Exploring and describing nurse managers views on the utilisation of agency nurses in district hospitals in the Cape Metropole

Bruiners, Selvador (2020-03)

Thesis (MNur)--Stellenbosch University, 2020.

Thesis

ENGLISH SUMMARY : Background: Nursing worldwide is regarded as a scare health human resource and there is literary evidence of an ongoing global nursing shortage. It is essential that nurse managers provide adequate staffing in hospitals. However, this often creates complex dilemmas, because nurse managers rely on agency nurses to amplify the permanent nursing staff due to the shortage. Although agency nursing has become and important strategy to manage the nursing shortage, it brings along associated challenges of quality of care rendered and reported unacceptable conduct. It is for these reasons that the views of Nurse Managers are significant, because it may provide valuable insight and direction to address the issues of quality of care, ethics and nursing standards, including contributing to the national strategy to improve the monitoring of agency nurses. Methods: A qualitative descriptive design was used for this study. A pilot interview was conducted to test the data-gathering instrument for possible errors, to clarify ambiguous questions, and to ensure a common interpretation of the terms used in the data-gathering instrument. No changes were made to the instrument. Data was collected from 14 participants in four focus groups, a face-to-face interview, and a telephonic interview, using semi-structured interview schedules. The interviews were recorded and transcribed verbatim. Thematic data analysis, using the Framework Approach, was guided by the research objectives. Atlas ti. computer software and manual data analysis were done to identify common themes. Ten common themes emerged from the data. Results: The literature indicates that NMs in many countries around the world utilise agency nurses and they experience similar advantages with the utilisation of agency nurses, albeit in varying degrees. These findings further revealed similar common practices for sourcing, deployment and supervision of agency nurses in district hospitals. Other findings were that hospitals have adequate structures and mechanisms in place to monitor and manage agency expenditure. There was also evidence that agency nurses provide quality nursing care. Unanticipated findings include examples of unacceptable conduct of some agencies and agency nurses, the display of caring attitudes towards agency nurses, and nurses from other provinces with different standards, who do agency work in the Western Cape Province. The challenges reported by participants indicated the need fro a monitoring system for the agency nursing industry. Conclusion: Agency nurses make a valuable contribution in assisting hospitals to deliver patient-centered quality care. The dilemmas faced with the utilisation of agency nurses will need further investigation and the development and implementation of policy to regulate the industry.

AFRIKAANSE OPSOMMING : Agtergrond: Verpleging word wereldwyd beskou as 'n skaars gesondheids menslike hulpbron en die literatuur toon 'n voortslepende verplegingstekort wereldwyd. Dit is noodsaaklik dat verpleegbestuurders voldoende personeel in hospitale verseker. Soms veroorsaak dit egter komplekse dilemmas, omdat verpleegbestuurders aangewese is op agentskapsverpleegkundiges om die permanente verpleegpersoneel aan te vul as gevolg van die tekort. Alhoewel agentskapsverpleging 'n belangrike strategie geword het om die verpleegtekort te bestuur, bring dit verwante uitdatings wat verband hou met die gehalte van sorg wat gelewer word en onaanvaarbare gedrag word ook ervaar. Om hierdie redes is die siening van verpleegbestuurders van belang, want dit kan waardevolle insig voorsien, en rigting aandui om die kwessies van gehaltesorg, etiek en verpleegstandaarde, insluitene 'n bydrae tot die nasionale strategie om verbeterde monitering van agentskapverpleegkundiges. Metode: 'n Kwalitatiewe ondersoekende studie met 'n filosofies ontwerp is onderneem. 'n Loods-onderhoud is gevoer om die dataversamelingsinstument te toets vir moontlike foute, om dubbelsinnige vrae uit te klaar en ook om te verseker dat daar 'n gemeenskaplike vertolding van die terme in die dataversamelingsinstrument is. Geen aanpassings is aan die instrument aangebring nie. Data is versamel van 14 deelnemers in 4 fokus groepe, 'n persoonlike onderhoud en 'n telefoon-onderhoud deur die gebruik van semi-gestruktureerde vraelyste. Die onderhoude is opgeneem en verbatim oorgeskryf. Tematiese data analise het geskied by wyse van die Raamwerkbenadering en is gelei deur die studie doelwitte. Data analise is gedoen met die gebruik van Atlas ti. rekenaar sagteware, asook met die hand, om gemeenskaplike temas te identifiseer. Resultate: Studie bevindings dui daarop dat verpleegbestuurders in baie lande agentskapverpleegkundiges benut, en hulle ervaar soortgelyke voordele met die gebruik van agentskapverpleegkundiges, alhoewel dit in aard verskil. Verdere bevindinge van hierdie studie dui op soortgelyke gesamentlike praktytke vir die inkoop, uitplasing en toesighouding van agentskapverpleegkundiges in distrikhospitale. Ander bevindinge was dat hospitale voldoende strukture en meganismes in plek het om agentskapspandering te monitor en te bestuur. Daar was ook bewyse dat agentskapverpleegkundiges gehalte verpleegsorg lewer. Onverwagte bevindinge sluit voorbeelde in van onaanvaarbare gedrag van sommige agentskappe en agentskapverpleegkundiges, 'n gesindheid van omgee vir agentskapverpleegkundiges, asook agentskapverpleegkundiges met verskillende standaarde, wie vanaf ander provinsies in die Wes-Kaap agentskapwerk doen. Uitdagings wat die deelnemers gerapporteer het, het gedui op 'n behoefte vir 'n stelsel om die agentskapsindustrie te monitor. Slotsom: Agentskapverpleegkundiges lewer 'n waardevolle bydrae tot hospitale in die lewering van pasient-gesentreerde gehaltesorg. Die dilemmas wat gepaard gaan met die gebruik van agentskapverpleegkundiges moet verder ondersoek word, en die ontwikkeling en implementering van beleid moet geskied om die industrie te reguleer.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/108127
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