An educational intervention on sepsis related to mechanical ventilation in adult public critical care units in the Eastern Cape
- Hlungwane, Emmanuel Zamokwakhe
- Authors: Hlungwane, Emmanuel Zamokwakhe
- Date: 2019
- Subjects: Intensive care nursing -- South Africa -- Eastern Cape , Intensive care units Septicemia -- Treatment
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/40139 , vital:35759
- Description: Sepsis is a leading cause of mortality and morbidity worldwide, and local adult public critical care units continue to experience incidences of sepsis. Professional nurses (PNs) need to base their nursing care on sepsis guidelines in order to properly manage sepsis on a mechanically ventilated adult patient in the critical care units. Adequate knowledge on sepsis guidelines remains crucially indicative to PNs as they endeavour to maintain asepsis on a critically ill patient. The aim was to develop, review and implement an educational intervention and investigate the effect of this intervention on the professional nurses’ knowledge and practices of sepsis in mechanically ventilated patients in adult public critical care units in the Eastern Cape Province. The research study followed a positivistic, quantitative research paradigm, using a quasi-experimental pre-post-test design, with an intervention research approach conducted in three phases. A pre-test questionnaire was administered to explore and describe the knowledge and practices of professional nurses related to sepsis in the mechanically ventilated patients in the adult public critical care units (Phase One). An educational intervention was developed, reviewed, and used to implement the sepsis guideline (Phase Two). The effect of the guideline on the knowledge and practices of the professional nurses in public adult critical care units were assessed through a post-test questionnaire (Phase Three). The questionnaires (pre-and post-) were developed by the researcher to collect the relevant data and were pilot tested to ascertain validity and reliability. The educational intervention to be implemented was developed based on the Surviving Sepsis Campaign Guidelines, reviewed by experts, implemented, and evaluated based on the sepsis guideline. A non-probability purposive sampling method was implemented. The intervention was implemented amongst three groups of PNs, namely experimental group one (EG1) (Powerpoint, Surviving Sepsis Campaign Guidelines and two monitoring visits), experimental group two (EG2) (Powerpoint and Surviving Sepsis Campaign Guidelines) and the control group (CG) (no exposure to intervention). Data was collected by means of a structured questionnaire. The target population was professional nurses working in selected adult public CCUs in the Eastern Cape. Descriptive statistics, such as mean, mode and median and inferential data analysis such as ANOVA and Chi square, have been conducted with the assistance of a statistician. The pre- and post-test questionnaire results on the knowledge related to SSC guidelines revealed a means of 57.72 and 54.61, as well as standard deviations of 13.99 and 12.15 with a difference of 3.11 for EG1. For EG2, the results revealed means of 53.28 and 62.18, standard deviations of 14.39 and 13.60 with a difference of -8.89 indicating a medium difference around 0.63 standard deviation. EG2 indicated more difference of above 0.5 standard deviation as compared to EG1. The control group on the other hand had produce large effect of mean difference above 0.8 standard deviation. Although there was no statistical significance found between the knowledge score between the three groups (EG1, EG2, CG), implementing the SSC guidelines (full intervention) in EG1 had medium effect on the knowledge of PNs on MV adult patient in the CCU. For EG2, there were positive relationships between the knowledge related to SCC Guidelines and practices related to SSC Guidelines. Ethical principles such as respect for person/informed consent, beneficence, privacy, and confidentiality, as well as rigour were maintained throughout the research study.
- Full Text:
- Date Issued: 2019
- Authors: Hlungwane, Emmanuel Zamokwakhe
- Date: 2019
- Subjects: Intensive care nursing -- South Africa -- Eastern Cape , Intensive care units Septicemia -- Treatment
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/40139 , vital:35759
- Description: Sepsis is a leading cause of mortality and morbidity worldwide, and local adult public critical care units continue to experience incidences of sepsis. Professional nurses (PNs) need to base their nursing care on sepsis guidelines in order to properly manage sepsis on a mechanically ventilated adult patient in the critical care units. Adequate knowledge on sepsis guidelines remains crucially indicative to PNs as they endeavour to maintain asepsis on a critically ill patient. The aim was to develop, review and implement an educational intervention and investigate the effect of this intervention on the professional nurses’ knowledge and practices of sepsis in mechanically ventilated patients in adult public critical care units in the Eastern Cape Province. The research study followed a positivistic, quantitative research paradigm, using a quasi-experimental pre-post-test design, with an intervention research approach conducted in three phases. A pre-test questionnaire was administered to explore and describe the knowledge and practices of professional nurses related to sepsis in the mechanically ventilated patients in the adult public critical care units (Phase One). An educational intervention was developed, reviewed, and used to implement the sepsis guideline (Phase Two). The effect of the guideline on the knowledge and practices of the professional nurses in public adult critical care units were assessed through a post-test questionnaire (Phase Three). The questionnaires (pre-and post-) were developed by the researcher to collect the relevant data and were pilot tested to ascertain validity and reliability. The educational intervention to be implemented was developed based on the Surviving Sepsis Campaign Guidelines, reviewed by experts, implemented, and evaluated based on the sepsis guideline. A non-probability purposive sampling method was implemented. The intervention was implemented amongst three groups of PNs, namely experimental group one (EG1) (Powerpoint, Surviving Sepsis Campaign Guidelines and two monitoring visits), experimental group two (EG2) (Powerpoint and Surviving Sepsis Campaign Guidelines) and the control group (CG) (no exposure to intervention). Data was collected by means of a structured questionnaire. The target population was professional nurses working in selected adult public CCUs in the Eastern Cape. Descriptive statistics, such as mean, mode and median and inferential data analysis such as ANOVA and Chi square, have been conducted with the assistance of a statistician. The pre- and post-test questionnaire results on the knowledge related to SSC guidelines revealed a means of 57.72 and 54.61, as well as standard deviations of 13.99 and 12.15 with a difference of 3.11 for EG1. For EG2, the results revealed means of 53.28 and 62.18, standard deviations of 14.39 and 13.60 with a difference of -8.89 indicating a medium difference around 0.63 standard deviation. EG2 indicated more difference of above 0.5 standard deviation as compared to EG1. The control group on the other hand had produce large effect of mean difference above 0.8 standard deviation. Although there was no statistical significance found between the knowledge score between the three groups (EG1, EG2, CG), implementing the SSC guidelines (full intervention) in EG1 had medium effect on the knowledge of PNs on MV adult patient in the CCU. For EG2, there were positive relationships between the knowledge related to SCC Guidelines and practices related to SSC Guidelines. Ethical principles such as respect for person/informed consent, beneficence, privacy, and confidentiality, as well as rigour were maintained throughout the research study.
- Full Text:
- Date Issued: 2019
A new synthetic approach for preparation of Efavirenz
- Authors: Chada, Sravanthi
- Date: 2017
- Subjects: Antiretroviral agents , Asymmetric synthesis , Enzyme inhibitors , HIV (Viruses) -- Enzymes
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/15512 , vital:28265
- Description: Efavirenz, a drug that is still inaccessible to millions of people worldwide, is potent non nucleoside reverse transcriptase inhibitor (NNRTI), is one of the preferred agents used in combination therapy for first-line treatment of the human immunodeficiency virus (HIV). NNRTIs attach to and block an HIV enzyme called reverse transcriptase, by blocking reverse transcriptase; NNRTIs prevent HIV from multiplying and can reduce the amount of HIV in the body. Efavirenz can't cure HIV/AIDS, but taken in combination with other HIV medicines (called an HIV regimen) every day helps people with HIV live longer healthier lives. Efavirenz also reduces the risk of HIV transmission and can be used by children who are suffering from HIV/AIDS. All the above therapeutic uses of efavirenz prompted us to identify the novel and hopefully cost efficient synthetic methodology for the preparation of efavirenz. In this thesis a new synthetic method for asymmetric synthesis of efavirenz is described. This route started from commercially available starting materials and it is first established in traditional batch chemistry and further the parameters transferred to a semi continuous flow protocol for optimization.
- Full Text:
- Date Issued: 2017
- Authors: Chada, Sravanthi
- Date: 2017
- Subjects: Antiretroviral agents , Asymmetric synthesis , Enzyme inhibitors , HIV (Viruses) -- Enzymes
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/15512 , vital:28265
- Description: Efavirenz, a drug that is still inaccessible to millions of people worldwide, is potent non nucleoside reverse transcriptase inhibitor (NNRTI), is one of the preferred agents used in combination therapy for first-line treatment of the human immunodeficiency virus (HIV). NNRTIs attach to and block an HIV enzyme called reverse transcriptase, by blocking reverse transcriptase; NNRTIs prevent HIV from multiplying and can reduce the amount of HIV in the body. Efavirenz can't cure HIV/AIDS, but taken in combination with other HIV medicines (called an HIV regimen) every day helps people with HIV live longer healthier lives. Efavirenz also reduces the risk of HIV transmission and can be used by children who are suffering from HIV/AIDS. All the above therapeutic uses of efavirenz prompted us to identify the novel and hopefully cost efficient synthetic methodology for the preparation of efavirenz. In this thesis a new synthetic method for asymmetric synthesis of efavirenz is described. This route started from commercially available starting materials and it is first established in traditional batch chemistry and further the parameters transferred to a semi continuous flow protocol for optimization.
- Full Text:
- Date Issued: 2017
A framework for the management of environmental information in Higher Education Institutions
- Authors: Jonamu, Blessing Tapiwa
- Date: 2014
- Subjects: Sustainability , Universities and colleges , Environmental management
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10492 , http://hdl.handle.net/10948/d1020620
- Description: Higher Education Institutions (HEIs) are not immune to the global environment problems. An increasing awareness of the environmental responsibilities of HEIs has led researchers to investigate the role of environmental information and Environmental Management Information Systems (EMISs) in HEIs. EMISs play a major role in environmental management and environmental decision making in HEIs. Internationally, an increasing number of HEIs are embracing the concept of ‘sustainable HEIs’ by undertaking green campus initiatives. HEIs often use diverse information systems, some of which are manual systems, proven to be inefficient and this gives rise to redundant and inconsistent databases which result in non-compliance with regulations, confusion and lack of co-ordinated effort. There is therefore need for an integrated, comprehensive software system and framework which can assist with the efficient management of environmental information at South African HEIs. This study fills a gap in the field of environmental sustainability at HEIs as the evaluation of existing sustainability programs has shown common weakness such as: Failure to effectively set baselines, flaws in data acquisition and management and missing documentation. The aim of this study is to propose a framework for Environmental Information Management (EIM) in HEIs. The framework includes guidelines related to the components of the framework which can also be used to perform a gap analysis to facilitate the improved design of effective and efficient EIM processes and data stores. The Design Science Research (DSR) methodology is the research methodology used in the development of the two artifacts of this study namely: The EIM framework for HEIs and an EMIS prototype to serve as proof of concept. Problem identification and motivation was the first activity of the DSR which was done through a rigorous literature review and an investigation and evaluation of extant systems. This resulted in the design of an initial EIM framework for HEIs. Nelson Mandela Metropolitan University (NMMU) was the HEI used as the case study. The EIM framework was applied at NMMU and this enabled the researcher to understand the current As-Is EIM processes at NMMU and this resulted in clear objectives of a solution. The EMIS prototype (data warehouse) was then designed and implemented based on the theoretical framework. Three sets of evaluations were done to determine the acceptance of the EIM framework for HEIs and the performance of the EMIS prototype. The EIM framework was generally positively accepted and minor suggestions were made. An updated version of the EIM framework was proposed and evaluated. The experimental evaluation results showed that the EMIS prototype was efficient and effective. The contribution of this study is an EIM framework for HEIs and an implementation of an EMIS (EnviroDW) at NMMU that could be utilised by other HEIs.
- Full Text:
- Date Issued: 2014
- Authors: Jonamu, Blessing Tapiwa
- Date: 2014
- Subjects: Sustainability , Universities and colleges , Environmental management
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10492 , http://hdl.handle.net/10948/d1020620
- Description: Higher Education Institutions (HEIs) are not immune to the global environment problems. An increasing awareness of the environmental responsibilities of HEIs has led researchers to investigate the role of environmental information and Environmental Management Information Systems (EMISs) in HEIs. EMISs play a major role in environmental management and environmental decision making in HEIs. Internationally, an increasing number of HEIs are embracing the concept of ‘sustainable HEIs’ by undertaking green campus initiatives. HEIs often use diverse information systems, some of which are manual systems, proven to be inefficient and this gives rise to redundant and inconsistent databases which result in non-compliance with regulations, confusion and lack of co-ordinated effort. There is therefore need for an integrated, comprehensive software system and framework which can assist with the efficient management of environmental information at South African HEIs. This study fills a gap in the field of environmental sustainability at HEIs as the evaluation of existing sustainability programs has shown common weakness such as: Failure to effectively set baselines, flaws in data acquisition and management and missing documentation. The aim of this study is to propose a framework for Environmental Information Management (EIM) in HEIs. The framework includes guidelines related to the components of the framework which can also be used to perform a gap analysis to facilitate the improved design of effective and efficient EIM processes and data stores. The Design Science Research (DSR) methodology is the research methodology used in the development of the two artifacts of this study namely: The EIM framework for HEIs and an EMIS prototype to serve as proof of concept. Problem identification and motivation was the first activity of the DSR which was done through a rigorous literature review and an investigation and evaluation of extant systems. This resulted in the design of an initial EIM framework for HEIs. Nelson Mandela Metropolitan University (NMMU) was the HEI used as the case study. The EIM framework was applied at NMMU and this enabled the researcher to understand the current As-Is EIM processes at NMMU and this resulted in clear objectives of a solution. The EMIS prototype (data warehouse) was then designed and implemented based on the theoretical framework. Three sets of evaluations were done to determine the acceptance of the EIM framework for HEIs and the performance of the EMIS prototype. The EIM framework was generally positively accepted and minor suggestions were made. An updated version of the EIM framework was proposed and evaluated. The experimental evaluation results showed that the EMIS prototype was efficient and effective. The contribution of this study is an EIM framework for HEIs and an implementation of an EMIS (EnviroDW) at NMMU that could be utilised by other HEIs.
- Full Text:
- Date Issued: 2014
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