The study emanated from the researcher’s experience and involvement in clinical nursing and nursing management. The researcher noted how heavy losses of recruited professional nurses might have had an influence on the quality of service delivery. It is a costly and time-consuming task to recruit enough nurses into the profession and retention of staff is especially difficult. There had been a significant increase in the number of professional nurses leaving the district hospitals either to primary health care service, private hospitals or other countries. Before the commencement of the study the turnover rate at the district hospital where the study was conducted, almost doubled the accepted norm, which was ten percent of the staff. For those reasons the researcher decided to conduct a study named, “Accelerated staff turnover among professional nurses at a district hospital.” The constant heavy losses of qualified nurses from the profession constitute one of the serious challenges for nursing managers. The researcher wanted answers to the following question: “What were your experiences of your job as a professional nurse at the district hospital?” The objectives of the study were: · to explore and describe factors leading to high staff turnover of professional nurses at a district hospital · to develop guidelines to help retain professional nurses. The design of this study, which was conducted in one of the district hospitals in the Makana Local Service Area in the Eastern Cape, is qualitative, descriptive and contextual. Informed permission for conducting the research was obtained from relevant authorities and participants were asked to sign a consent form before the researcher proceeded with the study. Participants that met the selection criteria were selected by means of purposive sampling. Data was obtained by means of semi-structured telephonic interviews that were audio-taped and later transcribed verbatim. To ensure trustworthiness of the study, the researcher applied the four strategies as proposed by Lincoln and Guba (De Vos, 2002:351) namely, credibility, transferability, dependability and confirmability. Collected data was analysed according to the descriptive method proposed by Tesch (in Creswell, 1994:154). The services of an independent coder, who was provided with transcripts and a protocol to guide data analysis, were utilised. A consensus meeting was held between the researcher and the independent coder to discuss the identified themes and sub-themes. Following the data analysis, a literature control was undertaken to highlight the similarities to and differences in comparison between this and previous studies. Four major themes and sub-themes were identified through analysis.

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Commerce, Law and Management, Wits School of Governance, 2016 / CEOs of public hospitals in South Africa are often held responsible when their institutions fail to deliver good quality care and are associated with poor health outcomes. Negative perceptions prevail and particularly in the National Department of Health it is held that the CEOs are generally not adequately qualified, inexperienced, incompetent and often inappropriately appointed. This study attempts to articulate the CEOs views (their side of the story) and in particular how they perceive the challenges that they face and what solutions they proffer in improving the running of their institutions. This research is viewed through the lens of the New Public Management paradigm (NPM), in terms of Public Sector Reform and in particular Health Sector Reform in South Africa. Thirty CEOs of public hospitals in South Africa responded to a survey of their opinions. The majority (86%) of them felt they were unable to manage their institutions effectively. A subsequent qualitative study of CEOs and experts in public management using in depth interviews and further focus group discussions with CEOs and senior hospital managers revealed that the major challenges that the CEOs faced were financial, human resources and operational management issues. Procurement and information challenges were linked to financial and human resources deficiencies, lack of accountability mechanisms and the presence of corruption. The Performance Management System currently in place did not work appropriately and was driven by perverse incentives. Political interference was also a pervasive problem. Their recommendations were that they needed clear and unambiguous delegations and the appropriate resources so that they can take full responsibility of their institutions. Clear accountability structures were paramount in achieving better health service management and care according to the advice of experts in public management as well as that of senior hospital managers. This requires the creation of enabling legislation and an appropriate accountability framework. The blanket application of NPM principles is also questioned. Selective application of the tools of NPM should be tested and consideration be given to the dimension of added public value in the South African public hospital context. / GR2018

The study explored the experiences of nurses regarding in-patients who attempt or succeed in committing suicide in a general hospital. The purpose of the study was to design support guidelines for the nurses who care for patients who attempt or successfully commit suicide whilst admitted at general hospital. A generic qualitative research approach was followed, using an exploratory and descriptive design. Data was collected through in-depth interviews from a purposive sample of six nurses who met the inclusion criteria. Content data analysis was done. The research findings revealed five themes. The findings indicate that the working environment was not safe for both the nurses and the patients; confused patients were unpredictable and withheld their intentions of suicide from the nurses. Nurses blamed themselves for in-patient suicide; as some are still living with feelings of guilt. Nurse unit managers provided support to the affected nurses; however debriefing sessions were not given to the affected employees. There were no clear guidelines on management of confused patients. Support guidelines for the nurses are presented in this study / Health Studies / M.A. (Health Studies)

Submitted in fulfilment of the requirements of the Degree of Master of Technology: Biomedical Technology, Durban University of Technology, 2013. / The purpose of the study was to evaluate knowledge and effects of Haemolytic Disease of the Newborn (HDN) in postnatal women from the Umgungundlovu District. Although the prevalence of HDN has declined because of prophylaxis from 45 cases per 10,000 births to 10.2 cases per 10,000 births but it is still a cause of infant and neonatal morbidity and mortality. The effects of the disease range from jaundice, kernicterus and in severe cases death. Methodology : An interviewer-administered questionnaire was used to obtain information about the knowledge and effects of HDN amongst postnatal women. The incidence rate was calculated using the number of cases that were found divided by the total number of deliveries during the study period. A total of 300 women were interviewed. SPSS version 19.0 was used to analyse data. Findings : Fifteen (15) of the 300 women had babies with confirmed HDN and only four of the 15 (26%) women had knowledge of HDN. Two hundred and eighty five women had babies with jaundice but were not affected by HDN and, of these women, 12 (4.2%) of them knew what HDN was. Overall, only 16 (5.3%) knew what HDN was. All 15 women who had babies with HDN indicated financial and emotional effects because of HDN. The total incidence was 0.09% for the first 12 months of the study period. Conclusion : Postnatal women with jaundiced babies lack knowledge of HDN and HDN has financial and emotional effects on these women. Although the incidence rate of HDN was found to be even smaller than previously reported, it still exists and threatens the lives of infants and neonates.

Submitted in fulfillment of the requirement for the Masters Degree of Technology (Public Relations Management), Department of Public Relations Management, Durban University of Technology, Durban, South Africa, 2015. / In South Africa, the media coverage and the general perceptions of the public about public hospitals have been pervasively negative and this has resulted in the overshadowing of the good work being done in hospitals. In an effort to overcome these negative perceptions, the Kwazulu-Natal Department of Health has introduced the practice of public relations in public hospitals since 2001. This effort is in line with the National Health Act 2004 (Act No 61 of 2003). The act is described by the Health Systems Trust to rest heavily on the Constitution which, amongst other things, requires the State to take reasonable legislative and other measures to progressively achieve the right of access to health care services, and reproductive health care, within its available resources. The rationale behind the introduction of public relations was that, by managing and influencing the public’s perceptions, public relations professionals in public hospitals would initiate a sequence of behaviours that would contribute towards the achievement of the hospitals’ objectives. However, are relevant stakeholders aware of the presence, the role and the functions of public relations in public hospitals? Based on the above, this study seeks to evaluate public relations practices within selected public hospitals in Kwazulu-Natal, South Africa. The study is qualitative, cross-sectional and descriptive in nature. Data will be collected through observation, questionnaires and interviews. The findings revealed that a lot more needs to be done by both the Department of Health in KwaZulu-Natal and hospital CEOs in order to benefit greatly from the practice of public relations in public hospitals as public relations practitioners are under-utilized. Issues of budget constraints, lack of public relations understanding by hospital CEOs are some of the factors impacting negatively the function of public relations in hospitals. It is more of a technical role that public relations practitioners play in public hospitals. This study came to the realisation that not enough attention is given to the practice of public relations in public hospitals. One of the major recommendations is that public relations practitioners should participate in the strategic management processes and be part of the planning process and they should use public relations strategies to build harmony between the hospital and all its external and internal publics. For public hospitals to realise the need and value from the function of public relations, they have to appreciate that the practice of public relations has grown over the years and they have to employ effective public relations practitioners in order to accomplish their goals.

The purpose of this study was to describe the perceptions of the bridging programme graduates regarding their preparedness to manage a nursing unit .Quantitative; descriptive survey design was used with a structured questionnaire as data collection instrument. The sample included 58 bridging programme graduates who had completed their training at a private nursing school and was working at seven private hospitals in KwaZulu Natal. The graduates reported competence in performing some but not all management competencies addressed by this survey. Some graduates reported they were placed in charge of the nursing unit, in spite of not feeling competent, as early as in their first month. Recommendations with regard to nursing education, nursing practice and further research, specifically relating to improvement of management competencies for new graduates, were made / Health Studies / M.A. (Health Studies)

Thesis (MA (Psychology))--University of Stellenbosch, 2007. / Much research has focused on the social and psychological dimensions of nursing; yet we have not identified the thoughts and feelings of health care professionals as a priority in trying to understand a variety of nursing phenomena. There is a need to explore how nurses understand their social and psychological worlds, specifically with regards to the phenomena of violence, abuse and neglect within health care. Therefore, this study has attempted to answer the following research question: How do nurses understand and talk about the occurrence of violence towards patients? The research question demanded the use of qualitative methods to collect and analyse data. In-depth interviews, consisting of open-ended questions were conducted. 11 female participants were enlisted from a tertiary hospital labour ward in Cape Town by means of convenience sampling. Data were transcribed and analysed using a combination of methods. In addition to more traditional methods, I have also included autoethnography in this thesis.

Thesis (MPA (School of Public Management and Planning))--University of Stellenbosch, 2005. / South Africa, as a young and emerging democracy, faces many challenges regarding the transformation of the socio-economic landscape of the South African society. The provision of better health care services and the overall development and empowerment of society are some of the many challenges government has to resolve. This research focuses specifically on service delivery in public hospitals with special emphasis on: 􀂙 An assessment of financial management outcomes within the context of the implementation of the Public Finance Management Act (Act 1 of 1999, as amended) [PFMA] in public hospitals; and 􀂙 An assessment of supply chain management (SCM) outcomes in relation to the achievement of empowerment and equity of disadvantaged communities within the context of Black Economic Empowerment (BEE). The PFMA is the result of financial reform in South Africa. The PFMA emphasises effective, efficient, economic and transparent use of public funds. This research assessed the financial management at the Head Office of the Western Cape Health Department, as well as at Karl Bremer, Lentegeur and Swellendam Hospitals for the financial years 1998/99 to 2002/03. The Western Cape Tender Board ceased to exist in December 2003. The procurement and provisioning processes have now been decentralised to the various departments with effect 1 January 2004 and have become the responsibility of supply chain units within departments. BEE and the preferential procurement policy are government initiatives that had to be executed on SCM as platform. The three hospitals were also used to assess progress on the implementation of SCM, as well as the realisation of BEE objectives. Annual Reports, Audit Reports and Strategic Planning documentation were used to extract the relevant information necessary for the research. Interviews with nineteen (19) officials were conducted. Good progress has been made with the implementation of the PFMA. All those officials that were interviewed displayed sensitivity for the responsible management of public funds. A lack of internal control measures was identified in almost all audit reports. The absence of a risk management plan and a functional internal audit unit is hampering the realisation of the objectives of the PFMA. With health care service delivery and black economic empowerment being topical issues in SA, this research endeavours to make recommendations that could assist the Western Cape government with the realisation of the intended objectives of better health care services delivery by public hospitals, transformation of the economy, equity and empowerment of the disadvantaged through SCM processes and eventually to secure “a better life for all”.

Thesis (MDF)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: The research on this topic was motivated by the concern about the state of disarray in the public hospitals infrastructure and that due to budget constrain across the globe, the governments can no longer afford to provide public health services alone without the assistance of the private sector. South African public healthcare system continues to function in a state of disarray. Public hospitals serve the vast majority of the South African population, but are underfunded and in most cases these hospitals have ailing infrastructure. The study will look at the mechanism to fund public hospitals. This study examines the role that the Industrial Development Corporation and the Development Bank of Southern Africa can play in addressing the gap that exists in funding public hospitals. It will attempt to answer the following questions of concern, how is public healthcare financed in South Africa, what are the major challenges in financing public hospitals, what is the current role played by the Industrial Development Corporation and the Development Bank of Southern Africa in funding the public hospitals and what are the other possible solutions to address these challenges. The findings indicate that, despite the government funding the public hospitals there is a shortfall of funds for hospitals to complete the project that they are engage in. Chris Hani Baragwanath Academic Hospital and other five cases of hospitals in KwaZulu Natal were looked at and confirmed that there is definitely a gap in funding public hospitals

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2016. / Introduction Registered midwives are expected to practice their duties within the parameters of their scope of practice. Pregnant women have certain expectations about the midwife and their skills. If such expectations are not met, substandard care occurs. Such substandard care has a negative impact for both the pregnant woman and the Department of Health. Aim of the study The aim of this study was to explore and describe the experiences of midwives working in maternity units, concerning midwifery practice breakdown in maternity units at a public hospital in KZN. Methodology A qualitative research study that was exploratory, descriptive and contextual in nature was conducted. Semi-structured interviews were conducted with 13 midwives. Data was transcribed verbatim then organised into codes. Results The study revealed that the majority of the participants faced practice breakdown almost daily and most of the midwifery practice breakdowns start during antenatal care visits. Midwives who attended to pregnant women during antenatal care did not follow set protocols and guidelines and this resulted in complications during delivery. Most midwives were emotionally stressed and did not wish to continue practicing midwifery. Midwives were of the opinion that the management did not care about their challenges and did nothing to resolve the challenges. / M