3. Electronic Theses and Dissertations (ETDs) - All submissions

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    Acceptability of rat-based diagnostic approach of tuberculosis among tuberculosis health care workers in
    (2018) Hassan, Tabia
    Background: Since the start of rat-based TB diagnostic tool in Tanzania in 2008, detection of new TB cases has increased by around 40%. In this study we aimed at examining factors that may affect acceptability of the rat-based TB diagnostic tool among TB health care workers in health care facilities served by APOPO in Dar-es-Salaam, Tanzania. Materials and Method: This was a mixed method exploratory sequential study design. We used in-depth interviews (IDIs) and structured questionnaire to collect qualitative and quantitative data respectively. Qualitative and quantitative data were analyzed using NVIVO software version 10 and Stata 14 respectively. Results: Twenty-five (56.8%) of participants aged between 18-34 years old and 26 (57.8%) were males. A total of 25 (55.6%) study participants showed higher levels of acceptability of the rats-based approach. Health care workers or personal factors score (perceived benefit and need, self-efficacy and skill proficiency on this new health innovation) was associated with acceptability having Odds ratio of 3.8 [95% CI: 1.0-14.2]. Through qualitative exploration, acceptability was motivated by support from their superior medical staffs, and relative advantages of the tool like fastness, and quality of the results. Issues found to be negatively associated with acceptability of the rat-based approach included lack of clear policy from specific government authority, limited patient awareness, inability of the rats to quantify concentration of TB bacteria, and failure to predict the resistance to the available drugs. Conclusion: This study provides critical information that can guide policy makers to expand and integrate this new innovation into the current TB diagnostic algorithm
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    Compliance to standard treatment guidelines in the management of hypertension by health care workers in Potchefstroom sub-district in North west province
    (2016) Siko, Peter Rapula
    INTRODUCTION Hypertension is one of the leading life style diseases and a main contributor of morbidity and mortality in many countries including South Africa. Standard Treatment Guidelines (STGs) are issued in this country to assist health care workers (HCWs) in the diagnosis and management of common conditions across all levels of care. The STGs include an Essential Drug List (EDL) as supported by WHO Bamako Initiatives (1980) for developing countries. Health systems, patient and physician related factors have been identified as the factors preventing blood pressure (BP) control in patients. OBJECTIVES Considering the debilitating effects caused by hypertension, the objectives were to find out if HCWs diagnose and manage hypertension correctly in terms of compliance to the guidelines. Guidelines are developed from credible evidence based research and are summarized for ease of use by HCWs. Most of the available studies on adherence to guidelines are self-reported and this research seeks to do a record analysis which is different from previous studies. METHOD 21 files of patients diagnosed between April 2009 and March 2011 with 475 documented visits spreading between 2009 and 2014 were purposefully selected from a sample of representative clinics and the hospital in the Potchefstroom sub district. A retrospective cross sectional study was performed using a validated data collection tool. The study included all adults above 18years of age and excluded all patients with co-morbidity at the time of diagnosis. RESULTS The total number of 475 entries represented 21 patients. The majority were males (57%), with a mean age of all patients of 52.81years. The mean systolic BP was 138.48mmHg and diastolic BP was 83.10mmHg. Compliance to diagnosis based on the clinical guideline, was 56% and 75% by nurses and doctors respectively with an overall compliance of 58%. Nurses also did not do well in terms of compliance to drug management at 63.5% with an overall compliance of 62.7%. There was an overall poor compliance to non drug management, where there was no record of health education in 55.8% of patients. CONCLUSIONS This study highlighted the significance of continuous professional development in terms of emphasis on international standards of diagnosis and non drug management. Drug management conforms to international trends of multiple drugs for better management of HPT. However, the generalization and transferability of results is compromised by the limited number of the sample size in the study. Source documents need to be properly monitored and information verified. Peer review of data and management oversight is encouraged. The use of a standard chronic form assisted in the management of patients by simplifying collection and documentation of clinical information over a 12 month period. _______________________________________________________________________________ KEYWORDS: Compliance, guidelines, guideline compliance, hypertension, health care workers
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    Emergency department workplace violence
    (2016) Jaffal, Amer
    Objectives: The aim of the current research was to determine the perception and experience of different emergency department occupational groups regarding workplace violence in the past 12 months and to determine the effect that it had on them in two government hospitals in Johannesburg, South Africa. Materials and Methods: The current research was a cross sectional, retrospective qualitative survey. Results: Eighty-six surveys (43%) out of the distributed 200 questionnaires were returned. Five surveys were unfilled leaving 81 surveys (40.5%) that are included in the analysis. Psychological violence was experienced by 73 % (n=51) of the participants while physical violence was experienced by 34.2% (n=27). Patients were the perpetrators of 61% and 67.9% of psychological and physical violence against staff members, respectively. Friends and family members who accompanied patients in the emergency department accounted for 27.4% psychological violence while this same set of people caused 17.3% of physical violence. Ninety-one percent of the participants reported that they did not receive any training courses on how to handle workplace violence incidents. Medical staff (doctors and nurses) were found to be at an increased risk to psychological violence. Conclusions: Workplace violence was commonly experienced by ED staff members. Majority of the incidents were in the form of psychological violence; however, a considerable percentage of the participants experienced physical violent incidents. Most of the violent incidents experienced were perceived to be preventable by majority of participants. This research supports the need for practical training and education of the ED staff members, on how to prevent and deal with issues related to ED WPV.
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    Knowledge, attitudes and practices of general assistants towards infection control at Letaba Hospital
    (2015-03-26) Peta, Mmalahla Rebecca
    Introduction - The implementation of infection prevention and control guidelines is important for the improvement of quality care in hospitals. This study aimed to identify gaps in the knowledge and attitudes of general assistants about infection control and to determine if their infection control practices are in line with current policies and guidelines. In investigating the practices of general assistants, the institution was assisted to identify gaps in knowledge and try to strengthen practices. Methodology: This descriptive cross-sectional study was conducted at Letaba hospital in Mopani district. The knowledge, attitudes and practices of 97 general assistants towards infection control at a given point in time was measured through a structured questionnaire which was administered to those who consented to participate. Purposive sampling was used as only those who were at work during the data collection period were included in the study. Results - This study revealed that over 50% of general assistants at Letaba hospital have only moderate knowledge about infection control. Fifty seven percent of general assistants reported moderately good infection control practices, while 23% practice infection control poorly. The majority (75%) of general assistants at Letaba hospital reported positive attitudes towards infection control. The results also show that the moderate score in knowledge affected the practice of infection control. Conclusion - This study shows that the knowledge and practice of infection at Letaba hospital is not optimal with regard to complying with infection control guidelines. It was, however, noted that attitudes towards infection control were good. Based on the fact that the attitudes were good, knowledge and practice can be improved with provision of appropriate supplies and strengthening training and supervision.
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