Relationship of nurses' intrapersonal characteristics with work performance and caring behaviors: A cross-sectional study.

This study aimed to describe intrapersonal characteristics (professional values, personality, empathy, and job involvement), work performance as perceived by nurses, and caring behaviors as perceived by patients, and to examine the relationships among these variables. A cross-sectional design was employed. A sample was recruited of 218 nurses and 116 patients in four private hospitals and four public hospitals. Data were collected using self-report measures. Data analysis included descriptive statistics, exploratory and confirmatory factor analyses, hierarchical linear modelling, correlations, and structural equation modeling. Nurses perceived their work performance to be of high quality. Among the intrapersonal characteristics, nurses had high scores for professional values, and moderately high scores for personality, empathy and job involvement. Patients perceived nurses' caring behaviors as moderately high. Professional values of nurses were the only selected intrapersonal characteristic with a statistically significant positive relationship, of practical importance, with work performance as perceived by nurses and with caring behaviors as perceived by patients at ward level. Managers can enhance nurses' work performance and caring behaviors through provision of in-service training that focuses on development of professional values.

Nurse prescribing and dispensing in South Africa: Gaps in the current legislative framework.

Background: Nurse prescribing and dispensing are central to ensuring universal health access in South Africa. Objective: To describe the historical development of the legal enablements of nurse prescribing and dispensing in South Africa and highlight gaps in the current legislative framework. Method: This is a discussion article. Results: We emphasise significant deficiencies in the current legislative landscape that pose challenges to these vital nursing practices and call for urgent revisions of the legislative framework, particularly the revision of Section 56 of the Nursing Act (33 of 2005) and its related regulations, to formalise authorisation of specialist nurse prescribers in public and private practice. This will also entail an application to the South African Health Products Regulatory Authority (SAPHRA) for the scheduling of substances by authorised nurse prescribers in the defined professional nurse and specialist nurse categories by the Minister of Health. Conclusion: There is a necessity for prompt legislative revisions to address identified deficiencies. Contribution: The contribution of this article lies in its advocacy for changes to the regulatory framework to further enable nurses to deliver safe and comprehensive health care.

Ten years of nurse-initiated antiretroviral treatment in South Africa: A narrative review of enablers and barriers.

BACKGROUND: The roll out of nurse-initiated and managed antiretroviral treatment (NIMART) was implemented in 2010 by the National Department of Health (NDoH) in South Africa in response to the large numbers of persons living with HIV who needed treatment. To enable access to treatment requires shifting the task from doctors to nurses, which had its own challenges, barriers and enablers. OBJECTIVES: The aim of this narrative is to review content on the implementation of NIMART in South Africa over the period 2010-2020, with a focus on enablers and barriers to the implementation. METHOD: A comprehensive search of databases, namely, PubMed, Google Scholar and Cumulative Index to Nursing and Allied Health Literature (CINAHL), yielded qualitative, quantitative and mixed-method studies that addressed various topics on NIMART. Inclusion and exclusion criteria were set and 38 publications met the inclusion criteria for the review. RESULTS: Training, mentorship, tailored tuberculosis (TB) and HIV guidelines, integration of services and monitoring and support have enabled the implementation of NIMART. This resulted in increased knowledge and confidence of nurses to initiate patients on antiretroviral treatment (ART) and decreased time to initiation and loads on referral facilities. Barriers such as non-standardised training, inadequate mentoring, human resource constraints, health system challenges, lack of support and empowerment, and challenges with legislation, policy and guidelines still hinder NIMART implementation. CONCLUSION: Identifying barriers and enablers will assist policymakers in implementing a structured programme for NIMART in South Africa and improve access, as well as the training and mentoring of professional nurses, which will enhance their competence and confidence.

Improving access--an innovative model.

PURPOSE: To present a model of health care delivery in South Africa that made health care services accessible and affordable to members of the community who do not have medical insurance. DATA SOURCES: Statutes and laws governing the practice of health care professionals in South Africa, published professional guidelines, local research data, and the author's experience of the model of health care delivery. CONCLUSIONS: The innovative and visionary approach of a few health care professionals has established a model of health care delivery specifically suited to their community's needs. This model of service delivery has provided an affordable and accessible health service to members of the local community, who have indicated their satisfaction with the service. IMPLICATIONS FOR PRACTICE: Economic and legal barriers to accessible and affordable health care services can be overcome to ensure that health care is available to the whole population. The nurse practitioner has an important role to play in making health care affordable and accessible to the community.

Legislative issues impacting on the practice of the South African nurse practitioner.

PURPOSE: To present an overview of the impact of the nurse practitioner (NP) on the South African health care arena and describe the legislative framework for NP practice. DATA SOURCES: Statutes and laws of the government of South Africa; published professional guidelines; authors' experiences. CONCLUSIONS: The key challenges for NPs in South Africa lie in lobbying for enabling legislation, obtaining access to education and training opportunities, and managing risks within the rapidly changing environment. IMPLICATIONS FOR PRACTICE: Some aspects of the NP's accountability and responsibilities have as yet not been adequately addressed in the current legislative framework and will certainly increase the risk for malpractice. South African NPs will have to establish partnerships with important role players, not only in South Africa, but also internationally, to ensure that an enabling environment for quality health services is created.