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Salehi R, Masoudi-Asl I, Gorji HA, Gharaee H. Gap analysis of strategies for promoting interprofessional teams in healthcare units. J Health Organ Manag 2024; 38:857-887. [PMID: 39198959 DOI: 10.1108/jhom-02-2024-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2024]
Abstract
PURPOSE A healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack substance. This study analyzed these strategies and found a performance gap. DESIGN/METHODOLOGY/APPROACH This study took a unique mixed-method approach, systematically reviewing both qualitative and quantitative studies that identified strategies to enhance interprofessional teams in healthcare units. To gauge the effectiveness of these strategies, the researcher utilized an Importance-Performance Analysis (IPA) in four specialized clinical training centers in Hamadan province, Iran. The analysis of the IPA involved 35 experts from these centers as the statistical population. FINDINGS Based on a systematic review, there are seven categories: contextual, strategic, communication, organizational, individual, Human Resources Management (HRM), and environmental for promoting interprofessional teams with a total of 36 sub-indicator. Based on the IPA, the HRM aspect shows the most extensive performance gap. The individual and organizational aspects fall under resource wastage, and the environmental aspect is within the indifferent zone. Also, some critical sub-indicators, such as incentives/rewards, roles and responsibilities, financial resources, team-initiated innovation, the culture of respect, partner resources, humility, data availability, set expectations, and team availability, are in the weak areas. PRACTICAL IMPLICATIONS This research has identified critical areas for improvement in promoting teamwork in clinical training centers through a comprehensive gap analysis. It also presents practical policy solutions to address these weak points, providing a clear roadmap for enhancing interprofessional teams in healthcare units. ORIGINALITY/VALUE Improving teamwork in healthcare can be challenging, but it is possible with proper strategies and tools. One of the highlights of the recent study was the combination of systematic review studies with IPA to identify areas for improving interprofessional teamwork in clinical training centers.
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Affiliation(s)
- Reza Salehi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Iravan Masoudi-Asl
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Abolghasem Gorji
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hojatolah Gharaee
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Craveiro I, Choudhury PK, de OLiveira APC, Pereira A, Fronteira I, Chança R, Cometto G, Poz MRD, Ferrinho P. Impacts of industrial actions, protests, strikes and lockouts by health and care workers during COVID-19 and other pandemic contexts: a systematic review. HUMAN RESOURCES FOR HEALTH 2024; 22:47. [PMID: 38956631 PMCID: PMC11221126 DOI: 10.1186/s12960-024-00923-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 05/17/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Public health emergencies of international concern (PHEICs) as the COVID-19 pandemic and others that have occurred since the early 2000s put enormous pressure on health and care systems. This is being a context for protests by health and care workers (HCWs) because of additional workload, working conditions and effects on mental and physical health. In this paper, we intended to analyze the demands of HCWs associated with industrial actions, protests, strikes and lockouts (IAPSLs) which occurred during COVID-19 pandemic and other PHEICs; to identify the impact of these grievances; and describe the relevant interventions to address these IAPSLs. METHODS We included studies published between January 2000 and March 2022 in PubMed, Embase, Scopus, BVS/LILACS, WHO's COVID-19 Research Database, ILO, OECD, HSRM, and Google Scholar for grey literature. Eligibility criteria were HCWs as participants, IAPSLs as phenomenon of interest occurring in the context of COVID-19 and other PHEICs. GRADE CERQual was used to assess risk of bias and confidence of evidence. RESULTS 1656 records were retrieved, and 91 were selected for full-text screening. We included 18 publications. A system-wide approach, rather than a limited approach to institutions on strike, makes it possible to understand the full impact of the strike on health and care services. PHEICs tend to aggravate already adverse working conditions of HCWs, acting as drivers for HCWs strikes, leading to staff shortages, and financial issues, both in the North and in the Global South, particularly evident in Asia and Africa. In addition, issues related to deficiencies in leadership and governance in heath sector and lack of medical products and technologies (e.g., lack of personal protective equipment) were the main drivers of strikes, each contributing 25% of the total drivers identified. CONCLUSIONS It is necessary to focus on the preparedness of health and care systems to respond adequately to PHEICs, and this includes being prepared for HCWs' IAPSLs, talked much in the context of COVID-19 pandemic. Evidence to assist policymakers in defining strategies to respond adequately to the health and care needs of the population during IAPSLs is crucial. The main impact of strikes is on the disruption of health care services' provision. Gender inequality being a major issue among HCWs, a proper understanding of the full impact of the strike on health and care services will only be possible if gender lens is combined with a systemic approach, rather than gender-undifferentiated approaches limited to the institutions on strike.
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Affiliation(s)
- Isabel Craveiro
- Global Health and Tropical Medicine, GHTM, LA-REAL, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal.
| | - Pradeep Kumar Choudhury
- Zakir Husain Centre for Educational Studies, School of Social Sciences, Jawaharlal Nehru University, Room No. 234, New Delhi, India
| | - Ana Paula Cavalcante de OLiveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, 7º Andar, Blocos D E E, Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Alessandra Pereira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, 7º Andar, Blocos D E E, Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Inês Fronteira
- Global Health and Tropical Medicine, GHTM, LA-REAL, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rua Marquês de Pombal, 125, Centro, Rio de Janeiro, RJ, 20230240, Brazil
| | - Giorgio Cometto
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202, Geneva, Switzerland
| | - Mario Roberto Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, 7º Andar, Blocos D E E, Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, GHTM, LA-REAL, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
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Alayande BT, Forbes C, Kingpriest P, Adejumo A, Williams W, Wina F, Agbo CA, Omolabake B, Bekele A, Ismaila BO, Kerray F, Sule A, Abahuje E, Robertson JM, Yule S, Riviello R, Isichei M. Non-technical skills training for Nigerian interprofessional surgical teams: a cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:547. [PMID: 38755653 PMCID: PMC11097506 DOI: 10.1186/s12909-024-05550-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Non-technical skills (NTS) including communication, teamwork, leadership, situational awareness, and decision making, are essential for enhancing surgical safety. Often perceived as tangential soft skills, NTS are many times not included in formal medical education curricula or continuing medical professional development. We aimed to explore exposure of interprofessional teams in North-Central Nigeria to NTS and ascertain perceived facilitators and barriers to interprofessional training in these skills to enhance surgical safety and inform design of a relevant contextualized curriculum. METHODS Six health facilities characterised by high surgical volumes in Nigeria's North-Central geopolitical zone were purposively identified. Federal, state, and private university teaching hospitals, non-teaching public and private hospitals, and a not-for-profit health facility were included. A nineteen-item, web-based, cross-sectional survey was distributed to 71 surgical providers, operating room nurses, and anaesthesia providers by snowball sampling through interprofessional surgical team leads from August to November 2021. Data were analysed using Fisher's exact test, proportions, and constant comparative methods for free text responses. RESULTS Respondents included 17 anaesthesia providers, 21 perioperative nurses, and 29 surgeons and surgical trainees, with a 95.7% survey completion rate. Over 96% had never heard of any NTS for surgery framework useful for variable resource contexts and only 8% had ever received any form of NTS training. Interprofessional teams identified communication and teamwork as the most deficient personal skills (38, 57%), and as the most needed for surgical team improvement (45, 67%). There was a very high demand for NTS training by all surgical team members (64, 96%). The main motivations for training were expectations of resultant improved patient safety and improved interprofessional team dynamics. Week-long, hybrid training courses (with combined in-person and online components) were the preferred format for delivery of NTS education. Factors that would facilitate attendance included a desire for patient safety and self-improvement, while barriers to attendance were conflicts of time, and training costs. CONCLUSIONS Interprofessional surgical teams in the Nigerian context have a high degree of interest in NTS training, and believe it can improve team dynamics, personal performance, and ultimately patient safety. Implementation of NTS training programs should emphasize interprofessional communication and teamworking.
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Affiliation(s)
- Barnabas Tobi Alayande
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
- Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America.
- Surgical Equity Research Hub, Jos, Nigeria.
| | - Callum Forbes
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America
| | | | | | - Wendy Williams
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Felix Wina
- Department of Surgery, Bingham University Teaching Hospital, Jos, Nigeria
| | - Christian Agbo Agbo
- Department of Surgery, Benue State University Teaching Hospital, Markudi, Nigeria
| | - Bamidele Omolabake
- Department of Surgery, Benue State University Teaching Hospital, Markudi, Nigeria
| | - Abebe Bekele
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
| | - Bashiru O Ismaila
- Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Fiona Kerray
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, UK
| | - Augustine Sule
- Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Egide Abahuje
- University of Rwanda, Kigali, Rwanda
- Department of Surgery, Northwestern University, Evanston, Ilinois, United States of America
| | - Jamie M Robertson
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Steven Yule
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, UK
| | - Robert Riviello
- Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, United States of America
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Mercy Isichei
- Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
- The Faith Alive Foundation, Jos, Nigeria
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Ohta R, Nitta T, Shimizu A, Sano C. Role of family medicine physicians in providing nutrition support to older patients admitted to orthopedics departments: a grounded theory approach. BMC PRIMARY CARE 2024; 25:121. [PMID: 38641569 PMCID: PMC11027398 DOI: 10.1186/s12875-024-02379-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Care of older adults requires comprehensive management and control of systemic diseases, which can be effectively managed by family physicians. Complicated medical conditions in older patients admitted to orthopedic departments (orthopedic patients) necessitate interprofessional collaboration. Nutrition is one of the essential components of management involved in improving the systemic condition of older patients. Nutrition support teams play an important role in nutrition management and can be supported by family physicians. However, the role of family physicians in nutrition support teams is not well documented. This study aimed to investigate the role of family physicians in supporting nutrition management in orthopedic patients. METHODS This qualitative study was conducted between January and June 2023 using constructivist grounded theory methodology. Eight family medicine physicians, three orthopedic surgeons, two nurses, two pharmacists, four rehabilitation therapists, four nutritionists, and one laboratory technician working in Japanese rural hospitals participated in the research. Data collection was performed through ethnography and semi-structured interviews. The analysis was performed iteratively during the study. RESULTS Using a grounded theory approach, four theories were developed regarding family physicians' role in providing nutrition support to orthopedic patients: hierarchical and relational limitation, delay of onset and detection of the need for geriatric care in orthopedic patients, providing effective family medicine in hospitals, and comprehensive management through the nutrition support team. CONCLUSIONS The inclusion of family physicians in nutrition support teams can help with early detection of the rapid deterioration of orthopedic patients' conditions, and comprehensive management can be provided by nutrition support teams. In rural primary care settings, family physicians play a vital role in providing geriatric care in community hospitals in collaboration with specialists. Family medicine in hospitals should be investigated in other settings for better geriatric care and to drive mutual learning among healthcare professionals.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan.
| | - Tachiko Nitta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan
| | - Akiko Shimizu
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo, Shimane, 693-8501, Japan
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Halilu SD, Maiyegun AA, Aiyekomogbon JO, Shirama YB, Mutalub YB, Oyediji FJ. Interprofessional Collaboration amongst Healthcare Workers of a Tertiary Hospital in North-Eastern Nigeria. Niger Postgrad Med J 2024; 31:163-169. [PMID: 38826020 DOI: 10.4103/npmj.npmj_281_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 05/14/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Interprofessional collaboration in healthcare is important to optimise healthcare delivery. However, relatively few studies have been conducted on the topic in Nigeria, especially in the North. OBJECTIVE The objective of this study was to determine the levels of interprofessional collaboration, enablers and barriers amongst healthcare workers. MATERIALS AND METHODS Data were collected using a five-domain modified Assessment of Interprofessional Team Collaboration Scale questionnaire, with a Likert scale of 1-5. The ideal mean score was ≤2 for the barriers domain and ≥4 for the other domains. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 23. RESULTS Two hundred and sixty-six participants responded to the questionnaire. Male and female respondents were 131 (49.2%) each. Half of the respondents were 31 to 40 years old. One hundred and thirty-six (51.1%) of the respondents were nurses, and 48 (18.0%) were doctors. The modal working experience was 6-11 years (41.4%), and 117 (44.0%) respondents had at least a bachelor's degree. The mean scores for the domains were 4.1032 for partnership, 3.2383 for cooperation, 3.6309 for coordination, 4.2844 for enablers and 3.7902 for barriers. CONCLUSION There was adequate level of partnership and enablers amongst the healthcare workers but insufficient cooperation and coordination and high level of barriers. Staff training on cooperation, coordination and identified barriers is necessary to improve interprofessional collaboration in the hospital.
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Affiliation(s)
| | | | | | - Yakubu Bababa Shirama
- Department of Radiology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Yahkub Babatunde Mutalub
- Department of Clinical Pharmacology, College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi, Nigeria
| | - Funmilayo Jane Oyediji
- Department of Ophthalmology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
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Fana TE, Goudge J. Managing under austerity: a qualitative study of management-union relations during attempts to cut labour costs in three South African public hospitals. J Health Organ Manag 2024; 38:89-105. [PMID: 38448233 PMCID: PMC10993010 DOI: 10.1108/jhom-11-2022-0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/28/2023] [Accepted: 10/13/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE In this paper, the authors examine the strategies used to reduce labour costs in three public hospitals in South Africa, which were effective and why. In the democratic era, after the revelations of large-scale corruption, the authors ask whether their case studies provide lessons for how public service institutions might re-make themselves, under circumstances of austerity. DESIGN/METHODOLOGY/APPROACH A comparative qualitative case study approach, collecting data using a combination of interviews with managers, focus group discussions and interviews with shop stewards and staff was used. FINDINGS Management in two hospitals relied on their financial power, divisions between unions and employees' loyalty. They lacked the insight to manage different actors, and their efforts to outsource services and draw on the Extended Public Works Program failed. They failed to support staff when working beyond their scope of practice, reducing employees' willingness to take on extra responsibilities. In the remaining hospital, while previous management had been removed due to protests by the unions, the new CEO provided stability and union-management relations were collaborative. Her legitimate power enabled unions and management to agree on appropriate cost cutting strategies. ORIGINALITY/VALUE Finding an appropriate balance between the new reality of reduced financial resources and the needs of staff and patients, requires competent unions and management, transparency and trust to develop legitimate power; managing in an authoritarian manner, without legitimate power, reduces organisational capacity. Ensuring a fair and orderly process to replace ineffective management is key, while South Africa grows cohorts of competent managers and builds managerial experience.
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Affiliation(s)
- Thanduxolo Elford Fana
- Faculty of Health Sciences,
Centre for Health Policy, School of
Public Health, University of the
Witwatersrand, Johannesburg, South
Africa
| | - Jane Goudge
- Faculty of Health Sciences,
Centre for Health Policy, School of
Public Health, University of the
Witwatersrand, Johannesburg, South
Africa
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Adigwe OP, Mohammed ENA, Onavbavba G. Preventing and Mitigating Inter-Professional Conflict Among Healthcare Professionals in Nigeria. J Healthc Leadersh 2023; 15:1-9. [PMID: 36636738 PMCID: PMC9831122 DOI: 10.2147/jhl.s392882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/02/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction The primary obligation of healthcare professionals is the well-being of patients. Inter-professional conflict can prevent the achievement of this goal, thereby potentially putting patients in peril. This study aimed at articulating contextual strategies to mitigate and prevent inter-professional conflict among healthcare workers in Nigeria. Methods A cross sectional study was undertaken in various health facilities in Nigeria. Questionnaires were administered to healthcare professionals. Completed questionnaires were analysed using Statistical Package for Social Sciences. Descriptive and inferential statistical analyses were undertaken. Results A total of 2207 valid responses were included for analysis. Findings revealed that almost all the respondents (92.9%) indicated that the Ministry of Health has a key role in resolving conflict in the healthcare sector. Close to three quarters (70.4%) of the study participants disagreed that leadership of hospitals and health agencies be limited to a particular profession. Almost all the participants (90.15%) indicated that cognate administrative expertise and experience are critical for leadership. A strong majority of the sample (93.5%) opined that reforms are required in the leadership selection process of hospital and other healthcare agencies. Conclusion Due to the criticality of this issue to patients' access to healthcare, findings from this study can underpin a proactive evidence based strategy that can comprehensively address inter-professional conflict among healthcare workers in Nigeria.
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Affiliation(s)
- Obi Peter Adigwe
- Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria,Correspondence: Obi Peter Adigwe, Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria, Email
| | - Elijah N A Mohammed
- Office of the Registrar, Pharmacists Council of Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Godspower Onavbavba
- Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria
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Aika IN, Enato E. Health care systems administrators perspectives on antimicrobial stewardship and infection prevention and control programs across three healthcare levels: a qualitative study. Antimicrob Resist Infect Control 2022; 11:157. [PMID: 36496430 PMCID: PMC9739345 DOI: 10.1186/s13756-022-01196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Antimicrobial stewardship (AMS) and infection prevention control (IPC) programs are proposed to address antimicrobial resistance. Nigeria's 5-years action plan for these programs is expiring by 2022. The objective of this study was to examine the perspectives, barriers and facilitators of these programs among health care managers and the current state of these programs in the three levels of healthcare facilities in Benin City, Nigeria. METHODS Fourteen in-depth interviews were conducted among hospital manager across primary, secondary and tertiary healthcare facilities. The interviews were guided by semi-structured questionnaire. Responses were audio-taped and hand written. Data were analyzed by transcribing recorded tapes into major themes. RESULTS Most of the participants viewed inappropriate prescribing as a problem both in the country and their facilities. None of the institutions have a formal AMS program, but participants believed that the presence of drug and therapeutic committee is a foundation for such programme. Majority of the participants acknowledged barriers to AMS to include lack of management backing, interprofessional rivalry, and poor laboratories. Only the tertiary institution has a formal IPC program. Some challenges to IPC across the healthcare institutions are inadequate waste disposal, lack of personal protective equipment and behavioral change among healthcare providers. CONCLUSION There is no AMS program across all facilities studied, although some forms of IPC activities are present in all healthcare institutions, only the tertiary facility has a formal IPC program. Effort should be made to strengthen AMS and IPC in the study facilities.
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Affiliation(s)
- Isabel Naomi Aika
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria.
| | - Ehijie Enato
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria
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Mohammed ENA, Onavbavba G, Wilson DOM, Adigwe OP. Understanding the Nature and Sources of Conflict Among Healthcare Professionals in Nigeria: A Qualitative Study. J Multidiscip Healthc 2022; 15:1979-1995. [PMID: 36101553 PMCID: PMC9464442 DOI: 10.2147/jmdh.s374201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Inter-professional conflict in the Nigerian health sector is a concept that is as old as modern medical practice and has resulted in disruption of health care delivery, with the overall impact bearing down on patients. Purpose This study aimed to provide an in-depth understanding and a clearer insight into the causes of conflict in the Nigerian health sector. Methods A qualitative strategy was employed using a semi-structured interview approach. Data were obtained from health practitioners from diverse backgrounds in various healthcare facilities. Results The phenomenon of conflict was reported as a long existent and trans-generational strain on inter-professional relationships occurring in all sectors of health practice, primarily between the physicians and other health care professionals. Inter-professional conflict was reported to emanate primarily from lapses in leadership, remuneration structure, role description, communication and emotional intelligence. This has affected the effectiveness of the Nigerian healthcare system and has contributed to hindrance in the provision of high-quality care in the country. Conclusion Evidence from this study can help in developing contextual policy in addressing inter-professional conflict in the health sector, and this will consequently improve health care delivery in the country.
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Affiliation(s)
- Elijah N A Mohammed
- Office of the Registrar, Pharmacists Council of Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Godspower Onavbavba
- Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria
| | - Diana Oyin-Mieyebi Wilson
- Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria
| | - Obi Peter Adigwe
- Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria
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Igwesi-Chidobe CN, Anyaene C, Akinfeleye A, Anikwe E, Gosselink R. Experiences of physiotherapists involved in front-line management of patients with COVID-19 in Nigeria: a qualitative study. BMJ Open 2022; 12:e060012. [PMID: 35487524 PMCID: PMC9051550 DOI: 10.1136/bmjopen-2021-060012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Evidence-based guidelines recommend physiotherapy for respiratory treatment and physical rehabilitation of patients with COVID-19. It is unclear to what extent physiotherapy services are used in the front-line management of COVID-19 in Nigeria. This study aimed to explore the experiences of front-line physiotherapists managing patients with COVID-19 in Nigeria. DESIGN Qualitative interview-based study. SETTING ICU and hospital COVID-19 wards, COVID-isolation and treatment centres in Nigeria, between August 2020 and January 2021. PARTICIPANTS Eight out of 20 physiotherapists managing patients with COVID-19 in the front line were recruited using purposive and snowball sampling. METHODS Qualitative in-depth semistructured telephone interviews of all consenting physiotherapists managing patients with COVID-19 in the front line in Nigeria were conducted and transcribed verbatim. Transcripts were thematically analysed. RESULTS Eight front-line physiotherapists (three neurological physiotherapists, two orthopaedic physiotherapists, one cardiopulmonary physiotherapist, one sports physiotherapist and one rotational physiotherapist) provided consent and data for this study. Four themes and 13 subthemes were generated illustrating discriminatory experiences of front-line physiotherapists, particularly from COVID-19 team leads; lack of multidisciplinary teamwork within COVID-19 teams; wide ranging stigmatisation from extended family members, colleagues, friends and the general public; material and psychosocial personal losses; lack of system support and suboptimal utilisation of physiotherapy in the management of COVID-19 in Nigeria. Personal agency, sense of professionalism, previous experience managing highly infectious diseases and being a cardiopulmonary physiotherapist were the factors that made the front-line physiotherapists to become involved in managing patients with COVID-19. However, discriminatory experiences made some of these physiotherapists to stop being involved in the management of patients with COVID-19 in the front line. Most front-line physiotherapists were not cardiopulmonary physiotherapists which may have influenced their level of expertise, multidisciplinary involvement and patient outcomes. CONCLUSIONS There is suboptimal involvement and support for physiotherapists, particularly cardiopulmonary physiotherapists treating patients with COVID-19 in the front line in Nigeria.
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Affiliation(s)
- Chinonso N Igwesi-Chidobe
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Nigeria
- Global Population Health Research Group, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Chiamaka Anyaene
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Nigeria
| | - Adegoke Akinfeleye
- Department of Physiotherapy, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria
| | - Ernest Anikwe
- Department of Physiotherapy, University College Hospital, Ibadan, Oyo, Nigeria
| | - Rik Gosselink
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
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Mohammed ENA. Knowledge, causes, and experience of inter-professional conflict and rivalry among healthcare professionals in Nigeria. BMC Health Serv Res 2022; 22:320. [PMID: 35264179 PMCID: PMC8905746 DOI: 10.1186/s12913-022-07664-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/22/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction The healthcare workforce is regarded as an essential component of any functioning health system, and a lack of optimal collaboration among this group can result to poor quality healthcare services to the population. In Nigerian setting, the health sector is faced with challenges of inter-professional conflict and rivalry. This study aimed at understanding knowledge, causes, and experience of inter-professional conflict and rivalry among healthcare professionals in Nigeria. Methods A cross sectional study was undertaken to administer questionnaires to healthcare personnel in various healthcare facilities in Nigeria. Data were analysed using Statistical Package for Social Sciences. Results A total of 2207 valid responses were received, and male participants were in majority as indicated by 63.7% of the sample. Collectively, doctors and pharmacists represented two-thirds of the sample, and majority of the participants were in the public sector (82.5%). Disparity in salary structure was the highest source of conflict. Whilst almost all the participants indicated that inter-professional rivalry and conflict are prevalent in health sector, about three-quarters of them (73.2%) disagreed that this practice is productive. A considerable number of the respondents had experienced inter-professional conflict and rivalry. Conclusion Evidence from this study can help policymakers in developing framework that can be utilised in addressing rivalry and conflict in the healthcare sector.
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Affiliation(s)
- Elijah N A Mohammed
- Pharmacists Council of Nigeria, Plot 7/9 Industrial Layout, Idu, P.M.B 415 Garki, Abuja, Federal Capital Territory, Nigeria.
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