This study was aimed at investigating the attitudes of nurse managers towards quality improvement programmes in the East London Hospital Complex. The research design comprised a qualitative, exploratory and descriptive approach. A purposive sample of 10 nurse managers participated in the study. The data were collected through interviews, using a semi-structured interview guide. Interviews were recorded using audiotape. Data were analysed manually and by using the computer software Atlas ti. Positive and negative themes were identified and ethical consideration was ensured by means of privacy, confidentiality and anonymity. The findings revealed that nurse managers in the East London Hospital Complex had overall positive attitudes towards quality improvement programmes. A few negative attitudes and their contributory factors were also identified. The limitations of the study and recommendations based on the findings of the study are presented

The purpose of this study was to determine the contribution of unit managers towards the training of student nurses coming to their units for clinical practica. The sample consisted of students training in the four nursing colleges in the Cape Peninsula, and unit managers working in health services accommodating students for clinical practica in the same area. The findings revealed that the majority of unit managers were teaching students whenever they had the opportunity. Generally unit managers were prepared for their teaching function, but many students were not satisfied with some clinical learning opportunities presented to them, for example drawing up patients' care plans, discussing patients' treatment plans when handing over report, giving assistance regarding patient care decisions and lending support when students are confronted with patient care problems. There appears to be a need to educate unit managers regarding these and other aspects of the students' training programme. / Health Studies / M.A. (Nursing Science)

The purpose of this study was to determine the contribution of unit managers towards the training of student nurses coming to their units for clinical practica. The sample consisted of students training in the four nursing colleges in the Cape Peninsula, and unit managers working in health services accommodating students for clinical practica in the same area. The findings revealed that the majority of unit managers were teaching students whenever they had the opportunity. Generally unit managers were prepared for their teaching function, but many students were not satisfied with some clinical learning opportunities presented to them, for example drawing up patients' care plans, discussing patients' treatment plans when handing over report, giving assistance regarding patient care decisions and lending support when students are confronted with patient care problems. There appears to be a need to educate unit managers regarding these and other aspects of the students' training programme. / Health Studies / M.A. (Nursing Science)

Health Studies / D. Litt. et phil. (Advanced Nursing Sciences)

This study investigated the attitudes and perceptions of nurse managers regarding cost containment issues in selected public hospitals in the Port Elizabeth metropole of the Eastern Cape. Four hospitals participated in the study, and 211 nurse managers completed questionnaires. The results obtained from the participants’ responses indicated that: ✦ Nurse managers are ill-prepared for many responsibilities regarding cost containment, and need appropriate orientation and preparation both during their initial formal, and during their nurse management and in service training in order to fulfil their “financial” or cost containment role more effectively. ✦ Nurse managers perceived the relationship between the productivity of staff and cost containment positively, but were reportedly unable to • prevent nurses from leaving their points of duty • curb the rate of absenteeism among nurses • reduce the number of resignations ✦ Nurse managers suggested that more effective hospital cost containment efforts should ensure that • effective security checks are performed to curb losses of stock and equipment • more public telephones are installed in hospitals • stricter controls regarding wheelchairs are implemented The rationalisation of staff and services, as well as specialised equipment among the four public hospitals could enhance these hospitals’ cost containment results. However, this would necessitate reorganising these hospitals’ services at provincial level. The nurse managers required more knowledge about hospitals’ financial management and cost containment issues. Guidelines for such a course were developed addressing: analysis of monthly variance reports; budgeting for manpower; balance statement; calculations for the supplies and expenses budget; income statements; the hospital’s budgetary cycle; break-even analysis; analysis of cost-effectiveness and cost-benefit analysis. / ADVANCED NURSING SCIENCES / D.Litt. et Phil.

The aim of this study was to develop an empowerment model that could be used to enhance nurse leaders’ participation in health policy development. The study explored the extent of nurse leaders’ participation in health policy development; built consensus on: essential leadership attributes and facilitators and barriers to nurse leaders participation in health policy development. A Delphi survey was applied which included the following criteria: expert panelists, iterative rounds, statistical analysis, and consensus building. The expert panelists were purposively selected and included national nurse leaders in leadership positions at the nursing professional associations, nursing regulatory bodies, ministries of health and universities in East Africa. The study was conducted in three iterative rounds. There were 78 expert panelists invited to participate in the study, the response rate was 47% for the first round, 65% for the second round and 100% for the third round. The data collection was done with the use of semi structured (first round) and structured questionnaires (second and third rounds). Data analysis for the first round was done by examining the data for the most commonly occurring categories. The second and third rounds were quantitative and descriptive statistics were used. The consensus accepted for the second round was 90%, and for the third round consensus was 70%. The findings of the study indicate that nurse leaders participate in health policy development though participation is limited and not consistent across all the stages of health policy development. The study revealed consensus on essential leadership attributes required for nurse leaders’ participation in health policy development, including transformational attributes, political skills, interpersonal and communication skills. The facilitators to nurse leaders’ participation in health policy development pertain to: knowledge and skills, involvement, image of nursing, support, structures and processes. Whereas, the barriers relate to: involvement, image of nursing, structures and processes. An empowerment model for nurse leaders participation in health policy development was developed. Implementation of the model may lead to enhance nurse leaders participation in health policy development. / Health Studies / D. Litt. et Phil. (Health Studies)

This study investigated the leadership challenges encountered by nurse unit managers and factors enhancing leadership in their units. Currently in South Africa’s private hospitals, nurse unit managers face challenges such as financial management, cultural diversity, new roles and technology. The aim of the study was to develop a support strategy for unit managers to achieve success in their leadership role. This study was conducted at a private hospital in Gauteng Province, South Africa. A qualitative research approach was followed. Data were gathered using semi structured individual interviews with a purposive sample of six operational unit managers with one and more years working experience as unit managers. Qualitative open coding for data analysis methods and presentation were employed. Three themes emerged from the findings namely, factors influencing the leadership role of the unit manager, the challenges encountered by unit managers in their leadership role and the needs of unit managers. The factors influencing the leadership and management roles were related to the challenges encountered by nurse unit managers in running their units. The findings indicate that a key need required of the unit manager is support and direction from executive management. From the needs expressed by the nurse unit managers, ideas were formulated by the researcher to support the development of a strategy to support the unit managers in their leadership role. The strategy includes eight key elements and is presented in the section that follows. / Health Studies / M.A. (Nursing Science)

Health Studies / D. Litt. et phil. (Advanced Nursing Sciences)

This study investigated the attitudes and perceptions of nurse managers regarding cost containment issues in selected public hospitals in the Port Elizabeth metropole of the Eastern Cape. Four hospitals participated in the study, and 211 nurse managers completed questionnaires. The results obtained from the participants’ responses indicated that: ✦ Nurse managers are ill-prepared for many responsibilities regarding cost containment, and need appropriate orientation and preparation both during their initial formal, and during their nurse management and in service training in order to fulfil their “financial” or cost containment role more effectively. ✦ Nurse managers perceived the relationship between the productivity of staff and cost containment positively, but were reportedly unable to • prevent nurses from leaving their points of duty • curb the rate of absenteeism among nurses • reduce the number of resignations ✦ Nurse managers suggested that more effective hospital cost containment efforts should ensure that • effective security checks are performed to curb losses of stock and equipment • more public telephones are installed in hospitals • stricter controls regarding wheelchairs are implemented The rationalisation of staff and services, as well as specialised equipment among the four public hospitals could enhance these hospitals’ cost containment results. However, this would necessitate reorganising these hospitals’ services at provincial level. The nurse managers required more knowledge about hospitals’ financial management and cost containment issues. Guidelines for such a course were developed addressing: analysis of monthly variance reports; budgeting for manpower; balance statement; calculations for the supplies and expenses budget; income statements; the hospital’s budgetary cycle; break-even analysis; analysis of cost-effectiveness and cost-benefit analysis. / ADVANCED NURSING SCIENCES / D.Litt. et Phil.

The aim of this study was to develop an empowerment model that could be used to enhance nurse leaders’ participation in health policy development. The study explored the extent of nurse leaders’ participation in health policy development; built consensus on: essential leadership attributes and facilitators and barriers to nurse leaders participation in health policy development. A Delphi survey was applied which included the following criteria: expert panelists, iterative rounds, statistical analysis, and consensus building. The expert panelists were purposively selected and included national nurse leaders in leadership positions at the nursing professional associations, nursing regulatory bodies, ministries of health and universities in East Africa. The study was conducted in three iterative rounds. There were 78 expert panelists invited to participate in the study, the response rate was 47% for the first round, 65% for the second round and 100% for the third round. The data collection was done with the use of semi structured (first round) and structured questionnaires (second and third rounds). Data analysis for the first round was done by examining the data for the most commonly occurring categories. The second and third rounds were quantitative and descriptive statistics were used. The consensus accepted for the second round was 90%, and for the third round consensus was 70%. The findings of the study indicate that nurse leaders participate in health policy development though participation is limited and not consistent across all the stages of health policy development. The study revealed consensus on essential leadership attributes required for nurse leaders’ participation in health policy development, including transformational attributes, political skills, interpersonal and communication skills. The facilitators to nurse leaders’ participation in health policy development pertain to: knowledge and skills, involvement, image of nursing, support, structures and processes. Whereas, the barriers relate to: involvement, image of nursing, structures and processes. An empowerment model for nurse leaders participation in health policy development was developed. Implementation of the model may lead to enhance nurse leaders participation in health policy development. / Health Studies / D. Litt. et Phil. (Health Studies)