A best practice guideline for a healthy work environment for professional nurses working in the South African Military Health Service
- Authors: Mabona, Jean Fezeka Madi
- Date: 2018
- Subjects: Nurses -- Employment -- South Africa , Medicine, Military -- South Africa South Africa -- National Defence Force -- Medical care , Work environment -- National Defence Force -- Medical care
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/30811 , vital:31146
- Description: Governments, internationally and nationally, are becoming aware of the importance of healthy work environments within their health departments, environments that are caring and supportive to health professionals. This awareness is brought about by the mounting evidence that healthy work environments are critical to recruiting and retaining health professionals. On the other hand, unhealthy work environments can contribute to medical errors, ineffective delivery of care, and conflict and stress among health professionals in the clinical setting and faculty shortage that can compromise academic excellence in the academic setting. The professional nurses working in the South African Military Health Service (SAMHS), a branch of the South African National Defence Force (SANDF) could experience the military environment as unhealthy because it is rigid and controlled. The hierarchical rank structure could deprive them of their autonomy as the decision-making powers are directly proportional to the rank. Stressful conditions could be experienced when these professional nurses are taken away from the well equipped hospital environment to the deployment areas away from home. There was, however, no evidence found on the work environment of professional nurses in the SAMHS during literature review. The aim of the study is therefore to explore and describe the experiences of professional nurses working in the SAMHS and their understanding of a healthy work environment and the scope and nature of a best practice guideline, then to integrate the evidence generated to the evidence emanating from the critical appraisal of the existing best practice guidelines from other health settings in order to develop a best practice guideline for a healthy work environment for nurses in the SAMHS. The study adopted a qualitative, exploratory, descriptive and contextual research design. The research study was made up of three phases. In Phase 1, semi-structured interviews were conducted with professional nurses to collect information on their experiences of working in the SAMHS and their understanding of evidence-based best practice guidelines. The interviews were transcribed by an independent transcriptionist and data analyzed using the eight steps of data analysis as suggested by Tesch. Themes were identified and grouped together to form new categories. The process of coding was supported by an independent coder. Lincoln and Guba’s model of Page | vii trustworthiness consisting of credibility, transferability, dependability and confirmability was used to ensure the validity of the study. An integrative literature review was conducted where the existing evidence-based best practice guidelines for healthy work environment for nurses were searched for, appraised, had data extracted and were synthesized in Phase 2. In Phase 3, evidence generated in Phase 1 and Phase 2 was triangulated, forming recommendations that were utilized to develop a best practice draft guideline for a healthy work environment for professional nurses working in the SAMHS. The draft guideline was sent to five expert reviewers for their comments and recommendations. These were considered in the development of the final guideline. The final guideline consists of several recommendations in four themes: the need for effective leadership to create an empowering environment; effective communication amongst members of the health team; a culture that supports team work, and; the need for an environment that promotes professional autonomy. Further recommendations were made to address factors that impact negatively on enhancement of a healthy work environment. The guideline is intended for use by SAMHS’ leadership, at Levels 2, the strategic level, Level 3, the formation level and Level 4, the unit level (hospitals, sickbays and clinics and nursing college) and all professional nurses working in all the military health institutions of the SAMHS, including the military clinics, sickbays and hospitals irrespective of positions. However, the guideline may also be adapted by nursing institutions outside the military such as public and private hospitals and clinics where they find it applicable. Results
- Full Text:
- Date Issued: 2018
- Authors: Mabona, Jean Fezeka Madi
- Date: 2018
- Subjects: Nurses -- Employment -- South Africa , Medicine, Military -- South Africa South Africa -- National Defence Force -- Medical care , Work environment -- National Defence Force -- Medical care
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/30811 , vital:31146
- Description: Governments, internationally and nationally, are becoming aware of the importance of healthy work environments within their health departments, environments that are caring and supportive to health professionals. This awareness is brought about by the mounting evidence that healthy work environments are critical to recruiting and retaining health professionals. On the other hand, unhealthy work environments can contribute to medical errors, ineffective delivery of care, and conflict and stress among health professionals in the clinical setting and faculty shortage that can compromise academic excellence in the academic setting. The professional nurses working in the South African Military Health Service (SAMHS), a branch of the South African National Defence Force (SANDF) could experience the military environment as unhealthy because it is rigid and controlled. The hierarchical rank structure could deprive them of their autonomy as the decision-making powers are directly proportional to the rank. Stressful conditions could be experienced when these professional nurses are taken away from the well equipped hospital environment to the deployment areas away from home. There was, however, no evidence found on the work environment of professional nurses in the SAMHS during literature review. The aim of the study is therefore to explore and describe the experiences of professional nurses working in the SAMHS and their understanding of a healthy work environment and the scope and nature of a best practice guideline, then to integrate the evidence generated to the evidence emanating from the critical appraisal of the existing best practice guidelines from other health settings in order to develop a best practice guideline for a healthy work environment for nurses in the SAMHS. The study adopted a qualitative, exploratory, descriptive and contextual research design. The research study was made up of three phases. In Phase 1, semi-structured interviews were conducted with professional nurses to collect information on their experiences of working in the SAMHS and their understanding of evidence-based best practice guidelines. The interviews were transcribed by an independent transcriptionist and data analyzed using the eight steps of data analysis as suggested by Tesch. Themes were identified and grouped together to form new categories. The process of coding was supported by an independent coder. Lincoln and Guba’s model of Page | vii trustworthiness consisting of credibility, transferability, dependability and confirmability was used to ensure the validity of the study. An integrative literature review was conducted where the existing evidence-based best practice guidelines for healthy work environment for nurses were searched for, appraised, had data extracted and were synthesized in Phase 2. In Phase 3, evidence generated in Phase 1 and Phase 2 was triangulated, forming recommendations that were utilized to develop a best practice draft guideline for a healthy work environment for professional nurses working in the SAMHS. The draft guideline was sent to five expert reviewers for their comments and recommendations. These were considered in the development of the final guideline. The final guideline consists of several recommendations in four themes: the need for effective leadership to create an empowering environment; effective communication amongst members of the health team; a culture that supports team work, and; the need for an environment that promotes professional autonomy. Further recommendations were made to address factors that impact negatively on enhancement of a healthy work environment. The guideline is intended for use by SAMHS’ leadership, at Levels 2, the strategic level, Level 3, the formation level and Level 4, the unit level (hospitals, sickbays and clinics and nursing college) and all professional nurses working in all the military health institutions of the SAMHS, including the military clinics, sickbays and hospitals irrespective of positions. However, the guideline may also be adapted by nursing institutions outside the military such as public and private hospitals and clinics where they find it applicable. Results
- Full Text:
- Date Issued: 2018
A best practice guideline for clinical teaching at a public college of nursing
- Authors: Gcawu, Sybil Nyameka
- Date: 2018
- Subjects: Nursing -- Study and teaching , Clinical medicine Medicine -- Study and teaching
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/30194 , vital:30860
- Description: Clinical teaching is a critical component of the education and training of undergraduate nursing students. It determines the level of clinical competence that nursing students achieve during their studies. It should be informed by current best practice evidence available in the nursing care literature (Emanuel, Day, Diegnan & Prys-Muller, 2011:21-22). Clinical teaching is centred around provision of patient care in clinical practice. It takes place through an interaction between the nurse educator and the nursing students. During this process nursing students are moulded so they can demonstrate minimum competency in order to be registered by the regulatory body. Nursing students learn to become competent nurses in the clinical learning environment (Baxter 2006; Nash, 2007 in Franklin, 2013:35). In South Africa nurse educators are required to be fully responsible for clinical teaching through the use of appropriate teaching approaches and learning facilitation techniques (RSA DoH, 2013:91). The overall purpose of the current research study was to explore and describe the current clinical teaching practices of nurse educators; to search, appraise, extract and synthesise literature related to clinical teaching in nursing; and to develop A Best Practice Guideline for Clinical Teaching at a Public College of Nursing in the Eastern Cape Province. This had to be realized in three phases. In Phase One a quantitative, exploratory, descriptive and contextual study was conducted. A structured questionnaire was used to collect data from the nurse educators involved in clinical teaching within the Diploma in Nursing (General, Community, Psychiatric) and Midwifery programme. The data analysed was used as the basis of Phase Two—namely, an integrative literature review of evidence pertaining to the clinical teaching practices of nurse educators doing clinical teaching within the undergraduate programmes. The evidence from Phases One and Two was used to develop a draft Best Practice Guideline. The draft guideline was reviewed by a group of expert reviewers and their suggestions were incorporated in the final guideline. Ethical considerations were maintained throughout the research study. The rigour of the research process was ensured by cognitive testing of the questionnaire, and by critical appraisal of the literature accessed from an integrative literature review. The v authenticity of critical appraisal was ensured by having the critical appraisal done by the researcher and an independent reviewer.
- Full Text:
- Date Issued: 2018
- Authors: Gcawu, Sybil Nyameka
- Date: 2018
- Subjects: Nursing -- Study and teaching , Clinical medicine Medicine -- Study and teaching
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/30194 , vital:30860
- Description: Clinical teaching is a critical component of the education and training of undergraduate nursing students. It determines the level of clinical competence that nursing students achieve during their studies. It should be informed by current best practice evidence available in the nursing care literature (Emanuel, Day, Diegnan & Prys-Muller, 2011:21-22). Clinical teaching is centred around provision of patient care in clinical practice. It takes place through an interaction between the nurse educator and the nursing students. During this process nursing students are moulded so they can demonstrate minimum competency in order to be registered by the regulatory body. Nursing students learn to become competent nurses in the clinical learning environment (Baxter 2006; Nash, 2007 in Franklin, 2013:35). In South Africa nurse educators are required to be fully responsible for clinical teaching through the use of appropriate teaching approaches and learning facilitation techniques (RSA DoH, 2013:91). The overall purpose of the current research study was to explore and describe the current clinical teaching practices of nurse educators; to search, appraise, extract and synthesise literature related to clinical teaching in nursing; and to develop A Best Practice Guideline for Clinical Teaching at a Public College of Nursing in the Eastern Cape Province. This had to be realized in three phases. In Phase One a quantitative, exploratory, descriptive and contextual study was conducted. A structured questionnaire was used to collect data from the nurse educators involved in clinical teaching within the Diploma in Nursing (General, Community, Psychiatric) and Midwifery programme. The data analysed was used as the basis of Phase Two—namely, an integrative literature review of evidence pertaining to the clinical teaching practices of nurse educators doing clinical teaching within the undergraduate programmes. The evidence from Phases One and Two was used to develop a draft Best Practice Guideline. The draft guideline was reviewed by a group of expert reviewers and their suggestions were incorporated in the final guideline. Ethical considerations were maintained throughout the research study. The rigour of the research process was ensured by cognitive testing of the questionnaire, and by critical appraisal of the literature accessed from an integrative literature review. The v authenticity of critical appraisal was ensured by having the critical appraisal done by the researcher and an independent reviewer.
- Full Text:
- Date Issued: 2018
Strategies to facilitate the use of birth care provided by skilled birth attendants in the rural areas of Ghana
- Authors: Adatara, Peter
- Date: 2018
- Subjects: Maternity nursing -- Ghana , Neonatal nursing -- methods Delivery (Obstetrics) Midwifery -- Ghana
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/23415 , vital:30541
- Description: Increasing skilled attendance during childbirth is well established in literature to play a significant role in averting the many preventable maternal deaths that occur in developing countries such as Ghana.Inadequate utilisation of skilled birth care services in Sub-Saharan Africa is believed to be a major hindrance to efforts aimed at improving the health of women, especially during delivery. There is low utilisation of birth care services provided by skilled birth attendants in the rural areas in Ghana. The purpose of this study was to develop strategies that could facilitate the utilisation of skilled birth care provided by skilled birth attendants in the rural areas of Ghana. The study adopted a qualitative, explorative, descriptive and contextual method to explore and describe women’s experiences regarding the utilisation or non-utilisation of skilled birth care services provided by skilled birth attendants in the rural areas in Ghana. The study was conducted in three phases: Phase One of this study described the research population, sampling method, data collection and analysis to obtain women’s experiences regarding the utilisation or non-utilisation of skilled birth care services. In this study, data were collected and analysed from the research population. The research population consisted of women who utilised skilled birth care attendants or unskilled care attendants during child birth. The data collection method used was individual interviews. Data collected from the interviews were transcribed verbatim and analysed according to the steps suggested by Tesch to identify themes and sub-themes. The study identified three themes and sub-themes: Theme 1: Experiences of participants related to the use of skilled birth care attendants; Theme 2: Participants expressed their reasons for choosing a home birth; Theme 3: Participants offered suggestions to improve skilled birth care at healthcare facilities. The findings in Phase one of this study formed the basis for the development of the strategies in Phase three. Phase Two of the research design focused on the development of a conceptual framework based on the research findings and utilized to develop strategies which skilled birth attendant may use to facilitate the use of skilled birth care services by women in the rural areas of Ghana where there is low utilisation of birth services provided by skilled birth attendants. The conceptual framework of Dickoff, James and Wiedenbach was used to provide a guide and a link between the different concepts in the research study. Phase Three of this study focused on the development of strategies that will facilitate an increased in the labouring women utilisation of the services provided by skilled birth attendants. The data obtained was used to developed three strategies such as collaboration, education and training, supportive supervision as well as community mobilisation and participation to guide skilled birth attendants to facilitate the utilisation of skilled birth care services during childbirth. The WHO Health for All model, the theoretical model underpinning this study, also guided the development of the strategies to facilitate labouring women utilisation of the services provided by skilled birth attendants. Recommendations regarding the implementation of a national collaborative, education and supportive supervision policies on a macro level are made, as well as recommendations for nursing practice, education and research. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because the strategies which are understandable, clear, simple, applicable and significant to skilled birth care in rural areas has been developed for use by skilled birth attendants to facilitate the utilisation of skilled birth care provided by skilled birth attendants in the rural areas of Ghana.
- Full Text:
- Date Issued: 2018
- Authors: Adatara, Peter
- Date: 2018
- Subjects: Maternity nursing -- Ghana , Neonatal nursing -- methods Delivery (Obstetrics) Midwifery -- Ghana
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/23415 , vital:30541
- Description: Increasing skilled attendance during childbirth is well established in literature to play a significant role in averting the many preventable maternal deaths that occur in developing countries such as Ghana.Inadequate utilisation of skilled birth care services in Sub-Saharan Africa is believed to be a major hindrance to efforts aimed at improving the health of women, especially during delivery. There is low utilisation of birth care services provided by skilled birth attendants in the rural areas in Ghana. The purpose of this study was to develop strategies that could facilitate the utilisation of skilled birth care provided by skilled birth attendants in the rural areas of Ghana. The study adopted a qualitative, explorative, descriptive and contextual method to explore and describe women’s experiences regarding the utilisation or non-utilisation of skilled birth care services provided by skilled birth attendants in the rural areas in Ghana. The study was conducted in three phases: Phase One of this study described the research population, sampling method, data collection and analysis to obtain women’s experiences regarding the utilisation or non-utilisation of skilled birth care services. In this study, data were collected and analysed from the research population. The research population consisted of women who utilised skilled birth care attendants or unskilled care attendants during child birth. The data collection method used was individual interviews. Data collected from the interviews were transcribed verbatim and analysed according to the steps suggested by Tesch to identify themes and sub-themes. The study identified three themes and sub-themes: Theme 1: Experiences of participants related to the use of skilled birth care attendants; Theme 2: Participants expressed their reasons for choosing a home birth; Theme 3: Participants offered suggestions to improve skilled birth care at healthcare facilities. The findings in Phase one of this study formed the basis for the development of the strategies in Phase three. Phase Two of the research design focused on the development of a conceptual framework based on the research findings and utilized to develop strategies which skilled birth attendant may use to facilitate the use of skilled birth care services by women in the rural areas of Ghana where there is low utilisation of birth services provided by skilled birth attendants. The conceptual framework of Dickoff, James and Wiedenbach was used to provide a guide and a link between the different concepts in the research study. Phase Three of this study focused on the development of strategies that will facilitate an increased in the labouring women utilisation of the services provided by skilled birth attendants. The data obtained was used to developed three strategies such as collaboration, education and training, supportive supervision as well as community mobilisation and participation to guide skilled birth attendants to facilitate the utilisation of skilled birth care services during childbirth. The WHO Health for All model, the theoretical model underpinning this study, also guided the development of the strategies to facilitate labouring women utilisation of the services provided by skilled birth attendants. Recommendations regarding the implementation of a national collaborative, education and supportive supervision policies on a macro level are made, as well as recommendations for nursing practice, education and research. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because the strategies which are understandable, clear, simple, applicable and significant to skilled birth care in rural areas has been developed for use by skilled birth attendants to facilitate the utilisation of skilled birth care provided by skilled birth attendants in the rural areas of Ghana.
- Full Text:
- Date Issued: 2018
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