published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (M. Nurs.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 180-193).

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Thesis (MEd) -- University of South Australia, 1998

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2005. / Appendices not included in e-thesis. Also held in print (65 leaves, 30 cm.) in Akoranga Theses Collection. (T 610.730690993 VAN)

Thesis (M.Nurs.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 142-150)

Introduction Patient safety IS fundamental to quality health and nursmg care and the ongomg improvement of patient safety is one of the most urgent issues facing health care today. Quality health and nursing care is a process which can be monitored, but which requires ongoing evaluation and change. The poor quality of patient care is a major problem of many hospitals in Rwanda and the University Central Hospital of Kigali, (CHUK), is no exception, especially in the Intensive Care Unit, (ICU). (Rwanda Ministry of Health Report, 2005). Pmpose of study The purpose of this study was to describe and explore the structure and processes of quality patient care at CHUK Intensive Care Unit, using the JFICM minimum standards, in order to improve the current quality of patient care and to further highlight gaps that might exist in this care for further research. Methodology The research was conducted in the Intensive Care Unit at CHUK. A checklist and self-reporting questionnaires, which were developed by the researcher, guided by the Joint Faculty ofIntensive Care Medicine (2003), constituted the instrument for this study. The sample consisted of 41 participants who were health care workers in the ICU and 20 of the patient's files. These files were used for researcher's observations during the period of data collection being 20thJune to 20th July 2008. A descriptive quantitative design was used. Results Design: While the ICU was in a self contained area with easy access to other departments the actual work environment did not comply with the recommendations of the JFICM (2003) minimum standards ofICU. ICU staffing: The staff consisted of only 1 medical doctor consultant and three specialist anesthetists. There were 11 Registered nurses (RNs) and 16 Enrolled nurses (ENs). A physiotherapist and dietician were available, but there was no biomedical engineer. The quantity of equipment was not adequate for the workload in the unit. There were no guidelines or protocols for nursing care and the unit had neither in-service training programmes nor research programmes available to the medical and nursing staff. While vital signs, ECG and oxygen were well monitored by using the nursing file (Appendix 10), the monitoring of patients was done without any guidelines or written procedures. The nursing reports, also, did not follow any guideline or procedure. Communications were generally poor because of the lack of equipment. The phone was not working for most of the time and there was no biotechnical engineer available to monitor the material and equipment. Conclusion According to the analysis of the structure and process standard based on JFICM (2003), the minimum standard of quality of ICU patient care at CHUK needs to be improved because the unit does not comply with an appropriate design, fulfil the staffing and operational requirements, or have the necessary equipment. Due to the shortage of qualified staff, plus the unavailability of protocols or guidelines, the processes of quality patient care were inadequate and need to be improved. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2009.

Aim: The aim of this study was to explore perceptions and practices of ICD nurses, when supporting families of critically ill patients, in two hospitals in Blantyre, Malawi. Methodology: A descriptive qualitative approach was used to explore perceptions and practices of ICD nurses, when supporting families of critically ill patients. Simpson's Conceptual Framework was used to guide this study. Purposive sampling was done where five nurses from a public and five from a private hospital were interviewed until data saturation. Repeat interviews were conducted at two week intervals, for data depth and verification. Each interview lasted 25-40 minutes. All interviews were tape recorded and transcribed. Manual data analysis was used to identify themes and categories. Documents used for family support care were also reviewed. Findings: The study revealed that nurses acknowledged that families experienced stress due to critical illness and ICD admission of their loved ones. The study also reiterated that families have psychological, social and spiritual needs, including the need for information, comfort and proximity to their loved ones. Nurses met the families' needs through empathy, dedication and commitment, inclusion of families in patient care and decision making and information giving to promote understanding and endurance during the stressful period. ICD nurses encountered some challenges when they provided support care to families, which included families' interference from wanting to be with their loved ones all the time, lack of clear policies to guide family support care, limited time to attend to the relatives due to shortage of nurses and nurses' own stress, especially when they did not have enough information to answer questions from families, when communication was inadequate from physicians to families. In addition all participants did not have formal training except "on the job" orientation, which was not enough to prepare them for family support care. Recommendations: Recommendations have been suggested for improvements m nursing practice, nursing management, nursing education and future nursing research. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

The aim of this study was to describe and compare the needs of families of critically ill patients in two adult ICUs from both the family and the nurses' perspectives. A non-experimental descriptive survey design with a quantitative approach was used to explore the family members' needs in an ICU situation. For this study, a non-probability convenience sample of 50 critical care nurses and 50 family members from adult Intensive Care Units (ICUs) in two tertiary hospitals was used. The Critical Care Family Need Inventory (CCFNI) (Molter, 1979) was used as a data collection instrument. There were different perceptions of family needs between families and nurses. Nurses were accurate with 21 (47%) of the 45 families' need items which was less than half of their perceived family needs compared to family members' perceptions despite the fact that the two groups were in agreement with 5 of the first 10 most important needs. Recommendations for future practice included incorporation of educational programmes for critical care nurses concerning family needs in ICU settings, and the provision of specific in-service training to improve communication skills. Critical care unit, critical care nurse, critically ill patient, family, family member, needs, perception, critical care nursing. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.