Theses and dissertations (Health Sciences)
Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12
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Item The knowledge, attitudes and practices of health care workers regarding the occupational exposure to blood and bodily fluids in a public hospital, KwaZulu-Natal(2023-05) Govender, Nakita; Ghuman, Shanaz; Niranjan, IvanThe risk of exposure to BBF amongst health care professionals may be considered a consequential yet vastly unexplored field of study in the medical setting, particularly in the developing world. In South Africa, knowledge and practices to safeguard health care workers (HCWs) from blood borne infections (BBI) proved substandard in necessitous health care facilities. Ideally, hospital management should be provided with data to guide and inform procedures for prevention and control for potential infections arising in the work environment. An extensive review of South African literature showcased finite research data published on blood and bodily fluid (BBF) exposures and factors affecting infection prevention and control (IPC). In the KwaZulu Natal province, knowledge, attitude and practices (KAP) of HCWs, regarding occupational exposure to BBF, as well as the HCWs perceptions on the barriers to IPC, in a public hospital, has yet to be studied, with no recently published research encountered thus far, in South Africa. This study aimed to evaluate the KAP of HCWs regarding occupational exposure to BBF in a public hospital of KwaZulu-Natal. An institutional based, observational-descriptive cross-sectional study with a quantitative approach was conducted, in order to determine the association between the knowledge and attitudes of HCWs and behavioral risks for occupational exposure, as well as the perceptions of HCWs, on the barriers to IPC in a public hospital of KwaZulu Natal. This study utilised a simple-random sampling technique from a total number of 199 HCWs. The minimum sample size was calculated at 166, by a statistician, in which the margin of error is set at 5%. This study found a correlation between profession as well as work department and risk of exposure to BBF. Level of education was found to play a significant role in HCW knowledge of PEP. Work practices were found to greatly influence the likelihood of an NSI. Post exposure prophylaxis amongst a substantial amount of HCWs who did experience an accidental exposure, was distressingly low. Underreporting seemed to have been associated with profession. The age of the respondents did play a significant role in terms of the needle recapping practices of HCWs, with the middle age category between 36 to 40 years most often engaged in needle recapping behaviour. As per the active belief of the HCWs themselves, lack of knowledge, feedback on monitoring and training on IPC, as well as lack of availability of infection prevention and control guidelines were considered to be barriers to IPC in the hospital. Respondnets in this study also displayed a potential lack of awareness on the infrequent or absence of regular infection prevention and control committee meetings. Additionally, more than half of the total sample exhibited complete ignorance in terms of cost requirements for IPC interventions as a likely impedance of IPC. A disquieting amount of HCWs were found to have received training more than 24 months ago which deviated from the recommended annual refresher training as per the Occupational Health and Safety Act (No. 85 of 1993).Item Exploring the working environment of enrolled nursing auxiliaries in private hospitals in the eThekwini District(2020-10) Ramiah, Vanitha; Ngxongo, Thembelihle Sylvia Patience; Naidoo, V.Background: The nursing professionals are recognised worldwide as being critical to the delivery of high quality, efficient nursing management and patient care in the healthcare services. However, shortage of skilled nurses in most countries, including South Africa, has led to an overburdened healthcare system with certain nursing categories doing much more than they are trained to do. The enrolled nursing auxiliaries (ENAs) are junior members of the nursing team who, on completion of a one-year basic nursing certificate programme, work either in public or private healthcare sectors. Aim of the study: The aim of the study was to explore the working environment of ENAs, in private hospitals in the eThekwini District, KwaZulu-Natal, South Africa. Methodology: An exploratory descriptive design was used. Data was collected by in-depth one-on-one interviews with ENAs, Registered Nurses (RNs) and Unit Managers (UMs) working in the medical and surgical units of the selected healthcare institutions and were analysed using Tesch’s method of data analysis. Findings: Three major themes that emerged from the data analysis were a) working experiences of the ENA, b) challenges experienced by the ENA, c) supervision of the ENA. This study found that due to the shortage of skilled nurses in the country, brain drain and cost containment in the private health sector, the dynamic healthcare environment resulted in ENAs endangering their professional status by functioning out of their scope of practice and performing a role for which they were never intended or academically prepared. The ENAs under study were dissatisfied by a lack of clear career development pathways from the private healthcare group to assist them with transitioning to the next level of qualification. They also felt that they were not recognised or rewarded for their contributions to nursing. Conclusion The private healthcare group under study should, as a priority, communicate to ENAs the plans for career development and funding which will allow ENAs to undertake training to the next level of qualification. The nursing agency utilisation should decrease from 40% to the benchmark of 25% to ensure sufficient numbers of skilled staff are working in the general nursing units. The emphasis by nursing leadership must be on teamwork to build a motivated workforce.Item Experiences of health care workers regarding maintenance of confidentiality concerning hearing challenged people in selected public health settings in eThekwini District, KwaZulu-Natal(2020-06-10) Dlamini, Snenhlanhla Kelly; Sibiya, M. N.Background Communication between a health care provider and a patient is a pre-requisite for any intervention to occur in the process of health care. Deaf patients depend on interpreters when seeking health care. Confidentiality is an issue since interpreters are involved in the Deaf community. Health care workers (HCWs) are tasked to ensure that the delivery of information to the patient is accurate and kept confidential. Aim of the study The aim of the study was to explore and describe the experiences of HCWs regarding maintenance of confidentiality concerning hearing challenged people in selected public health settings in eThekwini District, KwaZulu-Natal in South Africa. Methodology A descriptive exploratory qualitative design was used in this study. The study population comprised health care workers who worked with hearing challenged patients. Purposive sampling, which is a type of non-probability sampling, was used to select the study participants from the population. Structured interviews, using an interview schedule, were used to collect data. Data was collected until data saturation was reached. Data was analysed using Tesch’s eight steps of thematic analysis. Findings Six major themes that emerged from the data analysis were (a) training of health care workers, (b) communication preferences for hard of hearing patients, (c) communication challenges, (d) health care worker-patient relationship, (e) involvement of family members as interpreters and (f) measures to maintain confidentiality. The findings revealed that the majority of participants experienced communication challenges with patients who are hard of hearing since only few HCWs are trained in sign language. Conclusion The findings of this study will contribute to addressing issues related to the maintenance of confidentiality of hard of hearing patients. This study does not claim to exhaust the subject but to raise awareness of new investigations in other realities. Further research in the larger representative population of HCWs and hard of hearing patients is necessary to make the health care system more accessible and communication with HCWs more satisfying and effective. A doctoral study is necessary to develop a practice framework to facilitate communication between hard of hearing patients and HCWs.