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Computer and Internet Use among Tertiary Healthcare Providers and Trainees in a Nigerian Public Hospital
Ibrahim Taiwo ADELEKE,
Muniru Aderemi ASIRU,
Benson Macaulay OWEGHORO,
Ahmed Bolakale JIMOH,
Ameenah Muhammad NDANA
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
1-10
Received:
24 October 2014
Accepted:
27 October 2014
Published:
31 October 2014
Abstract: The Nigerian healthcare system is characterized with paper-based health information management systems and grossly inadequate IT-skilled healthcare providers. Nonetheless, the emerging digitization and globalization has the potentials to speed up the transformation of the current healthcare systems and revolutionize the provider-consumer relationship between healthcare providers and their teeming patients. This cross-sectional study determined the utilization of computer and the Internet among healthcare providers and trainees in a Nigerian public hospital (n=232). More than half (112, 52 %) of the participants were females and the vast majority (154, 72.3 %) were aged forty years or below with a Mean age of 35 ± 9 years. More than a third (78, 36.6 %) of the participants had used the Internet for over three years and early exposure to computer use did significantly influence (χ2= 3.19; p= 0.00) their current computer use. Updates on professional issues appeared the major reason (98, 46.0 %) for searching the Internet and this was mostly accessed (149, 70.0 %) through cell phone. Google Scholar was the most (154, 72.3 %) deployed search engine and participants were often constrained (93, 43.7 %) to use these technologies by inadequate time due to their busy schedules. For better appreciation of the technologies, participants solicited for further training in health IT. Healthcare providers and trainees at Federal Medical Centre, Bida have good disposition towards computer and Internet use especially to enhance their professional practice and to improve patient care quality. They overwhelmingly indicated interests for further ICT training in order to boost their sources of information for an improved healthcare practice. Any effort made to enrich their sources of information and to enhance their usability of these technologies would be worthwhile.
Abstract: The Nigerian healthcare system is characterized with paper-based health information management systems and grossly inadequate IT-skilled healthcare providers. Nonetheless, the emerging digitization and globalization has the potentials to speed up the transformation of the current healthcare systems and revolutionize the provider-consumer relationsh...
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The Rate, Reasons and Predictors of Hospital Discharge against Medical Advice among Inpatients of a Tertiary Health Facility in North-Central Nigeria
Samuel Adebowale Adefemi,
Ibrahim Taiwo Adeleke,
Philip Gara,
Olanrewaju Oloundare Abdul Ghaney,
Sunday Akingbola Omokanye,
Aivonya Momoh Jimoh Yusuf
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
11-16
Received:
1 December 2014
Accepted:
3 December 2014
Published:
14 December 2014
Abstract: Objective: To determine the rate of hospital discharges against medical advice (DAMA), identify reasons for such discharges and identify factors predicting such discharges compared with controls. Methods: This is a retrospective health records review of all patients who discharged against medical advice and matched cases of those discharged normally between 2009 and 2011. Patients with DAMA were identified and relevant socio-demographic as well as clinical data were extracted from their clinical charts. We compared characteristics of case control patients using χ2 and Wilcoxon Rank Sum test as appropriate. We used multivariate logistic regression to model the correlates of discharged against medical advice. We included in the analysis each characteristics that was significant (p=0.05) in bivariate comparison. We report odds ratio (ORs) and confidence intervals (CIs) from this model. Results: The prevalence of discharged against medical advice was 0.72% over the three year period. Patients who discharged against medical advice were younger, male gender and students. In addition they were predominantly Muslims and married with no form of formal education. Furthermore, residence in Bida where the hospital is situated and payment out of pocket is associated with DAMA. Most of these patients DAMA within the first five days of admission and signatories to the discharge were mostly parents, spouse, and other family members. Reasons for DAMA include financial constraints, improved health and desire to seek other treatments (faith/traditional based). The male gender, students and those without formal education all conferred increase odds of DAMA, while persons in age range 21-30 years, and married conferred protection against DAMA. Furthermore, individuals with normal delivery (SVD) (18), followed by RTA with minor injury such as bruises/laceration (14), and RTA with fracture (12) were much more likely to DAMA. Conclusion: Comparatively, DAMA rate at Federal Medical Centre, Bida is low. The factors associated with such DAMA include younger age, male sex and being a student. In addition, residing in Bida town and payments for healthcare out of pocket increase the likelihood of DAMA. We recommend formulation of explicit DAMA guidelines for the hospital and strengthening of the existing National Health Insurance Scheme as panacea for reduction in the rate of DAMA.
Abstract: Objective: To determine the rate of hospital discharges against medical advice (DAMA), identify reasons for such discharges and identify factors predicting such discharges compared with controls. Methods: This is a retrospective health records review of all patients who discharged against medical advice and matched cases of those discharged normall...
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Health Information Technology in Nigeria: Stakeholders’ Perspectives of Nationwide Implementations and Meaningful Use of the Emerging Technology in the Most Populous Black Nation
Ibrahim Taiwo Adeleke,
Sunday Adesubomi Erinle,
Ameenah Muhammad Ndana,
Tony Chuks Anamah,
Oluseye Abiodun Ogundele,
Danjuma Aliyu
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
17-24
Received:
26 November 2014
Accepted:
29 November 2014
Published:
14 December 2014
Abstract: Background: Nigeria is witnessing continuing advocacy and increase in number of individuals yearning for computerization of health information and healthcare processes. On the other hand, the Government of this most populous black nation is evolving plans and strategies for the adoption and implementation of health information technology (HIT). However, little is known about opinions of the diverse healthcare providers who would act the script of government in ensuring meaningful use of HIT in the country. Objective: This nationwide, cross-sectional study attempted to determine stakeholders’ perspectives of the emerging HIT in Nigeria. Result: HIT stakeholders who gave consent (n=233) at the two conferences participated in the study, 76% of whom were male professionals, mostly (117, 50.2%) from tertiary healthcare institutions. It worthy of note that three of the participants came from United States of America to attend the 1st National Conference on Health Information Technology in Nigeria. Of all participants, the majority (226, 99.1%) opined that HIT will improve communication among healthcare providers. A similar portion (223, 98.2%) were of the opinion that HIT will facilitate prompt retrieval of patient’s health records on point-of-care (POC). Nearly two-third (139, 62.6%) were optimistic of possible realization of nationwide implementations of HIT in the country by the year 2020. The results also indicate that gender, professional inclination, and place of work were important predictors of positive opinion of HIT. The three factors were associated with stakeholders’ opinion that the evolving HIT is capable of improving medical care quality (p=0.059; 0.000; 0.014) of the Nigerian populace. Most stakeholders (61%) recommended that the paper-based health records should be archived post implementation of HIT. Conclusion: The Nigerian healthcare system is manned by providers and stakeholders who are quite abreast of the benefits of health information technology and are willing to embrace the technology in their workflow. This is quite reassuring and tends to prompt the healthcare decision makers to proactively formulate policies and introduce interventions to encourage nationwide acceptance of the emerging technology. Nonetheless, there is more to be done on appropriate clinical documentation in order to set a friendly pedestal for effective takeoff, successful implementations and meaningful use. Appropriate funding and financial incentives for quality improvement is recommended. In addition, the National Conference on HIT should be convened annually and a technical committee be set up to appraise future implementations.
Abstract: Background: Nigeria is witnessing continuing advocacy and increase in number of individuals yearning for computerization of health information and healthcare processes. On the other hand, the Government of this most populous black nation is evolving plans and strategies for the adoption and implementation of health information technology (HIT). How...
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Knowledge, Access and Use of Internet-Based Health Information for Personal Healthcare among Employees of the Foremost Nigerian University
Benson Macaulay Oweghoro,
Ibrahim Taiwo Adeleke,
Patricia Philip Mshelia,
Lateef Mosebolatan Ogundiran,
Aivonya Momoh Jimoh Yusuf,
Deborah Ifeoluwa Adeoti
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
25-31
Received:
17 December 2014
Accepted:
18 December 2014
Published:
31 December 2014
Abstract: Background: Accessibility and use of the internet-based health information are vital concepts in healthcare delivery. The Internet is changing not only the way patients get health information, but the way they interact with their healthcare providers and others alike. Several studies have explored the use of the Internet by the healthcare providers. However little is known about the extent to which individual patients use the Internet for their own personal healthcare information needs. Objective: This present study determined basic IT knowledge, skills and access to internet-based health information to address personal healthcare needs of the University of Ibadan employees. Methods: This is a cross-sectional study that deployed multi-stage sampling techniques. Result: Four hundred and two (82.0%) of the 488 questionnaires distributed were analyzed. There were more (292, 72.6%) non-teaching participants in the study. All (402, 100%) participants were conversant with internet-based health information which was reported to have met their basic health needs. They all (402, 100%) admitted that internet-based health information could be easily understood, and they mostly sought for it to equip themselves with prior knowledge on their ailments. However, the majority (398, 97.0%) searched for internet-based health information because they reported to have lost confidence in their healthcare providers. Conclusion: It is obvious from this study that most employees of University of Ibadan appreciated the importance of internet-based health information for personal healthcare and seek it for diverse personal reasons. The outcome of this study has the potentials to prepare healthcare professionals for dealing appropriately with internet-informed patients and restore their confidence. The Nigerian healthcare systems need to formulate policies on access and use of internet-based health information by their patients.
Abstract: Background: Accessibility and use of the internet-based health information are vital concepts in healthcare delivery. The Internet is changing not only the way patients get health information, but the way they interact with their healthcare providers and others alike. Several studies have explored the use of the Internet by the healthcare providers...
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Knowledge, Attitude and Practice of Nursing Ethics and Law among Nurses at Federal Medical Centre, Bida
Danjuma Aliyu,
Ibrahim Taiwo Adeleke,
Sunday Oluwafemi Omoniyi,
Balarabe Ayuba Samaila,
Aliyu Adamu,
Aisha Yahaya Abubakar
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
32-37
Received:
18 December 2014
Accepted:
19 December 2014
Published:
31 December 2014
Abstract: It is universally acknowledged that nursing profession is guided by both ethic and legal principles as it is the tools for professional discipline which gives the nurse a broad idea of what is expected of her as she moves from the protective ambiance of school into the society. Social changes such as right to healthcare, increasing cost of healthcare and conflicting institutional policies create ethico-legal problems for the nurses. This study is a cross-sectional descriptive study designed to determine knowledge, attitude and practice of nursing ethics and law among nurses at Federal Medical Centre, Bida. A total of 149 questionnaires were administered using simple random sampling technique. The main findings of this study established that the participating nurses possess considerably good knowledge, attitude and practice of nursing ethics and law. Majority (82.6%) of the participants obtained knowledge about ethical dilemma mostly (36%) through seminar/workshops followed by those (31%) who knew about it right from their respective schools of training. Three factors of professional progression in this study; professional qualification (p=.015), years of experience (p=.000) and rank (p=.002) had noticeable effects on knowledge, attitude and practice of nursing ethics and law among the participants. Several options were identified by the participants as remedies to reduce the incidence of ethical and legal issues in their practice area. These include; periodic workshops, adherence to nursing code of ethics, utilization of hospital policy and personal development. Although participants differedon whether providers should adhere to patients' wish at all times,they possess good knowledge on nursing ethics and law. The overall results of the study suggested that there is need for nurses to understand the relationship and limitations between ethics, hospital policy and legal issues as they relate to nursing practice.
Abstract: It is universally acknowledged that nursing profession is guided by both ethic and legal principles as it is the tools for professional discipline which gives the nurse a broad idea of what is expected of her as she moves from the protective ambiance of school into the society. Social changes such as right to healthcare, increasing cost of healthca...
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Current Clinical Coding Practices and Implementation of ICD-10 in Africa: A Survey of Nigerian Hospitals
Ibrahim Taiwo Adeleke,
Olawole Olusegun Ajayi,
Ahmed Bolakale Jimoh,
Abdullateef Adisa Adebisi,
Sunday Akingbola Omokanye,
Mary Kehinde Jegede
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
38-46
Received:
19 December 2014
Accepted:
23 December 2014
Published:
31 December 2014
Abstract: Background: Clinical coding is an integral part of health information management (HIM) practice which provides valuable data for healthcare quality evaluation, health resource allocation, health services research, medical billing, public health programming, Case-Mix/DRG funding. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) is a veritable tool for the effectiveness of clinical coding practices. Objective: This present study determined implementation levels of ICD-10 as well as ICD-10-PCS and clinical coding practices in both public and for-profit hospitals in Nigeria. Methods: We used Chi square (χ2) and Cramer’s V (φc) to assess the level of association between type of workplace and implementations of ICD-10 and clinical coding practices. Statistical significance was set at .05. Result: The study discovered nationwide implementation of ICD-10 (179, 88.2%) and fair adoption of its procedure counterpart (79, 38.9%). Most hospitals in Nigeria especially, for-profit facilities (3, 100%) and tertiary healthcare settings (148, 93.1%) employed HIM professionals (214, 91.5%) to manage their clinical coding processes. Conversely, the study observed that challenges confronting clinical coding processes were enormous. Notable among these were absence of automation (70, 34.5%), lack of political will (51, 48.1%), inadequate clinical coders (153, 74.4%) and suboptimal documentation (186, 91.6). Suggestions to improve clinical coding practices ranges from continuing professional coding education (33, 10.3%) to initiation of Nigerian’s modification of ICD such that ICD-10 will become ICD-10-NGM (1, 0.3%). Conclusion: Most healthcare systems in Nigeria have implemented ICD-10 for coding and classification of diagnoses and procedures and the process is being managed by the right workforce (i.e. HIM professionals) which reassures effectiveness. However, lack of political will, inadequate and unmotivated workforce and suboptimal clinical documentation were among challenges confronting the practice in Nigeria. Therefore, this study suggests advocacy and coding education with a view to modifying the orientation of all stakeholders and to sensitize relevant authorities on the benefits of clinical coding practices in order to maximize its outcome and in effect, improve public health in the country.
Abstract: Background: Clinical coding is an integral part of health information management (HIM) practice which provides valuable data for healthcare quality evaluation, health resource allocation, health services research, medical billing, public health programming, Case-Mix/DRG funding. The International Statistical Classification of Diseases and Related H...
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ICT knowledge, Utilization and Perception among Healthcare Providers at National Hospital Abuja, Nigeria
Ibrahim Taiwo Adeleke,
Adejoke Abiola Salami,
Moses Achinbee,
Tony Chucks Anamah,
Ibrahim Babaminin Zakari,
Muhammad Hassan Wasagi
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
47-53
Received:
20 December 2014
Accepted:
23 December 2014
Published:
3 January 2015
Abstract: Background: Healthcare system in Nigeria is moving towards digitalization especially in the management of patients’ health information, with a view to harmonizing medical care practice for improved healthcare quality. Information and communication technology (ICT) has transformed the way people collaborate, identify potential collaborators or friends, communicate with each other, and identify information that is relevant to their practice. Rationale: Thus, ICT has been identified as one measure to ensure these emerging trends in the Nation’s healthcare systems. Design/objectives: This study deployed a cross-sectional structured questionnaire to determine ICT knowledge and utilization among healthcare providers at National Hospital Abuja (n=271). Methods: We devised stratified random sampling in the recruitment of participants. Result: It was found that profession, possession of a laptop computer, age and sex were associated with knowledge, utilization and perception of ICT. Most participants were advanced in the use of electronic mail (51.8%) and the Internet (47.1%) mostly acquired through self-efforts (46.5%). However, a greater portion of the participants exhibited poor knowledge of database management (47.8%) and statistical analysis package (46.3%). The vast majority have used computer (95.0%) and the Internet (93.6%) for more than 3 years and many (86.2 percent) expressed a desire for further ICT training. Virtually, all participants in this study opined that ICT will improve medical care quality but some anticipated concerns over medical confidentiality as ICT becomes widely adopted in the country’s healthcare systems. Aside their poor skill in database design and statistical analysis software, healthcare providers at National Hospital, Abuja possessed good knowledge and disposition towards ICT especially for the enhancement of their professional practice and for public health quality improvement. They indicated interest in further ICT training in order to enhance their information sources for an improved practice. It would be worthwhile to enrich their sources of information in order to improve public health.
Abstract: Background: Healthcare system in Nigeria is moving towards digitalization especially in the management of patients’ health information, with a view to harmonizing medical care practice for improved healthcare quality. Information and communication technology (ICT) has transformed the way people collaborate, identify potential collaborators or frien...
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Knowledge, Attitude and Practice of Preoperative Visit: A Survey of Nigerian Perioperative Nurses
Danjuma Aliyu,
Ibrahim Taiwo Adeleke,
Sunday Oluwafemi Omoniyi,
Silas Kolo,
Oluwafemi Michael Odofin,
Patience EssienEkaete
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
54-60
Received:
20 December 2014
Accepted:
23 December 2014
Published:
3 January 2015
Abstract: Background: The notion of preoperative visiting has been in existence since the 1960s and its value and worth in relation to healthcare delivery has been debated consistently since the term preoperative-visit is often confusing. However, little is known about knowledge, attitude and practice of preoperative visits among perioperative nurses in Nigeria. Objectives: The study sought to determine knowledge, attitude and practice of Nigerian perioperative nurses towards the practice of preoperative visits and to identify barriers militating against the practice. Design: This is a countrywide cross-sectional descriptive survey. Results: One hundred and forty six Nigerian perioperative nurses among the conferenceattendees gave consent to participate in this study. Half of the participants- 70(50%) of the participants worked with tertiary health facilitiesand 71(52.2%) were from the conference host region (Southwest, Nigeria).The majority (97.3%) of the participants possess good knowledge of preoperative visit. Equally, 139 (96%)of them acknowledged that the practice of preoperative visit is very important to perioperative nursing careas well as to the teeming patients.About two-third (63%) of the participants reported that they practice preoperative patient visit while 53 (37%) did not. Ninety two (72%) of the participants stated that they often document their opinions during preoperative visits to patients. Major factors militating against the practice of preoperative visit include timing of the visits (89%) and work overload (66%). It is equally important to note that 27 (18%) of the participantsidentified shortage of perioperative nurses as a barrier to preoperative visit. Years of experience, workplace, age and professional rank were associated withthe practice of preoperative visit. Conclusion: Most perioperative nurses in Nigeria have formally acquired knowledge of preoperative visit. However, there is a notable gap between their knowledge and attitude towards it. Therefore, they require periodic reminder through continuing professional development programs on their responsibilities towards the recipients/beneficiaries of the perioperative nursing care.
Abstract: Background: The notion of preoperative visiting has been in existence since the 1960s and its value and worth in relation to healthcare delivery has been debated consistently since the term preoperative-visit is often confusing. However, little is known about knowledge, attitude and practice of preoperative visits among perioperative nurses in Nige...
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HIV/AIDS Awareness among Secondary Schools’ Adolescents in South-Western Nigeria: A Correlate to Strengthen Advocacy and Strategic Sexuality Education Programs
Ibrahim Taiwo Adeleke,
Bilkisu Abidemi Azeez,
Danjuma Aliyu,
Lateef Mosebolatan Ogundiran,
Abdulkarim Salami,
Wasiu Adeyemi Adeoye
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
61-67
Received:
30 December 2014
Accepted:
4 January 2015
Published:
19 January 2015
Abstract: Background: The magnitude of the HIV epidemic and the prevailing lack of sexual health interventions targeting young people in sub-Saharan Africa calls for a wider awareness and strategic approach-based advocacy. Although adolescents are pivotal to manpower development and technological advancement in Nigeria, HIV epidemic is on the increase among this vulnerable group due to lack of sexuality education and rightful intervention programs. Design: This is a cross-sectional descriptive study. Objective: The main objective of the study was to determine the level of awareness, knowledge and attitude towards HIV/AIDS among secondary school students in Atisbo Local Government Area, Nigeria. Methods: Two-stage clustered sampling method was deployed to recruit participants into the study. Instrument: A pilot-tested questionnaire developed from review of literatures was administered on 343 participants upon their consent. Result: The Mean age of the participants was 16 ±2 years and nearly two-third (209, 63.0%) of them were females. The study discovered that half of the participants (165, 50.9%) live with both parents and a little more than one-third (113, 34.5%) belong to well-educated parents. Most participants (296, 91.9%) were quite awareof HIV/AIDS and about a quarter (79, 24.2%) of them have had sexual encounter. A greater portion of them (213, 64.9%) discuss sexual matters with their parents and the majority (205, 63.9%) would care for their HIV/AIDS positive relatives. Overall, father’s education, discussion of sexual matters with parents and age were all associated with participants’ awareness and behaviour toward sex and sexuality, HIV/AIDS and people living with HIV/AIDS. Conclusion: The surveyed secondary school students possess relatively good knowledge of HIV/AIDS, reasonable sexual practices and positive attitude towards sexuality, HIV/AIDS and people living with HIV/AIDS. Social settings and parental sexuality communication as a result of educational attainment, played significant roles in the attitude of their children. Efforts should be intensified to provide more comprehensive information on sexuality and HIV/AIDS through the mass media. This possibly will improve students’ attitudes toward abstinence, safer sex and behaviour toward people already infected with HIV/AIDS.
Abstract: Background: The magnitude of the HIV epidemic and the prevailing lack of sexual health interventions targeting young people in sub-Saharan Africa calls for a wider awareness and strategic approach-based advocacy. Although adolescents are pivotal to manpower development and technological advancement in Nigeria, HIV epidemic is on the increase among ...
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Perspectives of Continuing Formal Education among Nurses in Selected Secondary Healthcare Facilitiesin Northern Nigeria
Aliyu Adamu,
Ibrahim Taiwo Adeleke,
Danjuma Aliyu,
Tawheed Mahmud
Issue:
Volume 3, Issue 1-1, January 2015
Pages:
68-73
Received:
31 December 2014
Accepted:
8 January 2015
Published:
23 January 2015
Abstract: Objective: The purpose of this study was to determine registered nurses’ perception of continuing formal education (CFE). Methods: A quota sampling was used to recruit 100 registered nurses who attended a mandatory continuing professional development programs in two different locations (Minna and New Bussa) in Niger state, Nigeria. Results:The findings from the study reveal that the participants’ major reasons for undertaking continuing formal education were to be current in their specialty (86.5%), to develop proficiency necessary to meet patients' needs (95.8%) and to improve self-confidence (95.8%). The result also shows that the major motivating factors identified by the participants to undertake CFE were encouragement from management (95.8%) and funding supports (94.8%). Major barriers to undertaking CFE among nurses in this study were lack of funding (97.9%) and family roles of child bearing and caring (94.8%).Conclusion: The need for nurses to undertake CFE is well recognized by the participants in this study. However, the managers of healthcare systemsneed to provide nurses with the necessary supports to enable them attend such programs in order to enhance their productivity.
Abstract: Objective: The purpose of this study was to determine registered nurses’ perception of continuing formal education (CFE). Methods: A quota sampling was used to recruit 100 registered nurses who attended a mandatory continuing professional development programs in two different locations (Minna and New Bussa) in Niger state, Nigeria. Results:The find...
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