Patient satisfaction is one of the most desired outcomes of health care and it is directly related with effective utilization of health service. The objective of the study was to find out the outpatients’ satisfaction with health care services provided in the hospital. The cross sectional study was conducted on April 2013. Through stratified systematic random sampling technique, 776 patients were selected and interviewed at exit point using semi structure interview schedule. Out of the total patients, 63.9% were female and 36.1% were male. Majorities (45.5%) of them were of age group 20 to 39 years, 79.3% were married, and 15.2% were illiterate. Overall satisfaction level was 75.9% with mean score was 24.19 ± 2.92. Level of satisfaction was high: 764(98.5%) with access to care, 710(91.5%) with quality of care and 437(56.3%) with physical facility but low in 476(61.3%) with cost of healthcare and 394(50.8%) with courtesy of healthcare provider. Satisfaction level was significantly associated with availability of drugs and services in the hospital. It also had significant association with waiting time for showing report to doctor. Time taken for registration, consultation and investigations were not significantly associated with age, educational level, and socioeconomic status of the patients. Similarly sex, occupation and income of the patients had insignificant effect on the satisfaction. Thus, to make the service more responsive to the patient, the hospital management needs to improve the staff behavior, adequate supply of drugs and focus on reducing the waiting time. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10841 Journal of Chitwan Medical College 2014; 4(1): 11-18
Background. Postnatal period is six weeks after birth. It is critical but is the most neglected period. A large proportion of maternal and neonatal deaths occur during 48 hours following childbirth. The utilization of the recommended three postnatal checkups within seven days after delivery, which plays a vital role in preventing maternal and neonatal deaths, is low in Nepal. Objective. This study is aimed at identifying the factors associated with the utilization of complete postnatal care (PNC) among mothers. Method. A cross-sectional study was carried out among 318 mothers in wards 1, 2, 3, and 4 of Baglung municipality, Nepal. Data was collected by semi-structured interviews. Descriptive analysis and comparison of characteristics of women/families with complete vs. partial postnatal checkups using multivariable logistic regression were done. Results. Among 314 respondents receiving at least one PNC, 78% had partial and 22% had complete PNC. Relatively advantaged caste/ethnicity- Brahman/Chhetri (aOR=3.18, 95% CI: 1.24-8.12) and Janajati (aOR=2.87, 95% CI: 1.09-7.53) - compared to Dalits, husbands working as a job holder in Nepal (aOR=3.49, 95% CI: 1.50-8.13), and delivery in a private hospital (aOR=11.4, 95% CI: 5.40-24.2) were associated with having complete PNC. Conclusion. Although PNC attendance at least once was high, utilization of complete PNC was low. More focus to mothers from disadvantaged caste/ethnicity, those whose husbands are in foreign employment, and improvement in quality of care in government health facilities may increase the use of complete PNC.
Introduction Sound knowledge and good practice on insulin injection technique are essential for nurses in order to administer insulin correctly and to educate patients or their relatives adequately. This study aimed to assess the insulin injection practice through the use of insulin pen among nurses working in a tertiary healthcare center of Nepal. Materials and Methods A cross-sectional descriptive study was conducted among 67 nurses working in one of the tertiary healthcare centers of Nepal. Demographic information and insulin injection practice of nurses through the use of insulin pen were assessed using self-administered questionnaire. Each correct practice was scored “1” and incorrect practice was scored “0.” Results. The median (IQR) insulin injection practice score of nurses was 11 (9-12) out of 16. Thirty-seven (55.2%) nurses store insulin pen filled with insulin cartridge at room temperature while 57 (85.1%) nurses store unopened cartridge at refrigerator (2-8°C). The practice of hand washing and injection site cleaning was mentioned by 92.5% and 82.1% of the nurses, respectively. However, just over half of the nurses mix the premix (cloudy) insulin and prime insulin pen before each injection. Thirty-four (50.7%) nurses do not lift skin during injection and more than half of the nurses keep needle beneath the skin for less than 5 seconds after completely injecting the required dose of insulin. One out of ten nurses massage injection site after injecting insulin. Most of the nurses (86.6%) use single needle more than once and the median (IQR) frequency of needle reuse was 6 (3-12). Similarly, systematic site rotation was performed by 59 (88.1%) nurses and twenty (29.9%) nurses claim that they use single insulin pen for two different cartridges. Conclusion The insulin injection practice of nurses assessed through the use of insulin pen was suboptimal and highlights the need for urgent educational intervention.
Infant and Young Child Feeding (IYCF) practices differ in communities due to differences in knowledge, culture and other socio-economic factors. The objective of this study was to find out the practices of Satar mothers on ICYF and their correlates. A descriptive study employing non-probability sampling technique was used to select 132 mothers who had infants aged from 6 months to 23 months. Descriptive statistics and chi-square test were used to find out the association between practice of breastfeeding and complementary feeding with selected socio demographic variables. Findings depicted that practice of breastfeeding was lower than complementary feeding among Satar mothers. About 37.1% respondents initiated breast feeding in less than an hour (≤ 1 hour). While 80.3% respondents fed colostrums, almost the half of them (43.4%) practiced prelacteal feeding. Exclusive breastfeeding and introduction of complementary foods at the age of six months were 49.2% and 51.5% respectively. Exclusive breast feeding was found to have significant association with educational level of respondents (p=<0.001), education level of her husband (p=<0.001), sex of children (p=0.023) and place of delivery (p=<0.001). Feeding practices in Satar community were found to be associated with mother's educational status so there is still a need for programmes, which support and encourage breast-feeding particularly focusing more on younger and less well-educated mothers.
A post course practical skills evaluation was performed on a Neonatalie Newborn Simulator. Participants underwent a 2 day training course of 5 hours each. Thirty nine participants completed the course. The percentages of correct answers on a written test significantly increased from 82% to 99% after training. 100% of the trainees achieved passing scores. The trainees who participate in HBB training can significantly improve their knowledge and skills on simulators.
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