Durant les dernières années, le rôle et les responsabilités des infirmières gestionnaires de proximité (IGP) en soins infirmiers, soit les infirmières-chefs (IC) d’unité ainsi que les assistantes infirmières-chefs (AIC), ont changé suite aux réformes du système de santé ainsi qu’à l’augmentation des besoins de la population québécoise et la complexité de ces derniers. Malgré ces nombreux changements et les défis relatifs à l’occupation du rôle stratégique d’une IGP dans le système actuel, il n’existe aucune directive claire sur les compétences que devraient posséder les IGP. Or, des compétences spécifiques aux IGP devraient être identifiées et regroupées dans un référentiel de compétences pour les IGP afin que ces dernières puissent procéder à leur autoévaluation et assurer leur développement professionnel. Actuellement, bien qu’il existe un référentiel de compétences pour les infirmières soignantes (Boyer et al. 2020), un outil équivalent pour les IGP n’existe pas. Seulement des guides de standards de pratique semblent disponibles pour structurer et encadrer la pratique des IGP qui ont pourtant un rôle déterminant à jouer dans la mobilisation des équipes de soins à atteindre leurs objectifs de qualité et de sécurité de soins. Pour cette recherche, la définition de compétence de Tardif (2006) sera utilisée tout comme le cadre de référence de la mobilisation présenté par Tremblay et Simard (2005). Le but de ce projet était d’identifier, par une étude Delphi, les compétences de gestion nécessaires aux IGP pour exercer leur rôle de manière optimale. Pour ce faire, les données ont été collectées à l’aide de questions en ligne auprès de 13 IC et AIC de diverses unités d’un centre hospitalier universitaire de Montréal. Les résultats de cette recherche permettent donc de proposer des compétences à considérer pour le développement d’un éventuel référentiel de compétences en gestion de proximité. Le référentiel pourrait être un outil pertinent sur la clarification du rôle des IGP et permettrait de définir les connaissances et les compétences nécessaires à l’exercice optimal de ce rôle. / In the last few years, the responsibilities of the nurse managers, including chief nurses and assistant chief nurses, have changed following the reform of the health care system and the increased needs of the population requiring more complex care. Yet, despite those changes and the many challenges the nurse managers are facing, there is no clear agreement on which competencies are important for a nurse manager to display in order to be able to guide their team. However, the essential competencies required for nurse manager should be regroup in a competency framework, so they can self-evaluate and ensure their professional development. Indeed, it’s possible to find a competency framework for register nurses (Boyer et al. 2020), but there is no such thing for the nurse’s manager. It seems like it’s only possible to find some guidelines to structure and regulate the practice of nurse manager, who nevertheless have a crucial role in guiding their team to achieve their goals of offering security and quality care to the people. In this research, the definition of competency by Tardif (2006) and the framework of Tremblay and Simard (2005) on mobilization of teams were used. The aim of this study was to identify the competencies of management required by nurse’s managers in order to mobilise their team. The data were collected with online questions using the Delphi method answered by 13 nurses’ managers from a university hospital center in Montréal. The results of this research will therefore provide possible avenues of competencies for a possible competency framework for management. The competency framework could be a relevant tool for clarifying the role and defining the knowledge and skills necessary for the exercise of an optimal role of nurse manager.

The systems development life cycle (SDLC) has been the traditional method of decision support systems design. However, in the last decade several methodologies have been introduced to address the limitations arising in the use of the traditional method. These approaches include Courban's iterative design, Keen's adaptive design, prototyping and a number of mixed methodologies incorporating prototyping into the SDLC. Each of the previously established design methodologies has a number of differing characteristics that make each of them a more suitable strategy for certain environments. However, in some environments the current methodologies present certain limitations or unnecessary expenditures. These limitations suggest the need for an alternative methodology. This dissertation develops a new methodology, priority design, to meet this need. To determine what methodology would be most effective in a given situation, an analysis of the operating environment must be performed. Such issues as project complexity, project uncertainty, and limited user involvement must be addressed. This dissertation develops a set of guidelines to assist in this analysis. For clarity, the guidelines are applied to three, well-documented case studies. As an application of the priority design methodology, a decision support system for nurse scheduling is developed. The development of a useful DSS for nurse scheduling requires that projected staff requirements and issues of both coverage and differential assignment of personnel be addressed. / Ph. D.

A qualitative, exploratory, descriptive and contextual study was conducted to explore health care unit managers’ view of their role as leader-managers, and to determine the challenges they experience and the skills they need to be effective leader-managers in the 21st century, the Quantum Age. Semi-structured interviews were conducted with eight health care unit managers from a selected public hospital in the Western Cape Province. The findings revealed that health care unit managers experience workforce challenges, with staff shortage being a serious concern; personal challenges, such as an increased workload and role diversity; and organisational challenges with regard to the management of equipment. Desired attributes and skills for leader-managers as indicated by unit managers concur with Shelton’s (1999) Quantum Skills Model. Recommendations were made for nursing practice, education and research, including recommendations on the development of the seven quantum skills. / Health Studies / M.A. (Health Studies)

Text in Afrikaans / Summaries in Afrikaans and English / Die doel van die sensus was om 'n perspektief te verkry oar die bestuur van plaaslike owerhede in die Vrystaat se primere gesondheidsafdelings deur verpleegkundiges. Faktore rakende die omvang van die verpleegkundige in beheer se bestuursfunksies, die werksverhoudinge tussen hulle en hul hoofde, hul optimale benutting ten opsigte van bestuur en sekere aspekte van hul bestuursopleiding is ge"ldentifiseer as belangrike komponente. Ontleding van data het getoon dat verpleegkundiges en hoofde van mekaar verskil ten opsigte van hul sienings rakende die bestuursfunksies van die verpleegkundige in beheer. Werksverhoudinge tussen die verpleegkundiges en hul direkte toesighouer is nie altyd bevredigend nie. Die swak benutting van hul bestuursvaardighede blyk vir die verpleegkundiges in beheer onaanvaarbaar te wees. Sekere aspekte van die bestuursopleiding van verpleegkundiges behoort aandag te geniet. Plaaslike owerhede behoort aan verpleegkundiges geleenthede vir voortgesette bestuursopleiding te bied. Aanbevelings om die optimale benutting van verpleegkundiges in beheer van primere gesondheidsafdelings van plaaslike owerhede te bevorder, is geformuleer. / The purpose of this census was to obtain a perspective on the management of primary health services of local authorities by nurses in the Free State. Factors regarding the extent of management in primary health care services by nurses, working relationships between them and their superiors, their optimal utilisation with regard to management and certain aspects of their managerial training, were identified as important components. Analysis of data indicated that nurses and their superiors differ from one another regarding their views on managerial functions of the nurses in charge. Working relationships between nurses in charge and their superiors were not always satisfactory. Nurses found the poor utilization of their management skills unacceptable. Certain aspects of the managerial training of nurses should receive attention. Local authorities should provide opportunities for ongoing managerial training for nurses. Recommendations to utilise nurses in charge of primary health care services optimally, were formulated. / Health Studies / M.A.

Patient and public criticism of care in many South African public hospitals has resulted in negative media reports. The purpose of the study was to determine the effect of appointing Quality Assurance Nurse Managers (QANMs) on the provision of quality patient care in selected public hospitals of the Limpopo Province and to make recommendations where appropriate. The study was quantitative, exploratory and descriptive in nature. Data was collected by means of a self-developed questionnaire from 112 respondents, consisting of 10 QANMs and 102 Quality Assurance Team members (QAT). The response rate was 100% for the QANMs and 57% for the QAT members. The study found that most of the ten selected hospitals have a good QA foundation with a vision, mission and goals, QA programme and manual. Moreover, the appointment of the QANMs had a positive impact on the nursing care. Regarding the improvement and change in the provision of nursing care, the majority of the respondents indicated that patients’ complaints about nursing care had declined considerably; the in-service training assisted in improving nursing care, and patients were nursed in totality because of the quality guidelines in the QA manuals. However, the study found that the shortage of equipment, which interferes with the delivery of quality patient care, is a serious problem that hinders the QA programme and needs to be tackled. Recommendations were made for practice and further research. / Health Studies

Patient and public criticism of care in many South African public hospitals has resulted in negative media reports. The purpose of the study was to determine the effect of appointing Quality Assurance Nurse Managers (QANMs) on the provision of quality patient care in selected public hospitals of the Limpopo Province and to make recommendations where appropriate. The study was quantitative, exploratory and descriptive in nature. Data was collected by means of a self-developed questionnaire from 112 respondents, consisting of 10 QANMs and 102 Quality Assurance Team members (QAT). The response rate was 100% for the QANMs and 57% for the QAT members. The study found that most of the ten selected hospitals have a good QA foundation with a vision, mission and goals, QA programme and manual. Moreover, the appointment of the QANMs had a positive impact on the nursing care. Regarding the improvement and change in the provision of nursing care, the majority of the respondents indicated that patients’ complaints about nursing care had declined considerably; the in-service training assisted in improving nursing care, and patients were nursed in totality because of the quality guidelines in the QA manuals. However, the study found that the shortage of equipment, which interferes with the delivery of quality patient care, is a serious problem that hinders the QA programme and needs to be tackled. Recommendations were made for practice and further research. / Health Studies

A qualitative, exploratory, descriptive and contextual study was conducted to explore health care unit managers’ view of their role as leader-managers, and to determine the challenges they experience and the skills they need to be effective leader-managers in the 21st century, the Quantum Age. Semi-structured interviews were conducted with eight health care unit managers from a selected public hospital in the Western Cape Province. The findings revealed that health care unit managers experience workforce challenges, with staff shortage being a serious concern; personal challenges, such as an increased workload and role diversity; and organisational challenges with regard to the management of equipment. Desired attributes and skills for leader-managers as indicated by unit managers concur with Shelton’s (1999) Quantum Skills Model. Recommendations were made for nursing practice, education and research, including recommendations on the development of the seven quantum skills. / Health Studies / M.A. (Health Studies)

Text in Afrikaans / Summaries in Afrikaans and English / Die doel van die sensus was om 'n perspektief te verkry oar die bestuur van plaaslike owerhede in die Vrystaat se primere gesondheidsafdelings deur verpleegkundiges. Faktore rakende die omvang van die verpleegkundige in beheer se bestuursfunksies, die werksverhoudinge tussen hulle en hul hoofde, hul optimale benutting ten opsigte van bestuur en sekere aspekte van hul bestuursopleiding is ge"ldentifiseer as belangrike komponente. Ontleding van data het getoon dat verpleegkundiges en hoofde van mekaar verskil ten opsigte van hul sienings rakende die bestuursfunksies van die verpleegkundige in beheer. Werksverhoudinge tussen die verpleegkundiges en hul direkte toesighouer is nie altyd bevredigend nie. Die swak benutting van hul bestuursvaardighede blyk vir die verpleegkundiges in beheer onaanvaarbaar te wees. Sekere aspekte van die bestuursopleiding van verpleegkundiges behoort aandag te geniet. Plaaslike owerhede behoort aan verpleegkundiges geleenthede vir voortgesette bestuursopleiding te bied. Aanbevelings om die optimale benutting van verpleegkundiges in beheer van primere gesondheidsafdelings van plaaslike owerhede te bevorder, is geformuleer. / The purpose of this census was to obtain a perspective on the management of primary health services of local authorities by nurses in the Free State. Factors regarding the extent of management in primary health care services by nurses, working relationships between them and their superiors, their optimal utilisation with regard to management and certain aspects of their managerial training, were identified as important components. Analysis of data indicated that nurses and their superiors differ from one another regarding their views on managerial functions of the nurses in charge. Working relationships between nurses in charge and their superiors were not always satisfactory. Nurses found the poor utilization of their management skills unacceptable. Certain aspects of the managerial training of nurses should receive attention. Local authorities should provide opportunities for ongoing managerial training for nurses. Recommendations to utilise nurses in charge of primary health care services optimally, were formulated. / Health Studies / M.A.

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

The purpose of the study was to explore and describe the lived experiences of general nurses working at Standerton hospital medical wards which also admit psychiatric patients. A qualitative, descriptive phenomenological approach was used for the study. The study population consisted of seven general nurses working in medical wards at Standerton hospital. Purposive sampling was used to select participants who met the inclusion criteria. Researcher used in-depth face to face interviews to collect data until data saturation was achieved. Tesch’s method of qualitative data analysis was utilised to identify themes. Three themes and five sub-themes emerged from the study: theme1: perceived danger due to aggression sub-themes stress for medical patients, stress for medical patients’ families and stress for nurses. Theme 2: lack of skills in dealing with psychiatric patients’ sub- theme use of restrains. Theme 3: self fulfilling prophecy subtheme reported incidences. The study findings demonstrate the plight of general nurses who are not trained to work with psychiatric patients but continue to do so. Findings further accentuate what is already known about the labelling that goes with psychiatric patients and aggression as a resultant effect. Recommendations were made for future research, policy makers, nursing education and practice. / M.A. (Health Studies)