Department of Nursing and Midwifery
Permanent URI for this community
Browse
Browsing Department of Nursing and Midwifery by browse.metadata.advisor "Damons, Anneleen"
Now showing 1 - 17 of 17
Results Per Page
Sort Options
- ItemAssessing the knowledge and opinions of registered nurses with reference to quality indicators in clinincal nursing within a tertiary health institution in Saudi Arabia(Stellenbosch : Stellenbosch University, 2011-12) Pelser, Anya; Damons, Anneleen; Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: The quality of care nurses provide to patients is done with the expectation that skills and knowledge of each registered nurse will result in quality patient care. Compliance statistics for quality indicators (level of service indicators) or (LSI’s) in the tertiary health care institution in Saudi Arabia varies, raising the following questions: “Do nurses understand the importance of quality indicators in clinical nursing and do they know how to use them to improve patient care?” No studies done on registered nurses’ knowledge and opinions of quality indicators could be found thus indicate the necessity of a research study to determinine the knowledge and opinions of registered nurses on quality indicators in clinical nursing in the tertiary healthcare system in Saudi Arabia. This is the focus of this research. The objectives of the study were: - To determine the current knowledge and opinions of the professional nurses regarding quality indicators in a tertiary hospital in Saudi Arabia - To identify the factors that influence identification of quality indicators in clinical nursing - To identify the need for a training program regarding nurse sensitive quality indicators Data was collected through a questionnaire handed to more than 200 nurses working in general wards and intensive care areas in a single Saudi Arabian hospital. Participants were selected through a randomised list. The registered nurses who have participated in the pilot study’s responses were excluded from the final data analysis. No patients were included or involved in the study. A descriptive design with a quantitative approach was applied to investigate the professional nurses’ knowledge and opinions on quality indicators (level of service indicators) or (LSI’s) in clinical nursing in Saudi Arabia. Research data suggests that the knowledge and opinions of registered nurses in the tertiary health care institution in Saudi Arabia are not supporting the expectations of quality assurance in clinical nursing. Registered nurses have strong opinions of quality indicators in clinical nursing but do not have the knowledge to support those opinions. Improving initial and recurring training on quality indicators provided to nursing staff with diverse backgrounds and high turnover was recommended as an essential component in using quality indicators to drive improvements in patient care.
- ItemAssessing the nurse's knowledge and opinions regarding the management of persons with physical disabilities in two healthcare settings in Kimberley(Stellenbosch : University of Stellenbosch, 2011-03) Snyman, Johanna Hendrina; Damons, Anneleen; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: It generally is a problem for persons with disabilities to have barrier free access to buildings, which is their constitutional right. It is however, not only the physical facility that causes barriers for persons with disabilities but also the attitudes of the able-bodied persons. The aim of the study was to explore what opinions the nurses and persons with disabilities held in two healthcare settings in Kimberley with reference to the nursing care provided to persons with disabilities. To the researcher, it was important to gather the opinions of the nursing staff on how they saw persons with disabilities, but also to hear what they thought the problem areas in caring for persons with disabilities were. On the other hand, it was equally important to understand the persons with disabilities’ perceptions of the hospitals, nursing and what they saw as solutions to the problems. The objectives of the study were: • To determine what the opinions and knowledge of nurses working in two healthcare services in Kimberley are regarding the nursing management of persons with disabilities. • To determine what the opinions of persons with disabilities are in healthcare settings in Kimberley, with reference to the nursing care provided for persons with disabilities. Data was collected in two phases namely Phase 1 amongst the nursing staff in the private and state hospital in Kimberley and Phase 2 amongst the persons with disabilities. A list of staff members which was obtained from the Human Resource office in both the private and state hospitals were sent to the statistician Prof Kidd and who prepared a randomised list which was used for the participants in the study. The same process was followed when a list of all the people who are members of the Association for Persons with Disabilities (APD) and with the help of the statistician a randomised list was compiled from which the participants in the study were chosen. The design of this research is an explorative, descriptive non-experimental study with a quantitative approach, utilizing a structured questionnaire with closed and open ended questions. In this study it was found that the nursing staff was aware of the problems and barriers persons with disabilities encounter. The nurses, however, were aware of their own shortcomings. For example, the nurses identified the lack of training to equip them to assist the persons with disabilities during nursing care, while persons with disabilities also saw this as a problem. By addressing this shortcoming, nurses would be able to provide more holistic care. Recommendations were made based on the findings regarding the facility, perceptions, caregivers, procedures, doctors and the training of the nurses.
- ItemContextual factors influencing the turnover of nurses in specified intensive care units in the Cape Metropole(Stellenbosch : Stellenbosch University, 2013-03) Magana, Grace Wanjeri; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: The shortage of nurses in the intensive care units (ICU) affects both the nurse and the patient with regard to quality care and the quality of work life. Job satisfaction as well as factors within the organisation and work environment predisposes dissatisfaction. Identifying these factors may improve the quality of life at work and reduce staff shortages. The aim of this study is to evaluate the contextual factors influencing the turnover of intensive care nurses in specified hospitals in the Cape Metropole. The objectives were: • To determine the factors influencing the turnover of intensive care nurses in specified hospitals in the Cape Metropole. • To compare the findings of the data in the specified hospitals. An explorative, descriptive design with a quantitative approach has been applied. The research sample consists of all nurses working in the intensive care units in the specified hospitals at the time of the study. A convenience sampling was applied. A structured questionnaire containing predominantly closed-ended questions was used and data collection was conducted by the researcher herself. A pilot study consisting of 10% (N=21) of the sample was done in one of the hospitals to validate the reliability of the questionnaire. The 21 participants who completed the pilot test did not participate in the actual study. The reliability and validity of the findings was assured by the utilization of the statistician and experts in the nursing department. The data is presented in tables and histograms. A Chi -square test is used to test the statistical significance association between variables. Spearman’s ranks (rho) order correlation is used to show the strength of the relationship between two continuous variables. The findings of the study show that discontent with salaries, inferior working environments, organisational factors, physical as well as emotional stress and the lack of career development opportunities, were major determinants in the poor quality of life at work with regard to the two set objectives. Recommendations include those for better remuneration, improved career opportunities and the creation of a safe as well as a friendly work environment. The aim is to create a positive work environment and improve the quality of life at work.
- ItemError management in nursing amongst registered nurses working in a tertiary hospital in Saudi Arabia(Stellenbosch : Stellenbosch University, 2013-03) Haines, Fiona Imelda; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: Healthcare organizations have implemented numerous safety initiatives to address errors due to the impact on the patient, families, healthcare provider and the organization as highlighted in the Institute of Medicine report. However, error identification, reporting and management remain a challenge. Nurses have been identified as the healthcare provider with the greatest potential for errors. Supportive work environments are needed to provide optimal care to the nurse who makes an error; which may be minor to severe repercussions. The patient is identified as the first victim and the nurse who makes the error as the second victim. How nurse errors are reported, managed and disclosed is dependent on the response of leaders and peers which may be in a shame and blame or just culture approach. The aim of the study was to assess error management in nursing amongst registered nurses working in a tertiary hospital in Saudi Arabia. The objectives were to identify the occurrence of nursing related errors, determine the current process of reporting nursing errors, describe the management of nursing errors and explore the factors impacting on the management of nursing errors. The research methodology for this study was a descriptive, quantitative approach which is applicable when exploring the unknown. Ethical approval was obtained from the Ethics Board, University of Stellenbosch and the Institutional Review Board, King Faisal Specialist Hospital and Research Centre (General Organization) -Jeddah (KFSH&RC-J). The population was registered nurses working in KFSH&RC-J and assigned to the job descriptions of Staff Nurse 1&2, Clinical Nurse Coordinators and Assistant/Head nurses. Sample was selected using proportional allocation for nationality and simple random selection for nursing specialty; 215 RNs from these three groups. Data was collected using a questionnaire developed by the researcher and analysis completed using SPSS and regression analysis to identify factors which influences the reporting and management of errors. Data was presented in the form of frequency tables and graphs using the EXCEL program to analyze the data. The main findings of the study; there was significant difference in nurse leaders and professional nurses ability to identify nursing errors; questioning of the practice of peers, views of a non-punitive environment and the ability to differentiate between error and negligence. The nurse executive was positively associated with the average positive responses received. RNs of Middle Eastern nationality and the Adult nursing division were found to be slightly more negative in their perceptions about error reporting and management than other respondents. Improvements are needed in the processes of error reporting and management which include education; leadership development, underreporting of errors, feedback and communication, nurse manager support and disclosure of errors. Recommendations are the implementation of the Just Culture principles within the organization and leadership development to address error reporting and management. The need to develop a national database for error reporting in Saudi Arabia is recommended. Nursing errors occurred in one tertiary hospital in Saudi Arabia and an on-line system is available to report errors. However, nurses do not report errors as they fear being blamed and shamed. The process of error management within the organization has not been clearly defined.
- ItemExperiences and perceptions of clients attending a South African university sexual health clinic(Stellenbosch : Stellenbosch University, 2015-04) Adams, Rukshana; Van der Heever, Mariana M.; Damons, Anneleen; Stellenbosch University. Faculty of Health Sciences. Interdisciplinary Health Sciences. Nursing.ENGLISH ABSTRACT: he sexual health clinic at Stellenbosch University is attended by staff members and students. Yet, limited evidence exists regarding the views and expectations of the clients on service delivery at the sexual health clinic. The aim of the study was to explore the experiences and perceptions of clients attending the sexual health services offered at the campus health clinic. The following objectives were set: To explore the experiences and perceptions of the clients attending the sexual health service on service delivery. To identify the needs of the clients attending the sexual health service A descriptive qualitative approach was applied utilizing in-depth interviews. A sample of n=15 was drawn through purposive sampling and data saturation was achieved with the sample. Since the researcher is employed as a registered professional nurse at the clinic, data collection was completed by a researcher not affiliated to the university. Data was analyzed utilizing an interpretive approach. All applicable ethical principles such as anonymity, confidentiality and privacy were taken into consideration. The validity of the findings was enhanced through efforts to attain credibility, transferability, dependability and conformability. The findings of the study revealed that accessibility of the clinic is influenced by the geographical location of the clinic and that marketing and awareness of services requires attention. Other themes that emerged were operational hours, waiting period, building relationships, consultations and financial implications.
- ItemAn exploration of the experiences and perceptions of health and allied health care students regarding interprofessional collaboration and education in a rural clinical setting in South Africa(Stellenbosch : Stellenbosch University, 2014-04) Theunissen, Anna Luttig; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing.ENGLISH ABSTRACT: see full text for abstract
- ItemFactors associated with participation in continuous professional development activities leading to professional growth of professional nurses working in a public national referral hospital in Namibia.(Stellenbosch : Stellenbosch University, 2018-03) Mbidi, Tekla Shipahu Natangwe; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : In nursing, aspects such as attending in-service training, performing research, continuing professional education (CPE) have been identified as some of the approaches which influence the professional growth of nurses. Professional growth and development for professional nurses must be a fundamental part of nurses’ work environment. However, little is known about the factors that are associated with participation in continuous professional development activities leading to the professional growth of professional nurses in Namibia. The purpose of this study was to investigate how the factors associated with participation in continuous professional development activities lead to the professional growth of professional nurses working in a public national referral hospital in Namibia. A quantitative descriptive correlational case study design was conducted and the researcher targeted the total population of N=342 professional nurses working in a public national referral hospital. No sampling method was applied in this study. Data were collected with a previously validated Q-PDN data collection instrument. Data collection began with a pilot study conducted on 10% (n=34) of professional nurses in the hospital where the main study was conducted. The pilot study yielded consistent and reliable Cronbach alpha (α.848). The pilot study participants were excluded from participating in the main study which involved the distribution of a total of n=270 questionnaires. The return rate of questionnaires for the main study was n=241; an 89% response rate. The data were analysed using SPSS version 24. Pallant’s exploratory factor analysis (EFA) method was used to check the scale validity and reliability of the measures. SPSS AMOS Version 23 was utilised for confirmatory factor analysis (CFA), and structural equation modelling (SEM) to determine and confirm the relationships between the constructs in the conceptual framework. Results from the data were presented in tables, figures and flow diagrams. Ethics approval was obtained from Stellenbosch University and from the health facility in which the study was conducted. The study found that psychological empowerment importance factors, effort reward motivation factors, and structural empowerment condition factors, lead to professional growth of professional nurses in Namibia through participation in continuous professional development activities. The relationships between the factors in the final research measurement framework supported the conceptual framework’s professional growth associations linked to participation in continuous professional development activities. The participation in Continuous Professional Development (CPD) factor mediated the relationships between psychological empowerment importance factors and professional growth; structural empowerment conditions factors and professional growth, and effort reward motivation factors and professional growth. However, results found no significant relationship between psychological empowerment importance and structural empowerment conditions. The results provided further evidence for the importance of certification for the professional growth of professional nurses. This means that even if a professional nurse has worked for 10 years and has not obtained a post-graduate qualification he/she would not exhibit and embrace the professional growth concept. It was outlined that individual professional nurses participate in CPD activities for different reasons. Findings imply that nurses should be encouraged to acquire higher certification levels early in their nursing career, as this will have a greater impact on their professional growth. To be recognised as having attained professional growth, professional nurses must have obtained a post-graduate certification in addition to their years of clinical experience. Therefore, it would be ideal if nurse administrators develop and maintain professional nurses’ professional portfolios in order to keep tract of the staff members’ professional skills. Healthcare organisations may need to create better remuneration conditions for certified and experienced nurses to award their efforts and promote staff retention.
- ItemFactors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province(Stellenbosch : Stellenbosch University, 2021-03) Nicholson, Emerentia Cynthia; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : Background: With the current population growth, the population is also ageing which leads to more chronic diseases and the elderly receiving multiple medications. In South Africa, the Western Cape Province has the third-largest proportion of elderly persons (Statistics South Africa, 2019). However, limited published research exists on factors associated with safe medication administration in residential facilities for older persons, which attest to the fact that the safety of vulnerable older persons receives little attention. To address this gap in knowledge, the research aimed to determine the factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province. Methods: After obtaining ethics approval from The Health Research Ethics Committee of Stellenbosch University (S19/10/252) as well as permission from the residential facilities for older persons, a non-experimental cross-sectional descriptive design was applied, with a quantitative approach. Pre-testing of a self-administered validated questionnaire during a pilot test allowed for modifications to enhance reliability, validity, and appropriateness for the South African context. With the application of a stratified sampling method, 10 funded and 18 private residential facilities for older persons within the Metro-North, Western Cape Provence, were included. Study participants comprised of all three nurse categories, namely Professional nurses (registered nurses) (RNs) n=60 (48.8%), Enrolled nurses (ENs) n=35 (28.5%), and Nursing auxiliary (assistants) (ENAs) n=28 (22.8%). The response rate was n=123 (60.6%) of the total study population of N=203. Descriptive and inferential analyses were performed using the Statistical Package for the Social Sciences Version 27 (SPSS27), with the support of a biostatistician. Results are presented in bar graphs, tables, and figures. Results: The description of the results is according to the components in Donabedian’s Structure-Process-Outcome standards of the Quality of Care Model (2005:691-729). Study results showed that the workforce was mature, with n=34 (27.6%) having more than nine years of work experience. A total of n=43 (35.0%) did not receive medication training in the last five years. Increased workloads n=93 (75.6%) was perceived by participants as the highest source of job pressure. Organisational resources and infrastructures showed constraints in terms of medication storage difficulties, n=56 (45.5%), and blisters in an incorrect order, n=68 (55.3%). Procedures followed by the nurses during medication administration indicated various weaknesses, such as the negation of the performing of thorough checks in favour of administering medications based on assumptions that it would be correct, as n=95 (77.2%) will not check the content of blisters or containers, assuming it was correct. This was despite n=102 (82.9%) of the study participants who did come across incorrect content when administering medications. Furthermore, a witness signature was not required when making amendments to the MARs, n=47 (38.2%). A total of n=5 (4.1%) conceded that they signed the MAR charts before administering the medications. The use of technology was limited, as almost half of the participants did not use computers in the workplace, n=58 (47.2%). Missing of medication altogether was the most predominant medication error encountered in the facilities, n=79 (64.8%). Statistical tests showed a significant correlation between medications administered at the wrong times and interruptions during medication rounds p = <.001. Also, the most common error of medication accountability was not signing for medication administered, n=70 (56.9%). Conclusion: From these study results, it was clear that determining the factors associated with safe medication administration in the residential facilities for older persons could assist with avoiding medication errors among older persons to prevent harm and death. Recommendations regarding the implementation of the prescribed staffing model and increased medication training should be emphasised. A multifaceted approach is advised to address constraints such as bulky medication storage systems and inadequate workflow processes. Facilities should develop and implement risk management strategies to encourage medication error reporting. Also, further research is needed to identify the prevalence of medication errors in residential facilities for older persons. Therefore, the constant review of evidence-based practices can ensure effective ways to provide for the needs of the vulnerable elderly.
- ItemFactors influencing safe patient care provided by professional nurses in a private healthcare organisation in the Western Cape(Stellenbosch : Stellenbosch University, 2020-03) Daniels, Ruth Carol; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : Background: As the evolution of nursing takes place, professional nurses (PNs) are confronted with factors in the clinical field of healthcare organisations such as inadequate leadership, punitive cultures, insufficient learning and challenging demographic information which are influencing their provision of safe, patient care. The aim of the study was to determine the factors, which influence the safe patient care provided by PNs in a private healthcare organisation of the Western Cape, South Africa. The objectives of the study were to determine whether leadership, just culture, and organisational learning influence the PNs providing safe patient care and whether the personal background information of the PNs related to the PNs providing safe patient care in a private healthcare organisation of the Western Cape, South Africa. Methods: A quantitative descriptive design was applied to the study. The target population were all the PNs working in one private healthcare organisation of the Western Cape, South Africa. The researcher conducted a pilot test to refine the research methodology. The researcher collected the data with the assistance of a trained field worker. A reliable and validated questionnaire, designed by the Agency for Healthcare Quality and Research, the Hospital Survey on Patient Safety (United States of America), Version 1.0 was applied. Permission to conduct the study was obtained from the Health Research Ethics Committee (HREC) at Stellenbosch University [S19/02/046], the healthcare organisation and the participants by way of informed consent. Results: The results showed that leadership, just culture, and organisational learning influenced safe patient care provided by the PNs. Furthermore, the study found that the personal background information of the PN related to the safe patient care, which was provided by the PNs. The study found that the participants who held a Two Year General Diploma qualification were more inclined to agree with the items in the questionnaire even when items were negatively phrased. Most participants found that the management support for patient safety was inadequate (mean=59) and that management only became interested in patient safety after an adverse event happened (mean=41.8). Further results showed that the hospitals and units had a mean score of only m=46.50 for the non-punitive response to errors. Recommendations: Leadership of the organisation should be alluded to the factors influencing the safe patient care provided by the PNs. The development and implementation of a non-punitive culture is strongly suggested. Conclusion: The study identified that leadership, just culture and organisational learning were factors, which influenced the safe, patient care provided by the PNs, and in addition, that the personal background information related to safe patient care provided by the PNs in a private healthcare organisation of the Western Cape.
- ItemFactors that influence the retention of new nurse graduates currently employed within the public sector(Stellenbosch : Stellenbosch University, 2013-03) Neethling, Verena Lucia; Van der Heever, Mariana; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: In view of the escalating shortage of nurses, attention is focused on the emerging workforce and efforts to retain new nurse graduates. The aim of this study was to investigate possible factors that could influence the retention of new nurse graduates currently employed within the public sector in the Cape Winelands District of the Western Cape. The objectives of the study were to determine whether the retention of new nurse graduates is influenced by: • the mentoring programme • leadership in the workplace • workload pressure and stress • complexity of care • staff shortages A quantitative approach with a descriptive design was applied. The total population (N=73) consisted of all new nurse graduates who had registered with the South African Nursing Council within the last three years, and who were employed at one of the 6 provincial hospitals included in the study. Since the total population was relatively small, no specific sampling method was employed but the whole population served as the sample. A self-administered questionnaire was used for data collection. Ethical approval to conduct the study was obtained from the Health Research Ethical Committee at Stellenbosch University. Permission to conduct the study at the specific hospitals was obtained from the provincial government of the Western Cape. Informed consent was obtained from all the respondents. A pilot test was completed, prior to the initiation of the main study, during which the questionnaire was issued to n=7 respondents who were not part of the total population utilized in the actual study. Data was presented in the form of tables, histograms and frequencies. The results revealed diminished implementation of mentoring and orientation programmes for new graduates. Most respondents, however, indicated that they had received appropriate day to day guidance in the workplace. Unit managers had provided guidance relating to the development of leadership, problem-solving and conflict management skills. The new graduate nurses had not been sufficiently exposed to managerial duties such as supervising the budget and scheduling of off-duties. Most respondents reported that they had experienced work-related stress due to work overload associated with shortage of staff. Furthermore, respondents reported that they would be likely to resign due to issues that relate to complexities in patient care; for example, limited numbers of trained staff in specialization units, too little support and direction and the presence of low levels of motivation and burnout among staff. Recommendations: • Mentoring and orientation programmes for new nurse graduates should be reviewed or initiated. • New nurse graduates should be exposed to all leadership activities. • Staffing management issues should be reviewed to address issues such as work overload, burnout and unrealistic nurse-patient ratios. • Managers should focus on the strengths of new nurse graduates and structure a workforce that will support the new graduate with professional duties in order to reduce complexities of care. In conclusion, implementation of the transformational leadership approach and Herzberg’s Two-Factor Theory are proposed to ensure motivation, productivity and job satisfaction, which will ultimately improve the retention of new nurse graduates in the public sector.
- ItemAn ideal leadership style for unit managers in intensive care units of private health care institutions(Stellenbosch : University of Stellenbosch, 2009-03) Van der Heever, Mariana; Damons, Anneleen; Stellenberg, E. L.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: The work environment in critical care units in South Africa is hampered by a profound shortage of nurses, heavy workloads, conflict, high levels of stress, lack of motivation and dissatisfaction among the staff. The task of managing a C.C.U. has therefore become a challenge. It is important that unit managers apply a leadership style that matches these challenges. The aim of this study was to investigate the ideal style of leadership. The objectives set for the study were to identify the ideal leadership style required in the following areas: administrative functions education functions patient care research An explorative, descriptive research design was applied, with a quantitative approach to determine the ideal leadership style for unit managers in critical care units of private health care institutions. The research sample consisted of all nurses working permanently in eleven private hospitals in the Cape Metropolitan area. A questionnaire consisting of predominantly closed questions was used for the collection of data, which was collected by the researcher in person. Ethical approval was obtained from the Committee of Human Science Research at Stellenbosch University. Permission to conduct the research was obtained from the institutions and informed consent from the participants. A pilot study was conducted to test the questionnaire at a private hospital which did not form part of the study. A 10% sample of the relevant staff, namely 27 participants were involved in this study. The validity and reliability was assured through the pilot study and the use of a statistician as well as experts in nursing and a research methodologist. Data was tabulated and presented in histograms and frequencies. Statistical significant associations were drawn between variables, using the Chi-square test. The Spearman rank (rho) order correlation was used to show the strength of the relationship between two continuous variables. Findings of the study show that participatory leadership style and transformational leadership approach were valued in all four (4) of the objectives. Emphasis was placed on consultation prior to any decisions. Nurses requested an opportunity to give feedback on a regular basis regarding the unit managers conduct (Chi-square test p = 0.025). They also agreed that unit managers should apply the necessary rules and procedures (Chi-square test p = 0.016). A huge request was made for integrity, trust, impartiality, openness, approachability and particularly honesty. The nurses also maintained that the nurse manager’s behaviour should be congruent. Furthermore, the results indicate that nurses would like to be empowered by: being involved in the scheduling of off-duties taking the lead in climate meetings being granted opportunities (to all categories of nurses) to attend managerial meetings. N = 41 (48.2%) of nurses admitted that unit managers would instruct them to cope with insufficient staffing pertaining to ventilated patients, putting them under severe strain and at risk legally. N = 39 (47%) of nurses admitted that unit managers only consider qualifications and experience in the delegation of tasks if the workload in the unit justifies it. Safe patient care is not always a priority. N = 99 (96%) of nurses agreed that autocratic behaviour relating to task delegation exists. Recommendations included the application of transformational leadership and participatory management. The aim to create a healthier, more favourable work environment for critical care nurses will hopefully be attained through applying the ideal leadership style and leadership approach.
- ItemInformed consent : communication and miscommunication in clinical trials(Stellenbosch : Stellenbosch University, 2012-03) Moloi, Gaotswake Patience; Khondowe, Oswell; Damons, Anneleen; Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: Background Informed Consent (IC) has been proposed as the optimal method for ensuring the ethical entry of patients into clinical trials. IC is a vital part of the research process and as such entails more than obtaining a signature on a form. The IC must be given freely, without coercion, and must be based on a clear understanding of what participation involves. Aim The overall aim of this study was to attain an understanding of participants' knowledge regarding informed consent when participating in a research project. Methods The study was conducted at two public hospitals in a city in the Eastern Cape Province of South Africa. The quantitative study used descriptive survey design. A self administered questionnaire was used as a tool for data collection. Results The sample size consisted of 170 women with an average of 25.9 years. The majority had completed secondary level education. More than half of the participants did not have knowledge of the purpose of the original study. The majority of participants did not have knowledge of their responsibilities. Forty-two percent gave uninformative responses and 26% indicated they did not know their responsibilities. None of the participants understood the concept of randomization. The majority (85.9%) of participants indicated that information provided on the IC forms was sufficient for them to decide to participate. Conclusion Despite extensive efforts to ensure that participants understood their participation in the original studies, this study found poor recall of vital information for IC. A signed informed consent does not guarantee that participants understand information given. Recommendations The existing methods of communicating and obtaining of an informed consent seem to be insufficient for participants to make an informed decision. A new approach with more interactive features such as combination of audio-visual techniques might increase the possibilities of the understanding.
- ItemKnowledge, attitudes and practices of nurses in infection prevention and control within a tertiary hospital in Zambia(Stellenbosch : Stellenbosch University, 2017-03) Chitimwango, Priscilla Chisanga; Hector, Dawn; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : Background: Nurses are health care professionals whose duty it is to protect patients from acquiring infections while hospitalised or while in a health care set up. By maintaining an infection free environment, the patient’s recovery will be promoted and high-quality nursing care will be delivered. Nurses spend most of their time with patients. Therefore, they should have a good level of understanding of the knowledge, attitudes and practices in infection prevention and control in health care setups. The aim of the study was to determine the knowledge, attitudes and practices of nurses regarding infection prevention and control. The objectives were to determine: • The knowledge of nurses in infection prevention and control within a tertiary hospital within Zambia. • The attitude of nurses in infection prevention and control within a tertiary hospital in Zambia. • The practices of nurses in infection prevention and control within a tertiary hospital in Zambia and • To make recommendations to the risk programme and policies of the tertiary hospital within Zambia. Method: A quantitative descriptive study was conducted at a government tertiary hospital in Zambia. Sample: a Stratified random sampling was performed. A total of n= 196 nurses of all categories (70% from each category) were recruited in the study. Tools of data collection: a self-developed validated close-ended questionnaire guided by hospital policies, procedure standards, World Health Organisation and Zambian Centres for infection prevention and control, was used to collect data. Results: During the main study, n= 196 questionnaires were distributed, n= 196 participants completed the questionnaires, a response rate of 100%. Most of the participants were female; 84.7% (n= 166) while 15.3 % (n= 30) were male. The majority of participants had good knowledge in infection prevention and control with the mean score of 83.21. The attitude towards infection prevention and control was good with the mean score of 81.37. The practice in infection prevention and control was poor with the mean score of 48.88. Conclusion: Based on the findings of the current study, it can be concluded that, despite performing well in knowledge and showing a positive attitude towards infection prevention and control, nurses had unsatisfactory practice levels regarding infection prevention and control, exposing the patients to infection-related diseases. Recommendations: Strengthening infection prevention and control practice through regular in-service training/workshop; ensure that members of staff receive appropriate vaccinations regarding infection prevention and control; ensure that resources, e.g. personal protective equipment are available all the time; observing nurses’ practices (hand hygiene auditing and during invasive procedures) and provide feedback. Furthermore, research about the barriers in infection prevention and control practices.
- ItemNursing students’ perceptions of an extended undergraduate curriculum programme within a higher education institution in the Western Cape Province(Stellenbosch : Stellenbosch University, 2017-03) Julius, Chantal; Young, Cornelle; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : The South African government’s solution to correct past discriminations in higher education was to improve access for previously disadvantaged students to tertiary institutions. However, the poor performance of these students indicated their under-preparedness for tertiary education. Extended curriculum programmes were thus implemented to facilitate the success of these under-prepared students in tertiary education. The aim of this study was to explore nursing students’ perceptions of an extended undergraduate curriculum programme within a higher education institution in the Western Cape Province. The objectives of this study was to explore and describe the perceptions of the R425 Diploma nursing students within a higher education institution in the Western Cape Province about: • the extended undergraduate curriculum programme (ECP) that they had completed • whether the ECP assisted with their integration into the mainstream programme • how the ECP could be improved to better facilitate integration and success in the mainstream programme A descriptive design with a qualitative approach was applied and a purposive sampling method was utilised to select ten participants for two focus groups. The data was collected via focus groups with the use of semi-structured interviews to acquire diverse perspectives on the extended curriculum programme. The findings of the study included an insightful description of the extended curriculum programme by the participants, where they candidly spoke about the benefits but also the negative aspects of the programme. The participants articulated that the programme assisted immensely in their successful integration into the mainstream programme and gave valuable information on how the extended curriculum programme can be improved.
- Item'n Ondersoek na die hantering van pasiente met diabetes mellitus tipe 2 deur kliniese verpleegpraktisyns(Stellenbosch : University of Stellenbosch, 2011-03) Lehmkuhl, Harriet; Earle, M. C.; Damons, Anneleen; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: Complications of chronic conditions pose serious consequenses for the patient and financial implications for the health authorities, in the form of serious procedures, adaptions of medication, hospitalisation or rehabilitation. The goal of the study was to investigate the management of patients with diabetes mellitus type 2 on primary health care level. The objective of the study: • a retrospective investigation into the holistic management of patients with diabetes mellitus type 2 by CNPs. The research design was descriptive, non-experimental with a quantitative approach. The population included 896 files of patients diagnosed with diabetes mellitus type 2 over a period of 6 months at 4 clinics in the George Subdistrict. The sample consisted of 180 files, namely 20% of the population. The researcher gathered the data personally by means of a structured check list. Ethical approval was obtained by Stellenbosch University and above mentioned health authorities. Reliability and validity was ensured by means of a pilot study, as well as inputs from a statistician, experts in the fields of primary health care and a research panel. Descriptive statistics were used for data-analysis. Variables were presented in the form of tables, graphs and frequencies. Statistica Version 9 software were used and relations between the various variables were analysed by means of ANOVA (“Analysis of Variance”). By means of systematic probability sampling every second file that adhered to the inclusion criteria was drawn, until 20% saturation was reached at each clinic. Thereafter every second file was drawn from the rest of the appropriate files, until the sample was sufficient or until there were no more suitable files left over. The results of this study provide evidence that the holistic approach was not constantly applied by CNPs in patients with diabetes mellitus type 2. Drug treatment was renewed by a doctor every six months, but no attention was given to the diabetes mellitus in between the doctor's visits. Health information was given. It varied between 100% to 81%. Complications were not addressed appropriately though. In clinic A for example 6% (n=5) recorded on the condition of the patients' feet, while in clinic B 4% (n=2) addressed this issue. At clinic C nothing was recorded on this aspect, while at clinic D 13% (n=2) recorded on this. Respiratory and cardio-vascular systems often fail in patients with diabetes mellitus type 2. At clinic A CNPs enquired only in 18% (n=16) of cases about these systems, at clinic B 22% (n=11), at clinic C 27% (n=7) and at clinic D 6% (n=1). This study has the potential to stimulate further research, especially regarding the reasons why CNPs do not manage chronic patients holistically.
- ItemPrevalent elements related to human factors associated with medication administration errors in private healthcare institutions within the Western cape, South Africa: a nursing perspective(Stellenbosch : Stellenbosch University, 2016-12) Hill, Karen Jane; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH SUMMARY : The process of medication administration has been described in terms of medication prescribing, ordering, supplying, administration and documentation (Gordon, 2014). The World Health Organization views patient safety as a growing global concern. A research study conducted in the United Kingdom reported that complications related to medication administration could increase a patients’ hospital stay from 4.6 to 10.3 days (McCleod, Barber & Franklin, 2014). The volume of research that has been conducted into this phenomenon is extensive in the public sector but little in the private healthcare sector; where patient satisfaction is deemed to be linked to their perceptions of the quality of the service they are paying for, which is indirectly affected by the business models in place. The purpose of this study was to explore the perspectives of the nurses working in private healthcare institutions in the Western Cape, South Africa, regarding the prevalent elements relating to human factors that may be associated with medication administration errors. Enrolled Nurses (EN) and Registered Nurses (RN) working in the wards and intensive care units of the three participating hospitals were invited to participate. Both groups of nurses were included to deepen the understanding of the human factors affecting the nurses’ abilities to safely administer medication to patients, and to determine any stand out elements that might be more prevalent in one of the groups. The nature of the roles and scope of practice of the two nursing categories lends itself to the possibility of challenges varying within the groups. A quantitative approach with a descriptive design was selected for the study. A non-probability convenience sampling method was utilized. A total of n=329 (82.25%) of the total population (N=400) completed self-administered data collection questionnaires with Likert style and two open-ended questions. Validity and reliability testing of the data collection instrument was conducted and confirmed though input from nursing, medical, legal and pharmacy experts. The conducting of a pilot study and calculation of the Cronbach alpha coefficient test produced scores ranging between 0.755 to 0.925. Descriptive and inferential analysis was done to interpret the study findings. A statistician was consulted for the statistical analysis, which included Mann-Whitney testing to determine possible associations between selected components of the demographic data of the study population and those elements deemed to be the most prevalent. The results highlighted the following key areas of concern as playing a regular or common role in the incidence of medication administration errors (as perceived by the nurses): the pharmacy supply chain (75.68%), patient-nurse workload (74.46%), prescription legibility (71.12%), work pressure (69.60%), distractions (67.77%) and tiredness or exhaustion (67.47%). In addition to these findings, the study population highlighted the impact that medication substitution in the form of generics is playing in medication safety. The lack of up to date lists of generic medications is posing both a threat and a challenge in terms of patient safety. Whilst the results presented were in line with those identified in similar studies, there is a clear need for the total concept of incident management to be disseminated to the staff working with the patients. The creation of a “Just Culture” has been proven to reduce adverse events and empower staff in terms of monitoring and improving their own, and others, clinical performance thereby improving patient safety and care. In addition, and within the South African context, the study results suggest the need to explore the role and responsibilities of the EN’s in both the wards and intensive care units (ICU) in the private healthcare institutions. The results show a higher level of concern regarding the effects of human factors such as nurse-patient ratio, work pressure and distractions for the ward based EN as opposed to the EN based in the ICU.
- ItemSelf-directed learning readiness of nursing students in their fourth year of study in a public nursing college in Johannesburg, Gauteng Province, South Africa(Stellenbosch : Stellenbosch University, 2018-03) Mohoaduba, Princess Lindiwe; Damons, Anneleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY: Background: Self-directed learning (SDL) is an essential skill for effective continuing professional development (CPD) to keep abreast of the rapid changes in nursing and nursing education. Nursing education aims at empowering students in training with the enquiry skills necessary for self-directed learning to render up-to-date and relevant health care and to become lifelong learners. The level of readiness for self-directed learning by nursing students graduating from the public nursing college is however not known. Research aim: The aim of the study was to determine the level of readiness for self-directed learning of fourth-year nursing students at a public nursing college in Gauteng Province. Objectives: The objective of the study was to measure the level of motivation of fourth-year nursing students for self-management, their desire for learning and their level of self-control to determine their level of readiness for self-directed learning. Design: A quantitative approach was applied using the logical research process to gather quantifiable evidence. The study design was a descriptive survey. Convenience sampling, a non-probability sampling method, was utilized. Fisher’s self-directed learning readiness (SDLR) scale for nurses was used to collect data. Such data included participants’ demographic characteristics, as well as their self-management, readiness to learn and self-control subscales. Fisher’s SDLR was tested for validity and reliability, with a Chronbach’s alpha of 0.98. Research Setting: The study was conducted at a public nursing college in Gauteng Province, responsible for the education and training of nursing students in the four-year diploma programme leading to registration as a Nurse (General, Psychiatric and Community) and Midwife according to South African Nursing Council (SANC) Regulation 425 (1985). The students attended classes in the college through a block system and were placed in the hospital units and community health centres for clinical experiential learning. In the fourth year of study the students are engaged with the Psychiatric and Community courses. Population and Sampling: The participants were fourth-year nursing students in a public nursing college. The total number of nursing students was 94 (N=94). Ten (n=10) participated in the pilot study. The results of the pilot study were discussed separately and were not included in the results of the main study. Eighty-four fourth-year students were invited to participate in the study, excluding the ten students who had participated in the pilot study. Sixty-three participants (n=63), accounting for a 75 percent response rate, completed the self-rating, self-directed learning readiness Likert scale. The students constituted a mixed group of 55 female and eight males, with a mean age of 29. The data was analysed using inferential and descriptive statistics with the IBM Social Sciences Product for Statistics (SPSS) version 24, 2016. The results disclosed a high level of SDL among the fourth-year students with 87.3 percent of the students achieving scores higher than 150: according to Fisher a score of 150-200 suggests adequate readiness for self-directed learning (2001:520). However 14.7 percent of students showed low levels of SDL. The demographic characteristics of the participants were statistically not significant as determinants of SDL readiness. Conclusion: The majority of the fourth-year students displayed an adequate level of readiness for self-directed learning. The nurse educators could encourage an enquiry-based approach to teaching and learning to inculcate a positive approach towards SDL for lifelong learning and effective engagement in continuing professional development.