The development and implementation of a model to facilitate self-care of the professional nurses caring for critically ill patients in Gauteng Province, South Africa

BACKGROUND: Critically ill patients have received little attention in the caring literature and yet are a population for whom caring behaviors are particularly important. OBJECTIVES: To describe patients' perceptions of caring exhibited by professional nurses in a critical care unit and to describe the meaning to the patients of these demonstrations of caring. METHODS: We used a phenomenologic approach for this descriptive study, which was conducted on 13 patients hospitalized in a critical care unit for at least 48 hours within 48 hours of their transfer from the unit. We asked them to respond to two open-ended questions and recorded all interviews on audio tapes that were transcribed verbatim. RESULTS: Caring in a critical care unit is attentive, vigilant behavior on the part of the nurse. This vigilance embodies nurturance and incorporates highly skilled, technical practices, as well as basic nursing care and beyond. Caring is a healing process of which lifesaving actions by the nurse are a part. Identifying the characteristics of the individuals involved in this healing process was one way of describing caring. Personal attributes of nurses, family members, and patients themselves are important in the descriptions of the caring process. These attributes are incorporated into the concept of mutuality. CONCLUSIONS: Caring is descriptive of a mutual process in which intentions are joined to form a shared experience. In this mutual process, healing is an outcome that might otherwise be elusive.

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Comparison of mean on-scene times: road versus air transportation of critically ill patients in the Western Cape of South Africa

Emergency Medicine Journal ◽

10.1136/emj.2007.051540 ◽

2008 ◽

Vol 25 (3) ◽

pp. 136-139 ◽

Cited By ~ 7

Author(s):

D J Van Hoving ◽

W P Smith ◽

L A Wallis

Keyword(s):

South Africa ◽

Critically Ill ◽

Critically Ill Patients ◽

Air Transportation ◽

Western Cape

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Health provider perspectives on the implementation of the same-day-ART initiation policy in the Gauteng province of South Africa

Health Research Policy and Systems ◽

10.1186/s12961-020-00673-y ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Dorina Onoya ◽

Idah Mokhele ◽

Tembeka Sineke ◽

Bulelwa Mngoma ◽

Aneesa Moolla ◽

...

Keyword(s):

South Africa ◽

Health Care ◽

Health Providers ◽

Care Providers ◽

Hiv Diagnosis ◽

Gauteng Province ◽

Art Initiation ◽

Provider Perspectives ◽

Universal Test And Treat ◽

Professional Nurses

Abstract Background In September 2016, South Africa (SA) began implementing the universal-test-and-treat (UTT) policy in hopes of attaining the UNAIDS 90-90-90 targets by 2020. The SA National Department of Health provided a further directive to initiate antiretroviral therapy (ART) on the day of HIV diagnosis in September 2017. We conducted a qualitative study to determine the progress in implementing UTT and examine health providers' perspectives on the implementation of the same-day initiation (SDI) policy, six months after the policy change. Methods We conducted in-depth interviews with three professional nurses, and four HIV lay counsellors of five primary health clinics in the Gauteng province, between October and December 2017. In September 2018, we also conducted a focus group discussion with ten professional nurses/clinic managers from ten clinic facilities. The interviews and focus groups covered the adoption and implementation of UTT and SDI policies. Interviews were conducted in English, Sotho or Zulu and audio-recorded with participant consent. Audio-recordings were transcribed verbatim, translated to English and analysed thematically using NVivo 11. Results The data indicates inconsistencies across facilities and incongruities between counsellor and nursing provider perspectives regarding the SDI policy implementation. While nurses highlighted the clinical benefits of early ART initiation, they expressed concerns that immediate ART may be overwhelming for some patients, who may be unprepared and likely to disengage from care soon after the initial acceptance of ART. Accordingly, the SDI implementation was slow due to limited patient demand, provider ambivalence to the policy implementations, as well as challenges with infrastructure and human resources. The process for assessing patient readiness was poorly defined by health providers across facilities, inconsistent and counsellor dependent. Providers were also unclear on how to ensure that patients who defer treatment return for ongoing counselling. Conclusions Our results highlight important gaps in the drive to achieve the ART initiation target and demonstrate the need for further engagement with health care providers around the implementation of same-day ART initiation, particularly with regards to infrastructural/capacity needs and the management of patient readiness for lifelong ART on the day of HIV diagnosis. Additionally, there is a need for improved promotion of the SDI provision both in health care settings and in media communications to increase patient demand for early and lifelong ART.

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The Perception of Professional Nurses About the Introduction of the National Health Insurance (NHI) in a Private Hospital in Gauteng, South Africa

The Open Public Health Journal ◽

10.2174/1874944501811010234 ◽

2018 ◽

Vol 11 (1) ◽

pp. 234-242 ◽

Cited By ~ 1

Author(s):

V.K. Molokomme ◽

E. Seekoe ◽

D.T. Goon

Keyword(s):

South Africa ◽

Health Care Services ◽

Private Hospital ◽

Health Sector ◽

Public Hospitals ◽

Gauteng Province ◽

Care Services ◽

African Health ◽

Professional Nurses ◽

The Government

Introduction:Based on concerns raised by professional nurses working in a private hospital that hinge on financial implication of the NHI, the state of public health sector and implications of the NHI to the South African health system prompted the need to determine their perceptions on the introduction of the NHI in a private hospital in Gauteng province, South Africa.Methods:A qualitative, exploratory and descriptive design using a semi-structured individual interview schedule was conducted. Coding and thematic analysis of data were done. The sample was purposive, consisting of 18 professional nurses from a private hospital in Gauteng, South Africa.Results:Findings indicated that they acknowledge the principles of the NHI such as a right to access healthcare, equity, affordability, efficiency, effectiveness and appropriateness. However, there were concerns on the Department of Health’s ability to ensure adequate human resources, sufficient equipment, safe infrastructure, meeting the national core standards which are still hampered by challenges experienced in public hospitals. Participants indicated that the government is not ready for the implementation of the NHI, based on the perceived non-transparency on outcomes from NHI pilot sites.Conclusion:General views concerning funding challenges, based on perceived mismanagement of funds and irregular expenditure as well as poor communication with all stakeholders involved in the implementation of the NHI were raised. The NHI is not only about financing, it involves service delivery, management and governance of health care services. There is a gap in information available to healthcare workers concerning the implementation of the NHI in South Africa.

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