MPH / Department of Public Health

Department of Public Health / MPH

MCur / Department of Advanced Nursing Science

MCur / Department of Advanced Nursing Science / See the attached abstract below

PhDH / Department of Advanced Nursing Science / Introduction and background Professional nurses are responsible to supervise student nurses in the clinical areas in order to assist them in achieving the learning outcomes, develop clinical skills and competence; however, this role is overlooked as pinned to different factors influencing clinical supervision, including the related challenges regarding supervision. This study aimed to explore and describe professional nurses’ and student nurses’ perceptions of clinical supervision in training hospitals of Limpopo Province, South Africa. Research methodology The study used convergent parallel mixed methods design. The population in this study was professional nurses and student nurses working in seven training hospitals of Mopani and Vhembe district of Limpopo Province. Purposive sampling was used to sample districts, hospitals and student nurses whereas, convenience sampling was used to sample professional nurses. Self-administered questionnaires and focus group interviews were used in data collection. Quantitative data was v analysed using Statistical Package of Social Science (SPSS), version 22.0 and Tesch’s’ method was used to analyse qualitative data. Findings Perceptions of professional nurses and student nurses revealed several factors influencing supervision and challenges such as staff shortages, high number of student nurses allocated in clinical areas, heavy workload, inadequate material resources, poor communication and inadequate support. The findings were used in formulation of clinical supervision guidelines. Recommendations The recommendations of this study were based on the study findings. Intervention on the challenges of clinical supervision is recommended by utilisation of the formulated guidelines. This will assist in closing the existing gap regarding clinical supervision. / NRF

MCur / Department of Advanced Nursing Science / Background: The heavy workload of hospital nurses is a major problem globally. Nurses are experiencing higher workloads than ever before due to four main reasons, increased demand for nurses, inadequate appointment of new nurses, reduced staffing and increased overtime and reduction in patient length of stay. It is necessary for South Africa to find ways to reduce nursing workload and improve patient safety particularly in rural areas, to understand these effects of nursing workload on patient safety, the study was conducted with professional nurses from selected hospitals in Vhembe district, Limpopo Province. Purpose: The purpose of this study was to determine and to assess the effects of nurses‘ workloads on patient safety in the selected public hospitals, Vhembe District, Limpopo Province, South Africa. Methodology: Quantitative, exploratory descriptive design was adopted. Self-administered questionnaires were used for data collection from the sampled hospitals in Vhembe district. Hospitals were sampled based on the statistics of admitted patients in medical and surgical wards. Target population were professional nurses with at least two years working in the sampled wards. Ethical considerations were maintained. Results: There are several important consequences of high nursing workload. Findings show that a heavy nursing workload adversely affects patient safety. The study also shows that majority 80 (79.0%) of the respondents were overloaded by nursing responsibilities and this negatively affects nursing job satisfaction. As many as 55 (54.4%) indicated that such v workload contributes to high turnover and the nursing shortage. In addition to the higher patient acuity, work system factors and expectations also contribute to the nurses‘ workload: nurses are expected to perform non-professional tasks such as delivering and retrieving food trays; housekeeping duties; transporting patients; and ordering, coordinating, or performing ancillary services Conclusion: Nursing workload is affected by staffing levels and the patients‘ conditions, but also by the design of the nurses‘ work system. The study showed that a work situation above the assumed optimal level increases the risk for adverse events and patient mortality. However, the resources for nursing staff are limited in all public hospitals where the study focused. Professional nurses, therefore, must use available resources in the most optimal way. The study also recommended that there should be a creation of the nursing posts and the filling of all vacant positions in South Africa. Continuity of in-service training to empower professional nurses on patient safety was emphasised. / NRF

MPH / Department of Public Health / Despite the availability of the South African cervical cancer screening guidelines at clinics, women are still seen in the out-patient department of selected rural district hospital in Thulamela Municipality, referred from Primary Health Care (PHC) facilities with no cervical cancer screening results. Thus, cervical cancer screenings are done at a hospital and results often came back positive for cervical cancer. Such practices pose a risk of delayed cervical cancer diagnoses and its discovery at an advanced stage, increasing cervical cancer mortality rates. The purpose of this study was to investigate the compliance of professional nurses at primary health care facilities to the South African cervical cancer screening guidelines in Thulamela Municipality. This study adopted a qualitative approach as it aimed to get a better understanding on compliance of professional nurses regarding South Africa’s cervical cancer screening guidelines. Nonprobability sampling was used to select primary health care facilities including interested participants who were judged to possess the information that was required to answer the research question of this study. The sample size of the study was determined by data saturation. Trustworthiness was ensured by four criteria of Guba and Linclon, namely credibility, transferability, dependability and confirmability. A digital recorder was used to log individual responses during interview sessions. Data from the digital recordings were transcribed verbatim. Results were analysed and interpreted thematically. This study established that clinic professional nurses are non –compliance to the South African cervical cancer screening guidelines; nurses face several challenges such as inadequate knowledge of the cervical cancer screening guidelines, shortage of resources and shortage of staff. Recommendations that emanated from the discussion of the findings and the conclusion of this study are likely to have implications and applications for supporting and advancing the cervical cancer screenings. / NRF

MCur / Departrment of Advanced Nursing Science / In mental health, a Maximum-Security Ward is a special setting for care of patients who are unique and exceptional. People who have committed crimes due to their mental conditions are admitted for care, treatment and rehabilitation. Patients admitted in this ward are verbally and physically aggressive, violent, unpredictable, unmanageable and at times manipulative. Professional nurses working in the Maximum-Security Ward are at risk of suffering from occupational stress, burnout, lack motivation and are anxious. The aim of this study is to investigate the experiences of professional nurses working in the Maximum-Security Ward at Hayani hospital. A qualitative approach using a descriptive, exploratory and contextual design was used. A purposive, convenient sampling was used to sample professional nurses working in the Maximum-Security Ward of Hayani hospital. In-depth interviews were used to collect data. A voice recorder was utilised to record all data and the researcher being the main instrument for data collection. Dependability, confirmability and transferability were upheld to ensure trustworthiness of the findings. Data was analysed using Tech’s eight steps approach. Three themes with their categories and subcategories emerged after data analysis. The themes were as follows: the participants’ views on type of patients admitted in the ward, participants’ views on safety in the ward and participants’ views on staff interaction. The study recommended the following: Emotional counselling and debriefing sessions to be conducted at regular intervals or after a traumatic incident. Motivational and team building activities to be organised for professional nurses. Safety of professional nurses must be of significant value. More support is needed in times of emotional difficulties. Development of a model to support professional nurses. / NRF

MCur / Department of Advanced Nursing Science / Stress management is a major challenge in South Africa, as well as other countries. Job stress has negative effect on professional nurses ’rendering of patient care. They should thus be able to manage their stress successfully in order to render quality nursing care to the customers. The purpose of the study was to identify and describe factors contributing to stressors among professional nurses, the effects of stressors on the wellbeing of professional nurses and the management of stress by professional nurses. METHOD: A quantitative, exploratory, descriptive design was utilised. The target population of this research study comprised of all professional nurses who were at work the day the researcher visited the sampled hospitals. The questionnaires were used to collect data from the sampled professional nurses, and descriptive statistic was used to analyse the data. RESULTS: The findings revealed that 45% of the professional nurses experienced pressure of work without rest, whereas 75% viewed changes at work as challenging and 15% mostly experienced accidents while on duty. Most of them indicated that they had previously iii experienced anxiety and that they did not engage in exercise. The finding further revealed that EAP is not facilitated in most institutions and that 97.4% of the professional nurses like to have more knowledge on management of stress. The results of this study may be useful to the entire population of health professionals, policy

MCur / Department of Advanced Nursing Science / Background: The Mother-Baby Friendly Initiative (MBFI) promotes and supports breastfeeding in environments such as clinics, community health centres and hospitals that have fully-functioning maternity units. The implementation of the Mother-Baby Friendly Initiative in hospitals is associated with significant increases in the initiation and duration of exclusive breastfeeding (EBF). The Mother-Baby Friendly Initiative also leads to improved healthcare for infants, children and provides improved maternal health to all mothers. The main aim of this study was to assess the knowledge, attitudes and practices (KAP) of nurses regarding the Mother-Baby Friendly Initiative in non-accredited primary healthcare (PHC) facilities of Makhuduthamaga Sub-district. Method: Descriptive, cross-sectional and correlational study designs were used with the quantitative method. All the 18 non-accredited primary healthcare facilities were purposively selected and a total sampling method was used to select all the nurses working in these non-accredited primary healthcare facilities. Permission to conduct the study was sought from the University of Venda Research Ethics Committee and the Limpopo Department of Health Research Committee. Data was collected using a structured self-administered questionnaire. Content and face validity were enhanced before the actual data collection process. One hundred and ninety questionnaires were distributed and 164 responded, giving a response rate of 86.3%. Cronbach’s alpha test determined the reliability and reflected 0.981, indicating high reliability. Data was analysed using the Statistical Package for Social Sciences (SPSS) 23.0 and the Pearson coefficient of correlation established the relationship between variables. The study followed ethical considerations such as privacy, autonomy, confidentiality, fair treatment and right to self-determination. Results: In this study, 50.6% were professional nurses (PNs), 6.7% were nursing managers (NMs), 15.2% were enrolled nurses (ENs) and 27.4% were enrolled nursing assistants (ENAs). This study found that 100% of NMs, 65.1% of PNs, 54.2% of ENs and 26.7% of ENAs had received formal training on lactation management. Seventy-two percent (72%) of NMs, 90.4% of PNs, 72% of ENs vii and 66.7% of ENAs were knowledgeable about the duration of exclusive breastfeeding. This analysis found that the majority of nurses agreed that MBFI increases breastfeeding rates. Results showed that 63.6% of NMs, 69.6% of PNs, 56% of ENs and 46.7% of ENAs teach and demonstrate hand-milk expression to breastfeeding mothers. Furthermore, this research revealed that there was a significant relationship between the knowledge, attitudes and practices of nurses with a p-value of (p-00.01). Recommendations and Conclusion: This study recommends that all nurses should receive formal training on MBFI implementation and this should be conducted to improve ENs and ENAs’ awareness about MBFI. MBFI should be integrated into the training curriculum for all nursing categories. This study further recommends that a support model for implementation of MBFI be developed and implemented.