Background: Many deaths in hospitals occur within 24 hours of admission. Some of these deaths could be prevented if the patients were effectively triaged, identified quickly, and treatment initiated without delay. Triage and emergency care have always been weak and under-emphasized components of healthcare systems in rural areas of Limpopo Province, and yet, if well organised, it could lead to saving many lives and reducing the ultimate costs of care. There have been few studies, and there is little information focusing on nurses’ knowledge about triage in rural hospitals. Objective: This study aims to assess the knowledge and practices of triage amongst nurses working in the Emergency Departments (ED) of the Sekhukhune District, Limpopo Province, South Africa. Methods: By employing a quantitative, non-experimental research method, 84 nurses working in the Emergency Departments, completed and submitted structured questionnaires. The validity and reliability were ensured by pre-testing the data collection instrument on respondents who were not part of the main study. Data were analyzed by using the SPSS version 25, Excel computer programs and score methods. Results: The findings indicate that there is a correlation between triage knowledge and job title (p-value = 0.046). Registered nurses, specialty nurses, and enrolled nurses, were found to know more than auxiliary nurses. However, the study discovered that, among the nurses with knowledge, 61% exercised poor triage practice, while only 30% showed evidence of good practice. Conclusion: The study aims at defining triage knowledge and practice amongst nurses in the Emergency Departments. The results indicate that nurses have knowledge regarding triage but have difficulty in converting their factual knowledge into practice, as they scored poorly on questions about the practice. In addition, there emerged a significantly positive relationship between triage knowledge and job titles. The study recommends the development of strategies to enhance the conversion of factual knowledge into practice regarding triage in the ED. This could be implemented through sustainable training courses regarding triage for all the categories of nurses.
Purpose: Lack of knowledge and practical skills on triage remains a global problem, especially within rural hospitals, and very little is known about enhancing the knowledge and skills of emergency nursing staff in rural hospitals of South Africa. The objective was to describe the perceived strategies for enhancing knowledge and practices of triage among nurses working in the emergency departments (EDs) of rural hospitals in South Africa. Research methods: A descriptive qualitative research design was applied to achieve the research objective. A non-probability sampling method was applied to select 17 professional nurses from rural hospitals. An unstructured face-to-face interview method was used to collect data. Data collected were analyzed using Tesch’s method of data analysis. Results: The study findings highlighted the academic needs of nurses working in the ED of rural hospitals. Two themes emerged from this study; (1) The consistent description of the importance of triage training for emergency unit staff, and (2) The description of measures to enhance triage practices amongst emergency unit staff. Findings indicated that triage knowledge and practice remains a challenge, but with formulated strategies like continuous training by workshops, refresher courses, and offering a training module on triage, evaluation of developed guidelines and benchmarks is often enhanced. Conclusions: The study describes the strategies to enhance the conversion of knowledge and practice of triage amongst nurses working in the ED of rural hospitals. The paper argues that the knowledge and practical skills of nurses working in ED are enhanced through the provision of continuous training as workshops, triage module, evaluating the developed guidelines to implement triage, and benchmarking with other hospitals.
Background: Primary healthcare (PHC) in South Africa often experiences crucial challenges that lead to patients’ negative experiences regarding their care, compromising the significant role that PHC services could play in health promotion and disease prevention. The primary purpose of implementing the Ideal Clinic (IC) in South Africa was to improve patients’ care quality at the clinics. There seems to be a paucity of studies determining professional nurses’ experiences when implementing the IC. Purpose: This study aimed to explore and describe professional nurses’ experiences regarding implementing the IC at three selected clinics in the Makhado local area. Study method: A qualitative phenomenological research design was used to explore professional nurses’ experiences regarding IC implementation. Purposive sampling was used to select 15 professional nurses working at the three selected clinics. Data were collected using semi-structured one-on-one interviews. Interviews were conducted until saturation was reached. Trustworthiness was ensured by applying Lincoln and Guba’s four criteria, i.e., credibility, transferability, dependability, and confirmability. Ethical clearance was obtained from the University of Limpopo Turfloop Research and Ethics Committee, and permission to conduct the study was obtained from Limpopo Province Department of Health Research and Ethics Committee. Thematic analysis was used to analyze data. Results: The following themes emerged from the study findings: perceived benefits of the IC on the primary healthcare services provided to the community, challenges experienced by professional nurses when implementing the IC program, and challenges related to the supply of resources for implementing the IC. The study results revealed that, although the IC aimed to improve the overburdened PHC facilities in SA, the professional nurses still experienced some challenges when implementing the IC program. Some of the challenges faced were a lack of knowledge and training in the IC program, poor infrastructure and the shortage of equipment, and inadequate provision of support by line managers, all of which resulted in poor-quality patient care. Conclusion: This study revealed that the introduction and implementation of the IC can have potential benefits to the community and the primary healthcare system. However, it was not introduced and appropriately implemented, which resulted in professional nurses experiencing several challenges. The national department of health needs to strengthen the program’s implementation through proper training, consultation, and continuous support of the nurses. Provision of quality equipment and supplies is also recommended.
The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual disability unit. The intellectual disability unit provides basic nursing care to patients with known mental disabilities, such as learning, problem-solving, and judgment problems, which demand diverse physical activities. Nevertheless, the safety of nurses within the unit receives little attention. Thus, we adopted a quantitative cross-sectional epidemiological survey design to determine the prevalence of work-related musculoskeletal disorders amongst nurses working in the intellectual disability unit at the selected hospital in Limpopo Province, South Africa. A self-administered questionnaire collected data from 69 randomly selected nurses from the intellectual disability unit. Data were extracted, coded, and captured in MS Excel format (2016) and imported into the IBM Statistical Package for the Social Sciences (SPSS), software version 25.0, for analysis. The study reported a low (38%) prevalence of musculoskeletal disorders in the intellectual disability unit, with significant effects on nursing care and staffing. The effects of these WMSDs included missing work, interference with the daily routine, disturbance with sleeping patterns after work, and absenteeism from work. Since intellectually disabled patients depend entirely on nurses for the basic activities of daily living, this paper recommends the incorporation of physiotherapy among nurses in the intellectual disability unit to treat the incidence of lower back pain while mitigating nurses missing work or absenteeism.
A triage system in the emergency department is necessary to prioritize and allocate scarce health resources to the medical needs of the patients to facilitate quality health service delivery. This paper aimed to ascertain if the triage system is welcomed in the tertiary hospital of Limpopo Province by exploring patients’ perceptions in the emergency department in South Africa. A qualitative research approach was used in this study with descriptive, explorative, and contextual research design to reach the research objective. Purposive sampling was used to select the patients who participated in semi-structured one-on-one interviews, which lasted between 30 and 45 min. The sample size was determined by data saturation after 14 participants were interviewed. A narrative qualitative analysis method was used to interpret and categorize the patients’ perceptions into seven domains of Benner’s theory. The six relevant domains illustrated mixed patients‘ perceptions regarding the triage system in the emergency departments. The domain-helping role of the triage system was overweighed by the dissatisfaction of the needy patients who waited for an extended period to receive emergency services. We conclude that the triage system at the selected tertiary hospital is not welcomed due to its disorganization and patient-related factors in the emergency departments. The findings of this paper are a point of reference for reinforcing the triage practice and improved quality service delivery by the emergency department healthcare professionals and the department of health policymakers. Furthermore, the authors propose that the seven domains of Benner’s theory can serve as a foundation for research and improving triage practice within emergency departments.
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