BACKGROUND

The crop of novice nurses who are currently employed is a product of flexible learning who had limited contact hours with actual patients, which is contrary to those who graduated from traditional learning modalities. Hence, it is essential to evaluate how the impact of flexible learning modality has affected the practice preparedness levels of novice nurses in the hospital setting.

This study aimed to determine the level of practice preparedness and its associated factors among novice nurses who work in private hospitals.

The study utilized a cross-sectional survey design. Data was gathered from a total enumeration of ninety-four novice staff nurses who graduated from the flexible learning curriculum and are currently employed in private hospitals in Baguio City and La Trinidad. The tool used was a questionnaire in two parts. Part 1 consisted of questions related to demographic information and factors related to practice preparedness, and part 2 included the Nursing Practice Readiness Scale, with validity and reliability scores of >0.924 and 0.90, respectively. The data was analyzed using the SPSS V27 trial version. The protocol was approved by the Saint Louis University Research Ethics Committee.

Findings reveal that more novice nurses in private hospitals perceived themselves as well-prepared across all domains of practice preparedness: “Collaborative Interpersonal Relationship” (n=94, 100%); “Patient Centeredness” (n=92, 97.90%); “Self-regulation” (n=90, 95.70%); “Clinical Judgment and Nursing Performance” (n=78, 83.00%); and “Professional Attitudes” (n=76, 80.90%). There is a significant association between practice preparedness and the following factors: “Attended more than one Training/Seminars per year” (p=0.02), “Graduated from Private Schools” (p=0.03), and “Assigned in Regular Wards” (p=0.05). On the other hand, no significant association was found between practice preparedness and the following factors: “Sex” (p=0.61) and “Membership in Professional Organizations” (p=0.73).

In agreement with existing studies, practice preparedness is multifactorial. However, what this study contributes are new factors that are favorable in making novice nurses more confident in performing their roles and responsibilities. These include being a graduate of private schools, being assigned to regular wards, and attending professional training/seminars more than once annually. Advantageously, these factors that promote practice preparedness are modifiable.

Background: The crop of novice nurses who are currently employed is a product of flexible learning who had limited contact hours with actual patients, which is contrary to those who graduated from traditional learning modalities. Hence, it is essential to evaluate how the impact of flexible learning modality has affected the practice preparedness levels of novice nurses in the hospital setting. Objective: This study aimed to determine the level of practice preparedness and its associated factors among novice nurses who work in private hospitals. Methods: The study utilized a cross-sectional survey design. Data was gathered from a total enumeration of ninetyfour novice staff nurses who graduated from the flexible learning curriculum and are currently employed in private hospitals in Baguio City and La Trinidad. The tool used was a questionnaire in two parts. Part 1 consisted of questions related to demographic information and factors related to practice preparedness, and part 2 included the Nursing Practice Readiness Scale, with validity and reliability scores of >0.924 and 0.90, respectively. The data was analyzed using the SPSS V27 trial version. The protocol was approved by the Saint Louis University Research Ethics Committee. Results: Findings reveal that more novice nurses in private hospitals perceived themselves as well-prepared across all domains of practice preparedness: “Collaborative Interpersonal Relationship” (n = 94, 100%); “Patient Centeredness” (n = 92, 97.90%); “Self-regulation” (n = 90, 95.70%); “Clinical Judgment and Nursing Performance” (n = 78, 83.00%); and “Professional Attitudes” (n = 76, 80.90%). There is a significant association between practice preparedness and the following factors: “Attended more than one Training/Seminars per year” (p = 0.02), “Graduated from Private Schools” (p = 0.03), and “Assigned in Regular Wards” (p = 0.05).On the other hand, no significant association was found between practice preparedness and the following factors: “Sex” (p = 0.61) and “Membership in Professional Organizations” (p = 0.73). Conclusion In agreement with existing studies, practice preparedness is multifactorial. However, what this study contributes are new factors that are favorable in making novice nurses more confident in performing their roles and responsibilities. These include being a graduate of private schools, being assigned to regular wards, and attending professional training/seminars more than once annually. Advantageously, these factors that promote practice preparedness are modifiable.
nurses ; nursing staff, hospital ; hospitals, private

Introduction: The scarce local data on the etiology of childhood pneumonia admitted in a hospital has come from a few urban and rural government hospitals. There is no data from private hospitals. Knowing the most likely etiology of pneumonia is of outmost importance as this has implications on the diagnostic modalities requested and the institution of therapy. Objectives: The purpose of this study is to identify clinical and microbiologic diagnoses of clinically- and radiographically-confirmed pediatric pneumonia cases admitted in a private hospital. Secondarily, a discussion of specific etiologies is made. Methodology: Each consecutive, inpatient, pneumonia referral/admission in either one of two private, urban, tertiary hospitals, of a child 18 years and below from 1993 to 2021 was logged into a computer daily by a single pediatric infectious disease specialist. Clinical, epidemiologic, diagnostic and therapeutic data were recorded. All pneumonia cases, except those seen in newborns before their discharge from the nursery, were included. Results: Of the 496 cases, there was a clinical and/or microbiologic etiology in 43% of cases. The bacteremia rate was 6.3%. The most common identifiable etiologies were Mycoplasma pneumoniae (11.9%), Mycobacterium tuberculosis (5.2%), and Staphylococcus aureus (4.2%), while bronchiolitis (5.5%) and measles (4.8%) were the most common clinical diagnoses. There were several cases of ventilator-associated pneumonia and Pneumocystis jirovecii pneumonia. Conclusions Mycoplasma pneumoniae, tuberculosis, Staphylococcus aureus and Pneumocystis jirovecii are important pneumonia etiologies that have not been widely considered locally. The data presented here mirrors the practice of one pediatric infectious disease doctor in two hospitals where diagnostic and treatment options are readily available and utilized.
Child ; Inpatients ; Hospitals, Private ; Communicable Diseases ; Pneumonia

Background: The field of medicine is constantly changing. Notable changes occur in the patterns of clinical practice, business of medicine, shift in demographics/generation of the health care workforce, emergence of sub-specialization; and advances in research and technology. These changes can affect the way young physicians establish their practice and this is an area not addressed by the medical education and training. Purpose: There is little data in the literature regarding the experience of young physicians in establishing clinical practice. This study was undertaken to answer the central question: Among physicians in the field of Internal Medicine with or without subspecialty who graduated from training in 2013 to 2018, what were the issues and challenges that they faced as they established their clinical practice in the urban or mixed setting? Methodology: Qualitative research-case study; Key informant interview was conducted among junior Internal Medicine consultants who satisfied the inclusion criteria. Data analysis used thematic analysis consisting of reading, writing notes, describing, and classifying transcripts according to categories and themes. Results: After a comprehensive analysis of narratives, five emergent themes surfaced: “Tough Days” (Period of figuring out the system; Need for Self-introduction; Few patients and Feelings of frustration and depression); “Torn and Divided” (Unpredictable work schedule and workload; Lack of time for issues outside career); “Temporary Debt” (Large start-up cost; Expensive maintenance); “Difficult but Tolerable” (Family support; Call-a-colleague; Debt of gratitude to mentors) and lastly “Dreams and To-do’s”. Conclusions Our respondents have experienced substantial challenges in starting clinical practice. Learning the ways of the healthcare business, effectively promoting oneself to the community, dealing with the emotional turmoil of having few patients, coming up with a strategic schedule and area of practice, and looking for funds and paying it back, were the challenges and experiences of these young medical specialists as they establish their careers in the urban and/or rural setting.
Private Practice

Background: Patient-centered outcomes in chronic care assessed through Quality of Health Care can be measured by its congruence to the Chronic Care Model (CCM) using Patient Assessment of Chronic Illness Care (PACIC). Behavioral and quality measures that influence the patient’s perception of the quality of care remain unknown. Objective: This study aimed to assess the quality of chronic illness care among diabetic patients using PACIC and its relationship to socio-demographic factors. Methods: A cross-sectional study involving diabetic patients of the Out-Patient Department of a private hospital were enrolled through non-probability sampling. Overall score from the PACIC questionnaire, its subscale scores and its relationship with the socio-demographic factors were determined using descriptive statistics. Results: All participants were married and living with their families. Median age was 58. The over- all PACIC score was 3.53 + 0.72 SD. Problem solving/Contextual subscale presented the highest score while follow up/coordination had the least. Those who have college degrees had significantly lower mean scores than high school graduates (p-value = 0.032). Conclusion PACIC scores indicate a moderate to high quality of care. PACIC is a practical instrument that can be used in quality assessment and improvement programs.
Outpatients ; Diabetes Mellitus ; Chronic Disease ; Long-Term Care ; Hospitals, Private

PURPOSE: Scholarly works have reported about the nurses' salary and its impact on job satisfaction, nurse turnover, retention, work condition, and provision of nursing care. However, studies are either focused on the nurses in government hospitals or nurses working outside the country. Thus, the study aims to explore and describe the lived experience of nurses employed in private hospitals in Albay province, the Philippines, and explicate the need for better pay. DESIGN: The study used a qualitative design, specifically a descriptive phenomenology approach. METHODS: Purposive sampling and in-depth interviews were conducted among seventeen (17) nurse informants. The audio-recorded interviews were transcribed verbatim and analyzed following the seven-stage process as described by Colaizzi (1978) for data coding and identifying themes. The same process of analysis performed among the responses or data gathered through electronic communication platforms. FINDINGS: Four themes and nine sub-themes were identified. The first theme is 'Over but under,' which includes three sub-themes: (1) Over-worked, underpaid working conditions, (2) Finding an additional source of income as a result of low-wages, (3) More nurses are produced, but less are staying in the country, (4) Required by law in the country but not permitted by low salary. The second theme is 'Same but different,' which includes three sub-themes: (1) The Nursing profession is akin to others, yet uncompensated, (2) Work demands are comparable to government hospitals. The third theme is 'Caring but uncared-for,' which includes two sub-themes: (1) Psychologically upsetting, (2) Stimulates nurses transition. The fourth theme is 'Selfless foresight,' which include only one sub-theme (1) Increasing the salary attracts nurses to stay in the country. CONCLLUSION AND RECOMMENDATIONS: The study results showed that nurses in private hospitals need better remuneration as they experience poor work conditions. Also, it described a low salary that impacts the nurses' workload, their physical and mental health, their socio-economic being, their ability to avail professional development, the retention or turnover, and the provision of nursing care. The study findings suggest data triangulation of the study in some other private hospitals outside the region and explore strategies for increasing nurses' retention and satisfaction. Nonetheless, these efforts will robust the empirical data about the need for better pay among nurses in the private sector.
Job Satisfaction ; Personnel Turnover ; Hospitals, Private ; Salaries and Fringe Benefits

RESEARCH QUESTION: What are the profiles and the degree of burnout among resident physicians in private tertiary hospitals in Bacolod City? BACKGROUND: Exhaustion from work may result into negative effects not only to the medical staff and patients. Systematic reviews revealed an association in physician burnout and suboptimal quality of care, patient safety and patient satisfaction. However, the prevalence of burnout among resident physicians in Bacolod City has not been established. OBJECTIVES: The study aimed to determine the profiles and the degree of burnout among resident physicians in private tertiary hospitals in Bacolod City. STUDY DESIGN: Cross-sectional survey PARTICIPANTS: We invited all resident physicians in private hospitals in Bacolod City. OUTCOME MEASURE: This study used the 22-item Maslach Burnout Inventory-Human Services Survey. ANALYSIS: IBM SPSS version 22 was used in the data analysis. Mean and frequency distribution were utilized. Analysis of percentage of distribution was used to determine their difference. RESULTS: From December 2019 to January 2020, ninety-three resident physicians consented to participate in the study. The majority of the participants were young adults, females and single. Only a minority of the residents exercised regularly. The majority were practicing their religion. Most of the residents are in their early years of training. Residents in Internal Medicine comprised the majority of the respondents. Among the respondents, in the Emotional Exhaustion (EE) domain: 24.7% were low, 37.6% were moderate, and 37.6% were high. While in the Depersonalization (DP) domain: 43% were low, 34.4% were moderate, and 22.6% were high. Lastly, in the Personal Achievement (PA) domain: 33.3% were low, 35.5% were moderate, and 31.2% were high. High burnout was present in 22.6% among the respondents. CONCLUSIONS: High burn out was seen among young adults, male, single, and more senior resident physicians. Furthermore, residents who exercise regularly and practice their religion have lower burnout. And Internal Medicine residents were seen to have high burnout compared to other training specialization. Organizational- and physician-directed interventions have an essential role in preventing and reducing burnout in training institutions.
Burnout, Professional ; Burnout, Psychological ; Hospitals, Private ; Physicians

PURPOSE: Successful application experiences on public-private partnership (PPP) in different countries, suggest that PPP could be an option in road traffic injury (RTI) prevention. The present study aims at investigating the applicability of PPP policy in RTI prevention in Iran based on the experts' perspectives. METHODS: This is a qualitative study with grounded theory approach which has been conducted in Tabriz University of Medical Sciences, Iran in 2018. The participants were 22 experts in the field of RTIs selected using purposive sampling method. Data were collected by semi-structured interviews and analyzed with content-analysis method. RESULTS: The results were classified under 5 main themes (applicability, scopes and services, challenges, advantages, and strategies) for applying PPP policy and 37 sub-themes. Due to the prevalence of RTIs, the present challenges in public sector, existence of qualified private sector, and successful experiences in other areas, there are opportunities for private sector partnership in prevention of RTIs. Private sector could participate in different scopes and services regarding RTI prevention, including road construction and maintenance, maintenance and provision of vehicles safety and public education. The main challenges including legislation issues, ambiguities in collaboration, political and organizational unsustainability, government's financial hardship and lack of experienced experts in the field of RTI. However, there are significant advantages including high efficiency in program implementation, covering the weaknesses of public sector, effective and efficient management on application of PPP in RTI prevention. The strategies include identifying and prioritizing the assignable activities, identifying the qualified private sector, developing PPP policies and legal frameworks, creating a common language between public and private parties, trying to meet the expectations of the private sector by public sector, developing a comprehensive and sound contract, and cultivating public culture to accept private sector in the field of RTI prevention. CONCLUSION This study sought to determine whether PPP could be used as strategy to reduce the burden of RTIs in Iran. But it requires a lot of preliminary studies to provide the context and conditions for applying this policy.
Accidental Injuries ; prevention & control ; Accidents, Traffic ; prevention & control ; Adult ; Expert Testimony ; Female ; Humans ; Iran ; Male ; Middle Aged ; Public-Private Sector Partnerships ; organization & administration ; Qualitative Research

BACKGROUND: Potentially avoidable hospitalizations (PAH) contribute to an increased post-discharge mortality. METHODS: To investigate the between-hospital variation and the relationship between all predictors and mortality after discharge among older adults with PAH, we studied 15,186 older patients with PAH in 2,200 hospitals included in the National Health Insurance Service-Senior claims database from 2002 to 2013. Multivariable multilevel logistic regression analyses were performed to analyze the variance at between-hospital for mortality after accounting for differences in patient characteristics. RESULTS: The between-hospital variation in mortality that could be attributed to hospital practice variations were 37.6% at 1-week to 13.9% at 12-month post-discharge, after adjustment for individual patient characteristics and hospital-level factors. Hospital-level factors significantly explained mortality at 3 weeks after discharge. Clinics, compared with general hospitals, demonstrated a 2.75 times higher likelihood of deaths at 3-week post-discharge (p<0.001). Compared with private hospitals, public hospitals exhibited 1.61 times higher odds of 3-week mortality (p=0.01). CONCLUSION: This study demonstrates considerable between-hospital variations in PAH-related mortality that could be attributed to hospital practices. Monitoring of hospitals to identify practice variations would be warranted to improve the survival of older patients with PAH.
Adult ; Hospitalization ; Hospitals, General ; Hospitals, Private ; Hospitals, Public ; Humans ; Logistic Models ; Mortality ; National Health Programs

STUDY DESIGN: Retrospective review of an initial cohort of consecutive patients undergoing robot-assisted pedicle screw placement.PURPOSE: We aimed to evaluate the learning curve, if any, of this new technology over the course of our experience.OVERVIEW OF LITERATURE: Percutaneous pedicle screws have specific advantages over open freehand screws. However, they require intraoperative imaging for their placement (e.g., fluoroscopy and navigation) and require increased surgeon training and skill with the learning curve estimated at approximately 20–30 cases. To our knowledge, this is the first study that measures the learning curve of robot-guided purely percutaneous pedicle screw placement with comprehensive objective postoperative computed tomography (CT) scoring, time per screw placement, and fluoroscopy time.METHODS: We included the first 80 consecutive patients undergoing robot-assisted spinal surgery at Melbourne Private Hospital. Data were collected for pedicle screw placement accuracy, placement time, fluoroscopy time, and revision rate. Patient demographic and relevant perioperative and procedural data were also collected. The patients were divided equally into four sub-groups as per their chronological date of surgery to evaluate how the learning curve affected screw placement outcomes.RESULTS: Total 80 patients were included; 73 (91%) had complete data and postoperative CT imaging that could help assess that placement of 352 thoracolumbar pedicle screws. The rate of clinically acceptable screw placement was high (96.6%, 95.4%, 95.6%, and 90.7%, in groups 1 to 4, respectively, p=0.314) over time. The median time per screw was 7.0 minutes (6.5, 7.0, 6.0, and 6.0 minutes in groups 1 to 4, respectively, p=0.605). Intraoperative revision occurred in only 1 of the 352 screws (0.3%).CONCLUSIONS: We found that robot-assisted screw placement had high accuracy, low placement time, low fluoroscopy time, and a low complication rate. However, there were no significant differences in these parameters at the initial experience and the practiced, experience placement (after approximately 1 year), indicating that robot-assisted pedicle screw placement has a very short (almost no) learning curve.
Cohort Studies ; Fluoroscopy ; Hospitals, Private ; Humans ; Learning Curve ; Learning ; Pedicle Screws ; Retrospective Studies ; Robotic Surgical Procedures ; Spinal Fusion