Submitted in Fulfillment of the Requirements of the Degree of Doctor of Technology: Nursing Sciences, Durban University of Technology, Durban, South Africa, 2012. / Introduction While investigating alleged unprofessional conduct involving nurses, SANC collects a wealth of information which is used as the basis upon which to determine the nurses’ guilt or innocence in respect of unprofessional conduct. No evidence exists that such information is ever used to determine how similar acts of unprofessional conduct could be prevented and/or be used in mitigating the impact of such acts on patient safety. Given that nurses have most interaction with patients, there is much to learn from practice breakdown involving nurses. Methods A four phase cross sectional sequential exploratory mixed method approach using a modified soft system methodology (SSM) methodology was utilised to develop a framework for the integrated management of practice breakdown. Purposive sampling was followed to select five districts in KwaZulu-Natal for inclusion in the study. In addition Operational Nursing Managers, members of the Professional Conduct Committee of the South African Nursing Council, and representatives of organised labour were purposively sampled. Qualitative data regarding causes and current practices in the management of practice breakdown in the nursing profession was gathered from key groups via focus groups, and individual phone calls. Then a survey instrument used to test the elements of the emerging theory was developed. Finally, a framework for integrated management of practice errors is suggested. Results The study found that practice breakdown was a product of both environmental factors such as fallible managerial decisions, and unintended acts committed by nurses. In addition, the types of errors and consequences of error management were identified. Finally, conditions requisite for the integrated approach in the management of practice breakdown were identified and used to develop a framework for an integrated approach in the management of practice breakdown in nursing. Conclusion Creation of a positive practice environment for nurses is requisite for an integrated approach in the management of practice breakdown. / Appendices only available in the Hard copy of the Thesis / D

In 2009 there were 3.28 million non-fatal occupational injuries and illnesses (Bureau of Labor Statistics, 2010). Of these injuries and illnesses, 965,000 resulted in lost days from work. In addition there were 4,340 workplace fatalities. Given the number of occupational injuries, illnesses, and fatalities, and the associated direct and indirect costs, organizations have sought to improve safety at work. Safety climate and safety motivation are two variables hypothesized to affect safety behaviors and safety outcomes. Safety climate refers to the shared perceptions of workgroup members, of the organizations' commitment to safety as evidenced by heir immediate supervisors' pattern of implementing safety policies and procedures (Zohar, 2003). Therefore, the workgroup supervisor plays an major role in the development of safety climate. Social exchange theory and previous studies of leadership styles and safety suggest that supervisors who convey concern for subordinates' well-being increase workers' motivation to reciprocate by increasing their safe behaviors at work. However, no research to date has examined the relationship between supervisors' personality and workers perceptions of safety climate, or the effect of Big Five trait-level variables on workers safety motivation. In this study I hypothesize that supervisors' proactive personality and three Big Five traits will be positively related to workers' safety climate perceptions. In addition, I hypothesize that four Big Five traits in workers will be positively related to workers safety motivation. Finally, I hypothesize that group-level safety climate will be significantly related to individual-level safety motivation after controlling for workers' personality. Participants in this study were maintenance and construction workers from a municipal city bureau, in 28 workgroups, totaling 146 workers and 28 supervisors. Workgroup sizes vary but averaged 6.21 members, including the supervisor. The data were collected in small groups (paper-and-pencil) and electronically (on-line); workers and supervisors answered questionnaire items on personality variables, safety climate, safety motivation, safety behaviors, and safety outcomes. In addition, archival data on safety outcomes were collected. The data were analyzed using a combination of multiple regression, multi-level modeling, and path analysis to test hypotheses and answer research questions. Both proactive personality and Big Five traits in supervisors accounted for incremental variance in aggregated workgroup safety climate over controls. In addition, workgroup safety climate and individual workers' cautiousness were significant predictors of workgroup safety motivation in a hierarchical linear model. At the individual level of the model, only the traits of cautiousness and morality were significant predictors of individual safety motivation. Tests of the Neal and Griffin (2004) model showed that safety motivation partially mediated the relationship between individual safety climate and safety participation behaviors. In addition, safety motivation fully mediated the relationships between morality and both safety compliance and safety participation behaviors. Finally, safety motivation partially mediated the relationship between cautiousness and both safety compliance and safety participation behaviors. The results suggest that supervisor personality can have an effect on the on workgroup safety climate perceptions. In addition, this study provided evidence that Big Five traits are useful predictors of the antecedents of accidents and injuries. Suggestions for training managers and future research are also discussed.

There has been an upward trend of construction injuries and fatalities in the recent decade. Regulatory agencies, such as the NYC Department of Buildings, exist to create and modify construction safety laws, review construction projects, and enforce these laws through site inspections, and often make the data they collect available to the public. However, there is a lack of predictive modeling and a lack of research regarding how to make a proactive prediction of potential injuries and fatalities on construction sites. This study uses public data to predict future construction incidents using leading indicators from information gathered from the NYC permits-issued and complaints-received databases. Results indicate that it is possible to predict future construction incidents over multiple forecast windows using a logistic regression and zero-inflated Poisson model. While previous site incidents alone are significant in predicting future incidents, adding permit and complaint related information increased the true positive rate and decreased the false-negative rate.

Thesis submitted in fulfilment of the requirements for the degree Master of Technology Occupational Health Nursing in the Faculty of Health and Wellness Sciences at the Cape Peninsula University of Technology 2015 / Purpose of study: The purpose of this study was to explore the injury on duty prevention and management strategies that are currently used in different higher education settings. The study intended to shed light on specific areas of policy and practice discrepancies related to the disjuncture between employee interactions, regulated directives and organizational goals. Aims and objectives: One of the aims was to determine the types of work-related injuries that occur in HEI’s by verifying the injuries reported on Employers Reports of an Accident. A second aim was to examine strategies that have been put in place to prevent injuries in the workplace by reviewing policies and procedures related to injury prevention. The final aim was to examine systems in-place to manage occupational injuries by looking at staff health or employee wellness service flow charts or models used at the HEIs. Population and sample: Permanently employed personnel at two HEI’s in the Western Cape were participants in a multiple case study. The sample units consisted of health and safety representatives, human resources, maintenance personnel, estates and custodial, traffic services and departmental managers. Methodology: This study applied a mixed-method using a multiple case study design as an approach to the enquiry. Methods of data collection: Documents, questionnaires, and semi-structured interviews were be used to obtain data to answer the research questions. Process of analysis: Qualitative and quantitative themes will be analysed in a matrix. The three data sources were triangulated to validate the findings. Benefits of the study: Injury prevention benefits the employer and employee in many ways, including increased employee performance leading to increased productivity as well as cost savings. Main findings: Injuries that were reported are mostly musculoskeletal injuries; however other types of injuries may not be reported due to under reporting of injuries being common in this setting. Health and safety training and knowledge sharing was not well supported and injury prevention strategies were not optimized. The application of health and safety policies and procedures were not adequately communicated, enforced or monitored. Staff health and employee wellness strategies operate independently and do not facilitate a coordinated response to manage occupational injuries in this setting. Lack of monitoring, organizational support, training and knowledge sharing and communication were the four main challenges to injury prevention management systems. Conclusions: The implementation of an effective injury prevention and management programme could benefit the organization and translate into increased operational value (organizational quality). Key words: Higher Education Institutions, Occupational Injury prevention, Management of occupational injury.