Training needs of professional nurses in primary health care in the Cape Metropole, South Africa.

BACKGROUND: In the fast-changing healthcare environment, it is important to ensure that primary health care (PHC) nurses are suitably qualified and have access to appropriate and relevant ongoing education. AIM: The aim of this study was to determine the training needs of professional nurses working in PHC facilities. SETTING: The research was conducted in PHC facilities in the Cape Metropole, Western Cape, South Africa. METHODS: A quantitative descriptive survey with all-inclusive sampling was used. All professional nurses (N = 303), employed for at least a minimum of 6 months in PHC facilities were included in the study. The Hennessy-Hicks Training Needs Analysis (TNA) questionnaire was used to collect the data on professional tasks training needs and open-ended questions for specific PHC contextual training needs. Importance and performance means for each of the TNA subsections and training needs were calculated. Open-ended questions were analysed using content analysis, identifying training domains and topics in terms of frequency and ranking. RESULTS: The TNA identified 'Research' as the highest training need. Research tasks were significantly rated as the least important and the lowest rated performance compared to other domains. Child mental health was rated as the most important specific training need. CONCLUSION: The results of this survey provide insight into the training needs of professional nurses employed in PHC facilities and highlight the need for child mental healthcare and research training in this setting.Contribution: The study contributes to the understanding of the training and education needs of professional nurses working in PHC facilities.

A whatsapp community of practice to support new graduate nurses in South Africa.

Internationally, transition from student to registered nurse is a challenging and stressful period. This study investigated the use of an Instant Messaging application (WhatsApp) community of practice to support graduate nurses in their first year of practice in the Western Cape, South Africa. A preliminary survey was conducted to determine the technology readiness of 64 participants. Following the enrolment of a further 8 participants, 76 new graduate nurses were enrolled in the WhatsApp Community of Practice which ran over an 8-week period. A quantitative one-group pre and post study evaluation via Survey Face was conducted comparing socio-professional outcome measures. The analysis of the readiness survey showed high WhatsApp use and perceived ease of use and usefulness. Though only 9 males in the survey, age and gender had no impact on the reported use. Interactions with alumni, bridging and bonding social capital, professional integration and a sense of belonging to a community of practice significantly improved. For graduate nurses in non-urban settings, bonding, professional identity and theory practice integrations were significantly higher compared to urban graduates. The findings highlight the value of a WhatsApp community of practice for isolated graduated nurses, especially in critical phases of transition and their professional development.

Nursing students' perceptions of clinical learning opportunities and competence in administration of oral medication in the Western Cape.

BACKGROUND: Medication errors may result in patients' harm and even death. The improvement of nursing students' competence in the administration of medication through education and training can contribute to the reduction of medication errors. OBJECTIVES: This study aimed at describing the Bachelor of Nursing students' perceptions about clinical learning opportunities and competence in the administration of oral medication. METHOD: A quantitative descriptive design was employed. An all-inclusive sample of 176 nursing students registered at a university in the Western Cape, South Africa, in 2014 was considered for the study, of whom 125 students consented to participate and completed the questionnaires. Statistical Package for the Social Sciences (SPSS) version 22 was used for data analysis and descriptive statistics were conducted. RESULTS: The findings showed that a minority of students did not have opportunities to rotate in all specific types of wards. The findings indicated that a total of 92% (115) and 86.4% (108) of the 125 respondents were placed in medical and surgical wards, respectively, where they more likely had opportunities to practise the administration of oral medication. However, 59.2% (74) did not practise administration of oral medication on a daily basis. Only 19.2% (24) of respondents perceived themselves as competent in the administration of oral medication. CONCLUSION: The findings indicated that many students perceived their education and training as not providing sufficient learning opportunities to practise the administration of oral medication, whilst the majority of respondents perceived themselves as competent in some of the aspects related to the administration of oral medication, and very few perceived themselves as competent overall in the administration of oral medication.

Nurse graduates' experiences and support needs: A qualitative systematic review of South Africa's community service programme.

BACKGROUND: The student-to-nurse graduate transition is a pivotal phase in the professional development of nurses. In South Africa, this transition is part of a compulsory community service programme, which requires newly graduated nurses to work in rural and/or underserved areas for a period of 1 year. OBJECTIVES: The aim of this study was to review nurse graduates' experiences and support needs during their transition in the compulsory community service programme. METHODS: A qualitative systematic review of experiences was conducted. Qualitative research studies that addressed nurses' experience in South Africa (2008-2017) were identified in Cochrane, Joanna Briggs Institute (JBI), Academic Search Complete, CINAHL, PubMed, SABINET, Science Direct, SCOPUS and Google Scholar databases. The systematic review methods included searching, sifting, abstracting and quality assessment of relevant qualitative studies by two reviewers and cross-checking by a third reviewer. Two reviewers independently performed blinded data extraction and quality assessment using the confidence in qualitative synthesis findings (ConQual) approach. RESULTS: A total of 1257 studies were identified of which 12 met the inclusion criteria. Seven of the 12 studies were published articles and six were theses. The quality of the studies was found to be of high standard based on the ConQual rating. Four main themes emerged from the analysis: (1) rich developmental experiences through practice exposure, (2) difficulties in reconciling theory and practice, (3) contextual challenges in the workplace and (4) need for professional support structures, educational measures and public guidelines. CONCLUSION: Although positive experiences were reported, various challenges emerged, indicating the need for more systematic support mechanisms during transition.

"I felt a sense of belonging somewhere". Supporting graduates' job transitions with WhatsApp groups.

BACKGROUND: Nurse graduates' transition into the world of work is a very challenging phase of professional development. This research examined the affordances of using moderated WhatsApp groups to support nurse graduates in this phase. APPROACH AND METHODS: Study participants, newly graduated nurses (n = 72) from South Africa, were assigned to two WhatsApp groups. The groups were facilitated by moderators during the 12-week intervention. The intervention was based on a curriculum that incorporated topics related to professional immersion that emerged from a priori needs assessment. Twelve individual interviews were carried out and analysed together with the written conversations from the WhatsApp chats using content analysis as part of an interpretive paradigm. RESULTS: Three central affordances emerged in the analysis: (1) Instructional: joint learning and cooperative problem solving in-situ; (2) Social: co-constructing proximity and providing motivational and socio-emotional support; (3) Professional: scaffolding job immersion in becoming and being a nurse. Through re-connecting relatable social ties (former students) and tapping into a medium that afforded intimacy, immediacy and high levels of ownership, the intervention offered spatially, socio-culturally and often emotionally 'dislocated' graduates a provisional space to belong to. CONCLUSIONS: The feasibility and dynamics of supporting graduates in marginalised and remote areas with a facilitated, peer-mediated and WhatsApp-based transition support group are shown; practical recommendations and challenges are discussed.

Student nurses' perceptions of their educational environment at a school of nursing in Western Cape province, South Africa: A cross-sectional study.

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.

Performance in grade 12 mathematics and science predicts student nurses' performance in first year science modules at a university in the Western Cape.

BACKGROUND: The demand for highly qualified and skilled nurses is increasing in South Africa as well as around the world. Having a background in science can create a significant advantage for students wishing to enrol for an undergraduate nursing qualification because nursing as profession is grounded in scientific evidence. AIM: The aim of this study was to investigate the predictive validity of grade 12 mathematics and science on the academic performance of first year student nurses in science modules. METHOD: A quantitative research method using a cross-sectional predictive design was employed in this study. The participants included first year Bachelor of Nursing students enrolled at a university in the Western Cape, South Africa. Descriptive and inferential statistics were performed to analyse the data by using the IBM Statistical Package for Social Sciences versions 24. Descriptive analysis of all variables was performed as well as the Spearman's rank correlation test to describe the relationship among the study variables. Standard multiple linear regressions analysis was performed to determine the predictive validity of grade 12 mathematics and science on the academic performance of first year student nurses in science modules. RESULTS: The results of this study showed that grade 12 physical science is not a significant predictor (p > 0.062) of performance in first year science modules. The multiple linear regression revealed that grade 12 mathematics and life science grades explained 37.1% to 38.1% (R2 = 0.381 and adj R2 = 0.371) of the variation in the first year science grade distributions. CONCLUSION: Based on the results of the study it is evident that performance in grade 12 mathematics (ß = 2.997) and life science (ß = 3.175) subjects is a significant predictor (p < 0.001) of the performance in first year science modules for student nurses at the university identified for this study.

Clinical learning experiences of male nursing students in a Bachelor of Nursing programme: Strategies to overcome challenges.

BACKGROUND: Male nursing students are faced with more challenges in the clinical setting than their female counterparts. The ways in which male nurses are viewed and received by nursing staff and patients have an impact on how they perceive themselves and their role in the profession. These perceptions of self have a significant impact on their self-esteem. This study was conducted to explore the clinical learning experiences of male nursing students at a university during their placement in clinical settings in the Western Cape Province, and how these experiences impacted on their self-esteem. OBJECTIVES: To describe the learning experiences of male nursing students during placement in clinical settings, and how these impact on their self-esteem. METHOD: A qualitative, exploratory study was conducted. Purposive sampling was used to select participants. Three focus group (FG) discussions, consisting of six participants per group, were used to collect data. Data analysis was conducted by means of Coliazzi's (1978) seven steps method of qualitative analysis. STUDY FINDINGS: The following three major themes were identified: experiences that related to the constraints in the learning environment, the impact on the self-esteem, and the social support of students working in a female-dominated profession. CONCLUSION: Male nurses should be supported in nursing training, as the rate at which males enter the profession is increasing.

Nurse educators' experiences of case-based education in a South African nursing programme.

BACKGROUND: A school of nursing at a university in the Western Cape experienced an increase in student enrolments from an intake of 150 students to 300 students in the space of one year. This required a review of the teaching and learning approach to ensure that it was appropriate for effective facilitation of large classes. The case-based education (CBE) approach was adopted for the delivery of the Bachelor of Nursing programme in 2005. AIM: The aim of the study was to explore nurse educators' experiences, current practices and possible improvements to inform best practice of CBE at the nursing school in the Western Cape. METHODS: A participatory action research method was applied in a two day workshop conducted with nurse educators in the undergraduate nursing programme. The nominal group technique was used to collect the data. RESULTS: Three themes emerged from the final synthesis of the findings, namely: teaching and learning related issues, student issues and teacher issues. Amongst other aspects, theory and practice integration, as well as the need for peer support in facilitation of CBE, were identified as requiring strengthening. CONCLUSION: It was concluded that case-based education should continue to be used in the school, however, more workshops should be arranged to keep educators updated and new staff orientated in respect of this teaching and learning approach.

Do nursing students know and practise the Universal Precautions to prevent transmission of infectious agents?

BACKGROUND: Nursing students, like other healthcare students, are at high risk of occupational exposure to blood and bodily fluids. Studies have shown that use of the Universal Precautions (UPs) lowers this risk, but do students know and practise these precautions? OBJECTIVES: This study investigated the knowledge and practice of undergraduate nursing students regarding the UPs, and whether there was a correlation between knowledge of the UPs and their practice. METHOD: This was a descriptive quantitative study amongst undergraduate nursing students in years 2­4 (n=253), who were selected by means of stratified random sampling. A questionnaire was administered to the participants by the researcher. The data collected were analysed through use of the Statistical Package for Social Sciences (SPSS 16.0) and content analysis. RESULTS: It was established that there was indeed a lack of knowledge regarding the UPs, and that the students' self-reported practice of the UPs was poor. There was no statistically significant correlation between knowledge and practice of the UPs. CONCLUSION: More structured educational programmes are needed to improve both knowledge and practice of the UPs. These programmes should be offered across all nursing student study years as continuous professional development.

A framework for effective collaboration: a case study of collaboration in nursing education in the Western Cape, South Africa.

A fundamental purpose of mergers between higher education institutions (HEIs) in 2002 was to enable sharing of scarce resources between more advanced universities and those historically disadvantaged by the apartheid system of the South African Government. A common teaching platform for undergraduate nursing education in the Western Cape was established in 2005, in line with the transformation of the higher education system, as a collaborative initiative between three universities. In order to evaluate the common teaching platform, Stuffelbeam's context, input, process, product (CIPP) research model was employed. A sample of 108 participants was selected through stratified purposive sampling, and included three deputy vice-chancellors, three deans, three heads of department, 18 lecturers and 81 students. Semi-structured interviews were held with the staff members, whilst the students participated in focus group interviews. Open-ended questions informed by literature and the CIPP evaluation model were developed and used to guide the interviews. This enabled the researcher to obtain a rich description of the participants' experiences. The data were analysed inductively. The results revealed that the main purpose of collaboration was not achieved due to the lack of a common understanding of the concept of collaboration and its purpose; a lack of readiness to collaborate and a lack of sharing of resources. A framework for effective collaboration was developed based on the results.