Lived experiences of professional nurses caring for mechanically ventilated patients
- Authors: Else, Liana
- Date: 2015
- Subjects: Respiratory intensive care , Respiratory therapy , Respirators (Medical equipment) , Artificial respiration
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/8295 , vital:26320
- Description: Critical care nursing is a speciality that continues to evolve and transform. Critical care nurses of the 21st century routinely care for the complex, critically ill patient, integrating sophisticated technology with the accompanying psychosocial challenges and the ethical conflicts associated with critical illness – while, at the same time, addressing the needs and concerns of the family. Providing nursing care in such a dynamic and fast-track unit can pose various challenges for the critical care nurse. Professional nurses are the backbone of any health-care system. The quality of nursing directly affects the patients’ outcomes, and nursing care must therefore be rendered meticulously. Mechanical ventilator support is routinely needed for critically ill adults in these care units and is also a common therapy in sub-acute and long-term care settings. The care of the mechanically ventilated patient is the core of a professional nurse`s practice in the critical care unit. The mechanically ventilated patient presents many challenges for the professional nurse, while the critical care unit poses as a stressful environment for the professional nurse as well as the patient. The objectives of this study therefore were to explore and describe the lived experiences of professional nurses while caring for mechanically ventilated patients, and to develop recommendations to support professional nurses while caring for mechanically ventilated patients. A qualitative, explorative, descriptive and contextual research design was utilised. Data was collected by means of semi-structured interviews and analysed according to the framework provided by Tesch. Purposive sampling was used to select a sample of professional nurses working in a critical care environment. Guba’s model was utilised to verify data and to ensure trustworthiness of the study. Ethical principles were adhered to throughout this research study. With the analysed data, recommendations were to support professional nurses while caring for mechanically ventilated.
- Full Text:
- Date Issued: 2015
- Authors: Else, Liana
- Date: 2015
- Subjects: Respiratory intensive care , Respiratory therapy , Respirators (Medical equipment) , Artificial respiration
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/8295 , vital:26320
- Description: Critical care nursing is a speciality that continues to evolve and transform. Critical care nurses of the 21st century routinely care for the complex, critically ill patient, integrating sophisticated technology with the accompanying psychosocial challenges and the ethical conflicts associated with critical illness – while, at the same time, addressing the needs and concerns of the family. Providing nursing care in such a dynamic and fast-track unit can pose various challenges for the critical care nurse. Professional nurses are the backbone of any health-care system. The quality of nursing directly affects the patients’ outcomes, and nursing care must therefore be rendered meticulously. Mechanical ventilator support is routinely needed for critically ill adults in these care units and is also a common therapy in sub-acute and long-term care settings. The care of the mechanically ventilated patient is the core of a professional nurse`s practice in the critical care unit. The mechanically ventilated patient presents many challenges for the professional nurse, while the critical care unit poses as a stressful environment for the professional nurse as well as the patient. The objectives of this study therefore were to explore and describe the lived experiences of professional nurses while caring for mechanically ventilated patients, and to develop recommendations to support professional nurses while caring for mechanically ventilated patients. A qualitative, explorative, descriptive and contextual research design was utilised. Data was collected by means of semi-structured interviews and analysed according to the framework provided by Tesch. Purposive sampling was used to select a sample of professional nurses working in a critical care environment. Guba’s model was utilised to verify data and to ensure trustworthiness of the study. Ethical principles were adhered to throughout this research study. With the analysed data, recommendations were to support professional nurses while caring for mechanically ventilated.
- Full Text:
- Date Issued: 2015
Midwives' experiences of high stress levels due to emergency childbirths in Namibia Regional Hospital
- Authors: Ndikwetepo, Monika Ndaudika
- Date: 2015
- Subjects: Midwifery -- Namibia , Medical personnel -- Job stress -- Namibia , Childbirth -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10073 , http://hdl.handle.net/10948/d1021162
- Description: Many midwives throughout the world experienced high stress levels when they deal with emergency childbirths. Midwifery professionals experience certain unique stressors, such as midwives being responsible for the care of women when they are giving birth. Complications of childbirth may occur during labour leading to the life of the baby and the mother being threatened. Situations such as this leave midwives experiencing high levels of stress for which they often do not have effective coping mechanisms. When the stress is not managed, it may lead to burnout. When burnout occurs the midwives present with physical and psychological symptoms of stress, grief for the loss and lack of motivation, which results in staff turnover and a fear of working in a maternity ward. Consequently, patient care may be compromised as some midwives became apathetic and develop unacceptable attitudes toward their patients. Such behavior led to poor work performances, maternity services that are not woman-friendly and women seeing the maternity ward as a place where they are treated in rude and unfriendly manner which increased the chances of adverse childbirth outcomes. The aim of the study was to explore and describe the experiences of midwives who have to cope with stress associated with emergency childbirths. This information was used to develop the guidelines to help midwives to cope with the high stress associated with emergency childbirths. The researcher used a phenomenological, qualitative approach. The study was explorative, as little was known on this topic in the Namibian context and it was also descriptive and contextual. Purposive and convenient sampling was used to select the research sample. The research population was all the midwives working in the maternity ward of a Namibian regional hospital, who met the inclusion criteria. Data gathering was done using semi-structured interviews. Once data saturation occurred, interviewing stopped. The interviews were audio-taped and transcribed verbatim. Tesch’s eight steps of data analysis were followed to create meaning from the data collected. An independent coder assisted with the coding process to ensure the trustworthiness of the findings. Literature control was done after data collection to support and strengthen the study’s findings. Trustworthiness, as suggested by using Lincoln & Guba’s model of trustworthiness, included truth-value/credibility, applicability/transferability, consistency/dependability and neutrality/conformability was implemented. Ethical principles of beneficence, non-maleficence, autonomy and justice were ensured by obtaining permission to conduct the research from relevant authorities and from University structures, obtaining consent from the participants before the interviews, voluntary participation and right to withdraw from the study, privacy, confidentiality and dissemination of the results. Three main themes and sub-themes were identified namely: Midwives experienced significant stressors associated with emergency childbirth situations. Midwives experienced mixed emotions about dealing with emergency childbirth situations Midwives shared their views regarding their support needs associated with emergency childbirth situations. Recommendations for nursing education, clinical midwifery and for further research were made. Four guidelines were developed based on the study findings as well as literature related to these findings, to help the midwives to cope with high stress levels associated with emergency childbirths.
- Full Text:
- Date Issued: 2015
- Authors: Ndikwetepo, Monika Ndaudika
- Date: 2015
- Subjects: Midwifery -- Namibia , Medical personnel -- Job stress -- Namibia , Childbirth -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10073 , http://hdl.handle.net/10948/d1021162
- Description: Many midwives throughout the world experienced high stress levels when they deal with emergency childbirths. Midwifery professionals experience certain unique stressors, such as midwives being responsible for the care of women when they are giving birth. Complications of childbirth may occur during labour leading to the life of the baby and the mother being threatened. Situations such as this leave midwives experiencing high levels of stress for which they often do not have effective coping mechanisms. When the stress is not managed, it may lead to burnout. When burnout occurs the midwives present with physical and psychological symptoms of stress, grief for the loss and lack of motivation, which results in staff turnover and a fear of working in a maternity ward. Consequently, patient care may be compromised as some midwives became apathetic and develop unacceptable attitudes toward their patients. Such behavior led to poor work performances, maternity services that are not woman-friendly and women seeing the maternity ward as a place where they are treated in rude and unfriendly manner which increased the chances of adverse childbirth outcomes. The aim of the study was to explore and describe the experiences of midwives who have to cope with stress associated with emergency childbirths. This information was used to develop the guidelines to help midwives to cope with the high stress associated with emergency childbirths. The researcher used a phenomenological, qualitative approach. The study was explorative, as little was known on this topic in the Namibian context and it was also descriptive and contextual. Purposive and convenient sampling was used to select the research sample. The research population was all the midwives working in the maternity ward of a Namibian regional hospital, who met the inclusion criteria. Data gathering was done using semi-structured interviews. Once data saturation occurred, interviewing stopped. The interviews were audio-taped and transcribed verbatim. Tesch’s eight steps of data analysis were followed to create meaning from the data collected. An independent coder assisted with the coding process to ensure the trustworthiness of the findings. Literature control was done after data collection to support and strengthen the study’s findings. Trustworthiness, as suggested by using Lincoln & Guba’s model of trustworthiness, included truth-value/credibility, applicability/transferability, consistency/dependability and neutrality/conformability was implemented. Ethical principles of beneficence, non-maleficence, autonomy and justice were ensured by obtaining permission to conduct the research from relevant authorities and from University structures, obtaining consent from the participants before the interviews, voluntary participation and right to withdraw from the study, privacy, confidentiality and dissemination of the results. Three main themes and sub-themes were identified namely: Midwives experienced significant stressors associated with emergency childbirth situations. Midwives experienced mixed emotions about dealing with emergency childbirth situations Midwives shared their views regarding their support needs associated with emergency childbirth situations. Recommendations for nursing education, clinical midwifery and for further research were made. Four guidelines were developed based on the study findings as well as literature related to these findings, to help the midwives to cope with high stress levels associated with emergency childbirths.
- Full Text:
- Date Issued: 2015
Midwives' experiences regarding the utilization of partographs in a Namibian Regional Hospital
- Authors: Fernandes, Diina
- Date: 2015
- Subjects: Midwifery -- Namibia , Labor (Obstetrics) -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10071 , http://hdl.handle.net/10948/d1021158
- Description: Labour has been characterized as the most dangerous journey a woman undertakes. The reason being, that although it is a natural process, many labouring women suffer complications during labour and childbirth including prolonged or obstructed labour. These complications can result in maternal and infant morbidity and mortality. The partograph is a monitoring tool that can provide a continuous pictorial overview and is essential to monitor and manage labour. It is recommended by the WHO for use universally by midwives while monitoring labour. However partographs are poorly utilized and most parameters on the partograph are not monitored and findings after reviewing a labouring woman are not documented on the partograph. It is unclear how midwives working in Namibian Health services experience and utilize the partograph during the monitoring of a woman in labour. These may be the factors that hinder the effective utilization of the partograph. The objective of this study was to explore and describe the experiences of midwives regarding the utilization of the partograph for monitoring a labouring woman in a Namibian regional hospital in order to develop guidelines based on the findings to improve the use of the partograph by midwives in order to improve the management of labour. The research design was qualitative, descriptive, explorative and contextual in nature. The research population consisted of midwives working in a regional hospital in Namibia. A purposive and convenient sampling method was used to select participants. Specific inclusion criteria were met and consent was obtained from the participants and from the Regional Health Directorate Management of the hospital where the research was conducted. Interviews were conducted by an independent interviewer within the Department of Health to ensure an unbiased viewpoint. Data were collected by means of semi-structured in depth interviews with a guide, using an audio tape recorder. Field notes were used to record non- verbal communication. As soon as data were saturated, the interviews were stopped. They were then transcribed, verbatim and analysed using the Tesch’s approach as described in (Creswell, 2009:186). The service of an independent coder was utilized to ensure trustworthiness. Trustworthiness was further ensured by using the strategies suggested by Lincoln and Guba’s model, namely credibility, transferability, dependability and confirmability. Ethical considerations were honoured throughout by adhering to ethical principles during the study. These included ensuring that the participants` rights were respected, they were not harmed and fairness were ensured. On completion of the data analysis a literature control was conducted and existing literature was compared to the findings in order to identify similarities and differences and to verify whether the literature supported the findings. Four main themes that emerged during data analysis are: Theme 1.Midwives found it a positive experience to use the partograph when caring for a woman in labour. Theme 2. When a midwife experienced problems in using the partograph, it may lead to detrimental outcomes. Theme 3. Utilizing the partograph evoked differing emotions in midwives. Theme 4. Midwives` knowledge and skills in the utilization of the partograph should be updated regularly. By describing the lived experienced of midwives in the maternity ward on the use of the partograph, the midwives had a positive attitude to using the partograph, but they also found it difficult to utilize the instrument as was directed by the (WHO) due to challenges experienced such as: unrealistic staff/patient ratio, shortage of staff, time consuming, insufficient knowledge and skills among midwives and lack of appropriate equipment. There is a specific need to prevent further negative emotions by addressing the challenges experienced. Based on the findings, guidelines for partograph utilization which aimed at improving the midwifery care were developed. Recommendations were made regarding midwifery education, clinical midwifery care and midwifery research.
- Full Text:
- Date Issued: 2015
- Authors: Fernandes, Diina
- Date: 2015
- Subjects: Midwifery -- Namibia , Labor (Obstetrics) -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10071 , http://hdl.handle.net/10948/d1021158
- Description: Labour has been characterized as the most dangerous journey a woman undertakes. The reason being, that although it is a natural process, many labouring women suffer complications during labour and childbirth including prolonged or obstructed labour. These complications can result in maternal and infant morbidity and mortality. The partograph is a monitoring tool that can provide a continuous pictorial overview and is essential to monitor and manage labour. It is recommended by the WHO for use universally by midwives while monitoring labour. However partographs are poorly utilized and most parameters on the partograph are not monitored and findings after reviewing a labouring woman are not documented on the partograph. It is unclear how midwives working in Namibian Health services experience and utilize the partograph during the monitoring of a woman in labour. These may be the factors that hinder the effective utilization of the partograph. The objective of this study was to explore and describe the experiences of midwives regarding the utilization of the partograph for monitoring a labouring woman in a Namibian regional hospital in order to develop guidelines based on the findings to improve the use of the partograph by midwives in order to improve the management of labour. The research design was qualitative, descriptive, explorative and contextual in nature. The research population consisted of midwives working in a regional hospital in Namibia. A purposive and convenient sampling method was used to select participants. Specific inclusion criteria were met and consent was obtained from the participants and from the Regional Health Directorate Management of the hospital where the research was conducted. Interviews were conducted by an independent interviewer within the Department of Health to ensure an unbiased viewpoint. Data were collected by means of semi-structured in depth interviews with a guide, using an audio tape recorder. Field notes were used to record non- verbal communication. As soon as data were saturated, the interviews were stopped. They were then transcribed, verbatim and analysed using the Tesch’s approach as described in (Creswell, 2009:186). The service of an independent coder was utilized to ensure trustworthiness. Trustworthiness was further ensured by using the strategies suggested by Lincoln and Guba’s model, namely credibility, transferability, dependability and confirmability. Ethical considerations were honoured throughout by adhering to ethical principles during the study. These included ensuring that the participants` rights were respected, they were not harmed and fairness were ensured. On completion of the data analysis a literature control was conducted and existing literature was compared to the findings in order to identify similarities and differences and to verify whether the literature supported the findings. Four main themes that emerged during data analysis are: Theme 1.Midwives found it a positive experience to use the partograph when caring for a woman in labour. Theme 2. When a midwife experienced problems in using the partograph, it may lead to detrimental outcomes. Theme 3. Utilizing the partograph evoked differing emotions in midwives. Theme 4. Midwives` knowledge and skills in the utilization of the partograph should be updated regularly. By describing the lived experienced of midwives in the maternity ward on the use of the partograph, the midwives had a positive attitude to using the partograph, but they also found it difficult to utilize the instrument as was directed by the (WHO) due to challenges experienced such as: unrealistic staff/patient ratio, shortage of staff, time consuming, insufficient knowledge and skills among midwives and lack of appropriate equipment. There is a specific need to prevent further negative emotions by addressing the challenges experienced. Based on the findings, guidelines for partograph utilization which aimed at improving the midwifery care were developed. Recommendations were made regarding midwifery education, clinical midwifery care and midwifery research.
- Full Text:
- Date Issued: 2015
Optimising the teaching-learning environment of first-year nursing students at a public nursing college
- Matshotyana, Ntombiyakhe Victoria
- Authors: Matshotyana, Ntombiyakhe Victoria
- Date: 2015
- Subjects: College student development programs , Nursing students
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10052 , http://hdl.handle.net/10948/d1018274
- Description: Transition from secondary to tertiary education presents unique challenges for first-year nursing students, similar to those experienced by other first-year students at any other tertiary education institution. Nursing students’ experiences are further complicated by the fact that nursing education incorporates almost equal amounts of time for class attendance and clinical practice placement. As a facilitator of learning for first-year nursing students, the researcher had observed how some new students were apprehensive and uncertain in their first year of study at the college. These and other observations, including those of the researcher’s colleagues, prompted the researcher to conduct a study to obtain information on how the first-year students at her college experience their first year of the nursing programme. This study, therefore, examined the experiences of first-year nursing students at a public college in the Eastern Cape Province enrolled in the four-year diploma programme that leads to registration as a nurse and midwife with the South African Nursing Council (SANC). Insights into these experiences were used to develop guidelines for nurse educators to optimise the teaching-learning environment of these students.Kotzé’s (1998) nursing accompaniment theory was used as a theoretical grounding for the study. The study followed a qualitative, explorative, descriptive and contextual design. Two of the college’s campuses were sampled for the study. One campus was in a more rural area and the other in a more urban area. Data was collected using purposive sampling of second-year students who were requested to think back to their first year of the nursing programme. Semi-structured, in-depth, face-to-face, individual interviews were conducted. Interview sessions were digitally recorded and then transcribed verbatim by the researcher. The researcher and an independent coder analysed the transcriptions using Tesch’s method of data analysis. The study’s trustworthiness was demonstrated through the criteria of credibility, transferability, dependability, confirmability and authenticity. The results indicated that students had positive and negative experiences in their first year of the nursing programme. Literature control placed the study’s findings within the existing body of knowledge with regard to students’ experiences of their first year. The students’ suggestions on how to enhance first-year nursing students’ experiences were incorporated into the guidelines that were developed for nurse educators to optimise the teaching-learning environment of first-year nursing students at this college.
- Full Text:
- Date Issued: 2015
- Authors: Matshotyana, Ntombiyakhe Victoria
- Date: 2015
- Subjects: College student development programs , Nursing students
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10052 , http://hdl.handle.net/10948/d1018274
- Description: Transition from secondary to tertiary education presents unique challenges for first-year nursing students, similar to those experienced by other first-year students at any other tertiary education institution. Nursing students’ experiences are further complicated by the fact that nursing education incorporates almost equal amounts of time for class attendance and clinical practice placement. As a facilitator of learning for first-year nursing students, the researcher had observed how some new students were apprehensive and uncertain in their first year of study at the college. These and other observations, including those of the researcher’s colleagues, prompted the researcher to conduct a study to obtain information on how the first-year students at her college experience their first year of the nursing programme. This study, therefore, examined the experiences of first-year nursing students at a public college in the Eastern Cape Province enrolled in the four-year diploma programme that leads to registration as a nurse and midwife with the South African Nursing Council (SANC). Insights into these experiences were used to develop guidelines for nurse educators to optimise the teaching-learning environment of these students.Kotzé’s (1998) nursing accompaniment theory was used as a theoretical grounding for the study. The study followed a qualitative, explorative, descriptive and contextual design. Two of the college’s campuses were sampled for the study. One campus was in a more rural area and the other in a more urban area. Data was collected using purposive sampling of second-year students who were requested to think back to their first year of the nursing programme. Semi-structured, in-depth, face-to-face, individual interviews were conducted. Interview sessions were digitally recorded and then transcribed verbatim by the researcher. The researcher and an independent coder analysed the transcriptions using Tesch’s method of data analysis. The study’s trustworthiness was demonstrated through the criteria of credibility, transferability, dependability, confirmability and authenticity. The results indicated that students had positive and negative experiences in their first year of the nursing programme. Literature control placed the study’s findings within the existing body of knowledge with regard to students’ experiences of their first year. The students’ suggestions on how to enhance first-year nursing students’ experiences were incorporated into the guidelines that were developed for nurse educators to optimise the teaching-learning environment of first-year nursing students at this college.
- Full Text:
- Date Issued: 2015
Perceptions of Nelson Mandela Metropolitan obstetric unit midwives regarding consulting advanced midwives
- Sonti, Balandeli Siphumelele Israel
- Authors: Sonti, Balandeli Siphumelele Israel
- Date: 2015
- Subjects: Midwives -- South Africa -- Nelson Mandela Bay Municipality , Midwifery -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10074 , http://hdl.handle.net/10948/d1021196
- Description: The perceptions of Nelson Mandela Metropolitan Municipality obstetric unit midwives regarding consulting advanced midwives were researched. Currently South Africa is burdened with an increasing maternal mortality rate despite the control measures that have been put in place. One of those control measures is the skilling of midwives and ensuring that skilled birth attendants assist every woman in confinement. A concern, though, was observed by the researcher that an increasing number of midwives in the country now have an additional qualification in advanced midwifery and yet the maternal and neonatal mortality rates are gradually increasing. The researcher, as a midwife and a midwifery lecturer in that capacity, observed that in the clinical areas midwives prefer to consult with the doctor rather than the advanced midwife. In most cases looking and waiting for the doctor delays the management of the labouring woman as the doctor may not be immediately available. The advanced midwives are supposed to have advanced skills which should be used to assist in the absence of the doctor, particularly in the midwife obstetrics units. The study objectives were firstly, to describe and explore the perceptions of NMM obstetric unit midwives regarding consulting with advanced midwives. Secondly, based on the results of the study, to make recommendations to the managers of the obstetric units within the NMM that will enhance consulting between advanced midwives and midwives in obstetric units. The study was quantitative in nature and utilised an explorative, descriptive and contextual design. Sampling was made possible through simple random probability sampling using the non-replacement approach. The method of data collection was by self-administered questionnaires that were developed by the researcher under the guidance of a qualified and experienced statistician and researcher and the supervision of the research supervisor. Data was collected during July and September of 2014. One hundred and thirty questionnaires were distributed and ninety four were returned. Responses were captured on a spread sheet for easy and accurate calculation and the numerical data was categorized, ordered and manipulated with the help of a statistician using the software package Statistica Version 21 to ensure efficacy of the results The findings were presented by describing the biographic profile of participants, their competence in the identification and management of high risk situations, their consultation with advanced midwives in high risk situations, their reasons for not consulting advanced midwives and a description of factors that might encourage midwives to consult the advanced midwives. Literature controls were utilized to compare findings with current views of other researchers. Trustworthiness was maintained by observing the principles of reliability and validity. The ethical considerations of confidentiality, anonymity and protection of the participants from harm were maintained by the researcher. The findings revealed that there were significant numbers of midwives with many years of clinical experience and years in the units. The age difference of the midwives in the obstetrics units was seen to be an added advantage to the care of women as the young and old could complement each other with the latest information and experience in dealing with midwifery related emergencies respectively. The difference in gender was as expected but did not have an influence on the non-consulting with advanced midwives by the midwives who are working in the obstetrics units. Also, the limited confidence of midwives regarding their performance of certain low risk skills and their confidence in the performance of the advanced midwives was a reason to consult with the advanced midwives in their areas of speciality. Based on these findings, the researcher attended to the second objective and made the necessary recommendations to the managers of the obstetric units within the NMM to enhance consulting with advanced midwives by midwives in obstetric units. Midwives globally would gain information that would assist them in motivating recommendations to the managers of the obstetric units with regard to consulting with advanced midwives by midwives in their obstetric units.
- Full Text:
- Date Issued: 2015
- Authors: Sonti, Balandeli Siphumelele Israel
- Date: 2015
- Subjects: Midwives -- South Africa -- Nelson Mandela Bay Municipality , Midwifery -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10074 , http://hdl.handle.net/10948/d1021196
- Description: The perceptions of Nelson Mandela Metropolitan Municipality obstetric unit midwives regarding consulting advanced midwives were researched. Currently South Africa is burdened with an increasing maternal mortality rate despite the control measures that have been put in place. One of those control measures is the skilling of midwives and ensuring that skilled birth attendants assist every woman in confinement. A concern, though, was observed by the researcher that an increasing number of midwives in the country now have an additional qualification in advanced midwifery and yet the maternal and neonatal mortality rates are gradually increasing. The researcher, as a midwife and a midwifery lecturer in that capacity, observed that in the clinical areas midwives prefer to consult with the doctor rather than the advanced midwife. In most cases looking and waiting for the doctor delays the management of the labouring woman as the doctor may not be immediately available. The advanced midwives are supposed to have advanced skills which should be used to assist in the absence of the doctor, particularly in the midwife obstetrics units. The study objectives were firstly, to describe and explore the perceptions of NMM obstetric unit midwives regarding consulting with advanced midwives. Secondly, based on the results of the study, to make recommendations to the managers of the obstetric units within the NMM that will enhance consulting between advanced midwives and midwives in obstetric units. The study was quantitative in nature and utilised an explorative, descriptive and contextual design. Sampling was made possible through simple random probability sampling using the non-replacement approach. The method of data collection was by self-administered questionnaires that were developed by the researcher under the guidance of a qualified and experienced statistician and researcher and the supervision of the research supervisor. Data was collected during July and September of 2014. One hundred and thirty questionnaires were distributed and ninety four were returned. Responses were captured on a spread sheet for easy and accurate calculation and the numerical data was categorized, ordered and manipulated with the help of a statistician using the software package Statistica Version 21 to ensure efficacy of the results The findings were presented by describing the biographic profile of participants, their competence in the identification and management of high risk situations, their consultation with advanced midwives in high risk situations, their reasons for not consulting advanced midwives and a description of factors that might encourage midwives to consult the advanced midwives. Literature controls were utilized to compare findings with current views of other researchers. Trustworthiness was maintained by observing the principles of reliability and validity. The ethical considerations of confidentiality, anonymity and protection of the participants from harm were maintained by the researcher. The findings revealed that there were significant numbers of midwives with many years of clinical experience and years in the units. The age difference of the midwives in the obstetrics units was seen to be an added advantage to the care of women as the young and old could complement each other with the latest information and experience in dealing with midwifery related emergencies respectively. The difference in gender was as expected but did not have an influence on the non-consulting with advanced midwives by the midwives who are working in the obstetrics units. Also, the limited confidence of midwives regarding their performance of certain low risk skills and their confidence in the performance of the advanced midwives was a reason to consult with the advanced midwives in their areas of speciality. Based on these findings, the researcher attended to the second objective and made the necessary recommendations to the managers of the obstetric units within the NMM to enhance consulting with advanced midwives by midwives in obstetric units. Midwives globally would gain information that would assist them in motivating recommendations to the managers of the obstetric units with regard to consulting with advanced midwives by midwives in their obstetric units.
- Full Text:
- Date Issued: 2015
The perceptions of professional nurses with regard to the process of withdrawing life-support treatment in a private intensive care unit
- Authors: Pheiffer, Evette
- Date: 2015
- Subjects: Artificial respiration , Cardiotonic agents , Life support systems (Critical care)
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/3115 , vital:20400
- Description: Life-support treatment is regarded as the support of vital functions of respiration and circulation such as mechanical ventilation and inotropic support, and life-sustaining therapy which incorporate therapies such as artificial hydration, nutrition and haemodialysis. Life-support treatment is rendered to critically ill patients within the intensive care units. However, when treatment options are maximised, and the patient’s condition is unchanged, a decision is often made to withdraw treatment. Professional nurses are usually involved in the process of withdrawal of life-support treatment as they care for this population of patients. The study followed a qualitative, explorative, descriptive and contextual research paradigm in order to explore and describe the perceptions of professional nurses with regard to the process of withdrawing life-support treatment in a private intensive care unit. Data was collected by means of interviews, which were transcribed according to Tesch’s method of analysis. Field notes were used to supplement the data findings. Based on the data collected, it is clear that professional nurses experience difficulties when performing withdrawal of life-support treatment. There are a number of communication concerns which need to be addressed and suggestions were also made by the interview participants regarding these concerns. The study makes recommendations to assist professional nurses with the process of withdrawing life-support treatment in a private intensive care unit. The findings of the study will be disseminated to the relevant hospital and unit managers. Ethical principles were maintained throughout the study by adhering to the principles of privacy, confidentiality, anonymity and beneficence.
- Full Text:
- Date Issued: 2015
- Authors: Pheiffer, Evette
- Date: 2015
- Subjects: Artificial respiration , Cardiotonic agents , Life support systems (Critical care)
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/3115 , vital:20400
- Description: Life-support treatment is regarded as the support of vital functions of respiration and circulation such as mechanical ventilation and inotropic support, and life-sustaining therapy which incorporate therapies such as artificial hydration, nutrition and haemodialysis. Life-support treatment is rendered to critically ill patients within the intensive care units. However, when treatment options are maximised, and the patient’s condition is unchanged, a decision is often made to withdraw treatment. Professional nurses are usually involved in the process of withdrawal of life-support treatment as they care for this population of patients. The study followed a qualitative, explorative, descriptive and contextual research paradigm in order to explore and describe the perceptions of professional nurses with regard to the process of withdrawing life-support treatment in a private intensive care unit. Data was collected by means of interviews, which were transcribed according to Tesch’s method of analysis. Field notes were used to supplement the data findings. Based on the data collected, it is clear that professional nurses experience difficulties when performing withdrawal of life-support treatment. There are a number of communication concerns which need to be addressed and suggestions were also made by the interview participants regarding these concerns. The study makes recommendations to assist professional nurses with the process of withdrawing life-support treatment in a private intensive care unit. The findings of the study will be disseminated to the relevant hospital and unit managers. Ethical principles were maintained throughout the study by adhering to the principles of privacy, confidentiality, anonymity and beneficence.
- Full Text:
- Date Issued: 2015
Community service professional nurses' experiences of bullying in state hospitals
- Authors: Yon, Gadieja
- Date: 2014
- Subjects: Public health nurses , Bullying in the workplace , State hospitals
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10056 , http://hdl.handle.net/10948/d1018622
- Description: It is estimated that 80 percent of nurses experience some type of bullying in the workplace during their working lives, and bullying from colleagues has become a major concern. Bullying involves repeated forms of negative behaviours directed at a victim over time. More specifically, the victim is bullied repeatedly over time, with bullying ranging from mild to more severe forms that often go unreported. Bullying in the workplace may cause low self-esteem, depression and anxiety, physical illness and in some cases, the inability to work. The aim of this research study was to explore and describe community service professional nurses’ experiences of being bullied in state hospitals. The information gathered during the course of the study was used to develop strategies that can prevent the bullying of community service professional nurses in the workplace. The design of the study was qualitative, exploratory, descriptive, and contextual in nature. The population sample included all community service professional nurses in state hospitals in the Nelson Mandela Bay area. The researcher employed purposive sampling to select participants from the population of community service professional nurses employed at state hospitals. She collected data by conducting semi-structured individual interviews to gain in-depth accounts from participants and by making observations, which were captured in field notes. Data collected during the interviews were transcribed verbatim and analysed according to Tesch’s eight steps of analysis. Themes were identified through this process and compared to relevant literature. The researcher used the services of an independent coder to aid in the coding process. Trustworthiness was ensured by following Lincoln and Guba’s model of trustworthiness, which comprises the following concepts: credibility, transferability, dependability, and conformability. The researcher ensured that the study adhered to high ethical standards through the principles of justice, beneficence, non-maleficence, and respect for people.
- Full Text:
- Date Issued: 2014
- Authors: Yon, Gadieja
- Date: 2014
- Subjects: Public health nurses , Bullying in the workplace , State hospitals
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10056 , http://hdl.handle.net/10948/d1018622
- Description: It is estimated that 80 percent of nurses experience some type of bullying in the workplace during their working lives, and bullying from colleagues has become a major concern. Bullying involves repeated forms of negative behaviours directed at a victim over time. More specifically, the victim is bullied repeatedly over time, with bullying ranging from mild to more severe forms that often go unreported. Bullying in the workplace may cause low self-esteem, depression and anxiety, physical illness and in some cases, the inability to work. The aim of this research study was to explore and describe community service professional nurses’ experiences of being bullied in state hospitals. The information gathered during the course of the study was used to develop strategies that can prevent the bullying of community service professional nurses in the workplace. The design of the study was qualitative, exploratory, descriptive, and contextual in nature. The population sample included all community service professional nurses in state hospitals in the Nelson Mandela Bay area. The researcher employed purposive sampling to select participants from the population of community service professional nurses employed at state hospitals. She collected data by conducting semi-structured individual interviews to gain in-depth accounts from participants and by making observations, which were captured in field notes. Data collected during the interviews were transcribed verbatim and analysed according to Tesch’s eight steps of analysis. Themes were identified through this process and compared to relevant literature. The researcher used the services of an independent coder to aid in the coding process. Trustworthiness was ensured by following Lincoln and Guba’s model of trustworthiness, which comprises the following concepts: credibility, transferability, dependability, and conformability. The researcher ensured that the study adhered to high ethical standards through the principles of justice, beneficence, non-maleficence, and respect for people.
- Full Text:
- Date Issued: 2014
Die ervaring van die geregistreerde verpleegkundedosent ten opsigte van die kliniese begeleiding van verpleegstudente
- Authors: De Wet, Annemie
- Date: 2014
- Subjects: Nursing students , Mentoring in nursing -- South Africa
- Language: Afrikaans
- Type: Thesis , Masters , MCur
- Identifier: vital:10053 , http://hdl.handle.net/10948/1018275
- Description: Die doel van die studie was om vas te stel hoe die verpleegkundedosent die begeleiding van verpleegstudente in die praktyk ervaar. In die verlede was begeleiding van verpleegstudente met praktika in gesondheidsorginstansies deur ʼn professionele verpleegkundige gedoen wat deel was van die personeel se verantwoordelikhede. Die verpleegstudente doen hul teoretiese kennis op by ʼn tersiêre instansie en verkry hul praktiese kennis by ʼn geakkrediteerde gesondheidsorginstansie soos vereis deur die Suid-Afrikaanse Raad op Verpleging (SARV). Een van die take van ‘n verpleegkundedosent van die privaat opleidingskool is om die kliniese begeleiding van verpleegstudente in geakkrediteerde instellings te doen. Omdat verpleging ʼn beroep is waar vaardighede belangrik is, is praktiese inoefening van prosedures en evaluering van die verpleegstudente se vaardigheid daarin noodsaaklik. Die verpleegstudente is heeltyd besig met die pasiënte in die vorm van prosedures waarby die teorie wat in die opleidingskool verkry was, gekorreleer moet word met die prosedure om die hele prentjie te vorm. Dit is dus nodig dat begeleiding van die verpleegstudente gedoen moet word om vaardigheid en toepassing van kennis te verseker. Die navorser het ʼn kwalitatiewe, ondersoekende, beskrywende en kontekstuele studie gedoen waarvan die populasie die geregistreerde dosente van verskeie provinsiale en privaatverpleegskole in die Klein-Karoo en Suid-kaapdistrikte was. Die navorser het gebruik gemaak van ʼn nie-waarskynlike steekproef. Inligtingryke data was ingesamel deur semi-gestruktureerde onderhoude wat aangevul was met veldnotas soos verkry tydens onderhoude. Data-ontleding was reeds begin met data-insameling en Tesch se inhoudsontleding was gebruik om ʼn mening te vorm. ‘n Literatuurkontrole was gedoen om te bepaal wat vorige navorsing oor begeleiding bevind en aanbeveel het. Lincoln en Guba se model was gebruik vir betroubaarheidsversekering volgens die kriteria wat hulle aanbeveel het, naamlik geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid. Uit die data-ontleding het vier belangrike temas en subtemas te voorskyn gekom. Die temas was dat die verpleegkundedosente aspekte van die begeleiding van verpleegstudente in die gesondheidsorginstansie as positief en ook as negatief beleef. Die wyse waarop die gesondheidsorginstansies bestuur word, het die begeleiding beïnvloed en daar was riglyne voorgestel wat die kliniese personeel en dosente kan rig wanneer hulle betrokke raak by die begeleiding van verpleegstudente. Die begeleiding van verpleegstudente deur verpleegkundedosente, kliniese dosente en die gesondheidsorginstansie se opgeleide personeel, is ʼn belangrike deel van verpleegopleiding en bepaal uiteindelik die kwaliteit van die pasiëntsorg wat verskaf word deur die verpleegkundiges. Die navorser het riglyne daar gestel om die begeleiding van vepleegstudente te rig. Die riglyne moet nou geïmplementeer en getoets word binne die konteks van die bepaalde verpleegskole en dan weer geëvalueer word. Beperkings wat ondervind was in die studie was dat die steekproef ʼn klein groepie verpleegkundedosente op die platteland was, wat veralgemening bemoeilik, veral in die stedelike konteks. Die begeleiding van die verpleegstudente is gedoen met die ingeskrewe verpleegstudente (Die Suid-Afrikaanse Raad op Verpleging Regulasies, Regulasie 2176 en 2175 van 19 November 1993), naamlik die kategorie met die minste status en verantwoordelikheid onder verpleegstudente. Veralgemening na alle kategorieë, veral verpleegstudente besig met professionele verpleegprogramme, mag dus nie sinvol wees nie.
- Full Text:
- Date Issued: 2014
- Authors: De Wet, Annemie
- Date: 2014
- Subjects: Nursing students , Mentoring in nursing -- South Africa
- Language: Afrikaans
- Type: Thesis , Masters , MCur
- Identifier: vital:10053 , http://hdl.handle.net/10948/1018275
- Description: Die doel van die studie was om vas te stel hoe die verpleegkundedosent die begeleiding van verpleegstudente in die praktyk ervaar. In die verlede was begeleiding van verpleegstudente met praktika in gesondheidsorginstansies deur ʼn professionele verpleegkundige gedoen wat deel was van die personeel se verantwoordelikhede. Die verpleegstudente doen hul teoretiese kennis op by ʼn tersiêre instansie en verkry hul praktiese kennis by ʼn geakkrediteerde gesondheidsorginstansie soos vereis deur die Suid-Afrikaanse Raad op Verpleging (SARV). Een van die take van ‘n verpleegkundedosent van die privaat opleidingskool is om die kliniese begeleiding van verpleegstudente in geakkrediteerde instellings te doen. Omdat verpleging ʼn beroep is waar vaardighede belangrik is, is praktiese inoefening van prosedures en evaluering van die verpleegstudente se vaardigheid daarin noodsaaklik. Die verpleegstudente is heeltyd besig met die pasiënte in die vorm van prosedures waarby die teorie wat in die opleidingskool verkry was, gekorreleer moet word met die prosedure om die hele prentjie te vorm. Dit is dus nodig dat begeleiding van die verpleegstudente gedoen moet word om vaardigheid en toepassing van kennis te verseker. Die navorser het ʼn kwalitatiewe, ondersoekende, beskrywende en kontekstuele studie gedoen waarvan die populasie die geregistreerde dosente van verskeie provinsiale en privaatverpleegskole in die Klein-Karoo en Suid-kaapdistrikte was. Die navorser het gebruik gemaak van ʼn nie-waarskynlike steekproef. Inligtingryke data was ingesamel deur semi-gestruktureerde onderhoude wat aangevul was met veldnotas soos verkry tydens onderhoude. Data-ontleding was reeds begin met data-insameling en Tesch se inhoudsontleding was gebruik om ʼn mening te vorm. ‘n Literatuurkontrole was gedoen om te bepaal wat vorige navorsing oor begeleiding bevind en aanbeveel het. Lincoln en Guba se model was gebruik vir betroubaarheidsversekering volgens die kriteria wat hulle aanbeveel het, naamlik geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid. Uit die data-ontleding het vier belangrike temas en subtemas te voorskyn gekom. Die temas was dat die verpleegkundedosente aspekte van die begeleiding van verpleegstudente in die gesondheidsorginstansie as positief en ook as negatief beleef. Die wyse waarop die gesondheidsorginstansies bestuur word, het die begeleiding beïnvloed en daar was riglyne voorgestel wat die kliniese personeel en dosente kan rig wanneer hulle betrokke raak by die begeleiding van verpleegstudente. Die begeleiding van verpleegstudente deur verpleegkundedosente, kliniese dosente en die gesondheidsorginstansie se opgeleide personeel, is ʼn belangrike deel van verpleegopleiding en bepaal uiteindelik die kwaliteit van die pasiëntsorg wat verskaf word deur die verpleegkundiges. Die navorser het riglyne daar gestel om die begeleiding van vepleegstudente te rig. Die riglyne moet nou geïmplementeer en getoets word binne die konteks van die bepaalde verpleegskole en dan weer geëvalueer word. Beperkings wat ondervind was in die studie was dat die steekproef ʼn klein groepie verpleegkundedosente op die platteland was, wat veralgemening bemoeilik, veral in die stedelike konteks. Die begeleiding van die verpleegstudente is gedoen met die ingeskrewe verpleegstudente (Die Suid-Afrikaanse Raad op Verpleging Regulasies, Regulasie 2176 en 2175 van 19 November 1993), naamlik die kategorie met die minste status en verantwoordelikheid onder verpleegstudente. Veralgemening na alle kategorieë, veral verpleegstudente besig met professionele verpleegprogramme, mag dus nie sinvol wees nie.
- Full Text:
- Date Issued: 2014
Experiences of labouring women of the use of the birthing ball
- Authors: Vieira,Melissa Jolene
- Date: 2014
- Subjects: Delivery (Obstetrics) , Midwifery -- South Africa Midwives -- South Africa Neonatal nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/44088 , vital:37106
- Description: Labour pain seems to be a challenge to the most of the labour wards/units. The birthing pain is non-avoidable but could be managed. Labouring women are sometimes limiting themselves to their beds as they are not coping well with the amount of pain they experience and this behaviour affects the progress of their labour. Different methods of pain relief in labour are available but are sometimes perceived by labouring women and midwives as not effective. Mobility has been noted in several obstetrical and midwifery nursing literature as the best strategy to promote positive progress of labour thus limiting pain. The use of the birthing ball by labouring women appears to be serving the purpose of mobility in labour. The researcher of this study aimed to investigate the experiences related to the use of the birthing ball by the labouring women. The objectives of the study were: To explore and describe the experiences of women in labour related to the use of the birthing ball, and based on the findings of the study, to recommend guidelines for the midwives to manage the first stage of labour through the use of the birthing ball. The research design used was qualitative, descriptive, explorative and contextual in nature, utilizing the phenomenological approach. The research population consisted of women who had made use of the birthing ball during labour. Data collection consisted of one-on-one unstructured interviews and field notes. The question that the participants were asked was: “Tell me, how it was for you when you were using the birthing ball during labour?” Collected data was analysed according to Creswell’s data analysis spiral and the assistance of an independent coder. Following the data analysis, a literature control was undertaken to highlight the similarities to and differences in comparison between this and previous studies. Lincoln and Guba’s Model of trustworthiness was used in this study to enhance credibility of the findings. The four aspects that were considered were credibility, transferability, dependability and confirmability. The researcher ensured that the study was ethically correct by observing the principles of informed consent, confidentiality, anonymity and no harm done to participants. Three major themes and sub-themes were identified through analysis of the database. Participants’ experienced the birthing ball as a useful labour tool as: it relieves pain and allows them to relax and be comfortable, it helped to promote mobility during labour. Participants’ experienced the birthing ball as shortening the labour process as: it decreased the number of active pushes during delivery, it increased their contractions and resulted in a quick delivery. Participants experienced the use of the birthing ball as empowering during labour as: it introduces an element of fun which decreases their fear and resulted in a more positive labouring experience it allowed them to feel in control of their labour. Based on the findings of the study, conclusions were drawn, guidelines recommended and recommendations made concerning nursing research, nursing education and clinical practice.
- Full Text:
- Date Issued: 2014
- Authors: Vieira,Melissa Jolene
- Date: 2014
- Subjects: Delivery (Obstetrics) , Midwifery -- South Africa Midwives -- South Africa Neonatal nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/44088 , vital:37106
- Description: Labour pain seems to be a challenge to the most of the labour wards/units. The birthing pain is non-avoidable but could be managed. Labouring women are sometimes limiting themselves to their beds as they are not coping well with the amount of pain they experience and this behaviour affects the progress of their labour. Different methods of pain relief in labour are available but are sometimes perceived by labouring women and midwives as not effective. Mobility has been noted in several obstetrical and midwifery nursing literature as the best strategy to promote positive progress of labour thus limiting pain. The use of the birthing ball by labouring women appears to be serving the purpose of mobility in labour. The researcher of this study aimed to investigate the experiences related to the use of the birthing ball by the labouring women. The objectives of the study were: To explore and describe the experiences of women in labour related to the use of the birthing ball, and based on the findings of the study, to recommend guidelines for the midwives to manage the first stage of labour through the use of the birthing ball. The research design used was qualitative, descriptive, explorative and contextual in nature, utilizing the phenomenological approach. The research population consisted of women who had made use of the birthing ball during labour. Data collection consisted of one-on-one unstructured interviews and field notes. The question that the participants were asked was: “Tell me, how it was for you when you were using the birthing ball during labour?” Collected data was analysed according to Creswell’s data analysis spiral and the assistance of an independent coder. Following the data analysis, a literature control was undertaken to highlight the similarities to and differences in comparison between this and previous studies. Lincoln and Guba’s Model of trustworthiness was used in this study to enhance credibility of the findings. The four aspects that were considered were credibility, transferability, dependability and confirmability. The researcher ensured that the study was ethically correct by observing the principles of informed consent, confidentiality, anonymity and no harm done to participants. Three major themes and sub-themes were identified through analysis of the database. Participants’ experienced the birthing ball as a useful labour tool as: it relieves pain and allows them to relax and be comfortable, it helped to promote mobility during labour. Participants’ experienced the birthing ball as shortening the labour process as: it decreased the number of active pushes during delivery, it increased their contractions and resulted in a quick delivery. Participants experienced the use of the birthing ball as empowering during labour as: it introduces an element of fun which decreases their fear and resulted in a more positive labouring experience it allowed them to feel in control of their labour. Based on the findings of the study, conclusions were drawn, guidelines recommended and recommendations made concerning nursing research, nursing education and clinical practice.
- Full Text:
- Date Issued: 2014
Experiences of professional nurses related to caring for chronic mentally ill patients at rural primary healthcare clinics
- Authors: Sam, Noluthando
- Date: 2014
- Subjects: Mentally ill -- Rehabilitation , Chronically ill -- Rehabilitation , Hospitals -- Case management services , Mentally ill -- Care
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10068
- Description: Since the deinstitutionalisation of chronic mentally ill patients, there has been an increase in the number of relapsed chronic mentally ill patients who become acutely mentally ill and need to be re-admitted for acute care in psychiatric institutions. Professional nurses working at rural primary healthcare clinics find it difficult to care for these individuals because they lack the necessary knowledge and skills. Chronic mentally ill patients who have been admitted to acute care facilities are stabilised by rendering care, treatment and rehabilitation and then released into the care of the professional nurses working at rural primary healthcare clinics. These patients live in the community and have to make use of the primary healthcare clinics nearest to their homes to provide them with their prescribed medication and care. Furthermore the patients’ mental conditions do not always remain stable, possibly because of a knowledge deficit, at times about their mental status. Patients may become non-compliant, resulting in the recurrence of symptoms, and thus need to be re-admitted to the acute care facility. However, the problem leading to re-admission is not clear for all admissions. It may be that patients do not make use of the primary healthcare clinics. It also seems that the professional nurses in the primary healthcare clinics are unfamiliar in dealing with chronic mentally ill patients living in rural communities. The aim of this study was therefore, to explore and describe the experiences of these professional nurses in caring for chronic mentally ill patients living in a rural community. The researcher used qualitative, explorative, descriptive, and contextual research design. The research population consisted of professional nurses working at primary healthcare clinics. Non-probability purposive sampling was used to identify participants for inclusion in the study. Data collection was conducted using one-on-one, semi structured interviews, observations and field notes and interviews were tape-recorded and transcribed. Data analysis was conducted using Tesh’s method of content analysis to identify themes and sub-themes. A literature control was done to compare the findings to the current published research. Trustworthiness was ensured by using Gubas’s model (1985) of trustworthiness. A pilot study, conducted by interviewing a small sample prior to the start of the main study, determined whether the sampling and interviewing techniques of the researcher as well as the research questions were adequate for data collection. The researcher ensured that the study was of a high ethical standard by taking into consideration values that guide the principles of autonomy, beneficence, non-maleficence and justice. The findings of the study was categorised into three main themes and 13 sub-themes. The main themes were as follow: Professional nurses experience problems when they have to take care of psychiatric patients attending rural primary healthcare clinics. This theme had six sub-themes which were discussed in details in chapter three. The second theme was that professional nurses experience that psychiatric patients in rural communities experience problems which affected their well-being. This second theme has got five sub-themes which were discussed further in chapter three. The last theme was that professional nurses have positive experiences when caring for psychiatric patients in rural communities. This theme has got two sub-themes as well discussed further in chapter three.
- Full Text:
- Date Issued: 2014
- Authors: Sam, Noluthando
- Date: 2014
- Subjects: Mentally ill -- Rehabilitation , Chronically ill -- Rehabilitation , Hospitals -- Case management services , Mentally ill -- Care
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10068
- Description: Since the deinstitutionalisation of chronic mentally ill patients, there has been an increase in the number of relapsed chronic mentally ill patients who become acutely mentally ill and need to be re-admitted for acute care in psychiatric institutions. Professional nurses working at rural primary healthcare clinics find it difficult to care for these individuals because they lack the necessary knowledge and skills. Chronic mentally ill patients who have been admitted to acute care facilities are stabilised by rendering care, treatment and rehabilitation and then released into the care of the professional nurses working at rural primary healthcare clinics. These patients live in the community and have to make use of the primary healthcare clinics nearest to their homes to provide them with their prescribed medication and care. Furthermore the patients’ mental conditions do not always remain stable, possibly because of a knowledge deficit, at times about their mental status. Patients may become non-compliant, resulting in the recurrence of symptoms, and thus need to be re-admitted to the acute care facility. However, the problem leading to re-admission is not clear for all admissions. It may be that patients do not make use of the primary healthcare clinics. It also seems that the professional nurses in the primary healthcare clinics are unfamiliar in dealing with chronic mentally ill patients living in rural communities. The aim of this study was therefore, to explore and describe the experiences of these professional nurses in caring for chronic mentally ill patients living in a rural community. The researcher used qualitative, explorative, descriptive, and contextual research design. The research population consisted of professional nurses working at primary healthcare clinics. Non-probability purposive sampling was used to identify participants for inclusion in the study. Data collection was conducted using one-on-one, semi structured interviews, observations and field notes and interviews were tape-recorded and transcribed. Data analysis was conducted using Tesh’s method of content analysis to identify themes and sub-themes. A literature control was done to compare the findings to the current published research. Trustworthiness was ensured by using Gubas’s model (1985) of trustworthiness. A pilot study, conducted by interviewing a small sample prior to the start of the main study, determined whether the sampling and interviewing techniques of the researcher as well as the research questions were adequate for data collection. The researcher ensured that the study was of a high ethical standard by taking into consideration values that guide the principles of autonomy, beneficence, non-maleficence and justice. The findings of the study was categorised into three main themes and 13 sub-themes. The main themes were as follow: Professional nurses experience problems when they have to take care of psychiatric patients attending rural primary healthcare clinics. This theme had six sub-themes which were discussed in details in chapter three. The second theme was that professional nurses experience that psychiatric patients in rural communities experience problems which affected their well-being. This second theme has got five sub-themes which were discussed further in chapter three. The last theme was that professional nurses have positive experiences when caring for psychiatric patients in rural communities. This theme has got two sub-themes as well discussed further in chapter three.
- Full Text:
- Date Issued: 2014
Infection control practices for the prevention of surgical site infections in the operating room
- Authors: Opadotun, Olukemi
- Date: 2014
- Subjects: Surgical wound infections -- Prevention , Wounds and injuries -- Nursing , Operating room nursing , Surgical nursing , Evidence-based nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10050 , http://hdl.handle.net/10948/d1017195
- Description: Infections are a major cause of morbidity and mortality during the post-operative phase of patients’ recovery. Wound infections are the second most commonly encountered type of nosocomial infection. Because wound infections can be introduced by not applying infection control measures and sterile technique principles in the operating room, the implementation of infection control principles is an imperative. The aim of this study was to explore and describe infection control practices related to the prevention of Surgical site infections in the operating rooms in a public health care sector in the Nelson Mandela Bay Municipality. The findings were compared with practices, as indicated in an evidence-based guideline. The research design was quantitative, explorative, descriptive, comparative-descriptive and contextual in nature. The research sample consisted of all the professional nurses, in the operating room. The data were collected by means of a self-administered questionnaire. Descriptive statistics was used to present the data in the form of tables and graphs. Based on the analysis of the data, some recommendations were made for the implementation of infection control practices, in order to prevent Surgical site infections in the operating room.
- Full Text:
- Date Issued: 2014
- Authors: Opadotun, Olukemi
- Date: 2014
- Subjects: Surgical wound infections -- Prevention , Wounds and injuries -- Nursing , Operating room nursing , Surgical nursing , Evidence-based nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10050 , http://hdl.handle.net/10948/d1017195
- Description: Infections are a major cause of morbidity and mortality during the post-operative phase of patients’ recovery. Wound infections are the second most commonly encountered type of nosocomial infection. Because wound infections can be introduced by not applying infection control measures and sterile technique principles in the operating room, the implementation of infection control principles is an imperative. The aim of this study was to explore and describe infection control practices related to the prevention of Surgical site infections in the operating rooms in a public health care sector in the Nelson Mandela Bay Municipality. The findings were compared with practices, as indicated in an evidence-based guideline. The research design was quantitative, explorative, descriptive, comparative-descriptive and contextual in nature. The research sample consisted of all the professional nurses, in the operating room. The data were collected by means of a self-administered questionnaire. Descriptive statistics was used to present the data in the form of tables and graphs. Based on the analysis of the data, some recommendations were made for the implementation of infection control practices, in order to prevent Surgical site infections in the operating room.
- Full Text:
- Date Issued: 2014
Perceptions of private sector midwives and obstetricians regarding collaborative maternity
- Authors: Wibbelink, Margreet
- Date: 2014
- Subjects: Maternal health services , Maternal health care teams
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10067 , http://hdl.handle.net/10948/d1020979
- Description: The World Health Organization (WHO) states that no region in the world is justified in having a caesarean section rate greater than 10-15 percent, calculated as the number of caesarean deliveries over the total number of live births. There is however, an international increase in the rate of caesarean section deliveries and this is a concern to midwives. The increase is evident in South Africa as well. Currently the rate of caesarean section deliveries in the private sector can be as high as 70 percent per total number of live births per year. As a result, the public often perceives giving birth surgically in South Africa as ‘normal’ and ‘safer’ than vaginal delivery, even for low-risk pregnancies. The lack of involvement of midwives in the care of pregnant women in the private sector is indicated as one of the reasons related to the high caesarean section delivery rates. This motivated the researcher to undertake a study to explore and describe the perceptions of private sector midwives and obstetricians regarding the feasibility of collaboration in maternity care. A literature review to support the study identified research done previously regarding collaborative maternity care. The study followed a qualitative, exploratory, descriptive, contextual design. The research population included midwives and obstetricians in the private sector in the Eastern Cape. Non-probability, purposive sampling was used. The researcher conducted semi-structured one-to-one interviews to collect information rich data. The researcher ensured that the study was conducted in an ethical manner by adhering to ethical principles such as autonomy, non-maleficence, beneficence and justice. The interviews were transcribed and Creswell’s’ data analysis spiral was used as a guide for the data analysis. Themes and sub-themes were identified and grouped together to form new categories. An independent coder assisted with the coding process. Data analysis results revealed the following results Participants perceived a collaborative working relationship as being beneficial to maternity care. Participants identified that there might be critical impediments that need to be faced in order to realize collaborative maternity care. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four criteria namely credibility, transferability, dependability and conformability. The information obtained from this study assisted in developing guidelines to facilitate the implementation of collaborative maternity care between midwives and obstetricians in private practice in South Africa. The objective of the study was thus met.
- Full Text:
- Date Issued: 2014
- Authors: Wibbelink, Margreet
- Date: 2014
- Subjects: Maternal health services , Maternal health care teams
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10067 , http://hdl.handle.net/10948/d1020979
- Description: The World Health Organization (WHO) states that no region in the world is justified in having a caesarean section rate greater than 10-15 percent, calculated as the number of caesarean deliveries over the total number of live births. There is however, an international increase in the rate of caesarean section deliveries and this is a concern to midwives. The increase is evident in South Africa as well. Currently the rate of caesarean section deliveries in the private sector can be as high as 70 percent per total number of live births per year. As a result, the public often perceives giving birth surgically in South Africa as ‘normal’ and ‘safer’ than vaginal delivery, even for low-risk pregnancies. The lack of involvement of midwives in the care of pregnant women in the private sector is indicated as one of the reasons related to the high caesarean section delivery rates. This motivated the researcher to undertake a study to explore and describe the perceptions of private sector midwives and obstetricians regarding the feasibility of collaboration in maternity care. A literature review to support the study identified research done previously regarding collaborative maternity care. The study followed a qualitative, exploratory, descriptive, contextual design. The research population included midwives and obstetricians in the private sector in the Eastern Cape. Non-probability, purposive sampling was used. The researcher conducted semi-structured one-to-one interviews to collect information rich data. The researcher ensured that the study was conducted in an ethical manner by adhering to ethical principles such as autonomy, non-maleficence, beneficence and justice. The interviews were transcribed and Creswell’s’ data analysis spiral was used as a guide for the data analysis. Themes and sub-themes were identified and grouped together to form new categories. An independent coder assisted with the coding process. Data analysis results revealed the following results Participants perceived a collaborative working relationship as being beneficial to maternity care. Participants identified that there might be critical impediments that need to be faced in order to realize collaborative maternity care. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four criteria namely credibility, transferability, dependability and conformability. The information obtained from this study assisted in developing guidelines to facilitate the implementation of collaborative maternity care between midwives and obstetricians in private practice in South Africa. The objective of the study was thus met.
- Full Text:
- Date Issued: 2014
Strategies for the implementation of clinical practice guidelines in the intensive care : a systematic review
- Authors: Mpasa, Ferestas
- Date: 2014
- Subjects: Systematic reviews (Medical research) , Physician practice patterns , Intensive care units
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10059 , http://hdl.handle.net/10948/d1020046
- Description: Implementation strategies for the use of clinical practice guidelines are an integral component in bridging the gap between the best research evidence and clinical practice. However, despite some remarkable investments in health research regarding clinical practice guidelines implementation strategies, it is not yet known which of these are the most effective for intensive care units. The purpose of this research study was to systematically identify and /or search, appraise, extract and synthesize the best available evidence for clinical practice guidelines implementation strategies in intensive care units, in order to develop a draft guideline for clinical practice guidelines implementation strategies in the intensive care units. A systematic review design was used to systematically identify and /or search, appraise, extract and synthesize the best available evidence from the eligible included Level 2 studies (randomized controlled trials and quasi-experimental studies). Level 2 studies were applicable because they present robust evidence in the research results regarding effectiveness of clinical practice guideline implementation strategies. Furthermore, although other systematic reviews conducted in this area before, they included studies of In addition, no systematic review was identified that reviewed Level 2 studies and developed a guideline for clinical practice guideline implementation strategies in the intensive care units. Hence, including only Level 2 studies was distinctive to this research study. Databases searched included: CINAHL with full text, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials Issue 8 of 12, August 2013, and MEDLINE via PUBMED. Hand search in bound journals was also done. The search strategy identified 315 potentially relevant studies. After the process of critical appraisal, thirteen Level 2 studies were identified as relevant for the review. Of the 13 relevant studies, 10 were randomized controlled trials and three were quasi experimental studies. After the critical appraisal ten RCTs were included in the systematic review. Three studies (quasi-experimental) were excluded on the basis of methodological quality after the critical appraisal and agreement by the two independent reviewers. The Joanna Briggs Institute Critical Appraisal MASTARI Instrument for Randomized Controlled trials/ Experimental studies, and The Joanna Briggs Institute data extraction tools were used to critically appraise, and extract data from the ten included randomized controlled trials. The two reviewers who performed the critical appraisal were qualified critical care professional nurses and experts in research methodology. These reviewers conducted the critical appraisal independently to ensure the objectivity of the process. Appropriate ethical considerations were maintained throughout the process of the research study. The results indicated that 80 percent of the included studies were conducted in adult intensive care units while 20 percent were conducted in the neonatal intensive care units. Furthermore, 60 percent of the studies were conducted in the United States of America, 10 percent in France, a further 10 percent in Taiwan, another 10 percent in England and yet another 10 percfent was conducted in Australia and Newzealand. The included studies utilized more than one (multifaceted) implementation strategies to implement clinical practice guidelines in the intensive care units. The first most utilized were: printed educational materials; Information/ educational sessions/meetings; audit and feedback and champion/local opinion leaders; seconded by educational outreach visits; and computer or internet usage. Third most used were active/passive reminders; systems support; academic detailing/ one-on-one sessions teleconferences/videoconferences and workshops/in services. Fourth most used were ollaboration/interdisciplinary teams; slide shows, teleconferences/videoconferences and discussions. Fifth most used were practical training; monitoring visits and grand rounds. However all the strategies were of equal importance. Conclusively, the included studies utilized multifaceted implementation strategies. However, no study indicated the use of a guideline for the implementation strategies in the process of clinical practice guidelines implementation. The systematic review developed a draft guideline for clinical practice guideline implementation strategies in the intensive care units. The guideline will enhance effective implementation of clinical practice guidelines in such a complex environment.
- Full Text:
- Date Issued: 2014
- Authors: Mpasa, Ferestas
- Date: 2014
- Subjects: Systematic reviews (Medical research) , Physician practice patterns , Intensive care units
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10059 , http://hdl.handle.net/10948/d1020046
- Description: Implementation strategies for the use of clinical practice guidelines are an integral component in bridging the gap between the best research evidence and clinical practice. However, despite some remarkable investments in health research regarding clinical practice guidelines implementation strategies, it is not yet known which of these are the most effective for intensive care units. The purpose of this research study was to systematically identify and /or search, appraise, extract and synthesize the best available evidence for clinical practice guidelines implementation strategies in intensive care units, in order to develop a draft guideline for clinical practice guidelines implementation strategies in the intensive care units. A systematic review design was used to systematically identify and /or search, appraise, extract and synthesize the best available evidence from the eligible included Level 2 studies (randomized controlled trials and quasi-experimental studies). Level 2 studies were applicable because they present robust evidence in the research results regarding effectiveness of clinical practice guideline implementation strategies. Furthermore, although other systematic reviews conducted in this area before, they included studies of In addition, no systematic review was identified that reviewed Level 2 studies and developed a guideline for clinical practice guideline implementation strategies in the intensive care units. Hence, including only Level 2 studies was distinctive to this research study. Databases searched included: CINAHL with full text, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials Issue 8 of 12, August 2013, and MEDLINE via PUBMED. Hand search in bound journals was also done. The search strategy identified 315 potentially relevant studies. After the process of critical appraisal, thirteen Level 2 studies were identified as relevant for the review. Of the 13 relevant studies, 10 were randomized controlled trials and three were quasi experimental studies. After the critical appraisal ten RCTs were included in the systematic review. Three studies (quasi-experimental) were excluded on the basis of methodological quality after the critical appraisal and agreement by the two independent reviewers. The Joanna Briggs Institute Critical Appraisal MASTARI Instrument for Randomized Controlled trials/ Experimental studies, and The Joanna Briggs Institute data extraction tools were used to critically appraise, and extract data from the ten included randomized controlled trials. The two reviewers who performed the critical appraisal were qualified critical care professional nurses and experts in research methodology. These reviewers conducted the critical appraisal independently to ensure the objectivity of the process. Appropriate ethical considerations were maintained throughout the process of the research study. The results indicated that 80 percent of the included studies were conducted in adult intensive care units while 20 percent were conducted in the neonatal intensive care units. Furthermore, 60 percent of the studies were conducted in the United States of America, 10 percent in France, a further 10 percent in Taiwan, another 10 percent in England and yet another 10 percfent was conducted in Australia and Newzealand. The included studies utilized more than one (multifaceted) implementation strategies to implement clinical practice guidelines in the intensive care units. The first most utilized were: printed educational materials; Information/ educational sessions/meetings; audit and feedback and champion/local opinion leaders; seconded by educational outreach visits; and computer or internet usage. Third most used were active/passive reminders; systems support; academic detailing/ one-on-one sessions teleconferences/videoconferences and workshops/in services. Fourth most used were ollaboration/interdisciplinary teams; slide shows, teleconferences/videoconferences and discussions. Fifth most used were practical training; monitoring visits and grand rounds. However all the strategies were of equal importance. Conclusively, the included studies utilized multifaceted implementation strategies. However, no study indicated the use of a guideline for the implementation strategies in the process of clinical practice guidelines implementation. The systematic review developed a draft guideline for clinical practice guideline implementation strategies in the intensive care units. The guideline will enhance effective implementation of clinical practice guidelines in such a complex environment.
- Full Text:
- Date Issued: 2014
Barriers to implementation of evidence-based practices in a critical care unit
- Authors: Bowers, Candice Andrea
- Date: 2013
- Subjects: Evidence-based medicine , Critical care medicine , Nursing ethics
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10048 , http://hdl.handle.net/10948/d1013612
- Description: Over the last three decades there has been a greater need for health care practitioners to base their decision on the best available in order to optimise quality and cost-effective patient care. Evidence-based practice necessitates guideline development, education and review in order to achieve improved patient outcomes. However, initiatives that endeavour to disseminate and implement evidence-based practice have faced barriers and opposition. Barriers that might hamper the implementation of evidence-based practice include characteristics of the evidence itself, personal, institutional or organizational factors. The research study explored and described the barriers to implementation of evidence-based practices in a critical care unit. Based on the data analysis, recommendations were made to enhance the implementation of evidence-based practices in the critical care unit. A quantitative, explorative, descriptive and contextual research design was used to operationalize the research objectives. The target population comprised professional nurses in the critical care unit. Non-probability sampling was used to obtain data by means of a structured self-administered questionnaire. Descriptive data analysis was applied, using a statistical programme and the aid of a statistician. The results are graphically displayed using bar graphs and tables. Recommendations for nursing practice, education and research were made. Ethical principles have been maintained throughout the study.
- Full Text:
- Date Issued: 2013
- Authors: Bowers, Candice Andrea
- Date: 2013
- Subjects: Evidence-based medicine , Critical care medicine , Nursing ethics
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10048 , http://hdl.handle.net/10948/d1013612
- Description: Over the last three decades there has been a greater need for health care practitioners to base their decision on the best available in order to optimise quality and cost-effective patient care. Evidence-based practice necessitates guideline development, education and review in order to achieve improved patient outcomes. However, initiatives that endeavour to disseminate and implement evidence-based practice have faced barriers and opposition. Barriers that might hamper the implementation of evidence-based practice include characteristics of the evidence itself, personal, institutional or organizational factors. The research study explored and described the barriers to implementation of evidence-based practices in a critical care unit. Based on the data analysis, recommendations were made to enhance the implementation of evidence-based practices in the critical care unit. A quantitative, explorative, descriptive and contextual research design was used to operationalize the research objectives. The target population comprised professional nurses in the critical care unit. Non-probability sampling was used to obtain data by means of a structured self-administered questionnaire. Descriptive data analysis was applied, using a statistical programme and the aid of a statistician. The results are graphically displayed using bar graphs and tables. Recommendations for nursing practice, education and research were made. Ethical principles have been maintained throughout the study.
- Full Text:
- Date Issued: 2013
Endotracheal tube verification in the mechanically ventilated patient in a critical care unit
- Authors: Fataar, Danielle
- Date: 2013
- Subjects: Respirators (Medical equipment) , Critical care medicine , Intensive care units
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10020 , http://hdl.handle.net/10948/d1008057 , Respirators (Medical equipment) , Critical care medicine , Intensive care units
- Description: Critically ill patients often require assistance by means of intubation and mechanical ventilation to support their spontaneous breathing if they are unable to maintain it. Mechanical ventilation is one of the most commonly used treatment modalities in the care of the critically ill patient and up to 90% of patients world-wide require mechanical ventilation during some or most parts of their stay in critical care units Management of a patient’s airway is a critical part of patient care both in and out of hospital. Although there are many methods used in verifying the correct placement of the endotracheal tube, the need and ability to verify placement of an endotracheal tube correctly is of utmost importance, because many complications can occur should the tube be incorrectly placed. Since unrecognized oesophageal intubation can have many disastrous effects on patients, various methods for verifying correct endotracheal tube placement have been developed and considered. Some of these methods include direct visualization, end-tidal carbon dioxide measurement and oesophageal detector devices. This research study aimed to explore and describe the existing literature on the verification of endotracheal tubes in the mechanically ventilated patient in the critical- care unit. A systematic review was done in order to operationalize the primary objective. Furthermore, based on the literature collected from the systematic review, recommendations for the verification of the endotracheal tube in the mechanically ventilated patient in the critical care unit were made. Ethical considerations were maintained throughout the study and the quality of the systematic review was ensured by performing a critical appraisal of the evidence found.
- Full Text:
- Date Issued: 2013
- Authors: Fataar, Danielle
- Date: 2013
- Subjects: Respirators (Medical equipment) , Critical care medicine , Intensive care units
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10020 , http://hdl.handle.net/10948/d1008057 , Respirators (Medical equipment) , Critical care medicine , Intensive care units
- Description: Critically ill patients often require assistance by means of intubation and mechanical ventilation to support their spontaneous breathing if they are unable to maintain it. Mechanical ventilation is one of the most commonly used treatment modalities in the care of the critically ill patient and up to 90% of patients world-wide require mechanical ventilation during some or most parts of their stay in critical care units Management of a patient’s airway is a critical part of patient care both in and out of hospital. Although there are many methods used in verifying the correct placement of the endotracheal tube, the need and ability to verify placement of an endotracheal tube correctly is of utmost importance, because many complications can occur should the tube be incorrectly placed. Since unrecognized oesophageal intubation can have many disastrous effects on patients, various methods for verifying correct endotracheal tube placement have been developed and considered. Some of these methods include direct visualization, end-tidal carbon dioxide measurement and oesophageal detector devices. This research study aimed to explore and describe the existing literature on the verification of endotracheal tubes in the mechanically ventilated patient in the critical- care unit. A systematic review was done in order to operationalize the primary objective. Furthermore, based on the literature collected from the systematic review, recommendations for the verification of the endotracheal tube in the mechanically ventilated patient in the critical care unit were made. Ethical considerations were maintained throughout the study and the quality of the systematic review was ensured by performing a critical appraisal of the evidence found.
- Full Text:
- Date Issued: 2013
Experiences of professional nurses with regard to accessing information at the point-of-care via mobile-computing devices at a public hospital
- Authors: Benjamin, Valencia
- Date: 2013
- Subjects: Information storage and retrieval systems -- Hospitals , Point-of-care testing , Public hospitals -- Medical staff
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10060 , http://hdl.handle.net/10948/d1020193
- Description: Mobile computing devices are capable of changing how healthcare is delivered in the future, since they aim to merge and integrate all services into one device that is versatile, customisable, and portable. The aim of this study was to explore and describe the experiences of professional nurses with regard to accessing information at the point-of-care of the patient, in order to develop guidelines that could assist other professional nurses with implementing the mobile computing device for accessing information at the point-of-care of patients. To achieve the purpose of the study, a qualitative, explorative, descriptive, and contextual design was used to conduct this research – to gain an understanding of how the professional nurses experienced accessing information at the point-of-care via mobile computing devices. The study was conducted among the professional nurses employed at the public hospital, who were trained and provided with the mobile computing device for accessing information at the point-of-care for more than two years. In-depth interviewing was conducted to obtain the data. Data analysis was done using Tesch‘s method to make sense out of text and data. Four themes were identified, namely, the professional nurses‘ expression of various experiences regarding the training received; the need for support in implementing the mobile computing device; the accessing of information at the point-of-care as beneficial for educational purposes; and the accessing of information at the point-of-care as beneficial to patient care. Two main guidelines were developed. The study concludes with recommendations made with regard to the areas of nursing practice, education and research. Throughout the study, the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2010:298).
- Full Text:
- Date Issued: 2013
- Authors: Benjamin, Valencia
- Date: 2013
- Subjects: Information storage and retrieval systems -- Hospitals , Point-of-care testing , Public hospitals -- Medical staff
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10060 , http://hdl.handle.net/10948/d1020193
- Description: Mobile computing devices are capable of changing how healthcare is delivered in the future, since they aim to merge and integrate all services into one device that is versatile, customisable, and portable. The aim of this study was to explore and describe the experiences of professional nurses with regard to accessing information at the point-of-care of the patient, in order to develop guidelines that could assist other professional nurses with implementing the mobile computing device for accessing information at the point-of-care of patients. To achieve the purpose of the study, a qualitative, explorative, descriptive, and contextual design was used to conduct this research – to gain an understanding of how the professional nurses experienced accessing information at the point-of-care via mobile computing devices. The study was conducted among the professional nurses employed at the public hospital, who were trained and provided with the mobile computing device for accessing information at the point-of-care for more than two years. In-depth interviewing was conducted to obtain the data. Data analysis was done using Tesch‘s method to make sense out of text and data. Four themes were identified, namely, the professional nurses‘ expression of various experiences regarding the training received; the need for support in implementing the mobile computing device; the accessing of information at the point-of-care as beneficial for educational purposes; and the accessing of information at the point-of-care as beneficial to patient care. Two main guidelines were developed. The study concludes with recommendations made with regard to the areas of nursing practice, education and research. Throughout the study, the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2010:298).
- Full Text:
- Date Issued: 2013
Guidelines for a therapeutic programme to address the mental health needs of adolescents being treated in a psychiatric hospital
- Authors: Smith, Lourett
- Date: 2013
- Subjects: Teenagers , Psychiatric hospitals , Mental health facilities
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10036 , http://hdl.handle.net/10948/d1010963 , Teenagers , Psychiatric hospitals , Mental health facilities
- Description: It is estimated that about 10 million children and adolescents worldwide, annually suffer from psychiatric disorders. They often require hospital treatment because they are not coping with their psychiatric condition at home or there is a lack of supervision. Suicide amongst adolescents who are experiencing a crisis is a bleak reality. In-patient treatment provides the necessary structure and supervision in order to secure a stable environment which is vital for treating adolescents. Treatment usually includes a therapeutic programme provided by members of the multi-professional team. Since there is at present no adolescent in-patient treatment facility in the Nelson Mandela Bay to provide psychiatric care to adolescents who are experiencing a mental problem, these patients are admitted to psychiatric hospitals which cater only for the needs of adult patients or they are referred to facilities in other provinces. The goals and objectives of this study are firstly, to explore and describe the perceptions of mental health professionals working in psychiatric hospitals regarding what should be included in a therapeutic programme for adolescents and secondly, to develop guidelines for treating adolescents that can be implemented in psychiatric hospitals in the Nelson Mandela Bay. The study followed a qualitative, exploratory, descriptive, contextual design. The research population included various professionals who provide services at psychiatric hospitals in the Nelson Mandela Bay. Purposive sampling was utilized. Semi-structured interviews were conducted to collect information-rich data and field notes were kept. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. An independent coder assisted with the coding process to ensure the trustworthiness of the findings. Literature was reviewed in order to identify research that was done previously regarding adolescent psychiatric in-patient programmes in order to bridge the gaps that were identified. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness which consists of the following four constructs, namely, credibility, transferability, dependability and confirmability. The researcher ensured that the study was conducted in an ethical manner by adhering to ethical principles such as beneficence, justice and fidelity.
- Full Text:
- Date Issued: 2013
- Authors: Smith, Lourett
- Date: 2013
- Subjects: Teenagers , Psychiatric hospitals , Mental health facilities
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10036 , http://hdl.handle.net/10948/d1010963 , Teenagers , Psychiatric hospitals , Mental health facilities
- Description: It is estimated that about 10 million children and adolescents worldwide, annually suffer from psychiatric disorders. They often require hospital treatment because they are not coping with their psychiatric condition at home or there is a lack of supervision. Suicide amongst adolescents who are experiencing a crisis is a bleak reality. In-patient treatment provides the necessary structure and supervision in order to secure a stable environment which is vital for treating adolescents. Treatment usually includes a therapeutic programme provided by members of the multi-professional team. Since there is at present no adolescent in-patient treatment facility in the Nelson Mandela Bay to provide psychiatric care to adolescents who are experiencing a mental problem, these patients are admitted to psychiatric hospitals which cater only for the needs of adult patients or they are referred to facilities in other provinces. The goals and objectives of this study are firstly, to explore and describe the perceptions of mental health professionals working in psychiatric hospitals regarding what should be included in a therapeutic programme for adolescents and secondly, to develop guidelines for treating adolescents that can be implemented in psychiatric hospitals in the Nelson Mandela Bay. The study followed a qualitative, exploratory, descriptive, contextual design. The research population included various professionals who provide services at psychiatric hospitals in the Nelson Mandela Bay. Purposive sampling was utilized. Semi-structured interviews were conducted to collect information-rich data and field notes were kept. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. An independent coder assisted with the coding process to ensure the trustworthiness of the findings. Literature was reviewed in order to identify research that was done previously regarding adolescent psychiatric in-patient programmes in order to bridge the gaps that were identified. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness which consists of the following four constructs, namely, credibility, transferability, dependability and confirmability. The researcher ensured that the study was conducted in an ethical manner by adhering to ethical principles such as beneficence, justice and fidelity.
- Full Text:
- Date Issued: 2013
Nursing care practice related to patient safety in the operating room
- Authors: Theron, Margot Cecile
- Date: 2013
- Subjects: Operating room nurses -- South Africa -- Port Elizabeth , Nursing ethics -- South Africa -- Port Elizabeth , Nurse and patient -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10051 , http://hdl.handle.net/10948/d1017197
- Description: Patient safety is a primary concern of members of the surgical team. Professional nurses working in the operating room play a vital role in the safety of the patients from the moment the patient enters the operating room to the discharge of the patient to the unit. Quality nursing care is of the utmost importance and therefore it is the responsibility of a professional nurse to ensure patient safety during the peri-operative period. Team work and good communication in the operating room are essential in order to ensure patient safety. Nursing care practices related to patient safety should be a key aspect to consider in rendering care to the surgical patient and professional nurses should perform their duties to the best of their ability despite lack of resources and shortage of staff. The main purpose of the study was to explore and describe nursing care practice related to patient safety in the operating room at hospitals in the Nelson Mandela Metropolitan area. Once this was established recommendations on how to enhance nursing care practice related to patient safety in the operating room were made. This study is based on a quantitative, explorative, descriptive and contextual design. Convenient sampling was used in this study. Data were collected by means of a self-administered questionnaire. Descriptive and inferential statistics were used to analyse the data. Ethical considerations were adhered to and the findings of the research will be disseminated appropriately. Recommendations based on the findings that emerge from the data, as well as the literature review, will be offered to enhance nursing care practice related to patient safety in the operating room.
- Full Text:
- Date Issued: 2013
- Authors: Theron, Margot Cecile
- Date: 2013
- Subjects: Operating room nurses -- South Africa -- Port Elizabeth , Nursing ethics -- South Africa -- Port Elizabeth , Nurse and patient -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10051 , http://hdl.handle.net/10948/d1017197
- Description: Patient safety is a primary concern of members of the surgical team. Professional nurses working in the operating room play a vital role in the safety of the patients from the moment the patient enters the operating room to the discharge of the patient to the unit. Quality nursing care is of the utmost importance and therefore it is the responsibility of a professional nurse to ensure patient safety during the peri-operative period. Team work and good communication in the operating room are essential in order to ensure patient safety. Nursing care practices related to patient safety should be a key aspect to consider in rendering care to the surgical patient and professional nurses should perform their duties to the best of their ability despite lack of resources and shortage of staff. The main purpose of the study was to explore and describe nursing care practice related to patient safety in the operating room at hospitals in the Nelson Mandela Metropolitan area. Once this was established recommendations on how to enhance nursing care practice related to patient safety in the operating room were made. This study is based on a quantitative, explorative, descriptive and contextual design. Convenient sampling was used in this study. Data were collected by means of a self-administered questionnaire. Descriptive and inferential statistics were used to analyse the data. Ethical considerations were adhered to and the findings of the research will be disseminated appropriately. Recommendations based on the findings that emerge from the data, as well as the literature review, will be offered to enhance nursing care practice related to patient safety in the operating room.
- Full Text:
- Date Issued: 2013
Respiratory management of the mechanically ventilated spinal cord injured patient in a critical care unit
- Authors: Love, Janine Ann
- Date: 2013
- Subjects: Respirators (Medical equipment) , Critical care medicine , Intensive care units , Spinal cord -- Wounds and injuries
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10031 , http://hdl.handle.net/10948/d1008451 , Respirators (Medical equipment) , Critical care medicine , Intensive care units , Spinal cord -- Wounds and injuries
- Description: Background: Spinal Cord Injuries (SCIs) are traumatic, life-changing injuries that can affect every aspect of an individual's life and can lead to death if not treated timeously and appropriately. Respiratory complications occur frequently after the SCI and are the leading cause of mortality and morbidity. Respiratory complications are predictable based on the neurological level of impairment of the spinal cord lesion; the higher the neurological injury, the more severe the respiratory complication. Changes in pulmonary function, poor cough, hypersecretion, immobility and bronchospasm all contribute to the development of respiratory complications. If the patient is unable to protect his/her airway or if respiratory failure occurs, mechanical ventilation is often required. Many patients require prolonged ventilation and subsequently need to go for tracheostomies. The critical care nurse plays an important role in the early identification of complications and can, therefore, act to limit and prevent these complications, which may be a direct result from the injury or treatment modality such as mechanical ventilation. Respiratory management has been promoted in preventing and treating respiratory complications and is associated with better prognosis in the SCI patient. Design and method: The research study aims to explore and describe existing literature and to make recommendations for the respiratory management of a mechanically ventilated spinal cord injured patient in a critical care unit (CCU). A systematic review was undertaken with clear inclusion and exclusion criteria. Ethical principles were maintained throughout the study. The quality of the study was ensured by critically appraising data that was utilized in the systematic review. It is envisaged that the results from this systematic review will improve the respiratory management of the SCI patient and prevent any variations in practice. Results: Were presented under the following themes: priorities of care for the SCI patient in the acute phase, during the critical care phase and preventative care. Conclusion: The SCI patient regardless of the neurological level or completeness of injury should be admitted to the CCU for intensive ventilatory, cardiopulmonary support and hemodynamic monitoring in order to detect and prevent respiratory complications. The use of larger tidal volumes is associated with improved comfort and less dyspnea however if a patient has acute lung injury or ARDS the use of low tidal volumes 6ml/kg is recommended. Prevention and early identification of respiratory complications is associated with improved outcomes for the SCI patient.
- Full Text:
- Date Issued: 2013
- Authors: Love, Janine Ann
- Date: 2013
- Subjects: Respirators (Medical equipment) , Critical care medicine , Intensive care units , Spinal cord -- Wounds and injuries
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10031 , http://hdl.handle.net/10948/d1008451 , Respirators (Medical equipment) , Critical care medicine , Intensive care units , Spinal cord -- Wounds and injuries
- Description: Background: Spinal Cord Injuries (SCIs) are traumatic, life-changing injuries that can affect every aspect of an individual's life and can lead to death if not treated timeously and appropriately. Respiratory complications occur frequently after the SCI and are the leading cause of mortality and morbidity. Respiratory complications are predictable based on the neurological level of impairment of the spinal cord lesion; the higher the neurological injury, the more severe the respiratory complication. Changes in pulmonary function, poor cough, hypersecretion, immobility and bronchospasm all contribute to the development of respiratory complications. If the patient is unable to protect his/her airway or if respiratory failure occurs, mechanical ventilation is often required. Many patients require prolonged ventilation and subsequently need to go for tracheostomies. The critical care nurse plays an important role in the early identification of complications and can, therefore, act to limit and prevent these complications, which may be a direct result from the injury or treatment modality such as mechanical ventilation. Respiratory management has been promoted in preventing and treating respiratory complications and is associated with better prognosis in the SCI patient. Design and method: The research study aims to explore and describe existing literature and to make recommendations for the respiratory management of a mechanically ventilated spinal cord injured patient in a critical care unit (CCU). A systematic review was undertaken with clear inclusion and exclusion criteria. Ethical principles were maintained throughout the study. The quality of the study was ensured by critically appraising data that was utilized in the systematic review. It is envisaged that the results from this systematic review will improve the respiratory management of the SCI patient and prevent any variations in practice. Results: Were presented under the following themes: priorities of care for the SCI patient in the acute phase, during the critical care phase and preventative care. Conclusion: The SCI patient regardless of the neurological level or completeness of injury should be admitted to the CCU for intensive ventilatory, cardiopulmonary support and hemodynamic monitoring in order to detect and prevent respiratory complications. The use of larger tidal volumes is associated with improved comfort and less dyspnea however if a patient has acute lung injury or ARDS the use of low tidal volumes 6ml/kg is recommended. Prevention and early identification of respiratory complications is associated with improved outcomes for the SCI patient.
- Full Text:
- Date Issued: 2013
The lived experiences of professional nurses with regards to end-of-life issues in the Intensive Care Unit
- Authors: Clifford, Ilzé
- Date: 2013
- Subjects: Intensive care units , Death
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10055 , http://hdl.handle.net/10948/d1018572
- Description: Professional nurses working in an intensive care unit (ICU) are faced with the death of critically ill patients frequently. Modern day medicine and technology have made it possible for advanced life-sustaining measures to be implemented on patients who, without medical intervention, would otherwise not have survived. The question is raised: is modern technology preserving life and prolonging the dying process, or is it in the best interest of the patient for treatment to be withdrawn? Nurses, caring for these patients and their families, are practicing at the bedside of these dying patients and are thus often faced with end-of-life issues, particularly withdrawal of treatment. The primary functions of critical care nurses are toward their patients. Physicians are responsible for making decisions regarding withdrawal of treatment. However, the nurses in the ICU are responsible for implementing the decisions made; sometimes contradicting what they believe in. The experience of end-of-life issues, namely withdrawal of treatment, is a cause of distress for the professional nurse. Little research has been done on how the ICU nurses deal with end-of-life issues and what support structures are required to assist nurses in dealing with end-of-life issues (Hov, Hedelin & Athlin, 2006:204) The objectives of the study were to explore and describe the professional nurses‟ lived experiences of end-of-life issues in the intensive care unit. The study aimed to make recommendations regarding support strategies to assist professional nurses in dealing with end-of-life issues in the intensive care unit. The researcher has selected a qualitative research approach with an explorative, descriptive and contextual design in order to conduct the study. Data was collected by means of semi-structured interviews. Data was analysed using the steps as illustrated by Tesch‟s method. Ethical principles were maintained throughout the research study. The findings of this study are to be presented in a journal publication.
- Full Text:
- Date Issued: 2013
- Authors: Clifford, Ilzé
- Date: 2013
- Subjects: Intensive care units , Death
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10055 , http://hdl.handle.net/10948/d1018572
- Description: Professional nurses working in an intensive care unit (ICU) are faced with the death of critically ill patients frequently. Modern day medicine and technology have made it possible for advanced life-sustaining measures to be implemented on patients who, without medical intervention, would otherwise not have survived. The question is raised: is modern technology preserving life and prolonging the dying process, or is it in the best interest of the patient for treatment to be withdrawn? Nurses, caring for these patients and their families, are practicing at the bedside of these dying patients and are thus often faced with end-of-life issues, particularly withdrawal of treatment. The primary functions of critical care nurses are toward their patients. Physicians are responsible for making decisions regarding withdrawal of treatment. However, the nurses in the ICU are responsible for implementing the decisions made; sometimes contradicting what they believe in. The experience of end-of-life issues, namely withdrawal of treatment, is a cause of distress for the professional nurse. Little research has been done on how the ICU nurses deal with end-of-life issues and what support structures are required to assist nurses in dealing with end-of-life issues (Hov, Hedelin & Athlin, 2006:204) The objectives of the study were to explore and describe the professional nurses‟ lived experiences of end-of-life issues in the intensive care unit. The study aimed to make recommendations regarding support strategies to assist professional nurses in dealing with end-of-life issues in the intensive care unit. The researcher has selected a qualitative research approach with an explorative, descriptive and contextual design in order to conduct the study. Data was collected by means of semi-structured interviews. Data was analysed using the steps as illustrated by Tesch‟s method. Ethical principles were maintained throughout the research study. The findings of this study are to be presented in a journal publication.
- Full Text:
- Date Issued: 2013