Philosophiae Doctor - PhD / In this doctoral thesis, I explored how the national guidelines for higher education to institutionalise service-learning as a particular type of community engagement were implemented in South African higher education institutions. Whilst the particular School of Nursing where the study was conducted was cognisant of the national policy imperative on service-learning as stipulated in the guidelines of the Higher Education Quality Committee (HEQC), operationalisation within the academic programmes had not been addressed. An intervention study was thus undertaken to develop a service-learning implementation framework for the School of Nursing using the multi-phased design and development model of Rothman and Thomas (1994). The factors that influenced the implementation of the HEQC’s service-learning policy guidelines in the nursing programmes were explored during the first phase: problem analysis and project planning. During this phase, the research focused on the readiness of the school to institutionalise service-learning at organisational and individual level because service-learning scholars advocate a systems approach to service-learning institutionalisation. At organisational level, the research question investigated whether the higher education institution had created an enabling environment for the school to institutionalise service-learning successfully in the academic. The factors that were associated with readiness at organisational (school) level were those cited as critical success factors for service-learning institutionalisation by Furco (2002) or better known in South African terminology as service-learning good practice indicators. Individual readiness was determined in terms of service-learning scholarship and willingness to participate in service-learning -capacitating activities.

Problem: While the educational preparation of students in a tertiary nursing programme was the general focus of the study, the specific concern was with the degree to which students in the first and third year of the programme implemented all aspects of the nursing process in their delivery of patient care. The study developed out of a need to evaluate the effectiveness of theoretical teaching in regard to the students' ability to implement theoretical principles in clinical practice. The desired outcome of the study is that the data will be useful in developing more appropriate and effective teaching approaches that will result in improved clinical nursing practice. Methodology A survey of patients receiving nursing care from students in the first and third year of their programme was conducted on completion of a one week block of clinical experience for both groups of students. A questionnaire was the instrument of data collection. Factors included in the study were the patients' perceptions of the students' attention to four of the five phases of the nursing process: assessment, diagnosis, planning and evaluation. Questions addressing the degree of patient involvement in all of these phases were included throughout the questionnaire. Questionnaires were returned from twenty nine of the thirty one patients surveyed in the first year student group and from thirty of the thirty one patients surveyed in the third year student group; constituting a 93.5 percent and a 96.7 percent response respectively. Results The scores achieved by each group of students were compared against scores determined by the researcher to indicate realistic educational and professional standards of practice in each specified section and comparisons were also made between the two students groups to identify development of practice over the education programme. Scores indicated that: 1. Within each section of the study both student groups scored below the expected level on certain items, the most notable deficiencies being related to the aspects of patient empowerment through informing and involving. 2. The third year student group scored overall higher than the first year students in regard to attention to the more 'technical' aspects of the nursing process, but did not give the same degree of attention to the 'human' aspects, scoring equal to, or lower than their less experienced colleagues. Conclusions: 1. There are apparent philosophical differences between the graduates of the 'old style' training system and those involved in the tertiary nursing programme in regard to the individualization of patient care and the allocation of priorities within a time frame. 2. Clinical application of theoretical principles relies heavily on the reinforcement of these principles by the clinical teacher/supervisor. There is a need for these clinical supervisors to have: (a) a better understanding of the educational objectives for students in the clinical settings, and (b) assistance towards developing teaching/organizational strategies that will guide the student towards objective attainment when such abilities are not developed. Recommendations: Among the recommendations presented were: 1. that the nursing discipline within the university make formal and informal opportunities to inform all clinicians of the changes in nursing education and the implications these changes have on the overall approach to the delivery of patient care. 2. that there is an increased emphasis on the educational preparation of the clinical supervisors and that their commitment to the students' achievement of the clinical objectives is enhanced through involvement in programme planning and evaluation.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The issue of attrition of undergraduate participant nurses has remained a concern for an extremely long time. Attrition has been labelled as complex and in order to understand attrition it is important to pay attention to the rate, reasons and trends in South Africa. To understand attrition in South Africa, the trends internationally need to be taken into account to determine whether South Africa has a unique problem. Due to the enormous financial cost to the state and the students’ self-confidence, as well as their belief and understanding of why all the systems that have been put into place fail, it has become a concern. The reasons why students choose nursing and their academic progress throughout secondary schooling should give a clear indication to the educational authorities how successful the students could be. The aim of this study was to determine possible reasons for attrition in students who do the undergraduate diploma nursing course. The objective was to determine the attrition rate of students in the undergraduate course. Reasons for attrition involve a close investigation into age, home language, subjects taken in secondary school, family support, reasons for going into nursing, problems experienced, reasons for not completing the course and how these affected them. The objectives was met through a descriptive study with a quantitative approach. The target population (N=260/100%) consisted of all students that had not completed their undergraduate diploma nursing course over four years between the years 2007-2010, from a Nursing College in the Western Cape. The sample population (n=58/22%) voluntarily agreed to participate in the study. A telephonic questionnaire was administered with closed-ended questions and a small section which had a likert scale. Data was collected by the researcher and a trained field worker. Ethical approval was obtained from the Health Research Ethics Committee at the Faculty of Health Sciences, Stellenbosch University. Permission was also obtained from the Western Cape Provincial Administration to conduct the research. Informed consent was obtained from the students. Reliability and validity was supported by a pilot study conducted on (n=10/10%) of the students at the Western Cape College of Nursing to ensure feasibility of the study. The data was analysed by a statistician and presented in tables and graphs. Statistical analysis was determined by ordinal and nominal data. The results showed that there were numerous factors that contributed to the attrition of undergraduate nursing diploma students. The results showed that the majority of the students’ home language was Xhosa 43% (n=25/58) with the majority being female, single with one child. The main reasons for choosing nursing was because it was a vocation/calling. The recommendations were to ensure that all nursing colleges be integrated into institutions of higher education, thereby ensuring more stringent selection criteria. There needs to be a bridging year where the students are taught to improve their literacy and numeracy so that this will give the students a better understanding of the lectures being delivered in English. There needs to be systems in place to assist the students that are mediocre or struggling. The conclusion was that attrition is complex and requires more concrete systems to stem the rate. A total reformation of undergraduate diploma nursing programmes needs to be addressed. / AFRIKAANSE OPSOMMING: Die kwessie van attrisie by voorgraadse diploma student verpleegsters is al vir ’n geruime tyd kommerwekkend. Attrisie word as kompleks bestempel en om dit te begryp, is dit noodsaaklik om aandag te skenk aan die tempo waarteen dit vookom, asook die redes en tendense in Suid-Afrika te bepaal. Om attrisie in Suid-Afrika te kan begryp, moet die internasionale tendense in ag geneem word om te bepaal of Suid-Afrika ’n unieke probleem het. Weens die enorme finansiële onkoste wat die staat het ten opsigte hiervan en die student se selfvertroue, asook hulle geloof en begrip in al die sisteme wat in plek is wat gefaal het, word dit ’n bekommernis. Die redes waarom studente kies om verpleging te doen en hulle akademiese vordering gedurende hulle sekondêre skoolopleiding, behoort ’n duidelike aanduiding aan die onderwysowerhede te wees hoe suksesvol die studente kan wees. Die doel van hierdie studie is om die moontlike redes vir attrisie by studente wat die voorgraadse diploma kursus in verpleging volg, te bepaal. Die doelwit is om die attrisie-tempo by studente in die voorgraadse diploma kursus, te bepaal. Redes vir attrisie verg ’n indringende ondersoek van die ouderdom, huistaal, vakke geneem in die sekondêre skool, familie-ondersteuning, redes waarom verpleging as loopbaan gekies word, probleme wat ondervind word, redes waarom die kursus nie voltooi word nie en hoedat dit hulle geaffekteer het. Die doelwitte is behaal deur ’n beskrywende studie met ’n kwantitatiewe benadering te volg. Die teikenbevolking (N=260/100%) het bestaan uit alle studente wat nie hulle voorgraadse verpleegkursus binne vier jaar tussen die jare 2007-2010 aan ’n verpleegkollege in die Wes-Kaap voltooi het nie. Die steekproef bevolking (n=58/22%) het vrywillig ingestem om aan die studie deel te neem. ’n Telefoniese vraelys met geslote vrae is geadministreer en ’n klein gedeelte het ’n likertskaal bevat. Data is gekollekteer deur die navorser en ’n opgeleide veldwerker. Etiese goedkeuring is verkry van die Gesondheidsnavorsing se Etiese Komitee aan die Fakulteit van Gesondheidswetenskappe, Universiteit van Stellenbosch. Toestemming is ook verkry van die Wes-Kaapse Provinsiale Administrasie om die navorsing te doen. Ingeligte toestemming is van die deelnemers verkry. Betroubaarheid en geldigheid is ondersteun deur ’n loodsondersoek wat uitgevoer is op (n=10/10%) van die deelnemers aan die Wes-Kaap Kollege vir Verpleging om die uitvoerbaarheid van die studie te verseker. Die data is geanaliseer deur ’n statistikus en in tabelle en grafieke aangebied. Statistiese analise is bepaal deur ordinale en nominale data. Die uitslae het bewys dat daar ’n aantal faktore is wat bygedra het tot die attrisie van voorgraadse studente wat die verpleegdiploma doen. Die uitslae het bewys dat die meerderheid van die studente se huistaal Xhosa 43% (n=25/58) is, waarvan die meerderheid vroulik en enkel met een kind is. Die hoofredes waarom verpleging gekies is as loopbaan, is omdat dit ’n beroep/roeping is. Die aanbevelings is om te verseker dat alle verpleegkolleges geïntegreer word by instellings vir hoër onderwys, daardeur word strenger seleksie-kriteria verseker. Daar behoort ’n oorbruggingsjaar vir participante te wees om hulle geletterdheid en syfervaardigheid in so ’n mate te verbeter dat hulle lesings in Engels verstaan wanneer dit aangebied word. Daar behoort sisteme in plek te wees om participante te help wat gemiddeld presteer of sukkel. Die gevolgtrekking is dat attrisie kompleks is wat meer konkrete sisteme verg om die tempo waarteen dit plaasvind, die hoof te bied. ’n totale transformasie van voorgraadse diploma verplegingsprogramme behoort aangeroer te word.

Magister Curationis - MCur / Medication errors can result in harm and death, for which nurses are legally liable. The administration of medication by nurses can be improved through education and training to avoid medication errors in future. The study aimed to investigate fourth year Bachelor of Nursing students’ perceptions regarding the clinical learning opportunities and their competence in the administration of oral medication in a general hospital. A quantitative cross-sectional descriptive design was employed. The all-inclusive sample constituted 176 fourth year Bachelor of Nursing students. A total of 125 respondents completed the self- report questionnaires. Descriptive statistics were produced through data processing and univariate and bivariate analysis using of SPSS version 22. The study’s findings show that most of the 125 respondents were placed in a medical (92%, 115) and surgical ward (86.4%, 108). However, a total of 59.2% (74) of the 125 respondents did not practice administration of oral medication on a daily basis. The majority of the respondents perceived themselves as competent in the administration of oral medication. However, only a total of 19.2% (24) of the 125 respondents perceived themselves as competent in all 42 skills required for the correct procedure of administration of oral medication. A negative correlation was found between total self-assessment of competence scores and total clinical placement scores. An observation study, using the check list, of the competence of nursing students in the administration of medication is recommended to exclude bias associated with self-assessment. The use of simulation is recommended to enhance the opportunities and competence of the students in the administration of oral medication to many patients.

The four year nursing programme is offered at the NEI in the EC province where this study was conducted. As early as 2009 the majority of first and second year nursing students of the NEI were academically unsuccessful in the subject biological science. This prompted the researcher to conduct a qualitative, contextual, exploratory and descriptive study to explore and describe the factors influencing the academic performance of students in the subject biological science at the NEI. Following an explanation of the Appreciative Inquiry (AI) process as the framework of the study and the purpose of the study, the consecutive sample of second year nursing students who consented to participate completed a written appreciative interview schedule. The findings of the content analysis process revealed factors influencing performance in the subject biological science as biological science content, nurse educator characteristics, study strategies, resources and biological science assessments. The recommendation was for all the stakeholders to play their various active roles towards influencing biological science performance positively. / Dissertation (MCur)--University of Pretoria, 2013. / gm2014 / Nursing Science / unrestricted

Clinical learning is regarded as a vital component in nursing programmes and students need to work in various clinical environments. In the emergency nursing programme presented at a tertiary nursing education institution, the pre-hospital environment is used as a clinical learning environment in which students rotate for approximately eight weeks. The clinical experience that they gain may assist in them developing the necessary knowledge and skills. It also assists in theory-practice correlation. The purpose of this study was to evaluate the value of the pre-hospital environment utilised as part of the clinical learning component of the emergency nursing programme. A qualitative approach was utilised since the researcher wanted to study a particular phenomenon, namely the pre-hospital learning environment. Therefore, the research design was a descriptive design whereby the researcher could describe the real life situation in the pre-hospital learning environment as experienced by the emergency nurse students. The target population for the study was emergency nurses who had already obtained their qualification as a registered emergency nurse, as well as emergency nurse students that had completed their rotational period in the pre-hospital learning environment. For the purpose of this study the identified sample consisted of students enrolled for the emergency nursing programme at a tertiary nursing education institution in Gauteng. The sample was adequate to provide the researcher with sufficient in-depth data and was also representative of the accessible population. The final sample size was 45 emergency nurse students who had completed the pre-hospital rotational period between 2008 and 2011. Data collection was done by means of Appreciative Inquiry, a method used that not only focuses on the positive, but which is also a stimulating way of looking at organisational change. Stories (narratives) were shared by the emergency nurse students pertaining to their real life experiences. Initially stories were shared in writing on an Appreciative Inquiry interview schedule. For the purpose of data saturation, individual Appreciative interviews were conducted by an independent interviewer, utilising the Appreciative Inquiry interview schedule as a guide. Data analysis was conducted by the interviewer, supervisors and an independent data analyser to ensure trustworthiness. Four themes were identified, namely clinical exposure, competencies, team work and future recommendations. From the data analysis and the four themes recommendations could be made with regard to programme refinement. Copyright / Dissertation (MCur)--University of Pretoria, 2013. / Nursing Science / unrestricted

Philosophiae Doctor - PhD / Curriculum review can ensure that nurses develop appropriate competencies to respond to market demand. Regular revision and updating of curricula are in line with recommendations of the WHO to scale-up health professionals' education and training. Introducing transformative changes in education provides an opportunity to review the strengths and weaknesses of the current systems. The nursing profession was the first of the health professions in South Africa to transform its legislative framework, which led to the development of new qualifications.

Background Trauma is the leading cause of death in the young (ages 1-44) and the current life situation is responsible for producing emergency injuries from motor vehicle accidents, violence and from acute life threatening illnesses. The training of emergency nurses is therefore of priority based on the increasing demands on the entire emergency health care system. The study evaluates the education and training of emergency nursing programme that has been offered for the past seven (7) years at a Nursing Education Institution (NEI) in the Limpopo province. The programme has not has not been formally evaluated. Aim The overall aim of the study is to explore and describe the views of students pertaining to the emergency nursing programme offered at the NEI in the Limpopo province and to make recommendations for the refinement of the emergency nursing programme, based on the views of the nursing students. Methods A qualitative design working from an Appreciative Inquiry approach was employed. Purposive sampling was used and focus group interviews were conducted with 20 Professional nurses who are trained as emergency nurses at the NEI from 2007 to 2013. Two main themes emerged: theoretical aspects and clinical aspects, which included both positive and negative views. The findings were used to make recommendations to refine the programme / Health Studies / M.A. (Health Studies)

An exploratory, descriptive design in the phenomenological approach was used to describe and explore how student tutors' experienced the process of evaluation of their clinical teaching in a specific distance-learning programme. The researcher conducted a tape-recorded focus group interview with seven participants who voluntarily agreed to participate. After transcription, the data was analysed using Tesch's (1992:92) method of analysis to code the data into themes in order to identify commonalities. The findings of this study indicated that participants experienced the evaluation process positively and negatively. The negative experiences included difficulty in obtaining access to evaluators, practica facilities, and inconsistencies of evaluators. Recommendations were made for improving evaluation of teaching skills of student tutors in this distance programme. / Health Studies / M. A. (Health Studies)

An exploratory, descriptive design in the phenomenological approach was used to describe and explore how student tutors' experienced the process of evaluation of their clinical teaching in a specific distance-learning programme. The researcher conducted a tape-recorded focus group interview with seven participants who voluntarily agreed to participate. After transcription, the data was analysed using Tesch's (1992:92) method of analysis to code the data into themes in order to identify commonalities. The findings of this study indicated that participants experienced the evaluation process positively and negatively. The negative experiences included difficulty in obtaining access to evaluators, practica facilities, and inconsistencies of evaluators. Recommendations were made for improving evaluation of teaching skills of student tutors in this distance programme. / Health Studies / M. A. (Health Studies)