Le déploiement optimal de l’étendue de la pratique infirmière, qui traduit la mise en œuvre du rôle professionnel, est essentiel à l’accessibilité, à la continuité, à la qualité ainsi qu’à la sécurité des soins, dont ceux dispensés aux enfants et à leur famille. Or, il semble que les infirmières éprouvent certaines difficultés à déployer pleinement leur étendue de pratique, ce qui pourrait également compromettre la satisfaction professionnelle, un enjeu majeur pour la rétention du personnel dans les organisations de soins de santé. Le but de cette étude est de mesurer l’étendue effective de la pratique d’infirmières en pédiatrie, ses déterminants et son influence sur la satisfaction professionnelle. Le cadre de référence, un modèle original développé dans cette thèse, prend appui sur la théorie des caractéristiques de l’emploi (Hackman & Oldham, 1974), le modèle tension-autonomie (Karasek, 1985), la théorie du rôle (Biddle, 1979) et les travaux de D’Amour et al. (2012) portant sur l’étendue de la pratique infirmière. Afin d’atteindre le but de cette étude, le modèle développé met en relation les caractéristiques du travail et les caractéristiques individuelles d’influence potentielle sur le déploiement de l’étendue de la pratique infirmière. Il présuppose également un lien entre l’étendue de la pratique infirmière et la satisfaction professionnelle. Un devis corrélationnel descriptif a été retenu pour cette étude. Une enquête par questionnaire auprès d’infirmières de cinq secteurs d’activités d’un centre hospitalier pédiatrique universitaire du Québec a été réalisée (N=301). Les associations entre les variables ont été examinées en utilisant des analyses bivariées, multivariées et un modèle d’équations structurelles. Les analyses effectuées révèlent une bonne concordance du modèle développé (ratio x²/dl= 1,68; RMSEA = ,049; CFI = ,985). Au total, le modèle explique 32,5 % de la variance de l’étendue de la pratique infirmière et 11,3% de la variance de la satisfaction professionnelle. Les résultats font état d’un déploiement non-optimal de l’étendue de la pratique infirmière (3,21/6; É.T.= ,707). Les variables significativement associées au déploiement de l’étendue de la pratique infirmière sont: la latitude décisionnelle (β = ,319; p <0,01), la surcharge de rôle (β = ,201; p <0,05), l’ambiguïté de rôle (β = ,297; p <0,05), le besoin de croissance individuelle de l’infirmière (β = ,151; p <0,05) et le niveau de formation (β = ,128; p <0,05). Il est également démontré que l’étendue de la pratique infirmière est associée positivement à la satisfaction professionnelle (β = ,118; p <0,01). Une description plus détaillée des résultats de l’étendue de la pratique infirmière en fonction du niveau de formation et du poste occupé met en lumière que les infirmières bachelières ont une étendue de pratique significativement plus élevée (3,35; É.T =,746) que les infirmières collégiales (3,12; É.T =,669). L’occupation d’un poste de clinicienne est aussi associée à une plus grande étendue de pratique infirmière. Précisément, les infirmières qui occupent un poste d’infirmière obtiennent un score de 3,13/6 (É.T =,664) alors que le score des infirmières qui occupent un poste de clinicienne s’élève à 3,48/6 (É.T =,798). Cette étude innove en présentant un modèle de référence qui a le potentiel de générer des connaissances importantes en sciences infirmières en lien avec le déploiement optimal de l’étendue de pratique infirmière. Prenant appui sur ce modèle novateur, les résultats révèlent les caractéristiques du travail sur lesquelles il y a urgence d’agir afin d’accroître le déploiement de l’étendue de la pratique infirmière et par le fait même la satisfaction professionnelle. / Optimal deployment of the scope of nursing practice, through which nurses’ professional role is expressed, is essential for ensuring accessibility, continuity, quality, and safety of care, including those provided to children and their families. Even so, it seems that nurses encounter certain difficulties when it comes to fully deploying their scope of practice. The impossibility of carrying out care activities that form part of the scope of nursing practice can also compromise job satisfaction, a major issue for healthcare organizations in terms of staff retention. The aim of this study is to measure the actual scope of nursing practice in pediatrics, its determinants, and its influence on professional satisfaction. The reference framework, an original model developed in this thesis, is based on job characteristics theory (Hackman & Oldham, 1974), the job demand-control model (Karasek, 1985), role theory (Biddle, 1979) and the work of D’Amour et al. (2012) on scope of nursing practice. To achieve the study objectives, the model developed here examines the relationships between job characteristics and individual characteristics that can potentially influence the deployment of scope of nursing practice. The model also proposes a link between scope of nursing practice and professional satisfaction, a distinct dimension of job satisfaction. A descriptive correlational design was used for this study. A survey was carried out using a self-administered questionnaire completed by nurses in five activity sectors of a pediatric university hospital (N = 301). Variability in both actual scope of nursing practice and professional satisfaction was explained using sequential multivariate regressions assuming an additive and moderating effect for individual characteristics. The potential mediating effect of scope of nursing practice between job characteristics and professional satisfaction was verified using structural equations modelling. The analyses reveal good fit for the model developed (x²/df ratio index = 1.68, RMSEA = .049, CFI = .985). Altogether, the model explains 32.5% of the variance for actual scope of practice and 11.3% of the variance for professional satisfaction. The results show non-optimal deployment of the scope of nursing practice (3.21/6; SD = .707). The analyses demonstrated the significant influence on actual scope of nursing practice of certain variables of the model: decision latitude (β = .319; p <0.01), role overload (β = .201; p <0.05), role ambiguity (β = .297; p <0.05), nurse growth need (β = .151; p <0.05) and education level (β = .128; p <0.05). They also showed that actual scope of nursing practice exerts a positive influence on professional satisfaction (β = .118; p <0.01). A more detailed examination of nurses’ actual scope of practice in relation to education level and position occupied showed the scope of practice for baccalaureate-educated nurses to be significantly higher than that of nurses with college diplomas, with scores of 3.35 (SD = .746) and 3.12 (SD = .669) respectively. Occupying a nurse clinician position also had a positive influence on actual scope of nursing practice. Specifically, the mean score for staff nurses was 3.13/6 (SD = .664), while that for nurse clinicians was higher, at 3.48/6 (SD = .798). The results of this study break new ground by presenting a model with the potential to generate important knowledge in nursing related to the optimal deployment of nurses’ scope of practice. Based on this innovative model, the results highlight job characteristics that require urgent action in order to broaden the deployment of nurses’ scope of practice and thereby to increase professional satisfaction.

Submitted in fulfillment of the requirements for the Degree of Master of Health Sciences in Radiography, Durban University of Technology, 2017. / Background The current scope of practice for diagnostic radiographers, does not allow them to administer intravenous contrast media (IVCM) since there are no formal training guidelines accredited by the Health Professions Council of South Africa (HPCSA) (Koch 2014: 26). In selected countries abroad, radiographers are allowed to administer IVCM and have thus received the necessary and accredited training to do so. In view of this, the South African radiographer’s scope of practice is not on par with the selected countries. The radiologists in South Africa (SA) who are currently responsible for the administration of IVCM have issued a position statement which supports, in principle, the idea of radiographers administering IVCM should they receive the necessary and appropriate training to do so (RSSA 2011: 1-2). The aim of this research study was, therefore, to investigate the radiologists’ perspectives regarding the theoretical knowledge, clinical competencies and medico legal responsibilities required by radiographers in order to effectively administer IVCM. This research study provides input for the development of national training guidelines for radiographers to administer IVCM. Research Methodology A quantitative, descriptive study was conducted by targeting qualified radiologists residing and practicing within the province of KwaZulu Natal (KZN). Ethical approval was obtained from the Durban University of Technology’s (DUT) Institutional Research and Ethics Committee (IREC). All the participants were contacted in their personal capacity. The research tool was an online survey administered through SurveyMonkey which included questions and statements relating to the administration of IVCM and was structured so as to meet the study objectives. The research tool was evaluated and amended by an expert focus group to ensure reliability and validity. Confidentiality was maintained and all the data obtained during this research study was password protected. Results and discussion Fifty-nine radiologists (60.8 percent) participated in this study. Twelve respondents, however, were excluded due to incomplete surveys. The final response rate, therefore, was 48.5 percent (n=47) of which 72.3 percent of the respondents were from the private sector. Results illustrated the radiologists’ agreement regarding the theoretical, clinical/practical and medico legal training components for inclusion in the further training of radiographers to administer IVCM. Most respondents supported the inclusion of three assessments: theoretical (87.2 percent), clinical (93.6 percent) and a record of clinical competencies (95.7 percent). The assessments were considered equally important in terms of percentage weighting. The overall results compared favorably to the current international trends and practice standards of radiographers administering IVCM. Conclusion and Recommendations The study, in providing key data for the development of training guidelines for radiographers to administer IVCM, has demonstrated the importance of higher education (HE) and training in addressing transformation in health services with particular reference to professional scopes of practice. Furthermore, it reinforces the need for local research that will inform HE and training and hence a scope of practice that meets local needs. It was recommended that future studies should include those HE institutions offering training in Radiography as well as their stakeholders for the design and transformation of a national curriculum for radiographers to administer IVCM. / M

No description available.

Improving the quality of abortion care can reduce stigma, increase access, and enhance knowledge about pregnancy prevention and reproductive health. Midwifery-led medication abortion is considered effective, efficient, accessible, person-centred, equitable, and safe in alignment with the World Health Organization’s framework on quality abortion care. As research on client-centred access to healthcare recommends, Ontario’s expanded midwifery care models are improving the ease with which people can find and use sexual and reproductive services most appropriate to their unique needs. The expanded midwifery care presented in this study demonstrates how midwifery-led medication abortion provides high-quality services, decreases stigma, and improves access to safe, acceptable, and client-centred abortion care, particularly for commonly underserved populations deserving of health equity and Reproductive Justice. / The World Health Organization, the International Confederation of Midwives, and the Canadian Association of Midwives advocate for the inclusion of comprehensive abortion care within midwifery practice. International evidence shows positive outcomes in terms of efficacy, safety, acceptability, and post-abortion contraception uptake when midwives provide abortion services. In Canada, midwifery services are available across various populations, including urban, rural, remote, and Northern areas, suggesting a potential to enhance access and quality of abortion care, particularly for underserved people. Expanding the role of Canadian midwives to include comprehensive abortion care could improve accessibility, address gaps in service provision, support community needs, ensure professional sustainability, foster interprofessional collaboration, and offer continuity of care. Since 2017, the Ontario Ministry of Health has funded Expanded Midwifery Care Models to support midwifery integration, interprofessional collaboration, and delivery of midwifery-led sexual and reproductive care that is not funded under the current payment model. This research explores the individual and shared experiences of midwifery-led medication abortion delivered through Expanded Midwifery Care Models across three distinct regions in Ontario. The study employs interpretive description methodology to understand how midwifery influences the experiences of medication abortion for midwives, collaborating healthcare professionals, and clients. The methodology focuses on exploring how integrating a midwifery model of abortion care supports medication abortion services and promotes Reproductive Justice within primary care settings. By gathering insights from multiple perspectives, the findings hope to inform clinical practice, interest policymakers, and identify outcomes valued by midwives, clients, and healthcare professionals for future research on midwifery-led abortion care. / Thesis / Master of Science (MSc) / Quality abortion care improves the lives, health, and wellness of reproductive-aged people. Abortion is time-sensitive and people face barriers to this care. Reproductive-aged people benefit from healthcare systems that make abortion simple, safe, and effective. Internationally, midwives play a significant role in abortion care by delivering comprehensive services within sexual and reproductive healthcare. In Canada, however, the potential of midwifery in providing abortion care has not been fully realized. As an exception, Ontario’s Expanded Midwifery Care Models (EMCMs) - innovative sexual and reproductive healthcare delivery programs - have made it possible for midwives to provide abortion services. Midwifery-led abortion care in EMCMs includes providing early abortion care in ways that make it easier for people who find it difficult to access care. This research explores and compares the personal and professional experiences of medication abortion care delivered by midwives across three regions in Ontario.

A quantitative, descriptive and contextual research study was conducted to establish the impact of the South African Nursing Council regulation number 212 on the training of theatre nurses in the Northern are of the Eastern Cape Province. A survey was conducted, using a questionnaire as research instrument. Convenience sampling was used to select the required sample of registered theatre nurses employed in the area. The data analysis revealed that the way theatre nurses are utilized in the area does not yet show an impact in terms of the aim of this course namely to develop their knowledge, skills and attitudes in order to be effective practitioners. However, the respondents felt positive about the curriculum. / Health Studies / MA (Health Studies)

The purpose of this study was to determine the contribution of nursing auxiliaries towards health care services against their scope of practice. Nursing auxiliaries practising within the Elim, Letaba, Malamulele, Nkhensani, Shiluvana and Tintswalo hospitals in the Gazankulu Health Administration, in the Northern Transvaal Province, constituted the target population. The findings revealed that nursing auxiliaries are not functioning strictly according to their scope of practice. They are an essential component of nursing services in Gazankulu by rendering a major contribution towards health care services in fulfilling their scope of practice-role. Apart from their prescribed practice-role, they are also engaged in activities that should be performed by enrolled and professional nurses as well as doctors and general assistants. There appears to be a need for education for all categories of nursing staff regarding the scope of practice of nursing auxiliaries for improving the effective utilisation of this category of nursing personnel / M.A. (Nursing Science) / Health Studies

L’importance du rôle de l’infirmière dans le système de santé autant au niveau de l’accessibilité que la qualité et la sécurité des soins et services donnés à la population est reconnue. Pour être en mesure d’exercer pleinement ce rôle, les infirmières doivent être en mesure d’exercer à leur pleine étendue de pratique. Les infirmières œuvrant dans le domaine de la santé mentale n’y font pas exception. Or, les recherches démontrent que les infirmières ne parviennent pas à mettre en oeuvre l’ensemble des activités pour lesquelles elles détiennent la formation et l’expérience. Cette recherche vise à mesurer l’étendue de pratique effective des infirmières oeuvrant en santé mentale ainsi qu’à identifier l’influence du niveau de formation sur cette étendue de pratique. Cette étude prend appui sur le SCOP model de Déry et al. (2015) qui mentionne que certaines caractéristiques de l’environnement et individuelles, telles que le niveau de formation, peuvent influencer l’étendue effective de la pratique des infirmières. Le déploiement de cette étendue de pratique a le potentiel d’influencer à son tour la satisfaction professionnelle des infirmières (Déry et al., 2013), la qualité des soins aux patients ainsi que d’autres variables organisationnelles telles que l’accessibilité, les durées moyennes de séjours et les coûts. Un devis corrélationnel descriptif a été retenu pour cette étude. Un questionnaire de type Likert a été complété par les infirmières (n=80) d’un Institut universitaire en santé mentale du Québec. Des analyses de la variance ont été utilisées pour comparer les moyennes d’étendue de pratique selon les ni-veaux de formation. Les résultats démontrent un déploiement sous-optimal de l’étendue de la pratique des infirmières (4,24/6; E.T.= 0,63). Cette étendue de pratique est tout de même supérieure à l’étendue de pratique des infirmières d’autres milieux qui a été mesurée à l’aide du questionnaire de l’étendue de la pratique infirmière (QÉPI). Les analyses effectuées concernant l’influence du niveau de formation sur l’étendue de pratique n’ont révélées aucune différence significative entre les niveaux de formation F (3, 77) = 0,707, p = 0,551. Le niveau de formation des infirmières, la présence d’un biais de représentation, le manque de puissance statistique et certaines caractéristiques de l’emploi peuvent expliquer ces résultats. Les résultats de cette étude semblent constituer une recherche empirique initiale puisqu'il s’agit à ce jour de l’unique recherche à avoir mesuré l’étendue de pratique des infirmières œuvrant en santé mentale à l’aide du QÉPI et à avoir tenté de connaître l’influence que pouvait avoir le niveau de formation sur l’étendue de leur pratique. / The importance of nursing in the health care system, both in terms of accessibility and quality and safety of patient care is well documented. In order to be able to fully exercise their role, nurses must be able to accomplish their full scope of practice. This applies to all nurses, including mental health nurses. However, research shows that nurses are unable to implement all the activities for which they have the training and experience. The aim of this study is to measure the actual scope of mental health nursing practice and to identify the influence of the level of training on this scope of practice. This study is based on the SCOP Model, from Déry et al. (2015), which states that certain job and individual characteristics, such as the level of training, can determine the actual nursing scope of practice. The deployment of this scope of practice can potentially influence professional satisfaction, quality of care and organizational factors such as accessibility, average lengths of stays and costs (Déry et al. 2015). A descriptive correlational design was used for this study. A questionnaire using a Likert scale was completed by nurses (n = 80) from a Quebec mental health Institute. Analysis of variance tests were used. The results show a sub-optimal deployment of the scope of nursing practice (4.24/6; E.T. = 0.63). The scope of practice results is the highest that has been measure with the ASCOP questionnaire. No significant differences were found between nurses with different levels of training F (3, 77) = 0.707, p = 0.551. These results can be explain by the nurses education level, the presence of a representation bias, a lack of statistical power or certain of the work characteristics. The results obtained in this study constitute initial empirical data on the subject. It is the only research measuring mental health nurses’ scope of practice with the ASCOP questionnaire and attempting to know the potential influence of level of training on scope of practice.

A quantitative, descriptive and contextual research study was conducted to establish the impact of the South African Nursing Council regulation number 212 on the training of theatre nurses in the Northern are of the Eastern Cape Province. A survey was conducted, using a questionnaire as research instrument. Convenience sampling was used to select the required sample of registered theatre nurses employed in the area. The data analysis revealed that the way theatre nurses are utilized in the area does not yet show an impact in terms of the aim of this course namely to develop their knowledge, skills and attitudes in order to be effective practitioners. However, the respondents felt positive about the curriculum. / Health Studies / MA (Health Studies)

The purpose of this study was to determine the contribution of nursing auxiliaries towards health care services against their scope of practice. Nursing auxiliaries practising within the Elim, Letaba, Malamulele, Nkhensani, Shiluvana and Tintswalo hospitals in the Gazankulu Health Administration, in the Northern Transvaal Province, constituted the target population. The findings revealed that nursing auxiliaries are not functioning strictly according to their scope of practice. They are an essential component of nursing services in Gazankulu by rendering a major contribution towards health care services in fulfilling their scope of practice-role. Apart from their prescribed practice-role, they are also engaged in activities that should be performed by enrolled and professional nurses as well as doctors and general assistants. There appears to be a need for education for all categories of nursing staff regarding the scope of practice of nursing auxiliaries for improving the effective utilisation of this category of nursing personnel / M.A. (Nursing Science) / Health Studies