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Item Quality of Antenatal Care Services and Factors Influencing Maternal Satisfaction in Public Health Facilities of Wolkite Town, Gurage Zone, Southern Ethiopia(Addis Ababa University, 2023-06-23) Cheru Temesgen; Ababi Zergaw(Dr.)Although antenatal care (ANC) coverage in Ethiopia is increasing, the quality of ANC remains low. It is believed that increasing number ANC contact by itself is not enough to change current maternal health status and that the quality of ANC service can have important impact in the heath of mothers and new born. Objective: To assess quality of antenatal care services and factors influencing maternal satisfaction in Wolkite town public health facilities Methods: The study was carried out in Wolkite town the administrative center of the Gurage zone located 155 km west of capital city of the country, Addis Ababa. A facility-based cross sectional study design was conducted. The study populations were all pregnant women who attended the service in data collection period. Sample size was 409. A pretested structured questionnaire was used. Data entry, coding, cleaning was done by Epi-Info and the analysis was done by using SPSS version 26. Binomial and multinomial logistic regression analyses were conducted to examine the association between the socio-demographic, obstetric factors, process aspects of quality and maternal satisfaction. Ethical clearance was taken from the school of Public Health of Addis Ababa University research ethics committee Result: Out of 409 sampled pregnant women attending ANC clinic 398 (97.3%) were responded. About 48% % of respondent were satisfied with ANC services. Residence (AOR = 5.839 95% CI 3.175, 10.739), pregnancy status (AOR = 6.216 95% CI 2.943, 13.127), frequency of ANC visit (AOR = 1.804 95% CI 1.056, 3.082), counseling on nutrition (AOR = 2.875 95% CI 1.709, 4.835), prevention of mother to child transmission (PMTCT) of HIV(AOR = 2.337 95% CI 1.427, 3.827) and birth preparedness and complication readiness (BPCR) (AOR = 2.426 95% CI 1.341, 4.389)and provision of iron (AOR= 2.816 95% CI 1.249, 6.350) had an association with maternal satisfaction. Conclusion: Generally, maternal satisfaction with antenatal care services in this study was low. Absence of clean latrine & adequate water supply was the main reason stated by respondents. Effort should be made to improve accessibility of safe and potable water supplyItem Quality of Intrapartum and New Born Care in Public Health Care Facilities of Wolkite Town, Southern Ethiopia(Addis Ababa University, 2023-06-17) Berhanu Semra; Mesfin AddisseEven though, the world has made significant progress in reducing maternal and newborn mortality today, there are still far too many preventable and treatable maternal and newborn deaths globally. It is estimated that about six out of ten newborn problems and fifty percent of maternal mortality in developing countries are due to poor quality of care. However,in Ethiopia study on quality of intrapartum and newborn care is limited. Thus, the purpose of this study was to assess the quality of intrapartum and newborn care in public health facilities of Wolkite town in terms of three quality dimensions. Objectives: To assess the level of quality of intrapartum and newborn care in public health facilities of Welkite town, Southern Ethiopia, 2023. Methods: A facility-based cross-sectional study design was employed from March to April 2023 in 5 public health facilities for facility audit, among 342 mothers for exit interview and 185 mothers for observation. Consecutive random sampling method was applied. Data were collected by using document review, observation, and exit interview. Data was entered, coded and cleaned using Epidata version 4 and exported to Stata version 14 and SPSS version 25 for analysis. Descriptive and summary statistics were computed. Binary logistic regression was performed and variables which had p-values of ≤0.25 were selected and included in multivariable logistic regression analysis. Finally adjusted odds ratios with 95% confidence intervals and p-values < 0.05 were considered significant independent predictors of quality of intrapartum care. Result: The study revealed that the quality of intrapartum care in input and process components were 60% and 35.1% respectively. While, the quality of output as measured by maternal satisfaction was 42%, and 69.7% of newborns received good quality of care. Maternal education (AOR: 9.97, 95%CI: 1.52, 25.56), ANC visit (AOR: 6.32, 95%CI: 2.86, 14.00), transportation (AOR: 0.26, 95%CI: 0.15, 0.48) and process quality (AOR: 2.32, 95%CI: 1.27, 4.24) were independent predictors of maternal satisfaction with quality of intrapartum care. Conclusion and Recommendations: The quality of intrapartum and newborn care in the study area was minimal. Thus, efforts should be made by the government for improving facilities capacity and performance of health care providers in order to improve the quality of intrapartum and newborn care.Item Health Professionals‘ Psychological Distress and Associated Factors in the Post-Pandemic period of COVID-19 At Eka Kotebe General Hospital, Addis Ababa, Ethiopia(Addis Ababa University, 2023-06-21) Amira Kasim; Salle WorknehHumanity has battled a variety of pandemics. The Plague, Cholera, and Influenza are the most well-known of these pandemics and have caused the greatest number of fatalities. Now adays COVID-19 Is a global threat affecting all aspects of human life. Globally, the Pandemic affected how individuals‘ function, reorganizing professional work, requiring people to adjust to the constraints in place and limiting their ability to contact their loved once. Studies on this new pandemic have discovered that psychological distress in healthcare workers, such as anxiety, sadness, somatic discomfort, and burnout were experienced during the outbreak of the disease. However, the majority of studies have been done during the outbreak phase, while little has been done on job stress and psychological adaptability in healthcare personnel during the post-pandemic period. Objective: To assess Health Professionals‘ Psychological Distress and Associated Factors in the Post Pandemic period of COVID-19 at Eka Kotebe General Hospital, Addis Ababa, Ethiopia 2023. Methods: Institutional based cross-sectional study was done at EKGH. A sample of 416health professionals was included in this study using stratified simple random sampling technique. Self-administered questionnaire was used to collect information. After proper coding, data was entered into SPSS V.27 software. To evaluate the demographic traits and the trends in the concentration of the key variables, descriptive statistics were used. Multivariable logistic regression analyses were used to evaluate the significance of the association at P-value < 0.05. Result: 10.3% of the individuals reported experiencing psychological distress according to the IES-R scale. The two levels of psychological distress that the participants experienced the most frequently were mild (53.6%) and moderate (33.7%). The results of the multivariate logistic regression analysis showed that professionals with current medical illness (AOR= 4.9; 95%CI 2.39 to 10.2) and current substance users (AOR=3.8; 95% CI; 1.9 to 7.9) have statistically significant relationship with psychological distress. Conclusion: The findings of the current study confirmed the presence of psychological distress in the epidemic era and the concept that clinical circumstances like medical illness and current substance use affect health professionals' psychological distress as well as their ability to anticipate psychological distress during the post-pandemic period of COVID 19.Item Capstone Project on Reducing High Stock out of Medication in Kuyu General Hospital ,Kuyu Woreda,Oromia Region, Ethiopia.(Addis Abeba University, 2020-03) Kebede, Nugusie; D, Anagaw(PhD); Hailesellasie, WarrisawBackground: Shortages and stock outs of essential medicines have been increasing and become a global problem. High stock out of medication in public hospital specially has high impacts on delivering health care services and reduces the community satisfaction on health services given by the public facilities. Drug stock outs cause unplanned treatmentinterruptions. Further, repeated drug stock outs interrupt treatment which causes treatment discontinuity, and if not controlled could lead to drug resistance and/or treatment failure. Objective: To improve availability of essential medication in Kuyu General Hospital from 64% to 85% by the end of June 2020. Methods: Pre-post intervention study was used to identify the percentage of essential medication available in Kuyu general hospital and factors contributing to stock out of medication in the hospital. During pre-intervention the percentage of medication stock out in the last three months was assessed from the documents and intervention strategies were developed to improve the stock out of medication in the hospital. Strengthen DTC committee by onsite training, preparing bin card for medication and ABC-VEN reconciliation for pharmaceutical in the hospital are strategic intervention that was implemented. Pre intervention assessment was done from Dec 25 2019 to February 15 2020 and post intervention assessment was done from March 2020 to June 2020.Data were analysed using frequencies and percentages were estimated and the results were presented using tables and figures. Result: Availability of medication in Kuyu General Hospital increased from 64% during pre-intervention to 80% after intervention. Bin cards were prepared for 83.33% of item and updated for 67% of item during pre-intervention and prepared for all item assessed and update for 93.33% of item after intervention. From ABC-VEN matrix analysis done 10.91% of items consumes 65.10% of hospital budget. Vital items took 46.20% of items procured. Conclusion: Strengthening DTC committee activity by providing training and using stock management tools such as bin cards properly can reduce medication stock out in the hospital. Recommendation: DTC committee, Hospital management and pharmacy staff should work closely to continuously improve availability of medication in the hospital.Item Improving Ethical Practice at Neonatal Intensive Care Unit in Buee Primary Hospital.(Addis Abeba University, 2020-05) Alemayehu, Hiwot; Addise, Mesfine(Ass. Prof.); Nega, Adiam(MPH)Abstract Introduction: Ethics is defined as a moral philosophy or code of morals practiced by a person or group of people.There agreed ethical principles are autonomy, beneficence, non-maleficence, and justice, which are widely accepted in the neonatal practice. However, within the context of diverse values, beliefs and interests’ fundamental variations exist and they hugely influence the plans of new born management. There is limited information in Ethiopia regarding the practice of these ethical principles. The ethical principles of new born care are not clearly stated and not applied well by NICU staffs, in Buee Primary Hospital (BPH). The parents are not part of decision making and treatment of choice. Objectives: The objective of the project is to improve the practice of ethical principles at NICU in Buee Primary Hospital. Methods: Pre-post interventional study and descriptive qualitative approach was conducted to explore the practice of ethical principles at NICU in Buee Primary Hospital. The study populations are all health professionals working in the hospital. Key informant interview guide was conducted face to face by the investigator. The recorded audio note interviews were transcribed, and analyzed thematically using open code software version 4.2. Result: In the pre-intervention we conducted observation, document review and discussion to verify the root cause of the problem. In the- post intervention we developed implementation plan and the health professionals started to implement the plan. During this period, we evaluated the problem whether it has improved or not.Qualitative finding: The key informant interviews indicated gaps in the practice of ethical principles in NICU. The results of the selected strategies showed a significant improvement on the practice of low ethical principles in the unit.This was objectively measured using the observational checklist from 27% to 80% during the evaluation period of pre and post intervention. Conclusion and Recommendation: The results of this project suggested that a simple set of intervention was effective on improving the practice of ethical principles.The finding also proved the effectiveness of selected strategies, but it will be better to implement in a large scale in the hospital.Item Improving Outpatient and Inpatient Medical Recording Data Quality in Yerer General Hospital,2021(Addis Abeba University, 2021-07) Aboye, Hanna; Addise, Mesfin(MD, Ass. Prof.); Ayele, Wondimu(Ph.D.Ass. Prof.); Nega, Adiam(BSc, MPH)Background: Medical recording is an essential part of information use, dissemination,decision making for the health needs of the community health care system and quality service delivery. The medical recording quality is a serious issue to be addressed, especially in Africa which has been measured using different data quality dimensions, and the percentage result is below standard. In Ethiopia, the ministry of health (MoH) has focused on information revolution setting a five-year transformation plan, and has developed tools on a standard of data quality measurement. Those tools are used to measure the medical recording data quality in Yerer General Hospital for selected dimension. Objective: To improve medical recording of outpatient and inpatient data quality in Yerer General Hospital by the end of 2021 EC Method: It is a pre post study, we carried out a pre intervention; with baseline assessment using an infinite sample size calculation and proportional simple random sampling of cards which was admitted to the hospital between end of 2018 to end of 2019 time frame, and post intervention was in 2021 January to measure the improvement. After the intervention, a finite population sample size was used and a proportional random sampling method was applied for those admitted from January 21 to February 21 2021. Result: Training on health management information system was given as an intervention after pre intervention result was observed .pre intervention total completeness of outpatient and inpatient MR was 79.12% and 51.59% respectively. On post intervention result it decreased to 57% and 41% respectively. Pre intervention total accuracy of outpatient and inpatient MR was 63.6% and 55.7% respectively. On post intervention result it increased to 80.73% and 81.67% respectively. The timelessness has improved the cards are returned to the medical recording room in 24 hours after intervention. Conclusion: The intervention has influence on improvement of Total accuracy and timeliness but decrease score of the Total completeness of medical recording in Yerer General Hospital. Recommendation: Continues trainings and follow up are required to strengthen quality department of Yerer General Hospital.Item Improving Referral Feedback in Daye Primary Hospital, Sidama Region, Southern Ethiopia(Addis Abeba University, 2021-07) Tuke, Eshetu; Tassew, Berhanu(Bsc, MPH)Background: Referral is a two way process and ensures that a continuum of care is maintained to patients or clients. Referral system is a process by which a health provider transfers the responsibility of care temporarily or permanently to another health professional or social worker or to the community in response to its inability or limitation to provide the necessary care. It is done from the community to the primary care health service and to hospitals and within hospitals and vice versa. It also involves not only direct patient care but support services such as transport and communication. And once the care is completed, the receiving unit shall return the patient back to referring unit with timely referral feedback. This system is not practiced in Daye primary Hospital and uniformly. The objectives: To improve referral feedback in Daye primary hospital, in Sidama regional state, southern Ethiopia. Method: A pre-post intervention study to patients who were referred to Daye primary Hospital received referral feedback when referred back to the referring unit. A chart audit was conducted to calculate the percentage of completion of referral feedback forms and checklist was prepared to collect the information during chart auditing. The sample size was 62 chart audits referred in during pre intervention and post intervention. The reliability of the items in the check list was tested and revised. During the actual data collection process check the data collectors by randomly taking medical records with the checklist. Ethiopian hospital key performance indicator/KPI/ formula was used to analyses the difference between the pre-post intervention change in percentage the pre-post intervention change in percentage of referral feedback given (KPI 39) . Result: Pre intervention revised documents 62 medical records contained completed referral feedback from upon discharged (0%). A total of 68 referred patients were registered. All patients had referral paper (100). Fifty three of the discharged patient’s documents contained the completed and gave referral feedback forms (77.9%) to refer health facilitiesItem A Pre-Post Interventional Study on Improving the Implementation Status of Nursing/Midwifery Care Standard Practice At Haramya Hospital, Oromia Regional State, Ethiopia(Addis Abeba University, 2020-08) Abdulla, Abdulbasit Aliyi; Asrat, Gashaye (BSc, MPH); Tassew, Birhan(BSc, MPH)Background: The nursing/midwifery care standards help to ensure that patients are receiving high quality care. The standards support implementation of the basics of nurses‟/midwives‟ profession. Despite the importance of nursing care standards, implementation of the standards is lacking in most of the developing countries, including Ethiopia. Similarly, the baseline assessment of nursing standards in this study at Haramaya hospital was poor.Thus, it was critically important to improve the implementation of the Nursing/midwifery care standard practice in Haramaya general hospital. Objectives: To improve the implementation status of Nursing /midwifery Care Standards from 52.5% to 81% in wards of Haramaya Hospital, by the end of August 2020. Method: A facility based pre & post interventional study was conducted from March to August 2020 in Haramaya Hospital. A nationally tested and accepted instrument, the Ethiopian Hospitals Reform Implementation Guideline tool, was used to measure the performance on nursing/midwifery standards of care.The sampled nurses/midwives were allocated proportionally from all wards in the hospital. Data related to factors that hinder implementation of the nursing /midwifery standards was collected consecutively by data collectors using checklist and nursing standards through observational methods. Data quality was controlled through supervision and training of data collectors. Result: Among the total 88 the same respondents (44 before & 44 after), mean age was 27.23 years (SD=4.2) and the implementation status of nursing/midwifery care standards was 52.5% in pre-intervention & 78.4% after-intervention. This change was statistically significant at (df =44,P<0.001). Of the total of 80 patient cards documentation review (before 40 & 40 after intervention) the average implementation status of the standards in nursing/midwifery process & Medication administration record was 10.3 (50%) in pre-intervention & 28.5 (72.3%) after intervention. Conclusion and recommendation: The implementation status of the nursing /midwifery care standard practice is still below the expected criteria and it needs further intervention to increase its utilization. Knowledge, recognition & motivation are possible contributing factors for the improving of nursing/midwifery care standard practices those who are working at medical, surgical, & gynecology wards.Item Medical Equipment Management in Ayder Referral Hospital,Mekelle,Ethiopia.(Addis Abeba University, 2012-04) Mitiku, Mengistu; Addisse, Mesfin(MPH, PHD); Linnander, EricaAbstract 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.Item Tracer Drugs Stock Out in Durame Hospital SNNPR Ethiopia(Addis Abeba University, 2012-05) Adinew, Eshetu; Kumie, Abera( Dr. ); Mantopoulo, JeannieIntroduction: 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.Item 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.Item 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 .Item Improving Nursing Care Plan Completion in Dambi Dollo Hospital(Addis Abeba University, 2019-06) Balcha, Yonas; D, Anagaw(Dr.); A, GeshayeBackground: The nursing process has evolved during the past several decades and is now used by nurses throughout the world as an organizing framework for providing individualized person-centred care. Despite the important role of nurses/midwives have for the betterment of the health care, their independent work; the Nursing/midwifery care Practice standards do not get enough emphasis.According to global study approximately 30–40% of patients do not receive health care according to current scientific evidence and some patients receive unnecessary or harmful care. Pre-assessment study in Dembi Dollo general hospital in the beginning of 2019 also shows that the average nursing process completion rate was only 47%which shows considerable gaps in provision of services as compared the standards. Objective: - Using onsite training intervention improving nursing process completion from 47% to 75% in Dambi Dollo general hospital at the end of June 2019 GC. Methods: A pre- post intervention design was used in this project to examine the completion rate of nursing process. Base line data were collected from January to March 2019.The baseline assessment indicates low completeness of inpatient medical records. Only 47% of the 84 audited patient folders were completed. After base line assessment root cause analysis was conducted and the real root cause of the problem was identified. Based on the verification, lack of awareness about nursing process completeness was identified as a real root causes and two day nurses training on nursing process completeness and descriptive method of analyzed nursing process standard at facility level Data was analyzed using manual technique and the result was displays in Table and Graph. Results: the nursing process completion rate averagely increased from 47% pre-intervention to 76% post-intervention. Specifically nursing implementation practice and nursing diagnosis practice were considerably improved by 30 percentage points. Conclusion: The results of this project suggests cost efficient interventions such as experience sharing among medical staff and awareness about nursing process improves the implementation of nursing process completeness and there by supports the efforts being made to provide quality health services.Item Reducing Outpatient Waiting Time from Patient Registration Until to see Physician in Teklehaimanot General Hospital.(Addis Ababa University, 2019-10) Birhanu, Tigist; Derseh, Anagaw(Dr.); Tasew, BirhanPROBLEM STATEMENT: In Teklehaimanot general hospital long waiting time of registration to see a physician is one of the most problems. OBJECTIVE: The overall objective of the project is to reducing outpatient waiting time and increase customer satisfaction in Teklehaimanot general hospital Addis Ababa, Ethiopia by the end of June, 2019. METHOD: Pre post intervention was conducted in Teklehaimanot general Hospital from March 2019 to June 2019. RESULT: Patient waiting time and customer satisfaction improved based on pre and post intervention comparisons the success rate of patient satisfaction from 67% to 85% and waiting time from 180 minutes to 80 minutes. CONCLUSION: The results of this project suggests that a simple set of intervention assigning responsible person for medical record unit, giving training and using tracer card reduce the long OPD waiting time and improve client satisfaction. Among the three of them intervention, assigned responsible person for medical record unit was taken a great role to achieved the objective of this study. RECOMMENDATION: It is better if the department takes special consideration on full implementation and proper usage of a tracer card and continuous on job training should be given for the medical record unit staffs.Item To Assess and Improve the Low Bed Occupancy Rate in Mida Weremo Primary Hospital, Amhara, Ethiopia 2019(Addis Ababa University, 2019-07) Anberbir, Petros; Nega, Adiam; Tassew, BirhanIntroduction: Low bed occupancy rate (BOR) is the one of the biggest problem of the hospital. As a result it brings the indication of low quality health care services, customer and staff dissatisfaction and poor revenue generation. In this study measured and improved bed occupancy rate focused on installing operation care materials and start operation care service and provided post operative care at surgical ward in Mida Weremo primary hospital in Amhara /Ethiopia. Objective: To assess and improve low bed occupancy rate from 33.2% to 75% by the end of May 2019 G.C Methodology: A pre-post intervention study design was used to improve the low bed occupancy rate in Mida Weremo Primary Hospital. Data was collect from the admission and discharge registration log books including all patients admitted pre and post intervention by using the check list from each ward by data collectors. Total of 331 admitted patients were enrolled in study. Data was analyzed by using the following formula to calculate the BOR Formula of BOR= Total number of patient days for a given period (length of stay) x 100 Available beds (bed complement) x the number of days in the period. Result: Socio-demographic section of the study most admitted patients are male (59.3%) and Christian (82.7%). The mean ± SD age was 33.7 ± 27 and 32.4 ± 24.4 in the pre intervention and post intervention respectively. During the pre intervention study the BOR was 32.3%, 32%, 36% and 30.1% on September, October, November and December respectively. Operation service was started at the month of January. In this pre-post study BOR when we see the progress of BOR in each month with in the intervention periods 55.8%, 63.3%, 74.1% and 86.6% on February, March, April and May respectively. Conclusion: The fact that the hospital hasn’t started giving operation and post operation care service was attributed for low BOR and initiating this service was the main change idea. During post intervention period BOR was increased from 33.8% to 70% in this intervention period. Recommendation: It was recommended to hospital manager to give more attention and that the departments should record and report the necessary data accurately. It was also recommended to give more emphasis and do more researches on this field.Item Improving Referral Feedback for Patients Transfer from other Health Facility among Health Care Providers in Shebel Berenta Primary Hospital, Amhara Region North-West Ethiopia, 2019.(Addis Abeba University, 2019-09) Yazie, Melaku; Assefa, Demeke (MD, MPH); Asrate, Gashaye (MPH, PhD fellow)Problem statement: In shebel berenta primary hospital poor referral feed back to health facility is one of the most problem. Objective: To improve percentage of referral feedback provided by the health care provider in shebel berenta primary Hospital Methodology: A pre-post intervention study to examine percentage of patients referred to shebel berenta primary Hospital was provided with referral feedback when referred back to the referred unit or when to discharge.Item Pre-Post Intervention Study on Reducing Outpatient Department Waiting time to Consultation at Mettu Karl Referral Hospital, Ilubabor Administrative Zone, Oromia region, Western, Ethiopia, 2019(Addis Abeba University, 2019-09) Abdissa, Kuliche; Asrat, Gashaye (MPH, PhD fellow)Background: In Mettu Karl Referral Hospital, long waiting time of registration until to consultation with physician is one of the most problems. Because Patient spend substantial amount of time to get service delivered by health professional in outpatient department of the Hospital. Objective: The overall objective of the project is to reduce outpatient long waiting time from 128 minutes to 85 minutes and increase customer satisfaction from 5.8 scales to 7.0 by the end of June 2019. Method: A pre-post interventional study was conducted at Mettu Karl Referral Hospital, from March to June 2019 G.C with sample size of 400 OPD patients both at pre and post intervention period and data was collected by using hospital performance monitoring and improvement manual (HPMI) checklist and all steps of strategic problem solving methods from Ethiopia. Hospital Reform Implementation Guide (EHRIG) standard was used and the real root causes of outpatient long waiting time to consultation and low patient satisfaction in OPD identified were,long registration process and late starting clinic on time. Accordingly, re-arranging the registration process to reduce long process and awareness creation and discussion with physician was undertaken as an intervention, and data was entered and analyzed by using Statistical Package for Social Science Version 21 software. Descriptive analysis was used and results were presented in narration, graph and table. Result: Patient waiting time and customer satisfaction improved based on pre and post intervention comparisons. Patient waiting time was 128 minutes before intervention and decreased to 83.5 minutes and the success rate of patients‟ satisfaction increased from 58 % to 71% respectively after intervention. Conclusion and Recommendation: Committed management of arranging registration process until get physician and satisfaction of participants were the process could be effective to improve unnecessary waiting time in the hospital and continuous provision of follow up resulted in significant progress. Proper implementation and strong follow-up should be strengthened and the significant support from hospital leadership should be provided.Item 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.Item Improving Outpatient Medical Record Completeness in Enchini Primary Hospital, Oromia, Ethiopia(Addis Abeba University, 2019-06) Bokan, Dereje; Addissie, Mesfin(Dr.); Nega, AdiamBackground: Medical records management is one of the components of health information system that documents information related to a patient generated during patient-to-health care provider encounters at a health care facility. A well-managed medical records system is critical to improve the provision of quality health care services to ensure safe medical practice, efficient and effective services and improve the patient’s experience and satisfaction with their medical encounter. Objecti ve:-To i mprove outpati ent medi cal record compl etion from 37% to 90% in Enchini Hospit al at t he end of June 2019GC. Methods:A pre- post intervention design was used in this project to examine the completion rate of outpatient medical record.The pre-intervention assessment was conducted in the outpatient department of Enchini hospital. Base line data were collected between January and March 2019. The baseline data showed the completeness of outpatient medical records was low. Only 37% of the 50 audited patient folders were completed. A questionnaire was developed to assess knowledge gabs of all workers who were working at outpatient department such as nurses, general practitioners and medical record workers, whether supportive supervision was conducted by senior management team and availability of printing formats and materials. The root cause analysis was conducted to identify the root cause of the problem. Based on the verification, lack of awareness about outpatient medical record completeness was identified as a real root cause and a two day’s staff training on medical record completeness was conducted. Results: the outpatient medical record completion rate increased from 37% pre intervention to 89% post-intervention. Specifically, Summary sheet of all visit dates practice and International disease code practice were considerably improved by 90 and 80 percentage points respectively. Conclusion: The result of this project suggests that a simple set of intervention providing training on the awareness of medical record improves of outpatient medical record completeness. Recommendation: The hospital, the regional health bureau and FMoH need to give emphasis for the completeness of outpatient medical records as it contribute to good quality of healthcare.Item Assessment of Chronic Respiratory Symptoms and Lung Function Parameters among Large Scale Wood Factory Workers in Addis ,Abeba ,Ethiopia :A Comparative Cross-Sectional Study.(Addis Abeba University, 2019-10) Jabur, Belaynesh; Waluma, Samson(MSc, MPH, Ph.D); Belachew, Ayele(MD, MPH )Background: Occupational exposure to wood dust could cause numerous health problems including chronic respiratory symptoms and reduction of lung function parameters. However, information regarding prevalence of chronic respiratory symptoms and lung function parameters among large scale wood factory workers in Ethiopia is limited. Objective: The aim of this study was to assess prevalence of chronic respiratory symptoms, lung function parameters and associated factors among large scale wood factory workers in Addis Ababa, Ethiopia, 2019. Methods: An Institution based comparative cross-sectional study was conducted from February to April 2019. A total of 464 (232 wood workers and 232 Moha soft drink industry workers as control group) were included in the study. Chronic respiratory symptoms assessment was conducted in all participants from both groups while lung function test was conducted on 50 participants from each wood factory and soft drink industry. Stratified and simple random sampling was used to select wood workers and controls respectively.Chronic respiratory symptom was assessed using modified American Thoaracic Socity (ATS) questionnaire while lung function test was done using Easy on-pc spirometer. The data was entered in to a computer using Epi-data software version 4.4.2 then exported to SPSS version 23 and analyzed.Poisson regression, Multiple linear regressions and Multivariable logistic regression were performed. Results: In this study the prevalence ratio of overall chronic respiratory symptoms (PR = 2.17, 95% CI: 1.51–3.12) was significantly higher among wood workers (65.7%) compared to controls (23.3%).Moreover, sex, previous respiratory disease, not use of respiratory protective device and working department were associated with chronic respiratory symptoms. The wood workers had significantly lower FVC and FEV compared with controls. Conclusion: The wood workers had a higher prevalence of chronic respiratory symptoms and lower lung function parameters compared with controls, these reducing lung capacity.Therefore, respiratory protective devices should be provided to take preventive measures.