Nurses experiences regarding ideal clinic project implementation in eThekwini district.

Background: The South African National Department of Health introduced the ideal clinic realisation and maintenance (ICRM) programme in response to primary health care (PHC) services and to lay a strong foundation for the National Health Insurance implementation. The progress report 2015-2016 on the implementation of this programme indicated that achieving the 50% target in selected vital areas such as staffing, resource allocation, and utilisation was not achieved. Aim: The study aimed to explore and describe nurses' experiences regarding the ideal clinic project (ICP) implementation. Setting: The study was conducted in 18 PHC clinics in eThekwini district, KwaZulu-Natal. Methods: An exploratory descriptive, contextual qualitative design was employed guided by Donabedian's structure, process, and outcomes model. Data were collected using semi-structured interviews with 24 nurses between 15 September and 25 October 2020 following receipt of ethics and analysed using Tesch's open coding approach. Results: The three themes that emerged included structural limitations, processes involved in running the clinic, and support offered to the PHC clinics. These were highlighted as challenges experienced by nurses during the implementation of an ICP. Conclusion: Nurses' negative experiences and perceptions made it difficult for them to accomplish the ICP standards. Contribution: The findings from the study highlighted critical actions by the health care institution management which if instituted, could facilitate improved implementation of the ICP and achievement of the 50% target in selected vital areas.

Nurse managers' experiences regarding the use of key performance indicators in developing work plans.

BACKGROUND: Apart from monitoring and evaluation, key performance indicators (KPIs) are used for planning of quality healthcare services and are essential for ensuring that work plans are strategic. Nurse managers (NMs) are required to use reports on the KPIs from the District Health Barometer to prepare work plans. AIM: The aim of the study was to explore the experiences of NMs regarding the use of KPIs in developing work plans. SETTING: The study was conducted in one of the four local municipalities of iLembe district in KwaZulu-Natal. METHODS: A qualitative research design was used. Data were collected through semistructured interviews with 20 NMs from seven primary health care clinics between 16 November 2020 and 24 December 2020; data were then thematically analysed. RESULTS: Nurse managers experienced challenges related to knowledge creation, knowledge sharing and knowledge application regarding the use of KPIs in developing work plans. Possible strategies which, according to NMs, could facilitate the use of KPIs in developing work plans included support in the management role, skills development and orientation, provision of resources and participative management. CONCLUSION: Relevant knowledge management practices, including knowledge sharing, are essential for knowledge creation so that individuals develop task knowledge to fulfil role expectations. In the case of this study, knowledge creation for NMs could facilitate their appropriate use of KPIs in developing work plans.Contribution: It is recommended that NMs receive ongoing training on, and be actively involved in, data management and that mentoring and support be made available for NMs to facilitate the use of KPIs in developing work plans.

Financial management roles of nurse managers in selected public hospitals in KwaZulu-Natal province, South Africa.

BACKGROUND: The public health sector in South Africa has been facing severe financial cutbacks and financial constraints in recent times. The nurse manager (NM) is faced with the task of managing and reducing expenditure in the nursing sector without compromising the quality care. This requires skills and understanding of financial management. AIM: This study aimed to explore the financial management roles of NMs and to identify financial management development needs necessary for NMs' practice. SETTING: The study was conducted in KwaZulu-Natal. A total of eight hospitals from the five health districts were included. METHODS: The study used the naturalistic paradigm with a constructivist grounded theory approach. Interviews were used to initially gather data from six NMs who were purposively selected. Theoretical sampling was used to further recruit financial managers, chief executive officers, assistant nurse managers and operational managers. The final sample consisted of 18 participants. RESULTS: Financial management of the hospitals is the primary function of the financial managers and the chief executive officers. However, the role of NMs extends to the performance and participation in various activities relating to the financial functioning of the hospital. These include financial planning, financial monitoring, financial decision-making and financial control. CONCLUSION: Nurse managers have a financial management function in public health care organisations but lack the necessary skills, knowledge and competencies to function in this role and require additional training. Recommendations included that a competency framework be developed to improve the financial management competencies of NMs.

Perceptions of young men at the Free State School of Nursing with regards to teenage pregnancy.

BACKGROUND: Teenage pregnancy is a socio-economic challenge and a serious public health problem for communities in South Africa. It is, therefore, imperative that effective interventions and programmes be implemented to address this problem. A number of research studies have been conducted on teenage pregnancy in South Africa, but their focus was mainly on teenage girls excluding young men's involvement in teenage pregnancy. AIM: The aim of the study was to determine the perceptions of young men between the ages of 18 and 23 years towards teenage pregnancy. METHODS: A qualitative, explorative semi-structured interview descriptive design was used toconduct the study. The study was guided by the Johnson's Behavioral System Model. Purposive sampling was used to select 10 participants with whom semi-structured interviews were conducted. Thematic analysis of data were performed. SETTING: The study was conducted in Free State School of Nursing's two main campuses. RESULTS: The findings of this study revealed that young men were not involved in reproductive health programmes aiming to prevent teenage pregnancies. Father and son's poor communication on issues related to sex and teenage pregnancy contributes to unprotected sexual intercourse resulting in teenage pregnancy. Cultural and traditional practices such as the withdrawal method, not using contraceptives, and misleading teachings at the initiation schools contribute to risk factors of teenage pregnancy. CONCLUSION: There is still a gap in reproductive health that needs to be filled by involving young men to reduce teenage pregnancies. Involving young men in reproductive health programmes could lead to a decreased number of teenage pregnancies. Factors, such as cultural and traditional practices, and father and son sexual health education, need to be taken into consideration to prevent teenage pregnancies.

Factors influencing successful implementation of the basic antenatal care approach in primary health care facilities in eThekwini district, KwaZulu-Natal.

BACKGROUND: In a move to alleviate the burden of consistently high maternal and perinatal mortality rates, the South African National Department of Health (DoH) introduced Basic Antenatal Care (BANC) in all Primary Health Care facilities that were providing antenatal care services. However, not all facilities in the eThekwini district have successfully implemented the approach. The aim of the study was to identify the factors that influence successful implementation of the BANC approach. OBJECTIVES: The objectives were to identify facilities that had successfully implemented the BANC approach and the factors that influenced successful implementation of the BANC approach, in order to make recommendations on these factors. METHOD: A descriptive quantitative design was used. Firstly, primary health care facilities that were successful in implementing the BANC approach were identified through a retrospective record auditing. A total of 27 facilities were identified, of which 18 facilities were included in the study. This was followed by data collection from 59 midwives in order to identify the factors that influenced successful implementation of the BANC approach. The data was analysed using version 19 of the Statistical Package for the Social Sciences. RESULTS: The positive factors that influenced successful implementation of the BANC approach included: the availability and accessibility of BANC services, policies, guidelines and protocol; various means of communication; a comprehensive package of and the integration of primary health care services; training and in-service education; human and material resources; the support and supervision offered to the midwives by the primary health care supervisors; supervisors' understanding of the approach and the levels of experience of midwives involved in implementation of the BANC approach. CONCLUSION: The success that the facilities had achieved in implementing BANC approach was attributed to these positive factors.