Masters Degrees (Nursing and Midwifery)

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Browsing Masters Degrees (Nursing and Midwifery) by browse.metadata.advisor "Cohen, Mary A."

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    Attitudes and barriers to the use of the World Health Organisation’s surgical safety checklist at a specialized academic hospital in the Western Cape, South Africa
    (Stellenbosch : Stellenbosch University, 2023-03) Davids, Vanessa Berenice; Cohen, Mary A.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    The Surgical Safety Checklist (SSC) of the World Health Organization (WHO) has been developed and adopted by the surgical fraternity worldwide to reduce patient mortality and morbidity in surgical operating rooms (ORs). Further to this, the SSC has been implemented in ORs to enhance communication and teamwork among the OR team members. The aim of this study was to investigate the attitudes and barriers to the WHO’s SSC in a specialised tertiary academic hospital in the Western Cape, South Africa. The degree of impact of the SCC on teamwork and safety, the support rendered by all categories of OR personnel in compliance with the SSC, the initiation of the SSC by all the OR personnel, and the barriers to the use of the SSC where investigated. The Donabedian Structure-, Process- and Outcome models underpinned the study. A self-administered online survey published by O’Connor et al (2013:2) was used to collect data with a six-point Likert scale. English, Afrikaans, and Xhosa versions were provided. The respondents’ demographics were included. The OR personnel employed in all the ORs of the hospital were requested to participate, namely the surgeons, the anaesthetists, the professional registered nurses, the OR trainee professional nurses, the registered enrolled nurses, the registered enrolled nurse assistants, the radiographers, and the cardiac-bypass technicians (N=111). Data was collected over four weeks. The response rate was (N=61). Ethical approval was obtained from the Health Research Ethics Committee of the University of Stellenbosch (Ref: S21/08/150) and the ethical research departments of the Western Cape Department of Health (Ref: WC_202110_034) and the hospital in which the study was conducted. Prof T. Esterhuizen (Stellenbosch University’s Department of Epidemiology and Biostatistics) was consulted for guidance on the analysis using IBM Statistical Product and Services Solutions (SPSS28©). Descriptive and inferential statistics were computed from the raw data and are presented in tables. The research findings found that compliance with the phases of the SSC is inconsistently implemented. It is recommended that this be remedied to enhance patient safety and to promote OR team cohesion.
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    Burnout amongst primary health care nurses : a cross-sectional study
    (Stellenbosch : Stellenbosch University, 2014-04) Muller, Anna Petronella; Cohen, Mary A.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing.
    ENGLISH ABSTRACT: The imbalance between job demands and available resources could cause burnout which may impact quality patient care. A scientific investigation was conducted to evaluate burnout amongst primary health care (PHC) nurses. The objectives for the study were to identify the prevalence of burnout amongst PHC nurses and to explore the contributing factors to burnout in PHC settings. The Job Demands-Resources (JD-R) model (Bakker and Demerouti, 2007:309) was used as a conceptual framework for the study. A non-experimental, descriptive cross-sectional design with a quantitative approach was applied. The population and sample consisted of professional nurses (PN) and clinical nurse practitioners (CNP) (n=72) in the Eden District of the Western Cape. A self-report questionnaire was used to collect the data in an uncontrolled, natural environment. Analysis of the results exposed high levels of burnout amongst PHC nurses. Nurses in PHC facilities all had an equal chance to develop burnout, regardless of their level of experience. The occurrence of burnout is equal in community health centres and in community clinics, although a trend was observed that subjects in community clinics may experience more emotional exhaustion. Work pressure, workload or an increase in job demands, lack of organisational support and management problems were rated as the main factors contributing to burnout. Recommendations were made to improve the working environments of PHC nurses in order to increase motivational levels, job satisfaction and to foster work engagement, as well as to reduce levels of burnout. Opportunities for further research are recommended.
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    Experiences of nurses involved with neonatal deaths in Neonatal units in a Saudi Arabian Hospital
    (Stellenbosch : Stellenbosch University, 2019-04) Dlamini, Prisca Sithembile; Cohen, Mary A.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY : Background: Nurses who care for patients in neonatal intensive care units (NICU) address all their efforts to care for seriously ill newborns and their families. The death of a newborn and the grieving process is profound for families and the emotional involvement experienced by the nurses can be complicated. Many nurses do grieve when their patients die yet this is not often acknowledged or discussed. A need was identified in a NICU in Saudi Arabia where the researcher observed that some expatriate colleagues were struggling to come to terms with a neonatal death in the study setting. The aim of this study was to explore and describe the nurses’ experience following the death of a neonate in their care in neonatal units in a Saudi Arabian hospital. Methods: An exploratory descriptive qualitative design was applied to elicit the participant’s psychological experience of neonatal loss in their care. Fifteen participants who had experienced a neonatal death in their care were sampled from the staff establishment (N=56) in the research setting to participate in individual interviews conducted by a field worker. Consent to conduct the study was obtained from the Health Research Ethical Committee of Stellenbosch University and from the institution where the research was conducted. Informed consent was obtained from the participants at each interview including the use of a recorder. Interviews took place at a location of the participant’s choice, were audio-recorded, transcribed verbatim and member-checked by a field worker. The interviews were analysed thematically according to the Terre Blanche, Durrheim and Kelly method and the themes that emerged were emotional grief, support available for the staff, colleague or family support, spiritual or other rituals, religion and spirituality. Results: Findings show that the neonatal care nurses in this study experience a range of emotions, including professional self-doubt and protracted grief. A need for support and clear communication channels from the employer emerged that could assist with the development of coping strategies. Cultural training could be provided during orientation at the commencement of the employment contract on the needs and expectations of the parents.
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    Experiences of women in transition to survivorship following mastectomy in the Cape Metropole
    (Stellenbosch : Stellenbosch University, 2016-03) Stecher, Nicole Elizabeth; Cohen, Mary A.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing.
    ENGLISH ABSTRACT: Background: Breast cancer is one of the most common female malignancies worldwide and the cause of cancer death among women in developed and economically developing countries. The researcher, a professional nurse practicing in the operating theatre assisting with high volumes of breast surgery, identified a need to explore the needs of women following mastectomy as they transition into survivorship, in order to understand the challenges patients face after surgery. Methods: A qualitative design with a descriptive phenomenological approach was applied, underpinned by Husserl’ post-positive philosophy to elicit the participant’s needs following mastectomy. Seven women who had undergone mastectomy for breast cancer and who resided in the Cape Metropole were selected by means of snowball sampling to participate in individual interviews. Consent to conduct the study was obtained from the Health Research Ethical Committee at Stellenbosch University and informed consent was obtained from the participants before each interview. Interviews took place at a location of the participant’s choice, were audio recorded, transcribed verbatim and verified. The interviews were analysed thematically and the themes that emerged were emotional distress and individual coping mechanisms, concern for children and family, impact of changes to appearance and preferred support needs. Results: Findings show that support requirements are based on the individual’s psychological, physical and social needs. A need for breast cancer education and information in the individual’s mother tongue was expressed. It is suggested that women diagnosed with breast cancer should be educated along with their families in order to enhance the transition into survivorship.
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    Factors underlying registered nurse interactions in a multicultural tertiary healthcare perioperative area
    (Stellenbosch : Stellenbosch University, 2015-04) Herbert, Suzan Margaret; Cohen, Mary A.; Stellenberg, E. L.; Stellenbosch University. Faculty of Health Sciences. Interdisciplinary Health Sciences. Nursing.
    ENGLISH ABSTRACT: Disruptive behaviour among health care providers in high stress areas such as the perioperative setting has been linked to negative patient safety. Conflicts of power, role and personality lead to communication failure, which are identified as the leading root cause of medication errors and wrong site surgery. The aim of the study was to explore and describe the factors underlying registered nurse (RN) interactions in a tertiary healthcare perioperative area. A non-experimental, descriptive, exploratory study with self-administered survey using a quantitative approach was used. The total population of N=52 participants working in the perioperative area of a Middle Eastern tertiary healthcare centre were invited to participate in the study and the response rate was n=44, 85%. A structured self-administered questionnaire was used to collect the data. Reliability and validity was assured by means of a pilot study and consultation with nursing experts and a statistician. The Health Research Ethics Committee of the University of Stellenbosch approved the study. Permission for the study to be done in the tertiary care centre was obtained from the Internal Ethical Review Board and the Nursing Executive. Informed written consent was obtained from the participants. Anonymity and confidentiality was respected. The data was analysed with the assistance of a statistician and presented in frequencies, tables and histograms. The responses were compared using Mann-Whitney U test, Kruskal- Wallis ANOVA and Spearman’s Rank correlation, on a 95% confidence level. Only one factor showed a significant result, following Spearman’s Rank correlation that an association exists between work experience and lateral violence (p≤0.045239). The open-ended questions were categorized into themes and respect and communication emerged as factors necessary in teamwork and task management The level of respect and open communication between RNs were seen as important factors for interacting with colleagues in the workplace and if poor, affects team work. An area of concern was the high number of neutral responses to the statements on morale and conflict. Underpinned by the literature and the outcomes of this study, it is recommended that strong leadership is required to implement regular team building activities. Furthermore, perioperative staff should be monitored for emotional fatigue which results from conflict situations in order to avert adverse patient care events.
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    Knowledge of surgical counting practices of operating room nurses in provincial hospitals in the Cape Metropole
    (Stellenbosch : Stellenbosch University, 2016-03) Beukes, Robertha Devona; Cohen, Mary A.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing.
    ENGLISH ABSTRACT: Background: Retained surgical items are a preventable medical error that leads to patient harm and increased hospital stay. Surgical safety has emerged as a significant global health concern to avoid preventable medical errors and deaths globally. The cost implications for the facility and severe patient complications are significant and safety procedures to prevent this occurring are vital. Methods: A descriptive, cross-sectional design with a quantitative approach utilising a selfadministered questionnaire was used for this study. Four public hospitals were included in this study, which are situated in the Cape Metropole district. The study was conducted in their operating theatres to gain more information about surgical counting practices as it occurs in the natural setting. The population size was N=164 therefore no sampling was required on advice of the statistician. All nurses meeting the inclusion criteria were invited to participate in this study. Permission to conduct the study was obtained from the Health Research Ethics Committee at Stellenbosch University and the National Health Research Board. Data collection occurred at each respondent’s place of employment after an information session was held and informed, written consent obtained. Data was analysed by a statistician and presented in frequencies, tables and histographs. The variables were compared using either the Pearson chi-square test for differences in nursing category or the Mann-Whitney U-test for differences in years of experience. Results: Findings indicate that there is a serious knowledge deficit of the fundamental surgical counting procedures further corroborated by the section of the survey on clinical practice. Overall the respondents identified the major factor impacting surgical counting practice is handover during change of shift. It is suggested that increased awareness and training regarding surgical counting practices needs to be implemented. Conclusion: Renewed accountability for correct surgical counts needs to be fostered amongst theatre personnel by re-enforcement of counting policy and identifying bestpractices. There should be zero tolerance for not adhering to policy and deviation from recommended practice that compromise patient safety. The time spent with perioperative staff to reinforce surgical count policy and ensure application is standardised, is more valuable compared to the financial implications of legal proceedings and disciplinary measures lodged against facility and staff.