https://www.um.edu.mt/library/oar/handle/123456789/44196 2026-04-04T17:28:19Z https://www.um.edu.mt/library/oar/handle/123456789/112006 Title: The quality of customer care in the National Immunisation Services Abstract: The National Immunisation Service (NIS) delivers various serv1ces, in particular, immunisations to travellers, immunisations to categories of people at high risk of specific infectious diseases and scheduled immunisations recommended for children. The first three doses of diphtheria, tetanus and polio as scheduled for children are legally enforced by law which implies that the uptake should achieve high coverage rates in order to confer herd immunity and prevent outbreaks. Thus, investment in high standards of customer care quality within the NIS is imperative in order to attract clients for its services and improve the quality of their life. The aim of this study was to analyse the quality of customer care in the NIS and investigate if trained nurses are implementing their training on the job, as well as investigate if the clients are satisfied with the service delivered. The hypothesis of this study stated that 'Staff trained nurses in customer care provide better levels of service quality and satisfaction in the NIS'. A randomly selected sample of 72 participants was selected from the database at NIS and asked to fill in a questionnaire. Also, each NIS nurse was observed during her interaction ·with the clients, during the busy month of October and in December when the demand for the services is much less. Data was analysed by means of SPSS Version 12.0. Overall, findings from the questionnaire indicated that the clients were satisfied with the service. This was indicated by mean scores of > 2.0. Nurses' assessments on customer care training which included skills, attitudes and knowledge, also indicated that the quality of customer care delivered by both trained and non-trained nurses did not vary overall. This was demonstrated by comparison of mean scores between services delivered by trained and non-trained nurses, which showed close similarities. However, comments from the questionnaire and observations, indicated some discrepancies and performance gap in both physical and management aspects of services which need to be improved. Health services managers require to plan for better utilization of resources, monitoring and possible further studies in specific areas to enhance the quality of customer care and to better meet the needs and expectations of the NIS clients. Description: P.Q.DIP.HEALTH SERVICES MANGT. 2004-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/111768 Title: A needs assessment for nursing care in state community homes Abstract: Older people who live in community homes are likely to be vulnerable, have complex physical and mental health problems and therefore some level of nursing intervention will be needed. Assessment is considered to be the first step in the process of individualized nursing care. It provides information that is critical to the development of a plan of action that enhances personal health status. Provision of long-term care should reflect the preferences of consumers. This suggests that data are needed about the users' perspectives on the excellence of their care, and that consumers should be included as a source of data on that care. The objective of the study is to evaluate the dependency level and mental capabilities of the resident population within a state community home, to determine the nursing input needed, define the level of nursing intervention and to identify the hours of nursing care required for each resident through a scoring data. A qualitative approach was utilized which employed a validated questionnaire, consisting of the RCN assessment tool for older persons. The total population of the study group was one hundred and fourteen older persons residing in Mosta and Floriana homes. No exclusion criterion was employed. Results showed that in Mosta Home, 6 (9%) of residents did not need any nursing care, 15 (22%) residents needed 1 hour of nursing care per day, 10 (14%) residents needed 1.2 hours of nursing care per day, 16 (25%) residents needed 2.5 hours of nursing care per day and 21 (30%) residents needed 4.1 hours of nursing care per day. In Floriana Home, 10 (22%) of residents did not need any nursing care, 12 (26%) residents needed 1 hour of nursing care per day, 2 (4%) residents needed 1.2 hours of nursing care per day, 7 (15%) residents needed 2.5 hours of nursing care per day and 15 (33%) residents needed 4.1 hours of nursing care per day. This study was able to identify that findings show that the state community homes are not consistent with the Social Security Act, Legal Notice no.259 of 2004, were article 93 of the same act, specifies that the institutions at Cospicua, Floriana, Gzira, Mosta, Msida, Mtarfa and Zejtun as 'Hostels' for the Elderly and provide care at level one (Appendix 8). A Hostel provides shared accommodation in a house run by a housekeeper with the provision of meals (Tinker, 1997). Such housing is aimed for independent persons who require board and lodging accommodation. This study was able to identify the dependency needs of the service users in long-term settings. Similar studies should be repeated on a regular basis to ensure that desired policies, procedures and standards are reached and maintained over time in all state community homes. This would give a holistic picture of the dependency needs in statutory long-term care and ensuring that services provided remain appropriate to those needs. Description: P.Q.DIP.HEALTH SERVICES MANGT. 2004-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/111723 Title: General practitioners' perceptions on the introduction of a primary care service in the Accident and Emergency Department (St. Luke's Hospital, Malta) Abstract: Hospital services are the largest component of national health care expenditure and their cost impacts everyone. According to the latest survey carried out recently (as issued on the Sunday Times, Aug 31, 2003), it was indicated that 78% and 73% of the population use the Accident and Emergency (A & E) department and health centres respectively. This confirms the high turnover of patients attending casualty (110,000 per year), as well as those who attend the health centres (over 1.1 million per year). The demand for the Accident and Emergency (A&E) service is increasing annually, however one questions, out of so many patients attending the A & E department, how many of these are true emergencies and how many could have been treated at a health centre or by a private General Practitioner (GP)? It has been noted that on many occasions, a large percentage of patients attending the A & E department are presenting with conditions which could have been seen and treated by private GPs or GPs working at the health centers. From the perspective of the A&E service, this has been portrayed as problematic, contributing to 'inappropriate' utilization of hospital resources and expertise, prolonged waiting times and increased stress on the A & E staff. A study suggests that by employing general practitioners in the A&E department to treat patients with primary care problems may be beneficial to the health department. Description: P.Q.DIP.HEALTH SERVICES MANGT. 2004-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/111700 Title: A needs assessment for dietetic services within the Diabetes Department Abstract: Diabetes Mellitus has long been recognised as one of the major health problems in Malta, With a prevalence of 10% and with nearly three quarters of the adult population in Malta being overweight, the management of the overweight diabetic through energy controlled diet need hardly be stressed. Investing in a quality dietetic service would improve patients' quality of life, decrease complications associated with diabetes and the direct costs to the health service. The purpose of this descriptive study was to determine whether diabetic patients are being provided with the basic dietetic education needs efficiently and effectively. The study also aspired to improve the management process by analysing the present situation and assessing the ever-increasing needs and demands for this dietetic service. A descriptive analysis research design was used in this study. A randomly selected sample of 120 Maltese speaking diabetic patients of all age groups, 90 from the Diabetes clinic, St. Luke's Hospital and 30 from the health centres were interviewed. The research instrument was a specifically designed structured questionnaire. Further elite interviews were also conducted with service providers. A literature review identified the needs of improving health services' effectiveness and efficiency leading to patients' improved quality of life and decreasing complications. Data was analysed using SPSS ver 12.0. Findings revealed gaps in the service being provided. One of the most important result was that only 29.9% had actually consulted a dietitian and 94% did not have a pending appointment due to only 1 part time dietitian once a week for the whole service. This concern was also expressed by all service providers interviewed. With regards to patient satisfaction, only 19% said they were satisfied. 92%' of respondents expressed their desire for a new dietetic clinic to be set up. This was also expressed by the service providers. With regards to patient dietary knowledge, it revealed good knowledge on certain aspects but lacking in other. The main educator according to patients was the doctor (80.3%). The findings highlighted the evident need to improve the dietetic service. A proper management structure targeted towards improvement of services, interventions and resources would lead to a better outcome of diabetes health care services. It also seems worthwhile for health service managers to invest in the education and training of health professionals to optimise quality. Description: P.Q.DIP.HEALTH SERVICES MANGT. 2004-01-01T00:00:00Z