Nurse managers' perceptions of patient-centred care and its influence on quality nursing care and nurse job satisfaction: Empirical research qualitative.

AIM: To explore nurse managers' perceptions of patient-centered care (PCC), its influence on quality nursing care, nurse job satisfaction, and to provide baseline data for a context-driven PCC model. DESIGN: The study utilized a qualitative, phenomenological design, employing individual in-depth interviews to collect data on nurse managers' PCC perceptions until data saturation. METHODS: Sampling involved purposive selection of Northern Ghana, random selection of the tertiary hospital cluster with the three participating hospitals, and purposive sampling of the nine nurse managers. Data analysis employed thematic analysis based on a six-phase framework. Methodological trustworthiness was ensured through various strategies including prolonged engagement, supervisor discussions and crosschecking with interviewees. RESULTS: Three main themes emerged from the study including nurse managers' conceptualization of PCC, perceived patient-centred practices and its influence on nursing quality and job satisfaction. The findings emphasized the patient's individuality, cultural values, holistic care, the importance of strong nurse-patient relationships and a patient-centric environment. The nurse managers perceived PCC as positively influencing quality nursing care and nurse job satisfaction. The findings offer nuanced insights into nurse managers' perspectives on patient-centeredness and highlight areas for improvement.

Erratum: Analysis of Patient Safety Incident reporting system as an indicator of quality nursing in critical care units in KwaZulu-Natal, South Africa.

[This corrects the article DOI: 10.4102/hsag.v25i0.1263.].

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.

Perceptions of professional nurses regarding the National Core Standards tool in tertiary hospitals in KwaZulu-Natal.

BACKGROUND: Internationally, healthcare providers share a common goal of providing safe and high-quality care to every patient. In South Africa, the National Core Standards (NCS) tool was introduced to improve the quality of healthcare delivery. OBJECTIVES: This article is aimed to determine the perceptions of nurses concerning the use of NCS as a tool to measure quality care delivery in tertiary hospitals in KwaZulu-Natal. METHOD: This was a cross-sectional descriptive survey, where a purposive sampling technique was used to select hospitals. Six strata of departments were selected using simple stratified sampling. In each stratum, every second ward was selected from the provided list of wards using a systematic random sampling. The population of professional nurses in selected departments was 3050, from which 437 participants were selected by systematic random sampling. The collected data were analysed using Statistical Package for the Social Sciences (SPSS®) version 25. RESULTS: The study indicated that 53.5% respondents believed that the NCS tool allows them to identify areas of weakness, pointing to risks in basic human rights. However, only 49.7% respondents believed that the NCS tool allows staff inputs to identify relevant innovations. The study recommends improvement in the organisational climate and adoption of strategies that add value to patient care. CONCLUSION: Professional nurses perceived the NCS tool as a good tool for improving quality of healthcare delivery, but there is a need to improve environmental practice and involvement of all healthcare establishments to increase its effectiveness.

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

Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review.

BACKGROUND:  There is overwhelming evidence that the quality of health care in South Africa has been compromised by various challenges that impact negatively on healthcare quality. Improvement in quality care means fewer errors, reduced delays in care delivery, improvement in efficiency, increased market share and lower cost. Decline in quality health care has caused the public to lose trust in the healthcare system in South Africa. OBJECTIVES:  The purpose of this study was to identify challenges that are being incurred in practice that compromise quality in the healthcare sector, including strategies employed by government to improve the quality of health delivery. METHOD:  Literature search included the following computer-assisted databases and bibliographies: Medline (Medical Literature Online), EBSCOhost, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google, Google Scholar and ScienceDirect. Furthermore, websites were used to source policy documents of organisations such as the National Department of Health in South Africa and the World Health Organization. RESULTS:  Seventy-four articles were selected from 1366 retrieved. These articles quantify problems facing quality care delivery and strategies used to improve the healthcare system in South Africa. CONCLUSION:  The findings revealed that there were many quality improvement programmes that had been initiated, adapted, modified and then tested but did not produce the required level of quality service delivery as desired. As a result, the Government of South Africa has a challenge to ensure that implementation of National Core Standards will deliver the desired health outcomes, because achieving a lasting quality improvement system in health care seems to be an arduous challenge.

Engagement with Medication Among Kidney Transplant Recipients - A Descriptive Cross-Sectional Study.

The aim of this study was to determine the level of engagement with medication among kidney transplant recipients in South Africa. A descriptive cross-sectional study design with random sampling was used. Data were collected through structured face-to-face interviews. Total engagement with medication scores among kidney transplant recipients ranged from 60% to 100%, with a mean score of 80%. Although over half of the participants (55%) scored above the mean, only 19% had high levels of engagement with medication. Engagement with medication was significantly associated with race (Chi-square value = 66.225, df=42, P=0.010) and years post-kidney transplantation (Chi-square value = 415.423, df=364, P=0.032).

Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review

There is overwhelming evidence that the quality of health care in South Africa has been compromised by various challenges that impact negatively on healthcare quality. Improvement in quality care means fewer errors, reduced delays in care delivery, improvement in efficiency, increased market share and lower cost. Decline in quality health care has caused the public to lose trust in the healthcare system in South Africa.Objectives: The purpose of this study was to identify challenges that are being incurred in practice that compromise quality in the healthcare sector, including strategies employed by government to improve the quality of health delivery.Method: Literature search included the following computer-assisted databases and bibliographies: Medline (Medical Literature Online), EBSCOhost, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google, Google Scholar and ScienceDirect. Furthermore, websites were used to source policy documents of organisations such as the National Department of Health in South Africa and the World Health Organization.Results: Seventy-four articles were selected from 1366 retrieved. These articles quantify problems facing quality care delivery and strategies used to improve the healthcare system in South Africa.Conclusion: The findings revealed that there were many quality improvement programmes that had been initiated, adapted, modified and then tested but did not produce the required level of quality service delivery as desired. As a result, the Government of South Africa has a challenge to ensure that implementation of National Core Standards will deliver the desired health outcomes, because achieving a lasting quality improvement system in health care seems to be an arduous challenge

Client education experiences and expectations of women at the first level of maternal and child care in Kaduna state, Nigeria.

PURPOSE: to explore the client education experiences of women at first level maternal and child health-care facilities in Kaduna State Nigeria. The lack of access to appropriate information to assist women in making decisions about their health and utilize available services is recognized as a major contributory factor to the unabated high maternal and child mortality rates in Nigeria. DESIGN: a qualitative descriptive study was conducted. Nine focus group discussions were held with 65 women across the three senatorial zones of Kaduna State, Nigeria. Participants were recruited using maximum variation sampling technique. Audio recordings of the discussions were transcribed and the content analysed. The themes were determined by a priory approach and findings compared across groups through manually developed data matrices. FINDINGS: midwives were the major source of useful health information to the women who wished the midwives could cover more issues. The information provided by the midwives was skewed towards children and postnatal care, and some midwives ignored, or considered some of the women's questions interrupting. The harshness of midwives in emphasizing the need for prompt care, to women who came late to register or deliver, kept some women away. Women who never delivered in the facilities were not aware that the 'nurses' at the clinics were midwives, and desired to know more about midwifery in the facilities being tired of traditional birth attendants. CONCLUSION: the desire of women for more information and to know the 'midwife' suggests a gap between what the women expected and what they were provided. IMPLICATION FOR PRACTICE: it is important to expand the scope of client education to include critical pregnancy and labour related issues and friendly midwifery practices in the facility.

Symptoms experienced by HIV-infected Individuals on antiretroviral therapy in KwaZulu-Natal, South Africa.

Symptom management in HIV/AIDS is a critical issue that influences the quality of life of those living with the disease. Although the goals of treating the numbers living with HIV/AIDS have not yet been achieved, availability of antiretroviral therapies (ARVs) has been expanded to many clinical settings in KwaZulu-Natal, the epicenter of HIV infection in South Africa. The South African Department of Health (2007) estimates indicate that 5.54 million South Africans are living with HIV/AIDS, whereas UNAIDS (2007) estimates suggest that 18.8% of the population in South Africa is affected. Because the symptom experience may influence adherence to ARVs and quality of life, this study focused on the prevalence of symptoms reported by patients (N = 149) diagnosed with HIV/AIDS and adherence to medications and appointments. Self-report data were obtained from this community-based sample of HIV-infected patients who received care in outpatient clinics in Durban, KwaZulu-Natal, South Africa. With an average of three side effects, the most frequently reported by the study participants were fatigue/tiredness (41%), rashes (40%), headaches (32%), insomnia (31%), sadness (24%), disturbing dreams (23%), numbness (22%), pain (22%), and self-appearance (20%). On a scale of 1 to 10 (10 being worst possible), those with symptoms reported an average intensity of 4.2 (SD = 2.0), and the degree to which symptoms affected activity levels was 3.2 (SD = 2.2). Although intensity of symptoms and effects on activity levels were strongly correlated (r = .78, p < .001), there were no significant relationships between adherence and the intensity of symptoms or the relationship of symptoms with activity levels. Logistic regression analyses indicate that the presence of a greater number of symptoms was not associated with greater adherence (odds ratio = 2.27, 95% confidence interval = 0.60-8.70, ns). However, those who reported higher adherence were 1.5 times more likely to report greater physical health than low adherers (p = .04). High adherers were also 1.6 times more likely to report greater psychological health than low adherers (p = .03). This suggests that further study is needed to investigate adherence motivations for those living with HIV/AIDS in South Africa because adherence seems not to be linked to the frequency of symptoms or limitations on activity related to symptoms.

Fulbright Scholar opportunities for global health and women's health care in HIV/AIDS in sub-Saharan Africa.

This article addresses global health opportunities related to HIV/AIDS and women's health care in sub-Saharan Africa through Fulbright Scholar and Fulbright Student Awards. Although many universities offer a gateway to the J. William Fulbright awards, some disciplines and areas of specialization, including nursing and women's health, have had fewer scholars or students as recipients of these awards. Resource-limited countries, including the countries of sub-Saharan Africa, offer rich opportunities for cross-cultural exchange and advancement of global health. Amidst the context of the shortage of health care workers, the increasing prevalence of HIV/AIDS and other infectious and chronic diseases in sub-Saharan Africa, and the challenges of public health, this article addresses an example of partnerships in global nursing that can be developed through the Fulbright programs.

Social support and medication adherence in HIV disease in KwaZulu-Natal, South Africa.

BACKGROUND: A supportive social environment is critical for those with HIV/AIDS. In KwaZulu-Natal, in South Africa, antiretroviral therapy is available to some HIV-positive individuals. Antiretroviral adherence is an important issue for limiting HIV infection. Adherence to therapy may be linked to social support, particularly amidst the stigma prevalent in HIV. OBJECTIVE: The purpose of this study was to examine characteristics related to social support and antiretroviral medication adherence. DESIGN: This cross-sectional, descriptive study explored the nature of the relationships among social support and other selected variables, including sociodemographic variables, quality of life, and adherence. SETTINGS: After ethical review board approval, the sample of HIV-infected individuals who received care in outpatient clinics were recruited and completed the self-report instruments. PARTICIPANTS: The sample included English and/or isiZulu-speaking (n=149) individuals over the age of 18 years receiving treatment for HIV/AIDS. A total of 149 patients with a diagnosis of HIV/AIDS agreed to participate and completed questionnaires after completing informed consent procedures. The study participants were recruited at four outpatient settings in Durban, KwaZulu-Natal province of South Africa. METHODS: A descriptive, exploratory, cross-sectional design was utilized to explore the research questions: What are the characteristics of social support and the relationship to antiretroviral adherence in KwaZulu-Natal, South Africa? Descriptive statistics and regression analyses were used to answer the research questions. RESULTS: Data analyses indicated that social support scores on the Medical Outcomes Study Social Support Survey were moderate (M=64.4; S.D.=14.7) among the study participants. The number of close friends and family were significantly correlated with a greater sense of social support. Despite this, the lowest scores on the quality-of-life measure using the Medical Outcomes Study Short Form 36 item survey were reported on the Social Functioning Scale. CONCLUSIONS: In summary, the study findings suggest that a supportive social network is essential for those living with HIV/AIDS. However, social functioning and quality of life amidst the stigma of living with HIV in South Africa may be a concern and require further investigation.

Quality of life and physical functioning in HIV-infected individuals receiving antiretroviral therapy in KwaZulu-Natal, South Africa.

KwaZulu-Natal province, South Africa, accounts for 28.7% of the HIV infection total and one-third of infections among youth and children in South Africa. The purpose of this study was to examine the variables of HIV/AIDS symptoms, social support, influence of comorbid medical problems, length of time adhering to antiretroviral therapy medications, quality of life, adherence to antiretroviral medications, and physical functioning in HIV-infected individuals. Based on our model, the combination of these variables was found to determine physical functioning outcomes and adherence to HIV medications. Significant relationships were observed between physical functioning and the dependent variables of length of time on medications, comorbid health problems, and social support. A linear regression model was built to determine the degree to which these variables predicted physical functioning. In total, these predictor variables explained 29% of the variance in physical functioning. These results indicate that those individuals who reported a greater length of time on medications, fewer comorbid health problems, and greater social support had better physical functioning.