Thesis (MCurr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: In South Africa, currently enrolled nurses make up the largest proportion of members of the
nursing healthcare team. As in direct contact with patients it is essential that the practice
environment supports patient and nursing outcomes. Studies confirm the complexity of the
practice environment and the impact on both personnel and on the quality of nursing care
provided. Job satisfaction is integrally linked to the quality and safety of care provided.
The scarcity of registered professional nurses, particularly in the South African context, has
resulted in enrolled nurses being widely used to continue to deliver acute care in quite complex
situations. It is well documented that the use of suboptimal nursing personnel levels or
substituting enrolled nurses for registered professional nurses is associated with an increase of
adverse events such as infections, pressure ulcers and unanticipated death.
The purpose of this study was to explore the experiences of enrolled nurses regarding quality
nursing care in general nursing units in the private healthcare setting. The objectives being:
- The exploration of the enrolled nurses understanding of the concept of quality care
- The exploration of the enrolled nurses understanding of her value and contribution to
quality care and
- The exploration of the enrolled nurses experiences (positive and negative) of quality
nursing care in private health care setting A descriptive qualitative methodology was applied. A purposive sample size of n=13 was drawn
from the total population of N=387. An exploratory interview was completed. Lincoln and Guba’s
criteria of credibility, transferability, dependability and confirmability were applied and ethical
principles were met.
Findings demonstrated that enrolled nurses experienced both positive and negative work
experiences, some more negative than others. They had a very good understanding of quality
care but had difficulty in reconciling the patient’s needs with what they were able to deliver, due
to workload pressures and resource constraints: P6: “I miss the quality because that patient that needs just that back rub or just to hold
his hand ...the thing is with quality nursing we don’t do quality nursing on the patient
anymore.”
Most participants experienced registered professional nurses absolving their clinical supervisory
responsibility. This endangers the quality and duty of care of patients and is a legal liability. A
recommendation is that registered professional nurses require professional development
through utilising good role models. This exposure to positive learning experiences will enable
their professional development and ethical behaviour. Registered professional nurses need to
be taught the skills of how to be team players. / AFRIKAANSE OPSOMMING: Ingeskrewe verpleegsters maak huidiglik die grootste deel van die verplegingsspan se
gesondheidsorg uit. As gevolg van die direkte kontak met pasiënte, is dit belangrik dat die
omgewingspraktyk pasiënt- en verpleeguitkomste moet kan ondersteun. Navorsingsstudies
bevestig die kompleksiteit van die omgewingspraktyk en die impak wat dit op beide personeel
en op die kwaliteit van verpleging wat verskaf word, het. Werksbevrediging vorm ’n
geïntegreerde skakel met die kwaliteit en veiligheid van sorg wat verskaf word.
Die tekort aan geregistreerde professionele verpleegsters, veral binne die Suid-Afrikaanse
konteks, het tot die gevolg dat ingeskrewe verpleegsters oral gebruik word om akute sorg in
taamlik komplekse situasies te lewer.. Dit is goed gedokumenteer dat die gebruik van
suboptimale verpleegpersoneelvlakke of die vervanging van geregistreerde professionele
verpleegsters met ingeskrewe verpleegsters, geassosieer word met ’n toename in nadelige
gevalle soos infeksies, druk-ulkusse en onverwagte dood.
Die doel van hierdie studie is om die ervaringe van ingeskrewe verpleegsters ten opsigte van die
kwaliteit van verpleegsorg binne algemene verpleegeenhede in die private
gesondheidsorgomgewings te ondersoek. Die doelwitte is ’n ondersoek na die ingeskrewe
verpleegsters se:
- begrip van die konsep van kwaliteitsorg
- begrip van hul waarde en bydrae tot kwaliteitsorg en
- ervaringe (positief en negatief) van kwaliteit verpleegsorg binne private
gesondheidsorgomgewings. ’n Beskrywende, kwalitatiewe metodologie is toegepas. ’n Doelgerigte steekproefgrootte van n =
13 is geneem uit die totale populasie van N = 387. ’n Voortoets is voltooi. Lincoln en Guba se
kriteria van geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid is
toegepas en etiese beginsels is nagekom.
Bevindings het bewys dat ingeskrewe verpleegsters beide positiewe en negatiewe
werkservaringe gehad het; sommige meer negatief as ander. Hulle het ’n baie goeie begrip van
kwaliteitsorg, maar vind dit moeilik om aan die pasiënt se behoeftes, vanweë drukkende
werkladings en beperkte bronne te voldoen. P6: “Ek mis die kwaliteit want al wat die pasiënt benodig is die vryf van die rug of net die
vashou van sy hand…die probleem met kwaliteitsorg is dat ons nie meer kwaliteitsorg op
die pasiënt doen nie.”
Die meerderheid van die deelnemers verklaar dat die geregistreerde professionele
verpleegkundiges hulle kliniese toesighoudende verantwoordelikheid afskeep. Die gedrag is
bydraend tot swak kwaliteit pasient sorg en het direkte wetlik implikasies. Die aanbeveling is dat
professionele ontwikkeling van geregistreedrde verpleegkundigies verbeter kan word deur
gebruik te maak van goeie rol modelle. Die blootstelling aan positiewe leer ervarings en
omgewing sal bydrae tot hulle professionele ontwikkeling en etiese gedragspatrone.
Geregistreerde verpleegkundiges moet die vaardighede aanleer om as deel van ’n span te kan funksioneer.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/96099 |
| Date | 12 1900 |
| Creators | Haakestad, Andrea |
| Contributors | Furst, L., Stellenberg, E. L., Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Division of Nursing Science. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 111 p. |
| Rights | Stellenbosch University |
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