Influence of work-related stress on patient safety culture among nurses in a tertiary hospital: a cross-sectional study.

BACKGROUND: One of the global issues facing the nursing profession is work-related stress because it interferes with care quality and organisational competency. These kinds of stressful situations can cause damage to the mental ability of the affected individual resulting in low job productivity. In a Nigerian healthcare setting, patient safety is under-researched. AIM: This study aimed to assess the influence of work-related stress on patient safety culture among nurses in a tertiary hospital. MATERIALS AND METHODS: The study adopted a descriptive cross-sectional survey. The Population of the study was nurses who are currently serving as employees at Federal Medical Center Birnin-Kebbi. Proportional and systematic sampling methods were used in the selection of the sample of the study. The tools used for this study were adapted Hospital Survey on Patient Safety (HSOPS) and Nurses' Occupational Stressor Scale. Ethical approval was obtained from the research ethical committee of the hospital. RESULTS: The moderate stress experience was having the highest percentage (45.0%). The highest percentage of the nurses (69.9%) practised a moderate safety culture. There were weak or very weak significant negative correlations (P < 0.01) between patient safety culture practices and occupational stress across all the subscales of the nurses' occupational stressors scale except in the occupational hazards subscale in which there was extremely weak and non-significant negative correlation. Work-family conflict was a significant predictor of patient safety culture, t (208) = -2.341, P < 0.05. Difficulty in taking leave was a significant predictor of patient safety culture, t (208) = -2.190, P < 0.05. CONCLUSION: There was a significant negative correlation between stress and safety practice which implies that as stress increased safety practice decreased. These study findings can be used to develop ongoing strategies and targeted interventions in addressing work-related stress.

Exploring the barriers to Registered Nurses undertaking clinical teaching in clinical settings: A qualitative descriptive study.

AIM: The study aimed to explore and describe the barriers affecting Registered Nurses in undertaking clinical teaching in clinical settings. The exploration was based on the experiences of Registered Nurses at a selected teaching hospital in Namibia. The researcher intended to identify strategies that could be used to mitigate the negative effects of barriers to effective clinical teaching. DESIGN: A qualitative explorative, descriptive and contextual research design was used. METHODS: Purposive sampling was used to select 16 participants. Data were collected through in-depth, semi-structured interviews, which were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis. RESULTS: Clinical teaching is negatively affected by several barriers that hamper clinical teaching and nursing students' learning outcomes. Seven main themes were identified: (1) participants' understanding of clinical teaching; (2) organizational barriers; (3) patient barriers; (4) Registered Nurse barriers; (5) student barriers; (6) training institution barriers; and (7) strategies to mitigate barriers to clinical teaching. CONCLUSION: The findings revealed that several barriers negatively affect clinical nursing education and hamper the clinical teaching and learning of nursing students. PATIENT OR PUBLIC CONTRIBUTION: This study may assist in the development of targeted interventions that address the barriers that hinder clinical teaching at teaching hospitals. Additionally, this study could assist in improving the health care that is provided by nursing students to patients. The findings may assist with improved quality by reducing nursing students' theory-practice gap and by promoting collaboration between Registered Nurses and nurse educators in clinical settings.

Nutritional knowledge and practices of mothers with malnourished children in a regional hospital in Northeast Namibia.

Background: An estimated 159 million children under five are affected by malnutrition, with an additional 101 million children under five being underweight in sub-Saharan Africa. In Namibia, 24% of children under age 5 are stunted and 8% are severely stunted. The Kavango region has the highest rate of stunting (38.8%) in the country. Objective: The purpose of the study was to determine and describe the nutritional knowledge and practices of mothers with malnourished children regarding feeding at Rundu Intermediate Hospital, Kavango East Region, Namibia. Materials and Methods: A quantitative cross-sectional research design was used. A convenience sampling technique was used to select 199 mothers with malnourished children who were admitted to the pediatric ward. Data were collected via self-administered questionnaires with closed-ended questions. Results: 51.8% of the mothers had correct nutritional knowledge regarding breastfeeding for six months before giving other food, and 74.4% believed that newborns should be initiated to breastfeeding within an hour after birth, while the same number breastfed their babies on demand. Furthermore, 35.6% of the participants followed appropriate practices regarding feeding. Conclusions: Most mothers (51.8%) had appropriate nutritional knowledge. However, only a minority (35.6%) of the mothers had the appropriate practices regarding feeding their children. Hence, there was a knowledge/practice mismatch regarding the significance of exclusive breastfeeding during the first six months, and generally the vitality of breast milk to the child. These findings may be used to develop strategies and target interventions to create awareness among mothers regarding effective breastfeeding practices.

Factors associated with caesarean sections among pregnant women admitted to a private academic hospital in Ongwediva, Oshana region, Namibia.

Background: Caesarean section rates are increasing worldwide in both developed and developing countries becoming an issue of grave concern. Objective: The aim of the study was to determine the factors associated with caesarean sections performed on pregnant women admitted to a private academic hospital in Ongwediva, Oshana region, Namibia. Materials and Methods: A retrospective data approach was conducted on 200 patients' files using a self-administered checklist at a private academic hospital. A total of 200 records of mothers who underwent caesarean sections were systematically reviewed from January 2020 to December 2020 at a private academic hospital in Ongwediva, Namibia. A pretested structured checklist was used to record the data. Results: The study revealed that 95.5% of women who had caesarean sections (C-section) were performed. A previous C-section was the most frequent indication, while 0.5% were performed due to patient requests. The p-value for the chi-square statistic was smaller than the standard alpha value (P<0.05), i.e., there is a relationship between the demographic characteristics and factors associated with caesarean sections, as well as between socioeconomic factors and factors associated with caesarean sections. Conclusions: This study shows that 95.5% of C-sections are done as a necessity with clear indications, while only 0.5% are done due to patient requests. This study's findings can be used to develop strategies and targeted interventions geared towards reducing the increasing rates of cesarean section considering maternal age, the number of indications of primary cesarean delivery, and following standard operating procedures that might improve the quality of prenatal and delivery care.

Nursing students' experiences of communication in a multilingual and multicultural clinical environment: A qualitative study.

AIM: The aim of this study was to investigate nursing students' experiences of communication in a multilingual and multicultural clinical environment. BACKGROUND: Effective communication in a healthcare setting plays a crucial role in patient care. Yet, since universities, globally, have experienced an increase in the enrolment of both local and international students in various degree programmes, student populations have become increasingly multilingual and multicultural. This study was conducted in a multilingual country where many languages are not spoken by all citizens, which results in nursing students experiencing varied outcomes. DESIGN: A qualitative, explorative, descriptive research design was used. METHODS: Sixteen nursing students enrolled in either the Bachelor of Nursing Science (Clinical, Honours) or the Diploma in Nursing Science. Data were collected by means of in-depth, semi-structured interviews with a sample of 16 nursing students who were selected through convenience sampling. Data were analysed using thematic analysis. RESULTS: The study revealed four themes: aspects that complicate communication; interesting aspects about communication; the need for communication assistance; and the need for policy intervention, which is key to addressing challenges in multilingual clinical environments.

Barriers and Facilitators Affecting the Uptake of COVID-19 Vaccines: A Qualitative Perspective of Frontline Nurses in Namibia.

Aim: Vaccinations remain one of the most effective measures to prevent and control the spread of COVID-19, while also reducing hospitalizations and deaths, yet many are unwilling to be vaccinated. This study explores the barriers and facilitators affecting the uptake of COVID-19 vaccines among frontline nurses. Design: A qualitative, explorative, descriptive, and contextual research strategy was employed. Methods: A sample of 15 nurses were selected via purposeful sampling to the point of data saturation. The participants were nurses at the COVID-19 vaccinations Centre in Rundu, Namibia. Data were collected using semistructured interviews and analyzed thematically. Results: Three themes and 11 subthemes were identified, namely: (a) barriers, (b) facilitators, and (c) measures to increase the COVID-19 vaccine uptake. Barriers included living in deep rural areas, unavailability of vaccines, and misinformation, whereas scared of death, availability of COVID-19 vaccines, and family influence and peer pressure emerged as facilitators to the uptake of COVID-19 vaccines. Adoption of vaccination passport as a requirement to work premises and as an international travel requirement were the measures proposed to increase the COVID-19 vaccine uptake. Conclusion: The study found several facilitators and barriers to COVID-19 vaccine uptake among frontline nurses. The identified barriers cover the individual, health system, and social factors hindering the COVID-19 vaccine uptake among frontline nurses. Whereas fear of COVID-19 deaths, family influence, and availability of vaccines were found to promote COVID-19 uptake. This study recommends targeted interventions to improve the uptake of COVID-19 vaccines.

Factors contributing to burnout among nurses at a district hospital in Namibia: A qualitative perspective of nurses.

AIM: The aim of this study was to explore and describe the factors that contribute to burnout among nurses. BACKGROUND: Burnout remains one of the major occupational health problems, posing risks to human health globally. In Namibia, there has been growing public criticism of nurses, stating that they are rude or act in a manner that does not show professionalism towards their clients. Reasons for such unprofessional behaviour could be linked to negative attitudes on the part of nurses towards their clients, resulting from burnout syndrome. METHOD: A qualitative, exploratory, descriptive and contextual research design was followed as the basis for conducting the study. Using a purposive sampling technique, a sample of 20 nurses was selected from a population of 69 nurses employed in this setting. This sample size was determined by the saturation of data as reflected in repeating themes. Data were collected using individual semi-structured interviews and were analysed using qualitative thematic analysis. RESULTS: The following three themes emerged: understanding the concept of burnout, factors leading to burnout and creating a conducive environment as a corrective measure to address burnout and to advance nurses. CONCLUSIONS: Burnout is indeed real and affects nurses' performance negatively. Burnout has a negative impact on the well-being of nurses both physically and emotionally, which has the potential to compromise staff performance, productivity and the quality of patient care. Burnout among nurses is linked to many stressors such as poor staff management, inadequate resources, lack of support and lack of wellness programmes in the workplace. IMPLICATIONS FOR NURSING MANAGEMENT: Strengthening communication between frontline health workers and management by engaging and involving them more in decision making in matters that concern them is anticipated to address poor staff management, enhance staff performance and improve the quality of patient care. Staff wellness programmes in the workplace are believed to be a good coping mechanism to address work-related pressure and tensions, and they are believed to resolve some work-related stress that may result in increased staff productivity.

A qualitative descriptive enquiry of nursing students' experiences of utilising a portfolio as an assessment tool in nursing and midwifery education.

BACKGROUND: The use of a portfolio as an assessment tool in nursing and midwifery education is still a relatively new phenomenon. Institutions of higher education should therefore continuously explore the experiences of nursing students in the use of a portfolio in clinical nursing education. In Namibia little research exists on the perspectives of nursing students on the use of a portfolio as an assessment tool. PURPOSE: The purpose of the study was to explore nursing students' experiences with portfolio as an assessment tool in nursing and midwifery education. METHOD: The study used the qualitative approach, with an explorative, descriptive, and contextual design. Fifteen (15) undergraduate nursing students participated in this study, using a snowball sampling technique. Data was collected through semi-structured interviews. Data was analysed using thematic analysis for recurring themes. RESULTS: The following four themes emerged: understanding of a portfolio, positive experiences, negative experiences, and effective portfolio utilisation. CONCLUSION: The results revealed nursing students' positive and negative experiences, with suggestions for improvement. The findings may help identify strengths and weaknesses in portfolio usage for assessment purposes in nursing and midwifery education. This study recommended well-articulated plans and actions from students, clinical instructors, lecturers, faculty management teams, and the nurses in practice facilities, to address the challenges identified.

Knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at a regional hospital in the north east of Namibia.

BACKGROUND: In sub-Saharan Africa, over 1,000 newborns are infected with HIV every day, despite available medical interventions. Mother-to-child transmission (MTCT) remains one of the primary sources of HIV infection in children and without interventions 40% of babies born from HIV-positive mothers would be infected with the virus. It is estimated that 300 000 children become infected with HIV worldwide, whilst 1.5 million children die when their mothers opt for other choices instead of breastfeeding. OBJECTIVE: The purpose of the study was to assess and describe the knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at Rundu Intermediate Hospital, Kavango East Region in Namibia. METHOD: The study was a descriptive cross-sectional survey that used convenience sampling, as the researcher sought to use subjects available during the time of study to select 79 HIV positive mothers. RESULTS: Participants in this study (94%; n=51) had good knowledge of the benefit of exclusive breastfeeding and that the benefits of breastfeeding outweigh the risk of HIV transmission from mother to child. The results confirmed that (77.2%; n=42) of the mothers opted to take ART with the babies until they stop breastfeeding. CONCLUSION: HIV positive mothers had good knowledge, attitudes and practices regarding the benefits of exclusive breastfeeding. A significant number of mothers were, however, not sure about breastfeeding exclusively for 6 months as they would stop if offered free formula milk for the baby. Support by the fathers and others in the community is vital.