Strategy actions to include students in a private hospital's nursing teams: A qualitative study.

Background: Student nurse education focusses on preparing competent professionals integral to nursing teams. Aim: To develop strategic actions to include student nurses within the nursing team. Setting: A private healthcare group in South Africa. Methods: A qualitative approach in three phases was used. Thirty purposively sampled participants recorded reflective journals in phase one. Tesch's eight steps were utilised for analysis. Phase two involved non-probability volunteer sampling of 11 participants for the nominal group technique analysis. In phase three, total population sampling recruited nine panellists for an e-Delphi technique that provided data that were open coded. Results: Phase one identified themes, including perceptions of responsibilities, support needs, recognition, conflict and communication issues. Phase two revealed five strategic actions: fair treatment, aligned work allocation, active participation, respect and acknowledgement of contributions. Phase three validated 19 strategic statements underpinning the strategic actions. Conclusion: Unit managers play a key role in fostering inclusivity, impacting student nurse retention. Contribution: Enhancing team cohesion can improve workplace wellness and patient outcomes while aiding in retention and recruitment efforts.

A strategic action plan to enhance the accessibility of healthcare in rural areas of Zimbabwe.

OBJECTIVE: To identify strategies and develop a strategic action plan to enhance accessibility to healthcare in rural areas of Zimbabwe. METHODS: A cross sectional research approach with four (4) phases. Phase one (1) (quantitative), data was collected from professional nurses using self-administered questionnaires, healthcare users using interview questionnaires. Phase two (2) (qualitative), information was collected from a nominal group of national health directors leading to development strategic action plan in Phase three (3) informed by Phases 1 and 2, systems model and literature control. Strategic action plan was finalised and validated by members of the Parliamentary Portfolio Committee on Health in Phase 4. SETTINGS: Two districts (Masvingo and Chegutu) in two provinces (Masvingo and Mashonaland West) were involved. PARTICIPANTS: Conveniently sampled professional nurses (90) and healthcare users (445) using the sampled public health facilities (Phase 1); conveniently sampled national health coordinators (five) (Phase 2); and all five members of the Parliamentary Portfolio Committee on Health (Phase 4). RESEARCH FINDINGS: The strategic action plan focused on improving the health infrastructure; providing medical drugs, health workers and medical equipment; addressing shortages; and improving the capacity of the healthcare system. CONCLUSION: Active participation at all levels (professional nurses, healthcare users, national health directors and members of parliament) allowed the development of a strategic action plan.

Educators' ability to use concept mapping as a tool to facilitate meaningful learning.

Background: Meaningful learning is enhanced when concepts are visually differentiated, linked to or nested under other concepts, resulting in integrative reconciliation of knowledge and understanding. Competence in using concept mapping as a strategy to support students towards meaningful learning, is essential.Aim: The aim of the study was to describe the nature of the concept maps drawn by educators after a symposium on concept maps to transfer educational knowledge to the classroom.Design: A quantitative descriptive cross-sectional design was used to explore the nature of concept maps drawn by educators after having attended a workshop on concept mapping.Methods: The authors developed a checklist based on the principles of a good concept map to assess and describe to what extent the concept maps drawn by the participants, aligned with general principles on creating a concept map appropriate to enhance meaningful learning. During a symposium, participants were introduced to the advantages, principles and requirements for concept mapping. Sixty-two (62; 100%) participants drew concept maps. Using a checklist based on the principles of good concept mapping, we assessed concept maps from 22 (35.4%) volunteers to explore the extent to which the concept maps aligned with general principles necessary to enhance meaningful learning.Results: Criteria for a good concept map include the graphical presentation and establishing relationships between these concepts. The network-style concept map was used by the majority (68%) of the participants. Only 9% used the spoke concept map. The graphical presentation of concepts and the relationships between these was limited. Only 41% of the maps were understandable, while 36% made sense in the context of the chosen topic.Conclusions: Well-designed concept maps can add value to and improve educator teaching and student learning. Not all educators in this study understood what a good concept map is. Visualisation offered by concept maps assist in recognising how new knowledge can link with, and build on, existing knowledge.

Early cervical cancer screening: The influence of culture and religion.

BACKGROUND: Screening for cervical cancer at an early stage is essential for providing women with a better chance of receiving effective treatment for both precancers and cancer. Delaying screening until cancer has advanced can be detrimental, resulting in late presentation of cervical cancer and, as a result, cancer metastasis. AIM: The purpose of this study was to assess the extent to which culture and religion influence early cervical cancer screening in women. SETTING: The research was conducted in one of the rural districts in Manicaland Province of Zimbabwe. METHODS: A qualitative exploratory and contextual design was utilised, and data were gathered by means of semistructured interviews. At 17 semistructured interviews, data saturation was reached and further data collection terminated. Data were thematically analysed. RESULTS: Five themes that described participants' perceptions on culture and religion as barriers to early cervical cancer screening emerged from the data. These included a lack of knowledge, stigmatisation, cultural beliefs and values, religion and a lack of resources. These all negatively affected participants' motivation to seek early screening services. CONCLUSION: According to the study findings, culture and religion constitute impediments to early cervical cancer screening for rural women. Interventions that encourage screening, such as targeted health education and health promotion materials, must consider cultural and religious views if behaviour change in diverse groups is to be accomplished.Contribution: The study has the potential to inform Zimbabwean health policy and contribute to prospective interventions or health education that encourage women to attend early cancer screening.

Interpretation of the concept 'nursing': Utilisation in nursing education and practice.

BACKGROUND:  Nursing developed over centuries. Changing practice and education influenced its interpretation and understanding. Its meaning and interpretation may differ amongst education institutions, nurse educators and nurses, particularly student nurses. OBJECTIVES:  The objective was to develop a visual concept map of the concept of 'nursing', allowing nursing education institutions to have a similar approach and understanding in teaching the concept to student nurses. METHOD:  The research design was qualitative, explorative, descriptive and contextual. A self-designed, pretested online questionnaire collected data from various categories of nurse participants. An integrative review viewed literature sources published between 2006 and 2016 accessing definitions of 'nursing'. Data analysis involved thematic analysis of narrative data, data coding processes, interpretation and synthesis of data and further analysis using a systematic concept analysis process. The combined analysed data merged, developing a visual concept map of 'nursing'. Expert nurse educators validated the visual concept map of 'nursing' by e-Delphi technique, using an assessment rubric. RESULTS:  Various definitions of 'nursing' revealed identified themes and categories underpinning the concept. After formulation of connotative, denotative definitions and empirical referents, a visual concept map of 'nursing' was developed and validated to be an educational tool to facilitate the teaching of the concept of 'nursing', enhancing a similar understanding and interpretation thereof. CONCLUSION:  A visual concept map of 'nursing', a tool facilitating teaching the concept and promoting similar understanding of its meaning is valuable in an evolving digital era, where visual stimulation enhances teaching and learning.Contribution: The primary contribution of the manuscript provided a developed visual concept map of 'nursing', to use as a tool to stimulate critical thinking and integrate the various aspects outlined in the map. The visual concept map of 'nursing' assists in the education and training of all categories of nurses in the profession, especially student nurses, aiming to support better patient outcomes when the concept of nursing is understood and interpreted in the same way.

Nurse leadership: Sustaining a culture of safety.

Background: Nurse leaders are essential to manage nursing practices that affect patient safety; therefore, they must create and sustain a sound safety culture in a diverse cultural environment. Aim: To describe the specific actions required by nurse leadership to enhance the sustainability of a safety culture in hospitals and among a diverse nursing team, ultimately improving patient outcomes. Setting: Two hospitals in the United Arab Emirates (UAE) were selected purposively, based on the diversity of the nursing team. Methods: A quantitative design, using Reason's safety culture framework and Ekenedo's behavioural safety model, formed the theoretical background of this study to identify the safety culture and positive work environment that exist among culturally diverse nurses. Thirty-four nurse managers and 417 nurses were conveniently selected to participate. Various instruments were used to gather hospital outcomes and other data from respondents pertaining to their demographics, patient safety, positive work environments and safety culture. Results: Findings received from the nursing team describe the correlation between patient safety, a diverse nursing workforce and positive work environment affecting a safety culture and promoting positive patient outcomes. Conclusion: Nurse leaders' integration of specific actions to address the system, as well as diverse nursing teams' behavioural practices, create a patient care environment that adequately contributes to safety culture practices and enhances positive patient outcomes, which are essential for a culture of safety. Contribution: The study contributes by providing a structured integration of specific actions for nurse leaders to sustain practices ensuring positive patient outcomes.

A Strategic Action Plan to Improve an Integrated Family Planning and HIV Service: Using Multiple Nominal Groups to Ensure Stakeholder Involvement.

Introduction: The World Health Organization recommends that family planning be integrated in HIV services, to improve service offering and uptake; stakeholder involvement is crucial. The purpose of this manuscript is to share the utilization of nominal group technique (NGT) and multiple group analysis as a vehicle to ensure stakeholder involvement in the development of a strategic action plan to improve the implementation of integrated services in Ethiopia. Methods: A qualitative research design, employing a NGT, was applied as data-gathering method to develop a strategic action plan for facilitating the integration of family planning and HIV services. NGT was used to ensure the equal involvement of stakeholders in the development thereof. Twenty-four programme managers in Addis Ababa, Ethiopia - experts in family planning and HIV/AIDS programmes, working in 10 sub-city health departments - participated in the nominal groups to identify the strategies to be included in an action plan development to facilitate integrated services. Results: The first nominal group's participants identified 12 themes, derived from the 21 categories generated from 34 individual ideas. The second group identified nine themes, from 16 categories, generated from 30 individually ideas. A multiple group analysis utilizing the findings from both groups revealed the top five most important themes (leadership and management, capacity building, implementing policies and guidelines, advocacy/awareness and infrastructure) that were selected to be included in a strategic action plan to integrated family planning and HIV services in Ethiopia. Discussion: The strategic action plan developed by the researcher who took into account the findings from the multiple group analysis was validated in a face-to-face validation meeting by all the relevant stakeholder's participation. Stakeholder involvement, utilizing different nominal groups and conducting multiple nominal group analysis ensured ownership of the strategic action plan as those involved in the development, will be the individuals to implement in Ethiopia.

Contextualizing a framework for improving postnatal care in Ethiopia.

Background: Postnatal care is among the major recommended interventions to reduce maternal deaths. To improve the low postnatal care utilization in Ethiopia, the framework developed for this purpose in Kenya was contextualized and adapted for implementation in the Ethiopian context. Objectives: The objectives of this article are to share the process followed to contextualize Chelagat's framework for improving postnatal care, for the implementation in Ethiopia as well as the finalized contextualized framework. Methods: A quantitative descriptive research design was adapted. A self-administered questionnaire was used to gather data during November 2018 from 422 postnatal care providers and coordinators, using stratified random sampling. The AGREE II was utilized to assess adaptability and applicability and an open-ended question allowed to assess the challenges and opportunities for utilizing the framework. The data were analyzed using SPSS computer software, Version 23. Results: The findings revealed that the framework from Chelagat was adaptable to use for the improvement of postnatal care in the Ethiopian context. The results from the analysis of the data using AGREE II indicated an average domain score of 92%, for contextualization possibility. Conclusion: The framework originally developed by Chelagat was contextualized and refined to be implemented in Ethiopia to improve postnatal care.

Challenges in postnatal care provision in Ethiopia.

Background: Most maternal deaths occur during the first 48 h after delivery; thus, a critical time for monitoring possible complications arising from the delivery. Quality postnatal care can contribute to a decrease in maternal mortality and morbidity rates. Despite the importance of postnatal care, it is generally a neglected aspect of maternal and child health services in most developing countries, including Ethiopia. Objectives: The objective of the study was to describe the challenges experienced by postnatal care providers and coordinators in providing postnatal care in the Ethiopian context. Methods: A quantitative cross-sectional descriptive study was conducted and data were gathered from 422 postnatal care providers and coordinators during November 2018. A simple random sampling technique was used to select the respondents and the data were gathered through a self-administered questionnaire. The data were cleaned, coded and entered into the Statistical Package for Social Sciences (SPSS) version 21 for analysis. Open-ended questions for qualitative enhancement were open-coded and thematically analyzed. Results: The findings revealed a lack of physical resources; infrastructure problems; cultural concerns; inadequate capacity building; inaccessibility of health services; unavailability of guidelines; a lack of communication with healthcare users and poor monitoring and evaluation as challenges. Conclusion: To improve postnatal care in Ethiopia and, ultimately, mother and child health, the challenges experienced by postnatal care providers and coordinators have to be dealt with. A strategic action plan with the active involvement of all stakeholders must be developed and implemented to deal with the challenges and improve postnatal care.

Malnutrition and the Survival of Cervical Cancer Patients: A Prospective Cohort Study Using the PG-SGA Tool.

BACKGROUND: Cervical cancer is the second most common cancer among women in developing countries. Malnutrition is associated with poor prognosis and early detection of malnutrition and timely nutritional interventions can improve the outcome for cervical cancer patients. The study was aimed to assess the association between the nutritional status and survival of cervical cancer patients. METHODS: A prospective cohort study design was used. Overall 175 cervical cancer patients were followed over one year period with (median 8.5 mo, range (3.6-12). RESULTS: The prevalence of malnutrition determined by means of the PG-SGA was 17.7% at admission and 47.1% at the end of follow-up. According to the SGA, one in three (29.7%) patients required nutritional intervention at the end of follow-up. Patients who were malnourished (PG-SGA-B and C) had an increased risk of mortality (Hazard Ratio [HR]: 3.12, 95% CI: 1.23 - 7.86) as compared to those who were well nourished (PG-SGA-A). Patients from rural areas had an increased risk of mortality (HR: 6.99, 95% CI: 2.07 - 23.58) compared to patients from urban areas. CONCLUSION: In the context of developing country setting and COVID19 outbreak, malnutrition significantly decreases cervical cancer survival. A thorough nutrition assessment using scored PG-SGA is needed.

Application of Integrated Behavioral Model (IBM) to measure intention to get early screening and treatment of Sexually Transmitted Infections (STIs) among HIV at- risk sub-populations in Ethiopia.

BACKGROUND: Sexually Transmitted Infections (STIs) increase the risk of contracting Human Immunodeficiency Virus (HIV). Hence, early screening and treatment of STIs as a behavioral practice will reduce the odds of HIV infection among at risk and vulnerable sub-populations. To that end, HIV prevention strategies need to design evidence-based interventions using behavioral models or theories to help at-risk individuals adopt early screening and treatment of STI as preventive health behavior. In this study, commercial sex workers were considered as HIV at-risk sub-populations. OBJECTIVE: Measuring to what extent that Integrated Behavioral Model constructs explain individuals' intention to practice early screening and treatment of sexually transmitted infections as healthy behavior of interest in HIV prevention. DESIGN: Integrated Behavioral Model (IBM) measurement survey was conducted using Respondent Driven Sampling (RDS) in six towns located in the main transport corridors of Ethiopia. Respondents' answers to model construct-based questions and intention to practice the health behavior of interest were measured using Likert Scale. Analysis was done to assess the correlation and level of association of model construct-based questions with intention to practice the preventive health behavior. RESULTS: Respondents' attitude explained 32%, perceived control 2%, normative influence 21%, and self-efficacy 53 % of their intention to get early screening and treatment of sexually transmitted infections. CONCLUSION: Self-efficacy explained the variability of respondents' intention to get early screening and treatment of STIs most, while perceived control was the least. Hence, HIV prevention behavioral interventions targeting early screening and treatment of STIs should give high emphasis to self-efficacy.

Teenage pregnancy prevention: The church, community, culture and contraceptives.

It is important to prevent teenage pregnancies to enhance their health, educational level and economic prospects. Peer education should be explored as a strategy to prevent teenage pregnancies. The purpose of this paper is to share the perceptions of peer educators who underwent a peer education-training programme and the effect it had on their own sexual behaviour. A qualitative descriptive, explorative and contextual research design was conducted, using in-depth interviews from 15 participants to gather data. The findings revealed that participants had positive educational experiences; positive personal growth; and wanted to become mentors for their peers. Despite their increased level of knowledge and positive experiences, some found it difficult to mentor others due to religion, culture as well as the opinion of their parents and community. Peer education will only have an effect on contraceptives if the church, the community, diverse cultural norms and traditions are included in the dialogue about contraception.

Integrating HIV and Family Planning Services: The Pros and Cons.

BACKGROUND: The integration of HIV and family planning services as a one-stop service is a cost-effective way of service delivery, but it has advantages and disadvantages. METHODS: A cross-sectional study design was applied to conduct this research in Ethiopia from June 2015 to November 2018. Two-stage sampling was applied: 1) a simple random sampling method was used to select 31 public health centers, and 2) 403 clients and 305 service providers were selected by using a stratified simple random sampling. A self-administrator questionnaire was developed to collect the data from service providers, and an interview questionnaire was used to collect data from clients. The data were statistically computed using bi-variate and multivariate logistic regression. RESULTS: Integrated HIV and family planning services allow for the enhancement of the competencies of healthcare workers, client satisfaction, mobilization of fiscal resources, provision of infrastructures, and adequate numbers of human resources available. It can also mobilize additional resources for health education and improve awareness on HIV and family planning services. Despite the mentioned advantages, shortages of human resources, HIV drugs and contraceptives, funding and long waiting times were identified as the disadvantages of HIV and family planning service integration. There was a risk of nine times lower chance of intention to use an integrated HIV and family planning services, if a client waited for more than 1 hour and 6 times risk waited for 30-60 minutes. CONCLUSION: The advantages of offering an integrated service at a one-stop facility by far outweighing the disadvantages. It might be relevant to develop a strategic action plan for stakeholders to facilitate the integration of HIV and family planning services with the aim to improve service utilization and to reduce maternal and child morbidity and mortality.

Accessibility of healthcare in rural Zimbabwe: The perspective of nurses and healthcare users.

BACKGROUND: Accessibility of healthcare in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the healthcare system. Developing countries like Zimbabwe are significantly affected. AIM: The aim of this article was to share the perspectives of nurses and healthcare users (HCUs) in the rural areas of Zimbabwe with regard to the accessibility of healthcare. SETTING: The study was conducted at 45 rural health facilities in Chegutu district, Mashonaland West province and Masvingo district in Masvingo province, Zimbabwe. METHODS: A self-administered questionnaire (for professional nurses) and a structured interview questionnaire (for HCUs) were utilised to gather data in a cross-sectional survey. Two districts were randomly sampled from 59 districts. All nurses working in 45 public health facilities in the selected two districts, who were willing and available to participate, were included. Ninety nurses participated in the study. The HCUs were selected through a multistage sampling technique. The sample size for HCUs was calculated by using Dobson's formula, and 445 HCUs were included via convenience sampling. RESULTS: Nurses reported challenges such as work overload because of staffing shortages (55%) and the supply of necessary medical drugs that lacked consistency in both the quantity and type ordered(46.7%). The challenges faced by HCUs included long distances from villages to health facilities (86%), unaffordability of transport costs and lack of access to medical drugs (59.95%), causing them to seek assistance from traditional healers (43%). CONCLUSION: Both the nurses and HCUs perceived grave challenges regarding access to health facilities, health workers and medical drugs, all of which are bound to have an impact on the health of communities in rural Zimbabwe.

Accessibility of healthcare in rural Zimbabwe: the perspective of nurses and healthcare users

Background: Accessibility of healthcare in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the healthcare system. Developing countries like Zimbabwe are significantly affected. Aim: The aim of this article was to share the perspectives of nurses and healthcare users (HCUs) in the rural areas of Zimbabwe with regard to the accessibility of healthcare. Setting: The study was conducted at 45 rural health facilities in Chegutu district, Mashonaland West province and Masvingo district in Masvingo province, Zimbabwe. Methods: A self-administered questionnaire (for professional nurses) and a structured interview questionnaire (for HCUs) were utilised to gather data in a cross-sectional survey. Two districts were randomly sampled from 59 districts. All nurses working in 45 public health facilities in the selected two districts, who were willing and available to participate, were included. Ninety nurses participated in the study. The HCUs were selected through a multistage sampling technique. The sample size for HCUs was calculated by using Dobson's formula, and 445 HCUs were included via convenience sampling. Results: Nurses reported challenges such as work overload because of staffing shortages (55%) and the supply of necessary medical drugs that lacked consistency in both the quantity and type ordered(46.7%). The challenges faced by HCUs included long distances from villages to health facilities (86%), unaffordability of transport costs and lack of access to medical drugs (59.95%), causing them to seek assistance from traditional healers (43%). Conclusion: Both the nurses and HCUs perceived grave challenges regarding access to health facilities, health workers and medical drugs, all of which are bound to have an impact on the health of communities in rural Zimbabwe

Faculty's experience of a formal mentoring programme: the perfect fit.

BACKGROUND: The aging academic cohort in the faculty of health sciences necessitates transfer of knowledge and skills as a crucial component of sustainability. Formal mentoring programmes at higher education institutions aim to create a platform where experienced faculty can mentor newly appointed faculty to adjust to the context and gain knowledge and exposure. The formal mentoring programmes' structure and outcomes can create challenges and prevent the perfect fit between the mentor and mentee. PURPOSE: The aim is to provide a description of the experiences of mentors and mentees of a formal mentoring programme in a higher education institution. This pilot study strives to provide recommendations to enhance mentorship experiences that facilitate adjustment and knowledge and skill transfer through the perfect fit. METHODS: A qualitative, descriptive case study was conducted as a pilot study. The case used was the formal mentoring programme. The unit of analysis was three purposefully selected faculty and researchers who were intimately involved in the mentoring process. Guided narrative reports were used and analysed by Tesch's content analysis. RESULTS: Three themes emerged namely, knowledge and skills transfer, mentoring programme and mentoring process. CONCLUSION: The formal mentoring programme contributed positively to professional development, but posed challenges related to structural components. It is recommended that the structured mentoring programme be merged with informal mentoring to make it more authentic.

Facilitating the development of higher-order thinking skills (HOTS) of novice nursing postgraduates in Africa.

BACKGROUND: International research in nursing education has shown to be deficient regarding both the quality of research produced and the building of disciplinary capacity. The CHENMA (Collaboration for Higher Education of Nurses and Midwives in Africa) project aimed to strengthen nursing and midwifery expertise in Africa. Sixteen French-speaking students of the Democratic Republic of the Congo (DRC) enrolled for a master's degree in nursing midwifery at a South African university in 2008. Ten of the initial 16 students graduated with a master's degree in 2012. One student withdrew and five students completed a postgraduate diploma in midwifery. OBJECTIVES: The objective of this paper is to explore the quality of the output of those master's degree students, namely their dissertation (with specific reference to the demonstration of HOTS). METHODS: An exploratory, evaluative, single, descriptive case study was utilised. Realist, purposeful sampling was used. Six of the 10 completed final dissertations were evaluated as well as three reflective reports from the supervisor, translator and critical reader. RESULTS: The findings indicated that most dissertations fell below the expected standard, with a paucity of higher-order thinking and application skills. Language, and possibly cultural dynamics, seemed to be the largest barrier to learning and communication. The dissertations lacked conceptual skills, scientific writing skills, logical order of thought and congruency. Analysis of the dissertations revealed a limited ability of novice scholars to explore the nature of information and to interpret and manipulate the data in a novel way.

Nurses' scope of practice and the implication for quality nursing care.

PURPOSE: This article provides an overview of the implications for patients' health status and care needs when assessments are performed by nurses not licensed or competent to perform this task. The Waterlow scale (Judy Waterlow, The Nook, Stroke Road, Henlade, TAUNTON, TA3 5LX) scenario is used as a practice example to illustrate this case. ORGANIZATIONAL CONSTRUCT: The international nursing regulatory bodies, in South Africa called the South African Nursing Council, set the scope of practice wherein nurses are allowed to practice. Different categories of nurses are allowed to practice according to specified competencies, in alignment with their scope of practice. METHODS: A retrospective quantitative study was utilized. A checklist was used to perform an audit on a random sample of 157 out of an accessible population of 849 patient files. Data were gathered in May 2012, and the analysis was done using frequencies and percentages for categorical data. Reliability and validity were ensured, and all ethical principles were adhered to. FINDINGS: Eighty percent of risk assessments were performed by nurses not licensed or enrolled to perform this task unsupervised. Areas such as tissue malnutrition, neurological deficits, and medication were inaccurately scored, resulting in 50% of the Waterlow risk-assessment scales, as an example, being incorrectly interpreted. This has implications for quality nursing care and might put the patient and the institution at risk. CONCLUSIONS: Lower-category nurses and student nurses should be allowed to perform only tasks within their scope of practice for which they are licensed or enrolled. Nurses with limited formal theoretical training are not adequately prepared to perform tasks unsupervised, even in the current global nursing shortage scenario. CLINICAL RELEVANCE: To optimize and ensure safe and quality patient care, risk assessments should be done by a registered professional nurse, who will then coordinate the nursing care of the patient with the assistance of the lower category of nurses.

Workplace wellness for HIV/AIDS-affected nurses in South Africa.

PURPOSE: The development of a framework for a workplace wellness programme for HIV/AIDS infected and/or affected nurses in South Africa, who comprise registered nurses and midwives, enrolled staff nurses and auxiliary nurses. RESEARCH OBJECTIVES: To identify and describe components for a framework of a workplace wellness programme. BACKGROUND: Registered nurses and midwives, enrolled staff nurses and auxiliary nurses (referred to as nurses) in the South African nursing workforce are confronted daily with HIV/AIDS in the workplace due to the high HIV/AIDS prevalence rate among sexually and economically active adult women between 15-49 years of age. The research explains how health and wellness could be promoted by instituting a workplace wellness programme. RESEARCH DESIGN: Quantitative descriptive research. FINDINGS: The nurses emphasised the threat of HIV/AIDS and considered a workplace wellness programme a priority. CONCLUSION: A logic model underpinned the workplace wellness programme framework.

Family-centred care in the paediatric intensive care unit.

AIM: The aim was to assess emotional support given to mothers of children in intensive care units (ICUs) and make recommendations to nurse managers regarding family-centred nursing care in paediatric ICUs in South Africa. BACKGROUND: Family-centred care is an essential component of paediatric care. Nurse managers should enhance implementation and sustainability to ensure quality care. METHODS: A quantitative descriptive research design was used. Structured interviews using questionnaires were conducted with 62 mothers whose children were nursed in ICUs in Bloemfontein. FINDINGS: Fifteen stressors for mothers were identified and emotional support for mothers in ICU's was assessed and described. Analysis indicated that COPE (Creating Opportunities for Parent Empowerment) can be used within the South African context to enhance family-centred paediatric nursing care. CONCLUSION: Competencies of nurse practitioners and other staff involved must be improved and the seriousness and importance of emotional support as part of family-centred care should be emphasized. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should take responsibility for the training of staff in implementing COPE as a possible empowerment programme in Paediatric ICUs to ensure that emotional support is not neglected.