Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 4 de 4
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Afr J Prim Health Care Fam Med ; 8(1): e1-e2, 2016 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-27796121
2.
Artigo em Inglês | MEDLINE | ID: mdl-26245615

RESUMO

BACKGROUND: An integrated audit tool was developed for five chronic diseases, namely diabetes, hypertension, asthma, chronic obstructive pulmonary disease and epilepsy. Annual audits have been done in the Western Cape Metro district since 2009. The year 2012 was the first year that all six districts in South Africa's Western Cape Province participated in the audit process. AIM: To determine whether clinical audits improve chronic disease care in health districts over time. SETTING: Western Cape Province, South Africa. METHODS: Internal audits were conducted of primary healthcare facility processes and equipment availability as well as a folder review of 10 folders per chronic condition per facility. Random systematic sampling was used to select the 10 folders for the folder review. Combined data for all facilities gave a provincial overview and allowed for comparison between districts. Analysis was done comparing districts that have been participating in the audit process from 2009 to 2010 ('2012 old') to districts that started auditing recently ('2012 new'). RESULTS: The number of facilities audited has steadily increased from 29 in 2009 to 129 in 2012. Improvements between different years have been modest, and the overall provincial average seemed worse in 2012 compared to 2011. However, there was an improvement in the '2012 old' districts compared to the '2012 new' districts for both the facility audit and the folder review, including for eight clinical indicators, with '2012 new' districts being less likely to record clinical processes (OR 0.25, 95% CI 0.21-0.31). CONCLUSION: These findings are an indication of the value of audits to improve care processes over the long term. It is hoped that this improvement will lead to improved patient outcomes.


Assuntos
Doença Crônica/terapia , Atenção à Saúde/tendências , Auditoria Médica/tendências , Melhoria de Qualidade/tendências , Asma , Estudos Transversais , Atenção à Saúde/normas , Diabetes Mellitus , Epilepsia , Humanos , Hipertensão , Doença Pulmonar Obstrutiva Crônica , África do Sul
3.
Artigo em Inglês | AIM (África) | ID: biblio-1257802

RESUMO

Background: An integrated audit tool was developed for five chronic diseases, namely diabetes, hypertension, asthma, chronic obstructive pulmonary disease and epilepsy. Annual audits have been done in the Western Cape Metro district since 2009. The year 2012 was the first year that all six districts in South Africa's Western Cape Province participated in the audit process. Aim: To determine whether clinical audits improve chronic disease care in health districts over time. Setting: Western Cape Province, South Africa. Methods: Internal audits were conducted of primary healthcare facility processes and equipment availability as well as a folder review of 10 folders per chronic condition per facility. Random systematic sampling was used to select the 10 folders for the folder review. Combined data for all facilities gave a provincial overview and allowed for comparison between districts. Analysis was done comparing districts that have been participating in the audit process from 2009 to 2010 ('2012 old') to districts that started auditing recently ('2012 new'). Results: The number of facilities audited has steadily increased from 29 in 2009 to 129 in 2012. Improvements between different years have been modest; and the overall provincial average seemed worse in 2012 compared to 2011. However; there was an improvement in the '2012 old' districts compared to the '2012 new' districts for both the facility audit and the folder review; including for eight clinical indicators; with '2012 new' districts being less likely to record clinical processes (OR 0.25; 95% CI 0.21-0.31). Conclusion: These findings are an indication of the value of audits to improve care processes over the long term. It is hoped that this improvement will lead to improved patient outcomes


Assuntos
Asma , Doença Crônica , Hipertensão , Doença Cardiopulmonar , África do Sul
4.
Afr J Prim Health Care Fam Med ; 6(1): E1-9, 2014 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-26245425

RESUMO

BACKGROUND: Measurement of blood pressure (BP) is done poorly because of both human and machine errors. AIM: To assess the difference between BP recorded in a pragmatic way and that recorded using standard guidelines; to assess differences between wrist- and mercury sphygmomanometerbased readings; and to assess the impact on clinical decision-making. SETTING: Royal Swaziland Sugar Corporation Mhlume hospital, Swaziland. METHOD: After obtaining consent, BP was measured in a pragmatic way by a nurse practitioner who made treatment decisions. Thereafter, patients had their BP re-assessed using standard guidelines by mercury (gold standard) and wrist sphygmomanometer. RESULTS: The prevalence of hypertension was 25%. The mean systolic BP was 143 mmHg (pragmatic) and 133 mmHg (standard) using a mercury sphygmomanometer; and 140 mmHg for standard BP assessed using wrist device. The mean diastolic BP was 90 mmHg, 87 mmHg and 91 mmHg for pragmatic, standard mercury and wrist, respectively. Bland Altman analyses showed that pragmatic and standard BP measurements were different and could not be interchanged clinically.Treatment decisions between those based on pragmatic BP and standard BP agreed in 83.3% of cases, whilst 16.7% of participants had their treatment outcomes misclassified. A total of 19.5% of patients were started erroneously on anti-hypertensive therapy based on pragmatic BP. CONCLUSION: Clinicians need to revert to basic good clinical practice and measure BP more accurately in order to avoid unnecessary additional costs and morbidity associated within correct treatment resulting from disease misclassification. Contrary to existing research,wrist devices need to be used with caution.


Assuntos
Determinação da Pressão Arterial/métodos , Adulto , Pressão Sanguínea , Determinação da Pressão Arterial/normas , Essuatíni/epidemiologia , Feminino , Hospitais/estatística & dados numéricos , Humanos , Hipertensão/epidemiologia , Hipertensão/terapia , Masculino , Prevalência , Esfigmomanômetros , Punho
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...