Theses Utilizing the Theory of Regulatory Compliance

Improving medical records documentation among the health workers remains a
major challenge to achieving compliance to medical records documentation SOP in
many developing countries. Compliance to medical records documentation SOP can
be used to improve health care and protect people against catastrophic health care
risks and expenses. Most developing countries have low compliance to medical
records documentation SOP and rely on manual systems for documentation. Despite
having automated systems in some private and public health facilities, compliance to
medical records documentation is still below the acceptable standards. The main
objective of this study was to establish compliance with medical records
documentation SOP among health workers in Bungoma level 4 hospital, Kenya,
with specific objective of determining association between socio-demographic
characteristics and compliance with medical records documentation SOP, influence
of institutional characteristics and, influence of health workers’ IT Proficiency
on compliance with medical records documentation SOP among health workers in
Bungoma level 4 hospital. The current study adopted an analytical cross-sectional
design and quantitative data was collected using self-administered questionnaires,
stratified proportionate and simple random sampling techniques were both employed
to select 197 health workers sampled from a target population of 400 in Bungoma
level 4 hospital. Chi-square, fishers exact, and Binary logistic regression analyses
were used to test the association and the relationships between dependent
(compliance with medical records documentation SOP) and independent variables
(sociodemographic, institutional, and IT proficiency) respectively, albeit at a 95%
confidence interval (CI), frequency tables, pie charts, and bar graphs were used to
summarize and present the results. The current analysis confirmed that the
compliance level to medical records documentation SOP was indeed very low at
47.2%. Socio-demographic factors such as Cadre (Fisher‟s exact test =24.52;
p=0.002), level of education (Fisher‟s exact test =11.26; p=0.042), and work
experience χ2 (8.75, df=5, N =195) p=0.047 were significantly associated with
compliance to medical records documentation SOP. On both Institutional
characteristics (P=0.023, exp(B)=1.454) and healthcare worker‟s Information
Technology proficiency (P=0.027, exp(B)=2.156), positively influenced compliance
to medical records documentation SOP. The current study concludes that, cadre,
level of education, and work experience were significantly associated with
compliance to medical records documentation SOP, Institutional characteristics like
technical support, requisite documents, staff training and, health worker‟s
information technology proficiency, positively influenced compliance to medical
records documentation SOP respectively. The study therefore, recommends an
urgent need for the County Government to channel additional funding towards
employing more technical staff, procuring the requisite documentation tools, and
training of staff on the documentation tools. Otherwise, the facility health
management team needs to factor in periodic Information Technology refresher
training for health workers, since the majority of health workers in Bungoma level 4
facility seem to have at least an intermediate level of IT proficiency. Future research
should incorporate more robust data collection methods like observation checklists,
and also consider qualitative methods like Key Informant Interviews to establish
better insight on the compliance with medical records documentation SOP across all
level 4 health facilities in Bungoma County and beyond.

Another Thesis:

About Dr Fiene

Dr. Rick Fiene has spent his professional career in improving the quality of child care in various states, nationally, and internationally. He has done extensive research and publishing on the key components in improving child care quality through an early childhood program quality indicator model of training, technical assistance, quality rating & improvement systems, professional development, mentoring, licensing, risk assessment, differential program monitoring, and accreditation. Dr. Fiene is a retired professor of human development & psychology (Penn State University) where he was department head and director of the Capital Area Early Childhood Research and Training Institute.
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