Hospital and Health Care Administration

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    Medical Equipment Management in Ayder Referral Hospital,Mekelle,Ethiopia.
    (Addis Abeba University, 2012-04) Mitiku, Mengistu; Addisse, Mesfin(MPH, PHD); Linnander, Erica
    Abstract Problem statement: In Ayder referral hospital, there is no well-organized system for the management of medical equipment. Objective: The overall objective of the project is to improve medical equipment management by increasing the percentage of EHRIG standards pertaining to medical equipment management met and by increasing medical equipment repaired by the end of April, 2012. Result: The percentage of functional medical equipment showed at improvement from 72(72.7%)to 82(83.8%). Compliance with EHRIG standards for medical equipment management (operational standards met)increased from 3 to 5 out of 9(33.3% to 55.6%). Conclusion: Sustainable provision of trainings on medical equipment operation and handling can result in a significant improvement in medical equipment functionality. Moreover, establishing medical equipment maintenance work agreements has a great impact in the management of medical equipment and also adherence to the Ethiopian hospitals reform implementation guideline can bring about improved management of medical equipment in health facilities. Recommendation: Full implementation of the Ethiopian hospitals reform implementation guideline strategies should be made and it is better to establish medical equipment maintenance work agreements with experienced companies.
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    Tracer Drugs Stock Out in Durame Hospital SNNPR Ethiopia
    (Addis Abeba University, 2012-05) Adinew, Eshetu; Kumie, Abera( Dr. ); Mantopoulo, Jeannie
    Introduction: Although availability of tracer drugs was the most important objectives of national drug policy, the unavailability of tracer drugs remains to be a major problem for poor countries. Objective: Toimproved tracer drugs availability in the Durame hospital drug stores Design: Pre–post intervention study during August 2011 to March 2012, using tracer drug stock out registration form and physician inventory. Setting: Durame Primary hospital in Ethiopia. Participants: Pharmacist and pharmacy technicians, hospital administrator (CEO), clinical staff and DTC members. Implementation: The intervention included the following components:(1) Developing tracer drug monitoring form (2) enhanced DTC training on drug management, (3) Improving drug procurement, and (4) Improving communication between Pharmacy staff and Physicians. Communication is the most important to provide quality of health care for the client. The work plan progresses of implementation were monitored by check list. Main Outcome Measure: We measured tracer drugs stock out and availability. The tracer drugs stock out rate reduced significantly from 167 stock out days (34%) to 31 (6%) (P, <0.02) based on pre- and post-intervention comparisons. Lessons Learned: Our findings indicate that a well-organized tracer drugs monitoring management system should be effective in improving patient outcome in hospitals in low-income countries despite the lack of resources.Longer follow-up is required to assess the sustainability of the hospital improvements accomplished.
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    Improving Outpatient Satisfaction
    (Addis Abeba University, 2012-05) Amensisa, Tesfaye; Addisse, Mesfin (MD,MPH); Bradley, Elizabeth(PhD)
    Measuring patient experience towards health care services is important for improving quality of care. Asking patients to rate the service provided, availability of medicines, cleanliness of working environment and the extent of communication is an important step towards improving the quality of care. The Objective of this project is to improve the status of outpatient satisfaction at Goba Hospital from the current 7.4 average score to an average score of 8.4 at the end of April 2012. Methods: Source population was patients those come to the hospitals that fulfill inclusion criteria, Study population was those sampled (selected) during data collection period and study unit was a patient who visits the hospital. The total sample size was 50 patients. Systematic random sampling technique used to select patients to survey. Two twelve grade-completed data collectors were employed to collect the data and a diploma graduate supervisor was recruited to facilitate the data collection process. Data were analyzed using excel and presented by tables and graphs. Measurements of central tendency like mean and measurement of dispersion (standard deviation) were used and bivariate and multivariate analysis were used to measure strengthen of association. Result: - After the intervention, the overall satisfaction score was 8.6. Eighty present of the respondent rated as strongly agree that the latrine and bathrooms were clean. 86% and 76% of the respondent reported that the staff told them the side effect of medication and the staff told them the symptoms to lookout after the patient left the hospital. Cleanliness of latrine and bathrooms and someone discussed the patient what symptoms to lookout after the patient left the hospital are predictors of patient satisfaction in pre intervention at p-value and AOR {0.021, 0.014] and [0.072, 0.079 and in post intervention at p-value and COR {[0.05, 0.008] and [0.38, 0.022]} respectively after adjusting with confounder. Discussion: - Improving medication communication gaps and cleanness of latrine/ bathroom change the outpatient satisfaction from 7.4 score to 8.6 score. Hence, cleanliness of latrines and bathrooms and medication communication are predictors of patient satisfaction.
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    Reducing Medical Record Chart Loss in Godey General Hospital Somali Region, Ethiopia
    (Addis Ababa Universty, 2018-01) Ibrahim, Abdirahman; Assefa, Demeke (MD, Mph)
    Introduction: medical record chart are used to describe the systematic documentation of a single patient's medical history and care across time, within one particular health care provider's jurisdiction. Background: Godey general hospital has many problems,among those, medical record chart loss is the one that needs attention by senior management, because the loss was high (32 %). Objective to reduce the rate of medical record chart loss in Godey general hospital from 32% to 0% in June 2018. Methods: Pre post interventional study was conducted to measure the rate of medical record chart lost in Godey general hospital, Somali region. The source population was Godey hospital and the target population was all charts in the record unit of the hospital. It has been used sample of 50 medical record charts from the whole chart unit by simple random sampling. Data collection checklist was used to assure the presence or absence of the medical record chart.Finding: decreased medical record chart loss from before the intervention to after the intervention (32% pre intervention and 6% post intervention).
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    Educational Processes and Practices of Undergraduate Midwifery Clinical Teaching in Mekelle University
    (Addis Ababa Universty, 2018-05) Tamrat, Azeb; Whitehead, Cynthia (MD, PhD)
    Background: Clinical practice experiences are critically important to achieve the maximum level of clinical competence after obtaining adequate theoretical and practical instructions. However, graduates have problems in doing some easy tasks. Most new bachelor graduates have adequate theoretical knowledge but lack competence in the clinical environment. The objective of this study was to study the educational process and practice of clinical teaching of undergraduate BSc. midwifery education at Mekelle university. Method: Institutional based cross sectional study and qualitative exploratory design is conducted. Mixed method (qualitative and quantitative) data collection is implemented.The quantitative data is collected using structured questionnaire and the qualitative data is obtained from focus group discussion (FGD). Data is processed using SPSS statistical software, and descriptive analysis is made to describe the findings. Result: 72.7% said there are enough number of cases available in affiliate clinical attachment sites; and 75.8% of them responded those health facilities are well equipped so that they can practice well. Around 70% of the respondents’ said instructors company during the clinical attachment would help acquire better skill, 60% of the respondents said, their tutors relate the clinical teaching with theory (knowledge) and simulation teaching. More time is needed to be allocated in the curriculum for the skill teaching. Conclusion and recommendation: This study revealed the value of effective clinical placement of students will enhance midwifery practice. The study participants preferred affiliation sites for exercising midwifery care practice. This can be explained as the proportion of clients per student is high due to minimal number of students that assigned at affiliate hospital/health center. Instructors company during the clinical attachment would help acquire better skill since they can relate the theory and practice. Availability of equipment and fulfilled infrastructure of the institution are the key element for improving clinical practice. There is a huge need to revise the curriculum in order to give emphasis to skill teaching and have enough time allocated for the skill teaching.
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    Challenges Faced by Students, Instructors and Technologists during the Clinical Placement of Radiology Technology Students for clinical Practices.
    (Addis Ababa Universty, 2018-05) Nigatu, Bizuayehu; Martimianakis, Tina (Dr.)
    Background: Clinical placements are of paramount importance. It assists students in acquiring the necessary competencies in terms of knowledge, skill and attitude in practical settings so that they meet the requirement for graduation. The main objective of this study was to assess challenges faced by students, instructors and technologists during the clinical placement rotation of Radiology Technology Students at four college of health science affiliated hospitals. Method: A qualitative approach using focus group discussion and semi structured interview was used to explore the experiences of students, instructors and technologists regarding challenges encountered during the clinical placements of medical radiology technology students. (22) BSc regular Radiology Technology Students in the department of radiography took part in the study from an available pool of seventy three students. Participants were arranged in three groups of 7 and 8 students. In addition, one group of 7 out of the 19 available instructors was interviewed. Two technologists from each affiliated hospitals were selected for face- to – face interviews. A categorization approach was used to analyze the data with the goal of identifying core themes representing. Results: The qualitative analysis led to the identification of nine themes from the focus group data and interviews. From the students and instructor’s point of view, “love of profession”, “transportation services”, “clinical supervision”, “theory-practice gap”, “hand on practice”, “imaging modalities”, “skill lab”, “placement area”, and “Curriculum” were considered as important factors in clinical placement experience. Conclusion: This research showed that there are many challenges encountered by both students and instructors during placement of student radiology technology for clinical practice to different college of health science affiliated hospitals. Those challenges obviously affect the futureperformances of students or the proper application of appropriate skill during their work experiences.
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    An Assessment of Practice of Active Learning Approach in Wolita Sodo University Health Science College, Southern Ethiopia
    (Addis Ababa Universty, 2018-05) Alemnew, Biruh; Kulasegram, Mahan (Phd)
    The main purpose of this study was to assess the practices of implementation of active learning approaches in Wolita Sodo University Health Sciences College.To meet the objective of the study, a convergent parallel mixed design was employed. Lottery method was used to select the department of public health officer, from which students were sampled.The academic director of the college, 21 preclinical teachers and all 81 students from the second batch of department of public health officer were selected using availability sampling technique. Quantitative data were collected from all students and teachers using structured and pretested questionnaire. The academic director and selected teachers were interviewed using interview guide. Data analysis was done in three phases. First, analysis of the quantitative data was done in SPSS Version 20 and percentages, means and frequencies were used. Second, qualitative data was analyzed considering the research questions, using framework coding which is a deductive approach. Finally, quantitative and qualitative results were merged. Almost all instructors and students had a positive perception of active learning. Teachers are practicing active learning sometimes but the level of their practice was not satisfactory. Lecture was found to be the most commonly employed teaching technique followed by individual assignments, group work/discussion and question and answer methods. Shortage of time, large amount of contents to be covered during one classroom and lecturers and students tendency towards the traditional lecture method were found to be the most serious factors among the problems that affects the practice of active learning negatively. It has been recommended that teachers should be committed to discharge their roles to exercise active learning methodologies. Additionally, to improve the level of implementation of active learning, the administration of the college should continuously identify and solve those problems by developing a working group in coordination with teachers, students and other stakeholders.
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    Improving the Implementation of Nursing Care Process in Wacha Primary Hospital, Kafa Zone, SNNPR; Ethiopia.
    (Addis Abeba University, 2018-06) Million, Ermias; Derse, Anagaw(PhD); Asrat, Gashaw (MPH)
    Background: Nursing care Process is a systematic method which utilizes scientific reasoning, problem solving and critical thinking to direct nurses in caring for patients effectively.Despite the important role nursing process plays for the betterment of the health care, its implementation status is far below expected, particularly in developing countries. Similarly, the baseline assessment in this project showed that the implementation of nursing care process in wacha primary hospital was poor. Thus, after the intervention was made the implementation of the nursing care process completeness improved in the hospital. Objectives: To improve the implementation of nursing care process completeness from 10 % to 65% in medical and surgical wards of wacha primary hospital, by the end of May 2018. Methodology: A facility based pre- post interventional study was conducted from March 1 to May 30, 2018 in Wacha Primary Hospital, Kafa Zone, South Nation Nationalities People of Republic, Ethiopia. A total of 100 Medical Records were reviewed ba s e d on HPMI gui de l i ne of Et hi opi a (50 at baseline and 50 at the end of the study by simple random sampling method) to compare the nursing c a r e Process implementation status during pre and post-intervention periods.A structured questionnaire was used to collect the data. Result: The percentage of patient cards with complete nursing care process increased from 5(10%) to 40(80%) after intervention made. Nursing admission assessment from 3(6 %) to 41(82%), Nursing diagnosis from 5(10%) to 41(82%); Nursing care plan from 6(12%) to 40(80%); Nursing implementation from 7(8%) to 40(80%) and Nursing evaluation from 5(10%) to 40(80%), with all changes showing there is an improvement. Conclusion and Recommendations: Effective implementation of the nursing care process leads to improve quality of care for the patient and stimulates the construction of theoretical and scientific knowledge of nurses on the best clinical practice. Continuous internal supportive supervision of nurses followed by on job training can strengthen the implementation of the nursing care process. Wacha primary hospital senior management team should consider strengthening the internal supportive supervision to improve the nursing process in their health facility.
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    Enhancing the Completeness of Medical Records at Inpatient Department of Karat Primary Hospital KonsoWoreda, SNNPR
    (Addis Ababa Universty, 2018-06) Katusa, Kafita; Zergaw, Ababi (PhD)
    Background: The completeness of medical records is key performance indicator that is related with delivery of healthcare services in the hospital and assessed with minimum set of indictors such as physician note, physician order sheet, Nursing care plan, medication administration sheet, discharge summary, progress note and clinical pharmacist record form. Objective: The objective of the study was to enhance the completeness of inpatient medical records from 22% to 60% in time period from Feb to June, 2018 at In-patient department of Karat Primary Hospital, KonsoWoreda, SNNPR Design: before-after interventional study was carried from Feb to June, 2018 using document review, observation, inpatient medical record review form and focus group discussions. Setting; Karat primary hospital, SNNPR, Ethiopia Participants: SMT, Medical director, matron and all IPD clinical staffs. Result: the overall completeness of medical records rose from 22% pre-intervention to 54% post-intervention in in-patient department of Karat primary hospital from Feb to June, 2018 with total budget of 25000.00 Ethiopian Birr.
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    Increasing Skill Delivery Attendance at Gebretsadik Shawo General Hospital, Kafa zone, SNNPR
    (Addis Abeba University, 2018-06) Mengesha, Zerihun; Adisse, Mesfin(Dr.); Deresse, Anagaw(Dr.)
    Background :Utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified persons at home. Promotion of universal ANC follow-up and encouragement of mothers regarding the need for SBAs during childbirth is of paramount importance. Increase the awareness of mothers and their partners about the benefits of institutional delivery and SBAs and use of different means of behavioural change communication is very fundamental . Objective:To increase skilled birth attendance at Bonga Gebretsadik Shawo General Hospital from 120 to 180 per month by the end of 2010 E.C Methodology: A pre–post intervention study to examine the increase in skilled birth attendance before and after the intervention . Baseline data was collected in January 2010 and intervention period was from February to may 2010 E.C and final evaluation was conducted at the end of may 2010 E.C, after 4 months of implementation. For the assessment data Hospital Key performance indicator was used. Root cause analysis method is Focused group discussion and fishbone diagram . Effect of intervention was assessed by reviewing and comparing Antenatal and delivery room registration for intervention group . Result: Low partner involvement on maternal health activity was identified as real root cause for low skilled birth attendant and Birth preparedness plan with the involvement of male is selected as best intervention . Implementation of the intervention which is birth preparedness plan with the involvement of male partner was conducted for ANC 4 visitors and skilled delivery attendant was increased from 120 to 180 on average per month. Conclusion: Birth preparedness and complication readiness has significant effect on skilled delivery care use but Only a small numbers of ANC visitors were found to be prepared for birth and its complications in their last pregnancy during ANC follow up .
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    Maximize Operating Room Capacity by Intervening an Avoidable Cancelation at St. Peter Specialized Hospital
    (Addis Ababa Universty, 2018-06) Assefa, Samuel; Tassew, Birhan
    Background: Elective surgical case cancellation refers to any elective surgical case that is booked into the operation theatre list on the day prior to surgery, but is not operated upon as scheduled.Elective surgical case cancellation is common and can have significant adverse effects. The cancellation of planned surgeries causes prolonged wait times, harm to patients, and is a waste of scarce resources. Reasons for cancellations are complex because they are related to patients, organizational issues, and clinical staff. Objective: -To Assess the frequency, to identify reasons for cancellation and to intervening potentially avoidable causes of cancellation and observe the impacts of intervention made in St. peter specialized hospital. Methods: -The study took place at St. peter specialized hospital. This is a pre and post intervention study from February1/2010 to May 30/2010 E.C. All adult patients that underwent elective surgery in operation room with in the study period were including. Total number of cancellations as well as cause of cancellation was noted. Implementation: The most feasible intervention was addressing reasons of cancellation due to shortage of OR material (Guan, cape, drape). Result: -At Pre intervention period highly cancellation caused by shortage of surgical material (guan, Cape & drape). Plan was purchased each 100 of OR guan, drape & cape. Now all are ready for work. Conclusion: Cancellation of surgeries is significant problem in this hospital Reasons for cancellation identified was four categories. Whereas only one was selected for intervention in these study after taking impact, feasibility, cost effectiveness, time constraints into consideration. The highest present for reasons for cancellation were seen due to shortage of operation room material in pre-intervention period. Recommendation: As shortage of OR material (guan, cape and drape) which scores high in pre intervention, needs further in depth assessment and also other root causes should be addressed to see the desired changes. OR performance evaluation should be included in routine monitoring and hospitals clinical audit system.
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    A Pre and Post Intervantional Study on Medical Equipment Maintenance System in all Africa leprosy, Tuberculosis and Rehabilitation Training Centre (ALERT), Addis Ababa, Ethiopia, June 2018
    (Addis Ababa Universty, 2018-06) Tamirat, Yemiserach; Addise, Mesfin (MD, MPH)
    Introduction- Medical equipment is defined as any devise that is used in the rendering of patient care [1]. According to the world health organization, Medical equipment is used for the specific purposes of diagnosis and treatment of disease or rehabilitation following disease or injury. Problem Statement – The medical equipment maintenance system as a whole (both the IPM and corrective maintenance) in All Africa Leprosy, Tuberculosis and Rehabilitation Training Centre (ALERT) is not functioning well, the management and the maintenance system is not well organized and is not done in a regular interval, in addition the department of biomedical engineering is newly opened. Objective - The general objective of the study is to improve the preventive maintenance system in ALERT hospital. The specific objectives for the study were to increase the CR from 79% to 90%,LR from 25% to 60%and IPM from 40% to 60%by May 2018. Project Design/Methods: Pre-post interventional study was conducted at ALERT hospital located in the capital city of Addis Ababa with a catchment area of approximately five million populations with the total budget of the project 16000 at ALERT hospital from February to June 2018. Data Collection Procedure and Analysis - A pretested questioner which was developed by reviewing different literatures, which also includes international standards in equipment maintenance was used. SPSS version 20.0 was used for data entry, coding, cleaning and analysis. Chi square test of association was used to detect the association between pre and post intervention studies. The finding was presented using tables, graphs and texts. Result– The result of one month implementation of selected strategies showed that a significant improvement of preventive maintenance in the hospital.This was objectively measured by an increment in the completion rate from 79% to 90.5%, location rate from 25% to 61% and inspection and preventive maintenance yield from 40% to 72%. Conclusion and Recommendation - The result of this capstone project showed that, those selected strategies were effective on improving preventive maintenance system. Although the finding proves the effectiveness of selected strategies, user training is still a gap for the hospital. So, it will be better if these selected strategies will be implemented in a larger scale by including all clinical service providing departments.
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    Improving Patient Satisfaction in Outpatient Department at Gunchire Primery Hospital
    (Addis Ababa Universty, 2018-07) Abas, Tebarek; Assefaw, Demeke (Dr.)
    Problem statement: Patient satisfaction denotes the extent to which general health care needs of the clients are met to their requirements. Assessing and improving Patient satisfaction is one of the essential indicators for healthcare service improvement. It is needed for assessing for the current patient satisfaction situation, setting objectives and targets for the future and measuring progress and improvement in Gunchire Primery Hospital in SNNPR/Ethiopia. Objective: To improve the Overall patients satisfaction level in OPD from 63% to 86% in February ,2018 to July 30,2018. Method: Descriptive study comparing the status of patientstisfaction before and after a feasible intervention to improve patient satisfaction in the Outpatient Department of Gunchire Primery Hospital. A structured questionnaire was administered to collect the data and the study was carried out in 50 patients selected by random sampling method. Results: The overall patients satisfaction the respondents were satisfied by 86.54% that was improved from 63% to86.54% in pre-post interventions. The 5 categories' satisfaction level of respondents’ opinions by components, based on 29 survey conducted the average response rate regarding to physical facilities, the respondent satisfaction level were 88% satisfied and 12% were not satisfied by the physical facilities. Average response rate regarding to waiting time to services the respondent satisfaction level were 87% satisfied and 13% were not satisfied. Average response rate regarding to pharmacy services, the respondent satisfaction level were 86.5% satisfied and 13.5% were not satisfied. Average response rate regarding to doctor and nurse services, the respondent satisfaction level were 91.2% satisfied and 8.8% were not satisfied. Finally Average response rate regarding to registration services, the respondent satisfaction level were 80% satisfied and 20% were not satisfied.
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    A Pre-Post Interventional Study on Outpatient Satisfaction in St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
    (Addis Ababa Universty, 2018-10) Toffik, Nebat; Tassew, Birhan
    Introduction: Patient satisfaction is a primary means of measuring the effectiveness of healthcare delivery.Patients have Explicit desires for quality services when they visit health institutions. The care in the OPD is believed to indicate the quality of services of a hospital and is reflected by patients' satisfaction with the services being provided. Hence, this Study aimed to determine the level and determinants of patient satisfaction with outpatient department of St Paul’s Hospital millennium medical collage A.A, Ethiopia. Problem Statement: --in St Paul’s Hospital Millennium medical college, out patient satisfaction score is below the standard which is56% at pre assessment period but the standard is above 80%. Objective: -To improve out patient satisfaction of St Paul’s Hospital millennium medical collage from baseline of 56%in February 2018GC to 75%in June 2018 GC this 75% is decided after different literatures reviewed and also because of shortage of time and cost. Methodology: -Apre-post interventional study was conducted at St. Paul’s hospital millennium medical college, from February to June 2018GC with sample size of 50 OPD patients both at pre andpost intervention period and data was collected by using national hospital performance and monitoring manual checklist and all steps of strategic problem solving methods used and the real root causes of low outpatient satisfaction in OPD clinic were unclean toilet, low patient to pharmacy professionals communication on patient counseling & unavailability of medications founded accordingly, training was provided for pharmacy professionals on patient counseling and frequent cleaning of the toilet was undertaken as an intervention. And data was analyzed using SPSS version 20 IBM statistics. As result cleanliness of the toilet was increased from 26% to 56% and patient counseling of pharmacy professionals was increased from 40% to 62%. Satisfaction rate that was 56% before intervention was increased to 73% after intervention on conclusion a simple set of intervention could be significantly improving cleanliness of the toilet and communication of patientto pharmacy professionals.longer follow up would be required to assess the sustainability of provider to patient communication, and cleanliness of the toilet.
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    Completeness of Inpatient Medical Record in St.Paul’s Hospital Millennium Medical College
    (Addis Ababa Universty, 2018-10) Getahun, Fitsum; Asrat, Gashaye (BSC, MPH)
    Medical record is an account compiled by physicians and other health professionals of a patient`s medical history, present illness, findings on examination, details of treatment and progress notes and it is a legal record of care.The maintenance of complete and accurate medical record is a fundamental duty of health care providers. Complete medical record indicates the quality of patient care provided in the facility.Many ethical and legal issues are implemented in their maintenance including third party access and appropriate storage and disposal. Objective: To improve the percentage of inpatient medical record completeness from46.48% to 80 %at the end of Jun 2018. Methods:A pre- post intervention design was used in this project to examine the completion rate of inpatient medical records. The pre-intervention assessment was conducted in the inpatient department of SPHMMC. Base line data were collect in Feb 2018 .based on the baseline, the completeness of inpatient medical records was low , .only 46.48% of the 202 audited patient folders was completed. After base line assessment we conducted root cause analysis and identified the real root cause of the problem. Based on the verification, lack of awareness about inpatient medical record completeness, clinical forms not suitableto enter data, absence of monitoring and negligence were identified as a real root causes.We conducted two interventions; one day staff training on importance of inpatient medical record completeness and develop new clinical forms. Results:the documentation completion rate significantly increased from 46.48% pre-intervention to 78.6% post-intervention, the completeness of three out of the five elements of medical records (physician note, physician order sheet and discharge summery) especially significantly improved. Conclusion: The results of this project suggests that a simple set of intervention providing training on the importance of inpatient medical record and availing suitable inpatient medical record forms improves the inpatient medical record completeness. Recommendation: Ongoing monitoring and accountability system should be implement , It is better if the Health Management Information System Department takes special consideration on full implementation and proper management of inpatient medical records, Intensive and continuous training should be given for the healthcare provider by Health Management Information System Department..
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    Increasing the Infection Prevention Coverage in Shoarobit Primary Hospital Northshoa, Ethiopia.
    (Addis Abeba University, 2019-01) Bizu, Abebe; Tassew, Berhan
    Introduction Infection prevention and control is a central component of safe and high-quality service delivery at the facility level. With an inadequate practice of infection prevention, the risk of acquiring infections through exposure to blood, body fluids or contaminated materials in healthcare facilities is substantial.Lack of compliance with infection prevention and control measures has a number of consequences. Adherence to infection prevention and control practices is essential to providing safe and high quality patient care across all settings where healthcare is delivered. Objective – The overall objective of the project is to increase infection prevention and patient safety implementation from 50% to 80% at the end of June2011E.C in Shoarobit Primary Hospital ANRS,Ethiopia. Methods –Facility based pre-post interventional study design was applied in Shoarobit Primary Hospital.To understand the actual processes and problems faced on the ground, an actual state analysis was performed after measuring base line assessment. This allowed us to analyzed and understand the bottlenecks and problem areas within the hospital before implementing selected best interventions. Timeline and budget for capstone project completion:-from January 1st /30 to April /30/2019, with total project budget of 25465 ETB.
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    Improving Completeness Of Inpatient Medical Records In Amdework Primary Hospital, Amhara,North Ethiopia.
    (Addis Abeba University, 2019-06) Asmamaw, Baynakachew; Assefa, Demeke(Dr.)
    Back ground: Globally, Medical recording service is a component of all health care system, as it is the entry point of the health service and one of the key areas to have quality service in the health facilities. Clinical record documentation is one of the most basic professional responsibilities even if it is often poorly practiced. Record keeping and information management are the requirement for the provision of quality patient service. They are essential for the patient’s present and future healthcare decision making. The information contained in the record is essential, but the process of documenting it is often considered a lesser priority by many health institutions. Objective: The overall objective of the project is to improve completeness of inpatient medical records from 65 % to 90% in Amdework primary hospital by the end of June,30, 2019. Method: A pre-post intervention study design was applied to improve inpatient medical record completeness in Amdework Primary Hospital (APH) from January1-5,2019 for pre intervention period and from June1-5,2019 for post intervention period.Data was collected using structured audit tool and by simple random sampling technique a sample of 85 inpatient medical record was taken out of all inpatient medical records in Amdework Primary Hospital. The collected data was cleaned for its completeness and then entered into SPSS version 20 software for analyses and Independent T-test was used for comparing pre and post interventions. Result :The intervention was associated with improving completeness of inpatient medical record. At the beginning of the project completeness of inpatient medical record in Amdework primary Hospital was 65%, after intervention completeness of inpatient medical record became 93.6%. During post intervention from 85 inpatient cards the result shows that 97.6% has complete progress note, 97.6% has complete order sheet, 98.8% has complete medication administration record, 35.3% records has complete clinical pharmacist record and 100% has complete discharge summary. Conclusion :The overall completeness of inpatient medical record in mdework primary Hospital after intervention was 93.6% which have 28.6% improvement from the baseline assessment and the higher rate of completeness was seen in discharge summary 100 % completed and the least completed was clinical pharmacist record 35.3 % completed. Although there is significant improvement in completeness of medical record completeness and clinical pharmacist record still the objective is not achieved because the clinical pharmacist hiring is late and still forgetting to dated and signed to the main card. So in order to meet the objective of the indicator continuous supervision of inpatient clinical staffs should be done.
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    Improving the Implementation Status of Nursing Care Standards Process at Medical& Surgical Wards in Jogel General Hospital, Harar,Ethiopia.
    (Addis Abeba University, 2019-06) Dawied, Aynie Ali; Tasew, Birhan(BSC, MPH); Zergaw, Ababi(Dr.)
    Background:-Despite the important role of nursing care standard practice plays for the betterment of the health care, its implementation status is far below expected, particularl y in developing countries. Similarly, the baseline assessment in this study showed that the implementation of Nursing Care Process in Jogel general hospital is poor. Thus, in light of the national and regional efforts to improve health care deliver y& improve a health care Quality. it is critically important to improve the implementation status of the Nursing care Process in Jogel General Hospital. Objectives: To improve implementation of Nursing/midwifery Care Standard Practice from 42 % to 70% in Medical & surgical wards of Jogel Hospital, by the end of June, 2019. Methodology: A facilit y based pre- post interventional study will be conducted from March to June, 2019 in Jogel General Hospital, Harar, Ethiopia. The interventions include give in service training for ward nurses; strengthening internal supportive supervision, nursing audit committee, and provide the update nursing care format preparation .observational questionnaires about the challenges in implementation of the standards for a total of 80 staff nurse(40 pre-40post).A total of 60 Medical Records (MR) have been reviewed ( 30 at baseline and 30 will be at the end of the study) to assess & compare the medical record completeness about t he at t ached & complete document at i on of necess ar y format s during pre and post-intervention periods respectivel y. The proportion of standard checklists which wi l l me et Nursing Care Standard Practice with complete services, and observational self prepared questionnaires with10 item total of 100 inpatient admitted(50 pre-50 post intervention) about the nursing care quality and client satisfactions documentation a addition reviews standard 10item contain checklists fill and conduct focus discussion with a total of 14 staff (CEO, Matron, 2director of nurses and 1 2 s t a f f n u r s e ) of formats, and Chi-square test is calculated to test the difference in the outcome of interest between the pre –and post –intervention periods. Result:- The percentage of patient cards with complete Nursing Care Process increased from 42% in baseline to 70% after intervention. This change was statistically significant at (df = 1.44, P =0.0403). Similarly, the implementation of all components of the Nursing Process has increased: Nursing Admission Assessment (from 56% to 82% / P =0.0201), Nursing Diagnosis (from 38% to 78%, P =.0.0301); Nursing Care Plan (from 54% to 66% / P =0.0225); Nursing Implementation (from 47% to 64% / P =0.0152) and Nursing Evaluation (from 31% to 59%/ P = 0.0173), with all changes showing statistically significant at P < 0.05. Conclusion and Recommendations: - continuous on job training continuous flow of related forms can improve the implementation of the Nursing Process followed by. Continuous internal Supportive Supervision of Nurses in wards. Jogel general hospital managers should consider strengthening the internal Supportive Supervision to improve their health facility.
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    Improving Inpatient Medical Record Completeness in Bichena Primary Hospital ,East Gojjam zone,Amhara Region ,North West Ethiopia,2019.
    (Addis Abeba University, 2019-06) Geremew, Andualem; Assefa, Demeke
    Introduction: The completeness of medical records is an outstanding problem that affects the quality of health services in many hospitals of Ethiopia. Enhancing the completeness of patients records is inexpensive that can be implemented with the involvement of health workers. Maintaining a good record is important to enable health care workers to provide adequate care for their patients. In patient medical record completeness of Bichena Primary Hospital was lowered (55.6%). Objective: The objective of this study was to improve inpatient medical record completeness in Bichena Primary Hospital East Gojjam zone, Amhara region, Northwest Ethiopia. Methods: A Pre-post interventional study design supported with qualitative approach was conducted to improve inpatient medical record completeness in Bichena Primary Hospital (BPH) from the end of September to December 2019 for pre intervention period and from the end of February to May 2019 for post intervention period. Data were collected using structured audit tool and simple random sampling technique was used to select 384 patients’ cards among the inpatient department of the hospital. The collected data were cleaned for its completeness and then entered into Epi-info Version 7 and exported to SPSS version 20 software for analyses to determine what?.Independent T-test was used for comparing pre and post interventions. For the qualitative approach, six key informants for in-depth interview and 8 for focus group discussion were selected and data were collected through semi structured guide questioner to know the improvement of inpatient medical record completeness. Results and discussion: Inpatient medical record completeness improved from 55.6% to 92.2% when we measured after intervention and other components were also improved for example:patient card completeness from 88.2% to 96.9%progressnote12.4% to 90.4%,, order sheet77.1% to 95.3%, nursing care plan88% to 98.7%, medication administration54.6% to 90.6%, discharge summary28.6% to 93.4% and clinical pharmacist improved from41.9% to 76.3%. Conclusion and recommendations: Following our intervention inpatient medical record completeness was improved at Bichena Primary Hospital. There for, project works like capstone should be practice for better improvement of medical records completeness in all Primary Hospitals of East Gojjam zone in particular and Amhara region in general.
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    Improving Compliance Implementation of Infection Prevention and Patient Safety Standards in Kuyu General Hospital.
    (Addis Abeba University, 2019-06) Feleke, Abebe; D, Anagew(Dr.); N, Adiam
    Intruduction: A baseline assessment about compliance with Infection Prevention and patient safety standards at Kuyu General Hospital indicates low performance. Objective: To increase the percentage of compliance to Infection Prevention and patient safety standards met from 37.5% to 75% at Kuyu General Hospital at the end of May 2019. Methodology: Pre-post intervention study was used to evaluate the performance of IPPS standards.Pre-Intervention baseline data were collected in March 2019. In ordered to identify the root cause of the low compliance, the fish bone analysis was made and a decision matrix was used to have a comparative analysis of intervention strategies. After an intervention was conducted to improve the Ethiopian Hospitals Service Transformation Guideline, Infection Prevention and patient safety standards and follow-up data was collected in May 2019. The same indicator was used for the measurement such as perecentage, and frequency, the results are reported by Figure, and Tables. Result: After Provision of training for staff based on national standards of infection prevention and patient safety, Compliance with Ethiopian Hospitals Service Transformation Guideline standards finfection prevention and patient safety standard increased from 37.5% to 75%, health Education from 18%to 86% and waste sagrigation from 56%to78%. Conclusion: Provision of training for staff based on national standards of Ethiopian Hospitals Service Transformation Guideline, and policies resulted in improving stan finfection prevention and patient safety standards. Recommendation: Full implementation of the Ethiopian Hospitals Service Transformation Guideline standards finfection prevention and patient safety strategies should be made and it is better to give better attention and continuous follow up of the overall performance of standardized finfection prevention and patient safety practices.