Submitted in fulfilment of the requirements of the Degree of Master of Technology: Biomedical Technology, Durban University of Technology, 2013. / The purpose of the study was to evaluate knowledge and effects of Haemolytic Disease of the Newborn (HDN) in postnatal women from the Umgungundlovu District. Although the prevalence of HDN has declined because of prophylaxis from 45 cases per 10,000 births to 10.2 cases per 10,000 births but it is still a cause of infant and neonatal morbidity and mortality. The effects of the disease range from jaundice, kernicterus and in severe cases death. Methodology : An interviewer-administered questionnaire was used to obtain information about the knowledge and effects of HDN amongst postnatal women. The incidence rate was calculated using the number of cases that were found divided by the total number of deliveries during the study period. A total of 300 women were interviewed. SPSS version 19.0 was used to analyse data. Findings : Fifteen (15) of the 300 women had babies with confirmed HDN and only four of the 15 (26%) women had knowledge of HDN. Two hundred and eighty five women had babies with jaundice but were not affected by HDN and, of these women, 12 (4.2%) of them knew what HDN was. Overall, only 16 (5.3%) knew what HDN was. All 15 women who had babies with HDN indicated financial and emotional effects because of HDN. The total incidence was 0.09% for the first 12 months of the study period. Conclusion : Postnatal women with jaundiced babies lack knowledge of HDN and HDN has financial and emotional effects on these women. Although the incidence rate of HDN was found to be even smaller than previously reported, it still exists and threatens the lives of infants and neonates.

Thesis (MPA (School of Public Management and Planning))--University of Stellenbosch, 2005. / South Africa, as a young and emerging democracy, faces many challenges regarding the transformation of the socio-economic landscape of the South African society. The provision of better health care services and the overall development and empowerment of society are some of the many challenges government has to resolve. This research focuses specifically on service delivery in public hospitals with special emphasis on: 􀂙 An assessment of financial management outcomes within the context of the implementation of the Public Finance Management Act (Act 1 of 1999, as amended) [PFMA] in public hospitals; and 􀂙 An assessment of supply chain management (SCM) outcomes in relation to the achievement of empowerment and equity of disadvantaged communities within the context of Black Economic Empowerment (BEE). The PFMA is the result of financial reform in South Africa. The PFMA emphasises effective, efficient, economic and transparent use of public funds. This research assessed the financial management at the Head Office of the Western Cape Health Department, as well as at Karl Bremer, Lentegeur and Swellendam Hospitals for the financial years 1998/99 to 2002/03. The Western Cape Tender Board ceased to exist in December 2003. The procurement and provisioning processes have now been decentralised to the various departments with effect 1 January 2004 and have become the responsibility of supply chain units within departments. BEE and the preferential procurement policy are government initiatives that had to be executed on SCM as platform. The three hospitals were also used to assess progress on the implementation of SCM, as well as the realisation of BEE objectives. Annual Reports, Audit Reports and Strategic Planning documentation were used to extract the relevant information necessary for the research. Interviews with nineteen (19) officials were conducted. Good progress has been made with the implementation of the PFMA. All those officials that were interviewed displayed sensitivity for the responsible management of public funds. A lack of internal control measures was identified in almost all audit reports. The absence of a risk management plan and a functional internal audit unit is hampering the realisation of the objectives of the PFMA. With health care service delivery and black economic empowerment being topical issues in SA, this research endeavours to make recommendations that could assist the Western Cape government with the realisation of the intended objectives of better health care services delivery by public hospitals, transformation of the economy, equity and empowerment of the disadvantaged through SCM processes and eventually to secure “a better life for all”.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2016. / Introduction Registered midwives are expected to practice their duties within the parameters of their scope of practice. Pregnant women have certain expectations about the midwife and their skills. If such expectations are not met, substandard care occurs. Such substandard care has a negative impact for both the pregnant woman and the Department of Health. Aim of the study The aim of this study was to explore and describe the experiences of midwives working in maternity units, concerning midwifery practice breakdown in maternity units at a public hospital in KZN. Methodology A qualitative research study that was exploratory, descriptive and contextual in nature was conducted. Semi-structured interviews were conducted with 13 midwives. Data was transcribed verbatim then organised into codes. Results The study revealed that the majority of the participants faced practice breakdown almost daily and most of the midwifery practice breakdowns start during antenatal care visits. Midwives who attended to pregnant women during antenatal care did not follow set protocols and guidelines and this resulted in complications during delivery. Most midwives were emotionally stressed and did not wish to continue practicing midwifery. Midwives were of the opinion that the management did not care about their challenges and did nothing to resolve the challenges. / M

The World Health Organization (WHO) recommends that of all the live births per year no more than 10-15% of these should be delivered by caesarean section. Despite this recommendation there has been a global increase in the percentage of caesarean section deliveries over the past few decades. In South Africa the percentage is as high as 70% in certain health care institutions which is of concern to midwives. Caesarean section deliveries are needed when the life of the baby, mother or both are at stake. However, this method of delivery bears more disadvantages than advantages to the baby and mother. Despite these disadvantages, some women request a caesarean section in their birth plans while others are influenced by health professionals to request a caesarean section. Therefore, there is a need for labouring women to be guided where possible to have vaginal birth because of its many advantages. This study sought to explore and describe the perceptions of the midwives regarding their role in facilitating the choice of delivery mode for labouring women in public hospitals and midwifery obstetric units (MOUs) of the Nelson Mandela Bay and Sarah Baartman districts. Based on the results of the study, guidelines for midwives in this role were developed. Maputle’sWoman-Centred Childbirth Model (2010) was used as the theoretical lens through which this study was viewed. The researcher selected a quantitative survey design using an explorative, descriptive and contextual research approach. The population consisted of midwives who were working in labour wards at public hospitals and midwife-led MOUs. A non-probability convenience sample was used to collect data using a structured, self-administered questionnaire. The reliability and validity of the data collection instrument were ensured by using various means including a pre-test and an expert panel. Altogether, 300 questionnaires were distributed and 288 were returned. This number excluded the pilot study. Data was collected over a period of three months using the assistance of two fieldworkers. Data was captured and analysed under the supervision of the statistician and supervisors. Analysis was done by means of descriptive analyses that involved the production of frequencies and presented using charts, figures and tables. The major findings of the study are: -The midwives perceived themselves as the main facilitators of a suitable decision by the labouring woman for a safe delivery method - The midwives emphasised the importance of the delivery position preferred by the labouring woman -The midwives indicated that a collaboration between doctors, senior midwives, midwives and midwives in management positions could assist with a decision for a suitable delivery mode option. -The midwives agreed that the culture of the labouring woman should be considered when deciding on a delivery mode and therefore midwifery curriculum should include lessons about cultural diversity. Three principal guidelines were developed, namely: 1. Create an environment that promotes acceptance of a woman’s choice of a delivery mode. 2. Create an environment promoting a collaborative health care relationship 3. Create an environment that is sensitive to cultural needs in the maternity unit Ethical considerations in this study were upheld by maintaining the principles of beneficence, maleficence, autonomy and justice.

Recognising the enormous challenges in South Africa confronting the nursing of the mentally ill, the project was conducted in a public hospital in Gauteng. The purpose of the research was to describe professional nurses' perception of nursing mentally ill people in a general hospital setting and was carried out amongst a sample size of 124 professional nursing staff using a self-administered tool. The study looked at four different types of perceptions guided by categories of conceptual framework proposed by Mavundla (2000:1569-1570), namely perception of self, perception of patients, perception of environment and perceived feelings. The study found that the majority of professional nurses have a predominantly positive self- perception of nursing mentally ill people in a general hospital, although a significant number have a negative perception of patients, the nursing environment and perceived feelings. Lack of knowledge, skill and experience affect the nursing care of mentally ill people in the general hospital. / Health Studies / M.A. (Health Studies)

The aim of the study was to explore the perceptions of nurses regarding communication with nurse managers in the workplace. The design of the study was a generic qualitative. The methodology of choice was qualitative, explorative method. The sample was non-probability and the approach or technique used was purposive sampling method. It comprised of thirty nurses, ten of each category. The category was a component of professional nurses, enrolled nurses and enrolled nursing auxiliary nurses. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The findings showed that there were dynamics in communication from all nurse categories and that also indicated that there was a need to conduct a research so that the root cause may be identified and suggestions to be put in place to curb the challenges. In conclusion it showed that communication is the key problem of all and it is a worldwide problem. / Health Studies / M.A. (Health Studies)

Recognising the enormous challenges in South Africa confronting the nursing of the mentally ill, the project was conducted in a public hospital in Gauteng. The purpose of the research was to describe professional nurses' perception of nursing mentally ill people in a general hospital setting and was carried out amongst a sample size of 124 professional nursing staff using a self-administered tool. The study looked at four different types of perceptions guided by categories of conceptual framework proposed by Mavundla (2000:1569-1570), namely perception of self, perception of patients, perception of environment and perceived feelings. The study found that the majority of professional nurses have a predominantly positive self- perception of nursing mentally ill people in a general hospital, although a significant number have a negative perception of patients, the nursing environment and perceived feelings. Lack of knowledge, skill and experience affect the nursing care of mentally ill people in the general hospital. / Health Studies / M.A. (Health Studies)

Text in English / Professional nurses are regarded as the backbone of the health care system and quality patient care is linked to patient safety.The purpose of the study was to describe and explore the perceptions of professional nurses on impact of shortage of resources for quality patient care. The resources include health professionals, equipment and drugs. The study was conducted in Mankweng hospital which is a public hospital in the Capricorn district in Limpopo Province. Qualitative descriptive exploratory design was used which provided the researcher with in-depth information regarding phenomena under study. Data was collected from ten (10) professional nurses who have 5 to 20 years of nursing experience allocated in medical and surgical wards. Unstructured face-to-face interview was conducted using field notes and audio tape. Data was analysed following Creswell (2014) Tesch method. Five themes and eighteen subthemes emerged from data. The findings revealed that the shortage of health professionals and inadequate resources has a negative impact on provision of quality patient care. / Health Studies / M.A. (Health Studies)

The aim of the study was to explore the perceptions of nurses regarding communication with nurse managers in the workplace. The design of the study was a generic qualitative. The methodology of choice was qualitative, explorative method. The sample was non-probability and the approach or technique used was purposive sampling method. It comprised of thirty nurses, ten of each category. The category was a component of professional nurses, enrolled nurses and enrolled nursing auxiliary nurses. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The findings showed that there were dynamics in communication from all nurse categories and that also indicated that there was a need to conduct a research so that the root cause may be identified and suggestions to be put in place to curb the challenges. In conclusion it showed that communication is the key problem of all and it is a worldwide problem. / Health Studies / M.A. (Health Studies)

Submitted in fulfillment of the requirements for the degree of Master of Health Sciences (Nursing), Durban University of Technology, Durban, South Africa, 2017. / BACKGROUND: Quiet often when students return from clinical placement, complain of being abused by patients and their relatives. Student nurses view clinical placement as an anxiety producing part of the nursing programme (Magnavita and Heponiemi 2011: 208). As a result, some resign and leave nursing fearing for their lives. AIM OF THE STUDY: To determine the extent and types of violence experienced by student nurses from patients and their relatives or friends in public hospitals in KwaZulu-Natal, and whether this leads to intentions to leave the nursing profession. METHODOLOGY: A quantitative, descriptive cross sectional survey approach conducted amongst student nurses (n=421) at KwaZulu-Natal College Nursing R425 Program starting from their first year of training up to the midwifery module. Self-Administered Questionnaires (SAQ) were used to collect data and data analysed using SPSS version 23. RESULTS: All respondents (n=421) completed the SAQ (annexure B). Many student nurses, especially female students, are victims of intimidation, bullying and verbal abuse as opposed to physical and sexual abuse by patients’ relatives and patients. The workplace violence against student nurses resulted in anger and absenteeism. The majority have not reported any abuse and they were not even aware of any policy that exists in their institutions against any form of violence. DISCUSSION: Findings in this study revealed that student nurses, like all other nurses, were also at a high risk of workplace violence. This may be because nurses have the closest contact with patients and their relatives; hence they are at high risk of exposure to violence. Since all settings are potentially high risk for violence, it is therefore necessary for the management to improve security in all high-risk areas for the student nurses to be safe. RECOMMENDATIONS: Public hospitals and the Department of Health (DOH) needs to formulate clear policies regarding violence against student nurses, and information on how to report the occurrence. There is a need for development or improvement of policies, procedures and intervention strategies. The DOH needs to address the issues of violence by implementing strategies to create a supportive environment that facilitates empowerment for the positive emotional wellbeing of student nurses. Managers have the responsibility to create and maintain zero tolerance regarding workplace violence. Public hospitals need to employ Managers with required skills and higher education to deal with workplace violence. There is a need for further research and more details on workplace violence and its cause. / M