Blended learning: Assessing nursing students' perspectives.

BACKGROUND:  Blended learning combines face-to-face and online learning and has recently gained popularity, accelerated by the coronavirus disease 2019 (COVID-19) pandemic, often without active evaluation. OBJECTIVES:  This study aimed to assess university nursing students' perceptions of a blended learning approach during the COVID-19 pandemic. METHOD:  The population was 150 third-year nursing students from a university in the Western Cape, South Africa, using all-inclusive sampling. A one-group, pre-and post-evaluation study was conducted using a self-administered questionnaire (Student Perceptions of Blended Learning scale). Differences were assessed using Chi-squared and Mann-Whitney U tests with a significance level of p  0.05. RESULTS:  Before implementing blended learning, 128 students (85.3%) completed the questionnaire, while 95 (63.3%) did so after. Demographics and access showed no significant differences between the groups. Post-implementation showed a 10.1% increase in preference for blended learning (χ2 = 2.832, p = 0.092). Ease of use was rated significantly higher before implementation (3.07 ± 0.49), with no significant change post-implementation (2.99 ± 0.58). The blended learning process received lower ratings compared to content, with no significant differences before or after implementation for either (process: 2.55 ± 0.58 vs 2.54 ± 0.63; content: 2.75 ± 0.52 vs 2.79 ± 0.52). CONCLUSION:  Nursing students had a positive perception of blended learning, though the online learning component posed challenges with time and module comprehension.Contribution: The findings can help higher education institutions evaluate existing online management systems and guide nurse educators in meeting students' needs when developing module resources.

A Survey of Nurse Informatics Competencies of Professional Nurses in Clinical Practice Public Hospitals in South Africa.

Competence in Nursing Informatics (NI), is vital for efficient nursing care in today's technologically-enabled healthcare environment. In South Africa, little is known on the competence of professional nurses in clinical practice in nursing informatics. METHODS: This study used a cross-sectional descriptive survey to examine self-rated competence in nursing informatics among 205 nurses in clinical practice across two hospitals in the Western Cape. The TANIC© scale was used to rate the skills of participants in computer literacy, clinical information management, and information literacy. RESULTS: The highest rating was received for computer literacy, approaching a 'comfortable' competency level. Lower scores were received for clinical information management and information literacy, indicating 'novice' to 'advanced beginner' levels. CONCLUSION: The study showed that practicing nurses have a limited level of nursing informatics competence, especially in the domains of clinical information management and information literacy. These findings support the need for educational programmes to extend beyond basic computer skills and prioritize continuous professional development in nursing informatics.

Eco-nursing competencies for nurses: A scoping review.

Background: Nurses are tasked with addressing the health impacts of climate change. Eco-nursing competencies, covering knowledge, attitudes, and skills related to climate change, equip nurses to actively mitigate and adapt to its effects on health and the environment. Objective: To synthesize existing literature on eco-nursing roles and competencies for nurses. Methods: A scoping review of published papers examined nurses' roles and eco-nursing competencies. Databases searched included Academic Search Complete, CINAHL Plus, MEDLINE (PubMed), and Google Scholar. Search terms encompassed climate change and nursing synonyms, limited to English articles up to April 15, 2023. Thematic analysis was used to synthesize findings, delineating roles, and eco-nursing competencies. Results were tabulated. Results: Out of 445 papers identified, 31 underwent data analysis. These papers highlighted nurses' roles in climate change (42%), along with climate change knowledge and skills (64.5%), and attitudes (13%). Roles encompassed research, education, advocacy, leadership, and clinical practice, with corresponding competencies embedded within existing core competencies for general nurses, nurse specialists, and nurse managers. Conclusion: The review demonstrates that nurses' roles in climate change necessitate relevant knowledge, attitudes, and skills. Future research should contextualize these roles and eco-nursing competencies based on geographical locations, considering the distinct disease burden in each area. Registration: The study protocol was registered in the Open Science Framework on 5 March 2023 before conducting the full study https://doi.org/10.17605/OSF.IO/9GC4N. Tweetable abstract: Amidst growing concerns about climate change, nurses are increasingly tasked with preparing to mitigate its health impacts through the delineation of eco-nursing competencies. These competencies will equip nurses to effectively tackle the health and environmental ramifications of climate change, building upon existing core competencies tailored to various geographic contexts.

Cardiovascular risk among community members in three communities in the Cape Metropole of the Western Cape.

BACKGROUND:  Cardiovascular diseases pose a risk to population health in South Africa and are responsible for almost one in six deaths (17.3%). AIM:  To determine the cardiovascular risk among community members who attended a community outreach programme. SETTING:  Three communities in the Cape Metropole of the Western Cape. METHODS:  A health survey was conducted with 783 participants, 18 years and older, conveniently sampled. The survey included questions about cardiovascular risk factors, and biometric measurements of blood pressure (BP), height and weight were conducted. RESULTS:  A total of 777 participants were included in the study. Most participants were female (529, 68.1%), with an average age of 42.3 years (s.d. 14.2). Risk behaviours reported included smoking (216, 27.8%), consuming more than two drinks of alcohol daily (78, 10%), low physical activity (384, 49.4%), being stressed on most days (436, 56.1%) and unhealthy eating habits (253, 32.6%). More than half of the participants (402, 51.7%) had a body mass index (BMI) ≥ 30, 26.0% (202) had a systolic BP of ≥ 140 mm Hg and 22.4% (174) had a diastolic BP of ≥ 90 mm Hg; 16.6% (130) had a cardiovascular disease (CVD) risk of 10-20 and 19.3% (150) had a CVD risk of 20%. CONCLUSION:  Nearly a fifth of the participants had a significant probability of developing heart disease or experiencing a stroke over the next 10 years.Contribution: There is an urgent need for comprehensive health promotion and behaviour change interventions focused on reducing CVD risk factors at the community level.

COVID-19 fear among junior undergraduate nursing students during the pandemic in South Africa.

Background: During the COVID-19 pandemic, nursing students continued to work in facilities to complete clinical hours. Little was known about the impact of COVID-19 on nursing students during this time. Aim: To investigate fear of COVID-19 among junior undergraduate nursing students during the pandemic. Setting: A student nursing school at a university in the Western Cape, South Africa. Methods: A cross-sectional survey was conducted with 559 nursing students. A self-administered questionnaire with the validated COVID-19 fear scale (α= 0.84) was distributed. Scale reliability, factor analysis, means and 95% confidence intervals were calculated for items, overall scale and associations with demographic variables were tested using Kruskal-Wallis Independent Samples and Mann-Whitney U tests. Results: There were 370 respondents (68.51% response rate), predominantly female (294, 79.5%) and exhibited a mean age of 21.9 years (± 3.9). More than half, 192 respondents (51.9%) reported mild fear of COVID-19, 103 (27.8%) moderate fear and 57 (15.4%) severe fear. Apart from gender, no significant demographic associations with overall COVID-19 fear were found. Factor analysis identified two distinct factors, physiological and emotional expressions of fear (moderate significant positive correlation between factors [r = 0.541]). Conclusion: The study's findings reveal that junior undergraduate nursing students, during the pandemic, generally reported experiencing mild fear related to COVID-19. Contribution: This study contributes to the field of COVID-19 fear studies, provides insight into factors influencing fear levels and validates the scale's factor structure.

Professional Values of Undergraduate Students at a Nursing School in South Africa.

Background: Nursing schools play an important role in instilling nursing professional values in undergraduate nursing students and ensuring that they produce professional nurse graduates. Several studies in various countries have been conducted to describe the professional values held by nursing students, but this has not been explored in detail in South Africa. Aim: The purpose of this study was to describe the professional values held by undergraduate degree students at a nursing school in South Africa. Methods: A cross-sectional survey using a self-administered questionnaire was conducted. With a population of 1,233 undergraduate nursing students across four years in the degree programme at the nursing school, a sample of 294 was calculated as the representative (95% CI, 5% error, and 50% response distribution). The 26-item nurses professional values scale revision (NPVS-R) with five value dimensions was used to collect the data. Means, frequencies, and confidence intervals were used to describe the values and Mann-Whitney U tests and Kruskal-Wallis independent sample tests were used to compare the findings with the demographic characteristics. Results: A total number of 245 respondents completed the questionnaire (response rate of 83.3%). Overall, the nurse professional value score was high (113.1 ± 13.1). The values of trust (4.46 ± 0.61), justice (4.39 ± 0.57), and caring (4.38 ± 0.55) were rated significantly higher than those of professionalism (4.23 ± 0.64) and activism (4.22 ± 0.57). First- and final-year students had significantly higher professional value scores. Conclusion: The study results describe the professional values of undergraduate nursing students in the school and confirmed the importance of trust, justice, and caring as the key professional values in the South African setting. Clinical Relevance. Nursing education should embed and monitor nursing professional values in the curriculum. Instilling nursing professional values in undergraduate nurses during formal training programmes improves quality patient care and service delivery for clinical practice.

Training needs of professional nurses in primary health care in the Cape Metropole, South Africa.

BACKGROUND: In the fast-changing healthcare environment, it is important to ensure that primary health care (PHC) nurses are suitably qualified and have access to appropriate and relevant ongoing education. AIM: The aim of this study was to determine the training needs of professional nurses working in PHC facilities. SETTING: The research was conducted in PHC facilities in the Cape Metropole, Western Cape, South Africa. METHODS: A quantitative descriptive survey with all-inclusive sampling was used. All professional nurses (N = 303), employed for at least a minimum of 6 months in PHC facilities were included in the study. The Hennessy-Hicks Training Needs Analysis (TNA) questionnaire was used to collect the data on professional tasks training needs and open-ended questions for specific PHC contextual training needs. Importance and performance means for each of the TNA subsections and training needs were calculated. Open-ended questions were analysed using content analysis, identifying training domains and topics in terms of frequency and ranking. RESULTS: The TNA identified 'Research' as the highest training need. Research tasks were significantly rated as the least important and the lowest rated performance compared to other domains. Child mental health was rated as the most important specific training need. CONCLUSION: The results of this survey provide insight into the training needs of professional nurses employed in PHC facilities and highlight the need for child mental healthcare and research training in this setting.Contribution: The study contributes to the understanding of the training and education needs of professional nurses working in PHC facilities.

Out of Chaos Leaders Emerged.

COVID-19 had a major influence on nursing with the pandemic resulting in changes in the work environment while experiencing physical and emotional challenges such as moral distress, fear for self and family and dealing with the unknown. However, during this period, nurses demonstrated extraordinary resilience, crafted innovations in clinical practice, communication and support, providing leadership in the health service and in the nursing profession.

Nursing informatics skills relevance and competence for final year nursing students.

BACKGROUND:  The increasing use of technology in nursing practice requires nursing students to be competent in nursing informatics with an attitude of acceptance of technology in the healthcare environment. OBJECTIVES:  The objectives of the study were to determine final year nursing students' perceptions and skills in nursing informatics and their attitudes towards computerisation in nursing practice. METHOD:  The study population were 198 final year nursing students from a selected university in the Western Cape, South Africa. All-inclusive sampling was used. A descriptive survey was conducted using a self-administered questionnaire which included two validated scales, namely the validated Nursing Informatics Competency Assessment Tool (NICAT) and the Nurses' Attitudes towards Computerisation scale. Means and 95% confidence intervals (CI) of the ratings of the perceived relevance of nursing informatics skills in nursing practice, perceived levels of competence in nursing informatics skills and attitudes towards computers were calculated. RESULTS:  A total of 91 undergraduate respondents completed the survey. Computer literacy skills were rated overall as most relevant (4.23, 95% confidence interval [95% CI]: 4.06-4.40) and the skills perceived most competent (4.16, 95% CI: 3.81-4.22). The respondents had an overall positive score for attitudes towards computerisation in healthcare (67.34, s.d. = 10.40, 95% CI: 65.18-69.51). CONCLUSION:  The study concluded that computer literacy skills, informatics literacy skills and information management skills were relevant to nursing practice, despite varying levels of competence in these skills among nurses.Contribution: What key insights into the research results and its future function are revealed? How do these insights link to the focus and scope of the journal? It should be a concise statement of the primary contribution of the manuscript; and how it fits within the scope of the journal.

Perceived technology use, attitudes, and barriers among primary care nurses.

Background: In primary healthcare, health information technology has the potential to facilitate the delivery of healthcare services by improving quality of care, efficiency and patient safety. However, little is known about the uptake and technology acceptance among primary healthcare nurses. Aim: The aim of this study was to describe health information technology acceptance and use among primary healthcare nurses. Setting: Primary healthcare centres in the Western Cape. Methods: A quantitative descriptive survey was conducted with a sample of 160 nurses working in primary healthcare for more than 6 months, using a self-administered questionnaire based on the technology acceptance model constructs. Eighteen primary healthcare centres were randomly selected with a sample of 160 using nonprobability purposive sampling. Results: Ninety-three (58.1%) respondents completed the survey. Three-quarters of the respondents reported positive attitudes, positive perceptions of usefulness and ease of use towards the use of health information technology. Barriers of access and training were reported by 75%, with around half the respondents reporting poor computer and information accessing skills. Health information technology use was varied, with high ratings for seeking and using and low ratings of ability to use health information technology for patient administration and management. Health information technology use was predicted by perceptions of ease of use. Conclusion: This research presents a mixed picture of acceptance of technology among primary healthcare nurses and highlights the lack of access to computers and Internet in these settings. Contribution: This study contributes to the field of technology acceptance among primary healthcare nurses.

Public perceptions on Twitter of nurses during the COVID-19 pandemic.

BACKGROUND: The use of social media platforms to convey public opinions and attitudes has exponentially increased over the last decade on topics related to health. In all these social media postings related to the pandemic, specific attention has been focused on healthcare professionals, specifically nurses. OBJECTIVE: This study aimed to explore how the keyword 'nurse' is located in COVID-19 pandemic-related tweets during a selected period of the pandemic in order to assess public perception. METHODS: Tweets related to COVID-19 were downloaded from Twitter for the period January 1st, 2020, to November 11th, 2021. Sentiment analysis was used to identify opinions, emotions, and approaches expressed in tweet which included 'nurse', 'COVID-19', and 'pandemic' as either keyword or hashtags. RESULTS: A total of 2,440,696 most used unique words in the downloaded 582,399 tweets were included and the sentiment analysis indicated that 24.4% (n = 595,530) of the tweets demonstrated positive sentiment while 14.1% (n = 343,433) of the tweets demonstrated negative sentiment during COVID-19. Within these results, 17% (n = 416,366) of the tweets included positive basic emotion words of trust and 4.9% (n = 120,654) of joy. In terms of negative basic emotion words, 9.9% (n = 241,758) of the tweets included the word fear, 8.3% (n = 202,179) anticipation, 7.9% (n = 193,145) sadness, 5.7% (n = 139,791) anger, 4.2% (n = 103,936) disgust, and 3.6% (n = 88,338) of the tweets included the word surprised. CONCLUSIONS: It is encouraging to note that with the advent of major health crises, public perceptions on social media, appears to portray an image of nurses which reflects the professionalism and values of the profession.

Acceptability and feasibility of a screening protocol for antenatal depression (SPADe) in Blantyre District, Malawi.

BACKGROUND: Depression is one of the most common perinatal mental health problems that affect pregnant women. Antenatal depression can adversely affect the well-being of the pregnant woman and her foetus. Depression is rarely detected by midwives due to the unavailability of relevant screening instruments in Malawi. A Screening Protocol for Antenatal Depression (SPADe) was developed and recommended for possible use to screen for depression in antenatal clinics in the country. The acceptability and feasibility of using the SPADe protocol to screen for depression has not been established. The aim of this study was to assess the acceptability and feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre district. METHODS: This study used a quantitative survey design to collect data among 60 midwives in three antenatal clinics in primary care settings. All inclusive sampling of all 60 midwives were used. The Structured Assessment of FEasibility and Ottawa Acceptability of Decision Rules Instruments were used to collect the data. Descriptive statistics and Chi square tests were used to analyse the data. RESULTS: This study found that it was feasible to implement SPADe and the following enablers for screening depression had the highest ratings: the SPADe is applicable to pregnant women (M = 3.9, sd = 0.4); the intended goal of the SPADe matches the prioritised goals of Malawi Ministry of Health (M = 3.9, sd = 0.5); and the SPADe is likely to be effective (M = 3.8, sd = 0.6). On the other hand, barriers for implementing the SPADe were: the need for specific training to deliver the SPADe (M = 3.7, sd = 0.7); ongoing support and supervision (M = 3.5, sd = 0.8); and additional resources (M = 3.0, sd = 0.9). This study also found that the implementation of the SPADe was acceptable to respondents. The overall mean score for respondents on acceptability of screening antenatal depression using SPADe was found to be high (M = 4.6, sd = 0.6). However the differences in the respondents' mean scores on acceptability of screening for depression in antenatal clinics using SPADe in relation to their demographic characteristics were not significant (p > .05). CONCLUSION: This study suggests that midwives feel that it is feasible and acceptable for them to implement the SPADe in antenatal clinics with ongoing training, support and clinical supervision.

Evaluation of a digital programme for final year nursing students during COVID-19.

Aim: The aim of this study was to evaluate a digital programme aimed to address COVID-19 related anxiety of final year undergraduate nursing students on returning to the clinical practice during the pandemic in South Africa. Background: In South Africa, concern about the physical and psychological safety of nursing students resulted in the planning of a psychological first aid program to facilitate nursing students return to clinical practice. Design: A survey was conducted in September 2020 following the August 2020 return of final year nursing students to clinical facilities. Methods: All final year nursing students were invited to participate in the study (N = 196). An online survey was circulated via WhatsApp asking respondents to rate their anxiety and fear of COVID-19 before and after return to practice following an intervention (eCOVID). Related pair analysis was done on the main outcome measures of anxiety, COVID-19 fears and concerns using Related Samples Wilcoxon Signed Rank tests. Results: After the programme, the respondents reported a significant reduction in anxiety (W = 2.92, p =.004) and COVID fear (W=0.3.1, p =.001), specifically related to infecting family, being exposed to COVID-19 at work, propagating infection at work and lacking access to COVID-19 information and communication. Conclusion: The implementation of a dedicated digital programme, underpinned by a sound theory base of psychological first aid, may have decreased anxiety and fear in nursing students during clinical practice in the pandemic.Contribution: The study contributes to evidence on psychological first aid support of nursing students during the COVID-19 pandemic.

Nursing informatics skills relevance and competence for final year nursing students

Background: The increasing use of technology in nursing practice requires nursing students to be competent in nursing informatics with an attitude of acceptance of technology in the healthcare environment. Objectives: The objectives of the study were to determine final year nursing students' perceptions and skills in nursing informatics and their attitudes towards computerisation in nursing practice. Method: The study population were 198 final year nursing students from a selected university in the Western Cape, South Africa. All-inclusive sampling was used. A descriptive survey was conducted using a self-administered questionnaire which included two validated scales, namely the validated Nursing Informatics Competency Assessment Tool (NICAT) and the Nurses' Attitudes towards Computerisation scale. Means and 95% confidence intervals (CI) of the ratings of the perceived relevance of nursing informatics skills in nursing practice, perceived levels of competence in nursing informatics skills and attitudes towards computers were calculated. Results: A total of 91 undergraduate respondents completed the survey. Computer literacy skills were rated overall as most relevant (4.23, 95% confidence interval [95% CI]: 4.06­4.40) and the skills perceived most competent (4.16, 95% CI: 3.81­4.22). The respondents had an overall positive score for attitudes towards computerisation in healthcare (67.34, s.d. = 10.40, 95% CI: 65.18­69.51). Conclusion: The study concluded that computer literacy skills, informatics literacy skills and information management skills were relevant to nursing practice, despite varying levels of competence in these skills among nurses.

Stress and coping - Perceptions of final year nursing students returning to clinical practice during the COVID-19 pandemic, South Africa.

BACKGROUND: The novel nature of the coronavirus disease 2019 (COVID-19) pandemic places challenges on nursing students as they try to complete the clinical requirement of their training. Nursing faculties need to understand these challenges to support and equip nursing students to enter the workforce. AIM: To explore and describe the anticipated and subsequent perceptions of final year Bachelor of Nursing students returning to clinical practice during the COVID-19 pandemic in South Africa. SETTING: The study was conducted at two universities in the Western Cape and KwaZulu-Natal, South Africa. Both universities offer 4-year Bachelor of Nursing programmes accredited by the South African Nursing Council and were in 'hot spot areas' for SARS-CoV-2. METHODS: A qualitative study with focus groups discussions of final year undergraduate nursing students from both universities were conducted. Data were analysed through content analysis using Lazarus and Folkman's Stress Appraisal Coping Model. RESULTS: Five focus groups discussions with a total of 25 participants were conducted. Three themes with eight sub-themes emerged, the key themes being: primary appraisal and anticipation of returning to clinical practice; contextual influence on primary appraisal and reappraisal to facilitate positive return to clinical practice. CONCLUSION: Primary perceptions of returning to clinical practice revolved around uncertainty and stress. However, through preparation and the process of reappraisal, participants were able to adapt and cope with the challenges in returning to clinical practice during the pandemic. CONTRIBUTION: It is important to recognise the role of faculty in supporting nursing students' transition into situations of uncertainty such as the pandemic.

Operational nurse managers' perceptions on the competence of community service nurses in public settings in the Western Cape.

BACKGROUND: Community service nurses placed in the Western Cape Government public health facilities render essential healthcare to underserved populations. Anecdotal evidence from operational nurse managers indicated concerns that community service nurses may lack competence in basic required nursing competencies. OBJECTIVES: To investigate operational nurse managers' perceptions of the competence of community service nurses in public health facilities in the Western Cape. METHOD: A quantitative survey was conducted with an all-inclusive sample of 297 operational nurse managers in the Western Cape. A self-administered questionnaire with 65 questions with a 4-point rating scale was used to rate perceived competence of community service nurses across the South African Nursing Council (SANC) competencies. Descriptive and inferential statistics were calculated per competency domain. RESULTS: The survey (response rate: 59%) showed that the operational nurse managers perceived the community service nurses to be competent in the clinical patient care domain and mostly either developing proficiency or proficient in the SANC competencies of legal framework and ethical practice, interprofessional relationships, leadership, quality management and management competency domains. CONCLUSION: Community service nurses were found to be competent in the clinical patient care, possibly because of the integration of theory and practice focus of work-integrated learning in the programme. Education and practice supportive strategies for community service nurses should be developed to support the successful transition from students to community service nurses, especially around the development of research and critical thinking skills.

Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi.

BACKGROUND: Depression is often underdiagnosed by treating health professionals. This is a situation in Malawi where there is no routine screening of depression at antenatal clinics. Recently, a Screening Protocol for Antenatal Depression (SPADe) that can be used by midwives to screen for antenatal depression was developed in Blantyre District. SPADe proposes multistage screening of antenatal depression by midwives which may enable early detection and treatment of pregnant women with depression. Proper treatment of antenatal depression can assist in achieving Sustainable Development Goals (SDGs). However, utilisation of SPADe in clinical practice to screening for depression in antenatal clinics has not been established yet. Therefore, the primary aim of this study is to assess feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. The secondary aim was to assess acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. METHODS: This will be a feasibility study which will consist of scientific investigations that will support movement of evidence-based, effective health care approach, SPADe, from the clinical knowledge base into routine use. This study will consist three phases: phase 1 will introduce SPADe in antenatal clinics in Blantyre District where screening of depression is almost none existent; phase 2 will implement screening of depression using SPADe in antenatal clinics in Blantyre District; and phase 3 will evaluate the screening of antenatal depression using SPADe to establish its feasibility, acceptability and fidelity in antenatal clinics in Blantyre District. DISCUSSION: This study will establish and document feasibility, acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. It is expected that midwives will develop more confidence in detecting and dealing with antenatal depression. Consequently, there will be increased numbers of pregnant women detected with depression by midwives and increased accessibility to mental health care by pregnant women in antenatal clinics.