Browsing by Author "Van As, Saria"
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- ItemBarriers and facilitators in the meticulous compilation and adaptation of standardised nursing care plans in a public hospital of the Eden district, South Africa : a nursing perspective(Stellenbosch : Stellenbosch University, 2018-12) Van As, Saria; Bell, Janet; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : Background: South African Nursing Council Regulation, No. R.2598 (as amended) requires that registered nurses (RNs) develop, implement and evaluate nursing care plans as part of their legal scope of practice. Keeping meticulous records forms an indispensable part of nursing care in order to provide continuity and quality patient care. Risks associated with poor care planning can include non-attainment of patient goals, patient dissatisfaction with care received, inferior quality of nursing care and lengthened hospitalisation. Document audits conducted in the study hospital provided evidence that standard care plans were often incomplete, inaccurate and not relevant to the patient’s condition. However, these audits cannot provide insights into why this poor practice occurs. The aim of this study was to describe the particular barriers and facilitators RNs experienced in the meticulous compilation and adaptation of standardised nursing care plans as part of their patient care activities in order to inform strategies that may be developed to promote meticulous practice in this aspect of care planning by RNs. Four study objectives were formulated, namely: to describe (i) barriers and (ii) facilitators influencing RNs in the meticulous compilation and adaptation of standardised nursing care plans, (iii) to determine if associations exist between demographic data and the most reported barriers and facilitators, and (iv) to identify strategies suggested by RNs to reinforce facilitators or minimise barriers. Methods: A quantitative approach with a descriptive design was used to meet the stated objectives. A 41-item structured questionnaire which was developed by the researcher, consisting of three sections, was used as the data collection tool. It was available in Afrikaans and English. Data were collected from RNs working in medical and surgical units of a public hospital in the Eden District. Of the 43 possible respondents, 29 respondents completed the questionnaire, with a response rate of 67% (n=29). A descriptive analysis of each of the scale items was conducted. Hypothesis tests between each of the five demographic variables and all the scale items were performed to identify trends showing associations between these variables and scale items by using the non-parametric Kruskal-Wallis and Mann-Whitney U tests. Results: The most prominent barriers reported included lack of multidisciplinary collaboration, failure to update objectives and plans daily, a lack of plans for every type of diagnosis, lack of involvement in the development of plans, and workload. Facilitators included ease of identifying priorities of care, compiling individual care plans when necessary, adequate knowledge, and predominantly positive attitudes towards the application of standardised nursing care plans. Significant associations were found between age and availability of a policy as well as the availability of plans for every diagnosis, and also between gender and completion of plans being a waste of time. Furthermore, type of basic qualification showed significant associations with validation of plans, minimising unnecessary documentation, careful use, aiding in the provision of high-quality care, and continuity of care. The type of qualification, specifically the 4-year diploma, impacts on how RNs view and experience the use of standardised nursing care plans. Meliorating strategies included the use of individual care plans or a combination of standardised and individual care plans, regular refresher training, as well as more audits – specifically aimed at the content of the standardised nursing care plans. Conclusion: Study results confirmed that RNs experience various barriers and facilitators in the meticulous compilation and adaptation of standardised nursing care plans, and associations exist between demographic variables and the identified barriers and facilitators. RNs offered meliorating strategies regarding the most reported barriers that were incorporated into the study recommendations.