Masters Degrees (Family Medicine and Primary Care)
Permanent URI for this collection
Browse
Browsing Masters Degrees (Family Medicine and Primary Care) by browse.metadata.advisor "Hill, Paul"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
- ItemAre we ready for an emergency(Stellenbosch : Stellenbosch University, 2012-12) Adamson, Kaashiefah; Hill, Paul; Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences.Introduction Trauma and emergencies contribute to the quadruple burden of disease in South Africa and being prepared for an emergency requires rapid access to emergency equipment, drugs and emergency trolleys to optimally manage an emergency. This is the first descriptive study looking specifically at essential emergency equipment, drugs and the emergency trolley required for the provision of optimal emergency care at Community Health Centres (CHCs) in the Western Cape Metropole. Aims and Objectives The aim of the study was to evaluate whether eight 24 hour emergency units at CHCs in the Western Cape Metropole had the appropriate and essential emergency equipment, drugs and emergency trolleys necessary for the delivery of optimal emergency care, using the Emergency Medicine Society of South Africa (EMSSA) guidelines as the audit tool. Objectives included: 1. To assess availability of essential emergency equipment 2. To assess availability of essential emergency drugs 3. To assess the functionality of existing emergency trolleys Methodology EMSSA guidelines were used as the evaluation audit tool to perform a survey of emergency equipment, drugs and emergency trolleys at eight 24 hour CHCs in the Western Cape Metro pole. Data collection for the study was conducted at the eight 24 hour CHCs over a 3 month period during the months of June 2012 to August 2012. The data was analyzed using the Statistical Package for Health Sciences (Statistica, version 10 of 2012) and Microsoft Excel. Results A total of 81 emergency equipment items, 43 emergency drug items (37 emergency drugs, 6 intravenous fluids) and 78 emergency trolley items were required to be in each emergency unit. An average of 62% of all recommended emergency equipment items, 80% of all emergency drugs and 52.4% of all emergency trolley items were found to be present in this survey. Essential emergency paediatric equipment including bag ventilation devices, Magill’s forceps, masks, intraosseous needles and appropriate blood pressure cuffs were found to be absent at 2 CHCs. All CHCs had access to a defibrillator and ECG machine but these were found to be dysfunctional at 2 CHCs due to expired batteries and no tracing paper being available. Expired first line emergency drugs (adrenaline and atropine) were found at certain CHCs. The recording of emergency trolley checklists and stocking of essential emergency items were found to be incongruent, inconsistent and not up to the recommended standard. Conclusion Essential emergency equipment and drugs and the functionality of emergency trolleys were found to be generally inadequate. Considerable deficiencies of essential emergency items were found, particularly paediatric equipment and drugs and this may negatively impact on resuscitative efforts and outcome in both paediatric and adult emergency care at CHCs in the Western Cape Metropole.
- ItemQuality of care in adult diabetic patients in the Graaff-Reinet Municipal Clinic(Stellenbosch : Stellenbosch University, 2011-12) Van der Merwe, T. J.; Hill, Paul; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Family Medicine and Primary Care.ENGLISH SUMMARY : Introduction/Background: Graaff-Reinet is a rural community in the Cacadau district in the Eastern-Cape with a population of about 45,000 people. The Graaff-Reinet Municipal Area includes the town of Graaff-Reinet itself and a large farming community. Healthcare workers in the area became aware that diabetic control was sub-optimal and that a number of patients were being admitted to the local hospital due to diabetic complications. Diabetes is a costly and a very serious medical problem. Many patients with diabetes do not receive the standard of care required to avoid the complications directly associated with the disease. High quality care for patients with diabetes has been shown to make a difference. General agreement among the community of healthcare professionals on a single set of measures could provide a powerful tool for focussing on key components of care as a basis for quality improvement. In this study quality of diabetes care was determined by assessing adherence to the American Diabetes Association (ADA) clinical practice recommendations as reported by the American Diabetic Association Standard of medical care guidelines. AIMS AND OBJECTIVES: The aims and objectives of this study were to investigate the quality of diabetic care patients at the Graaff-Reinet Muncipal Clinic are receiving. METHOD: A retrospective descriptive study design was used to investigate the quality of care that diabetic patients at the Graaff-Reinet Municipal Clinic are receiving. This study was conducted over a one month time period during April 2008. Only diabetic patients 18 years and older and who were able to give written informed consent were included in this study. Patient interviews were conducted by healthcare professionals and data obtained from patient files. RESULTS: In this study, among the 82 participants, 59 were female and 23 males. Mean patient age was 56.78 years. 74.39% of patients were unemployed. Co- morbid diseases were present in 62 (75.66%) of patients while 66 (80.48%) had an average Body Mass Index (BMI) above 25kg/m2. The average blood glucose of patients was 10.8 mmol/L. The mean systolic and diastolic pressure was 150mmHg and 81.3mmHg respectively. No patients had their glycosylated haemoglobin (HBA1C ) tested while only 26.82% of patients had an eye examination. From the 82 patients 14 (17.07%) had a foot examination. Lipograms were done on only 5 patients while no patients had their urine tested for micro albumin. Self-monitoring of glucose was reported by only 8.53% of patients. CONCLUSION: This study concluded that quality of care of diabetic patients at the Day Hospital in Graaff-Reinet is suboptimal and does not meet the American Diabetic Association (ADA) standards. Major changes will need to be implemented in order to make a difference to the quality of care. A follow up study will be necessary to investigate whether the implementation of new diabetic strategies and guidelines has resulted in improvements in standards of care.