Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: The research focused on the knowledge of occupational safety by hospital managers towards HIV and other blood borne pathogens transmission in Abakaliki region in eastern Nigeria. These pathogens are easily transmissible by needle sticks and other occupational accidents. It is important to identify factors that pre-expose hospital cleaners to occupational risk exposure that can lead to the transmission of HIV, HBV and HCV. The research was conducted in 10 different hospitals. A total of 90 questionnaires were administered to the hospital cleaners that volunteered to participate in the research and 68 questionnaires were returned representing 75.6% of the total questionnaires. The mean age and standard deviation of the respondents in this study was 38.6 + or – 5.4 years. The researcher conducted a semi-structured interview with all the 10 hospital managers involved with the study and the interviews showed there was a need for an organised training on hospital work and occupational hazards, risk exposures and precautions. The questionnaires showed the knowledge of hospital cleaners on occupational safety and it was observed the majority of the hospital cleaners were not aware of post exposure prophylaxis for HIV. The workers relatively had good practices put in place to prevent HIV, HBV and HCV transmission but majority of them had not received HBV vaccine due to lack of awareness and availability. There was a significant positive correlation between the knowledge of the health workers and HIV transmission and the practice put in place by health workers to prevent HIV transmission (P<0.05). This implies as the knowledge of the health workers about HIV transmission increases, the practice put in place by health workers to prevent HIV transmission and Hepatitis B&C increases. Therefore there is need for continuous training on blood borne pathogens transmission such as HIV transmission in the hospitals and its routes of transmission. There is need for awareness creation for HBV vaccine and Post exposure prophylaxis for HIV exposure. / AFRIKAANSE OPSOMMING: Nie beskikbaar / jfl201601

South African hospitals, as a result of numerous factors, have the problem of an increasing workload for nursing staff, which in turn may affect patient treatment quality. This project aimed at addressing patient treatment quality specifically from the perspective of worker capabilities by investigating the strain level and predicted human error probability associated with specific patient-centered tasks in the South African health care sector. This was achieved through two independent yet interlinked studies which focused on seven patient-centred tasks. The tasks analysed were the tasks of setting up and changing intravenous medication, administering injection and pill medication, measuring blood glucose, temperature and heart rate and blood pressure. In the first study, work environment and task characteristics, task structure and execution were analysed. In addition to the task execution, the resulting strain levels, in the form of heart rate measures and subjective ratings of workload, were studied. The second study determined the error protocols and predictive error probability within the healthcare environment for the seven pre-defined tasks. The results for the first study established that different organizational and environment factors could affect task complexity and workload. The individual task components and information processing requirements for each task was also established. For the strain analysis, significant results for the tasks were determined for heart rate frequency and the heart rate variability measures, but some of these were contradictory. For the second study, specific error protocols and error reporting data were determined for the hospital where this research was conducted. Additionally the predictive error probability for the pre-defined tasks was determined. This combined approach and collective results indicate that strain and predictive error probability as a result of task workload can be determined in the field as well as being able to identify which factors have an effect on task strain and error probability. The value of this research lies in the foundation that the gathered information provides and the numerous potential applications of this data. These applications include providing recommendations aimed at improving nursing work environment with regards to workload, improving patient treatment as a result of a reduction in errors and the potential foundation these results provide for future research

On t.p.: Master of Arts in Social Work (Welfare Programme management) / Thesis (MA(MW))--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Medical social workers working in children's wards are more prone to burnout because of the stressful nature of their work. Because social work requires emotional involvement, it is not uncommon for workers to be emotionally drained and frustrated, which might lead to burnout. Stress amongst social workers is an important issue, as a stressed workforce can negatively affect the quality of service. This study was undertaken with the aim of providing guidelines for handling stress amongst medical social workers working in children's wards, in order to promote job satisfaction and enhance work performance. Chronically ill children who are hospitalised, often suffer from behavioural and emotional problems that require social work intervention, which in turn puts pressure on the social worker. Concurrent stressors on the children and their families may exhaust their normal coping capacity and further complicate the child's adaptation to hospitalisation. The role of the medical social worker is to provide social support to the child and the family in order to promote positive coping in the child during and after hospital treatment. The demands put on the social worker by hospitalised children can cause stress, which could adversely affect their work performance and job satisfaction. Social workers therefore, have to carefully select an appropriate practice framework when dealing with hospitalised children. This entails the selection of appropriate perspectives, theories and models to ensure effective intervention. These frameworks provide structure and directive to social work intervention, and combined with supervision, can promote job satisfaction amongst medical social workers. The study was undertaken amongst medical social workers working in paediatric wards within hospitals in the Cape Metropolitan area. The empirical study focused on an investigation of factors, which might contribute to the experience of burnout amongst the social workers. Work-related stressors playa major role in increasing the likelihood of burnout amongst social workers. If these stressors are not properly dealt with they might lead to burnout amongst medical social workers, which will have a direct bearing on the child's benefit from medical services. A combination of both organisationally based and individually based strategies should be implemented in order to overcome job-related stress and to prevent burnout. / AFRIKAANSE OPSOMMING: Mediese maatskaplike werkers wat in kindersale werk, is meer geneig tot uitbranding as gevolg van die stresvolle aard van hulle werk. Maatskaplike werk vereis emosionele betrokkenheid. Dit is dus nie ongewoon vir maatskaplike werkers om emosioneel gedreineerd en gefrustreerd te voel nie. Laasgenoemde is kenmerke van uitbranding. Oormatige stres by maatskaplike werkers kan 'n negatiewe uitwerking op die kwaliteit van hul dienslewering hê. Hierdie navorsingstudie was onderneem met die oog op die daarstelling van riglyne vir die hantering van stres by mediese maatskaplike werkers, wat in kindersale werk om sodoende werkstevredenheid en -verrigting te bevorder. Kroniese siek kinders wat gehospitaliseer word, presenteer dikwels met gedrags- en emosionele probleme wat uiteraard tydens intervensie addisionele druk op die maatskaplike werker plaas. Gepaardgaande stressors kan daartoe lei dat pasiënte en hul gesinne afwyk van hul normale funksionering wat weer die pasiënt se hanteringsvermoë en aanpassing by die hospitaalopset belemmer. Die rol van die mediese maatskaplike werker is om sosiale ondersteuning aan bogenoemde partye te gee ten einde positiewe hanteringsvermoë tydens en na mediese behandeling, by pasiënte te vestig. Die eise wat deur pasiënte aan maatskaplike werkers gestel word kan stres veroorsaak wat hul werksverrigtinge en tevredenheid negatief kan affekteer. Maatskaplike werkers moet dus versigtig te werk gaan in die keuse van 'n gepaste praktykraamwerk vir intervensie ten opsigte van gehospitaliseerde kinders. 'n Verantwoordbare keuse van perspektiewe, teorieë en modelle lê ten grondslag van effektiewe maatskaplike werk intervensie. Hierdie raamwerke bied struktuur en rigting aan maatskaplike werk intervensie. Laasgenoemde, tesame met Stellenbosch University http://scholar.sun.ac.za superviste kan werkstevredenheid onder mediese maatskaplike werkers bevorder. Stressors wat met werk verband hou, speel 'n groot rol in die toename van uitbranding onder mediese maatskaplike werkers. Indien hierdie stressors nie effektief hanteer word nie, kan dit tot uitbranding by maatskaplike werkers ly wat dan weer die pasiënt se benutting van mediese dienste negatief beïnvloed. Die ondersoekgroep het bestaan uit tien mediese maatskaplike werkers wat werksaam was in paediatriese sale in hospitale binne die Kaapse Metropool. Tydens 'n empiriese ondersoek is gefokus op faktore wat moontlik aanleiding kan gee tot die uitbranding van maatskaplike werkers. Dit word dus aanbeveel dat 'n kombinasie van strategieë van beide die orgarusaste en die persoon geïmplementeer moet word om werksverwante stres te oorkom en dus uitbranding by mediese maatskaplike werkers te voorkom.

Thesis (MMed)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Introduction: The morbidity and mortality associated with tuberculosis (TB) disease is of grave consequences for the health and employment of afflicted individuals. Healthcare workers are identified amongst high risk groups in communities. The prevalence/incidence of TB is dependent on the presence of associated risk factors which varies in diversity and intensity in different communities and workplaces. Understanding the risk factors operating in any given environment is indispensable to any tuberculosis control programme. Objective: The objective of this study was to describe the occurrence and trends of TB disease as well as to determine the risk factors associated with the disease among Tygerberg hospital employees. Method: A cross-sectional descriptive study design with a nested case-control component was used to determine the occurrence (and trends) and risk factors of TB disease respectively. Occurrence and trends of tuberculosis: The frequencies, distribution and trends of TB disease from 2008 to 2011 were obtained by calculating and comparing the annual incidence rates for each variable. Cases were identified from the occupational health clinic TB register, while the various denominator data were obtained from the Human Resource database. Determination of risk factors: Cases were recruited from the occupational health clinic TB register and controls were randomly selected from unaffected workers during the study period. Self-administered risk factor questionnaires were completed by both cases and controls. Multivariate logistic regression analysis was used to determine the association between known and suspected risk factors and the occurrence of TB disease amongst employees. Results: Sixty six cases of TB disease occurred in the workforce during the study period resulting in an annual average incidence rate of 397/100,000 population (95% CI: 307/100,000-505/100,000). Twenty three (34.8%) of the 66 cases occurred in Housekeeping staff, making them the most affected sub-group [1181/100,000 population (95% CI: 747/100,000-1768/100,000)]. The rate of TB disease in nurses was 1.7 times (95%CI: 1.4-2.0) that of doctors. Workers in the 40-49 years age-group experienced the highest incidence [490/100,000 population (95%CI: 329.6/100,000-706.8/100,000)] of TB disease compared to the other age-groups. There was no obvious difference in gender occurrences. Disease rates varied among different racial groups, with the highest rate in black employees [1473/100,000 population, (95%CI: 924/100,000-1981/100,000)]. Distribution of TB disease in the institution was widespread, with security department being the most affected [2500/100,000 population (95%CI: 311/100,000- 9262/100,000)]. There was a downward but statistically insignificant (annual range 9-23; p=0.28) trend in the rate of disease occurrence over the study period. No previous training on TB prevention (OR: 2.97, 95% CI: 1.15 - 7.71), HIV (OR: 67.08, 95% CI: 7.54 – 596.64) and working without knowledge of TB risk profile of the workplace (OR: 8.66, 95% CI: 1.10 – 67.96) were associated with TB disease occurrence. Conclusion: Occurrence of TB disease among Tygerberg hospital employees was low compared to that of the general population of its drainage areas. Disease occurrence in the facility was wide and varied with respect to occupational groups, workplaces and time. Well-established risk factors for TB infection (and disease) were found to be determinants of disease occurrence in the facility.

It has been widely reported that despite high health expenditure and a myriad of policies in place, South Africa’s health outcomes are worse than those in many lower income countries. The adverse health outcomes are even more pronounced in a rural province such as the Eastern Cape Province. Consequently, the Eastern Cape Department of Health (ECDOH) had turned to Private Public Partnerships (PPP) with the hope of mitigating some of the challenges beleaguering the health system in the province. This study evaluated the impact of the implementation of one of the PPP models at an Eastern Cape Hospital on key employee job outcomes. This is crucial as there had not yet, been this type of scientific assessment of the impact of the PPP model since the inception of the PPP about half a decade ago. Theoretical guidance of the study was provided by the Job Characteristics Theory (JCT) of Oldham and Hackman (1975), which predicted that changes in five core characteristics of a job will affect three critical psychological states which will in turn impact on key employee job outcomes. Uniquely, this study veered away from the traditional quantitative approach to the application of the JCT but rather adopted a qualitative case study approach. There is historical evidence that cross cultural validation of a theory in a new setting (a South African PPP hospital in this instance) benefits from an initial qualitative study. Data collection and analysis were guided by the JCT. Primary data collection was by semi-structured, face to face, one on one interviews. The analyses of the data specifically employed pattern matching and explanation building techniques, all underpinned by the JCT. Validity of interview data was strongly contributed to by available relevant case study documents. This study found that indeed, the implementation of this PPP model brought about changes in all five (JCT) core job characteristics of clinical staff, but to varying degrees in the three unique shared service areas. Interestingly, the three psychological states were found to have been impacted upon by changes in the JCT core job characteristics but also by factors related to the context of the job, such as quality of supervision and co-worker relationship. In contrast to the predictions of the JCT, this study also found that the key job outcomes were impacted directly by such contextual factors as the recent availability of specialists and staff shortages, among others. It also emerged that the PPP implementation has directly evoked a perception of inequity and breach of psychological contract among clinical staff working at the shared service areas. Among the three shared areas, the accident and emergency unit was discovered to have had the worst overall impact. Due to the importance of contextual factors at this PPP setting, key recommendations were directed towards improved management of the jobs. It is also recommended that a follow-up quantitative study be commissioned to further explore the main themes that emerged from this study. This research report is presented in three sections. Section 1 is the evaluative report itself, structured as an academic paper. Section 2 expands on the literature that was briefly reviewed in Section 1 while Section 3 outlines, in greater details, the research methods followed during the conduct of the research and the justifications thereof.

The purpose of this study was to explore and to describe experiences of learner nurses regarding clinical supervision at private hospitals in East London in the Eastern Cape. These were Life Healthcare hospitals. A qualitative, contextual approach was used and the exploratory, descriptive design was seen as most appropriate in this study. The subjects were the learner nurses in the Bridging Course Programme leading to registration as a General Nurse. The research questions were: How did you as a learner nurse, doing the Bridging Course, experience clinical supervision at Life Healthcare hospitals? A pilot study was conducted in a clinical setting involving respondents with similar characteristics to the study population. Fourteen participants were selected for this study by using a purposive, non-probability sampling method. Data were collected by means of individual interviews during which participants were able to describe their experiences during clinical supervision; data were collected until data saturation was reached.During data analysis, the researcher used the process of bracketing and remained neutral, setting aside previous knowledge and beliefs about the phenomenon under investigation. The researcher listened to the audiotapes used for data collection several times until she was completely satisfied with the interpretation of the verbatim data. Transcriptions were made within three days of the interview. The research was done in an ethically reflective manner and the researcher ensured the trustworthiness of the study at all times. The researcher allowed the participants freedom to conduct their lives as autonomous agents, without external The purpose of this study was to explore and to describe experiences of learner nurses regarding clinical supervision at private hospitals in East London in the Eastern Cape. These were Life Healthcare hospitals. A qualitative, contextual approach was used and the exploratory, descriptive design was seen as most appropriate in this study. The subjects were the learner nurses in the Bridging Course Programme leading to registration as a General Nurse. The research questions were: How did you as a learner nurse, doing the Bridging Course, experience clinical supervision at Life Healthcare hospitals? A pilot study was conducted in a clinical setting involving respondents with similar characteristics to the study population. Fourteen participants were selected for this study by using a purposive, non-probability sampling method. Data were collected by means of individual interviews during which participants were able to describe their experiences during clinical supervision; data were collected until data saturation was reached.During data analysis, the researcher used the process of bracketing and remained neutral, setting aside previous knowledge and beliefs about the phenomenon under investigation. The researcher listened to the audiotapes used for data collection several times until she was completely satisfied with the interpretation of the verbatim data. Transcriptions were made within three days of the interview. The research was done in an ethically reflective manner and the researcher ensured the trustworthiness of the study at all times. The researcher allowed the participants freedom to conduct their lives as autonomous agents, without external control, coercion or exploitation. The following findings were evident: Three main themes emerged from data analyses. These comprised inadequate clinical supervision, satisfactory clinical supervision and suggestions and inputs regarding clinical supervision. Detailed discussions about the findings in relation to earlier studies were conducted. Recommendations to improve clinical supervision were made in order to improve the experiences of learner nurses during training. The findings of the research will be made available through the University of Fort Hare library and the Life College of Learning. Furthermore the information of this study will be shared with colleagues and will be published in an accredited nursing journal such as Curationis as well as other journals.control, coercion or exploitation. The following findings were evident: Three main themes emerged from data analyses. These comprised inadequate clinical supervision, satisfactory clinical supervision and suggestions and inputs regarding clinical supervision. Detailed discussions about the findings in relation to earlier studies were conducted. Recommendations to improve clinical supervision were made in order to improve the experiences of learner nurses during training. The findings of the research will be made available through the University of Fort Hare library and the Life College of Learning. Furthermore the information of this study will be shared with colleagues and will be published in an accredited nursing journal such as Curationis as well as other journals.