Barriers to implementing patient safety incident reporting and learning guidelines in specialised care units, KwaZulu-Natal: A qualitative study.

BACKGROUND: Globally, increased occurrences of patient safety incidents have become a public concern. The implementation of Patient safety incidents reporting and learning guidelines is fundamental to reducing preventable patient harm. To improve the implementation of these guidelines in specialised care units in KwaZulu-Natal, the views of healthcare professionals were unearthed. AIM: This study explores the healthcare professionals' views toward the implementation of Patient safety incident reporting and learning guidelines in specialised care units. METHODS: A descriptive, explorative qualitative approach was used to collect qualitative data from healthcare professionals working in specialised care units. The study was conducted in specialised care units of three purposely selected public hospitals in two districts of KwaZulu-Natal. Group discussions and semi-structured interviews were conducted from August to October 2021. Content data analysis was performed using Tesch's method of analysis process. RESULTS: The main themes that emerged during data analysis were; ineffective reporting system affecting the communication of Patient safety incident guidelines, inadequate institutional and management support for the healthcare professionals, insufficient education and training of healthcare professionals, and poor human resources affecting the implementation of Patient Safety Incident guidelines. The findings highlighted that there were more major barriers to the implementation of the Patient safety incident reporting and learning guidelines. CONCLUSION: This study confirmed that the Patient safety incident reporting and learning guidelines are still not successfully implemented in the specialised care units and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised Patient safety incident reporting and learning guidelines, designed in consultation with the frontline healthcare professionals. These must consist of standardised, simple- user-friendly reporting process as well as a better implementation strategy to guide the healthcare professionals. Continuous professional development programmes may play an important role in the facilitation of the implementation process.

Mental Healthcare workers' experiences in managing psychiatric patients' aggression in Maseru.

Background: Aggression and violence in psychiatric clinical facilities are a common case, and mental healthcare workers utilise various management strategies to combat it. It is therefore crucial for mental healthcare workers to acquire skills for the management strategies of aggressive behaviour of psychiatric patients. Aim: The aim of the study was to describe mental healthcare workers' experiences in the management strategies of aggressive and violent behaviour by psychiatric patients in Maseru district. Setting: A psychiatric hospital situated to the south in Maseru in the rural countryside and general hospital located in the western lowlands of Lesotho in the village of Morija were used. Methods: This study adopted a qualitative, exploratory, descriptive and contextual research design. There were two focus group interviews conducted per clinical facility, which consisted of six members in each group. There were four participants for individual interviews from psychiatric clinical facility and three individual interviews from general clinical facility. Results: Thematic analysis of the data resulted in themes and sub-themes. These were psychological intervention strategy, physical strategy, chemical strategy, empowerment strategy and policy strategy. Participants viewed various management strategies of aggressive and violent behaviour of psychiatric patients they utilise in clinical facilities as effective. Conclusion: The mental healthcare workers' experiences in managing aggression and violent behaviour of psychiatric patients were expression of psychological, physical, chemical, empowerment and policy strategies. Contribution: The study will enhance the knowledge, skills and attitudes regarding management strategies that mental healthcare workers can utilise in managing aggressive and violent behaviour of psychiatric patients.

Psychosocial experiences of mothers caring for children with cerebral palsy in the eThekwini district.

Background: Cerebral palsy (CP) is the most prevalent neurological illness in children, and it can cause permanent sensory, motor and cognitive problems for the rest of one's life. Raising a child with special needs necessitates extensive resources. Women in the middle and lower income brackets are more likely to care for children with CP. Aim: To explore and describe the psychosocial experiences of mothers of children with CP in eThekwini. Setting: This study was conducted at KwaZulu-Natal Children's Hospital and rehabilitation centre. Methods: The research methods were exploratory and descriptive in nature, with a qualitative approach. Purposive convenience sampling was used to select 12 participants who were parents of children with CP under the age of 18. For data collection, semistructured interviews were utilised. The purpose of thematic analysis is to uncover, analyse and summarise themes and patterns within a data set. Semistructured interviews were used to collect data. Results: The psychosocial experiences of mothers of children with CP revealed three key themes. Themes included the burden of care, a lack of social support and the impact of children with CP on mothers. Conclusion: Participants whose children with CP experienced physical, emotional, psychological and social issues, including inaccessible services and buildings and social isolation from family, friends and the community. Contribution: This study helps to strengthen the development and review of policies on care, support interventions and mother empowerment for children with CP.

Cervical cancer screening management practices and prevention in uMsunduzi Local Municipality primary care clinics.

Background: Although cervical cancer is preventable, it remains the most feared and second most common cancer in women worldwide, as well as the leading cause of cancer deaths in many low- and middle-income countries, including South Africa. Numerous studies conducted globally, in Africa and in South Africa revealed a knowledge gap about cervical cancer and its preventive strategies, including cervical cancer screening, among nurses and the general population. Aim: The purpose was to investigate and describe nurses' knowledge and management practices regarding cervical cancer screening in uMsunduzi Local Municipality, KwaZulu-Natal. Methods: The study was directed by a positivism paradigm. A quantitative research approach and nonexperimental descriptive design was used in this study. Probability random sampling was used, and a self-administered questionnaire was used to collect data. Eighty-three professional nurses participated in the study. Results: The study discovered that professional nurses working in selected clinics in uMsunduzi Local Municipality, KwaZulu-Natal, had a high level of knowledge about cervical cancer and its screening. Nonetheless, despite the high level of knowledge demonstrated, the level of practice remained low. Conclusion: Cervical cancer morbidity and mortality have long been a major health concern in South Africa's general population. The study found that PNs are knowledgeable about cervical cancer screening; conversely, practice was low. This paper includes recommendations for future research, nursing practice, nursing education and the Department of Health. Contribution: This study contributed vastly to the body of knowledge in managing cervical cancer screening practices, particularly in health promotion and prevention of diseases at primary care level.

Clinical support and perceived competency levels of midwifery students: A descriptive analysis.

Background: Midwifery students in South Africa place great value on the clinical support they receive from midwifery practitioners. Adequate clinical support should help midwifery students to practice procedures safely and independently, allowing them to be competent upon degree completion. Aim: To describe the clinical support and perceived competency levels of midwifery students. Setting: Public hospitals in KwaZulu-Natal. Methods: The researcher chose a quantitative research method using a descriptive design. An all-inclusive purposive and convenience sampling method was undertaken to recruit midwifery students from an undergraduate nursing programme at a university in KwaZulu-Natal. Gatekeepers permission and ethics approval was obtained from the university's registrar and research ethics committee. A self-evaluation questionnaire describing the clinical support and perceived competency levels was completed by 60 respondents. Data were analysed using International Business Machines Corporation Statistical Package for Social Sciences (IBM-SPSS) Version 27. Results: The results highlighted that the clinical support midwifery students received, was beneficial to their clinical learning outcomes. Eighty per cent of clinical support offered to midwifery students was obtained through clinical supervision. Ninety-three per cent of respondents revealed that the clinical support they received were from midwifery practitioners (without a speciality qualification). Although students rated themselves as competent in 88.6% of midwifery procedures, poor outcomes were identified in 11.4% procedures. Conclusion: Midwifery practitioners play a significant role in supporting midwifery students during clinical placement. Advancing the roles of midwifery practitioners through mentorship training is likely to strengthen the quality of clinical support provided and thus improve the competence levels of midwifery students. Contribution: The findings in this paper are valuable in developing clinical support training guidelines for midwifery practitioners.

Multidisciplinary team members' perceptions regarding advanced psychiatric nurses' attitudes on mental healthcare.

BACKGROUND: The attitudes of advanced psychiatric nurses significantly contribute to the management, treatment plan and care of the mental healthcare users, and resultantly affects the quality and standards of mental healthcare. Considering these effects, it is imperative to understand how the attitudes of advanced psychiatric nurses are perceived by other multidisciplinary team members. AIM: To describe the perceptions of the multidisciplinary team members regarding advanced psychiatric nurses' attitudes in clinical practice. SETTING: Three mental health institutions were utilised to obtain the perceptions related to the attitudes displayed by advanced psychiatric nurses in the clinical environment. METHOD: A qualitative research descriptive approach was adopted to obtain in-depth descriptions of the attitudes portrayed by advanced psychiatric nurses. Eight purposefully sampled multidisciplinary team members were interviewed to obtain information. Data were analysed using Colaizzi's method. RESULTS: Themes and sub-themes emerged. Mental healthcare providers exhibited both negative and positive attitudes towards mental health patients. By perception, unfavorable attitudes hindered effective communication and psychosocial rehabilitation programs for mental health patients. Positivity enhanced feedback during ward rounds and during clinical meetings. CONCLUSION: Despite the positive impact advanced psychiatric nurses have on mental health care, views regarding mental health patients remain negative. It is recommended that advanced psychiatric nursing education curriculum address negative attitudes, views, and stereotypes. Mental healthcare users need to be provided with psychosocial rehabilitation programs and activities that address advance psychiatric nurses' lack of initiatives. CONTRIBUTION: A clear set of principles and protocols underpins the collaborative effort among multidisciplinary teams in mental health care.

Experiences of advanced psychiatric nurses regarding the need for prescriptive authority in KwaZulu-Natal.

BACKGROUND: Nurse prescribing has become a global and transformational practice to ensure the achieving of optimal health outcomes, including advanced psychiatric nurses. Despite the transformational practice globally, South Africa seems to lag behind because nurses do not have permission to prescribe medication. AIM: To describe the experiences of advanced psychiatric nurses regarding the need to prescribe medication treatment in KwaZulu-Natal. SETTING: The study took place in three mental healthcare institutions in KwaZulu-Natal in inpatient units. METHOD: The qualitative, descriptive design was used to collect the experiences of advanced psychiatric nurses in KwaZulu-Natal regarding the need for prescriptive authority. Six focus group interviews were conducted to gather information. The seven steps of Colaizzi's method were used to analyze the data. RESULTS: The study found two primary themes and two sub-themes. The findings highlighted the necessity for advanced psychiatric nurse role recognition and prescribing. Insufficient use of skilled psychiatric nurses caused delays in addressing mental health patients in emergencies. CONCLUSION: The two themes, prescribing role of advanced psychiatric nurses and role recognition, revealed that granting advanced psychiatric nurses' autonomy to prescribe remained a challenge. Advanced psychiatric nurses are expected to provide high-quality care, but they are limited in their abilities. Because advanced psychiatric nurses are not used to prescribe in KwaZulu-Natal, they rely on psychiatrists to manage psychotic patients. CONTRIBUTION: The evaluation of policies and procedures that guide advanced psychiatric nurses in prescribing psychotropic medications.