Scielo RSS <![CDATA[Curationis]]> vol. 42 num. 1 lang. en <![CDATA[SciELO Logo]]> <![CDATA[<b>Promoting experiential learning through the use of high-fidelity human patient simulators in midwifery: A qualitative study</b>]]> BACKGROUND: The need to use innovative teaching and learning strategies in the nursing pedagogy is important in the 21st century. The challenges of clinical sites and opportunities for nursing students to gain clinical experience are a growing concern for many nurse educators. High-fidelity human patient simulators (HFHPS) are computerised mannequins that replicate a real-life patient, and when integrated into classroom teaching they allow students to become fully immersed into an almost real-life scenario. OBJECTIVES: The aim of this study was to describe how HFHPS can promote experiential learning following the management of postpartum haemorrhage as a midwifery clinical emergency. METHOD: A descriptive qualitative research approach was carried out in this study. The research setting was a local university in KwaZulu-Natal. The total population included all (N = 43) fourth-year baccalaureate of nursing undergraduate student midwives who participated as observers and/or role-players of a scenario role-play. An all-inclusive sampling was performed. There were 43 student midwives involved in the simulation teaching session with 6 of these students actively participating in each role-play at a time, while the remaining 37 observed. This occurred in two separate sessions and all the student midwives were involved in a debriefing session. These student midwives were then followed up and asked to participate in a focus group. The data in this article came from two separate focus groups which comprised 20 student midwives in total. Data were analysed using content analysis. RESULTS: Four categories emerged from the data, namely HFHPS offers a unique opportunity for student midwives to manage complex real-life emergencies; promotes reflection by allowing student midwives to reflect or review their roles, decisions and skills; allows student midwives to learn from their own experiences and encourages student midwives to try out what they learnt in a real-life situation CONCLUSION: High-fidelity human patient simulators can be used in a complex case scenario to promote experiential learning of a clinical emergency. <![CDATA[<b>Challenges of primary healthcare nurses regarding the integration of HIV and AIDS services into primary healthcare in Vhembe district of Limpopo province, South Africa</b>]]> BACKGROUND: Integration of human immunodeficiency virus and acquired immune deficiency syndrome (HIV and AIDS) services into primary healthcare (PHC) is a key public health approach to achieving universal access to antiretroviral therapy (ART). Despite the government's efforts of integrating HIV services into PHC, an insufficient number of PHC staff and inadequate infrastructure are challenging when integrating HIV and AIDS services into PHC. This study explored the challenges of PHC nurses regarding the integration of HIV and AIDS services into PHC. OBJECTIVES: The aim of the study was to explore the challenges of PHC nurses regarding the integration of HIV and AIDS services into PHC. METHOD: An exploratory, descriptive and contextual qualitative research design utilising face-to-face semi-structured interviews was conducted with 12 PHC nurses from selected clinics and health centres in the Vhembe district of Limpopo province. RESULTS: Two main themes emerged from data analysis which included challenges related to healthcare recipients and challenges related to healthcare providers. CONCLUSION: Clear policies on the integration of HIV and AIDS services into PHC should be available and should include strategies to promote HIV testing and counselling, adherence to ART and scheduled appointments, disclosure of HIV status as well as revising the human resource policy to reduce workload. <![CDATA[<b>Compliance to the Integrated School Health Policy: Intersectoral and multisectoral collaboration</b>]]> BACKGROUND: Implementation of the Integrated School Health Policy (ISHP) requires strong intersectoral collaboration on the part of key role players such as the Department of Health, Department of Basic Education and Department of Social Development. These departments and educational structures such as school governing bodies, teacher unions and learner organisations, academic institutions, civil society and development partner organisations are also expected to contribute to the development of sustainable and comprehensive school health programmes. OBJECTIVES: The objective of this study was to describe the compliance of the schools in the City of Tshwane to the ISHP in 2015. METHOD: A quantitative, explorative and descriptive study was conducted in the City of Tshwane using a questionnaire to determine the extent of compliance to the application of the ISHP in selected schools. RESULTS: The results indicated a widespread non-compliance to ISHP programmes. There was insufficient stakeholder integration in the school health programmes at schools in the City of Tshwane. CONCLUSION: The lack of collaboration with relevant stakeholders in school health service delivery will lead to a fragmented, uncoordinated and unsustainable approach to the execution of ISHP programmes. This might result in delayed or no detection and intervention in cases of, among others, mental, psychosocial and health challenges to learning, as well as development of nutrition-related conditions. <![CDATA[<b>Nurses' attitudes towards the implementation of the Mother-Baby Friendly Initiative in selected primary healthcare facilities at Makhuduthamaga Municipality, Limpopo province</b>]]> BACKGROUND: The implementation of the Mother-Baby Friendly Initiative (MBFI) strategy demonstrated its capabilities to improve global children's health and maternal survival. However, its implementation in primary healthcare (PHC) facilities remains a challenge as many nurses are reluctant to adopt it for the improvement of child and maternal healthcare services in their respective clinics. OBJECTIVES: The primary objective of this study was to determine the attitudes of nurses towards the implementation of the MBFI in selected PHC facilities in the Makhuduthamaga Municipality, Limpopo province. METHOD: This study used a quantitative, descriptive design, and all respondents were conveniently sampled. A self-administered questionnaire was used to collect data. One-hundred and seventy-seven questionnaires were distributed, and 153 nurses responded and completed the questionnaire. The Statistical Package for Social Sciences version 23 was used to analyse data. RESULTS: Results show that the majority of nurses (professional nurses [PNs] = 65, 78%; enrolled nurses [ENs] = 18, 72%; enrolled nursing auxiliaries [ENAs] = 23, 51%) had a positive attitude towards the MBFI strategy implementation as they agreed that it increased breastfeeding rates. Most PNs (n = 58, 70%) and ENs (n = 15, 60%) showed positive attitudes towards exclusive breastfeeding (EBF) as they agreed that it was the ideal feeding option for any child, and most ENAs (n = 38, 84%) showed a negative attitude as they disagreed that EBF was the ideal feeding option for any child. CONCLUSION: In this study, most PNs and ENs had a positive attitude in all the aspects that determined their attitudes towards MBFI strategy implementation. A concern is the fact that most ENAs showed negative attitudes in almost all the statements that were in line with the principles of MBFI, as they disagreed in most aspects. Therefore, this study recommends that on-going orientation and trainings should be offered to all nurses including ENAs to equip them with information that can assist in changing their attitudes towards MBFI implementation in PHC facilities. <![CDATA[<b>Challenges experienced by health care professionals working in resource-poor intensive care settings in the Limpopo province of South Africa</b>]]> BACKGROUND: Providing optimal care to critically ill patients poses challenges in resource-poor settings because of the lack of equipment, inadequately trained personnel and limited infrastructure. OBJECTIVES: This study explored challenges experienced by health care professionals working in resource-poor intensive care units. METHOD: A qualitative, explorative, descriptive design was used. The population comprised nurses and doctors working in an intensive care unit of one hospital in the Limpopo province of South Africa. A purposive sample was selected and 17 semi-structured interviews were conducted. Data were analysed using Tesch's method. Ethical considerations were adhered to. RESULTS: Participants experienced challenges related to provision of suboptimal patient care, the challenge of non-adherence to protocols and/or instructions and the challenge of practising beyond the scope of practice. CONCLUSION: Lack of resources resulted in providing suboptimal intensive patient care. Patients were prone to infections and their safety might be compromised. <![CDATA[<b>A retrospective audit of nursing-related morbidity recorded in a state hospital in KwaZulu-Natal</b>]]> BACKGROUND: Health care professionals are expected to deliver safe and effective health services; however there is increased realisation that adverse events in the health system are a major cause of preventable morbidity and mortality. OBJECTIVES: To conduct a retrospective audit of nursing-related morbidities in a state hospital in KwaZulu-Natal, South Africa. METHOD: A retrospective audit of nursing-related morbidities documented by the surgical service was carried out using the Hybrid Electronic Medical Registry data for a period of 3 years - 01 November 2013 to 31 October 2016. RESULTS: There were a total of 12 444 admissions to surgical service during the study period, with 461 nursing-related morbidities reported. There was an increase in the number of documented nursing-related morbidities noted during November 2015 to October 2016, with 79% of all reported nursing-related morbidities documented during this period. A total of 54% of nursing-related morbidities were associated with males (n = 248) and 46% (n = 213) with females. The most commonly documented nursing-related morbidity was drugs/medication (n = 167, 36%) with the second most common being adjunct management (n = 130, 28%). CONCLUSION: The study has identified the most commonly documented nursing-related morbidities in the surgical service of a state hospital. The findings of the study could provide direction for further research and educational initiatives. <![CDATA[<b>Student nurses' perceptions of their educational environment at a school of nursing in Western Cape province, South Africa: A cross-sectional study</b>]]> BACKGROUND: Educational environments have been found to bear a substantial relationship with the academic performance and success, as well as the retention, of students. OBJECTIVES: The study objectives were to (1) evaluate the educational environment as perceived by undergraduate nursing students at a school of nursing (SON) in Western Cape province and (2) investigate whether the educational environment, or components thereof, is perceived negatively or positively among undergraduate nursing students of different year level, gender, home language and ethnicity. METHOD: A quantitative research method with a cross-sectional design was implemented. Data were collected from 232 undergraduate nursing students from a SON at a university in Western Cape province, South Africa. The subscales and the items of the educational environment questionnaire were compared among undergraduate nursing students. Data were analysed by means of the IBM Statistical Package for Social Sciences (IBM SPSS-24) using analysis of variances (ANOVAs), independent-sample t-tests, mean scores, standard deviations and percentages RESULTS: The mean score attained for the entire participant group was 195 (standard deviation [SD] = 24.2) out of 268 (equivalent to 72.8% of maximum score), which indicated that the educational environment was perceived substantially more positively than negatively. The overall mean score was significantly higher (p < 0.05) for male students (M = 202; SD = 21) and for black students (M = 202; SD = 21). The digital resources (DR) subscale was the only subscale with a statement or item that was rated as absolute negative (M = 1.9; SD = 0.9). CONCLUSION: The educational environment at the institution concerned was perceived as predominantly positive by its undergraduate nursing students. Although the educational environment was predominantly perceived as positive, the results of this study also indicated that enhancements are required to improve the physical classroom conditions, skills laboratories, DR and the implemented teaching and learning strategies. It is vital for university management to prioritise the creation of an educational environment which would ensure that quality learning takes place. <![CDATA[<b>Recommendations to facilitate managers' compliance with quality standards at primary health care clinics</b>]]> BACKGROUND: The Republic of South Africa (RSA) is shifting towards universal health coverage and a unified health system. This milestone can be achieved through the implementation of National Health Insurance (NHI). To employ NHI, health establishments in the country are compelled to comply with quality standards. The non-compliance with quality standards at primary health care (PHC) clinics within a district in Gauteng, which was verified by quality standards' audit reports, prompted an intervention. No prior research aimed at facilitating managers' compliance with quality standards has been conducted within the context under study. This research gap necessitated an exploration on how managers' compliance to quality standards at PHC clinics within a district in Gauteng could best be facilitated. OBJECTIVES: To describe recommendations to facilitate managers' compliance with quality standards at PHC clinics within a district in Gauteng. METHOD: A qualitative, exploratory, descriptive and contextual research design was used in this study. Semi-structured, individual interviews were conducted. RESULTS: The recommendations to facilitate managers' compliance with quality standards at PHC clinics within a district in Gauteng were described. However, for the purpose of this article, only the recommendations seeking to address challenges with management practices as a reason for non-compliance with quality standards at PHC clinics will be discussed. These recommendations include involvement of PHC clinic managers in decision-making, adequate support from senior management and improvement of internal communication practices. CONCLUSION: The researcher concludes that the senior management team in the district under study should strive to embrace the described recommendations as a strategy to facilitate managers' compliance to quality standards at PHC clinics. <![CDATA[<b>Clinical supervision and support: Perspectives of undergraduate nursing students on their clinical learning environment in Malawi</b>]]> BACKGROUND: The nurse educators' role in clinical learning is to define the necessary prerequisites of an ideal clinical learning environment. OBJECTIVES: The purpose of the study was to explore and describe the Kamuzu College of Nursing (KCN) undergraduate nursing students' perspectives on clinical supervision and support in their clinical learning environment and their preferences in the clinical learning environment. METHOD: A mixed method research approach was used to explore and describe clinical supervision from the students' perspectives on the features of their actual and preferred clinical learning environment. The study's population comprised all third- and fourth-year undergraduate nursing students (n = 219). A sample (n = 125) was randomly selected from the population for the quantitative survey of which 120 questionnaires (96%) were valid for analysis. The data collection for qualitative arm of the study comprised interviews conducted through purposive sampling interviewing 20 participants. Survey results were analysed using the Statistical Package for the Social Science (Version 16) and the qualitative data were analysed using the content analysis approach where themes were generated. RESULTS: The study found that the participants were not satisfied with clinical supervision and support during clinical learning. The participants preferred improved clinical supervision and support in their clinical learning. Comparing the difference between actual and the preferred items of supervision the results were statistically significant at p < 0.05. CONCLUSION: There is a need to improve students' clinical supervision and support at KCN. Nurse educators need to plan for clinical supervision and support effectively to promote proficient nursing graduates. <![CDATA[<b>Positioning public nursing colleges in South African higher education: Stakeholders' perspectives</b>]]> BACKGROUND: Public nursing colleges (PNCs) are currently redeploying from provincial departments of health to higher education to become part of a unified higher education system in South Africa. As primary producers of nurses, this migration process needs to be managed carefully, with stakeholders having a common understanding of this process. OBJECTIVES: This study aimed to explore the stakeholders' perspectives on the positioning of PNCs in higher education. METHOD: The study followed a qualitative grounded theory design. Purposive and theoretical sampling were utilised to achieve a sample size of 40 participants, including representatives from the Department of Higher Education and Training; professional associates; nursing educators; student leaders; nursing leaders; and nurses from the healthcare setting. Data were collected through observations, interviews and document analysis. RESULTS: It emerged from the study that the integration of PNCs into higher education is a result of the country's political and legal context. A number of policy and legal frameworks emerged as contextual conditions that provided a basis for the change. The integration of PNCs into higher education was conceptualised as a functional shift in the governance of colleges; a political tool to transform nursing education; a means to enhance the quality of college-based nursing programmes, and a vehicle for the greater professionalisation of nursing. Conflicting legislation and funding emerged as two issues of concern. CONCLUSION: Integrating PNCs with higher education came about because of political changes and the resolution of the ruling party to improve the quality of graduates produced, who will in turn improve the quality of healthcare service delivery offered. <![CDATA[<b>An exploration into the quality of life of women treated for cervical cancer</b>]]> BACKGROUND: Cervical cancer mainly occurs among women from the developing world, and women face unique challenges in terms of their disease and treatment. Most women present with advanced cervical cancer and receive the standard curative treatment with external beam radiotherapy and brachytherapy with or without chemotherapy. OBJECTIVES: To describe the quality of life (QOL) of women treated for cervical cancer during treatment (M0), at 6 months after completing treatment (M6) and at 12 months after treatment (M12 METHODS: A cross-sectional design, calculated sample size (n = 153) and convenience sampling were used. Data were collected through structured interviews, and the EORTC QLQ-C30 and EORTC QLQ CX24 served as data collection instruments. Descriptive statistics were used to analyse the data, and the Kruskal-Wallis H test was used to compare the mean responses across the groups (p ≤ 0.05). RESULTS: The mean age of the respondents was 50.6 years (standard deviation [SD] 11.9). The global health status improved significantly in contrast with the functional scores. Financial difficulties were rampant, especially during the treatment phase. Insomnia and urinary frequency were the most cumbersome problems and remained so even after treatment. CONCLUSIONS: Despite an improvement in the global health, cervical cancer and its treatment had a negative influence on the QOL in all domains of lives of these women. Assessing the QOL of patients during treatment and follow-up visits would allow nurses to develop interventions to address distressing problems timeously. In addition, Africa's nurses should assess social functioning and develop programmes to prevent social dysfunction. <![CDATA[<b>Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review</b>]]> BACKGROUND: There is overwhelming evidence that the quality of health care in South Africa has been compromised by various challenges that impact negatively on healthcare quality. Improvement in quality care means fewer errors, reduced delays in care delivery, improvement in efficiency, increased market share and lower cost. Decline in quality health care has caused the public to lose trust in the healthcare system in South Africa. OBJECTIVES: The purpose of this study was to identify challenges that are being incurred in practice that compromise quality in the healthcare sector, including strategies employed by government to improve the quality of health delivery. METHOD: Literature search included the following computer-assisted databases and bibliographies: Medline (Medical Literature Online), EBSCOhost, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google, Google Scholar and ScienceDirect. Furthermore, websites were used to source policy documents of organisations such as the National Department of Health in South Africa and the World Health Organization. RESULTS: Seventy-four articles were selected from 1366 retrieved. These articles quantify problems facing quality care delivery and strategies used to improve the healthcare system in South Africa. CONCLUSION: The findings revealed that there were many quality improvement programmes that had been initiated, adapted, modified and then tested but did not produce the required level of quality service delivery as desired. As a result, the Government of South Africa has a challenge to ensure that implementation of National Core Standards will deliver the desired health outcomes, because achieving a lasting quality improvement system in health care seems to be an arduous challenge.