Despite a number of research studies showing the correlation between higher nurse staffing levels and improved outcomes, RCN members continues to report lower nurse-to-patient ratios than what research results suggests (RCN, 2011:1). This reflected a general concern within the nursing profession. The operating room requires appropriate staffing which is critical to the safety of surgical patients and quality of patient care. The research study was motivated by the researcher’s own experiences while working in an OR in a private hospital where continuous discussions were held with management about the shortage of skilled staff; and where a shortage of OR nurses resulted in the use of Central Sterilizing Department (CSD) staff to do OR duties. The objective of the study was to explore and describe the perceptions of nurses regarding staffing in the operating rooms of a private hospital in the Nelson Mandela Bay Health District. The researcher used qualitative methods and designs to explore and described the perception of nurses regarding staffing in the operating room (OR) of a private hospital in the Nelson Mandela Bay Health District. The research population of the study included all the nurses working in the OR of a private hospital. The total number of 20 OR nurses was individually interviewed by means of semi-structured interviews. Three main themes emerged that includes nurses ‘perceptions with regard to the implications of inadequate staffing in the OR; nurses experiences towards top management with regard to staffing in the OR and recommendations from participants to improve staffing in the OR. Research findings concluded that nurses have a perception that shortage of OR nurses causes lack of communication, physical, emotional and psychological strain. They also perceived OR nurses to work under unrealistic conditions and to receive added responsibilities due to staff shortages, which affect the overall delivery of quality patient care. Comments included failure of management to attend to staff complaints and the perception of high staff turnover due to a lack of recognition and acknowledgement of overworked staff.

This study was aimed at investigating the attitudes of nurse managers towards quality improvement programmes in the East London Hospital Complex. The research design comprised a qualitative, exploratory and descriptive approach. A purposive sample of 10 nurse managers participated in the study. The data were collected through interviews, using a semi-structured interview guide. Interviews were recorded using audiotape. Data were analysed manually and by using the computer software Atlas ti. Positive and negative themes were identified and ethical consideration was ensured by means of privacy, confidentiality and anonymity. The findings revealed that nurse managers in the East London Hospital Complex had overall positive attitudes towards quality improvement programmes. A few negative attitudes and their contributory factors were also identified. The limitations of the study and recommendations based on the findings of the study are presented

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.

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)

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.