The neonatal transfer process through the lens of neonatologists at public hospitals in South Africa

Background: Neonatal care is provided by various levels of healthcare facilities in South Africa. Intensive care for neonates is only provided at the higher levels, hence the need for transfers from lower-level to higher-level facilities (e.g. primary hospitals to tertiary hospitals) or across levels of facilities, particularly when life-threatening situations arise (e.g. cardiac deterioration, respiratory deterioration and desaturation).Aim: The aim of the study was to explore neonatologists’ views regarding the neonatal transfer process and to describe the preparedness of advanced life support (ALS) paramedics to undertake such transfers.Setting: The setting consisted of neonatologists from three provinces i.e. KwaZulu-Natal, Gauteng and Western cape.Method: A qualitative descriptive design was utilised in this study. Semistructured interviews were conducted on the public health hospitals in three provinces (N = 9; n = 3) with neonatologists (N = 7; n = 7) who were involved in the transfers of critically ill neonates. The process of thematic analysis was used.Results: The themes that emerged in this study were: an awareness of local contextual realities related to neonatal transfers, challenges evident within the context of neonatal transfers, decision-making around the transfer of ill neonates, ALS paramedic preparedness for transfers and good clinical governanceConclusion: The study found that there was a need to be aware of local contextual realities confronting neonatal transfers, a need for greater preparedness for paramedics to undertake these transfers, a need for a sound referral processes and a need for coordinated transfer effort between paramedics, hospital staff and transport team members for the successful transfer of critically ill neonates.Contribution: The findings highlight the challenges confronting the neonatal transfer process in South Africa through the lens of neonatologist at public hospitals. Hence, the study reinforces the preparedness and coordination of the transfer process, along with more efficient communication between paramedics, hospital staff and the transfer team.

Acknowledgement to reviewers

No abstract available.

Interactive workshops as a learning and teaching method for primary healthcare nurses

Background: Traditionally, learning by and teaching for primary healthcare (PHC) nurses use didactic, teacher-centred approaches. Hence, the feasibility of interactive workshops in non-threatening PHC environments to refresh nurses’ knowledge on patient care needs exploring.Aim: To describe interactive workshops as a learning and teaching method for PHC nurses.Setting: Primary healthcare clinics.Methods: Systematic literature search followed by an exploratory experimental pre or post-test control group design. Random clinic sampling (n = 26) led to clinic inclusion at the control (n = 5) and experimental (n = 5) sites. Nurses (n = 42) were conveniently selected for the control (n = 21) and experimental (n = 21) groups. Experimental participants (n = 21) attended interactive workshops (n = 5) where various strategies were applied, whilst addressing key diabetes messages. Both groups completed a questionnaire aligned to diabetes messages pre- and post-workshop. Additionally, a Likert scale questionnaire was posed to the experimental group post-workshop. Data was analysed statistically and presented as descriptive statistics, frequencies and percentages.Results: Articles reviewed (n = 20) identified types of interactive activities, role players, learning content covered, feasibility and duration of the interactive workshops. Pre or post-testing results of the workshops participants indicate improved knowledge related to peripheral sensation (0.03) and ( 0.01). Results from the questionnaire revealed participants’ satisfaction with the interactive workshops.Conclusion: Interactive workshops as a learning and teaching method could lead to change in knowledge, and participant satisfaction. However, using a combination of interactive workshops and other teaching modalities may enhance learning and teaching further.Contribution: Interactive workshops are a feasible instructional method during refresher courses for healthcare providers.

Experiences of advanced psychiatric nurses regarding the need for prescriptive authority in KwaZulu-Natal

Background: Nurse prescribing has become a global and transformational practice to ensure the achieving of optimal health outcomes, including advanced psychiatric nurses. Despite the transformational practice globally, South Africa seems to lag behind because nurses do not have permission to prescribe medication.Aim: To describe the experiences of advanced psychiatric nurses regarding the need to prescribe medication treatment in KwaZulu-Natal.Setting: The study took place in three mental healthcare institutions in KwaZulu-Natal in inpatient units.Method: The qualitative, descriptive design was used to collect the experiences of advanced psychiatric nurses in KwaZulu-Natal regarding the need for prescriptive authority. Six focus group interviews were conducted to gather information. The seven steps of Colaizzi’s method were used to analyze the data.Results: The study found two primary themes and two sub-themes. The findings highlighted the necessity for advanced psychiatric nurse role recognition and prescribing. Insufficient use of skilled psychiatric nurses caused delays in addressing mental health patients in emergencies.Conclusion: The two themes, prescribing role of advanced psychiatric nurses and role recognition, revealed that granting advanced psychiatric nurses’ autonomy to prescribe remained a challenge. Advanced psychiatric nurses are expected to provide high-quality care, but they are limited in their abilities. Because advanced psychiatric nurses are not used to prescribe in KwaZulu-Natal, they rely on psychiatrists to manage psychotic patients.Contribution: The evaluation of policies and procedures that guide advanced psychiatric nurses in prescribing psychotropic medications.

A model to foster and facilitate trust and trusting relationships in the nursing education context

Background: In the nursing education context, the fostering of trust and establishing trusting relationships are important facets of teaching and learning.Aim: The purpose of the study was to understand trust and trusting relationships in teaching and learning, and to develop a model to foster and facilitate trust and trusting relationships in the nursing education context.Setting: Two nursing education institutions were purposively sampled that offered a comprehensive programme in nursing.Methods: A grounded theory study was conducted with the aim to develop a model for trust and trusting relationships in teaching and learning. Purposive, convenience and theoretical sampling of participants were applied. The sample size consisted of 5 educators and 23 students at a university and 9 educators and 37 students at a public nursing education institution. Charmaz’s methods were used for the data analysis. Collection and analysis of data were conducted concurrently.Results: Data of views from the educators and students on trust were synthesised. Themes identified were: professional relations, expectations of the role players in nursing education, creating a conducive teaching and learning context, and outcomes of lack of trust. From the findings, a substantive model to foster and facilitate trust and trusting relationships in nursing education was developed.Conclusion: The study contributed to understanding trust in nursing education. Recommendations focus on fostering and facilitating self-trust and trusting relationships and also on how the model could be implemented in nursing education.Contribution: Fostering and facilitating trust and trusting relationships in the nursing education context will enhance a trusting culture and contribute to the quality of teaching and learning.

Erratum: Factors influencing patient falls in a private hospital group in the Cape Metropole of the Western Cape

No abstract available.

Erratum: Community engagement in the Faculty of Health Science: A concept analysis

No abstract available.

The efficacy of bedaquiline versus kanamycin in multi-drug resistant tuberculosis: A systematic scoping review

Background: Drug-resistant tuberculosis (DR-TB) has become a serious cause of concern both on a global scale and in South Africa. It is associated with a lower successful treatment rate, thus creating a hurdle in achieving good treatment outcomes for patients.Aim: The aim of this study was to compare the efficacy of the drug kanamycin, an injectable aminoglycoside, to bedaquiline, a newer oral drug used to treat DR-TB.Methods: PubMed and Google Scholar, both of which are online databases, were extensively searched using the necessary keywords so that studies that were relevant to the scoping review were retrieved. A data-charting list was developed to extract the needed data for this scoping review.Results: The main findings of the scoping review showed that bedaquiline was highly efficacious in the treatment of DR-TB, and that it was a valuable addition in the treatment of DR-TB. The findings of the study also showed that kanamycin does not have good efficacy against DR-TB. and its use extends the treatment of DR˗TB.Conclusion: It stands to reason that bedaquiline replaces kanamycin in the DR-TB drug regimen as it was shown to be more efficacious and patients experienced better treatment outcomes in a shorter period of time. There were also fewer adverse effects associated with bedaquiline as compared to kanamycin.Contribution: Bedaquiline-based DR-TB therapy is more efficacious than aminoglycoside-based regimens which include kanamycin.