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.

Analysis of patient safety incident reporting system as an indicator of quality nursing in critical care units in KwaZulu-Natal, South Africa

Background: Patient Safety Incidents occur frequently in critical care units, contribute to patient harm, compromise quality of patient care and increase healthcare costs. It is essential that Patient Safety Incidents in critical care units are continually measured to plan for quality improvement interventions.Aim: To analyse Patient Safety Incident reporting system, including the evidence of types, frequencies, and patient outcomes of reported incidents in critical care units.Setting: The study was conducted in the critical care units of ten hospitals of eThekwini district, in KwaZulu-Natal, South Africa.Methods: A quantitative approach using a descriptive cross sectional survey was adopted to collect data from the registered nurses working in critical care units of randomly selected hospitals. Self-administered questionnaires were distributed to 270 registered nurses of which 224 (83%) returned completed questionnaires. A descriptive statistical analysis was initially conducted, then the Pearson Chi-square test was performed between the participating hospitals.Findings: One thousand and seventeen (n = 1017) incidents in ten hospitals were self-reported. Of these incidents, 18% (n = 70) were insignificant, 35% (n = 90) minor, 25% (n = 75) moderate, 12% (n = 32) major and 10% (n = 26) catastrophic. Patient Safety Incidents were classified into six categories: (a) Hospital-related incidents (42% [n = 416]); (b) Patient care-related incidents (30% [n = 310]); (c) (Death 12% [n = 124]); (d) Medication-related incidents, (7% [n = 75]); (e) Blood product-related incidents (5% [n = 51]) and (f) Procedure-related incidents (4% [n = 41]).Conclusion: This study's findings indicating 1017 Patient Safety Incidents of predominantly serious nature, (47% considering moderate, major and catastrophic) are a cause for concern