The use of automated integrated management of childhood illness guidelines in primary health care in the Western Cape in South Africa

dc.contributor.advisorMash, Boben_ZA
dc.contributor.authorRhode, Hilary Wallis Julianaen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Family Medicine and Primary Care.en_ZA
dc.descriptionThesis (MPhil)--Stellenbosch University, 2012.en_ZA
dc.description.abstractIntroduction Under-5 year mortality in South Africa is increasing and effectiveness of primary care is a key factor. Adherence to IMCI guidelines by primary care nurses is critical. The IMCI guidelines provide a standardized integrated approach to delivering quality care. Nurses in South Africa are currently using a paper-based guideline. The automated guideline in the format of a convertible personalised computer tablet aimed to improve training in IMCI and the quality of clinical decision making. The automated guideline was designed to systematically guide the nurse through the algorithms thus reducing errors and making care more effective. This study evaluated the use of automated guidelines in improving the training of nurses. Methods A sample size of thirty Professional Registered Nurses (PNs) was selected from the one year Postgraduate Diploma in Clinical Nursing Science at Stellenbosch University. Observational study design compared 15 PNs who used and 15 who did not use the automated guidelines during training. Nurses were compared in terms of their knowledge of IMCI after classroom based teaching and adherence to IMCI in clinical training practices. Results Both groups improved their knowledge of IMCI, but were not significantly different at the end of the classroom teaching. Nurses in the automated group showed significant improvement in their clinical practice (p<0.05): gathering information on HIV risk (50% vs. 93%) or immunisations (68% vs. 93%); making a complete assessment of the patient (61% vs. 100%), prescribing correct medication (50% vs. 85%), correct dose (42% vs. 85%) and safety netting (78% vs. 96%). Conclusion The use of automated guidelines showed potential for improving adherence to IMCI in the Western Cape. Further research is needed to determine if the widespread use of the automated version by PNs translates into better quality of care and improved health outcomes.en_ZA
dc.format.extent53 p.
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.subjectDissertations -- Family medicineen_ZA
dc.subjectTheses -- Family medicineen_ZA
dc.subjectCommunity health services for children -- South Africa -- Western Capeen_ZA
dc.subjectIntegrated delivery of health care. -- South Africa -- Western Capeen_ZA
dc.titleThe use of automated integrated management of childhood illness guidelines in primary health care in the Western Cape in South Africaen_ZA
dc.rights.holderStellenbosch Universityen_ZA

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