Experiences of professional autonomy among critical care nurses in Kenya: a qualitative study

Exercising autonomy allows nurses to demonstrate their knowledge and skills. However, more information is needed about the critical care nurses' perceptions of their professional autonomy in rural areas. Objective: To explore the perceptions, facilitators and barriers to professional autonomy among critical care nurses in rural Kenya. Methods: The hermeneutic phenomenological study design was used in this study. Data were collected in a critical care unit using a semi-structured interview guide. A sample of 10 participants were recruited. The study was conducted in Nyeri County Referral Hospital. Results: Three themes emerged from the study on the nurses' experiences of professional autonomy, perceptions of autonomy, facilitators of autonomy, and barriers to autonomy. Conclusion: Autonomy undeniably plays a pivotal role in defining the professional status of the nursing profession. Perceptions, facilitators and barriers to professional autonomy form the background of the current professional status. Nurses, therefore, exercise autonomy effectively when it aligns with patient care needs and when a conducive environment supports it.

Blended learning during and beyond the COVID-19 pandemic: Attitudes of nurse educators in Gauteng

Background: The use of blended learning (BL) pedagogy has become inevitable due to contemporary technological innovations in the nursing education sector. As of late, the need to use BL pedagogy has resulted by the sudden occurrence of the COVID-19 pandemic. However, several nurse educators still experience uncertainties in using BL due to technological, psychological, infrastructure and equipment readiness barriers. Aim: To report the attitudes of nurse educators towards the use of BL pedagogy as a new norm of teaching and learning in public nursing education institutions (NEIs) in the Gauteng Province (GP), South Africa, during and beyond the COVID-19 pandemic period. Setting: The study was conducted in five Gauteng public NEIs. Methods: A descriptive non-experimental quantitative design was conducted with 144 nurse educators. Data was collected through a questionnaire. Statistical Analysis Software (SAS) was used to analyse data with the help of a biostatistician. Results: Technologically, only 50% (N = 72) found BL easy to use while 48% (n = 69) were ready and willing to use the BL Psychologically, more than half, that is, 65% (n = 94) lacked the confidence to use BL pedagogy. About 55% (n = 79) reported having inadequate BL infrastructure, while 32% (n = 46) seemed to be satisfied with the availability of effective equipment to support BL pedagogy. Conclusion: Based on the results, it is apparent that nurse educators in Gauteng are not technologically and psychologically ready, since the infrastructure and equipment to support the BL are not adequately provided.

Child health promotion during the COVID-19 pandemic: A health and welfare sector collaboration

Background: Fragmented service provision and a lack of efficient cooperation between health and welfare sectors serving children and families remain ongoing challenges in South Africa. The coronavirus disease 2019 (COVID-19) pandemic escalated this fragmentation. A community of practice (CoP) was established by the Centre for Social Development in Africa to promote collaboration between the sectors and to assist communities in their environments. Aim: To explore and describe collaboration on child health promotion between professional nurses and social workers, who formed part of the CoP during the COVID-19 pandemic. Setting: The study was conducted in five public schools from four of the seven district regions of the City of Johannesburg, Gauteng province. Methods: A qualitative, exploratory, descriptive research design was employed to conduct psychosocial and health screenings of children and their families. Focus group interviews were conducted, and field notes were used to collect and confirm data from the team. Results: Four themes emerged. Participants shared their positive and negative experiences faced during the fieldwork, their realisation of the value of collaboration between various sectors and their desire and capacity to do more. Conclusion: Participants indicated that collaboration between the health and welfare sectors is vital to support and promote the health of children and their families. The COVID-19 pandemic highlighted the need for collaboration between these sectors in the children and their families' ongoing struggles.

Perceptions of nurses on TB with HIV adherence counselling skills in a health sub-district, Cape Town: A qualitative study

Background: People living with HIV (PLHIV) co-infected with Tuberculosis (TB) account for one in three HIV-related deaths. Retention in care and adherence to medication remain key behaviours that PLHIV co-infected with TB must adopt to achieve better health outcomes. Nevertheless, TB with HIV adherence-counselling services provided by nurses designed to enhance these behaviours remain inadequate. Additionally, limited information is found in the literature on the perceptions of nurses regarding their TB with HIV adherence counselling skills pertaining to PLHIV co-infected with TB. Aim: To explore and describe the perceptions of nurses regarding their TB with HIV adherence counselling skills of PLHIV co-infected with TB. Setting: The study was conducted in a health sub-district of Cape Town. Method: An exploratory, descriptive qualitative design was followed. A total of 14 purposively sampled nurses were interviewed individually. Nurses caring for PLHIV co-infected with TB were included and nurses not offering care to PLHIV co-infected with TB were excluded. All interviews were audio recorded with the participants' permission followed by verbatim transcriptions. Thematic analysis was done using ATLASti.8 electronic software. Results: It was established that the varied roles of these nurses increased their workload. Nonetheless, despite the gap in their counselling skills, the majority still maintained work expertise, professionalism and empathy towards the patients. Additionally, there were perceived barriers impacting patients' attendance of their follow up appointments. Conclusion: Based on the findings of this study, there is a need to equip nurses caring for PLHIV co-infected with TB with adherence counselling skills to improve practice.

Best practice recommendations for healthy work environments for nurses: An integrative literature review

Healthy work environments that maximise the health and well-being of nurses are essential in achieving good patient and societal outcomes, as well as optimal organisational performance. While studies have been conducted on healthy work environments, there is no available evidence that an integrative literature review summarising best-practice recommendations related to healthy work environments has been conducted before. This review aimed to summarise existing best-practice recommendations related to a healthy work environment for nurses. An integrative literature review following the approach adapted from Whittemore and Knafl was used. Existing guidelines related to healthy work environments for nurses were searched. EBSCOhost (CINAHL, Medline), Biomed Central, Science Direct, PubMed and Google Scholar and organisational websites via Google were searched, followed by a citation search. Twelve guidelines were identified for data extraction and synthesis, and themes were subsequently formulated. Four themes emerged from the integrative literature review regarding a healthy work environment for nurses: (1) the need for effective nursing leadership, (2) effective communication as central to enhancement of a healthy environment, (3) effective teamwork as an integral part of a healthy work environment and (4) the need for professional autonomy. In summary, a healthy work environment for nurses requires leadership, effective communication, teamwork and professional autonomy.

Knowledge of emergency preparedness among nurses in Machakos level five Hospital in Machakos County, Kenya

BACKGROUND An emergency is an unexpected event that disrupts normal operations within a health facility and requires immediate interventions to address it. Knowledge of emergency preparedness is an important role of clinical nursing to enhance patient outcomes. This study aimed to determine the types of emergencies received at Machakos Level 5 Hospital (ML5H) and to assess the nurses' level of knowledge on emergency preparedness. MATERIALS AND METHOD This was a descriptive cross-sectional research design. The study was conducted at Machakos Level 5 Hospital, Machakos County, Kenya. The sample included 132 nurses working at ML5H, who were randomly selected and consented to participate in the study. Data was collected using a self-administered questionnaire and an observation checklist. Data were coded and entered into SPSS version 25 software and the analysis included descriptive statistical tests. RESULTS A little more than a half (56%) of the nurses were found to have adequate knowledge of emergency preparedness; 65% had attended training on emergency preparedness and 63% indicated that training had enhanced their competence. CONCLUSION A higher proportion of nurses reported not participating in emergency drills that could be used to improve their knowledge and skills in emergency preparedness. The results of the study indicate that there is a need to enhance the knowledge of nurses' on emergency preparedness.

Self-leadership of nurses in a critical care outreach service: The development of a conceptual framework

Background: Globally, critical care outreach services (CCOS) were implemented in health care facilities; however, compliance with guidelines is poor. The authors have noticed that a gap exists in the literature on how self-leadership might influence nurses' implementation of CCOS. Self-leadership is about leadership applied to oneself. Critical care outreach services assist nurses with the nursing care of a patient whose health is declining. Leadership is needed for the successful implementation of CCOS. Aim: This article aims to outline the method the authors followed for developing the conceptual framework for how self-leadership amongst nurses influenced the functioning of CCOS. Setting: The research was conducted at a private hospital in Pretoria. Methods: A qualitative approach was followed to provide an accurate description of nurses' experiences on their self-leadership in a CCOS. The practice-oriented theory of Dickoff (1968) was the reasoning map for developing and constructing the conceptual framework. Results: Bedside nurses experienced the following self-leadership strategies: constructive thought patterns, natural rewards and behaviours focused on their implementation of CCOS. Conclusion: The conceptual framework was part of another study and provided the authors with a rationale that guided the authors with the development of self-leadership strategies in a CCOS. Contribution: The conceptual framework provided the authors with an understanding of how nurses' self-leadership influenced the implementation of CCOS. The conceptual framework can also assist in developing training programmes for nurses to improve their self-leadership and ultimately improve nurses' competence in providing quality nursing care to patients.

Knowledge and Practice about Glasgow Coma Scale Assessment among Nurses Working in Adult Intensive Care Units of Federal Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study

The Glasgow Coma Scale is a dependable and objective neurological assessment instrument used for determining and recording a patient's level of consciousness. Therefore, the knowledge, practice, and factors affecting Glasgow coma scale evaluation among nurses working in adult intensive care units of federally administered hospitals in Addis Ababa, Ethiopia, were investigated. METHODS: From April 4 to 24, 2020, 121 Adult Intensive Care Unit nurses at Ethiopian federal hospitals participated in an institutional-based cross-sectional survey with a standardized selfadministered questionnaire. The information was entered into Epidata version 3.1 and then exported to SPSS version 25.0 for analysis. Bivariable and multivariable logistic regressions were used to examine the relationships between independent and dependent variables. RESULT: According to this study, nurses working in the Adult Intensive Care Unit of federal hospitals in Addis Ababa, Ethiopia, had poor knowledge (51.2%) and poor practice (62%) of the Glasgow Coma Scale's basic theoretical notions and competencies. Furthermore, the education and gender of nurses were linked to their level of knowledge and clinical practice. Being a male and having a master's degree were both significantly linked with knowledge (AOR = 4.13, 95% CI: (1.87­9.1)), (AOR=7.4, 95% CI: (1.4-38)) and practice (AOR = 2.7, 95% CI: (1.2­6)), (AOR = 10.4, 95% CI: (2.0­53)) respectively. CONCLUSION: The findings from this study showed that nurses had poor knowledge and application of practice-related clinical scenarios on the Glasgow Coma Scale

Mobile colposcopy by trained nurses in a cervical cancer screening programme at Battor, Ghana

Objectives: Cervical precancer screening programs are difficult to establish in low resource settings partly because of a lack of human resource. Our aiming was to overcome this challenge. We hypothesized that this could be done through task shifting to trained nurses. Design: Descriptive retrospective cross-sectional review. Setting: Training was at the Cervical Cancer Prevention and Training Center (CCPTC) and screening was carried out at the clinic and at outreaches / peripheral facilities.Participants: All women who reported to the clinic for screening or were recruited during outreaches Interventions: All 4 nurses were trained for at least 2weeks (module 1). A total of 904 women were screened by the trained nurses using the EVA system. Quality assurance was ensured. Main outcome measures: Primary screening and follow-up were carried out by the trained nurses with quality assured through image sharing and meetings with peers and experienced gynaecologists. Results: 828 women had primary screening and 76 had follow-up screening. 739 (89.3%) were screened at the clinic and 89 (10.7%) at outreaches/peripheral facilities. Of all screened, 130 (14.5%) had cervical lesions, and 25 (2.8%) were treated, 12 (48.0%) by Loop Electrosurgical Excision Procedure (LEEP) performed by a gynaecologist, 11 (44.0%) with thermal coagulation by trained nurses except one, and 2 (8.0%) with cryotherapy by trained nurses. Conclusion: We demonstrate the utility of a model where nurses trained in basic colposcopy can be used to successfully implement a cervical precancer screening and treatment program in low-resource settings

Strategies to enhance resilience to cope with workplace adversities post-COVID-19 among ICU nurses

Background: It is critical for intensive care unit (ICU) nurses to develop resilient coping strategies to cope with workplace adversities. The coping strategies will mitigate the development of maladaptive psychological disorders prone to working in a stressful environment. Objectives: The aim of this study is to analyse previous literature conducted on strategies that enhance resilience in ICU nurses to cope with workplace adversities beyond the coronavirus disease 2019 (COVID-19) pandemic. The study was conducted by examining all available global literature in the context of the aim of the study. Method: An integrative literature review was chosen for the study. Purposive sampling method was used to select the relevant databases to answer the review question, namely Google Scholar, EBSCOhost, Medline and Nursing/Academic Edition. The search terms used were 'strategies', 'resilience', 'intensive care unit nurses', 'coping', 'workplace adversities', 'beyond COVID-19' and post 'COVID-19'. Results: Three themes emerged from the study, namely promoting personal attributes, effective relational support and active psychological support. Conclusion: Enhancing resilience among ICU nurses requires both intentional individualised care from the ICU nurses and a systematic approach by nursing management that will meet the psychological needs of ICU nurses when working in a stressful ICU environment.Contribution: The findings of the review have highlighted specific strategies of improving resilience in ICU nurses, which can ultimately create a safe working environment in the ICU.

Professional quality of life of nurses in critical care units: Influence of demographic characteristics

Background. Professional quality of life, measured as compassion satisfaction, is a prerequisite for nurses working in intensive care units where patients rely on their care. Nurses who experience compassion satisfaction, or good professional quality of life, engage enthusiastically with all work activities and render quality patient care. In contrast, compassion fatigue eventually leads to disengagement from work activities and unsatisfactory patient outcomes. In this study, we described the demographic factors influencing professional quality of life of intensive care nurses working in public hospitals in Gauteng, South Africa (SA), during the first wave of the COVID-19 pandemic. Objective. To describe the demographic factors associated with professional quality of life of critical care nurses working in Gauteng, SA. Methods. In this cross-sectional study, we used total population sampling and invited all nurses who had worked for at least 1 year in one of the critical care units of three selected public hospitals in Gauteng to participate. One-hundred and fifty-four nurses responded and completed the ProQol-5 tool during the first wave of the COVID-19 pandemic. Data were analysed using descriptive and inferential statistics. Results. The nurses' average age was 45 years, and 59.1% (n=91) had an additional qualification in critical care nursing. Most of the nurses had a diploma (51.3%; n=79), with a mean work experience of 12.56 years. The main demographic variables that influenced professional quality of life were years of work experience (p=0.047), nurses' education with specific reference to a bachelor's degree (p=0.006) and nurse-patient ratio (p<0.001). Conclusions. Nurses working in critical care units in public hospitals in Gauteng experienced low to moderate compassion satisfaction, moderate to high burnout and secondary traumatic stress, suggesting compassion fatigue. The high workload, which may have been associated with the COVID-19 pandemic, influenced nurses' professional quality of life.

Incidences de la présence des garde-malades sur la prise en charge médicale des patients. Etude menée au Centre Hospitalier Universitaire de Brazzaville

La gestion du malade dans l?univers hospitalier implique non seulement le personnel soignant, mais aussi d?autres acteurs sociaux encore moins connus des gestionnaires des structures hospitalières et des catégories socio professionnelles y évoluant. Parmi ces acteurs encore moins connu, il y a le garde-malade faisant partie du personnel hospitalier en charge de la prise en charge des patients en milieu hospitalier. Cependant au Centre Hospitalier et Universitaire de Brazzaville en République du Congo, les garde-malades sont constitués des parents, amis et connaissances dont la représentation est importante dans cet univers hospitalier. Cette représentation aussi remarquable soit ­ elle, interpelle plus d?un observateur au point de s?interroger sur les raisons à l?origine de cette présence. Notre étude répond à la logique qui est celle de tenter de comprendre et d?analyser ce phénomène devenu très inquiétant. Ce phénomène est donc à lire dans la perspective de la complexité des réalités sociales qui s?expliquent à partir des déterminants socio culturels, fondements de la vie sociale. Aussi, la faiblesse des services sous tutelle du C.H.U-B et la culture bantoue, laquelle repose sur la solidarité mécanique qui, appelle à la cohésion sociale, constituent des facteurs qui expliquent ce phénomène. A cet effet, une observation participante a été effectuée dans cette structure hospitalière. Celle-ci a permis de relever une influence importante qui, pour diverses raisons réponde aux préoccupations des malades. Cette étude présente trois intérêts : scientifique, social et personnel. D?abord, elle montre la difficulté en ressources humaines qui se traduit par la sous représentativité des catégories socio professionnelles qui, contribueraient à résoudre la question de l?effectivité de prise en charge du malade. Ensuite, l?étude présente un autre intérêt qui met en exergue la cohésion sociale qui, s?exprime à travers la chaine de solidarité dont la famille est le maillon. Le dernier centre d?intérêt est personnel. Il met en relief un aspect culturel très intéressant, celui de l?homogénéité et de la dynamique des rapports des acteurs impliqués dans la gestion du malade. Quoi qu?il en soit, le garde-malade joue un rôle de premier plan dans la gestion du malade. Il accompagne le personnel soignant, car partageant le même environnement social que le malade. Aussi, sa visibilité nécessite un encadrement juridique pour lui donner une véritable identité.

The management of the patient in the hospital word involves not only the nursing staff, but also other social actors even less known to the manager of hospital structures and socio-professional categories. Among these actors even less known, there is the nurse who is part of the hospital staff in charge of the care of patients in hospital environment. Howerver at the Brazzaville Hospital and University Center in the Republic of Congo, the nurses are made up of relatives, friends and acquaintanees whose representation is important in this hospital environment. This representation, as remarkable as it is, calls out to more than one observer to the point of questioning the reasons behind this presence.Our study reponds to the logic of trying to understand and analyze this phenomenon, which has become very worrying. This phenomenon should therefore be read in the perspective of the complexity of social realities which can be explained on the basis of socio-cultural determinants, the foundations of social life. Also, the weakness of the services under the supervision of the C.H.U-B and of the Bantu culture, which is based on mechanical solidarity, which, calls for social cohesion, are factors that explain this phenomenon. To this end, a participant observation was carried out this hospital structure. This made it possible to identify an important influence which, for various reasons, responds to the concerns of patients. This study has three interests: scientific, social and personal. First, it shows the difficulty in human resources which result in the representativeness of the socio-professional categories which would help to resolve the issue of effectiveness of patient care. The study presents another interest which highlights the social cohesion which is expressed through the chain of solidarity of which the family is the link. The last area of interest is personal. It highlights a very interesting cultural aspect, that of the homogeneity and dynamics of relationships of the actors involved in the management of the patient. In any case, the nurse plays a leading role in management of the patient. He supports the nursing staff, because they share the same social environment as the patient. Also, its visibility requires a legal framework to give it a real identity

Accessibility of healthcare in rural Zimbabwe: the perspective of nurses and healthcare users

Background: Accessibility of healthcare in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the healthcare system. Developing countries like Zimbabwe are significantly affected. Aim: The aim of this article was to share the perspectives of nurses and healthcare users (HCUs) in the rural areas of Zimbabwe with regard to the accessibility of healthcare. Setting: The study was conducted at 45 rural health facilities in Chegutu district, Mashonaland West province and Masvingo district in Masvingo province, Zimbabwe. Methods: A self-administered questionnaire (for professional nurses) and a structured interview questionnaire (for HCUs) were utilised to gather data in a cross-sectional survey. Two districts were randomly sampled from 59 districts. All nurses working in 45 public health facilities in the selected two districts, who were willing and available to participate, were included. Ninety nurses participated in the study. The HCUs were selected through a multistage sampling technique. The sample size for HCUs was calculated by using Dobson's formula, and 445 HCUs were included via convenience sampling. Results: Nurses reported challenges such as work overload because of staffing shortages (55%) and the supply of necessary medical drugs that lacked consistency in both the quantity and type ordered(46.7%). The challenges faced by HCUs included long distances from villages to health facilities (86%), unaffordability of transport costs and lack of access to medical drugs (59.95%), causing them to seek assistance from traditional healers (43%). Conclusion: Both the nurses and HCUs perceived grave challenges regarding access to health facilities, health workers and medical drugs, all of which are bound to have an impact on the health of communities in rural Zimbabwe

Rwandan primary healthcare providers' perception of their capability in the diagnostic practice

Background: Skill-mix imbalance is a global concern for primary healthcare in low-income countries. In Rwanda, primary healthcare facilities (health centres, HCs) are predominantly led by nurses. They have to diagnose a multitude of health complaints. Whether they feel capable of undertaking this responsibility has yet to be explored. Aim: This study explored how healthcare providers (HPs) at Rwandan HCs perceived their capability in the diagnostic practice. Setting: Rural and urban HCs in Muhanga district, Rwanda. Method: Qualitative, semi-structured interviews with nurses and clinical officers, and observations of consultations were made. Findings were analysed thematically. Results: Rwandan HPs were confident in their competences to perform diagnostic procedures although nurses felt that the responsibilities lay beyond their professional training. Clinical officers believed that their professional training prepared them to function competently and autonomously in the diagnostic practice, although all HPs experienced a high dependency on medical history taking, physical examination and laboratory tests for reaching a diagnosis. Resource constraints (time, rooms and laboratory tests) were seen as a barrier to perform diagnostic tasks optimally, and HPs experienced in-service training and supervision as insufficient. They increased their diagnostic competences through work experience, self-learning and supportive peer collaboration. Conclusion: Clinical officers perceived themselves as capable in the diagnostic practice. Nurses may compensate for insufficient school training through in-service learning opportunities and feel capable in the diagnostic practice. Formative mentorship schemes and tailored education may prove valuable, but further research on how to improve HPs' diagnostic capability in Rwanda's primary healthcare sector is needed

Self-assessed competencies of nurses at an emergency department in Ghana

Introduction: The nature and scope of emergency nursing exposes nurses to a wide array of patient populations with rapidly changing and unexpected clinical conditions, sophisticated logistics and procedures. Hence, emergency centre (EC) nurses ought to be ready to face diverse clinical challenges and deliver care to patients in a timely cost-effective manner and with the needed competence. The current study aimed at examining the self assessed competencies of nurses, and comparing ratings among certified emergency nurses (ENs) and general nurses (GNs) working at an EC of a tertiary hospital in Ghana. Methods: A descriptive cross-sectional quantitative study was carried out among 109 conveniently sampled nurses. Participants evaluated their perceived competencies on a validated instrument under five domains, namely: diagnostic function (DF), administering and monitoring therapeutic interventions (AMTI), effective management of rapidly changing situations (EMRCS), organisational and work load competency (OWLC), and the helping role (HR). Descriptive and inferential data analyses were by SPSS version 25. Results: Participants generally had good competencies in the performance of emergency nursing procedures. Highest scores were obtained in OWLC (median score of 83.3%) while EMRCS recorded the least scores (median score of 57.9%). With the exception of the DF domain (p=0.166), ENs perceived themselves as significantly more competent than their counterpart GNs in 4 (OWLC, HR, AMTI, EMRCS) out of the five studied domains (p < 0.05). Discussion: Specialist training enhances nurses' perceived competences in emergency nursing procedures. This reiterates the need for regular theory and practice-based education for GNs on intermediate and advanced procedures as they prepare to enrol in specialist programmes. As nurses take on expanded professional roles in this emerging nursing specialty in low- and middle-income countries, it is important the needed capacity is developed to adequately address the needs of patients and families that require services in ECs

An assessment of Nurses' knowledge, attitude and practice of emergency care related to road traffic accident victims at three selected hospitals in Rwanda

Introduction:Quality emergency nursing care is an important variable in reducing death and disability due to road traffic accidents (RTA), yet little is known about emergency nursing care within the Rwandan context. This study aims to describe the knowledge, attitude and practice (KAP) of nurses of the emergency care of RTA patients.Method:We employed a cross sectional design to survey the full cohort of nurses working in Accident and Emergency (A&E) units in three selected Rwandan hospitals (N = 51). Results:This study revealed that the knowledge and practice of nurses is either high or very high and the majority of them (73.657%) had a positive attitude towards emergency management of RTA patients. Being trained before working in A&E units was associated with a significant increase in the likelihood of being at thelevel of practice which is (1) very high (OR = 5.35, 95%, CI = 5.20­5.50), (2) high (OR = 1.60, 95%,CI = 1.17­2.19) (3), moderate (OR = 5.35,95%, CI = 4.15­6.88) and (4) low (OR = 1.33,95%, CI = 1.33­133)and it decreased more than 99.9% the likelihood of being at low level of practice in all levels.Discussion:The study showed that training had a significant effect on practice and this is supported by previousstudies. Training interventions to improve the management of RTA patients by nurses working in A&E should beregularly audited to ensure ongoing quality of care

Working conditions in a mental health institution: An exploratory study of professional nurses in Limpopo province, South Africa

Background: Professional nurses are responsible for the provision of care, treatment and rehabilitation of all mental healthcare users (MHCUs) in the institutions for mental healthcare. However, professional nurses find themselves in difficult circumstances under which they must provide quality healthcare services to MHCUs. Objectives: The study explored and described the challenges experienced by the professional nurses working in a mental healthcare institution in Limpopo province of South Africa.Method: A qualitative approach was used to explore and describe the challenges faced by professional nurses working in a mental healthcare institution. The study was conducted from July 2016 to December 2016. Purposive sampling was used to select participants. Data were obtained through individual in-depth interviews with professional nurses between the ages of 26 and 50 years. Data collection continued until data saturation, which occurred after interviewing 18 participants. Tech's open coding method was used to analyse data in this study.Results: Four themes emerged from data analysis, namely: inadequate safety measures, inadequate resources, impact of high workload and shortage of staff. The themes were further sub-divided into sub-themes.Conclusion: The study revealed several challenges that professional nurses face in mental healthcare institutions which might be a barrier to the provision of quality healthcare. Conducive working environments should be established to enable professional health nurses to provide quality nursing care, thereby promoting the health of MHCUs

Tooth loss awareness and reasons for non-replacement of missing teeth among nurses at Jos University Teaching Hospital, Jos, Nigeria

Objective: Full complement and replacement of lost teeth improves oral health and quality of life. The objective of this study was to assess the level of awareness of factors that can prevent premature loss of teeth and the reason for non-replacement of missing/lost teeth among nurses in a tertiary health institution. Methods: This study was a descriptive cross-sectional study, 251 nurses of the Jos University Teaching Hospital participated. Self-administered questionnaires were used for data collection. Analysis of data was done with IBM SPSS version 23.0. Results: The mean age of the 251 nurses was 38±9.88. 174(69.3%) were females while 77(30.7%) were males. Out of 91(36.3%) that had missing teeth, 16(17.6%) actually replaced their missing teeth with the majority of them representing 81.3% adopting removable acrylic partial denture as modality. Among the 75(82.4%) that did not replace their missing teeth, the reason for the non-replacement by the majority- 40.0% was that they didn't feel replacement was necessary. Conclusion: The awareness level on factors that can prevent premature loss of teeth was observed to be high among the participants, but many have missing teeth that needed replacement. Majority did not replace their missing teeth as a result of low level of awareness of the consequences and probably due to financial challenges and because of the non-coverage of prosthetic treatments by the National Health Insurance Scheme 'NHIS' in Nigeria

Nurses' perception of the multidisciplinary team approach of care for adolescent mothers and their children in Ugu, KwaZulu-Natal

Background: Adolescent childbearing has numerous consequences on maternal health, child health and the well-being of society. Because of the high-risk nature of adolescent pregnancy, a multidisciplinary team (MDT) approach is recommended to achieve satisfactory pregnancy outcomes. Aim: The aim of this study was to explore nurses' perceptions of the MDT approach in the continuum of care for adolescent mothers and their children. Setting: The study was conducted in a local district hospital in Ugu, KwaZulu-Natal. Methods: An explorative and descriptive qualitative study design was used. The first author and hospital staff (clinical midwives and the clinical manager of obstetrics and gynaecology) collaborated on the development of the focus group discussion (FGD) guide to explore nurses' perception of the MDT approach of care for adolescent mothers and their children. A total of three FGDs were conducted. Data were analysed using thematic analysis. Results: Six overarching themes emerged from the data analysis which included professional benefits of adopting the MDT approach of care for adolescent mothers and their children, barriers to the multidisciplinary collaboration, clinical benefits of adopting the MDT approach of care for parenting adolescent mothers, problems and needs of adolescent mothers, and nurses' reasons regarding their willingness to participate in a multidisciplinary collaboration in the care of parenting adolescent mothers.Conclusion: In the opinion of nurses, the MDT approach of care for adolescent mothers and their children is an important strategy to improve maternal and child health outcomes. This study has important implications for the design of an intervention