Assessment of activities performed by clinical nurse practitioners and implications for staffing and patient care at primary health care level in South Africa

Background: The shortage of nurses in public healthcare facilities in South Africa is well documented; finding creative solutions to this problem remains a priority.Objective: This study sought to establish the amount of time that clinical nurse practitioners (CNPs) in one district of the Western Cape spend on clinical services and the implications for staffing and skills mix in order to deliver quality patient care.Methods: A descriptive cross-sectional study was conducted across 15 purposively selected clinics providing primary health services in 5 sub-districts. The frequency of activities and time CNPs spent on each activity in fixed and mobile clinics were recorded. Time spent on activities and health facility staff profiles were correlated and predictors of the total time spent by CNPs with patients were identified.Results: The time spent on clinical activities was associated with the number of CNPs in the facilities. CNPs in fixed clinics spent a median time of about 13 minutes with each patient whereas CNPs in mobile clinics spent 3 minutes. Fixed-clinic CNPs also spent more time on their non-core functions than their core functions, more time with patients, and saw fewer patients compared to mobile-clinic CNPs.Conclusions: The findings give insight into the time CNPs in rural fixed and mobile clinics spend with their patients, and how patient caseload may affect consultation times. Two promising strategies were identified – task shifting and adjustments in health workerd eployment – as ways to address staffing and skills mix, which skills mix creates the potential for using healthcare workers fully whilst enhancing the long-term health of these rural communities.

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Proposal for Improving Records Management Practices of Traditional Institutions in Ga Molepo, South Africa

Mousaion ◽

10.25159/2054 ◽

2017 ◽

Vol 35 (1) ◽

pp. 46-67

Author(s):

Mahlaga Johannes Molepo ◽

Linda M. Cloete

Keyword(s):

South Africa ◽

Rural Communities ◽

Management Practices ◽

Records Management ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Record Keeping ◽

Local Municipalities ◽

Management Procedures ◽

Traditional Institutions

The way in which an institution treats its records is crucial for its survival in a rapidly changing society. The purpose of the study was to investigate the records management practices and challenges faced by traditional institutions of leadership and governance in Ga Molepo, Limpopo, South Africa. The researcher employed a cross-sectional survey in order to quantitatively examine the challenges faced by members of traditional councils. A researcher administered questionnaire was used as a data collection tool to study a stratified sample of 35 members from an estimated population of 350. The findings revealed patterns and trends of non-compliance with records management standards and guidelines. Although there were sporadic cases of record keeping, a greater number of respondents revealed that traditional institutions lack the facilities, equipment, education and trained/skilled personnel to apply correct records management procedures in their daily administration of their traditional communities. The main value of the study is to create awareness of records management as one of the neglected areas in traditional institutions â€“ which are by current legislative arrangement, the closest form of leadership and governance for rural communities in light of their relationship with local municipalities and the Department of Cooperative Governance and Traditional Affairs.

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Performance in grade 12 mathematics and science predicts student nurses’ performance in first year science modules at a university in the Western Cape

Curationis ◽

10.4102/curationis.v40i1.1776 ◽

2017 ◽

Vol 40 (1) ◽

Cited By ~ 1

Author(s):

Katlego D.T. Mthimunye ◽

Felicity M. Daniels

Keyword(s):

South Africa ◽

Academic Performance ◽

Predictive Validity ◽

Life Science ◽

Student Nurses ◽

First Year ◽

Western Cape ◽

Cross Sectional ◽

Mathematics And Science ◽

First Year Student

Background: The demand for highly qualified and skilled nurses is increasing in South Africa as well as around the world. Having a background in science can create a significant advantage for students wishing to enrol for an undergraduate nursing qualification because nursing as profession is grounded in scientific evidence.Aim: The aim of this study was to investigate the predictive validity of grade 12 mathematics and science on the academic performance of first year student nurses in science modules.Method: A quantitative research method using a cross-sectional predictive design was employed in this study. The participants included first year Bachelor of Nursing students enrolled at a university in the Western Cape, South Africa. Descriptive and inferential statistics were performed to analyse the data by using the IBM Statistical Package for Social Sciences versions 24. Descriptive analysis of all variables was performed as well as the Spearman’s rank correlation test to describe the relationship among the study variables. Standard multiple linear regressions analysis was performed to determine the predictive validity of grade 12 mathematics and science on the academic performance of first year student nurses in science modules.Results: The results of this study showed that grade 12 physical science is not a significant predictor (p > 0.062) of performance in first year science modules. The multiple linear regression revealed that grade 12 mathematics and life science grades explained 37.1% to 38.1% (R2 = 0.381 and adj R2 = 0.371) of the variation in the first year science grade distributions.Conclusion: Based on the results of the study it is evident that performance in grade 12 mathematics (β = 2.997) and life science (β = 3.175) subjects is a significant predictor (p < 0.001) of the performance in first year science modules for student nurses at the university identified for this study.

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What's in the lunchbox? Dietary behaviour of learners from disadvantaged schools in the Western Cape, South Africa

Public Health Nutrition ◽

10.1017/s1368980011001108 ◽

2011 ◽

Vol 14 (10) ◽

pp. 1752-1758 ◽

Cited By ~ 19

Author(s):

Zulfa Abrahams ◽

Anniza de Villiers ◽

Nelia P Steyn ◽

Jean Fourie ◽

Lucinda Dalais ◽

...

Keyword(s):

South Africa ◽

Self Efficacy ◽

Primary Schools ◽

Dietary Diversity ◽

Standard Of Living ◽

Dietary Behaviour ◽

Processed Meat ◽

Western Cape ◽

Cross Sectional Survey ◽

Cross Sectional

AbstractObjectiveTo identify and describe factors associated with food shop (known as tuck shop in South Africa) and lunchbox behaviours of primary-school learners in South Africa.DesignAnalysis of data collected in 2008 from a cross-sectional survey.SettingSixteen primary schools in the Western Cape, South Africa.SubjectsA total of 717 grade 4 learners aged 10–12 years.ResultsA 24 h recall established that 69 % of learners carried a lunchbox to school and 49 % had consumed at least one item purchased from the school food shop/vendor. Most lunchboxes contained white bread with processed meat, whereas the most frequent food shop/vendor purchase comprised chips/crisps. Learners who carried a lunchbox to school had significantly lower BMI percentiles (P = 0·002) and BMI-for-age (P = 0·034), compared with their counterparts. Moreover, they were younger, had higher standard-of-living and dietary diversity scores, consumed more meals per day, had greater self-efficacy and came from predominantly urban schools, compared with those who did not carry a lunchbox to school. Learners who ate food shop/vendor purchases had a lower standard-of-living score and higher dietary diversity and meal scores. Only 2 % of learners were underweight, whereas 19 % were stunted and 21 % were overweight/obese (BMI ≥ 25 kg/m2).ConclusionsChildren who carried a lunchbox to school appeared to have greater dietary diversity, consumed more regular meals, had a higher standard of living and greater nutritional self-efficacy compared with those who did not carry a lunchbox to school.

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Commitment and the emigration intentions of South African professional nurses

Health SA Gesondheid ◽

10.4102/hsag.v18i1.512 ◽

2013 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Jeffrey J. Bagraim

Keyword(s):

South Africa ◽

South African ◽

Employee Commitment ◽

Western Cape ◽

Public Health Services ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Tertiary Hospitals ◽

Quantitative Design ◽

The Relationship

The emigration of skilled nurses from South Africa exacerbates the crisis in the provision of public health services. A descriptive, quantitative design was applied to investigate the relationship between intention to emigrate and employee commitment. Over 400 registered nurses (N = 419), working within public sector tertiary hospitals in the Western Cape, responded to a cross-sectional survey questionnaire. Three foci of employee commitment (organisational, professional and national) were examined but only national commitment significantly helped predict intention to emigrate from South Africa in the regression model (beta = -0.0525, p < 0.0001). The implications of the results obtained in this study are discussed.Die emigrasie van verpleegkundiges uit Suid-Afrika vererger die krisis in die verskaffing van gesondheidsorgdienste in die land. ’n Beskrywende, kwantitatiewe ontwerp is gebruik om die verwantskap tussen werknemertoewyding en die voorneme om te emigreer te ondersoek. Meer as 400 verpleegsters (N = 419) wat in openbare tersiêre hospitale in die Wes-Kaap werk, het op die vraelys gereageer. Drie fokusareas van toewyding (organisatories, professioneel en nasionaal) is gemeet, maar net nasionale toewyding het daartoe bygedra om emigrasievoorneme te voorspel (beta = -0.0525, p < 0.0001). Die implikasies van hierdie resultate word bespreek.

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Nurses’ views on promotion and the influence of race, class and gender in relation to the Employment Equity Act

SA Journal of Industrial Psychology ◽

10.4102/sajip.v45i0.1611 ◽

2019 ◽

Vol 45 ◽

Author(s):

Mariana M. Van der Heever ◽

Anita S. Van der Merwe ◽

Talitha Crowley

Keyword(s):

South Africa ◽

Public Sector ◽

Diversity Training ◽

Survey Design ◽

Mixed Race ◽

Western Cape ◽

Employment Equity ◽

Cross Sectional ◽

Managerial Positions ◽

And Gender

Orientation: Regardless of the implementation of the Employment Equity Act (EEA), No. 55 of 1998 and the abolishment of apartheid in 1994, African and mixed-race females are under-represented in managerial positions in the public sector of the Western Cape (WC) in South Africa and nationally in the private health sector.Research purpose: The purpose was to explore the views of nurses about promotion to managerial positions in view of the Employment Equity Act (EEA) and the possible influence of race, class and gender.Motivation for the study: South Africa has a history of racial hierarchies and gender inequities. It was therefore important to explore the influence of the EEA and race, class and gender on the promotion of nurses in the post-apartheid context.Research approach/design and method: A cross-sectional descriptive survey design was completed. Six hundred and eighty-eight (n = 688) nurses consented to participate and 573 (83%) questionnaires were returned.Main findings: Race as a social construct surfaced in the superior viewing of white and the inferior viewing of African nurses. Mixed-race and white nurses seemed disgruntled with the EEA because of the benefits it holds for African nurses. African nurses seemed angered by their under-representation in managerial positions in the private and public sectors in the WC. White nurses seemed convinced that African, mixed-race and Indian nurses experience upward mobility. Mixed-race nurses (public sector WC) showed concerns about the career successes of males in a female-dominated profession.Practical/managerial implications: Managerial structures should be required to invest in diversity training, create awareness of the noble intentions of the EEA and communicate the relevance of employment equity plans.Contribution/value-add: The findings provided evidence that reflected a need for diversity training and the creation of awareness about the longstanding influence of racial and gender hierarchies.

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Development of a training programme for primary care providers to counsel patients with risky lifestyle behaviours in South Africa

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v7i1.819 ◽

2015 ◽

Vol 7 (1) ◽

Cited By ~ 6

Author(s):

Zelra Malan ◽

Bob Mash ◽

Kathy Everett-Murphy

Keyword(s):

South Africa ◽

Primary Care ◽

Nurse Practitioners ◽

Communicable Disease ◽

Primary Care Providers ◽

Training Programme ◽

Care Providers ◽

Clinical Nurse ◽

Lifestyle Behaviours ◽

Behaviour Change Counselling

Background: We are facing a global epidemic of non-communicable disease (NCDs), which has been linked with four risky lifestyle behaviours. It is recommended that primary care providers (PCPs) provide individual brief behaviour change counselling (BBCC) as part of everyday primarycare, however currently training is required to build capacity. Local training programmes are not sufficient to achieve competence.Aim: This study aimed to redesign the current training for PCPs in South Africa, around a new model for BBCC that would offer a standardised approach to addressing patients’ risky lifestyle behaviours.Setting: The study population included clinical nurse practitioners and primary care doctors in the Western Cape Province.Methods: The analyse, design, develop, implement and evaluate (ADDIE) model provided a systematic approach to the analysis of learning needs, the design and development of the training programme, its implementation and initial evaluation.Results: This study designed a new training programme for PCPs in BBCC, which was based on a conceptual model that combined the 5As (ask, alert, assess, assist and arrange) with a guiding style derived from motivational interviewing. The programme was developed as an eight-hour training programme that combined theory, modelling and simulated practice with feedback, for either clinical nurse practitioners or primary care doctors.Conclusion: This was the first attempt at developing and implementing a best practice BBCC training programme in our context, targeting a variety of PCPs, and addressing different risk factors.

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The Nutritional Status of Adult Antiretroviral Therapy Recipients with a Recent HIV Diagnosis; A Cross-Sectional Study in Primary Health Facilities in Gauteng, South Africa

Healthcare ◽

10.3390/healthcare8030290 ◽

2020 ◽

Vol 8 (3) ◽

pp. 290

Author(s):

Khabo Mahlangu ◽

Perpetua Modjadji ◽

Sphiwe Madiba

Keyword(s):

South Africa ◽

Antiretroviral Therapy ◽

Nutritional Status ◽

Health Facilities ◽

The Body ◽

Hiv Care ◽

Hiv Diagnosis ◽

Cross Sectional ◽

Primary Health ◽

Primary Health Facilities

The study determined the nutritional status of adult antiretroviral therapy (ART) recipients, and investigated the association between the duration on ART and the nutritional status. This study was based in primary health facilities in Gauteng, South Africa. The data collected included sociodemographic variables; the duration of the treatment; and the body mass index (BMI), classified as undernutrition (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or overweight/obesity (≥25 kg/m2). ART recipients (n = 480) had a mean age of 35 (± 8.4SD) years. All had taken ART for six months or more (range 6–48 months). The data were analyzed using STATA 13.0. The overall prevalence of overweight/obesity was 39%, it was higher in females (46%) than in males (30%), 26% were overweight, and 13% were obese. Underweight was 13%, and was higher in males (18%) than females (9%). Being overweight was more likely in those aged ≥35 years and those in smaller households. Being obese was less likely in males, in the employed, and in those with a higher income, but was more likely in those with a longer duration on ART. Abdominal obesity was high, but less likely in males. Interventions to prevent overweight/obesity should be integrated into routine HIV care, while at the same time addressing the burden of undernutrition among ART recipients.

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