TThe perceptions of clinical nurse practitioners on service delivery in primary health care facilities in Eden District, Western Cape

Moses, Katy Selina (2017-03)

Thesis (MCur)--Stellenbosch University, 2017.

Thesis

ENGLISH SUMMARY : Background: South Africa is facing many challenges in the process of changing the health care system to satisfy society as well as meeting international requirements. Programs were gradually expanded at Primary Health Care (PHC) level, in order to improve the quality of service delivery and patient access to care. Since the implementation of decentralized and integrated models of care, patients were redirected to clinics closer to their residence. Clinical Nurse Practitioners (CNPs) are directly involved in providing care in the expanded programs on a PHC level, since they have authorization under the Nursing Act (No. 33 of 2005) to prescribe drugs. The aim of the study is to explore the perceptions of CNPs regarding factors that influence service delivery in expanded programs in PHC facilities, specifically in the Eden District in the Western Cape. Methods: A qualitative approach with a descriptive design was utilized to explore and describe the perceptions of CNPs regarding service delivery in expanded programs. The study applied purposive sampling to select participants from four clinics in George sub-district, Western Cape. Permission was obtained from the Health Research Ethics Committee of Stellenbosch University and the Department of Health, Western Cape. Nine semi-structured interviews were conducted, transcribed and analyzed using the five stages described by Denscombe. Sub-themes emerged from six major themes. Results: The themes that emerged included: expansions in duties/roles, impact of extended duties and the challenges to comply with the changes. Factors that influenced participants’ perception of the services rendered at PHC facilities include, for example, the increased workload and the shortage of staff to cope with the constant changes. Conclusion: The factors that affect service delivery in a PHC setting are interrelated and have an impact on quality of care. Recommendations were made to contribute positively to the morale of staff and the provision of quality service delivery. Opportunities for further research are recommended.

AFRIKAANSE OPSOMMING : Agtergrond: Suid Afrika ondervind baie uitdagings in die proses om die gesondheidsorgsisteem te verander om die gemeenskap tevrede te stel en om aan internasionale vereistes te voldoen. Programme op Primere Gesondheidsorg (PGS) vlak het geleidelik uitgebrei om die kwaliteit van dienslewering en die toegang tot dienste vir pasiente te verbeter. Sedert die implementering van gedesentraliseerde en geintegreerde modelle van diens, is pasiente na klinieke nader aan hul woning verwys. Kliniese verpleegpraktisyns (KVPs) is direk betrokke by die lewering van dienste in die uitgebreide programme op PGS-vlak omdat hulle deur die Wet op Verpleging (Nr. 33 van 2005) gemagtig is om medikasie voor te skryf. Die doel van die studie is om die persepsies van KVPs oor die faktore wat dienslewering in die uitgebreide programme in PGS-fasiliteite, spesifiek die van die Eden Distrik in die Wes-Kaap, te ondersoek. Metode: ‘n Kwalitatiewe benadering met ’n beskrywende ontwerp was gebruik om die persepsie van KVPs met betrekking tot dienslewering in uigebreide programme te ondersoek en te beskryf. Doelgerigte steekproefneming was in die studie gebruik om deelnemers in vier klinieke in die George sub-distrik van die Wes-Kaap te kies. Toestemming om die studie te doen was van die Gesondheidsnavorsing Etiese Kommittee van die Universiteit van Stellenbosch en die Wes-Kaapse Department van Gesondheid verkry. Semi-gestruktureerde onderhoude was met nege deelnemers gevoer, getranskribeer en geanaliseer volgens die vyf stappe wat deur Denscombe beskryf word. Sub-temas het uit ses hoof temas na vore gekom. Resultate: Die temas wat na vore gekom het, sluit in: uitbreiding van pligte/rol, impak van die uitgebreide pligte en uitdagings om aan die verandering te voldoen. Faktore wat die deelnemers se persepsies oor dienslewering in PGS-fasiliteite beinvloed het, sluit in byvoorbeeld die verhoging in die werkslading en die personeeltekort om aan die voortdurende veranderinge te voldoen. Slotsom: Die faktore wat dienslewering in PGS affekteer is interafhanklik en het ’n impak op die kwaliteit van dienslewering. Voorstelle is gemaak om ‘n positiewe bydrae te lewer tot die moraal van personeel en kwaliteit dienslewering.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/101245
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