Nursing Science

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    Experiences of community service nurses and unit managers in a rural public hospital in Zululand district, Kwazulu-Natal province
    (University of Zululand, 2022) Jiyane, Jabulisiwe Gertrude
    Introduction Community Service Nurses function under the Nursing Act No. 33 of 2005 and South African Nursing Council Regulation R765 of 24 August 2007. In South Africa, all nursing graduates who are citizens of South Africa should perform remunerated community service for one year, in public healthcare facility. The period of transition from being a student nurse to becoming a qualified professional nurse is often stressful. The nurses surfing through this transition sometimes feel inadequately prepared for the clinical environment. Purpose of the Study The purpose of the study is to explore and describe the experiences of the community service nurses in the rural public hospital located in a rural area during their one year period of community service. Methodology A qualitative, explorative, descriptive, and contextual research design was conducted, using semi- structured interviews with (5) five Unit Managers and (8) eight Community Service Nurses. Purposive sampling was used. Data were analysed using thematic method of content analysis. Results Five themes and sub-themes emerged, the key themes being: inadequate human and material resources, supportive learning environment, and management of a clinical unit, allocation to nursing units and experience or role taking in leadership. Conclusion The community service nurses received inadequate supervision and support by experienced professional nurses in the various nursing units due to staff shortages. The challenge limited the CSNs’ opportunities to acquire clinical skills and competencies for delivery quality care to patients.
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    Perceptions of pregnant women regarding their attendance of antenatal care at selected clinics in the Umzinyathi District Municipality Kwazulu-Natal
    (University of Zululand, 2022-12) Mathaba, Noxolo Thule
    Introduction and Background Attendance of Antenatal Care (ANC) remains prioritised by health care workers and pregnant women in general, as it serves to maintain a healthy pregnancy and positive pregnancy outcomes. Aim of the study The aim of the study was to explore perceptions of pregnant women regarding their attendance of antenatal care in the UMzinyathi district municipality how they perceive it and discover the driving/ influencing factors behind ANC attendance. Methodology and Design A qualitative approach was used. The study used the In-depth interview method to interview pregnant women attending ANC at 3 clinics in UMzinyathi district municipality. Data collection was conducted through in-depth interviews. Purposive sampling was used to conduct in-depth interviews with 16 pregnant women attending ANC at the clinics. Data Analysis Themes emerged revealed certain factors that influenced attendance pregnant women to attend ANC. These themes addressed various notion of perceptions pregnant women which include the following: The first theme was (i) protection of the baby and the mother; (ii) knowledge benefits regarding fetus and pregnancy related to pregnant women attending to gain knowledge about their state of pregnancy. (iii) Reasons for attending ANC; (iv) Delays in ANC attendance. Recommendations Pregnant women should be educated in their communities about the importance of early booking of ANC. Benefits of antenatal care and educating pregnant women on the purpose of ANC to improve attendance of ANC should be emphasised. Midwives should provide health education on importance of attending ANC according to BANC model. Other recommendation include use Mobile clinics for women who do not have the time to go to the clinics as well use of outreach team campaigns to raise awareness about importance of early booking and attendance according to BANC model. Conclusions The study findings revealed that although pregnant women who attended ANC, did it for the wrong reasons, and they lacked the knowledge on the benefits of ANC. Health care workers also play their part in negatively influencing ANC attendance through malpractice. A number of factors and determinants of ANC attendance showed that there are still a lot of strategies that need to be introduced to encourage pregnant women to attend ANC. Pregnant women already attending ANC need further education to provide them with knowledge on the purposes of ANC services. Further research is required to develop health literacy.
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    Person-Centred caring towards improvement of diabetic foot care compliance in rural primary health care, KwaZulu-Natal
    (University of Zululand, 2022-12) Joubert, Anné Suzanne
    BACKGROUND The five-year mortality rate after a diabetic diabetic is higher than 40% globally. In KwaZulu-Natal, 2500 diabetic foot amputations are carried out per year. Only 7.8% of patients with diabetes undergo foot examinations within KwaZulu-Natal public health, while 90% are not educated about foot care. Person-centredness and caring can potentially improve foot care outcomes for patients with Type 2 Diabetes Mellitus. AIM & OBJECTIVES This study aims to identify how registered nurses could achieve person-centred caring to improve diabetic foot care compliance in the rural primary healthcare context in KwaZulu-Natal. The objectives of the study were to: determine the experiences of patients with Type 2 Diabetes Mellitus regarding person-centred caring in the management of foot care. To describe the experiences of registered nurses regarding person-centred caring in the management of diabetic foot care. To explore current practices of registered nurses regarding diabetic foot care. To compare data from in-town clinics to out-of-town clinics and develop a person-centred caring, guideline-based in-service training programme for registered nurses in the management of diabetic foot care. METHODOLOGY A mixed-method-convergent design was used for the study. The rural King Cetshwayo district was stratified according to subdistrict and in-town versus out-of-town. One in-town clinic and two out-of-town clinics were selected from each sub-district for data collection. Interviewed surveys were conducted with 376 patients with Type 2 Diabetes Mellitus to determine their experiences of person-centred caring, in foot care management at the primary healthcare clinics. During the qualitative strand of the study, 18 semi-structured interviews were conducted with registered nurses working at primary healthcare clinics. Qualitative content analysis was used to analyse the semi-structured interviews. FINDINGS The central theme of the study is that the registered nurses feel they are nursing the queues. They feel patients with Type 2 Diabetes Mellitus and their foot care gets neglected. As a result, these patients don’t attend clinics and relatives are sent to collect medication. Registered nurses are rushing to “push” the long queues of integrated chronic patients. Nursing care gets neglected due to staff shortages, non-conduciveness of facilities and a lack of training. In the quantitative data, the patients with Type 2 Diabetes Mellitus significantly disagreed that nurses were competent in managing diabetic foot care. The competence was a significant predictor of diabetic foot problems, which suggests that when diabetic foot problems arose, registered nurses became more competent. Even though patients significantly disagreed that nurses were competent in managing diabetic foot care, they significantly agreed that they are cared for with compassion. RECOMMENDATIONS AND CONCLUSION The data supports that diabetic foot care was only done when problems arose and that currently there is no preventative diabetic foot care. There is a need for an in-service training programme that considers the district’s rurality. This training will have to equip registered nurses with the knowledge to implement person-centred caring while managing the foot care of patients with Type 2 Diabetes Mellitus.
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    Experiences of Clinical Instructors in Using High Fidelity Manikins to Teach Student Nurses at the Selected Higher Education Institution in KwaZulu-Natal
    (University of Zululand, 2021-12) Mbambo, Jabulile
    Introduction In the past, student training during clinical practice has been conducted on live humans with minimum use of manikins to equip students with clinical skills required in the education of a nurse. The advancement of medical technology has brought major changes in the clinical training of student nurses through the introduction of high fidelity manikins (HFM). This transition has brought various challenges to clinical instructors. Aim of the study The aim of the study was to explore and describe the experiences of clinical instructors’ use of HFMs to teach the student nurses at higher education institutions (HEIs) in KwaZulu-Natal. Methodology A qualitative research methodology was used for the study. The research study was guided by the National League of Nurses/Jeffries Simulation Framework (NLN/JSF). Data was collected from 10 participants using unstructured individual face-to-face interviews which were purposefully selected. Data collection was determined by data saturation and analysed thematically. Findings The study revealed four major themes: use of HFMs, staff in-service and training, environmental factors, and maintenance of resources. In addition, various sub-themes emerged. The study findings revealed that clinical instructors faced various challenges in using HFMs to teach clinical practice to student nurses at HEIs. Conclusion and recommendations of the study Clinical instructors are faced with various challenges in using HFMs to teach student nurses. These challenges range from human and material resources and technical knowledge, to infrastructural problems. Therefore, several recommendations are made with regard to nursing education institutions, nursing education administration, and policy development and implementation. Moreover, further research is recommended to be conducted about the phenomenon. Key words: Manikin; High Fidelity; Simulation; Clinical Practice; Clinical Instructor.
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    Malaria education provided by midwives and nurses to pregnant women attending antenatal clinics within Tarkwa Nsuaem municipal assembly, Western region, Ghana
    (University of Zululand, 2021) Amoah, James Mckeown
    It is estimated that about 3.4 billion people living in 92 countries of the world are at risk of malaria infection. In 2018, WHO Africa Region accounted for 93% of global malaria cases and 94% of malaria deaths. Pregnant women in these malaria prone countries are more likely to get infected with malaria, suffer severe complications and unfortunately die from the disease, than any other group of people. In Sub-Saharan African countries like Ghana, health education forms an integral part of the methods used in the implementation of malaria control interventions. This research therefore sought to discover the malaria education midwives and nurses provide to pregnant women attending antenatal clinics within Tarkwa Nsuaem Municipal Assembly in Ghana. A cross sectional descriptive quantitative research design was used with a sample size of 356 participants using stratified random sampling method. TNMA was divided into two (2) zones and two (2) health facilities with the highest antenatal attendance were selected purposively. Pregnant women from these health facilities who met the inclusion criteria were randomly selected. These pregnant women completed a self-completion questionnaire after signing the consent form. The data collected were analysed using SPSS 16.0. Most (95.8%) of the pregnant women had heard of malaria through Home/family members, Hospital/antenatal clinics, and Television as their top three sources of malaria education. The respondents’ malaria knowledge was high. The malaria health education is provided anytime they visit the antenatal clinic and includes their husbands and partners. Topics covered in the education were causes, symptoms, diagnosis, first aid, treatment, and prevention of Malaria. It is recommended that learning aids especially pictures and videos should be used during the education to make it exciting. Also, husbands and partners should be involved in the education to improve compliance to malaria education.
University of Zululand