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

This study investigated the clinical accompaniment of nursing students in a rural hospital. Nursing students are allocated to clinical facilities for clinical exposure and learning opportunities; to integrate theoretical knowledge with practical skills and professional socialization under guidance and support from professional practitioners. Although the rural hospital, as context for this study, provides unique and challenging learning opportunities for clinical teaching and learning, the environment as such and the relationship between the stakeholders (nursing students and professional nurses) seem to be questionable and not conducive for learning. A qualitative, explorative, descriptive and contextual design served as framework for this study. Data was collected by means of semi–structured focus–group interviews with samples selected from two (2) populations of stakeholders with first hand experience of the clinical accompaniment of nursing students allocated to the rural hospital for clinical exposure and learning. The first sample consisted of thirteen (n=13) nursing students and the second sample consisted of professional nurses (n=6) directly involved in the clinical accompaniment of the nursing students. The focus of the interviews was the participants' experience of the clinical accompaniment in a specific rural hospital. Data was analyzed by means of the process of content analysis as described by Graneheim and Lundman (2004). Three (3) themes and eight (8) subthemes emerged from the data collected from the nursing students. The data collected from the professional nurses resulted in five (5) themes and eleven (11) subthemes. The collected data was integrated with relevant national and international literature to culminate in eight (8) conclusive statements. The conclusive statements served as basis for the proposal of guidelines to improve the clinical accompaniment of nursing students in a rural hospital and to enhance learning in the clinical practice area. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

This study investigated the clinical accompaniment of nursing students in a rural hospital. Nursing students are allocated to clinical facilities for clinical exposure and learning opportunities; to integrate theoretical knowledge with practical skills and professional socialization under guidance and support from professional practitioners. Although the rural hospital, as context for this study, provides unique and challenging learning opportunities for clinical teaching and learning, the environment as such and the relationship between the stakeholders (nursing students and professional nurses) seem to be questionable and not conducive for learning. A qualitative, explorative, descriptive and contextual design served as framework for this study. Data was collected by means of semi–structured focus–group interviews with samples selected from two (2) populations of stakeholders with first hand experience of the clinical accompaniment of nursing students allocated to the rural hospital for clinical exposure and learning. The first sample consisted of thirteen (n=13) nursing students and the second sample consisted of professional nurses (n=6) directly involved in the clinical accompaniment of the nursing students. The focus of the interviews was the participants' experience of the clinical accompaniment in a specific rural hospital. Data was analyzed by means of the process of content analysis as described by Graneheim and Lundman (2004). Three (3) themes and eight (8) subthemes emerged from the data collected from the nursing students. The data collected from the professional nurses resulted in five (5) themes and eleven (11) subthemes. The collected data was integrated with relevant national and international literature to culminate in eight (8) conclusive statements. The conclusive statements served as basis for the proposal of guidelines to improve the clinical accompaniment of nursing students in a rural hospital and to enhance learning in the clinical practice area. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

Background: Research on nursing practice has highlighted a relationship between non-nursing tasks (NNTs), nursing tasks left undone (NTLU), and internationally it was found that these factors have an effect on job satisfaction. Since the last study done on NNTs and NTLU in 1988, much has changed in South Africa`s health system. Current South African studies have revealed that decreased numbers of PNs in South Africa experience satisfaction. Therefore, this study explores the relationship between NNTs, NTLU and job satisfaction on both individual PN level and unit level in South Africa, and contributes to the international debate. Aim: To investigate the relationship between NNTs, NTLU and job satisfaction among professional nurses (PNs) in medical and surgical units in private and public hospitals in South Africa. Method: A cross-sectional survey design was used including 1166 PNs in 60 medical and surgical units in 55 private hospitals and seven national referral hospitals in South Africa who completed the survey. Measures: Relationships between NNTs, NTLU, job satisfaction and aspects of job satisfaction. Results: The three main NNTs performed were filling-in for non-nursing services (d=0.47), cleaning patient’s rooms and equipment (d=0.48) and obtaining supplies and equipment (d=0.64). Nationally more than 50% of PNs reported the following NTLU – comfort/talk with patients (62.2%), educating patients and family (57.9%) and develop or update nursing care plans/pathways (51.6%). PNs in private hospitals are more satisfied with their jobs than PNs in public hospitals. PNs were most dissatisfied with the opportunities for advancement (M = 2.60) and educational opportunities (M=2.64) aspects of job satisfaction. At unit level, NTLU positively correlated with three NNTs, and job satisfaction correlated mostly and negatively with NTLU. Conclusion: South African PNs perform many NNTs. However, the performance of NNTs does not influence their job satisfaction to the extent the NTLU does. Although PNs in this study indicated that NNTs do not have a significant influence on NTLU, it may reveal a greater issue, in that PNs have grown accustomed to performing NNTs as part of their workload. Clarifying professional nurses’ scope of practice and increased use of support services may provide PNs with more time to conduct nursing tasks which should improve job satisfaction. Recommendations for practice, education, policy/orientation programmes and research are made from the findings of this study. / MCur, North-West University, Potchefstroom Campus, 2014

Background: Research on nursing practice has highlighted a relationship between non-nursing tasks (NNTs), nursing tasks left undone (NTLU), and internationally it was found that these factors have an effect on job satisfaction. Since the last study done on NNTs and NTLU in 1988, much has changed in South Africa`s health system. Current South African studies have revealed that decreased numbers of PNs in South Africa experience satisfaction. Therefore, this study explores the relationship between NNTs, NTLU and job satisfaction on both individual PN level and unit level in South Africa, and contributes to the international debate. Aim: To investigate the relationship between NNTs, NTLU and job satisfaction among professional nurses (PNs) in medical and surgical units in private and public hospitals in South Africa. Method: A cross-sectional survey design was used including 1166 PNs in 60 medical and surgical units in 55 private hospitals and seven national referral hospitals in South Africa who completed the survey. Measures: Relationships between NNTs, NTLU, job satisfaction and aspects of job satisfaction. Results: The three main NNTs performed were filling-in for non-nursing services (d=0.47), cleaning patient’s rooms and equipment (d=0.48) and obtaining supplies and equipment (d=0.64). Nationally more than 50% of PNs reported the following NTLU – comfort/talk with patients (62.2%), educating patients and family (57.9%) and develop or update nursing care plans/pathways (51.6%). PNs in private hospitals are more satisfied with their jobs than PNs in public hospitals. PNs were most dissatisfied with the opportunities for advancement (M = 2.60) and educational opportunities (M=2.64) aspects of job satisfaction. At unit level, NTLU positively correlated with three NNTs, and job satisfaction correlated mostly and negatively with NTLU. Conclusion: South African PNs perform many NNTs. However, the performance of NNTs does not influence their job satisfaction to the extent the NTLU does. Although PNs in this study indicated that NNTs do not have a significant influence on NTLU, it may reveal a greater issue, in that PNs have grown accustomed to performing NNTs as part of their workload. Clarifying professional nurses’ scope of practice and increased use of support services may provide PNs with more time to conduct nursing tasks which should improve job satisfaction. Recommendations for practice, education, policy/orientation programmes and research are made from the findings of this study. / MCur, North-West University, Potchefstroom Campus, 2014

The dualistic South African health system is divided into a private and public health care sector. The core difference between these two sectors is that private hospitals are based on a business model with a profit motive, while public hospitals offer a free service, accessible to all citizens of South Africa and is nurse-driven. The increased need towards higher quality health care is evident in the launching of the National Health Insurance system. The pilot of this system was activated in ten sub-districts in South Africa and will become the mechanism to enhance quality and safety of patient care in the private and public sectors. Registered nurses’ reporting of quality and safety of patient care is an important factor in quality-related research and has been linked with international studies on quality of care. As the registered nurses are directly involved in all the facets of patient care, this population serves as a valuable contribution in the assessment of quality care. In this research quality of care refers to quality, patient safety and adverse events. Quality of care refers to the extent to which actual care is in conformity with the present criteria for good care. Patient safety is a parameter used to monitor and enhance quality. Through enhanced patient safety, adverse events can be prevented. Adverse events refer to all the incidents that can affect a patient during hospitalisation that is not due to the patient’s illness, such as hospital acquired infections, medication safety and patient falls with injury. This research aimed to explore and describe the nurse reported differences in quality of care, patient safety and adverse events in the adult medical and surgical units of private and public hospitals in the Free State and North West Provinces. This study was conducted within the RN4CAST research programme, an international consortium of fifteen countries working together towards the formulation of nurse workforce forecasting models. A quantitative, correlational, explorative, descriptive and contextual design was followed. The population consisted of registered nurses employed for at least one year in the selected private and public hospitals in the two participating provinces. Private hospitals with more than 100 beds were included. The public hospitals had a level three status. An all-inclusive sampling was conducted (n=332) after participants gave informed consent. Data was collected through the completion of the National Nurse Survey that covered four sections of which quality of care, patient safety and adverse events was one. Field workers were utilised during data collection. Data capturing was conducted by means of EpiData 3.1. Secondary data analysis was utilised by means of SPSS 16.0. Descriptive statistics were extracted with regard to the demographic status of the participants. The descriptive statistics were congruent with the demographic profile of nursing in South Africa. The inferential statistics included the difference in quality of care, patient safety and adverse events between the private and public hospitals in the selected provinces. Both the t-test based on the quality of care and patient safety as well as the Mann-Whitney test on adverse events indicated an insignificant difference between nurse reported quality of care, patient safety and adverse events between the private and public hospitals. Reliability and validity were assured and recommendations were formulated for nursing education, practice and research. / MCur, North-West University, Potchefstroom Campus, 2013

The dualistic South African health system is divided into a private and public health care sector. The core difference between these two sectors is that private hospitals are based on a business model with a profit motive, while public hospitals offer a free service, accessible to all citizens of South Africa and is nurse-driven. The increased need towards higher quality health care is evident in the launching of the National Health Insurance system. The pilot of this system was activated in ten sub-districts in South Africa and will become the mechanism to enhance quality and safety of patient care in the private and public sectors. Registered nurses’ reporting of quality and safety of patient care is an important factor in quality-related research and has been linked with international studies on quality of care. As the registered nurses are directly involved in all the facets of patient care, this population serves as a valuable contribution in the assessment of quality care. In this research quality of care refers to quality, patient safety and adverse events. Quality of care refers to the extent to which actual care is in conformity with the present criteria for good care. Patient safety is a parameter used to monitor and enhance quality. Through enhanced patient safety, adverse events can be prevented. Adverse events refer to all the incidents that can affect a patient during hospitalisation that is not due to the patient’s illness, such as hospital acquired infections, medication safety and patient falls with injury. This research aimed to explore and describe the nurse reported differences in quality of care, patient safety and adverse events in the adult medical and surgical units of private and public hospitals in the Free State and North West Provinces. This study was conducted within the RN4CAST research programme, an international consortium of fifteen countries working together towards the formulation of nurse workforce forecasting models. A quantitative, correlational, explorative, descriptive and contextual design was followed. The population consisted of registered nurses employed for at least one year in the selected private and public hospitals in the two participating provinces. Private hospitals with more than 100 beds were included. The public hospitals had a level three status. An all-inclusive sampling was conducted (n=332) after participants gave informed consent. Data was collected through the completion of the National Nurse Survey that covered four sections of which quality of care, patient safety and adverse events was one. Field workers were utilised during data collection. Data capturing was conducted by means of EpiData 3.1. Secondary data analysis was utilised by means of SPSS 16.0. Descriptive statistics were extracted with regard to the demographic status of the participants. The descriptive statistics were congruent with the demographic profile of nursing in South Africa. The inferential statistics included the difference in quality of care, patient safety and adverse events between the private and public hospitals in the selected provinces. Both the t-test based on the quality of care and patient safety as well as the Mann-Whitney test on adverse events indicated an insignificant difference between nurse reported quality of care, patient safety and adverse events between the private and public hospitals. Reliability and validity were assured and recommendations were formulated for nursing education, practice and research. / MCur, North-West University, Potchefstroom Campus, 2013

Text in Afrikaans / In hierdie beskrywende, verkennende en kontekstuele studie is ondersoek gedoen na redes waarom opgeleide intensiewesorgverpleegkundiges uit die intensiewesorgomgewing bedank en buite die intensiewesorgomgewing werk in die noordelike gedeelte van Gauteng. Doelwitte vir die studie was om die faktore te bepaal wat bydra tot die bedanking uit die intensiewesorgeenheid, die identifisering van die nie-verpleegkundige beroepe wat tans beoefen word en die bepaling van die faktore wat bydra tot die beoefening van 'n nie-verpleegkundige beroep. Die data is ingesamel deur middel van 'n vraelys wat voltooi is deur opgeleide intensiewesorgverpleegkundiges wat bedank het uit die intensiewesorgomgewing. Die sneeubalsteekproeftegniek is gebruik. Die data-analise het getoon dat redes vir bedanking uit die intensiewesorgomgewing die volgende insluit: onvoldoende salarisse, te veel stres en emosionele uitputting, ongerieflike werkure, personeeltekort en onbevredigende werkomstandighede. Daar is bevind dat verpleeg-sessiewerk steeds deur die respondente gedoen word, al werk hulle huidig voltyds buite die intensiewesorgomgewing. / In this exploratory, descriptive and contextual study research has been done to establish the reasons why intensive care nursing personnel resign from the intensive care environment in the northern Gauteng region. The researcher aimed to establish the factors that contributed to the resignations from the intensive care environment, to identify the non-nursing careers currently being practised by former intensive care nursing staff and to establish the factors that influenced them to practice non-nursing careers. The data was collected through questionnaires completed by former intensive care nursing personnel. The snowball test sampling method has been used. Data analysis has shown the following to be inter alia the reasons for the resignations from the intensive care environment: insufficient income, exhaustion and emotional stress, inconvenient working hours, staff shortages and unsatisfactory working conditions. One finding is that respondents are still doing nursing session work although they are working full-time in nonnursing capacities. / Health Studies / M.A. (Verpleegkunde)

Hierdie navorsing het die bevordering van die regering se gesondheidsbevorderingsdoelwitte soos vervat in die Witskrif vir die Transformasie van die Gesondheidstelsel in Suid-Afrika, Kennisgewing 667 van 1997 (White Paper for the Transformation of the Health System in South Africa Notice 667 of 1997) ten doel. 'n Verdere doel was om die behoefte na beroepsgesondheidsbevorderende programme in geselekteerde beroepsituasies vanuit 'n verpleegkundige perspektief vas te stel. Die resultate van hierdie navorsing het aangedui dat daar wel 'n behoefte bestaan aan beroepsgesondheidsbevorderende programme in geselekteerde beroepsituasies. Hierdie behoefte is vasgestel deur middel van die literatuurstudie en deur die versameling van inligting deur middel van 'n opname. 'n Holistiese en bemagtigingsbenadering tot beroepsgesondheidsbevorderende, asook 'n gesondheidsbevorderende verplegingsbenaderingsraamwerk word voorgestel. Addisioneel word riglyne vir die ontwikkeling en implementering van beroepsgesondheidsbevorderingsprogramme asook 'n gesondheidsbevorderende verpleegopleidingsprogram voorgestel. Daar word aanbeveel dat gesondheidsbevorderende verpleegkunde ingesluit word in alle verpleegkunde praktyke en verpleegkunde kurrikula. Aanbevelings ten opsigte van toekomstige navorsing sentreer rondom 'n ondersoek na die huidige status van beroepsgesondheidsbevordering, navorsing met betrekking tot die gesondheidsbevorderende werkplek en kampus - wat alle belanghebbendes insluit - die status van gesondheidsbevorderende opleiding; en navorsing gelyksoortig aan hierdie een in ander streke van Suid-Afrika. Die skeiding tussen beroeps- en primere gesondheidsorg in werkplekke behoort ook ondersoek te word. / This research is aimed at furthering the health promotion and occupational health objectives of the government as is set out in the "The White Paper for the Transformation of the Health System in South Africa Notice 667 of 1997". The aim of this research was to determine the need for occupational health promotion programmes in selected occupational settings from a nursing perspective. The overall outcome of this research demonstrated that a need exists for occupational health promotion programmes in selected occupational settings. This was illustrated by the literature study and by the information collected through a survey. Three frameworks are proposed, namely a holistic approach to an occupational health promotion programme, an empowerment occupational health promotion approach, and a health promoting nursing framework. In addition, guidelines for the development and implementation of an occupational health promotion programme and a health promotion and health promoting nursing training programme are recommended. It is also recommended that health promoting nursing be included in all nursing practice and nursing training curricula. Recommendations for future research centred on the investigation of the present status of occupational health promotion, research regarding the health promoting workplace and campus that involves all stakeholders, the status of health promotion training, and research similar to this one in other regions of South Africa. The division of occupational health and primary health care in occupational health settings needs to be investigated as well. / Health Studies / M.A. (Advanced Nursing Sciences)

Text in Afrikaans / Die effek van die klient-verpleegkundige-verhoudings op kliente se keuse en volgehoue gebruik van kontraseptiewe metodes het tot op hede baie min aandag geniet. Die doel van hierdie studie was 'n ondersoek na die ongetroude klient se persepsie van die verpleegkundige se houding. Die steekproef het bestaan uit 99 kliente (tussen die ouderdomme van 15 en 50 jaar) wat die betrokke reproduktiewegesondheidsklinieke in die Kaapse Metropool besoek het. Die eerste 20 kliente wat die kliniek besoek het, is genader om 'n vraelys in te vul. Hierdie studie toon 'n algehele positiwiteit, naamlik 58,3% teenoor die houding van geregistreerde verpleegkundiges. Die meerderheid van die kliente (88,0%) het aangedui dat hulle weer die kliniek sal besoek wat dus die kliente se tevredenheid toon. / The effect of the client-registered nurse relationship on clients' choice and continuous use of contraceptive methods has until now received very little attention. The purpose of this study was to explore unmarried clients' perception of the attitude of the registered nurse. The sample existed of 99 clients (between the ages of 15 and 50 years) who visited the relevant reproductive health clinics in the Cape Metropole. The first 20 clients who visited the clinic were approached to complete a questionnaire. This study shows an overall positivity of 58,3% with regard to the attitude of registered nurses. Most of the clients (88,0%) indicated that they would visit the clinic again, which indicate their satisfaction. / Health Studies / M.A. (Nursing Science)