South Africa is experiencing a serious shortage of nurses, which has to be addressed to prevent crises in health care services. Previous studies (Fletcher 2001:324; Oosthuizen 2005:117) found that nurses change their work environment due to dissatisfaction with their job situations. This implies that creating a favourable environment in the workplace situation could help retain professional nurses in their posts, implying that retention strategies should be effective.An exploratory, descriptive, contextual and qualitative design was used to describe nurse managers’views on factors which could influence professional nurse retention, as well as their views regarding attributes that were required to enable them to contribute towards enhancing professional nurse retention. A purposive sample of nurse managers employed in public and private hospitals in the Gauteng province was selected. Semi-structured interviews were conducted with 21 nurse managers.The results were analysed qualitatively and contextualised within Vogt, Cox, Velthouse and Thames’s Cork-Top (Bottleneck) Theory of Nurse Retention (1983) and Lewin’s Force-Field Analysis Theory (1952).Factors pertaining to individual nurses, the organisation and nurse managers could influence the retention of professional nurses. Poor working conditions, long and inconvenient working hours,uncompetitive salaries and professional development of nurses have to be addressed to enhance professional nurses’ retention. Unsafe working environments and a lack of resources threaten the safety and well-being of nurses and patients and contribute to high turnover rates. Nurse managers have to address shortcomings in their managerial and leadership skills and implement changes within a multigenerational nursing workforce and challenging working environments.OpsommingSuid-Afrika ervaar ’n ernstige tekort aan verpleegkundiges wat aangespreek moet word ten einde krisisse in gesondheidsorgdienste te voorkom. Vorige studies (Fletcher 2001:324; Oosthuizen 2005:117) het bevind dat verpleegkundiges hulle werksomgewing verander as gevolg van ontevredenheid met hulle werksituasies. Dit impliseer dat die daarstelling van ’n gunstige omgewing in die werkpleksituasie, kan help om professionele verpleegkundiges in hulle poste te behou, wat beteken dat retensiestrategieë doeltreffend moet wees.’n Verkennende, beskrywende, kontekstuele, kwalitatiewe ontwerp was gebruik om verpleegbestuurders se sienings te bekom, oor faktore wat professionele verpleegkundiges se retensie kan beïnvloed, asook hulle sienings omtrent vereiste hoedanighede wat hulle in staat sou stel om professionele verpleegkundiges se retensie te bevorder. ’n Doelgerigte steekproef van verpleegbestuurders in openbare en private hospitale in die Gauteng provinsie is gekies. Semigestruktureerde onderhoude is met 21 verpleegbestuurders gevoer. Die resultate is kwalitatief ontleed en gekontekstualiseer volgens Vogt, Cox, Velthouse en Thames se Kurkprop Bottelnek(Cork-Top Bottleneck) Teorie van Verpleegretensie (1983) en Lewin se Kragveld Analise Teorie(1952).Faktore met betrekking tot individuele verpleegkundiges, die organisasie en verpleegbestuurders kan die retensie van professionele verpleegkundiges beïnvloed. Swak werksomstandighede,lang en ongerieflike werksure, nie-mededingende salarisse en professionele ontwikkeling van verpleegkundiges moet aangespreek word om professionele verpleegkundiges se retensie te bevorder. Onveilige werksomgewings en ’n gebrek aan hulpbronne bedreig die veiligheid en die welsyn van verpleegkundiges en pasiënte en dra by tot hoë omsetsyfers. Verpleegbestuurders moet die tekortkominge in hulle bestuurs- en leierskapsvaardighede aanspreek en veranderinge implementeer binne ’n multigenerasie verpleegwerkkrag en uitdagende werksomgewings.
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.
Aim This paper describes the development of the training programme for South African professional nurses on how to manage critically ill COVID‐19 patients in intensive care units and repurposed general wards. Design and methods The Analysis, Design, Development, Implementation and Evaluation educational instructional design model guided the development of the training programme. A case‐based study approach and blended learning were used to deliver the six modules. Results The training programme was developed, reviewed and validated by the coordinating team of facilitators involved in the initiative. Implementation of the training programme and the result thereof will not be discussed as part of this manuscript. Conclusion The training programme aimed to enhance the knowledge of professional nurses in the management of critically ill patients with COVID‐19. As the pandemic evolves, a need for training and ongoing support was identified, which might address the need for surge capacity and hospital readiness planning.
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