qui, pour diverses raisons réponde aux préoccupations des malades. Cette étude présente trois intérêts : scientifique, social et personnel. D?abord, elle montre la difficulté en ressources humaines qui se traduit par la sous représentativité des catégories socio professionnelles qui, contribueraient à résoudre la question de l?effectivité de prise en charge du malade. Ensuite, l?étude présente un autre intérêt qui met en exergue la cohésion sociale qui, s?exprime à travers la chaine de solidarité dont la famille est le maillon. Le dernier centre d?intérêt est personnel. Il met en relief un aspect culturel très intéressant, celui de l?homogénéité et de la dynamique des rapports des acteurs impliqués dans la gestion du malade. Quoi qu?il en soit, le garde-malade joue un rôle de premier plan dans la gestion du malade. Il accompagne le personnel soignant, car partageant le même environnement social que le malade. Aussi, sa visibilité nécessite un encadrement juridique pour lui donner une véritable identité.
The management of the patient in the hospital word involves not only the nursing staff, but also other social actors even less known to the manager of hospital structures and socio-professional categories. Among these actors even less known, there is the nurse who is part of the hospital staff in charge of the care of patients in hospital environment. Howerver at the Brazzaville Hospital and University Center in the Republic of Congo, the nurses are made up of relatives, friends and acquaintanees whose representation is important in this hospital environment. This representation, as remarkable as it is, calls out to more than one observer to the point of questioning the reasons behind this presence.Our study reponds to the logic of trying to understand and analyze this phenomenon, which has become very worrying. This phenomenon should therefore be read in the perspective of the complexity of social realities which can be explained on the basis of socio-cultural determinants, the foundations of social life. Also, the weakness of the services under the supervision of the C.H.U-B and of the Bantu culture, which is based on mechanical solidarity, which, calls for social cohesion, are factors that explain this phenomenon. To this end, a participant observation was carried out this hospital structure. This made it possible to identify an important influence which, for various reasons, responds to the concerns of patients. This study has three interests: scientific, social and personal. First, it shows the difficulty in human resources which result in the representativeness of the socio-professional categories which would help to resolve the issue of effectiveness of patient care. The study presents another interest which highlights the social cohesion which is expressed through the chain of solidarity of which the family is the link. The last area of interest is personal. It highlights a very interesting cultural aspect, that of the homogeneity and dynamics of relationships of the actors involved in the management of the patient. In any case, the nurse plays a leading role in management of the patient. He supports the nursing staff, because they share the same social environment as the patient. Also, its visibility requires a legal framework to give it a real identity
Subject(s)
Humans , Male , Female , Social Environment , Hospital-Patient Relations , Case Management , Inpatients , Nurses , Nursing Staff , Professional-Family Relations , Sociology, Medical , Family CharacteristicsABSTRACT
Introduction: Nursing staff working with intellectually disabled in-patients experience unique stress factors that can influence their personal well-being and work performance. Objectives: To compile a profile of stress factors experienced by nursing staff working with intellectually disabled in-patients at the Free State Psychiatric Complex (FSPC). Methods: This descriptive study included 89 nursing staff members from this environment. A questionnaire was used to collect socio-demographic information and determine personal and occupational stressors. The data were summarised by frequencies and percentages (categorical variables) and means or percentiles (numerical variables). Results: Most participants were aged between 46 and 55 (41.2%), female (93.2%) and black (93.2%), and 76.7% had children or dependant minors. The main stressors among participants were pressure providing financially for their children and dependant minors (71.2%), caring for them (39.4%) and fearing them moving away (25.8%). Occupational stressors included high workload (66.3%), lack of decision-making by superiors (58.1%), underpayment (53.5%), endangerment of physical health (52.3%) and safety (50.0%), working hours (51.2%), pressure of expectations from superiors (48.8%), uncertainty of employment (48.8%), work responsibilities (47.7%) and perceiving that skills and training were not appreciated. They experienced stress regarding health issues such as hyper- and hypotension (35.3%). Because of stress 34.5% of participants took leave, 34.5% developed depression and 14.3% had panic attacks. Conclusion: Most of the respondents experienced personal and occupational stress that influenced their health, which poses serious challenges for the management of the FSPC. Security should be upgraded, medical and psychological support for the staff and care facilities for their dependants should be provided, and financial problems experienced by these staff members should be addressed. The workload of the nursing staff at FSPC needs urgent attention. This can be done by means of a workforce analysis to determine minimum staffing levels for nursing
Subject(s)
Attitude of Health Personnel , Education of Intellectually Disabled , Nursing Staff , Psychiatric Department, Hospital , South Africa , Stress, PsychologicalABSTRACT
Introduction: A variety of effects may result in the occurrence of a wound which may result in immediate loss of all or part of organ functioning; sympathetic stress response; hemorrhage and blood clotting; bacterial contamination and death of cells. Careful asepsis is the most important factor in keeping these effects to a minimum and promoting the successful care of wounds which is dependent on the nurse's knowledge and understanding of normal wound healing physiology; method of closure and the optimal treatment of the wound and with this knowledge; nurses can provide a systematic and holistic patient assessment; and consider any potential wound related complications (Vuolo JC 2006). Aim: This investigation aimed to assess wound dressing performances among nursing personnel in the three surgical wards of Olabisi Onabanjo University Teaching Hospital (O.O.U.T.H.) Shagamu Ogun State Nigeria.Methodology:The investigators utilized the descriptive method of research. A total of sixty nursing personnel in the male; female; and paediatric surgical wards were randomly selected for the investigation. Performance of wound dressing was assessed through an investigators formulated questionnaire and evaluation checklist based on the concept of sterile wound dressing technique.Results: Nurses have a very good performance of wound dressing as they applied the concepts/principles of sterile technique in the performance of the procedure. There was no significant difference between nurses in the performance of wound dressing and their demographic variables such as age; gender; religion; and educational qualification. However; significant difference was found between length of clinical experience and practice of wound dressing.Conclusion: Findings suggests a relationship between length of clinical experience and practice of good wound dressing. Hence regular seminars on wound dressing should be organized to refresh nurses and keep them up to date in nursing practice
Subject(s)
Attitude , Health Personnel , Negative-Pressure Wound Therapy , Nursing Staff , Surgical Fixation Devices , Surgical Wound Infection , Technology Assessment, Biomedical , Wound Closure TechniquesABSTRACT
Objectives: The objectives of this study were to assess nursing staff knowledge; attitudes and practices regarding the Baby-Friendly Hospital Initiative (BFHI); to assess the knowledge of maternity obstetric unit (MOU) managers regarding BFHI principles and their attitude towards BFHI implementation; and to describe the barriers and constraints to the implementation of BFHI principles. Study design: Cross-sectional descriptive survey. Setting: The study was done in eight non-BFHI-accredited primary care maternity obstetric units in Cape Town.Subjects: The subjects were eight MOU managers and a random sample of 45 nursing staff.Outcomes measures: Knowledge; attitude and practices regarding BFHI and barriers to BFHI implementation were assessed by an intervieweradministered questionnaire.Results: The study emonstrated acceptable awareness and knowledge of the recommended BFHI principles. A total of 56.6of the staff could define rooming-in; 47.2could define the components of the BFHI; and 52.8could name three baby-friendly care practices and routines. Eighty-nine per cent of the nursing staff were able to demonstrate correct positioning of the baby for breastfeeding; and 91.1could demonstrate the correct attachment of the baby to the breast. Only 8.9of the nursing staff were able to adequately demonstrate the correct hand milk-expressing technique; 35.6knew about the correct management of painful nipples and 22.2knew how to manage engorgement.Only 40could adequately describe the safe preparation of infant formula. The enrolled nursing assistants (ENA) were significantly less knowledgeable than the other cadres of nurses. The majority of the nurses had a positive attitude toward BFHI principles and practices
Subject(s)
Attitude , Breast Feeding , Nursing StaffABSTRACT
Objectives: The objectives of this study were to assess nursing staff knowledge; attitudes and practices regarding the Baby-Friendly Hospital Initiative (BFHI); to assess the knowledge of maternity obstetric unit (MOU) managers regarding BFHI principles and their attitude towards BFHI implementation; and to describe the barriers and constraints to the implementation of BFHI principles. Study design: Cross-sectional descriptive survey. Setting: The study was done in eight non-BFHI-accredited primary care maternity obstetric units in Cape Town.Subjects: The subjects were eight MOU managers and a random sample of 45 nursing staff.Outcomes measures: Knowledge; attitude and practices regarding BFHI and barriers to BFHI implementation were assessed by an intervieweradministered questionnaire.Results: The study emonstrated acceptable awareness and knowledge of the recommended BFHI principles. A total of 56.6of the staff could define rooming-in; 47.2could define the components of the BFHI; and 52.8could name three baby-friendly care practices and routines. Eighty-nine per cent of the nursing staff were able to demonstrate correct positioning of the baby for breastfeeding; and 91.1could demonstrate the correct attachment of the baby to the breast. Only 8.9of the nursing staff were able to adequately demonstrate the correct hand milk-expressing technique; 35.6knew about the correct management of painful nipples and 22.2knew how to manage engorgement.Only 40could adequately describe the safe preparation of infant formula. The enrolled nursing assistants (ENA) were significantly less knowledgeable than the other cadres of nurses. The majority of the nurses had a positive attitude toward BFHI principles and practices
Subject(s)
Attitude , Breast Feeding , Nursing StaffABSTRACT
Objectives: The objectives of this study were to assess nursing staff knowledge; attitudes and practices regarding the Baby-Friendly Hospital Initiative (BFHI); to assess the knowledge of maternity obstetric unit (MOU) managers regarding BFHI principles and their attitude towards BFHI implementation; and to describe the barriers and constraints to the implementation of BFHI principles.Study design: Cross-sectional descriptive survey. Setting: The study was done in eight non-BFHI-accredited primary care maternity obstetric units in Cape Town.Subjects: The subjects were eight MOU managers and a random sample of 45 nursing staff.Outcomes measures: Knowledge; attitude and practices regarding BFHI and barriers to BFHI implementation were assessed by an intervieweradministered questionnaire.Results: The study demonstrated acceptable awareness and knowledge of the recommended BFHI principles. A total of 56.6 of the staff could define rooming-in; 47.2 could define the components of the BFHI; and 52.8 could name three baby-friendly care practices and routines. Eighty-nine per cent of the nursing staff were able to demonstrate correct positioning of the baby for breastfeeding; and 91.1 could demonstrate the correct attachment of the baby to the breast. Only 8.9 of the nursing staff were able to adequately demonstrate the correct hand milk-expressing technique; 35.6 knew about the correct management of painful nipples and 22.2 knew how to manage engorgement. Only 40could adequately describe the safe preparation of infant formula. The enrolled nursing assistants (ENA) were significantly less knowledgeable than the other cadres of nurses. The majority of the nurses had a positive attitude toward BFHI principles and practices
Subject(s)
Attitude , Breast Feeding , Hospitals , Nursing StaffABSTRACT
South Africa is experiencing a serious shortage of nurses; which has to be addressed to prevent crises in health care services. Previous studies (Fletcher 2001:324; Oosthuizen 2005:117) found that nurses change their work environment due to dissatisfaction with their job situations. This implies that creating a favourable environment in the workplace situation could help retain professional nurses in their posts; implying that retention strategies should be effective. An exploratory; descriptive; contextual and qualitative design was used to describe nurse managers' views on factors which could influence professional nurse retention; as well as their views regarding attributes that were required to enable them to contribute towards enhancing professional nurse retention. A purposive sample of nurse managers employed in public and private hospitals in the Gauteng province was selected. Semi-structured interviews were conducted with 21 nurse managers. The results were analysed qualitatively and contextualised within Vogt; Cox; Velthouse and Thames's Cork-Top (Bottleneck) Theory of Nurse Retention (1983) and Lewin's Force-Field Analysis Theory (1952). Factors pertaining to individual nurses; the organisation and nurse managers could influence the retention of professional nurses. Poor working conditions; long and inconvenient working hours; uncompetitive salaries and professional development of nurses have to be addressed to enhance professional nurses' retention. Unsafe working environments and a lack of resources threaten the safety and well-being of nurses and patients and contribute to high turnover rates. Nurse managers have to address shortcomings in their managerial and leadership skills and implement changes within a multigenerational nursing workforce and challenging working environments
Subject(s)
Goals , Hospitals , Nurse Administrators , Nursing Staff , Retention, PsychologyABSTRACT
In their effort to provide adequate and quality health services; health systems in both developed and the developing countries have to confront the challenges of an ever increasing population with limited or diminishing resources. This includes the human resource which constitutes a major input in health care delivery and a key determinant of the cost and quality of care. There is an increasing need therefore for health organizations to identify the most appropriate staffing levels and skill mix to ensure efficient use of the limited health personnel. This paper demonstrates the use of the workload indicator of staffing needs (WISN) methodology in determining staffing requirements for the nursing staff in a hospital setting. It shows how the results can be used to assess overstaffing and understaffing as well as determine the work pressure among the different categories of nurses thus providing a basis for effective nurse redistribution to exploit efficiency gains without compromising the quality of services
Subject(s)
Hospitals , Nursing Staff , Teaching , WorkloadABSTRACT
Aim. To determine the nurse/patient ratios required to render safe; competent ICU nursing. Method. A patient classification system (CritScore) was used to compile an objective 3-month patient profile. The number (of full-time and agency staff) and the professional profiles of nursing staff allocated to the unit during this period were documented. Results. The majority of the patients were class 3 patients. While there was concordance between the total number of nurses present in relation to the number predicted by CritScore; the number of ICU-trained nurses was consistently below that ascertained by CritScore. This unit was staffed on average with more than 50 nonpermanent staff who were employed on a temporary basis via agencies. Conclusion. The number of nursing hands allocated is important; but even more so is the quality; or competence; of these hands. Nursing care without an acceptable level of competence in a critical care unit may be considered as a potentially harmful intrusion for the patient
Subject(s)
Nursing Staff , Patients , Professional Competence , Quality of Health CareSubject(s)
Drugs, Essential , Education, Continuing , Materials Management, Hospital , Nursing StaffSubject(s)
Drugs, Essential , Education, Continuing , Materials Management, Hospital , Nursing StaffABSTRACT
The main objective of the study was to relate the attitudes of nursing staff towards HIV positive and AIDS patients to the nurses' age; sex; religious affiliation and marital status. 211 nurses were randomly selected for the study form all health centres and the only District hospital in Nyeri; Kenya. Information was collected using a self-administered questionnaire; with the help and/or supervision of the investigators. There was statistically significant relationship between marital status of the nurses and the need to keep the HIV status of the patient confidential. 69 of the nurses said that it was not necessary to observe confidentiality for a number of reasons. Out of the 31 of those who said taht confidentiality was necessary; 83 were married. Nurses' expressed fear of contracting AIDS through casual contact did not have a significant relationship with christian denomination to which they were affiliated. 32 of the nurses said that one could get AIDS through casual contact. Other parameters are presented and discussed in this paper. It is evident that nurses need to be more enlightened on AIDS facts in order to improve on the quality of nursing care for HIV/AIDS patients
Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Knowledge , Nursing Staff , Occupational ExposureABSTRACT
The important factors that determine the duration of breast feeding are linked with the information given to the mothers; the supportive attitudes of nursing personnel and the cultural beliefs of an individual mother as well as the new parttens of urban family structure which tends to be small
Subject(s)
Attitude , Breast Feeding , Cultural Characteristics , Knowledge , Nursing Staff , Urban PopulationABSTRACT
The objectives of the study were: (1) to determine the relationship between nurses' level of basic training and its influence on their performance; (2) determine factors in nurses' work environment that negatively affect their performance; (3) determine factors in the service conditions of the nurses that influence their performance; (4) assess the level of interpersonal relationship among nurses that influence their performance; (5) assess the level of nurse-client interaction in relation to nurses' performance. Study was carried out by focus group discussion for various grades of nurses and in-depth interviews for individual supervisors. Some of the findings were that professional nurses perform tasks below their level of training; e.g. cleaning wards. Lack of basic facilities like equipment and supplies affect the performance of duty. When other members of the Health Team; for example; doctors; revenue collectors; and orderlies are not at post; nurses are forced to do their work at the expense of the nurses' work. There is lack of continuing education and in-service training and there is undue delay in the selection of nurses for the upgrading of their knowledge and skills