dc.description.abstract |
In health care, evidence-based practices take place when decisions that affect the care
of patients are taken with due weight accorded to all valid and reliable evidence from
medical records. Medical records furnish documentary evidence necessary for health
care provision hence the need for strategies to ensure medical records are stored in a
uniform and standardized manner where they retain their evidential weight. The aim
of this study was to assess medical records management in support of evidence-based
medical practices at Kisii Teaching and Referral Hospital with a view of proposing
strategies to improve medical records management in the hospital. The objectives of
the study were: to ascertain the status of medical records in supporting evidence-based
practices at Kisii Teaching and Referral Hospital; to establish policies and procedural
frameworks governing the management of medical records at Kisii Teaching and
Referral Hospital; to find out the knowledge and skills of staff in the management of
medical records at Kisii Teaching and Referral Hospital; to explore the use of
information and communication technology in managing medical records in
supporting evidence-based practices at Kisii Teaching and Referral Hospital; and to
propose strategies to improve on medical records management for better healthcare
service delivery at Kisii Teaching and Referral Hospital. The study was underpinned
by The Records Continuum and The Johns Hopkins Nursing Evidence-Based Practice
models. The study adopted a qualitative research methodology using a case study
design. Purposive sampling technique was used. The study sample consisted of 52
respondents drawn from four departments that create and generate; use; and manage
medical records. Data was collected through the triangulation of interviews,
observation, and documentary reviews and analyzed thematically. The findings
established that: there was an absence of comprehensive medical records management
policies and procedural frameworks; and there was a scarcity of medical records
management knowledge and skill at the hospital. Although the hospital has adopted
the use of information and communication technology in the provision of healthcare,
medical records management processes were partially automated. Overall, the
findings revealed several challenges in the management of medical records that
impact on the provision of health care based on reliable evidence. In conclusion, the
general status of medical records management was inadequately positioned to manage
medical records as strategic evidence resource and support evidence-based practices
at the hospital. Therefore, the study recommended that Kisii Teaching and Referral
Hospital should develop operational policies and procedural frameworks for medical
records management, build medical records management capacity and further provide
medical records management training to existing staff to acquire skills and
knowledge of medical records management among others. |
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