Faculty of Health Sciences
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Item Exploring factors influencing patient safety incident reporting by nurses in primary health care facilities in King Sabata Dalindyebo sub-district, Eastern Cape(2024) Tolobisa, Patiswa; Naranjee, N.; Moonsamy, S.Patient incident reporting is a crucial activity for enhancing healthcare standards and ensuring patient safety. Reporting patient safety incidents offers a comprehensive overview of incidents, detailing what occurred and how it happened, thereby facilitating learning and improvement. The study identified several factors influencing patient safety incident reporting, including a lack of understanding of incident reporting, a blame culture, minimal support by managers, a lack of training, inadequate facilities, a lack of feedback and debriefing, and the absence of rewards and punishment system. A necessary positive activity to improve health care standards and patient safety is patient incident reporting. Patient safety incidents provides a broad picture of what has happened, how it happened and facilitates learning. AIMS AND OBJECTIVES OF THE STUDY The aim of the study was to explore and describe factors influencing the reporting of patient safety incidents in primary health care facilities from nurses’ viewpoints. The objectives were to explore factors influencing PSI reporting behaviours in primary health care facilities in King Sabata Dalindyebo sub-district, OR Tambo District, Eastern Cape, to explore nurses’ knowledge and understanding of PSI reporting, and to provide recommendations for improving PSI reporting. METHOD In this study, a qualitative, exploratory, descriptive design assisted the researcher in exploring the factors influencing reporting of patient safety incidents by nurses in primary health care facilities. The target population was all 48 nurses permanently employed in the primary health care facilities in Mqanduli cluster, King Sabata Dalindyebo. A non probability, purposive sampling method was used to select the participants for the study, where 10 nurses were interviewed as determined by data saturation. Individual interviews were conducted using semi-structured interviews in English based on an interview guide which lasted for 15-20 minutes for each participant. The data was analysed using the thematic data analysis method. FINDINGS Five themes emerged from the thematic analysis, with 19 subthemes. Themes were: (1) Experiences of patient safety incident reporting, (2) contributory factors to patient safety incidents, (3) importance of patient safety incident reporting (4) barriers to PSI reporting, and (5) recommendations by participants.The reporting process for patient safety is influenced by a number of factors, such as nurses' reluctance to report for fear of punishment, the emphasis placed on unclear reporting systems, management behaviour, lack of training and education, and fear of lawsuits. The experience of implementing patient safety incident reporting necessitates support from management in the form of training and provision of resources, creating a positive work environment and safety culture by not punishing those who make errors, and rewarding those who report patient safety incidents. CONCLUSION The nurses at Mqanduli cluster, King Sabata Dalindyebo Sub-District had challenges regarding the reporting of patient safety incidents due to a number of issues tabled by the participants that were influencing factors to patient safety incidents that should have been prevented such as negligence. The participants proposed recommendations such as development through training of the nursing staff regarding how to report patient safety incidents and provision of resources.Item Framework to mitigate disruptive behaviours involving radiographers at central hospitals in Harare Metropolitan Province, Zimbabwe(2022-09-29) Chinene, Bornface; Nkosi, Pauline Busisiwe; Sibiya, Maureen NokuthulaBackground Disruptive behaviours in healthcare have become an unprecedented global problem, transcending borders, work settings and professional groups. Concerns about their impact on patient safety has led many international medical organisations and other healthcare professions to escalate the urgency of knowing the prevalence, causes and consequences of these unprofessional behaviours in different healthcare settings. Evidence shows that assessing and mitigating disruptive behaviours is critical to empowering health workers to focus on delivering high-quality, cost-effective and safe patient care. However, there is a paucity of literature exploring disruptive behaviours involving radiographers in Zimbabwe. Additionally, there is no written policy to monitor and mitigate disruptive behaviours in the Zimbabwean radiography workforce. The challenge of disruptive behaviours is of significant concern for radiographers because they use radiation that has hazardous effects on living organism cells. Aim The aim of the research was to explore disruptive behaviours involving radiographers and the consequences thereof at central hospitals in Harare Metropolitan Province in order to develop a framework to mitigate these behaviours so that healthy radiography work environments are promoted. Methodology A mixed-methods convergent parallel approach using the parallel databases variant was employed. Disruptive behaviours from 100 randomly sampled radiographers were evaluated using a semi-structured questionnaire. In addition, in-depth interviews were conducted with 11 radiography managers selected by criterion purposive sampling, in order to explore factors and strategies to mitigate these behaviours. Findings Disruptive behaviours involving radiographers in HMP are rampant and create an unhealthy work environment that can lead to compromised patient radiation protection by negatively affecting the implementation of radiation protection protocols or procedures. Cultural and environmental factors relating to disruptive behaviours in Harare Metropolitan Province include a power hierarchy, the work environment and the absence of a reporting framework. Nevertheless, the strategies to mitigate these behaviours may include awareness, willingness to address the behaviours and conflict resolution.Item Handover processes and practices of critically ill patients between nursing staff from the intensive care units of private hospitals in the eThekwini District, KwaZulu-Natal(2022-05-13) Anwar, Deshni; Ngxongo, Thembelihle Sylvia Patience; Naidoo, VasanthrieNursing handover is an integral part of safe patient care in the Intensive Care Unit (ICU).The term handover refers to a nurse taking responsibility and accountability of care from another nurse at the end of the shift and is used interchangeably with terms such as hand-off, handover, sign off, inter-shift report and shift report. Nursing handover can represent a potential risk for patients and health institutions as information during the handover processes can be lost, misinterpreted or miscommunicated. Thus, the process of communication during handover is vital in the fast-paced world of an Intensive Care Unit. Purpose of the study The purpose of this study was to explore handover processes and practices between nursing staff from the Intensive Care Units of private hospitals in the eThekwini district. Methodology A qualitative, exploratory, descriptive design guided the study by implementing the Situation, Background, Assessment and Recommendations (SBAR) framework. In-depth interviews of Intensive Care Nurses were conducted to collect data. Intensive Care Unit trained and experienced Registered Nurses and Enrolled Nurses were interviewed. A total of twenty-two (22) participants were interviewed during the working hours of the participants. Findings The study findings revealed that during handover practices in the Intensive Care Unit communication is the most important component of human interaction and is necessary for the transfer of information from the sender to the receiver. Handover was, however, not consistent in all hospitals and the junior nurses were not given the necessary support and supervision at times, due to the acuity of the patients and the shortage of nurses in the unit. There was no structured handover tool in place to ensure that the process was formalized for all nurses in the Intensive Care Units to follow. Conclusion The study concluded with recommendations made to improve the handover process which included the use of Situation, Background, Assessment and Recommendations (SBAR) framework to ensure that the process is structured, having a team leader free to assist junior staff to ensure the handover runs smoothly, handover processes should be taught in nursing colleges and that nursing management should assist the staff by drawing up a proper handover policy. Further research should be conducted on this topic but in other departments in the hospitals to evaluate how their handover practices are done.