This study explored and described the impact of the rights and obligations of nurses on the delivery of quality patient care in a clinical setting. Quantitative research approach was utilised. Data was collected using a self-administered questionnaire. The research results revealed that respondents who participated in this study were aware of their rights and obligations, the effects and impact of factors influencing such rights and obligations on patient care. It was established that “patient abandonment” observed when nurses embark on a strike as their constitutionally enshrined right is not due to a lack of insight about their rights and obligations, but on how such rights and obligations are implemented. The researcher recommends that further research be undertaken to explore the causes of nurses embarking on strike actions despite their high level of knowledge concerning the impact of such actions on patient care in a clinical setting / Health Studies / M.A. (Health Studies)

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)

This study explored and described the impact of the rights and obligations of nurses on the delivery of quality patient care in a clinical setting. Quantitative research approach was utilised. Data was collected using a self-administered questionnaire. The research results revealed that respondents who participated in this study were aware of their rights and obligations, the effects and impact of factors influencing such rights and obligations on patient care. It was established that “patient abandonment” observed when nurses embark on a strike as their constitutionally enshrined right is not due to a lack of insight about their rights and obligations, but on how such rights and obligations are implemented. The researcher recommends that further research be undertaken to explore the causes of nurses embarking on strike actions despite their high level of knowledge concerning the impact of such actions on patient care in a clinical setting / Health Studies / M.A. (Health Studies)

Submitted in fulfilment of requirements for the Degree of Masters in Technology: Nursing, Durban University of Technology, 2013. / Introduction : Empirical research pertaining to spirituality has grown in the Western context, with a myriad studies, that have documented the salience of spirituality to health and wellbeing in relation to a range of issues such as HIV/AIDS, cancer and heart disease (Koenig et al. 2001:1189). It is against this backdrop that nursing scholars have begun to research the role of spirituality and spiritual care in nursing practice, in the Euro-American context. In South Africa research in this field is sparse, hence prompting the need for the current study. Problem statement : There is a huge gap in the South African nursing literature on spirituality and spiritual care, grounding the need for research in this area. Internationally however studies have grown focussing on the views of practitioners and faculty with regard to spirituality and spiritual care in nursing practice. Objectives : To explore the views of nurses at public hospitals in KwaZulu-Natal regarding the role of spirituality and spiritual care in nursing practice. To investigate nursing practitioners’ views on the salience of spirituality to patients. To investigate whether nurses utilize spiritually based activities in nursing. To investigate whether current nursing education and training has prepared nurses for spiritual care. Methodology : The study utilized a descriptive survey utilizing a cross-sectional design. A quantitative research design was utilized to survey nursing practitioners at selected public hospitals through a process of multiphase random sampling. Data was collected using survey questionnaires. Findings : Findings of this study have shown that nurses do accept spirituality and spiritual care as being part of their role. Participants (n=385) acknowledged that spiritual care is a component of holistic patient care. This aspect of care, they agreed, lacks the attention it seriously needs. In addition, majority of nurses considered nursing to be part of their spiritual path. Results indicated that the more spiritual nurses viewed themselves, the more positive their perspectives were towards providing spiritual care.

In today’s world healthcare all over the world is profoundly challenged by rapid technological advancements, violence, terrorism, diverse cultures, proliferating chronic diseases, and the worst nursing shortage. In addition to these complex and daunting challenges healthcare continue to focus the attention on hospitals to review and modify the way care is delivered to patients. As key role players and consistent members of the multidisciplinary team critical care nurses are uniquely positioned to modify and review the quality of patient care through synergy between the patients’ needs, the nurses’ competencies, and the critical care environment. A collaborative approach towards enhancing synergy in a CCU was undertaken in a CCU in a private hospital in Gauteng. The study was guided by the American Association for Critical Care Nurses Synergy Model for Patient Care and conducted within the critical social theory paradigm. The nature of the research was descriptive, explorative and contextual and both qualitative and quantitative approaches were used. Action research cycles were followed to assess existing synergy between the patients’ needs, the nurses’ competencies and the characteristics of the environment in the CCU. An action plan was formulated and implemented towards enhancing synergy in the CCU. The implemented plan was adjusted based on observations and reflections following each of the five cycles of the project / Health Studies / D. Litt. et Phil. (Health Studies)

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2008. / The South African Nursing Council believes that “quality nursing practice is based on adequate knowledge, skills or competencies, ethically and scientifically based comprehensive and holistic patient care, timely, accurate and complete or comprehensive recording” (SANC, n.d.). The aim of professional regulation is to protect the public from unsafe practices and to ensure quality services (SANC, n.d.). A shortage of nursing staff resulted in the implementation of a staffing strategy of increasing the work hours of nurses by ten hours a week. Patient complaints and unacceptable patient incidences resulted in it becoming essential to evaluate the effect of this strategy on patient care. As a goal of this study, the researcher decided to investigate the quality of patient care before the implementation of the strategy and the effect of the strategy on patient care after the implementation. The objectives of the study were set to determine whether • The patients were assessed according to activities of daily living and psychosocial data; • The nursing diagnosis was done • Nursing interventions are prescribed for each problem identified • The patients’ records were utilised to enhance individualised patient care and to ensure responsibility and accountability for patient care • The evaluation of patient progress was done according to the different prescriptions and interventions at least twice in 24 hours • A written final report for discharge criteria and health education was provided • A comparison of the quality of nursing care delivered before and after the implementation of the staffing strategy exist Research question What is the effect of an implemented staffing strategy in a selected hospital in KwaZulu-Natal on the quality of care delivered? Research methodology A non-experimental, descriptive design with a quantitative approach was applied. Population and sampling The target population for the study was patient care records of patients who were hospitalised during 2003. A non-probability convenience sample for a retrospective audit of a total of 372 patient care records over a period of 12 months was audited. An evaluation of the records was done and a comparison was drawn between the results obtained before and after the implementation of the staffing strategy. For both periods, 186 patient records were audited. The pilot study included the audit of 40 files. Reliability and validity were assured with a pilot study and the use of experts in nursing management, quality assurance, research methodology and statistics. The researcher audited the patient files personally. Ethical approval was obtained from Stellenbosch University and the ethics committee of the hospital. All principles related to ethics, such as confidentiality and anonymity, were maintained. Neither patient names were used nor the name of the hospital or wards from which the records were used. Codes were used to identify the hospital wards. The hospital was informed in the letter requesting consent to conduct the research, that the researcher intends publishing the findings of the research. Data analysis and interpretation Statistical associations using Chi-square tests were carried out to determine the significance between the various variables. The results of this study were presented in percentages, tables and histograms. Findings obtained showed that the quality of nursing declined after the strategy. Documentation of patient records was incomplete and did not meet legal requirements. Recommendations The implementation and maintenance of a quality assurance programme, human resource management, the on-going use of the nursing process and record keeping should be emphasised in the clinical practice environment and in the formal education environment.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Educators across the health professions are now concerned with the teaching and assessment of professional skills. Caring behaviour is one of the attributes of professionalism in the health sciences professions and in the nursing profession it is regarded as the essence of the profession. The aim of this study is to explore the understandings and experiences of caring behaviours of first- and fourth year nursing students and how they would like to be assessed about their caring behaviours in a curriculum where it is not overtly taught. This will be investigated according to Watson’s carative factors and theoretical framework of caring, while Bloom’s Taxonomy of the affective learning domain will also be consulted. The design of the study is qualitative and explorative. A purposive sample was drawn from first-year nursing students (n=64), and fourth-year nursing students (n=41) at one nursing education institution. The sample of students (n=105) from seven (7) private training hospitals in the Western Cape participated in nine (9) focus group interviews (n=10-15). Data analysis was done by means of a framework analysis approach with a deductive strategy. Research findings from this study are extensively discussed and will be used to inform the undergraduate nursing curricula in South Africa about the profiles of caring nursing students and to make recommendations about the internalisation of caring behaviours, according to the affective learning domain. / AFRIKAANSE OPSOMMING: Opvoeders vanuit die verskeie gesondheidsberoepe, is tans met die leer en assessering van professionele vaardighede gemoeid. Sorgsame gedrag is een kenmerk van professionalisme in die gesondheidsberoepe. In verpleegkunde word sorgsame gedrag as die kern van die beroep beskou. Die doel van hierdie studie is om die begrip en ervarings van eerste- en vierde-jaar verpleegkunde studente rondom sorgsame gedrag te ondersoek. ʼn Verdere doel is om te bepaal hoe hierdie studente graag geassesseer wil word oor hul sorgsame gedrag in ʼn kurrikulum waar hierdie kenmerk nie pertinent geleer word nie. Watson se sorgsaamheidsfaktore en teoretiese raamwerk oor sorgsaamheid, sal gebruik word om die onderwerp na te vors. Bloom se Taksonomie van die affektiewe leergebied sal gesamentlik met Watson gebruik word as teoretiese grondslag vir die navorsing. Die studie-ontwerp is kwalitatief en verkennend. ʼn Doelbewuste seleksie is gedoen om spesifieke eerstejaar verpleegkunde studente (n=64) en vierdejaar verpleegkunde studente (n=41) by die navorsing te betrek. Die geselekteerde studente (n=105) van sewe (7) private opleidingshospitale in die Wes-Kaap, het aan nege (9) fokusgroep onderhoude deelgeneem (n=10-15). Die data-analise is deur middel van ʼn raamwerk-analise benader en ʼn deduktiewe strategie is gebruik. Die resultate van hierdie navorsing word omvattend bespreek en sal gebruik word ten doel voorgraadse verpleegkunde kurrikula in Suid-Afrika te informeer rakende die sorgsaamheidsprofiel van verpleegkunde studente. Aanbevelings, volgens die affektiewe leergebied, word ook gemaak oor hoe sorgsame gedrag geïnternaliseer kan word.

In today’s world healthcare all over the world is profoundly challenged by rapid technological advancements, violence, terrorism, diverse cultures, proliferating chronic diseases, and the worst nursing shortage. In addition to these complex and daunting challenges healthcare continue to focus the attention on hospitals to review and modify the way care is delivered to patients. As key role players and consistent members of the multidisciplinary team critical care nurses are uniquely positioned to modify and review the quality of patient care through synergy between the patients’ needs, the nurses’ competencies, and the critical care environment. A collaborative approach towards enhancing synergy in a CCU was undertaken in a CCU in a private hospital in Gauteng. The study was guided by the American Association for Critical Care Nurses Synergy Model for Patient Care and conducted within the critical social theory paradigm. The nature of the research was descriptive, explorative and contextual and both qualitative and quantitative approaches were used. Action research cycles were followed to assess existing synergy between the patients’ needs, the nurses’ competencies and the characteristics of the environment in the CCU. An action plan was formulated and implemented towards enhancing synergy in the CCU. The implemented plan was adjusted based on observations and reflections following each of the five cycles of the project / Health Studies / D. Litt. et Phil. (Health Studies)

Submitted in fulfillment of the requirements for the degree of Master of Health Sciences (Nursing), Durban University of Technology, Durban, South Africa, 2017. / BACKGROUND: Quiet often when students return from clinical placement, complain of being abused by patients and their relatives. Student nurses view clinical placement as an anxiety producing part of the nursing programme (Magnavita and Heponiemi 2011: 208). As a result, some resign and leave nursing fearing for their lives. AIM OF THE STUDY: To determine the extent and types of violence experienced by student nurses from patients and their relatives or friends in public hospitals in KwaZulu-Natal, and whether this leads to intentions to leave the nursing profession. METHODOLOGY: A quantitative, descriptive cross sectional survey approach conducted amongst student nurses (n=421) at KwaZulu-Natal College Nursing R425 Program starting from their first year of training up to the midwifery module. Self-Administered Questionnaires (SAQ) were used to collect data and data analysed using SPSS version 23. RESULTS: All respondents (n=421) completed the SAQ (annexure B). Many student nurses, especially female students, are victims of intimidation, bullying and verbal abuse as opposed to physical and sexual abuse by patients’ relatives and patients. The workplace violence against student nurses resulted in anger and absenteeism. The majority have not reported any abuse and they were not even aware of any policy that exists in their institutions against any form of violence. DISCUSSION: Findings in this study revealed that student nurses, like all other nurses, were also at a high risk of workplace violence. This may be because nurses have the closest contact with patients and their relatives; hence they are at high risk of exposure to violence. Since all settings are potentially high risk for violence, it is therefore necessary for the management to improve security in all high-risk areas for the student nurses to be safe. RECOMMENDATIONS: Public hospitals and the Department of Health (DOH) needs to formulate clear policies regarding violence against student nurses, and information on how to report the occurrence. There is a need for development or improvement of policies, procedures and intervention strategies. The DOH needs to address the issues of violence by implementing strategies to create a supportive environment that facilitates empowerment for the positive emotional wellbeing of student nurses. Managers have the responsibility to create and maintain zero tolerance regarding workplace violence. Public hospitals need to employ Managers with required skills and higher education to deal with workplace violence. There is a need for further research and more details on workplace violence and its cause. / M

MCur / Department of Advanced Nursing Science