Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Evidence-based medicine , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/23600 , vital:58194
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
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- Date Issued: 2022-09
Barriers to implementation of evidence-based practices in a critical care unit
- Authors: Bowers, Candice Andrea
- Date: 2013
- Subjects: Evidence-based medicine , Critical care medicine , Nursing ethics
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10048 , http://hdl.handle.net/10948/d1013612
- Description: Over the last three decades there has been a greater need for health care practitioners to base their decision on the best available in order to optimise quality and cost-effective patient care. Evidence-based practice necessitates guideline development, education and review in order to achieve improved patient outcomes. However, initiatives that endeavour to disseminate and implement evidence-based practice have faced barriers and opposition. Barriers that might hamper the implementation of evidence-based practice include characteristics of the evidence itself, personal, institutional or organizational factors. The research study explored and described the barriers to implementation of evidence-based practices in a critical care unit. Based on the data analysis, recommendations were made to enhance the implementation of evidence-based practices in the critical care unit. A quantitative, explorative, descriptive and contextual research design was used to operationalize the research objectives. The target population comprised professional nurses in the critical care unit. Non-probability sampling was used to obtain data by means of a structured self-administered questionnaire. Descriptive data analysis was applied, using a statistical programme and the aid of a statistician. The results are graphically displayed using bar graphs and tables. Recommendations for nursing practice, education and research were made. Ethical principles have been maintained throughout the study.
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- Date Issued: 2013