XXX Pharmacy is an independently-owned retail pharmacy in Johannesburg. Good Pharmacy Practice standards make it mandatory for pharmacists to provide “pharmaceutical care”, a highly patient-centred approach to providing pharmaceutical services. Since XXX Pharmacy has a high patient load, a shortage of dispensary staff and a strategic focus on operational efficiency, the question arose whether pharmacists comply fully with Good Pharmacy Practice standards for the provision of pharmaceutical care. Non-compliance poses operational risks that could undermine the business’s financial performance. The research statement was thus that the current performance management system undermines compliance with Good Pharmacy Practice standards for the provision of pharmaceutical care to patients. A triangulation approach was used. The quantitative research method, in which 200 patients completed a questionnaire, investigated two research objectives: (i) whether the pharmacy complies with Good Pharmacy Practice standards for pharmaceutical care; and (ii) whether there is a relationship between patients’ race or gender and their responses. The qualitative research method involved conducting individual semi-structured interviews with all four dispensary employees to achieve another two research objectives: (i) to determine whether the provision of pharmaceutical care is viewed as a key performance area by pharmacists; and (ii) to investigate what aspects of the implementation of the performance management system are viewed as enabling or undermining the provision of pharmaceutical care.

XXX Pharmacy is an independently-owned retail pharmacy in Johannesburg. Good Pharmacy Practice standards make it mandatory for pharmacists to provide “pharmaceutical care”, a highly patient-centred approach to providing pharmaceutical services. Since XXX Pharmacy has a high patient load, a shortage of dispensary staff and a strategic focus on operational efficiency, the question arose whether pharmacists comply fully with Good Pharmacy Practice standards for the provision of pharmaceutical care. Non-compliance poses operational risks that could undermine the business’s financial performance. The research statement was thus that the current performance management system undermines compliance with Good Pharmacy Practice standards for the provision of pharmaceutical care to patients. A triangulation approach was used. The quantitative research method, in which 200 patients completed a questionnaire, investigated two research objectives: (i) whether the pharmacy complies with Good Pharmacy Practice standards for pharmaceutical care; and (ii) whether there is a relationship between patients’ race or gender and their responses. The qualitative research method involved conducting individual semi-structured interviews with all four dispensary employees to achieve another two research objectives: (i) to determine whether the provision of pharmaceutical care is viewed as a key performance area by pharmacists; and (ii) to investigate what aspects of the implementation of the performance management system are viewed as enabling or undermining the provision of pharmaceutical care.

Thesis (MCurr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The aim of this study was to compare the impact of a four-day structured Basic Infection Prevention and Control course on the knowledge of, and adherence to, Standard Precautions in clinical nursing practice amongst nurses who had completed the course and those who did not. The specific precautionary measures of investigation included hand hygiene, personal protective equipment (PPE) and sharps management. The secondary aim of the study was to identify any personal and contextual factors that influenced the application of such Standard Precautions measures in public healthcare facilities within the Cape Winelands and Overberg District. Sixty eight students (those who had been trained) with a similar number of controls (who had not been trained) were enrolled in the study. Although both the participants and controls had the knowledge, their adherence to hand hygiene, PPE and sharps management in clinical nursing practice was poor. Staff attitude was found to be the main factor for non-adherence. The knowledge of the participants was good as they had answered most of the questions correctly. It seems as if there was retention of knowledge after the four-day Basic Infection Prevention and Control course. There were, however, no significant differences between the two groups. For both groups attitude and behavioural change must be addressed in order to improve adherence to hand hygiene, PPE and sharps management. The findings of the study will form recommendations towards improved infection prevention and control practices at public healthcare facility level in the Cape Winelands District. / AFRIKAANSE OPSOMMING: Die doel van die studie was om die impak van 'n 4-dag gestruktureerde Basiese Infeksiebeheerkursus op die kennis en toepassing van Standaard Voorsorgmaatreëls in kliniese praktyk in die Kaapse Wynland en Overberg Distrikte ondersoek, vergeleke met 'n groep wat nie die kursus bygewoon het nie. Die spesifieke Voorsorgmaatreëls wat ondersoek is, het handhigiëne, die gebruik van beskermende drag en die hantering en beheer van skerpvoorwerpe ingesluit. Die studie het ook gekyk na enige kontekstuele en persoonlike faktore wat die toepassing van Standaard Voorsorgmaatreëls in openbare gesondheidsorgfasiliteite beïnvloed. Agt en sestig verpleegkundiges het die 4-dag Basiese Infeksiebeheerkursus bygewoon en 'n gelyke aantal kontrole studente het nie die kursus bygewoon nie. Alhoewel beide groepe die kennis van handhigiëne, die dra van beskermende drag en die hantering van skerpvoorwerpe gehad het, was die toepassing van die Standaard Voorsorgmaatreëls in kliniese praktyk baie swak. Personeel se houding was die grootste faktor wat gelei het tot die nie-toepassing van Standaard Voorsorgmaatreëls. Die kennis van die kursusgangers was goed, want albei groepe het die meeste van die vrae korrek beantwoord. Die waarneming wat gemaak is, is dat die kursusgangers se kennis wel verbeter het na die bywoning van die 4-dag Basiese Infeksiebeheerkursus. Data weerspieël egter geen noemenswaardige verskille tussen die groepe nie. Beide groepe se houding en gedrag moet aangespreek word om die toepassing van handhigiëne, die dra van beskermende drag en die hantering van skerpvoorwerpe te verbeter. Die bevindinge van die studie sal gebruik word om aanbevelings te maak ten einde infeksiebeheerpraktyke in die Kaapse Wynland Distrik te verbeter.

Clinical practice guidelines are one way of ensuring that healthcare is based on the evidence-based practices. In a dynamic unit, like the critical care unit, where sound decision-making and critical thinking are required in the care of critically ill patients, the implementation of such guidelines for care is of utmost importance. Guideline implementation is however not so simplistic, and various studies have proven that there are various barriers linked to guideline implementation. However, most the barriers have proven to be related to individual factors. Therefore, a greater focus has been placed on organisational contextual factors that might have an influence on clinical practice guideline implementation. The research study followed a positivistic, quantitative paradigm, where the hypothesised relationship between the organisational contextual factors and clinical practice guideline implementation were investigated. A structured pre-existing questionnaire, namely the Alberta Context Tool, was used to collect data from 65 registered nurses in private critical care units. Descriptive and inferential statistics were used to analyse the data. The findings revealed that although the organisational contextual factors were prevalent in the private critical care units sampled, some factors like leadership and culture scored higher than the other factors. Positive relations were reported between the organisational contextual factors and clinical practice guideline implementation. The results imply that the alternative hypothesis H1 is supported, and thus proved that there are significant relationships between organisational contextual factors and clinical practice guideline implementation in private critical care units in the East London area.Recommendations were made on how to enhance organisational contextual factors in the implementation of clinical practice guidelines. Ethical principles were maintained throughout the study.

Background: Evolving technology, practice boundaries, and models of service provision have changed what the diagnostic radiography workforce in Computed Tomography (CT) need to know and be able to do at different career stages. It is unknown whether existing UK educational and practice frameworks support CT roles, or how organisational role descriptors constitute CT competence. Aims: The study explores multiple stakeholder perspectives of competent practice in diagnostic radiography and CT using this information to generate and gain consensus on novel modality-specific skills for the four-tier radiography structure. Methods: Study 1: Document analysis of published UK educational and practice frameworks using content and framework analysis. Study 2: Document analysis of UK CT role descriptors using a context analytical approach. Study 3: Modified e-Delphi study to gain consensus on novel technical and clinical CT practice competencies. Results: Existing radiography competencies were classified into 3 themes: delivering person-centred care; applying technical principles, quality and efficiency; and ensuring best practice. Generic competencies endorsed by professional and regulatory bodies were not consistently replicated within organisational role descriptors. CT practice expectations are ambiguous and modified from radiographic competencies. Modified e-Delphi panellists provided judgement on 215 practice competencies and advanced capabilities which have been refined and organised into a coherent framework. Conclusions: The ComPACT framework formalises the tacit technical knowledge, clinical competencies and professional capabilities that specifically address the practice area of CT. Further work is required to validate the framework and define educational standards, but there is potential to influence future graduates, workforce development and national standards.

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As a Rogerian mental health therapist, a personal journey was taken that establishes my practice ethics as an applied theatre practitioner. What was undertaken was the unpacking of a practice ethics gained through my training as an actor and therapist. This thesis examines the role of codes or standards of practice in humanistic counselling, applied theatre and a synthesized practice between both. Standards of practice shape these practices through the specific ideologies relevant within the institutional cultures in which the practice is applied. This is especially problematic when the institutional setting understands care delivery as practice shaped by problem identification, interventions and expected outcome goals. Further, the ideology that underpins the standard, becomes self-reinforcing and tends to exert influence over what type of practice is culturally relevant or considered best practice within the institutional setting. This is of concern for practitioners who practice from a different or multiple ideological base from the institutional setting in which they work. A shaping goal of the research was to test-out, through critical evaluation, if the American Counseling Association's (ACA's) standards of practice was relevant and applicable to a synthesized practice between humanistic counselling practice and applied theatre practice. The results posed by the critical evaluation suggest that the ACAs standard is not applicable because it promotes empirical, or rather, evidenced-based models of practice over humanist ones. Because of its limited scope of application, the ACAs model is not applicable to synthesized or dual practices that bridge particular fields. Through lines of valuing within bridged fields, usually represent multiple ideological drivers. It was found that as a standard of practice the British Association of Counsellors and Psychotherapists (BACP) standard is a better fit. It is compatible with social construction. Within the research Carl Rogers' humanistic, client-centered and non-directive therapy is contrasted with Joseph Chaikin's brand of experimental theatre exemplified in his The Presence of the Actor. Chaikin's book is used as a tool to reconstruct examples of what I came to understand as ethical practice while attending drama school in the UK. The understandings gleaned by the juxtaposition impacts how I understand the ACAs utility as a practitioner.

8 ABSTRACT Title: Implementation of nursing practice standards in Nachod Regional Hospital Author: Kateřina Fialová Department: Charles University in Prague, Faculty of Humanities, Department of Management and Supervision in Social and Health Organisations Supervisor: Mgr. Petr Vrzáček, Department of Management and Supervision in Social and Health Organisations The focus of the thesis was development and especially implementation of nursing practice standards as well as exploration of non-medical health professionals' attitudes towards this process in Nachod Regional Hospital. The theoretical part clarified the concept of quality, standard, audit, accreditation, certification and also addressed the role of health and nursing care management in quality control. The practical part was divided into three research sections. The first one diagnosed nursing practice standards, their prototype version above all. The findings from this diagnosis provided two recommendations - to revise current version of methodology for standard process creation and to start changing health professionals' attitudes towards standards and standardization of nursing practice. The quantitative research in the second section analysed in detail attitudes and motivation of non-medical health professionals to make the development...

In this confirmatory factor analysis, factors previously identified to explain the variability in Middle School Mathematics Teachers’ perception of the Common Core State Standards of Mathematics were considered as factors hypothesized to effect high school math teachers’ perceptions of challenging math tasks (CMTs). The factor of student characterization (i.e., disposition, academic preparation, and student behavior) was additionally considered as a factor hypothesized to explain teachers’ perceptions of CMTs, as well as site-based variables (i.e., curriculum, assessment and evaluation, professional development, and collaboration). In addition, teachers’ understanding of the importance of the mathematical practice standards and teacher familiarity with enacting CMTs were factors considered in the model. The original septenary factor structure was modified and good model fit was achieved. In addition to the confirmatory factor analysis model which provides a structure for considering teachers perceptions of CMTs, descriptive statistics are presented from the survey developed that captured teachers’ perceptions of CMTs relative to their sites.

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