In Botswana, nurses play a major role in the provision of healthcare. Most of the time it is the professional nurses who frequently discover patients with cardiac arrests and it is necessary for them to be trained to perform CPR as efficiently as possible. The aim of this study is to describe and explore the perceptions, barriers and needs as experienced by nurses in Botswana during the provision of CPR. For this study, the researcher utilised both quantitative and qualitative research designs in four phases. Phase one assessed and audited the existing available facilities in the provision of CPR. Phase two investigated the existing knowledge and skills of registered nurses in the performance of CPR. Focus groups discussions and semi-structured interviews were held during phase three to identify the perceived barriers, needs in the performance of CPR. In phase four, the researcher made recommendation to improve the provision of CPR in relation to system, nurse and patient. Convenience sampling and purposive sampling were used in this study respectively. The auditing of the equipment in the two referral hospitals showed that the availability of equipment was below 50%. The CPR knowledge and skills demonstrated by the nurses in the pre-test were inadequate. Following CPR training with the help of a manikin, the knowledge and skills among registered nurses improved substantially. The focus group discussions and semi-structured interviews among registered nurses and senior nurse mangers revealed that there was a lack of organisational support and resources, lack of knowledge and skills among registered nurses, inadequate policies and protocols are the major contributory factors affecting the registered nurses performance in the provision of CPR. In order to enhance the performance of the registered nurses while providing CPR, the researcher recommends the two referral hospitals to • have adequate provision of equipment • introduce regular BLS training program for registered nurses • have clearly defined policies regarding the nurses’ role on end-of-life care / Health Studies

In Botswana, nurses play a major role in the provision of healthcare. Most of the time it is the professional nurses who frequently discover patients with cardiac arrests and it is necessary for them to be trained to perform CPR as efficiently as possible. The aim of this study is to describe and explore the perceptions, barriers and needs as experienced by nurses in Botswana during the provision of CPR. For this study, the researcher utilised both quantitative and qualitative research designs in four phases. Phase one assessed and audited the existing available facilities in the provision of CPR. Phase two investigated the existing knowledge and skills of registered nurses in the performance of CPR. Focus groups discussions and semi-structured interviews were held during phase three to identify the perceived barriers, needs in the performance of CPR. In phase four, the researcher made recommendation to improve the provision of CPR in relation to system, nurse and patient. Convenience sampling and purposive sampling were used in this study respectively. The auditing of the equipment in the two referral hospitals showed that the availability of equipment was below 50%. The CPR knowledge and skills demonstrated by the nurses in the pre-test were inadequate. Following CPR training with the help of a manikin, the knowledge and skills among registered nurses improved substantially. The focus group discussions and semi-structured interviews among registered nurses and senior nurse mangers revealed that there was a lack of organisational support and resources, lack of knowledge and skills among registered nurses, inadequate policies and protocols are the major contributory factors affecting the registered nurses performance in the provision of CPR. In order to enhance the performance of the registered nurses while providing CPR, the researcher recommends the two referral hospitals to • have adequate provision of equipment • introduce regular BLS training program for registered nurses • have clearly defined policies regarding the nurses’ role on end-of-life care / Health Studies

After nursing school, graduate nurses complete a licensure examination to demonstrate possession of the minimal knowledge necessary to practice nursing. Even with the successful completion of the examination, many new graduate nurses still lack the competencies required for safe practice. This discrepancy between demonstrated knowledge and competent practice, which is termed a transition-to-practice gap, is a safety issue especially for persons with chronic illnesses. The purpose of this study was to identify and clarify this transition gap to determine possible solutions in the local setting of a large health care system. The theoretical model framing this investigation was Benner's novice to expert theory. A descriptive case study was used to answer the research question regarding which competencies new graduate nurses should possess to facilitate their transition from an educational setting to a practice setting. Purposeful sampling yielded 4 nursing staff educators who had worked with graduate nurses in the past 12 months. Data from interviews with participants were coded using in vivo, initial, and axial coding. Participants reported that graduate nurses lacked adequate communication, socialization, and technical skills. Poor communication and socialization proficiencies compromised collaborative patient care, while the absence of technical skills such as physical assessment impaired direct patient care. Findings supported the development of a transition-to-practice course to prepare graduate nurses to provide quality health care. The implications of social change resulting from this transition-to-practice course may include the positive transformation of new graduate nurses, the improved professional nursing practice setting, and the positive health outcomes of community members.

This research is concerned with the assessment of student nurses' practice, implementation of which has been considered problematic since the move of initial training into higher education. It examines clinical nurses' accounts of assessment, and rejects an approach based on identification of competencies as too rationalistic for a situated practice. Insights from, in particular, Foucault, Deleuze, and Derrida were used to analyse practitioners' alternative discourse of practice, and the processes of self-constitution and decision-making. Eighteen practitioners from different settings were interviewed in depth about how they determine acceptable performance. Three participants were interviewed twice to develop ideas arising from the first round of conversations. Practitioners' accounts challenged the conventional understanding of assessment, and the construction of practice implicit in current policy. The analysis suggests a more fluid, un-predetermined understanding, characterised by hesitation and uncertainty, though without losing a concern with safe practice. Several implications for policy and practice are presented. These require a shift of authority towards practitioners' situated judgements and away from predetermined outcomes, both in respect of programme planning and policy guidelines on the specification of standards. A new alliance is proposed to encourage a more authentic engagement with the process from both clinical and educational practitioners.