Evaluation of the standards of nursing care in pediatric wards in referral hospitals in Swaziland

Mhlongo, Zanele Claudia (2000-03)

Thesis (MCur)--Stellenbosch University, 2000.

Thesis

ENGLISH ABSTRACT: Recent escalation of medical costs, cost containment and decreasing public funds, drew attention to the importance of formulation and evaluation of standards of nursing care. Practice experience and consultations with nurse managers indicated a great need for standards to evaluate the quality of care in the pediatric units of the big hospitals in Swaziland. A non-experimental, explorative and descriptive study was conducted in the four regional hospitals in Swaziland. Checklists were developed by the researcher to evaluate standards of care relating to the structure, process and outcome dimension of care. Structure standards refer to minimum requirements regarding the facilities, equipment, supplies, and availability of generic documents and staff. Process standards are mainly concerned with the specific nursing procedures and practices, while the Outcome standards evaluate the parents' satisfaction with the nursing care of their child, the amount of information received prior to discharge and the level of communication between the parents and the nursing staff. The most important results are: .:. None of the hospitals met the pre-set requirement to be considered as delivering a satisfactory level of care for any of the three dimensions of care . •:. Critical nursing procedures were often performed ineffectively and inefficiently . •:. Most parents viewed their communication with the nursing staff negatively. Recommendations include the development and implementation of a formalized quality improvement programme on all levels of care, auditing of records and patient care and in-service education for all personnel regarding quality care. Keywords: Quality care, formulation and evaluation of standards - pediatric patients

AFRIKAANSE OPSOMMING: Die onlangse verhoging in mediese koste, kostebesparings en verminderde openbare fondse, het die aandag gevestig op die belang van formulering en evaluering van standaarde vir verpleegsorg. Praktykervaring en konsultasies met verpleegbestuurders het aangedui dat daar 'n groot behoefte bestaan vir standaarde om die gehalte van verpleegsorg in pediatriese eenhede in die groot hospitale van Swaziland, te evalueer. 'n Nie-eksperimentele, verkennende en beskrywende studie is onderneem in die vier streekshospitale in Swaziland. Kontrolelyste is deur die navorser ontwikkel om standaarde van sorg te evalueer ten opsigte van die struktuur-, proses-, en uitkomsdimensie van sorg. Struktuurstandaarde verwys na die minimum vereistes ten opsigte van die fasiliteite, toerusting en voorrade, die beskikbaarheid van generiese dokumentasie en die personeel. Prosesstandaarde hou hoofsaaklik verband met spesifieke verpleegprosedures en praktyke terwyl Uitkomsstandaarde die ouers se tevredenheid met die verpleging van hulle kind, die hoeveelheid inligting ontvang voor ontslag en die vlak van kommunikasie tussen die ouers en die verpleegpersoneel evalueer. Die belangrikste resultate is: .:. Geen hospitaal het ten opsigte van enige van die drie dimensies van sorg, aan die voorafbepaalde vereiste voldoen om beskou te word dat hulle 'n bevredigende vlak van sorg lewer nie . •:. Kritiese verpleegprosedures is dikwels oneffektief en ondoeltreffend uitgevoer. .:. Die meeste ouers het fn negatiewe siening gehad ten opsigte van die kommunikasie met die verpleegpersoneel. Aanbevelings sluit in die ontwikkeling en implementering van fn geformaliseerde gehalte verbeteringsprogram op alle vlakke van sorg, oudit van rekords en pasiëntsorg en indiensopleiding vir alle personeel ten opsigte van gehaltesorg. Sleutelwoorde: Gehaltesorg, formulering en evaluering van standaarde - pediatriese pasiënte

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