Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Quality improvement cycle for cardiac failure in primary health care : Elsies River community health centre, Cape Town
Thesis (MMed)--Stellenbosch University, 2011.
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | en_ZA |
| Published: |
Stellenbosch : Stellenbosch University
2015
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613938023137280 |
|---|---|
| access_status_str | Open Access |
| author | Cornoc, N. S. |
| author2 | Mash, R. |
| author_browse | Cornoc, N. S. Mash, R. |
| author_facet | Mash, R. Cornoc, N. S. |
| author_sort | Cornoc, N. S. |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed)--Stellenbosch University, 2011. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/97226 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:44:05.289Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/97226 Quality improvement cycle for cardiac failure in primary health care : Elsies River community health centre, Cape Town Cornoc, N. S. Mash, R. Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Cardiac failure -- Care Primary health care -- South Africa -- Western Cape -- Evaluation Congestive health failure -- Treatment Heart -- Diseases -- Patients -- Care UCTD Thesis (MMed)--Stellenbosch University, 2011. ENGLISH SUMMANRY: Introduction The study aimed to assess and improve the quality of care for congestive cardiac failure in a public sector, primary health care setting, in Cape Town. There is currently no literature available on the quality of care for the management of congestive cardiac failure in primary health care in South Africa. Methods A disease register was constructed by identifying patients prescribed Furosemide and checking the medical records. Altogether 95 patients with CCF were identified. The study followed the usual steps for a quality improvement cycle: Formation of an audit team; agreeing on criteria based on current CCF guidelines; collection of data from medical records to measure the criteria; analysis and feedback of results to the staff; critical reflection, planning and implementing change; re-audit of the medical records. Results There was a mean age of 63.4 years, 21% were male and 75% were females. The results of the initial audit revealed suboptimal management of patients diagnosed with CCF: 53% had an aetiological diagnosis recorded in the clinical notes, 24% had a documented functional capacity, 12% of patients had documented precipitating/exacerbating factors, 58% had fluid status documented, and 37% had documentation of their cardiac rate and rhythm. The intervention consisted of feedback on the audit results and critical reflection with the relevant staff members. The doctors were provided with a printed protocol to refer to for the management of CCF. Clinicians were resistant to change and to taking on new tasks in relation to the management of patients with CCF and decided to only focus on improving the clinical assessment of patients. The results of the re-audit after 5-months in 40 patients demonstrated improvement in the clinical assessment criteria: 95% of the patients had an aetiological diagnosis recorded in the notes, 50% had a documented functional capacity, 42% had documented precipitating/exacerbating factors documented, 72% had their fluid status documented, and 85% of patients had their cardiac rate and rhythm documented. None of the five assessment criteria were met at baseline but post-intervention three of the five met the target set and all showed substantial improvement. There was no improvement noted in any of the other criteria, which were not specifically focused on in the plan to improve clinical practice. Conclusion The current quality of care for CCF in primary health care is poor and needs to be improved. The quality improvement cycle led to substantial improvement in the clinical assessment of patients with CCF. Recommendations are made regarding future criteria, which could be included in local audit tools. 2015-07-23T05:18:21Z 2015-07-23T05:18:21Z 2015-12 Thesis http://hdl.handle.net/10019.1/97226 en_ZA Stellenbosch University 26 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Cardiac failure -- Care Primary health care -- South Africa -- Western Cape -- Evaluation Congestive health failure -- Treatment Heart -- Diseases -- Patients -- Care UCTD Cornoc, N. S. Quality improvement cycle for cardiac failure in primary health care : Elsies River community health centre, Cape Town |
| title | Quality improvement cycle for cardiac failure in primary health care : Elsies River community health centre, Cape Town |
| title_full | Quality improvement cycle for cardiac failure in primary health care : Elsies River community health centre, Cape Town |
| title_fullStr | Quality improvement cycle for cardiac failure in primary health care : Elsies River community health centre, Cape Town |
| title_full_unstemmed | Quality improvement cycle for cardiac failure in primary health care : Elsies River community health centre, Cape Town |
| title_short | Quality improvement cycle for cardiac failure in primary health care : Elsies River community health centre, Cape Town |
| title_sort | quality improvement cycle for cardiac failure in primary health care elsies river community health centre cape town |
| topic | Cardiac failure -- Care Primary health care -- South Africa -- Western Cape -- Evaluation Congestive health failure -- Treatment Heart -- Diseases -- Patients -- Care UCTD |
| url | http://hdl.handle.net/10019.1/97226 |
| work_keys_str_mv | AT cornocns qualityimprovementcycleforcardiacfailureinprimaryhealthcareelsiesrivercommunityhealthcentrecapetown |