Masters Degrees (Nursing and Midwifery)

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    Perceptions of primary healthcare nurses about the effectiveness of their working environment for integrated primary healthcare service delivery in Nelson Mandela Bay Health District
    (Stellenbosch : Stellenbosch University, 2024-03) Baartman, Zubrina; Young, Cornelle; Baron, Justine Carla; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: An effective working environment is imperative to provide successful integrated primary healthcare (IPHC) services to the community. Such an environment comprises a collaborative primary healthcare team, functional organisational support, and effective cooperation among team members and with the community. Healthcare efficiency, accessibility, and equity are increased through a working environment which positively affects IPHC delivery. Without an effective working environment and with recurrent patient visits causing overcrowding, subsequent patient dissatisfaction and complaints are experienced. A loss of trust in the primary healthcare (PHC) system are thus encountered. Therefore, it was necessary to explore the perceptions of PHC nurses on the effectiveness of their working environment in enabling IPHC service delivery in the Nelson Mandela Bay Health District, sub-district B in the Eastern Cape Province. Methods: A qualitative research methodology was used with an exploratory research design. The study population comprised nine PHC nurses. Semi- structured interviews were conducted, using an interview guide with open-ended questions, and data was analysed using thematic analysis. Results: Findings of the study indicated that staff shortages and a lack of training opportunities act as barriers to a conducive working environment for IPHC delivery. This situation is exacerbated by inadequate internal and external infrastructure: sub- standard provision of utilities such as water, sewerage, and electricity, the lack of equipment and pharmacy stock, and unreliable transportation of patients for referrals. High patient loads, ineffectual teamwork within the clinic, and insufficient management support are more impediments in the setting towards an effective working environment for IPHC services. Conclusion: Primary healthcare nurses identified challenges within their current working environment to render effective IPHC service. A favourable working environment should be established to increase comprehensive and integrative PHC service delivery as a quality component of South African healthcare.
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    Structural empowerment to ease the transition of new nurse graduates : exploring the experiences of operational managers in primary healthcare clinics
    (Stellenbosch : Stellenbosch University, 2024-03) Nzimande, Londiwe; van Schalkwyk, Talita; Van der Heever, Mariana; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Introduction: Operational Managers, the first-line nurse managers in the clinical setting, have a duty to empower new nurse graduates during the transitional phase from being nursing students to functioning as qualified nurse practitioners, referred to as professional nurses in South Africa. Little is known about the role of operational managers in supporting new nurse graduates’ transition to practice through access to information, resources, support, and opportunities to learn and develop in the context of the primary health Care (PHC) clinics in the SA public healthcare sector. The study aimed to explore the experiences of operational managers on the use of structural empowerment to ease new nurse graduate’s transition to practice to practice in PHC clinics. Methods: A descriptive qualitative approach was applied to attain the aim of the study. The population comprised fifteen operational managers (OMs) working at the PHC clinics within uMhlathuze local municipality in KwaZulu Natal province of South Africa. The final sample comprised eight participants who were purposively selected and met the inclusion criteria. Individual interviews were conducted using a self-developed semi-structured interview guide. Thematic data analysis was conducted on the results. Trustworthiness was achieved by ensuring credibility, dependability, confirmability, and transferability. Ethical approval was obtained from the Stellenbosch University Health Research Ethics Committee. Permission to conduct the study was granted by the KZN Department of Health Ethics Committee. The ethical principles of self-determination, beneficence, and justice were adhered to. Results: Four major themes emerged from data analysis: 1) minimal orientation, 2) outplay of the professional development process, 3) use of human and material resources, and 4) barriers to new nurse graduate’s empowerment process. The themes were further divided into nine sub-themes that described the experiences of how OMs facilitated access to structural empowerment elements to ease the transition to the practice of new nurse graduates working under their care in PHC clinics. It emerged that minimal orientation was provided to new nurse graduates through the induction and orientation processes. Such processes were sub-optimal and primarily focused only on introducing the students to the clinical guidelines. In addition, professional development of non-clinical competencies such as management and leadership skills were not considered during the transitional phase. The clinical competencies were role-modelled by senior professional nurses. The rollout of informal continuous professional development for new nurse graduates happened through in-service training workshops and informal training in the different primary healthcare streams. Coordination of access to human and material resources needed for professional development coordinated by the OMs requires innovation due to time and resource constraints. Staff shortages and busy clinic workloads were found to be barriers that hindered the empowerment process, which led to inconsistent on-site mentorship by senior professional nurses and new nurse graduates receiving inadequate feedback about their performance. Conclusion: OMs appear to have limited capacity to coordinate effective professional development opportunities and support structures for new nurse graduates. These findings suggest the development of formal policies guiding the implementation of effective professional development and orientation programs for the new nurse graduates during the transition to practice phase.
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    Knowledge, attitude and practices regarding legal and ethical standards in nursing practice among nurses at district hospitals in Namibia
    (Stellenbosch : Stellenbosch University, 2024-03) Munenguni, Elise Taati; Hector, Dawn; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: At district hospitals in Namibia, it remains a concern regarding the practices of the legal and ethical standards among nurses. This concern may be associated with the adherence and level of knowledge and attitude regarding the legal and ethical standards in nursing. In order to provide safe and high-quality care to patients it is deemed necessary for the nurses to possess adequate knowledge, favourable attitude as well as excellent level of implementing practices regarding the legal and ethical standards in nursing. It is for this reason that the aim of the study was to investigate the knowledge, attitude and practices regarding the legal and ethical standards in nursing practice among nurses at district hospitals in Namibia. Methods: A quantitative, cross-sectional descriptive design was applied in the study. The total study population of 239 who met the criteria were given the opportunity to partake in this study to target 161 participants for the study. Ethical clearance was granted by the Health Research Ethics Committee of Stellenbosch University en health ministry of Namibia. The data were collected using a self-administered questionnaire tested with Cronbach Alpha score 0.847. Hundred and fifty-one nurses agreed to partake in the study however only 144 questionnaires were completed and returned. Stata statistical software, version 17 was used to analyse the data and to determine comparisons between the variables. Results: The study revealed that the participants had good knowledge as the mean knowledge score was 80.63%. However, the participants had an unfavourable attitude towards the legal and ethical standards in nursing with a mean score of 52.77%. In addition, the participants had poor practices regarding the legal and ethical standards in nursing with a mean score of 67.31%, which is <80%. The Two-sample t-test shows significance when comparing knowledge with the gender ( females scored higher) and nursing categories (registered nurses scored higher); the Pearson chi-square and Fisher’s exact tests show a significance in the association of attitude and practice with age, nursing categories, qualification and work experience; ANOVA test result show significance in the participants qualification and the their knowledge score and Bonferonni post-hoc results found statistically significant between a two year Certificate in enrolled nursing and midwifery and a 4-year Diploma in comprehensive nursing and midwifery science ( p<0.05). Conclusion: The study revealed that the nurses' attitudes are unfavourable towards the legal and ethical standards in nursing. Although they possessed sufficient knowledge, they had poor application practices in relation to the legal and ethical standards in nursing. Therefore, it is recommended that stakeholders of nursing practice at the district hospitals increase awareness and strengthen the culture of legal and ethical standards of the profession.
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    Exploring the role of the nurse educator, at a nursing education institution in Cape Town, on preparing undergraduate nursing students to provide compassionate nursing care
    (Stellenbosch : Stellenbosch University, 2024-03) Lotz, Claudette; Robertson, Anneline; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: Compassionate nursing care (CNC) involves recognizing and understanding an individual's vulnerability, going beyond the clinical aspect, to embrace a patient-centred approach with respect, empathy, kindness, and care. It is an approach that acknowledges humanity and alleviating suffering with understanding. Nurse educators are largely responsible to facilitate nursing students to provider CNC, but the lack of clarity on specific program curricula poses a challenge. To effectively produce nurses capable of providing CNC, detailed teaching strategies need to be implemented. This study explored the role of the nurse educator, at a Nursing education institution in Cape Town, on preparing undergraduate nursing students to provide compassionate nursing care. Methods: A qualitative explorative design was used to explore the nurse educators’ views on their role in, preparing an undergraduate nursing student to provide compassionate nursing care. Ethical approval was obtained from the Health Research Ethics Committee at the Stellenbosch University, Western Cape Department of Health and the selected NEI, before data collection commenced. Convenience sampling was used to select nurse educators, who had experience in undergraduate nursing education between six and 21 years. Eight in depth interviews were performed using a semi structured interview guide. The interviews were transcribed and analysed using transcript coding, by identifying key messages in each transcript, categorised on an Excel spreadsheet. The data that was collected from the interviews were unpacked, observed, and compared to reveal patterns, comparisons, and diversities. Subsequently, the themes that inherently supported the identified data were categorized into specific themes and subthemes. Results: Four themes emerged: Defining CNC, providing compassionate nursing care, CNC and the curriculum, and the role of the nursing educator in teaching and assessment of CNC.16 Sub themes emerged. The educator’s definition of compassionate care involves recognizing and comprehending the vulnerability of an individual and their circumstances, and it entails demonstrating respect, empathy, a kind approach, caring, and sensitivity. These attributes may be expressed as awareness of a situation when a person is vulnerable and suffering, physically or emotionally. Participants expressed that CNC is accepting and respecting the patient’s culture, understanding what a person is experiencing and then responding with empathy and sensitivity to their needs, thereby providing person centred care. Ethical principles, including autonomy and confidentiality, are introduced early in the program, seamlessly integrated throughout the curriculum. Compassionate care is taught from the first semester and remains a consistent element in every module. The educators noted varying student capacities for learning and delivering compassionate care, with some displaying immediate aptitude and others gaining confidence gradually over time. Conclusion: The findings revealed that, the nurse educator has a key role in preparing nursing students to be competent in providing CNC through theoretical and clinical assessments. Various factors in the students’ journey contribute to their development into becoming competent providers of compassionate nursing care. The participants expressed that integrating a compassion module on CNC in the undergraduate program will benefit both the students and patients.
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    Exploring registered nurses' understanding of the concept of critical thinking in a private hospital in the Gauteng Province, South Africa
    (Stellenbosch : Stellenbosch University, 2023-12) Mboqoka, Khululwa Nomangwekazi; Bell, Janet; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: In hospital environments, registered nurses are faced with difficult scenarios needing appropriate critical thinking skills. As health care systems become more sophisticated, these critical thinking abilities help registered nurses to be able to synthesise information and make swift, appropriate clinical decisions that lead to safe and efficient health care delivery. The current study was based on the researcher’s concern regarding an apparent lack of disposition towards critical thinking amongst registered nurses working in medical and surgical wards. Registered nurses are essential healthcare professionals in meeting patient needs in a health care system. Method: This study aimed to explore and describe registered nurses’ understanding of critical thinking in their clinical practice in medical and surgical wards in a private hospital in South Africa. The objective of this study was to explore how registered nurses understand critical thinking as a concept in their clinical practice. The researcher used a qualitative approach for this study. The approach applied an exploratory, descriptive design to explore the understanding and description of the concept of critical thinking by registered nurses who are working in medical and surgical wards. Data was analysed using a thematic analysis approach, which entailed a process of reading and re-reading data, coding, and generating themes from which data was interpreted and findings deduced. To conduct this research study participants were drawn from the group of registered nurses working in the medical and surgical wards of the study site who met the inclusion criteria. The final sample size comprised twelve registered nurses (RNs). Semi-structured individual interviews supported by an interview guide were used to gather data from participants. Results: The findings indicated a lack of understanding of the concept of critical thinking by registered nurses. Even though some nurses had an idea of the concept, it appeared that there is a big gap in nursing education and clinical teaching when facilitating achieving critical thinking as one of the objectives. The themes that emerged from the data indicated that there are factors that have a negative influence on how registered nurses think and apply their minds in clinical wards. Conclusion: The study concludes that registered nurses need support in developing critical thinking skills. It was also deduced that some demarcations and limited resources impede critical thinking in the wards.