Browsing by Author "Stevens, Haroldene"

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    Trauma and emergency nurse specialists’ perceptions of factors that hinder and facilitate the implementation of specialised skills in their practice within the public health sector in the Western Cape Province
    (Stellenbosch : Stellenbosch University, 2021-12) Stevens, Haroldene; Mabuda, Bernard Tendani; Young, Cornelle; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY : Background: Any investment in the training of trauma and emergency nurse specialists needs to be justified in terms of their contribution as specialist nurse practitioners to the actual delivery of trauma and emergency care. The utilisation of these specialists to the full extent of their education and training will optimise the value of their contributions within the multi-disciplinary emergency team. However, factors that enable or act as barriers to the implementation of specialised skills of trauma and emergency nurse specialists in their practice are not well understood and these factors need further investigation in the South African context. An understanding of these factors can provide the foundation to guide future empowerment of their role and optimal utilisation of their specialised skills. Methods: This research used an exploratory-descriptive qualitative design with a purposive and maximum variation sampling technique. WhatsApp video calling facilitated the use of a semi-structured interview guide to assemble data. Data was thematically analysed as described by the six steps of Braun and Clarke. Results: Analysis of the research data revealed four themes that capture specialised practice barriers and facilitators: these were individualistic influences, organisational context, role adversity and role ambiguity. The findings of the study suggest that the skills of trauma and emergency nurses are not used optimally in their practice settings because of barriers within the organisational context and practice environment. Moreover, a lack of awareness of specialised skills and the specific role functions of trauma and emergency nurse specialists led to strains in inter-professional relations and in multi-disciplinary teamwork. This research also revealed the possibility that perceived Scope of Practice restrictions and loss of confidence in specialised skills, because of very few practice opportunities, hinder the optimal implementation of specialised skills. Conversely, implementation of specialised skills was facilitated by individual motivation, patient advocacy, supportive unit managers and expert role models. Conclusion: The findings of this study articulated a concern for issues of implementing the skills of trauma and emergency nurse specialists in their practice. Their potential is not being optimised to ensure the productivity and sustainability of the specialist role, regardless of their confidence and competence in their specialised skills and enabling influences. Factors that were identified in hindering implementation of their specialised skills could support recommendations; this was evident from the need to address modifiable practice barriers.