M.Cur. / The purpose of this study was to describe the clinical competencies of the shift leader in the ICU setting in order to determine if there is a gap between what is expected of the shift leader and what is happening in reality. A quantitative, descriptive design was used and cluster sampling implemented. A survey, utilizing questionnaires, was used to gather data from three clusters, comprising 11 hospitals from a single private healthcare group. 251 questionnaires were distributed and 98 were returned, indicating a response rate of 39%. Validity and reliability were ensured. Results indicated that respondents classified the majority of competencies as essential competencies. None were classified as critical competencies and only four were classified as specific competencies. Shift leaders were viewed as competent by all respondents in all three clusters. Results were used to describe a typology of the competencies of the shift leader in the ICU setting.

M.Cur. / Nursing practitioners working in the critical care unit are responsible for quality nursing care of the patient on pressure-controlled ventilation. Pressure-controlled ventilation is a high-risk interaction, with potential life-threatening complications, for example barotrauma.There are, however, in the South-African context no standards for pressure-controlled ventilation with which quality nursing of the patient on pressure-controlled ventilation can be evaluated. The following question is then asked in this study: Which standards should be formulated for the adult patient on pressure-controlled ventilation incritical care units? The goal of this study is then to formulate standards for the adult patient on pressure-controlled ventilation in critical care units. An explorative, descriptive and modified standard-generating research design is followed in this study. The research methodology as suggested by Muller (1998a:606-609; 1998b:636-637) for standard development during the quality improvement process is used in this study. Standard formulation consists out of three phases, namely a development phase, a quantifying-/ validation phase and a testing phase. During the development phase of this study, a literature study is conducted after which concept standards for the adult patient on pressure-controlled ventilation in critical care units are formulated. During the validation phase of this study, the concept standards are validated by means of a consensus debate session with clinical domain experts. Seventeen standards in total were formulated. Standard one to fifteen are structure standards. These standards address the ethico-legal, philosophical and management framework according to which the nurse practitioner functions during the nursing of the adult patient on pressure controlled ventilation in critical care units. It also includes the fascilitating context, as well as facilities, equipment, stock and medication, procedures and protocols and aspect of personnel development necessary to nurse the patient on pressure-controlled ventilation. Lastly in this group of standards the knowledge and skills which the critical care nurse requires for nursing the patient on pressurecontrolled ventilation are described. Standard sixteen is the process standard for nursing the patient on pressure-controlled ventilation.This standard is described as one comprehensive standard to facilitate easy use in practice and to address the nursing process holistically. Standard seventeen can be described as the outcome standard for the nursing of the adult patient on pressure-controlled ventilation and describes the expected aspects of quality improvement.

M.Cur. / The intensive care nurse practising respiratory nursing care, is responsible for giving high quality nursing care. Due to the rising cost of health care more pressure is placed on the nurse to provide a high quality nursing care (Sanazaro, 1986:27) Bruwer (1986:220-245) states that there is a need for an orderly, methodical qua l Ity assurance approach on all nursing levels in South Africa, based on a South African model, as well as the development of nursing standards for public and private hospitals. Mechanical ventilation forms an important part of the nursing of the adult critically ill patient in the intensive care unit. To ensure that the patient benefits from mechanical ventilation and does not suffer from complications due to mechanical ventilation, standards must be developed to ensure the giving of a high quality of nursing care. Without these standards it is impossible to determine the quality of their nursing care given. The quality can furthermore,only be questioned and not be determined scientifically. Standards for providing high quality nursing care to mechanically ventilated patients do not exist in South Africa. The quality of the nursing care that these patients receive is therefore questioned.

Nursing care is considered a primary predictor of patient assessment of the overall hospital experience. Yet, quality nursing care remains difficult to define. Limited research about nurse or patient perspectives on what constitutes quality nursing care in hospital settings prevents the identification of a shared description or insight into their possible interrelationship. Research about nurse and patient descriptions is needed to establish behaviors, attributes, and activities associated with quality nursing care to improve the health and well-being of hospitalized patients. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection