ABSTRACT
BACKGROUND: There is a substantial amount of literature on the perception of the practice environment and quality of care as perceived by registered nurses and community services nurses in South Africa and worldwide, but there is little to no research that could be found regarding other categories of nurses, and how these perceptions differ between the different categories. Therefore, the aim of this study is to describe the different nursing categories' perceptions of the practice environment and quality of care and the association between the variables. METHODS: This study applied a cross-sectional survey design. Data were collected in April 2021 in the public sector of the North West Province. Multiphase sampling was applied to all categories of nurses who worked in an in-patient unit in the selected hospital for at least 3 months (n = 236). RESULTS: All nursing categories perceived the practice environment as negative, regarding nurse participation in hospital affairs; nurse manager ability, leadership, and support of nurses and staffing and resource adequacy. Perceived quality of care and patient safety items were perceived as neutral and good. However, in all instances, the perceptions of community service nurses and registered nurses were most negative, and enrolled nurse assistants most positive. Adverse events towards patients and nurses were perceived to only occur a few times a year. Overall, nurse perceptions of quality of care and patient safety were most correlated with the subscale of nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses. Adverse events towards patients were most correlated with the collegial nurse-physician relationship subscale, while adverse events towards nurses were correlated with the foundations of quality of care subscale. CONCLUSION: Improving the practice environment, especially regarding the subscale nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses, is associated with improved quality of care. Nurses with higher qualifications, registered nurses and community service nurses rated quality of care lower than other categories of nurses, contributing to literature that higher qualified staff are more competent to assess the practice environment and quality of care.
ABSTRACT
BACKGROUND: The South African mining healthcare sector faces injuries, illnesses including HIV and AIDS and high staff turnover rates. In this sector, nurse managers should create an optimal environment for providing nursing care by motivating, influencing and empowering nurses. OBJECTIVES: This study aimed to investigate the relationship between nurse managers' resilience and empowering leader behaviour in this sector. METHOD: The study employed a quantitative, descriptive and correlational design. The research population comprised 31 nurse managers, 101 professional nurses, 79 enrolled nurses and 79 enrolled nursing auxiliaries who participated in the study. Two questionnaires were used as data collection methods, namely Wagnild and Young's Resilience Scale Questionnaire to investigate the resilience of nurse managers and the Empowering Leadership Questionnaire to measure empowering leader behaviour of the nurses supervised by a particular nurse manager. RESULTS: Out of 31 nurse managers, 8 had a low level, 19 had a moderate level and 4 had a high level of resilience. According to Hoteling's t-test the nurse managers in the low resilience group displayed lower empowering leader behaviour as perceived by their team members than those in the high resilience group in terms of the five factors included in the Empowerment Leadership Questionnaire. CONCLUSION: Respondents with high resilience scores tended to have higher leader empowering behaviour.Recommendations include the strengthening of nurse managers' resilience through workshops and reflection practices, debriefing and performance feedback sessions.
