New research findings, changes in legislation and the use of information technology in nursing, requires continuous in-service training of psychiatric nurses (Booyens, 2004:381; Muller, 2004:294) to cope with, reflect on, evaluate and modify their clinical practice based on emerging knowledge (Cowen et al.,2009:2; Polit & Beck, 2006:4). Many studies have been conducted on the importance of in-service training, and authors agree that in-service training improves the quality of nursing care. However few studies on in-service in South Africa and psychiatric nursing science have been conducted, of which the last study conducted on psychiatric nursing science in South Africa was 1986 (Nel, 1986:1-125). Personal observations found that some psychiatric hospitals in Gauteng do not conduct in-service training at all and informal discussions held with nursing managers highlighted that when in-service training programmes are compiled that are poorly followed, and it is unclear what the needs of psychiatric nurses are in terms of in-service training to keep them updated and empowered to perform to the best of their ability. The objectives of the study were to explore and describe the needs and benefits of in-service training for psychiatric nurses in a specific psychiatric hospital in Gauteng and to formulate recommendations for in-service training for psychiatric nurses in this hospital. The research project followed a qualitative, explorative, descriptive and contextual approach. Six focus group interviews were conducted and relevant data obtained. The findings of this research included seven main themes, namely the need for in-service training, career advantages, social advantages, physical advantages, psychological advantages of in-service training, recommendations regarding in-service training and factors that hinder in-service training. These findings were enriched with direct quotations from the transcriptions as verbalized by psychiatric nurses during focus group discussions. The findings were compared with available relevant literature for confirmation. Recommendations were formulated for nursing education, nursing research and nursing practice that focus on in-service training for psychiatric nurses. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2012

The aim of this study was to develop guidelines for the support of newly qualified nurses to ease their transition from student to professional practitioners in Lesotho; based on an exploration and description of the newly qualified nurses’ first hand experience of their transition from student to professional practitioners in a public hospital in Lesotho. The rationale behind the study was the researcher’s perception of an attitude change observed in the newly qualified professional practitioners. An explorative, descriptive, contextual, qualitative research design was chosen. The sample included all newly qualified professional nurses who worked in a public hospital in Lesotho for a period of one year or less. Data collection took place by means of semi–structured individual interviews with ten (10) participants and a focus group interview with eight (8) of the original participants. Content analysis of the data in the qualitative tradition was independently done by two coders who identified four (4) themes and ten (10) sub–themes. The first theme was described as reality shock, including the sub–themes emotional reactions and limited resources. The second theme, competence, includes the sub–themes of knowledge, skills and attitude. A third theme describes the participants experience of the support from management, colleagues, the Ministry of Health and Social welfare, nursing educational institutions and the community. The fourth theme describes the participants’ vision for the future. Each of the themes was discussed together with relevant data obtained from literature and reduced to a conclusive statement which served as basis for the formulation of guidelines to ease the transition from student to professional practitioner in Lesotho. The research report concluded with the researcher’s evaluation of the study and recommendations for nursing education, nursing management and further research. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

INTRODUCTION AND AIM: Research recognises the clear links between nurses’ experience of professional burnout and the quality of the work environment. To that end it is extremely important for nurse managers to create an organisational climate that promotes the emotional stability of nurses. This could help to improve global patient safety by reducing the frequency of adverse events. Many of the factors commonly associated with burnout, also causes unsafe patient care, and poor quality of care. Effectively managing patient safety must be a priority in units where nurses face high pressure. Staff in critical care units (CCUs) spends a tremendous amount of time with people, including the patient, family members, physicians, and other members of the multidisciplinary team that might lead to emotional and physical exhaustion and burnout. The aim of this study was to investigate the relationship between nurse burnout and the safety and quality of patient care in private critical care units in Gauteng. RESEARCH DESIGN AND METHOD: A quantitative correlational design was selected to address the research question at hand. A previously developed checklist was used to describe the demographic characteristics of the critical care units that participated in the study (n=31). A total of 298 critical care nurses participated in the study (n=298). Burnout among registered nurses working in these units was explored by means of the Maslach Burnout Inventory Scale (MBI). The registered nurses’ perceptions of the safety and quality of patient care in their units were explored by means of the RN4CAST questionnaire. Data was analysed using descriptive and inferential statistics. FINDINGS: The mean scores for emotional exhaustion measured 2.69, for depersonalisation 1.55 and for personal accomplishment 4.43. From the mean scores of each of the sub–scales of the MBI it was evident that registered nurses working in private critical care units in Gauteng province did not experience burnout. The relationship between burnout and the safety and quality of patient care was investigated by means of a Spearman rank correlation coefficient. The results indicated that emotional exhaustion demonstrated a negative relationship with the quality of nursing care in the unit (r = –0.275; p=0.00), and patient safety in the unit (r = –0.245; p=0.00). Depersonalisation demostrated a negative relationship with the quality of care in the nursing unit (r = –0.249; p=0.00 and patient safety in the unit (r = –0.205; p=0.00). Personal accomplishment demonstrated a weak positive relationship with the quality of nursing care in the unit (r = 0.197; p=0.003) and a moderate positive relationship with patient safety in the unit (r = 0.204; p=0.00). The results demonstrated a relationship between burnout and the safety and quality of patient care in private critical care units in Gauteng. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

The aim of this study was to develop guidelines for the support of newly qualified nurses to ease their transition from student to professional practitioners in Lesotho; based on an exploration and description of the newly qualified nurses’ first hand experience of their transition from student to professional practitioners in a public hospital in Lesotho. The rationale behind the study was the researcher’s perception of an attitude change observed in the newly qualified professional practitioners. An explorative, descriptive, contextual, qualitative research design was chosen. The sample included all newly qualified professional nurses who worked in a public hospital in Lesotho for a period of one year or less. Data collection took place by means of semi–structured individual interviews with ten (10) participants and a focus group interview with eight (8) of the original participants. Content analysis of the data in the qualitative tradition was independently done by two coders who identified four (4) themes and ten (10) sub–themes. The first theme was described as reality shock, including the sub–themes emotional reactions and limited resources. The second theme, competence, includes the sub–themes of knowledge, skills and attitude. A third theme describes the participants experience of the support from management, colleagues, the Ministry of Health and Social welfare, nursing educational institutions and the community. The fourth theme describes the participants’ vision for the future. Each of the themes was discussed together with relevant data obtained from literature and reduced to a conclusive statement which served as basis for the formulation of guidelines to ease the transition from student to professional practitioner in Lesotho. The research report concluded with the researcher’s evaluation of the study and recommendations for nursing education, nursing management and further research. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

INTRODUCTION AND AIM: Research recognises the clear links between nurses’ experience of professional burnout and the quality of the work environment. To that end it is extremely important for nurse managers to create an organisational climate that promotes the emotional stability of nurses. This could help to improve global patient safety by reducing the frequency of adverse events. Many of the factors commonly associated with burnout, also causes unsafe patient care, and poor quality of care. Effectively managing patient safety must be a priority in units where nurses face high pressure. Staff in critical care units (CCUs) spends a tremendous amount of time with people, including the patient, family members, physicians, and other members of the multidisciplinary team that might lead to emotional and physical exhaustion and burnout. The aim of this study was to investigate the relationship between nurse burnout and the safety and quality of patient care in private critical care units in Gauteng. RESEARCH DESIGN AND METHOD: A quantitative correlational design was selected to address the research question at hand. A previously developed checklist was used to describe the demographic characteristics of the critical care units that participated in the study (n=31). A total of 298 critical care nurses participated in the study (n=298). Burnout among registered nurses working in these units was explored by means of the Maslach Burnout Inventory Scale (MBI). The registered nurses’ perceptions of the safety and quality of patient care in their units were explored by means of the RN4CAST questionnaire. Data was analysed using descriptive and inferential statistics. FINDINGS: The mean scores for emotional exhaustion measured 2.69, for depersonalisation 1.55 and for personal accomplishment 4.43. From the mean scores of each of the sub–scales of the MBI it was evident that registered nurses working in private critical care units in Gauteng province did not experience burnout. The relationship between burnout and the safety and quality of patient care was investigated by means of a Spearman rank correlation coefficient. The results indicated that emotional exhaustion demonstrated a negative relationship with the quality of nursing care in the unit (r = –0.275; p=0.00), and patient safety in the unit (r = –0.245; p=0.00). Depersonalisation demostrated a negative relationship with the quality of care in the nursing unit (r = –0.249; p=0.00 and patient safety in the unit (r = –0.205; p=0.00). Personal accomplishment demonstrated a weak positive relationship with the quality of nursing care in the unit (r = 0.197; p=0.003) and a moderate positive relationship with patient safety in the unit (r = 0.204; p=0.00). The results demonstrated a relationship between burnout and the safety and quality of patient care in private critical care units in Gauteng. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

New research findings, changes in legislation and the use of information technology in nursing, requires continuous in-service training of psychiatric nurses (Booyens, 2004:381; Muller, 2004:294) to cope with, reflect on, evaluate and modify their clinical practice based on emerging knowledge (Cowen et al.,2009:2; Polit & Beck, 2006:4). Many studies have been conducted on the importance of in-service training, and authors agree that in-service training improves the quality of nursing care. However few studies on in-service in South Africa and psychiatric nursing science have been conducted, of which the last study conducted on psychiatric nursing science in South Africa was 1986 (Nel, 1986:1-125). Personal observations found that some psychiatric hospitals in Gauteng do not conduct in-service training at all and informal discussions held with nursing managers highlighted that when in-service training programmes are compiled that are poorly followed, and it is unclear what the needs of psychiatric nurses are in terms of in-service training to keep them updated and empowered to perform to the best of their ability. The objectives of the study were to explore and describe the needs and benefits of in-service training for psychiatric nurses in a specific psychiatric hospital in Gauteng and to formulate recommendations for in-service training for psychiatric nurses in this hospital. The research project followed a qualitative, explorative, descriptive and contextual approach. Six focus group interviews were conducted and relevant data obtained. The findings of this research included seven main themes, namely the need for in-service training, career advantages, social advantages, physical advantages, psychological advantages of in-service training, recommendations regarding in-service training and factors that hinder in-service training. These findings were enriched with direct quotations from the transcriptions as verbalized by psychiatric nurses during focus group discussions. The findings were compared with available relevant literature for confirmation. Recommendations were formulated for nursing education, nursing research and nursing practice that focus on in-service training for psychiatric nurses. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2012

Please read the abstract in the section 00front of this document / Thesis (DPhil)--University of Pretoria, 2009. / Nursing Science / unrestricted

In South Africa professional nurses undergo training which gives them different levels of skills. It is difficult for professional nurses to render comprehensive primary health care services without specific knowledge and skills. Some lack skills in preventative and promotive health care delivery; others are not trained to take care of a pregnant woman or a baby after delivery, or of a mental health patient; while yet others are only curatively oriented. It is possible that they do not recognise their own limitations and are not aware of the skills needed to render comprehensive primary health care services. Their perceptions could influence their practice and severely affect the quality of health services. The aim of this research was to explore and describe the perceptions that professional nurses working in primary health care clinics have of the skills required to render quality comprehensive primary health care services, and the perceptions they have of their own level of skills to render quality comprehensive primary health care services, as well as to formulate guidelines for the facilitation of trained professional nurses to truly render quality comprehensive primary health care services. A qualitative design was followed. Permission was obtained from the Potchefstroom District Health Manager to conduct this research. Purposive voluntary sampling was used to identify the three samples who complied with the set selection criteria. Data collection was done by means of semi-structured interviews. Experts in qualitative research evaluated the semi-structured interview schedule. A trial run was done and the interview schedule was then finalised to conduct the interviews. The interviews were recorded on audiotape and then transcribed. The interviewer made field notes to serve as an analytical basis for the collected data. Data was collected until data saturation was achieved. Data analysis was done by means of open coding. A co-coder was appointed and two consensus meetings took place. The findings indicated that professional nurses perceive the skills required to render quality comprehensive primary health care services as the ability to assess, diagnose and manage patients, as well as specific skills acquired during the various nurse training programmes. The more comprehensively trained, the more competent they feel. The less comprehensively trained, the more negative they experience their work. They view their own level of skills as ranging from adequate to lacking and inadequate, depending on their training. They feel that it is impo~ant to develop skills ranging from computer skills to the full range of skills. The conclusions drawn are that the professional nurses with different training and levels of skills are well aware of the skills required to re.nder comprehensive primary health care services. They maintain that trained professional nurses need qualifications in General Nursing, Midwifery, Community Nursing, Psychiatric Nursing and Clinical Nursing Science, and Health Assessment, Treatment and Care. The professional nurses with all five qualifications feel confident and enjoy their work, whereas those who are not fully trained lack certain skills and experience negative feelings working in the primary health care clinics. Recommendations are made for nursing education, nursing research and nursing practice with specific reference to the formulation of guidelines for the facilitation of trained professional nurses to truly render comprehensive primary health care services, with a focus on quality control, orientation, mentoring, planning of training, support systems, and consultancy. / Thesis (M.Cur.)--Potchefstroom University for Christian Higher Education, 2003

Worldwide, patients who visit health-care facilities generally have to wait very long to be attended by physicians and professional nurses. In South Africa, the Cape Triage Score system was implemented with great success in Emergency departments in the Cape Metropole. In primary health-care clinics the concern is that patients have to wait too long for service delivery, even if they are very ill and need hospitalisation. In this research study the role of triage in reducing waiting times in primary health-care clinics was examined. The Cape Triage Score system that was used in Emergency departments in the private sector and also in public hospitals was adapted for a pilot intervention study. This was done to determine if the utilisation of this system can reduce the waiting times of patients visiting primary health-care clinics. The researcher utilised a quantitative design with an intervention, after measuring the baseline waiting time. The strategies applied included an exploratory, descriptive and contextual strategy. The study was carried out in three steps according to the objectives set for the study. Firstly, the baseline assessment of the current waiting times in two PHC clinics in a sub-district of the North West Province was done. A waiting-time survey checklist was used to determine the baseline waiting time of patients visiting primary health-care clinics. These waiting-time survey checklists consisted of a few components that assessed different aspects of waiting time. The second objective was to explore and describe literature in order to understand primary health-care waiting times, triage and related constructs. The third objective was to pilot an adapted Cape Triage Score system to determine if the intervention contributed to reducing waiting times for patients visiting primary health-care clinics. Data was analysed according to Cohen’s effect sizes. The comparison between the baseline waiting times and pilot intervention waiting-time assessment was done according to Cohen’s effect sizes. The analysis of the data indicated a practical significance for the component where the pilot Cape Triage Score system was applied, as patients were referred to the physician and professional nurse according to the severity of their condition. The outcome of the study indicated no reduction in the overall waiting time of patients visiting primary health-care clinics due to the different components of the waiting-time survey checklist. Finally, the research was evaluated, limitations were identified and recommendations were stipulated for nursing practice, education, research and policy. / MCur, North-West University, Potchefstroom Campus, 2014

In South Africa professional nurses undergo training which gives them different levels of skills. It is difficult for professional nurses to render comprehensive primary health care services without specific knowledge and skills. Some lack skills in preventative and promotive health care delivery; others are not trained to take care of a pregnant woman or a baby after delivery, or of a mental health patient; while yet others are only curatively oriented. It is possible that they do not recognise their own limitations and are not aware of the skills needed to render comprehensive primary health care services. Their perceptions could influence their practice and severely affect the quality of health services. The aim of this research was to explore and describe the perceptions that professional nurses working in primary health care clinics have of the skills required to render quality comprehensive primary health care services, and the perceptions they have of their own level of skills to render quality comprehensive primary health care services, as well as to formulate guidelines for the facilitation of trained professional nurses to truly render quality comprehensive primary health care services. A qualitative design was followed. Permission was obtained from the Potchefstroom District Health Manager to conduct this research. Purposive voluntary sampling was used to identify the three samples who complied with the set selection criteria. Data collection was done by means of semi-structured interviews. Experts in qualitative research evaluated the semi-structured interview schedule. A trial run was done and the interview schedule was then finalised to conduct the interviews. The interviews were recorded on audiotape and then transcribed. The interviewer made field notes to serve as an analytical basis for the collected data. Data was collected until data saturation was achieved. Data analysis was done by means of open coding. A co-coder was appointed and two consensus meetings took place. The findings indicated that professional nurses perceive the skills required to render quality comprehensive primary health care services as the ability to assess, diagnose and manage patients, as well as specific skills acquired during the various nurse training programmes. The more comprehensively trained, the more competent they feel. The less comprehensively trained, the more negative they experience their work. They view their own level of skills as ranging from adequate to lacking and inadequate, depending on their training. They feel that it is impo~ant to develop skills ranging from computer skills to the full range of skills. The conclusions drawn are that the professional nurses with different training and levels of skills are well aware of the skills required to re.nder comprehensive primary health care services. They maintain that trained professional nurses need qualifications in General Nursing, Midwifery, Community Nursing, Psychiatric Nursing and Clinical Nursing Science, and Health Assessment, Treatment and Care. The professional nurses with all five qualifications feel confident and enjoy their work, whereas those who are not fully trained lack certain skills and experience negative feelings working in the primary health care clinics. Recommendations are made for nursing education, nursing research and nursing practice with specific reference to the formulation of guidelines for the facilitation of trained professional nurses to truly render comprehensive primary health care services, with a focus on quality control, orientation, mentoring, planning of training, support systems, and consultancy. / Thesis (M.Cur.)--Potchefstroom University for Christian Higher Education, 2003