/library/oar/handle/123456789/63289 2026-05-29T17:22:46Z /library/oar/handle/123456789/44862 Title: Nurses' perspectives regarding the use of medical equipment on the general wards at St. Luke's Hospital. Abstract: The growth of technology in health care appears to be taking place at an extraordinary rate since the use of high technology once confined to critical care areas is now moving into the general wards. The purpose of this study was to explore nurses' perspectives regarding the use of medical equipment on the general wards at St. Luke's Hospital. The study used an exploratory descriptive research design to determine nurses' views towards the influence of equipment on nursing practices, identify what and how nurses learn about the equipment commonly used together with an exploration on safety issues related to equipment usage. Nurses' perspectives related to equipment maintenance and accessibility were also examined. Data was collected from a proportional stratified sample of nurses (n=160) working in the general wards within the hospital. A self-administered questionnaire formulated by the researcher was used to collect data. Validity and reliability testing of the tool were performed. A response rate of 97.5% was obtained. An interview schedule based on the questionnaire was also utilized to interview 23 ward managers. Qualitative data was analysed through content analysis while statistical tests were used to analyse quantitative data. Findings revealed that there is a high frequency of equipment usage in the general wards and overall it appeared that nurses feel more comfortable to use medical equipment while nursing patients. Most of the nurses perceived themselves as being competent in equipment handling while ward managers stated that medical equipment is used safely and competently in their wards. However, this study revealed that equipment training is not provided regularly for nurses and the most common method of learning was through another staff member. Most nurses learned how to operate equipment or its function but knowledge on equipment safety appears to be lacking. Several factors such as 'appropriate facilities', 'patient workload' and 'staff compliment' were prioritized as influencing medical equipment training. Nurses stated that improper equipment use could lead to serious consequences. Although several nurses agreed with the immediate reporting of incidents related to medical equipment and a larger amount agreed to report these to higher hospital authorities, there appears to be some reluctance in reporting. Most respondents agreed with the setting up of a medical equipment library since they seemed to know that benefits such as better utilisation of resource and equipment maintenance could be yielded. The results highlighted several management implications and a number of recommendations were identified. The development of a medical equipment management policy, which covers all aspects of equipment management while involving all stakeholders appears to be needed. It would be beneficial to evaluate current methods of equipment training for nurses in order to identify what changes could be done to improve the ways by which training is being provided. A new approach to equipment incidents could be the implementation of a 'blame-free' incident reporting system approach to enhance learning from errors. Finally, it was agreed that equipment management inefficiencies could be addressed through the introduction of a full operational medical equipment library. Description: M.SC.HEALTH SERVICES MANGT. 2005-01-01T00:00:00Z /library/oar/handle/123456789/44711 Title: Exploring patient centered care at St. Luke's Hospital. Abstract: This study aimed to explore the issue of patient centred care in the main hospital of the Maltese Islands. To reach such an aim, the researcher opted for the use of three tools, a survey, interviews and an observation phase. With this choice it was possible to perform triangulation of findings and have better and more reliable results. The survey consisted in querying recently discharged patients about various aspects of their experience within the hospital. The interviews performed were of the elite type and investigated how the organisation perceived the patient centred care agenda with all its interlinking aspects. The observation phase was performed within the ward setting of the hospital, to observe the organisational climate as regards patient centred care and document various interactions, related with this type of care. The main findings of this study were that patient centred care is practiced at a moderate level within St.Luke's Hospital (SLH). Findings seem to indicate that such care is affected by the age of the patient and also the speciality with which the patient had contact whilst in hospital. It was noted that orthopaedic wards faired better then surgical and medical wards in that order. Also, statistical significance was found between the age of the patients and their relative perception as regards patient centred care. Results indicated that the older the age of the patient, the less the perception that they were receiving patient centred care. From the results of the interviews, it was concluded that organisational members had a good knowledge of the term patient centred care but each gave a personalised interpretation of the concept which most often reflected the professional background of the respondent. When queried about the commitment towards this agenda, the respondents sustained that there is commitment towards patient centred care within SLH. However, from the interviews it was noted that barriers exist for this type of care which were identified as being of multiple nature. The main ones which were given prominence by the respondents included, overcrowding problems, lack of coordination between professions, ward environment, financial issues and barriers constituted by cultural aspects. The observation phase confirmed most barriers identified by the respondents and documented the day by day work of the staff within four different wards for a total observation time of sixteen hours. Various aspects of the wards were documented with the main themes being that of the actual physical environment of the wards and also the interaction between the staff of the ward, mainly doctors and nurses with the patients. It was observed that certain aspects of the physical environment hinder patient centred care, whilst overall the interaction between staff and the patients was satisfactory. Given the findings, various recommendations to management were proposed with the main ones being a needs assessment to analyse the problem of overdemand at SLH, the setting up of a Customer Care Department and also a substantial improvement in the physical environment of the wards. Only after such recommendations are put into practice can the agenda of patient centred care be given sufficient impetus within SLH to effect policies and strategic managerial decisions. Description: M.SC.HEALTH SERVICES MANGT. 2005-01-01T00:00:00Z /library/oar/handle/123456789/44630 Title: Nursing managers' leadership skills : an investigation. Abstract: In Malta, the demand for state health care services is on the increase. This increase does not only pose an economic problem, but also a burden on the human resources, especially nurses, working in this sector. However, it is acknowledged that through leadership, human resources can be efficient and effective. Since, Departmental Managers represent the majority of nurses working at the state-funded acute hospital in Malta, this study sought to identify those leadership skills which these managers employ and which they are expected to practice, through a bottom-up approach. Inspired by grounded theory, this research revealed how employees at shopfloor level are led. Through qualitative inquiry, staff described the leadership skills which Departmental Managers use in their daily work. In fact, it was revealed that Departmental Managers use both positive and negative leadership characteristics. However, whereas Positive characteristics resulted from only one source of information, Negative characteristics were obtained from two different sources of information. In addition to this, staff put forward the leadership skills which they expect Departmental Managers to practice in their daily work. These leadership skills were compared to what they mentioned as being those leadership skills actually practised by Departmental Managers. In reality, most of the leadership skills which staff stated that Departmental Managers do not practice, they repeated as being those skills which these managers are expected to practice. Interestingly, thirteen skills which staff expects Departmental Managers to practice are emotional intelligence skills. Description: M.SC.HEALTH SERVICES MANGT. 2005-01-01T00:00:00Z /library/oar/handle/123456789/43930 Title: Paramedics' and pharmacists' attitudes towards changes in working times at St. Luke's Hospital. Abstract: In view of the increased focus on efficient utilisation of human resources and the likely changes in hospital management in the near future, this study sought to investigate the implications for paramedics and pharmacists with regards to possible changes in working times and to explore the effects of such changes on their family and social commitments. The study also aimed to assess their satisfaction with the current working patterns and to identify those commitments which would influence working time preferences and the implementation of alternative working patterns. A descriptive exploratory research design was chosen as the data collection method which was carried out in three phases. In the first phase, a self-administered questionnaire was used to collect data from 330 paramedics and 42 pharmacists working at St. Luke's Hospital followed by a focus group composed of a representative of each profession. Further information was obtained, in the second phase, from the line managers of the individual paramedics and pharmacists through another focus group, while in the third phase, elite interviews with the Director of Human Resources and Union Representatives were conducted. Analysis of results was performed using descriptive and inferential statistics for quantitative data and content analysis for qualitative data. Results show that overall paramedics and pharmacists are satisfied with features of current work patterns particularly the daily work hours which fit either very well or fairly well with their family or social commitments. The study also revealed that individuals on reduced hours were the most satisfied with working patterns while those working roster patterns were the least satisfied. Flexible working patterns appeared to be the preferred alternative pattern. The issue of more flexibility was also discussed in both focus groups and the elite interviews. Results indicate that given a choice, paramedics' and pharmacists' work pattern preferences would be influenced by their personal/ social lifestyle, family commitments and their health. Moreover, the three factors identified as the most influential in the implementation of new work patterns were employees' participation in discussions to implement a new pattern, staffs' opinions about the new pattern and the amount of information given to them. The main recommendation which could emerge from this research study includes introducing more flexible working patterns that would provide the employee with enough time for those commitments outside work and therefore ensure less resistance to any changes. Moreover, this would help achieve maximum utilisation of resources and a more efficient service would be provided. Another recommendation would be to actively involve employees at all levels of the organisation in the change process providing assurance that alternative work patterns will not be imposed. Finally, it is important to mention that all those involved should work together to ensure that at the end of the day a better service is provided and the needs of the patient are met. Description: M.SC.HEALTH SERVICES MANGT. 2005-01-01T00:00:00Z