Violence in society has reached epidemic level and has permeated the walls of the workplace. Workplace violence has also spread across all occupations, especially those dealing with the public, and has escalated over the years. In this thesis the researcher explored the experiences, perceptions and coping mechanisms used by nurses exposed to violence in the health setting. The main focus was to determine how the nurses interpret abuse, and does this interpretation determine their response to the abuse.

A Dissertation in fulfillment of the requirements for the Degree of Master of Commerce by Research in Information Systems / Electronic Medical Records (EMR) systems aim to provide an integrated solution to a number of hospital processes, including supporting administrative functions such as patient billing, providing clinical guidelines, and allowing clinicians to order and view lab reports. Yet with all these possible benefits, like many other types of information systems and technologies, their impact on hospital performance has been a key area of interest and a source of debate. This study examines the extent to which EMR systems are available across South African hospitals as well as how well they have been integrated into the processes of the said hospitals. The diffusion of EMR systems means they are available in the relevant clinical units whilst their infusion suggests they are comprehensively embedded into the processes that they are meant to support. The most important question answered in this study was whether the diffusion and infusion of these systems had any impact on the performance of hospitals. Answering this question would aid decision makers on whether more effort is indeed needed to ensure their availability across units and their embedding into hospital processes. The study collected data from a number of hospitals in the private and public sector with multiple informants providing data on diffusion and infusion of these systems as well as on hospital performance. Performance measures included the hospitals’ economic efficiency, their clinical effectiveness, patient safety, and patient satisfaction. Key findings were that while there are performance benefits in the diffusion of EMR systems across units, the impacts are not always positive for some hospitals. Large hospitals were less likely to benefit from the diffusion of these systems. However the comprehensive use of these systems provided benefits for all types of hospitals, suggesting that while availability may be important, it is the comprehensive embedding of the EMR system into the hospital’s processes that is more beneficial to all types of hospitals. These results present further opportunity for research into why the impact of EMR systems is not always positive for some hospitals. / MT2017

Thesis (MTech (Human Resource Management))--Cape Peninsula University of Technology, 2018. / The principle of the right to strike is internationally documented, as determined by the Committee on Freedom of Association. In South Africa, the right to strike is enshrined and protected in Section 23 of the country's Constitution under its Bill of Rights. Under specific circumstances, the Constitution allows for legislation to limit a right listed in Section 23. At the same time, the Constitution guarantees that everyone has the right to life and health care services. South African industrial action is regulated by the Labour Relations Act (LRA) No. 66 of 1995, as amended, which precludes workers who are employed in essential services from striking, because interruption of these services may endanger lives. However, the LRA also provides for the conclusion of a Minimum Service Agreement (MSA), where minimum services replace essential services. No MSA has been ratified since the LRA was promulgated in 1995. It is on this premise that the author investigated the mechanisms which have been put in place to create a balance between the right to strike and the need to provide essential services in the event of a strike. This study used a qualitative research design. Open-ended questionnaires were distributed to the target research sample. Purposive sampling was applied to a total of 30 participants who were selected from the Western Cape Department of Health's essential services. The qualitative data was analysed using theme identification to make sense of the findings. The research results reveal that employees who are providing essential services have the right to strike only if certain conditions are met. One of these conditions is the conclusion of a Minimum Service Agreement (MSA) to ensure a balance between the rights of health workers to strike and the rights of citizens to be provided with health care services. This agreement provides the duties and responsibilities of the employer and employees for the continuation of minimum services in the event of a public sector strike to ensure that service delivery is not interrupted. Specific recommendations are made by the researcher regarding the MSA, and measures are discussed to ensure that the minimum services within essential services remain operational in the event of a public sector strike.

Thesis (DTech. degree: Food and Beverage Management ) -- Tshwane University of Technology, 2012. / Evaluates the present food-service systems in use in public hospitals based on related indicators. This was done with the view of proposing, should it be found necessary, a more comprehensive monitoring and evaluation tool that would be expected to improve food-service delivery and quality.

Violence in society has reached epidemic level and has permeated the walls of the workplace. Workplace violence has also spread across all occupations, especially those dealing with the public, and has escalated over the years. In this thesis the researcher explored the experiences, perceptions and coping mechanisms used by nurses exposed to violence in the health setting. The main focus was to determine how the nurses interpret abuse, and does this interpretation determine their response to the abuse.

Submitted in fulfillment of the requirements for the Master’s Degree in Health Sciences in Radiography, Durban University of Technology, Durban, South Africa, 2017. / Introduction Work related stressors are identified as the main reason for the decline in patient care in Radiography in public hospitals. Radiographers opt to leave the public sector because of stressful experiences. Research has shown that the scarcity of qualitative studies on the phenomenon makes it difficult to understand work related stress in relation to radiography as a profession. Aim of the study The aim of the study was to explore and describe work related stressors in Radiography at a public hospital in Gauteng, South Africa. Methodology This study was a qualitative, exploratory, descriptive study. An interview guide was used to elicit information from 10 participants through semi-structured interviews. All the interviews were one-on-one and were audio-recorded. The data were analysed through Tesch’s eight steps of thematic analysis. Findings The following three themes emerged during data analysis, namely: personal well-being of Radiographers; decline in quality patient care and impaired radiography service; and, environmental enablers. The findings of the study revealed that the participants’ general health was compromised by various factors pertaining to work related stress. Conclusion Interventions necessary for dealing with work related stressors are highlighted as a way of enabling improvement of the working environment conditions. The participants in the study felt that hiring more staff could alleviate their work related stressors. The study has shown that it is also imperative that staff and management are constantly communicating well. / M

There is increasing concern that newly qualified registered nurses (RNs) find it difficult to make a smooth transition from completing their four-year nursing training to taking up their posts as first time RNs. In a constantly changing healthcare system, these newly qualified RNs are expected to work independently and be competent in applying the decision making and problem-solving skills gained during their training. While certain aspects of clinical incompetence may be ascribed to individual factors, the importance of the clinical learning environment and its influence on the development of clinical competence cannot be ignored. Nurses need support and guidance to effect a successful transition from being novice to competent nurse and the environment is regarded as important in developing technical competencies. The research study followed a positivistic, quantitative paradigm, where the hypothesized relationship between clinical learning environmental factors and clinical competence of newly qualified RNs were explored. Data was collected from the experienced RNs in the hospitals by means of a structured pre-existing questionnaire, namely the Competency Inventory for Registered Nurses (CIRN). Descriptive statistics and inferential statistics were used to analyse data. The analysed data was used to describe the findings. Recommendations were made based on the findings. Results suggested that the development of clinical competence is dependent on both the individual and context. Positive relations were reported between clinical learning environmental factors and clinical competencies.

Thesis (MTech (Office Management and Technology))--Cape Peninsula University of Technology, 2017. / Healthcare facilities across South Africa are increasingly facing a myriad of societal, fiscal, political and cultural challenges associated with demands for greater quality in the provision of healthcare services. This study measures service quality and customer satisfaction at a Cape Town hospital (hereinafter referred to as Hospital X), with the aim of providing its management with information to enable them to enhance service quality and thus improve customer satisfaction. It is essential to note that the respondents in this study were the parents or guardians of patients. The views of the patients were not obtained directly from them as it would have been unethical for minors to have participated in the survey. Their parents or guardians were surveyed in order to obtain the requisite data. The problem investigated was that management at public hospitals does not regularly research what customers need from a service quality point of view, Therefore, Hospital X may be failing to provide a quality service to its customers, namely, parents and guardians. Against this background, the researcher set out to measure customer perceptions and expectations of service quality by making use of the SERVQUAL model. “Customer expectation” is what the customer can reasonably expect given the available resources and is likely to be influenced by personal needs and past experience. “Customer perceptions” are totally subjective and based on the customer’s interaction with the service provided at Hospital X. The SERVQUAL model (reliability, assurance, tangibles, empathy and responsiveness), is commonly known as the RATER model, RATER being an acronym formed from the first letter of each of the five dimensions of SERVQUAL. The study incorporates the SERVQUAL dimensions within a survey comprising a number of questions structured on a six-point Likert scale. The results of applying the SERVQUAL model will indicate whether or not Hospital X provides a quality service to their customers. The study seeks to demonstrate the importance of service quality and customer satisfaction to hospital management, as well as the impact that effective service quality can have on customers’ evaluation of their overall hospital experience. (The term customer will be used interchangeably with parent and/or guardian in this study.)

The primary purpose of CTG is to detect early signs of intrapartum hypoxia and improve foetal outcomes. Intrapartum hypoxia remains the major cause of perinatal deaths mainly in monitored labours. This is attributed to the midwives’ lack of skills in the foetal implementation and interpretation of CTG. Midwives interpret foetal heart rate patterns erroneously hence they fail to detect early signs of severe foetal compromise. Accurate interpretation of CTG is the cornerstone for clinical decision during intra-partum foetal surveillance. Therefore, it is mandatory that midwives are competent in CTG. The purpose of the study was to explore and describe the perceptions of midwives in KwaZulu-Natal public hospitals regarding their level of competence related to the CTG. The purpose of the study was to explore and describe the perceptions of midwives in KwaZulu-Natal public hospitals regarding their level of competence related to the CTG. The objectives of this study were: -to explore and describe the perceptions of the midwives regarding their level of competence relating to cardiotocography. -to establish the levels of competence of midwives in relation to CTG. -to develop clinical guidelines that could be utilised by midwives in the implementation and interpretation of the cardiotocograph. The study utilised a quantitative non-experimental comparative descriptive research design. A self-developed and self-administered questionnaire was developed under the supervision of a statistician and was to collect data from a purposively selected sample of midwives who work in labour wards in Kwa-Zulu Natal public hospitals. A sample of 226 practicing midwives working in labour wards of the nine KZN public hospitals was selected using a non-probability convenience sampling method; only 125 responded. Data were collected on an excel spread sheet and analysed under the supervision of the statistician and research supervisor. The researcher assured of validity and reliability of the data collection method and data as well as of the data collection instrument. The findings revealed that the midwives in KZN public hospitals perceived themselves as being competent regarding CTG tasks; however they lack knowledge and skills in the implementation and interpretation of CTG. It was also evident that the midwives’ years of midwifery clinical experience, labour ward experience, possession of additional post basic midwifery qualification and the perceived level of competence related to CTG tasks number of years of the midwives did not influence their level of competence in the implementation and interpretation of CTG. Literature control supported these findings and there was consistency with that literature. Recommendations were made and clinical guidelines were developed to assist midwives with the assessment of foetal heart rate and the interpretation of the cardiotocograph results.

The Port Elizabeth (PE) hospital complex is one of the public hospital groups in South Africa facing a critical shortage of medical practitioners, with reference to doctors in particular. In the quest of finding how to retain doctors in the hospital complex, the aims of this research were to survey doctors’ career intentions; to investigate factors that could be contributing to these career intentions so as to uncover some of the reasons why doctors are leaving the public sector; and to identify effective ways in which the government and hospitals might improve retention by pointing out areas that need improvement. The factors that influence doctors’ career intention included income, work conditions, risk of contracting infection, risk of injury at work, hours of work, work load, work related stress, paid leave days, resources, personal growth and development opportunities, ongoing training opportunities, advancement and promotion opportunities, relation with co-workers, relations with supervisor/superiors, and sense of meaning. Findings revealed that even though the tendency to leave’ group (43%) was smaller than the ‘tendency to stay’ (57%), the majority (85%) of those who intended to leave were younger doctors. Despite some significant differences in responses between the two groups, results revealed that both groups were dissatisfied with almost all conditions of work apart from relationships with supervisors and co-workers. To a large extent, both groups revealed that work conditions are better in the private hospitals than in their current hospitals. viii The fact that some doctors could stay in the public hospital sector despite intense dissatisfaction with conditions of work, and despite the perception that that there are better options in the private hospitals could be attributed to the fact that most of these doctors are older and are at their retirement stage . Adding to this is that most of these doctors, who indicated willingness to say, scored high in sense of meaning as a factor influencing their career intention. This research was based on the assumption that there was no retention strategy put in place to solve the problems facing PE hospital complex. However, during this research a strategy was being developed and implemented by the Eastern Cape Department of Health. Therefore, evaluation and recommendations of the strategy are provided in the conclusions of the study. These recommendations relate not only to the implementation of the strategy, but improving it to accommodate all problems currently facing the doctors and finding ways and means of making the strategy sustainable; creating private-public partnerships; focusing on creating a sense of meaning amongst the doctors (especially the younger ones) and focusing on retaining the risk group which was the younger doctors.