Browsing by Author "Kerr, Jane."

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An analysis of nonverbal communication between nurses and hospitalised older adults in selected hospitals in Cameroon=Ukuhlaziya ukuxhumana ngezimpawu phakathi kwabahlengikazi nabantu asebekhulile abalaliswe kwezinye zezibhedlela ezikhethiwe zaseCameroon.
(2023) Wanko Keutchafo, Esther Lydie.; Kerr, Jane.
Background: Nurse-patient communication has been recognised as one of the most important aspects of successful patient outcomes. In relation to older adults, whose numbers are growing worldwide, nurses’ communication with older adults is essential because older adults will seek medical assistance more than before. Since most rely on nonverbal communication because of hearing deficits, and changes in attention and coding of information – all restrictions in interaction and effective verbal communication – nurses’ nonverbal communication will be a vital skill to develop good nurse-older patient relationships. In a context where there are no long-term care settings, nurses will be required to achieve effective nonverbal communication when older adults are admitted to the wards. Aim: This study aimed at analysing nonverbal communication between nurses and hospitalised older adults in selected hospitals in Cameroon, to develop a model for effective nonverbal communication between nurses and older adults. Methods: A mixed-methods approach was used in this study. A total of 372 participants were included through overt, theoretical, and convenience sampling. To collect the qualitative data through participant observations and individual interviews, twenty-seven (27) nurses were observed, of which 13 nurses were interviewed, and 29 older adults were observed, of which eight (8) were interviewed. In addition, 316 nursing students participated in the survey. Qualitative data analysis was composed of open coding, axial coding, and selective coding, which were intertwined as the researcher moved back and forth between data collection and data analysis. Additionally, comparative analysis, theoretical sensitivity, and memos were used during the process of analysing the qualitative data. Quantitative data were analysed using SPPS version 25, where descriptive and inferential analyses were run. Additionally, an explanatory factor analysis based on the principal component analysis method with varimax rotation was conducted, to determine the common factors that explain the order and structure among measured variables. Results: Firstly, the results showed that there was limited evidence of studies on nonverbal communication between nurses and cognitively intact hospitalised older adults in clinical settings. Secondly, the results showed that hospitalised older adults made both positive and negative interpretations of nurses’ nonverbal communication. They also had specific nonverbal communication needs. Thirdly, the results showed that nurses mainly used haptics, kinesics, and proxemics to communicate nonverbally with hospitalised older adults to build relationships with them, convey affection, reassure them, and support verbal communication. Further, the results showed that nursing students held slightly positive attitudes towards older adults; yet, the tool used to assess their attitudes showed moderate psychometric properties and two factor loadings. Finally, the results showed that the proposed model for effective nonverbal communication with hospitalised older adults, which emerged from the data, encompassed all six categories of Strauss and Corbin’s framework, which are: causal conditions, contextual conditions, core phenomenon, action/interaction strategies, intervening conditions and expected outcomes. Conclusions: This study revealed that nurses mainly use few nonverbal communication techniques to communicate with hospitalised older adults, which cannot achieve effective communication, vital in nurse-patient relationships. The proposed model provides a guide for effective nonverbal communication with older adults and acknowledges that older adults’ interpretations and needs of nonverbal communication, as well as attitudes towards them, all influence effective nonverbal communication with hospitalised older adults. It is hoped that nurses will consider these to improve their nonverbal communication with hospitalised older adults for better patient outcomes such as: patient satisfaction, shorter lengths of stay in hospitals and improved quality of care. Iqoqa Isendlalelo: Ukukhulumisana phakathi kwabahlengikazi neziguli kubalulekile ukuze isiguli silulame kahle. Ngokuphathelene nabantu asebekhulile ngeminyaka, indlela umhlengikazi akwazi ngayo ukuxhumana nabo ibalulekile ngoba abantu abaningi asebekhulile bathembele ekusebenziseni izimpawu lapho bekhuluma, okuyikhono okusemqoka ukuba umhlengikazi abe nalo ukuze kuthuthukiswe ubudlelwane obuhle phakathi kwabahlengikazi neziguli esezikhulile ezimweni lapho kungekho khona uhlelo lokunakekelwa isikhathi reside. Inhloso: Ukuhlaziya ukuxhumana ngokusebenzisa izimpawu phakathi kwabahlengikazi nabantu asebekhulile ngeminyaka abalaliswe ezibhedlela ezithile zaseCameroon, ukuze kusungulwe inqubo esebenza kahle yokuxhumana ngezimpawu. Izindlela zokwenza: Kulolu cwaningo kusetshenziswe izindlela ezixubile lapho kwabandakanywa khona ababambiqhaza abangama-372 kusetshenziswa uhlelo lokukhetha ngokusobala, ngokulandela indlela yezinjulalwazi nalolo oluvumelana nesimo. Kwabukwa abahlengikazi abangama-27, kwathi abayi-13 kubo kwaxoxwa nabo. Kwabukwa abantu asebekhulile abangama-29, kwase kuthi abayisishiyagalombili kubo kwaxoxwa nabo. Ngaphezu kwalokho, kunabahlengikazi abangamathwasa abangama-316 ababamba iqhaza kule nhlolovo. Ukuhlaziywa kwemininingo eyikhwalithethivu kwakunalezi zinyathelo ezintathu; ukuhluza ulwazi oluqoqiwe ukwenza ucwaningo lube yizingxenye ezincane bese zinikezwa amakhodi, ukuhlela amakhodi olwazi oluhluziwe bese ebekwa ngemikhakha kuye ngokuhlobana kwawo nokuhlobanisa yonke imikhakha ibe umkhakha owodwa owumgogodla kanye nokuhlaziya ngokuqhathanisa, kanye nerekhodi lomcwaningi eliqukethe umbono wakhe, neziphetho afinyelele kuzo nokuphawula. Imininingo eyikhwantithethivu yahlaziywa kusetshenziswa uhlelo lwekhompuyutha i-SPPS version 25, lapho kwenziwa khona ukuhlola okuchazayo nokucabangelayo. Imiphumela: Okokuqala, bube buncane ubufakazi bokuthi lukhona ucwaningo olwenziwe odabeni lokuxhumana ngokusebenzisa izimpawu phakathi kwabahlengikazi nabantu asebekhulile abalaliswe esibhedlela abanengqondo esebenza ngokugcwele endaweni yokwelapha. Okwesibili, abantu asebekhulile ngeminyaka abalaliswe esibhedlela, ababenezidingo ezithile zokuxhumana ngezimpawu, bakuqonda ngokunembile okwakushiwo abahlengikazi lapho bekhuluma nabo ngezimpawu, kanti kwezinye izimo abazange bakuqonde ngokunembile okwakushiwo. Okwesithathu, abahlengikazi basebenzisa ikakhulukazi ukuthinta, izimpawu zomzimba, nezinga lokuqhelelana noma ukusondelana nomuntu ukuze bakhe ubudlelwano nabantu asebekhulile abalaliswe esibhedlela, bababonise uthando, babanikeze ithemba futhi baxoxe nabo. Ngaphezu kwalokho, abahlengikazi abasengamathwasa babonisa isimo sengqondo esihle kakhudlwana kubantu asebekhulile; nokho, ithuluzi elisetshenzisiwe ukuze kuhlaziywe isimo sabo sengqondo libonise izimpawu zokusebenza kahle. Okokugcina, isibonelo sendlela ephumelelayo yokuxhumana ngezimpawu nabantu asebekhulile abalaliswe esibhedlela satholakala emininingweni futhi sididiyela yonke imikhakha eyisithupha yohlaka lukaStrauss noCorbin. Isiphetho: Ngokuvamile abahlengikazi basebenzisa izindlela zokuxhumana ngezimpawu ezimbalwa ukuze baxhumane nabantu asebekhulile abalaliswe esibhedlela, ezazingasizi ekudluliseleni umyalezo ngempumelelo. Indlela ehlongozwayo inikeza isiqondiso sokuxhumana ngezimpawu nabantu asebekhulile ngendlela ephumelelayo futhi iyavuma ukuthi indlela abantu asebekhulile abaqonda ngayo izinto nezidingo zabo zokuxhumana ngezimpawu, kuhlanganise nendlela umuntu ababheka ngayo, kunomthelela ekuxhumaneni nabo ngezimpawu ngempumelelo. Kuthenjwa ukuthi abahlengikazi bazokuhlola lokhu ukuze bathuthukise indlela abakhulumisana ngayo ngezimpawu neziguli esezikhulile ezilaliswe esibhedlela ukuze kuthuthukiswe izinga lokwaneliseka kweziguli, kuncishiswe ubude besikhathi ezisihlala esibhedlela futhi kuthuthukiswe izinga lokunakekelwa kwabantu abadala.
An analysis of nurse managers' human resources management related to HIV and tuberculosis affected/infected nurses in selected hospitals in KwaZulu-Natal, South Africa - an ethnographic study.
(2014) Kerr, Jane.; Brysiewicz, Petra.; Bhengu, Busisiwe Rosemary.
INTRODUCTION: Providing sufficient quality nurses in resource strapped countries is a human resource management challenge which nurse managers’ experience on a daily basis. THE PURPOSE of this study was to analyse and to determine the issues which affect the the human resources management of nurse managers in selected hospitals in the eThekwini District of the Province of KwaZulu-Natal, South Africa, and to formulate draft guidelines to assist nurse managers with human resource management. METHODOLOGY: A constructionist, reflexive ethnographic approach was used. The ethnographer spent two years in the field collecting data from informants, who were nurse managers, in four (4) selected district hospitals. Data was collected using unstructured informant interviews, non-participant observation and confirmatory document analysis. Data analysis led to eliciting codes from the data, searching for semantic relationships, performing componential analyses and discovering the themes for discussion within the final ethnographic report. A nominal group process was used to develop the draft guidelines. FINDINGS: The findings showed that the human resources management around sick nurses is a complex task. The themes of nurse managers’ experiences were a “burden” of maintaining confidentiality, as well as an emotional burden. Administratively, they experience the burden of absenteeism and the burden of policy compliance. The final theme is the burden of the deaths of HIV and Tuberculosis affected/infected nurses. CONCLUSION AND RECOMMENDATIONS: Organizations should create a non-judgmental work environment where non- disclosure by employees is respected in order to promote disclosure. They should have an awareness of the emotional effect on nurse managers and provide them with support. Emphasis needs to be placed on an HIV and AIDS policy and programme, incapacity leave workplace strategies and return to work policies. It is also recommended that contingency plans be provided when the death or prolonged absence of an employee impacts the staffing of the organization; consideration to be given to piloting and refining the draft guidelines; the management of employees on prolonged sick leave be included in the Nursing Administration Curricula taught to future nurse managers; and further research be conducted to assess employee reluctance to report needle stick injuries (sharps injuries) as well as the related phenomenon of stigmatization.
An analysis of quality improvement by nurses at a selected tertiary healthcare facility in Rwanda.
(2017) Batunga, Antoinette.; Kerr, Jane.
BACKGROUND: Improving and maintaining the quality of care in healthcare institutions is not easy and has become a continuous challenge. Though quality improvement continues to be a global issue, the Government of Rwanda, guided by its Vision 2020, has made significant progress in the health field, especially in providing accessible quality care and services to all Rwandan citizens. Furthermore, the Rwanda Ministry of Health, through its 2015 health policy, has introduced a number of interventions to improve quality of care, such as promoting customer care, ongoing training and capacity building of the staff in the health sector, and decentralising health care infrastructures. A number of constraints have been noted which hinder effective quality improvement, such as shortage of human and material resources. It has become important to analyse quality improvement by nurses at a selected tertiary healthcare facility in Rwanda. Purpose of the study: The purpose of this study was to analyse quality improvement by nurses; in order to develop guidelines for nurses on effective quality practices at a selected tertiary healthcare facility in Rwanda. Methodology: A concurrent mixed methods approach (quantitative and qualitative), was used in this study. Data were collected by the researcher over a two month period. In a quantitative approach, data were collected using a checklist to conduct an audit of quality improvement activities by nurses and purposive sampling was used to identify 13 quality improvement documents in 11 units/departments. In a qualitative approach, data were collected from registered nurses and patients who were seeking healthcare services at the time of data collection. Interview guides were used. Purposive sampling was used to identify 15 registered nurses; and 17 patients for the qualitative data collection and 12 nurse managers and experts in guideline development to participate in guideline development process. Quantitative data were analysed using SPSS version 23, while qualitative data were analysed using thematic content analysis. Nominal group technique was used to develop guidelines for nurses to improve the quality of care at the selected facility. Findings: Out of 11 departments from the selected hospital, the majority (90.9 %) of departments had incident reporting documents. Seventy-two per cent of departments reported having an audit tool for measuring the quality of care that was available and accessible to users. It was found that 36.6 % had a copy of quality policy document; 18.2% reported having registration books for complaints, however it was found that these complaints books were not used on a daily basis. Furthermore, it was noted that only 18.2% of departments had a copy of the quality action plan. Concerning annual quality report findings indicated that of 11 departments, none had a copy of the annual quality report. Findings from qualitative data in this study revealed a number of factors related to quality improvement, which were grouped into three categories: organisational resources, managerial roles, and customer care. Regarding the organisation resources, a number of subthemes emerged in this study: lack of materials and equipment, shortages of nurses and doctors, lack of guidelines to guide nurses on improving the quality of nursing care and lack of sufficient drugs in the hospital pharmacy (reported by both nurses and patients). Construction and renovation of buildings has been happening which has reduced congestion for patients. Regarding managerial role, factors that hindered quality improvement were nurses’ resistance to change, lack of knowledge concerning quality improvement, lack of supervision, and lack of health education for patients. Regarding customer care, patients were dissatisfied with the lack of sufficient drugs, long waiting times, lack of sufficient beds and rooms. Although a number of challenges were reported that hinder quality of care, patients appreciated effective performance and care from their healthcare workers that increased their satisfaction with the quality of care provided. Proper explanations and orientation made it easy for patients to seek healthcare services in the different departments and pharmacy turn around time has improved. It was also noted that nurses recognised that career development and support was helping them to improve the quality of care. Based on the findings from this study, quality improvement guidelines for nurses have been developed for the selected tertiary hospital where this study was conducted. Recommendations: Increase in-service training on quality improvement to raise employees’ knowledge and skills levels. Emphasise proper staffing and staff management of employees to avoid work overload in some units. Reduce waiting times and provide sufficient essential drugs in the hospital pharmacy reducing the need for patients to buy drugs from private pharmacies. Remedy lack of equipment and materials to enable nurses to work in a suitable environment. Conclusion: Despite challenges faced by the healthcare facility, there has been remarkable progress in quality improvement through response to needs in human and material resources. Improvement of quality care is a cornerstone in the health of the population of Rwanda. Keywords: Quality improvement, Quality of care, Standards of care, Patient Satisfaction.
Assessment of knowledge, attitude, and practice of pregnant women in respect of prevention of Mother-To-Child Transmission (PMTCT) of HIV/AIDS at a selected antenatal clinic in Durban, South Africa.
(2015) Haghdoost, Samira Navazandeh.; Kerr, Jane.
Background: South Africa is one of the sub-Saharan African countries with high rates of HIV/AIDS infection and Kwazulu-Natal province has a particularly high rate of HIV prevalence. Mother-To-Child Transmission (MTCT) of HIV, which can occur during pregnancy, labour, or breastfeeding, is one of the causes of the high rate of HIV and AIDS among children in this region. One of the best strategies to reduce the rate of infection among children is the Prevention of Mother-To-Child Transmission (PMTCT) during pregnancy, labour, and the postnatal period by giving antiretroviral drugs to pregnant women who are HIV-positive. The reasons for an increasing MTCT of HIV might include lack of knowledge of mothers of the risk of MTCT, benefits of preventive interventions, such as prophylactic ARV drugs and infant feeding options. Studies conducted in Sub-Saharan African countries showed that there was a low level of knowledge in mothers about MTCT and PMTCT services. Proper implementation of these services however, requires adequate knowledge and appropriate attitudes and practices of pregnant women toward PMTCT. As there was no published study covering KwaZulu-Natal province to demonstrate the relationship between these factors and PMTCT, it was considered necessary to conduct this study to identify the current level of knowledge of pregnant women and the effective factors impacting on their participation in the PMTCT program. Objective: The objective of this study was to assess the level of knowledge, attitude, and practice of pregnant women toward the PMTCT program and associated factors in a selected antenatal clinic in South Africa. Methods: This was an institution-based, cross-sectional study conducted among pregnant women attending an antenatal care clinic in eThekwini district, South Africa during August 2015. A simple random sampling technique was used to select 345 antenatal care attendees. Data were collected through use of a structured pre-tested questionnaire. Information was then entered into Statistical Package for the Social Sciences (SPSS), Version 22, and were analysed. Finally, data were explored through graphic displays, analysed, interpreted, and summarized. Results: In this research, 345 voluntary pregnant women were studied. The mean age was 26.3 years and the majority (66.3%) had secondary education or above. Of the respondents, 52.7% were single, 38.7% had a regular boyfriend, 8.0% were married and 0.6% were separated. In addition, 29.2% were employed and 70.8% did not have any occupation. This study found that 58.5% had poor, 26.9% had moderate and 14.6% had good basic HIV/AIDS knowledge. On the other hand, 20.4% had poor, 67.6% had moderate and 12.0% had good knowledge on MTCT of HIV and its prevention and they obtained information from health care workers (89.4%) followed by television and radio (22.4%). It was found that age, level of education and occupation had a significant effect on the level of knowledge of respondents. Despite their moderate knowledge concerning PMTCT, 97.6% had a good attitude towards the PMTCT program and 83.1% would support it. Furthermore, it was found that 98.5% did the HIV test and of those who shared the test result, 42.8% were HIV-positive and 52% were HIV-negative. Of respondents, 93.3% discussed having an HIV test with their male partner and 71.0% of partners wanted a couple testing, 15.7% wanted woman to be tested alone and 3.3% did not want the woman to be tested. This study also revealed that 51.9% had antenatal clinic (ANC) visits in their previous pregnancy, but 29.7% did not. It was found that the knowledge level of participants significantly correlated with their ANC visits. In addition, 30.6% did not receive PMTCT counselling upon arrival at the antenatal clinic, but 69.4% received it and 89.8% of them were convinced to continue using PMTCT services. Conclusion: The study showed that the knowledge of pregnant women about PMTCT was moderate, but there were some gaps found in their basic knowledge about HIV/AIDS. Moreover, their knowledge was significantly dependant on their age and education level. On the other hand, the majority had a good attitude and practice towards the PMTCT program. However, it is recommended that the PMTCT counselling should be extended to improve the knowledge of HIV/AIDS and PMTCT strategies in pregnant women through community mobilization.
Evaluation of N95 respirator mask compliance in a selected hospital in KwaZulu-Natal.
(2016) Mbhele, Zandile Benediltor.; Kerr, Jane.
Introduction Airborne infection control strategies to prevent Mycobacterium tuberculosis (M. tuberculosis) transmission have long been a neglected component of tuberculosis (TB) control programmes. The challenges facing health care workers (HCWs) are that of occupational acquired TB and human immunodeficiency virus (HIV). The emerging infectious diseases such as blood borne viruses and HIV in recent years have created new challenges for all HCWs including students who may be interacting with infected patients and clients during their clinical exposure. Microbes transmitted by airborne droplets or contact routes often generate anxieties and fears of being infected among HCWs and students particularly when placed in units having high risk patients/clients. Objectives of the study The study objectives were threefold: To evaluate the level of N95 respirator mask compliance among HCWs in the selected hospital; to determine the perceived barriers to compliance regarding the use of the N95 respirator masks by the HCWs of the selected hospital. To evaluate compliance with infection prevention and control policy, and administration and environmental control strategies related to N95 respirator masks in the selected hospital. Method A quantitative, non-experimental and descriptive design was used to conduct the study. A sample of 280 HCWs working in the selected institution met the inclusion criteria for this study. 98.5 % (n=276) were nurses and 1.5% (n =4) were doctors. A structured questionnaire was used to collect data and the SPSS version 22 was used for data analysis. Results Compliance with the use of N95 respirator mask was measured and evaluated as low in the study. N = 208 (74.6%) respondents reported that they do not wear the N95 respirator mask as a habitual inclination. N = 204 (72.9%) respondents reported that there was no respiratory protection programme in the institution. N = 270 (92.6%) respondents reported they were not medically evaluated before being permitted to wear the N95 respirator mask and N = 270 (96.4%) respondents reported that they were not fit tested. Barriers to the use of the N95 respirator masks included the unavailability of the N95 masks in the facility, high environmental temperatures, unavailability of respiratory protection policies, and that the N95 mask is uncomfortable and hinders communication. Administrative and environmental measures to control TB are not available Recommendations It is recommended that compliance with the respiratory protection programme in the health care facilities of the province of KwaZulu-Natal as a whole be further researched in future, that N95 masks be made available, and that a respiratory protection policy is made available to the HWCs. Key words: Compliance, HCWs, N95 respirator masks, respiratory programme, fit test, medical evaluation, and TB prevention and control.
Exploring nurse managers' perceptions of labour unions at a selected hospital in KwaZulu-Natal.
(2015) Shezi, Thulisile Teresa.; Kerr, Jane.
INTRODUCTION: The relationship between the workers union and nurses managers is associated with a lot of stress. The workers experience pressure to go on strike. Hostility indirectly exposed patient to poor quality care. Nieman (2003:4) argues that the outcomes of the strikes may have positive effects on patient care for example, increases in the number of nurses employed, improved security systems in hospitals and a given voice in decision making. The positive benefit for the workers will be salary increase (Schraeder & Friedman 2002:22). PURPOSE: The purpose of this study was to explore Nurse Managers’ perceptions of labour unions in a selected hospital in KwaZulu-Natal. METHODOLOGY: A qualitative, descriptive design was used to determine, explore and describe the nurse managers’ Perceptions and Attitudes towards labour unions. Data were collected through interviews, then transcribed verbatim and analysed to discover the themes. FINDINGS: The data analysis revealed that Nurse Managers in this setting have positive and negative perceptions toward labour unions. Their positive perceptions included advocacy for patients’ rights and negotiation nurse salary increases by labour unions. On the other hand, Nurse Managers’ are fearful of union members, feel threatened, and have a poor relationship with union members. This leads to a pressure to go on strike, which exposes patients to the risk of death, poor quality care and cross infection. CONCLUSIONS AND RECOMMENDATIONS: The findings of this study have indicated that Nurse Managers have difficulty managing a relationship with labour unions, and that there is a need for them to acquire the skills to do this effectively.
Exploring reasons for the high staff turnover amongst professional nurses at the Mandeni sub-district primary healthcare facilities.
(2017) Msomi, Babhekile Rejoice.; Kerr, Jane.
Introduction Primary healthcare (PHC) facilities are the first level of health care, therefore it is essential that these services are always accessible to the local community. The South African healthcare system has adopted a primary healthcare approach aiming to achieve health for all South African citizens. This is the reason why PHC services are rendered free of charge in all public clinics in South Africa. However, professional nurse turnover is impacting negatively on accessibility as well as quality of services rendered in the rural PHC clinics. Therefore, this research seeks to explore the reasons for high staff turnover amongst the professional nurses and to increase access of PHC services to the community and improve quality of services delivered by these clinics. Aim To explore the reasons for high staff turnover amongst professional nurses at the Mandeni sub-district PHC facilities. Method A qualitative exploratory study was conducted in seven PHC clinics and one Community Health (CHC) clinic was selected. Five professional nurses, including one operational manager were selected purposely. Data was collected using unstructured interviews. The main research question for this study was: “Why have you decided to leave employment at the PHC clinic?” Results The study’s findings revealed that professional nurses were overworked due to high patient load, lack of support from the management, favouritism, poor working conditions, professional nurse shortage, unmanageable subordinates, intimidation at the workplace, ever complaining community, financial problems, family responsibilities, poor work schedules and doing on-call duties, and lack of resources like poor water supply.
Exploring unit manager’s experiences with community service nurses in selected nursing units in KwaZulu-Natal.
(2016) Sewkarran, Vashni.; Kerr, Jane.
Background: Community service for nurses was introduced in January 2008, after it was legislated in the Nursing Act (55 of 2005). Unit managers assist these nurses during their transition process, from community service nurse, to professional nurses, but are confronted with many challenges. A number of these challenges include various committee meetings, resource allocations, staff supervision and development. Consequently, they are torn between their multiple roles (Dutton, Baker, Crickmore, Hudson, Marshburn, & Rose, 2012:1-6). Aim: The aim of this study was to explore the unit manager’s experiences with community service nurses in selected nursing units in KwaZulu-Natal. Method: The study adopted an exploratory, descriptive and contextual approach in which individual semi-structured interviews were conducted following a qualitative approach. The target population was all the unit managers in a district, a district/ regional, a regional/ tertiary and in specialized health care facilities. Purposive sampling was used to select the study subjects. The sample size included all the unit managers who met the inclusion criteria. Semi-structured interviews were undertaken with ten unit managers in four health care facilities. Interviews were transcribed verbatim, and analysed using content analysis. Results: The results revealed that unit managers welcomed community service nurses. The major concern was that they lacked knowledge as to why community service for nurses was implemented, and how to manage these nurses. The findings further revealed that the unit managers in different health care facilities are doing what they feel is right and required during that year of remunerated community service. Recommendations: Management in health care facilities should provide training for unit managers and professional nurses in acting positions regarding roles and responsibilities of community service nurses as part of their orientation and in-service training program. It is recommended that each institution has specific policies, procedures and an orientation program, such as, allocation policy, job description and performance appraisal to guide unit managers in respect of community service nurses’ supervision. Furthermore, the relevant stakeholders should aim at improving current orientation, mentorship and preceptorship programs for community service nurses Conclusion: From the shared perceptions of the unit managers, although the findings cannot be generalised, this study showed that the unit manager’s experiences with community service nurses in the selected nursing units was very similar. It is recommended that a document outlining the specific scope of practice and acts and omissions for community service nurses be put in place for the benefit of the unit managers. Unit managers need to be supported by nursing management.
An implementation evaluation study of a nurse initiated and managed antiretroviral therapy (NIMART) program in primary health care clinics in the Ugu district of KwaZulu-Natal.
(2016) Xaba, Pearl.; Kerr, Jane.
AIM The purpose of this study was to conduct an implementation evaluation study of Nurse Initiated and Managed Antiretroviral Therapy (NIMART) program in Primary Health Care (PHC) clinics in the Ugu district of KwaZulu-Natal. METHOD A quantitative non-experimental descriptive approach and evaluative design consisting of self-administered questionnaires was used to conduct the study to evaluate the availability of the latest Antiretroviral Therapy Guidelines, to evaluate the implementation of the Nurse Initiated and Managed Antiretroviral Therapy (NIMART) program and to evaluate the knowledge and practice of professional nurses towards the NIMART program in the 56 clinics of the Ugu district. Information leaflets were given to the participants and informed consent was obtained from each participant. The number of participants that were enrolled in the study was 52 because they met the inclusion criteria of working in the PHC clinics in the Ugu district and were trained in the NIMART course. The other 4 participants were not trained in the NIMART course and were excluded according to the exclusion criteria. RESULTS The study revealed that in 98% (n=51) of the clinics in the Ugu district, nurses were initiating adults on ART and only 2% (n=1) were still being initiated by the doctor. Furthermore, the majority of respondents indicated that children were initiated on ART in their clinics, while some respondents reported that in their clinics children are still initiated by the clinic visiting doctor or hospital doctor. The findings indicated that 98% (n=51) of clinics have the latest ART Guidelines available, while only 2% (n=1) of clinics indicated that they have outdated ART Guidelines available in the clinic. The study revealed that most respondents knew the correct ART regimens, ART eligibility criteria and when blood for CD4 count and viral load is taken, while there were still some respondents who did not know. CONCLUSIONS AND RECOMMENDATIONS The District HAST Manager and clinics’ Operational Managers must ensure that the latest 2015 National Consolidated Guidelines for PMTCT are available in all the PHC clinics. More nurses should be trained in NIMART. All the nurses that are NIMART trained should receive mentorship after the training so that they become competent and confident in initiating and managing HIV-positive patients on ART. The findings of this study revealed that there were some gaps in nurse’s knowledge around ART regimens, blood tests and eligibility criteria. This study can be used as a baseline to evaluate all the professional nurses trained in NIMART in Ugu district. The District Training Coordinator must arrange a workshop regarding the 2015 National Consolidated Guidelines to refresh NIMART nurses about ART regimens, about blood tests to be done and about the ART eligibility criteria.
An investigation into first-line nurse managers' lived experiences in two district hospitals in Yaounde, Cameroon : a descriptive phenomenological inquiry.
(2016) Keutchafo, Esther Lydie Wanko.; Kerr, Jane.
INTRODUCTION: Managing a district hospital ward in the Cameroonian health care system is a challenge for unit managers who are appointed to a managerial position because of their clinical skills, without being trained as managers, and with limited financial, material and human resources. PURPOSE: The purpose of this study was to describe the first-line nurse managers’ lived experiences in two selected district hospitals in Yaoundé, Cameroon in a work environment as described above. METHODOLOGY: A constructionist, descriptive Husserlian phenomenological approach was used. The researcher interviewed ten unit managers in two district hospitals. Data were collected through semi-structured interviews, then audio-recorded and transcribed verbatim. The seven-steps of Colaizzi’s qualitative data analysis method were used to find the essence of what it is like to be a unit manager in the selected district hospitals. FINDINGS: The data analysis revealed that managing a district hospital unit is like “being a mother of a family”. The transition to this role happened by surprise and with no formal training preceding it and includes providing, teaching, controlling, correcting, and planning. This role implies facing difficulties and making some sacrifices. It requires assistance from others and specific characteristics in the role-players. CONCLUSIONS AND RECOMMENDATIONS: Health care organizations should foster, support and strengthen the roles of unit managers in Cameroon. They should dedicate financial and material resources to education and training in order for unit managers to acquire the necessary leadership and management skills. Finally, unit managers should be transformational leaders in a context where staff are in need of supervisors who not only facilitate an environment that allows them to be productive, but who also demonstrate their concern for the staff’s well-being as individuals.
A process evaluation of the implementation of the HIV/AIDS counselling and testing (HCT) program for employees at a selected public hospital in KwaZulu-Natal (KZN).
(2011) Moodley, Selvarani.; Kerr, Jane.
AIM The aim of the study was to conduct a process evaluation of the implementation of the HIV/AIDS counselling and treatment program (HCT) for employees to ensure the delivery of standardised, high quality and ethical HIV counselling and testing services at a selected Regional Hospital in KwaZulu-Natal. METHOD A quantitative, non-experimental descriptive evaluative design was used to conduct the study. The study consisted of a two (2) questionnaire survey of a sample of 140 participants; One for the staff working in the HCT clinic (n=8) to evaluate the implementation of the HCT activities and the other for the staff that are employed at the selected public hospital (n=132) to evaluate their knowledge, attitudes and practise towards the HCT program. A checklist of the venue was also completed to evaluate the resources available at the HCT clinic. Informed consent was obtained from each participant. SPSS version 19 was used for data analysis. RESULTS The study revealed that the implementation practises of the HCT program were not according to the National Policy for HIV Counselling and Testing Guidelines (Department of Health, 2009) with regards to the availability of resources at the HCT clinic such as HIV test kits, chairs, gloves and sharps containers were available. Privacy was maintained while resources including condoms; directions such as posters to the clinic; pamphlets and reading material were unavailable. Nurse’s knowledge and attitude was neutral. There were no correlations between nurses that attended a HIV course and those that did not. The distribution of knowledge was the same across all categories of experience and level of education. The majority of nurses had an HIV test voluntarily and found out the results. The finding of the study does not indicate whether or not the HIV test was done at the staff HCT clinic or elsewhere. A small minority reported that they tested for employer and insurance purposes. A significant proportion of participants did not test because they were afraid that a person they know may test them and tell others and also because they did not think that the medical and nursing staff kept their testing information confidential. CONCLUSIONS AND RECOMMENDATIONS For the HCT program to be successfully implemented, resources and supplies must be available at the HCT clinic should an employee wish to use its services. It is recommended that funds be made available and budgeted for to increase the supplies of HIV test kits; provide condoms, books, pamphlets and reading material at the clinic. The researcher also recommends courses be offered to nurses that are interested; include HIV/AIDS courses in the curriculum of nurses attending the college; provide in-service education/training for employees regarding the HCT program, its resources and activities; provide anti-retro viral treatment (ART) to employees at the HCT clinic in order to decrease untimely AIDS deaths.