Browsing by Author "Reid, Stephen John Young."

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Challenges faced by professional nurses in accessing information technology in health care facilities for healthcare delivery in northern KwaZulu-Natal.
(2010) Asah, Flora Nah.; Reid, Stephen John Young.
Information Technology (IT) is revolutionizing every sphere of human interaction. IT has changed the way individuals communicate. In the healthcare system, information technologies are considered the key to addressing challenges to healthcare delivery such as shortages of healthcare professionals, and networking. Therefore, healthcare providers need to possess information technology skills, knowledge, and resources to communicate and manage information effectively and efficiently and also to be able to perform their duties adequately in such an information technology age. Nurses, the largest group of healthcare providers who spend the most time with patients, are also frontline healthcare managers and need to have access to IT and should be computer literate in order to perform their duties quickly and adequately. In South Africa, the health system has been slow in integrating IT into healthcare delivery, particularly in rural and remote areas where such services are most needed. A "digital divide" exists, by which access to computers and the internet remain a privilege, and many nurses are unable to use a computer even after completing the computer literacy courses. This study aims to investigate the challenges faced by professional nurses to access and use information technology in healthcare facilities after being trained. Data was collected through focus group discussions conducted with professional nurses from two regional and four district hospitals. Participants who had received computer training offered by the Department of Health were selected to ensure that issues beyond a lack of training could be explored. Focus group discussions were recorded and transcribed verbatim. Content analysis was used to identify themes from the transcriptions. Results show that professional nurses had little access to information technology. Reasons given were a lack of hardware and appropriate software, insufficient training and lack of support, irrelevance of the computer courses, and negative attitudes towards computers. Despite previous computer training, the professional nurses interviewed felt they lacked the skills to use computers confidently in their daily activities. The quality of the training was perceived as inadequate and irrelevant with a lack of ongoing support to cement new skills and build confidence. The provision of training workshops for nurses is not sufficient to ensure that IT will be used for healthcare delivery. On-going support an motivation, among others, are needed to encourage nurses to use IT efficiently.
Education for rural medical practice.
(2010) Reid, Stephen John Young.; Vithal, Renuka.; Samuel, Michael Anthony.
In the context of a country and a continent that is largely rural, education for rural medical practice in Africa is relatively undocumented and poorly conceptualized. The arena of medical education in South Africa has been largely unchanged by the transition to democracy, despite intentions of reform. The literature reveals a lack of empirical evidence as well as theory in education for rural health, particularly in developing countries. This report presents twelve original papers on a range of key issues that represent the author’s contribution to filling this gap in South Africa. It aims to contribute to the development of a discourse in education for rural medical practice in an African context, and culminates in a theoretical paper regarding pedagogy for rural health. A conceptual framework is utilized that is based on the standard chronological steps in the initial career path of medical doctors in South Africa. Beginning with the literature that is focused around the need to recruit and retain health professionals in rural and underserved areas around the world, the report then addresses the policy context for medical education in South Africa, examining the obstacles to true reform of a transformatory nature. The selection of students of rural origin, and the curricular elements necessary to prepare graduates for rural practice are then investigated, including the actual career choices that medical graduates make in South Africa. Out in the workplace, the educational components of the year of compulsory community service are described, including organizational learning and apprenticeship as novice practitioners, placed under severe pressure in rural hospitals in the South African public health service. A community-oriented type of medical practice is described amongst exemplary individuals, indicating the aspiration towards a different kind of educational outcome. Finally the thesis as such is presented in the final paper regarding a theoretical basis for education for rural health, consisting of the combined notions of placed-based and critical pedagogy. It is argued that while the geographic elements of rural practice require a pedagogy that is situated in a particular rural context, the developmental imperatives of South Africa demand a critical analysis of health and the health care system, and the conceptual basis of this position is explained.
Investigating the quality of referral and support systems between fixed clinics and district hospitals in area 3 of KwaZulu-Natal Provincial Department of Health.
(2010) Hombakazi, Nkosi Phumla.; Reid, Stephen John Young.
Introduction A well-functioning primary health care system depends on all three levels of healthcare, that is, the primary, secondary and tertiary levels of care. District hospitals have a major role to play in the development of a strong referral system. This study was undertaken to evaluate whether the primary health care clinics in Area 3 possess all the key essential components for a strong referral system. Area 3 comprises 3 districts in northern KwaZulu-Natal, i.e. the Umkhanyakude, Uthungulu and Zululand districts. Aim The aim of the study was to evaluate referral support systems between fixed clinics and district hospitals in the three districts of Area 3 in KwaZulu-Natal province. Methods A descriptive study was undertaken in 58 randomly selected clinics in Area 3. Data was collected between July and August 2007, on availability of: communication technology, transport for patients being referred to the district hospital, and guidelines. Referral letters were reviewed to determine if they contained adequate information. Professional nurses were interviewed to determine the training they had attended. Results A third (34%) of clinic nurses on duty had been trained in Primary Health Care; 57% of clinics had at least one professional nurse on duty with a PHC diploma. The proportion of nurses trained in short courses ranged between 4% and 47%. Fifty-six out of fifty-eight (97%) of clinics had telephones; 57% reported problems with telephones. Eighty-eight out of one hundred and seven (88%) of selected referral letters did not have adequate information. Only 32% of urgently referred patients were collected by an ambulance within 1 hour. All 58 clinics had the Essential Drug List (EDL) available; availability of the other guidelines ranged between 29% and 79%. Discussion The percentage of clinic nurses with a PHC diploma or trained on short courses indicates that most clinic nurses render health services without or with inadequate knowledge and skills. Poor quality of referral letters and inefficient transportation of referred patients, especially emergencies, confirm a weak referral support system. User perceptions of the referral system have not been explored. Recommendations Training and support of clinic nurses needs to be prioritised to improve patient assessment and management, as well as the quality of referral letters. District management should advocate for improvement of patient transportation. Future studies should explore the use of referral letters by and training of, clinic nurses; as well as determine user perceptions.