M.Cur. / Please refer to full text to view abstract

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Professional competence is expected of all nurses in practice. Although new nurses have met the competency requirement for practice legally, opinions vary among new nurses and nurse administrators as to whether new nurses are indeed competent to practice nursing. The purpose of this phenomenological research study was to learn what new nurses think about professional competence. The research question guiding this study was, "What is professional competence from the perspective of newly licensed registered nurses?" / by Priscilla Dunson Bartolone. / Vita. / Thesis (D.N.S.)--Florida Atlantic University, 2008. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2008. Mode of access: World Wide Web.

M.Cur. / The nursing service manager is responsible and accountable for ensuring quality health care in a nursing service. The principle of liability requires a formal quality improvement programme in the nursing service according to which a specific level of quality nursing can be maintained. It is therefore clearly evident that a quality improvement programme, objectively maintain and evaluate the quality of a service. Opportunities for improvement are identified, and a mechanism is provided for taking remedial steps to bring about and maintain improvement, The abovementioned is of utmost importance and implies a constant commitment to health care service of a high quality. The overall objective of this study is to formulate and describe guidelines for a quality improvement programme for the nursing service of a referral hospital in the Gauteng Province. This study is an explorative, descriptive, qualitative and contextual research aiming to investigate the perceptions of quality in nursing/midwifery which will facilitate the exploration and description of a value clarification on quality, by the chief professional nurses, senior professional nurses, administrative personnel and patients within the nursing service of the referral hospital in the Gauteng Province. Focus group interviews, naive sketches and interviews as methods of data gathering was conducted. A simple random sampling method was used. A total number of three focus group interviews were conducted: one with seven chief professional nurses, one with fourteen senior professional nurses and one with twelve administrative personnel using tape recordings with the written consent of the participants. Naive sketches were obtained from the same groups. An expert psychiatric nurse, with a master's degree in the field and whose daily activities involved interviewing of the psychiatric nursing students and psychiatric patients, conducted the focus group interviews. The researcher conducted thirty individual patient interviews. Trustworthiness in this research was done according to Guba's model (!!! Krefting, 1991:214-222). Data analysis was done according to Tesch's (1990, in Creswell, 1994:155) protocol. An external coder with expertise in the field of coding in qualitative data was utilised to analyse and categorize the data. The researcher and the independent coder had consensus discussions for the formulation of the main categories and sub categories. Consensus discussions were also conducted with the study leader. The results were quantified based on the number of respondents whose perception on quality had reference to the same categories. The structured coding was based on the principles of quality: structure, process and outcome. A description of the conceptual framework was developed from the data analysis and a literature study. This framework with its content and criteria serves as scientific and theoretical basis of the quality improvement programme and are based on the values/value clarification on quality of the different roleplayers in the nursing service. Fifteen belief statements/values were described from the value clarification. The guidelines for the quality improvement programme of the nursing service in the referral hospital were described, based on the eight steps of the quality assurance model of Laing and Nish (Booyens, 1998: 576). A description of values is the first step and from these values on quality in the nursing service, the formulation of management standards was deduced in conjunction with the conceptual framework and the nursing/midwifery practice standards of the Nursing Department of RAU. Lastly the evaluation, limitations, recommendations and conclusion of the study were done.

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. / Please refer to full text to view abstract

M.Cur. (Intensive Care Nursing) / The problem of intensive care nurses leaving the profession due to non-conducive working environments and uncompetitive conditions of employment is becoming more alarming and is therefore as relevant as ever. The researcher is concerned about the quality of nurse-awareness nurses create in order to practice quality nurse care. Confusion among nurses about their professional rights and responsibilities adds fuel to the fire. The management of health care services is at times not sensitive to the needs of nurses, and nurses are not always recognized for their inherent professional worth. In the adult intensive care unit at which the researcher practices as unit manager she perceived her colleagues to be experiencing some sort of emotional and spiritual discomfort in going about their daily activities. As the researcher felt responsible for the well-being of the staff in the unit she decided to investigate the phenomenon via a formal research study. The objectives of the study were two-fold: Firstly to explore and describe the registered nurse's experience of nursing in the intensive care unit and then to use the information obtained to describe guidelines for the compilation of a support programme for the nurses nursing in the unit The research questions that were generated are: How do registered nurses in the intensive care unit experience nursing there and how can the information be utilized to describe guidelines to support these nurses? The researcher used an exploratory, descriptive, contextual and phenomenological qualitative design to answer these research questions. Phenomenological interviews were conducted with five interviewees who had been possessively selected.

Nurses make up the largest human resource component of healthcare. With this in mind, understanding what quality care means to the nurses providing it becomes relevant. There have been numerous efforts made to understand, define, measure, and influence the phenomenon of quality nursing care. These efforts have reflected the perspectives of patients, nurses, and nursing leadership. Bedside critical care nurses provide care in a dynamic, high-paced environment where patients have life-threatening conditions, may not be conscious of their care or condition, and outcomes including mortality are multifactorial, not always care-dependent. In such a scenario, outcome-based assessments of quality nursing care may result in inaccurate findings, making it difficult to create and institute improvement efforts. This qualitative phenomenological study was designed to uncover the meaning of quality nursing care through the lived experiences of bedside critical care nurses. Twenty-two bedside critical care nurses were interviewed, and their responses analyzed using van Manen’s method of phenomenology to uncover five essential themes that represent the meaning of quality nursing care: (a) It is not just taking care of the illness; (b) Being there for another, it’s the little things; (c) It is knowing your stuff—bed bath, and beyond; (d) It is roles, not just responsibilities; and (e) It means having resources.The results and discussion aim to clarify, through example, the meaning of quality nursing care differentiated from its definition. Findings of this study contribute to a large body of literature regarding quality nursing care. Furthermore, the results are relevant to nurses, educators, managers, and leadership to aid in assessment of quality nursing care and support its provision.

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.

atisfaction with diabetes care, perceived feelings of empowerment to participate in self-care management, and glycemic control in a sample of older African American men and women with diabetes. A descriptive correlational quantitative design was used. The participants in this study were 73 men and women of African descent who were at least 50 years, English speaking, and diagnosed with diabetes for at least one year. The participants were asked to complete three survey instruments: the Patient Satisfaction Questionnaire-18 (PSQ-18), which measured how satisfied the participants were with their medical care; the Diabetes Empowerment Scale-Short Form (DES-SF), which measured attitudes towards diabetes and self-management of diabetes; and a demographic form, which collected data on the demographics of each participant. The most recent hemoglobin A1c (HbA1c) of each participant was obtained from the medical records. The correlations between HbA1c, DES, and the PSQ-18 subscales were exam ined. The study data indicated all correlations were statistically significant and negative with one exception. There was no correlation between HbA1c and time spent, a satisfaction subscale. Approximately half the participants were high school graduates, married, and reported being born in the Caribbean. Most had primary care physicians, but less than half reported attending a diabetes education program. The average BMI was 33.0. The findings of this study indicated older African adults who reported higher satisfaction with the care provided by their health care provider reported feeling more empowered to participate in diabetes self-care and reported lower HbA1c levels, suggesting better glycemic control (R2 = .39; P=<.001). / The implications of this study are that feeling empowered to participate in diabetes self-care management may result in improved glycemic control. Positive diabetes outcomes have been linked in the literature with persons feeling empowered to participate in diabetes self-care. The significance of the findings from this study is that given the relationship between empowerment and glycemic control, nurses should support the empowerment model of diabetes teaching. Diabetes education should provide written materials that are culturally sensitive for African American elders. / by Bridgette M. Johnson. / Thesis (Ph.D.)--Florida Atlantic University, 2012. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2012. Mode of access: World Wide Web.