Masters Degrees (School of Nursing)
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Browsing Masters Degrees (School of Nursing) by Advisor "MacKenzie, M. J."
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Item Open Access Attrition of undergraduate nursing students at South African Universities(University of the Free State, 2014-07) Roos, Erna; Fichardt, A. E.; MacKenzie, M. J.English: The aim of the study was to determine and describe the attrition rate and the factors influencing undergraduate nursing students to discontinue the nursing programme at selected South African universities. Knowing the current attrition rate and understanding why nursing students do not complete an undergraduate programme can be a possible means to decrease the poor production rate of degree qualified registered nurses. These comprehensively trained registered nurses are needed to assist in implementing the healthcare plans made by the current South African Government. They are the frontline practitioners in providing healthcare to the South African population. A quantitative descriptive design was used to gather the required information, with a specifically designed questionnaire and structured interview guide. Two populations were selected, namely Study Population One: Universities, which are grantees of the Atlantic Philanthropies and ELMA Group of Foundations under the University-based nursing education of South Africa (UNEDSA) project. The second study population is identified as former nursing students, who were enrolled at the nursing educational institutions within the selected universities. No intervention or treatments were used therefore, no harm was anticipated for the participants of this study. The expected outcome was to determine, calculate and compare attrition rates at the selected universities and to identify and trend the factors influencing former nursing students to discontinue their undergraduate nursing studies. This information could be valuable in making recommendations to existing selection criteria used to select candidates for an undergraduate nursing programme. Furthermore, recommendations can be made to establish and maintain a data base to gather information of the completion and attrition rates of nursing students per intake. The information received from the data base is needed for strategic planning for the following year. Lastly, recommendations can be made to implement strategies to assist at-risk nursing students, who consider discontinuing the undergraduate programme. The study revealed that attrition of undergraduate nursing students does occur at the participating universities. Attrition furthermore occurs at a higher rate than prescribed by the South African Department of Higher Education. A further discovery was that not all selected candidates register for the undergraduate nursing programme, thus contributing to the low number of degree qualified registered nurses. The second phase of the study reveals the main factors influencing undergraduate nursing students to discontinue the undergraduate programme to be academic and financial reasons. Another factor of a high occurrence that influenced former nursing students to discontinue their undergraduate studies was poor wellness and health. From the above-mentioned discoveries recommendations could be made with regards to the following: - Review the current selection criteria to perform a personal interview with each candidate, establish personality traits of applicants to further select the best possible candidate and include a general health questionnaire and medical certificate to declare the candidate fit to practice nursing - Establish and maintain a data base at each Nursing Educational Institution to determine the number of applicants, the number of candidates selected and the number of students who finally registered for the nursing programme as well as the number of nursing students who discontinue each year - Investigate reasons why selected candidates did not register for the undergraduate nursing programme - Share attrition and completion rates with the South African Nursing Council (SANC) to maintain a national data base - Perform an exit interview with a nursing student who voice the decision to discontinue the undergraduate nursing programme to determine and trend the possible factors that influenced the student to discontinue the programme - Identify retention strategies to best assist the at-risk nursing students to include academic and clinical support, financial assistance and wellness and health programmesItem Open Access A patient flow system for antenatal primary healthcare facilities in the Frances Baard District, Northern Cape Province(University of the Free State, 2016-02) Valla, Anna; MacKenzie, M. J.; Joubert, A.English: Long waiting times in primary healthcare (PHC) facilities is a major challenge for the National Department of Health. The aim of the study was therefore to develop a patient flow system which would reduce long waiting times for patients in antenatal PHC facilities in the Frances Baard District, Northern Cape Province. A quantitative, non-experimental design was used to collect data. A specifically compiled checklist was applied to audit 12 antenatal PHC facilities to identify aspects which should be included in a proposed patient flow system. Twenty-one (n=21) healthcare providers also participated in an “in-action” Delphi technique process to seek consensus with regard to the identified aspects. The consensus seeking target was ≥ 60%. Subsequently, a patient flow system was compiled, based on the “in-action” Delphi technique process. The results of the audit checklist were discussed according to the main headings in the checklist of which the first was the need for a patient flow system. The major challenges in this regard are determined by the fact that only 50% (n=6) of PHC facility assessed had any form of patient flow system or an appointment system in place. Eight of the facilities (66.6%) regularly experience bottlenecks at reception and in waiting areas, observation and consultation rooms, and toilets and at the pharmacy. Secondly, a lack of human resources was identified. Eleven healthcare facilities (91.6%) did not have queue marshals to direct healthcare users and organize patient flow. During the study, 11 of the healthcare facilities (91.6%) experienced a shortage of professional nurses to render PHC. Only three healthcare facilities (25%) had a pharmacist assistant to dispense medication and professional nurses fulfilled this role. In the last instance, physical resources were also a problem. Ten of the healthcare facilities (83.3%) did not have computers, printers or Internet access. Nine of the facilities (75%) did not have the minimum equipment required to render proper basic antenatal care services. None of the healthcare facilities had a separate change room additional to the antenatal consultation rooms (n=12 100%). vii The level of consensus with regard to the list of identified aspects to be included in patient flow system gained from the audit results was 67%. Although these respondents agreed on the required proposed aspects to be included, they were also given an opportunity to add additional aspects. The original list of aspects was extended by adding the additional aspects agreed upon. No consensus was reached in the ranking of the aspects in the proposed patient flow system (< 60%). Consensus was reached on 25 of final list of 27 aspects to be included in the patient flow system. As indicated, a final patient flow system was developed based on the research results. The following recommendations would require further consideration as well: All healthcare facilities need dedicated, trained queue marshals to direct and organized the varied healthcare users. If this is not possible, administrative personnel, nursing staff or volunteers must be trained to execute this task. More healthcare providers need to be scheduled during clinic peak times. Healthcare users need to be booked according to appointment dates and times, to prevent overcrowded facilities and bottlenecks in the morning. A separate changing room where the next patient can undress while the present patient is being attended to would be ideal to save time. Finally, all healthcare facilities should have the necessary equipment and material resources to render proper healthcare services. It is extremely time consuming to move between consultation rooms sharing equipment, and is frustrating for both the healthcare provider and the healthcare user. Each antenatal consultation room should have a telephone to arrange referrals immediately and to swiftly obtain laboratory results on which treatment can be selected.