Hospital managers are best suited and located to enhance patient safety culture within their institutions.This study sought to provide insight on the perceptions of 10 managerial staff regarding th...

Bone and joint infections are associated with prolonged hospitalizations, high morbidity and complexity of care. They are difficult to treat, and successful therapy requires organism-specific antimicrobial therapy at high doses for a prolonged duration as recommended in standard treatment guidelines (STGs). Adherence to the treatment plan is equally important, which is enhanced with knowledge of the condition as well as appropriate antibiotics. Consequently, the aim of this study was to provide antimicrobial stewardship (AMS) services to outpatients with chronic bone and joint infections presenting to the orthopaedic clinic at a public South African tertiary hospital. A total of 44 patients participated in this study. Chronic osteomyelitis was diagnosed in 39 (89%) patients and septic arthritis in 5 (11%). The majority (43%) of infections were caused by Staphylococcus aureus followed by Pseudomonas aeruginosa (14%). Seventy-one antibiotics were prescribed at baseline with rifampicin prescribed the most (39%), followed by ciprofloxacin (23%). The majority (96%) of the antibiotics were not prescribed according to the South African STG; however, interventions were only needed in 31% of prescribed antibiotics (n = 71) since the STG only recommends empiric therapy directed against Staphylococcus aureus. Seventy-seven percent of the patients obtained a high self-reported adherence score at baseline. Consequently, there is a need to improve AMS in bone and joint infections to improve future care.

Skin and soft tissue infections (SSTIs) are one of the most common infectious diseases requiring antibiotics. However, complications of SSTIs may lead to the overprescribing of antibiotics and to subsequent antibiotic resistance. Consequently, monitoring the prescribing alignment with the current recommendations from the South African Standard Treatment Guidelines (STG) is necessary in order to improve future care. This study involved reviewing pertinent patients with SSTIs who were prescribed antimicrobials in the surgical ward of a leading South African tertiary public hospital from April to June 2021 using an adapted data collection tool. Sixty-seven patient files were reviewed. Among the patients with SSTIs, hypertension and chronic osteomyelitis were the most frequent co-morbidities at 22.4% and 13.4%, respectively. The most diagnosed SSTIs were surgical site infections (35.1%), wound site infections (23%), and major abscesses (16.2%). Blood cultures were performed on 40.3% of patients, with Staphylococcus aureus (32.7%) and Enterococcus spp. (21.2%) being the most cultured pathogens. Cefazolin was prescribed empirically for 46.3% of patients for their SSTIs. In addition, SSTIs were treated with gentamycin, ciprofloxacin, and rifampicin at 17.5%, 11.3%, and 8.8%, respectively, with treatment fully complying with STG recommendations in 55.2% of cases. Overall, the most common cause of SSTIs was Staphylococcus aureus, and empiric treatment is recommended as the initial management. Subsequently, culture sensitivities should be performed to enhance adherence to STGs and to improve future care.

Mental health challenges in academic settings are increasingly recognised, yet research on staff wellbeing remains limited, particularly within African universities. This study provides the first institution-wide assessment of psychological distress and burnout among academic staff at a South African university. A cross-sectional survey using validated tools, the 28-item General Health Questionnaire (GHQ-28 ) and the Oldenburg Burnout Inventory (OLBI) was administered to 157 academic employees, and data were analysed using descriptive statistics, non-parametric tests, and ordinal regression. The median age of participants was 42 years (Interquartile range [IQR] = 34–50; SD = 11.4), and the majority of participants were female (n = 110, 70%). The sample included staff across academic ranks, with lecturers being the most common (n = 64, 41%). Results showed that nearly half of participants (49%) exhibited severe psychological distress, and over a quarter (27%) reported high levels of burnout. Female staff reported significantly higher distress and burnout scores compared to their male counterparts. Less than a third (28%) of participants reported feeling safe to disclose mental health concerns, while over half expressed dissatisfaction with institutional support. Participants indicated strong support for both individual-level services, such as confidential counselling and workshops, and systemic changes, including flexible work arrangements and leadership-driven mental health initiatives. Findings highlight the need for integrated, participatory mental health strategies that are culturally and contextually tailored. These results offer timely evidence to inform the development of institutional strategies, policies, and practices to promote mental health among academic staff.

Background. Patient safety research is scarce in developing countries. Estimates of patient harm due to healthcare processes in resource-poor settings are thought to be greater than those in developed countries. Ideally, errors in healthcare should be seen as opportunities to improve the future quality of care.Objective. This study aimed to investigate patient safety culture within high-risk units of a tertiary hospital in South Africa.Methods. A quantitative, descriptive, cross-sectional methodology, using a survey questionnaire that measured 10 safety dimensions and one outcome measure among clinical and nursing staff, was employed.Results. Two hundred participants completed the survey questionnaire. Areas of strength identified by the participants included organizational learning (91.09%), staff attitudes (88.83%), and perceptions of patient safety (76.65%). Dimensions that have potential for improvement included awareness and training (74.04%), litigation (73.53%), feedback and communication about errors (70.77%), non-punitive response to error reporting (51.01%), size and tertiary level of the hospital (53.76%), and infrastructure and resources (58.07%). The only dimension identified as weak was teamwork and staffing (43.72%). In terms of the patient safety grade, respondents graded their own units highly but graded the hospital as a whole as having a poor patient safety grade.Conclusion. There are still significant gaps in the quality of care provided at this tertiary hospital. The current patient safety culture is perceived as punitive in nature with regard to reporting adverse events. It is advised that targeted patient safety improvements be made, followed by further investigation.

Academic staff face workplace stressors such as high workloads, job insecurity, and limited institutional support, which contribute to psychological distress and burnout. While workplace-based interventions are important for maintaining well-being, their effectiveness in academic settings remains underexplored. This systematic review including qualitative, quantitative, and mixed methods studies synthesized evidence on individual-level mental health interventions for university academic staff. Five databases (PsycINFO, MEDLINE, Web of Science, SCOPUS, ERIC) were searched for peer-reviewed studies published between 2003 and 2023. From 1058 records, seven studies met the inclusion criteria. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT) and the GUIDance for the rEporting of intervention Development (GUIDED) framework. Interventions included lifestyle regimens, mindfulness, yoga, community therapy, and institutionally embedded wellness programs. The findings suggest that brief, structured, and theoretically grounded interventions can improve psychological well-being, reduce burnout, and enhance coping. Facilitators included leadership support, institutional integration, peer networks, and flexible delivery; barriers included stigma, workload pressures, attrition, and digital challenges. Most studies were conducted in the Global North, limiting transferability to resource-constrained contexts. Overall, individual-level interventions show promise, but sustainable, culturally adapted, and multilevel strategies are needed to strengthen mental health support in higher education. These insights also contribute to broader efforts to promote health and safety in the workplace by identifying practical strategies to enhance well-being across diverse occupational settings.