Sustainability is a complex system of interaction between a hospital, individual, community, and environmental factors that is required to work in harmony to keep a patient healthy. With the complexities that exist within healthcare, the nurse leader is required to ensure that the care environment, processes and the safety behaviours required from nurses to provide safe healthcare is in place and sustained to contribute to the enhancement of patient safety, whilst in the care of the diverse nursing workforce. The aim of the study is to develop an action plan to sustain best safety culture practices for improved patient outcomes in hospitals with a culturally diverse nursing workforce. Methodology: A multiple method design was utilised to study the safety culture and positive work environment (hospital climate) that exists among culturally diverse nurses and how it is managed by the nurse managers in order to identify and describe actions that can be included in an action plan to sustain best safety culture practices for improved patient outcomes. Purposeful and convenience sampling methods were used in the study. Two hospitals, with a very diverse nursing workforce were purposefully selected to participate in the study. Pretesting of the questionnaire and e-Delphi embedded assessment validation instrument were done by participants not part of sample groups. Phase 1: The Hospitals outcomes data for nursing admission assessment within 24-hours, falls and hospital acquired pressure ulcer incidences and hand hygiene rates were collected on a checklist. Phase 2: Two questionnaires (1) nurses capturing: biographical data and culture, patient safety (nursing admission assessment within 24-hours, falls and HAPU and hand hygiene), and safety culture and positive work environment (hospital climate); (2) nurse managers capturing: biographical data and culture, patient safety (nursing admission assessment within 24- hours, falls and HAPU and hand hygiene), safety culture and Positive Work Environment (hospital climate) and just culture practices. Phase 3: the Draft e-Delphi action plan with embedded assessment validation instrument was developed. Phase 4: The panel experts selected to validate the e-Delphi draft action plan with embedded assessment validation instrument in pre-determined rounds. Data analysis: Phase 1: The outcomes data was displayed in bar graphs and illustrated that (1) the nursing admission assessment within 24 hour period not been sustained over time for the medical, surgical, paediatric and critical care areas; (2) a hundred and sixty two fall incidence; (3) ninety six HAPU incidences and (4) hand hygiene rate of between 80-94% being reported. Phase 2: A participation rate of 46.33% by nurses and 73.91% by nurse managers were achieved. The data for the 2 questionnaires indicated the need to include 54 action statement to address the culture, patient safety, hospital climate (PWE), safety culture and just culture gaps identified. Phase 3: the e-Delphi draft action plan developed based on literature review and data from phase 1 and phase 2. Phase 4: 100% participation rate was achieved. Consensus was reached within two rounds that the 54 action statements are essential and important for patient safety and identified the responsible persons required enacting on action statement and timeframe required to complete action. Recommendation: The Action Plan to enhance a sustainable Culture of Safety to improve patient outcomes were decided by panel experts. Plan to disseminate the plan among the CNO for implementation. / Health Studies / D. Litt. et Phil. (Health Studies)

Summaries in English and Shona / Introduction Despite wide spread information and knowledge of HIV and AIDS transmission, High school teenage girls continued to engage in risky sexual behaviour in Tshwane, a District of Gauteng Province of South Africa. Age-parity relationships between High school teenage girls and older men known as “Sugar Daddies” or “Blessers”, who showered High school teenage girls with money and expensive gifts, were believed to be spreading HIV. High school teenage girls failed to negotiate condom use due to lack of autonomy, coupled with sexual violence, resulting in HIV transmission. Consequently, Tshwane became one of the highest HIV burdened cities in South Africa. Purpose of the study This study explored and described the High school teenage girls’ knowledge and perceptions of the risks of human immunodeficiency virus and acquired immune deficiency syndrome in Tshwane, a District of Gauteng Province of South Africa. Method The study used a quantitative approach. The data were collected using questionnaires. The population comprised of all girls aged 15 to 19 at a selected High school. The sample consisted of 109 girls. Systematic sampling was used. The study was conducted in the school hall of a selected High school. Data were analysed using SPSS version 23 program. Results Generally, the High school teenage girls’ HIV knowledge was very high (84.4%) as compared to their knowledge on AIDS (3.7%). Only 10.1% of the High school teenage girls knew what the window period entailed. They were aware of HIV preventive measures evidenced by abstinence ranking first (1) and had the highest score of five (5). 17.4% of the High school teenage girls doubted the usefulness of the condom in combating HIV infection. Health care workers were easily accessible (30.3%). The television was the most available mass media (92%). The radio was most preferred (31%). High school teenage girls preferred to discuss HIV related information with their peers and friends (50%). 42% of the High school teenage girls preferred to discuss sex related topics with parents or guardians. Those who were below 18-years were 7.2 times less likely to have sex. 90% of the 19-year-old girls had had sex. Therefore, High school teenage girls’ perception of HIV risk was low because they continued to be involved in concurrent multiple relationships although 90% of those involved were using condoms. Conclusion Although High school teenage girls proved that they had knowledge of HIV and AIDS, they still had a low perception of HIV risk because they were involved in concurrent multiple sexual relationships with older men. / Habedi, Debbie Kgomotso / Kunyangwe vane ruzivo rwechirwere cheshura matongo, vasikana vane makore ari pakati pegumi nematatu negumi nemapfumbamwe vari kuenderera mberi nekuita unhu unoita kuti vabatwe nechirwere cheshuramatongo (AIDS). Vasikana ava vari kudanana nevarume vakuru kuvadarika vamwe masadzimba zvinoita kuti vatapurirwe utachiona hweHIV zvinoita kuti vasikana vane hutachiona uhwu vawandise muguta reTshwane, mudunhu reGauteng munyika yeSouth Africa. Vanasikana ava vanopuwa mari nekutengerwa mbozhanhre nenguvo zvinodhura nekudya tunonaka. Nekuda kwekuti varume vanesimba rehudzvinyiriri nekuvarwisa, muAfrica, vasikana ava havakwanisi kushandisa makondomu kuzvidzivirira kubva kuhutachiona hweHIV. Ndosaka guta reTshwane raita mukurumbira munyika yeSouth Africa nekuti vanasikana vane hutachiona hweHIV vari kuwandisa. Gwaro iri rinoongorora nekutsanangura ruzivo uye maonero evanasikana huipi hwechirwe cheshuramatongo muguta guru reTShwane, mudunhu reGauteng. Munyika yeSouth Africa. Mafambiro Egwaro Gwaro iri riri kuongorora nekutsanangura ruzivo nemaonerwo anoitwa hutachiona hweHIV nechirwere cheshuramatongo nevasikana vari pakati pemakore gumi nemakore matatu nevanegumi nemakore mapfumbamwe pachikoro chesekonari chakasarudzwa mugutu guru reTshwane, mudunhu reGauteng, munyika yeSouth Africa. Vasikana vaka pindura mibvunzo pamusoro peruzivo rwavaiva narwo uye zvakanyangara zvinoita kuti vabatwe nehutachiona hweHIV. Vasikana zana nevapfumbamwe ndivo vakapindura mibvunzo. Vasikana vakapindura mibvunza yaiva pamapepa muhoro yepachikoro pavo. Zvakabuda Muchidzidzo Zvakaonekwa kuti vasikana vane ruzivo rwechirwere cheshuramatongo asi vane zvimwe zvinhu zvavasinga nzwisisi pamusoro pechirwere ichi zvekuzvidzivirira. Vasikana havakwanisi kupa mutsauko wehutachiona (HIV) nechirwere cheshuramatongo (AIDS). Vanasikana vazhinji vanofunga kuti hutachiona hweHIV hunotapurirwana pakutsvodana uye pakushandisa zvimbuzi. Vasikana vazhinji havakwanisi kutsanangura nguva inogara hutachina hweHIV mumuviri hwusati hwaonekwa kuti hurimo. Vasikana havana chokwadi chekuti makondomu anogona kudzivirira hutachiona hweHIV kuti hwusapinda mumuviri nguva dzebonde. Vadzidzisi vechikoro ndivo vakasarudzwa kuti vane ruzivo rwechirwere cheshuramatongo. Vasikana havafariri kudzidziswa nezve chirwere cheshuramatongo nevabereki vavo. Vanofarira kukurukura nezvechirwere ichi nevanhu vezera ravo. Vasikana vasingagari nevabereki vavo vanoita bonde kudarika vanogara nevabereki vavo uye vanoita bonde nevadiwa vazhinji vamwe vacho varume vakuru madzisaimba. Vasikana vanotaridza kusatya kubatwa nechirwere chishuramatongo nemhaka yehunhu wawo hwakashata hweku danana nevarume vazhinji uye kusashandisa makondomu nguva dzebonde. Mhendero Zvidzidzo zvinopiwa vasikana zvinechekuita nezvepabonde zvinofanira kuongororwa zvipamhidzirwe kuti vasikana vagone kuzvidzivirira kuchirwere cheshuramatongo. Madzimudzangara netelevhizhoni zvino kurudzirwa kudzidzisa mitambo nedzimbo dzinodzidzisa pamusoro pekudzivirira chirwere cheshuramatongo. Vabereki vanofanira kudzidziswawo kuti vagone kudzidzisa vana vavo kuti vagone kuzvidzivirira kuti vasabatwa nechirwere ichi. Vanasikana vanofanirwa kudzidziswa kushandisa makondomu pese pavanoita bonde. Makondomu anofanira kuiswa pachena paano kwanisa kuwonekwa nevasikana. / Health Studies / M.P.H. (Health Studies)