Jascinth Lindo

Doctor at triage - effect on waiting time and patient satisfaction in a Jamaican hospital.

INTRODUCTION Waiting time in the Emergency Departments is a major source of patient dissatisfaction in hospitals. Triage attempts to have the most critically ill patients seen first with an overall reduction in waiting time. Triage teams may include specially trained nurses or alternatively a specialist physician. The aim of this study was to determine if inclusion of a specialist physician on the triage team at the University Hospital of the West Indies (UHWI) in Kingston Jamaica reduced waiting time and improved patient satisfaction. METHODS A prospective, cross sectional survey of ambulatory care patients was undertaken in 2006. Triage was completed by a team consisting of a doctor and two nurses during the first week and by nurses only during the second week. RESULTS The study showed that there was no significant difference in the length of time patients spent in the emergency department based on whether or not they were triaged by a physician led team or by a team of nurses only. Type of triage team did not affect the level of patient satisfaction. Waiting time was significantly influenced by factors which came into play after triage such as the wait for X-ray and laboratory services. CONCLUSIONS There appears to be no reduction in waiting times experienced by patients at the UHWI emergency department as a result of inclusion of a specialist emergency physician in the triage process. This suggests that specialist emergency department nurses are adequately trained in triage, and that delays in the triage process at UHWI are due to other factors.

Factors Associated With Stress Among Second Year Student Nurses During Clinical Training in Jamaica.

The aim of this study is to determine the levels of stress among students in the Jamaican clinical setting and describe the perceived contributing factors to this stress. This cross-sectional study of 106secondyear students enrolled at 2 schools of nursing in Jamaica used a 30-item self-administered questionnaire to gather data on levels of stress and contributing factors. Participants were asked to rate the levels of stress experienced (scale: 0-5, where 5 was highest). Data were analyzed using Statistical Package for the Social Sciences® Version 19 for Windows®. The response rate was 98% (106/108), and 97.2% were females. The average age of respondents was 23.16 ± 9.01years. The majority of participants were single (78.3%) and resident in Kingston and St. Andrew (61.3%). The level of stress experienced in the clinical setting was rated 3.48 ± 1.3/5; financial difficulties (3.17 ± 1.6/5) and interactions with unit staff (3.15 ± 1.4/5) were rated the greatest contributors to stress. Students experienced fear of harming the patient (50%), and only 24% expressed consistent confidence. Except for the interactions with preceptors (P < .05), there were no differences in levels of stress between schools. Students enrolled at 2 nursing schools experienced moderately high levels of stress in the clinical environment. Financial concerns and interaction with ward staff were significant sources of stress. Collaborative strategies to address stress in the clinical areas are imperative.

The lived experiences of adolescents with sickle cell disease in Kingston, Jamaica.

Aim To explore the lived experiences of adolescents with sickle cell disease, in Kingston, Jamaica. Method A descriptive qualitative design was used for this research. In-depth interviews were conducted with six adolescents with sickle cell disease at a Sickle Cell Unit operated by the University of the West Indies. Interviews were audiotaped, transcribed, and thematically analyzed. Results The majority of the adolescents demonstrated a positive self-concept. They reported strong family, school, and peer support which made them feel accepted. All were actively engaged in social activities such as parties, but had challenges participating in sporting activities. Various coping strategies were utilized to address challenges of the disease including praying, watching television, and surfing the Internet. Conclusion Sickle cell disease can be very challenging for the adolescent, but with positive self-concept and increased social support, especially from family and peers, these adolescents were able to effectively cope with their condition and live productive lives.

Attitudes of patients towards being cared for by male nurses in a Jamaican hospital

AIM To determine the attitudes of patients towards male nurses in a Jamaican hospital. BACKGROUND More males in nursing will help to address the nursing shortage and provide diversity in the profession. Patient attitudes towards male nurses will influence recruitment and retention. METHODS A cross-sectional study was used. Data were collected using a self-administered questionnaire and an attitudinal measuring scale. RESULTS Seventy-three patients responded (response rate 91%). Male nurses were perceived negatively by 51% of respondents. However, only 10% had a negative perception of the care they received from male nurses. More males (80%) than females (54%) had a negative attitude towards receiving an enema from a male nurse. CONCLUSIONS Patients generally had a negative attitude towards male nurses but had a positive view if they were cared for by a male nurse. These traits can be used as the basis of changing the gender balance of nurses in Jamaica.

Low adherence to secondary prophylaxis among clients diagnosed with rheumatic fever, Jamaica

Abstract Objectives: To determine the level of adherence and possible barriers to secondary prophylaxis among clients with rheumatic fever in Kingston, Jamaica. Methods: Cross-sectional survey of 39 clients diagnosed with rheumatic fever, receiving penicillin prophylaxis for more than a year using a 22-item self-administered questionnaire on adherence to secondary prophylaxis and knowledge of rheumatic fever. The patients’ records were reviewed to determine the number of prophylaxis injections the patients received for the year 2010. Results: The majority of participants (74%) were females and 51% were adults. Only 48·7% had a high level of adherence. The majority (72%) had low knowledge levels regarding their illness, while only 5% had a high knowledge level score. Most clients (70%) strongly agreed that nurses and doctors encouraged them to take their prophylaxis. However, over 60% reported that they travelled long distances and or waited long periods to get their injections. One-third reported that they missed appointments because of fear of injections and having to take time off from work or school. Discussion: Clients attending the health centers studied had limited knowledge about rheumatic fever. Barriers to adherence included fear of the injections, long commutes, and long waiting periods at the facilities studied.

The Health of Office-Based Workers in Kingston, Jamaica

The health status of Jamaican workers was evaluated as a baseline for workplace health promotion interventions. Socio-demographic, health status, and lifestyle data were collected from 1,087 employees. Blood pressure, glucose and cholesterol levels, and body mass index were measured for study participants. The most common illness reported by the study participants was migraine headaches (16.0%), followed by hypertension (13.5%) and asthma (6.1%). Based on blood pressure measurements, 34.1% were pre-hypertensive (120-139/80-89 mmHg), 13.1% had Stage 1 hypertension (140-159/90-99 mmHg), and 2.3% Stage 2 hypertension (≥160/≥100 mmHg). Furthermore, 33% were overweight, 16.7% were obese, and 10% were extremely obese. Most (55.1%) of the study participants reported excessive fast-food consumption in the last 7 days. The high rates of obesity, hypertension, and fast-food consumption reported in this study emphasized the need for focused health promotion strategies. Universality across institutions presented an excellent opportunity for national workplace health intervention programs.

Lifestyles of Jamaican men with hypertension.

Purpose: Determine the extent to which the lifestyles of Jamaican men with hypertension met the guidelines of the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Design and Methods: Following informed consent, a convenience sample of Jamaican men with hypertension (n = 48), of African ethnicity, attending a Type 5 Health Center was interviewed over a four week period, using a 31-item interview schedule. Results: Mean age of respondents was 65.2 (± 12.1) years (range = 35-89 years) with 33% having blood pressure (BP) controlled to 130/80 mmHg. Those meeting the guidelines were normal weight 23 (47.9%), DASH (dietary approaches to stop hypertension) diet zero, medication 7 (14.6%), exercise 14 (29.2%), alcohol restriction 38 (79.2%), and smoking cessation 40 (83.3%). Medication adherence was associated with BP control (r = −0.30, p < .04). More than half of the respondents believed that hypertension could be cured and that they could stop all treatment if their BP was normal. Discussion and Conclusions: Only a third of the sample had BP controlled to ≤130/80 mmHg. Adherence to the JNC 7 lifestyle guidelines was inadequate. Implications for Practice: A nurse led intervention, focusing on perceptions and lifestyle practices, is indicated.