Utilisation of partogram at a district in the North West Province, South Africa

Background: The partogram or partograph is a tool used to monitor the progress of labour and serves as a diagnostic tool for labour-related abnormalities such as prolonged labour, cephalopelvic disproportion (CPD) and obstructed labour. Appropriate utilisation of the partogram aids health caregivers with early diagnosis and facilitates clinical judgement and interventions to prevent complications of abnormal labour. The partogram is thus a mandatory tool to be utilised to monitor the progress of labour for intrapartum care in South Africa. Aim: This study aimed to assess and describe the utilisation of the partogram in a district of the North West Province. Setting: The study was conducted in the private rooms of facilities rendering maternity services in the district. Methods: A quantitative cross-sectional descriptive design was employed. A purposive sampling was used to select healthcare facilities, and simple random sampling was employed to select plotted partograms. Data were collected using a checklist and analysed using Statistical Package for Social Sciences software version 22. Results: A total of 279 partograms were analysed. The average partogram utilisation was 20% correct and 80% substandard or not recorded. All files had partogram documents included. Conclusion: A large percentage (80%) of the partograms were not completed according to the World Health Organization (WHO) standards. There was a concern about high proportions of unrecorded parameters such as monitoring of foetal and maternal conditions, and the progress of labour. Contribution: The findings and recommendations of the study could improve partogram utilisation in maternity care

Empowerment of the nurse unit manager in creating a climate conductive to learning

M.Cur.The overall purpose of this study is to describe empowerment strategies for the nurse unit manager to create a climate conducive to clinical learning at the nursing college in the North-West Province. In view of the South African Nursing Council report (1990), it clearly indicates that the nurse unit managers do not apply their theoretical knowledge to clinical practice, and that the student learning in the clinical nursing units are not up to the expected standard, hence the quality of clinical nursing education is questionable. The current education system in South Africa focuses on the provision of quality assurance in order to be in line with international standards. In accordance with the South African Qualifications Authority, the Constitution, South African Nursing Council, Batho-Pele principles, National Plan for Higher Education and outcomes-based education, there is a need to create a climate that is conducive to learning in the nursing units in order to develop the students' abilities regarding analytical, critical, evaluative and creative thinking. The nurse unit manager is experiencing problems with regard to clinical nursing education and the nursing students are also complaining that the clinical learning areas are not conducive to their learning. Therefore, the products that are produced by such an environment lack knowledge, skills, values and attitudes inherent in the nursing profession. Hence this study strives to describe empowerment strategies for the nurse unit manager to create a climate conducive to learning, based on their expert knowledge and experiences. The research questions arising from this problem are: What are the expectations and perceptions of the nursing students about the role of the nurse unit manager in creating a climate conducive to learning at the nursing college in the North-West Province? How can the nurse unit manager be empowered to create a climate conducive to clinical learning? The objectives are: Phase One: Stage one: To explore and describe the expectations of the nursing students regarding the role of the nurse unit manager in creating a climate conducive to learning. Stage two: To explore and describe the expectations and perceptions of the nurse unit manager regarding their role in creating a climate conducive to learning. Phase Two: To describe a conceptual framework. Phase Three: To describe empowerment strategies for the nurse unit manager to create a climate conducive to learning. The research design in this study was qualitative, descriptive, explorative and contextual in nature. In stage one of phase one, descriptive naïve sketches were used as a method of data gathering (Giorgi in Ornery, 1983:52) whereby 22 nursing students from the nursing college were selected for the research study. The following open-ended questions were written on the chalkboard, namely: "What are your expectations about the role of the nurse unit manager in creating the clinical nursing units as a climate conducive to learning?" The data was analysed according to Tesch's descriptive method (in Creswell, 1994:155). An independent coder who was purposively selected was used in the categorisation of data. The researcher held meetings with the independent coder for consensus discussions reached independently. Trustworthiness was ensured as described by Lincoln and Guba's (1985:290-326) model of trustworthiness. In order to ensure the credibility of the study, five nursing students who participated in the study were selected to participate in individual interviews to validate the categories and subcategories. In stage two of phase one, focus group interviews were conducted as a method of data gathering whereby 13 nurse unit managers from the clinical learning areas where the nursing students are placed for their clinical learning experiences were selected by the quota sampling technique. The interview was conducted by a nurse educator with a Master's degree, who is also a psychiatric nurse with expertise and experience in interviewing skills. A tape recorder was utilised with the nurse unit manager's permission to collect data. A follow-up interview with five nurse unit managers was conducted to validate the data gathered during the focus group interview. The following open-ended questions was used to obtain data from the nurse unit manager: "What are your perceptions regarding your role in creating an environment conducive to clinical learning?" "How can you be empowered as part of your role, to create clinical nursing units as climates conducive for clinical teaching and learning for nursing students?" Data was analysed according to Tesch's descriptive method (in Creswell, 1994:155). An independent coder was purposively selected in the categorisation ( iv ) of data. Categories were defined and arranged in table form for both participants in order to arrive at final categories. Trustworthiness was ensured as described by Lincoln and Guba's (1985:290-326) model of trustworthiness. Findings were conceptualised and conclusive statements made through logical deductive, inductive reasoning and inferences. A conceptual framework was developed within Muller's (1998) management process and the legal and professional frameworks. The integrated empowering process was adapted from Muller's management process, Vogt & Murrel's (1990) & Hokanson-Hawks' (1999) empowerment methods. This process comprises planning, organising (providing and structuring), directing (education, leading, mentoring and supporting), and control (actualising). Empowerment strategies for the nurse unit manager were described to create a climate conducive to learning, based on the results of phase one and phase two. Evaluation of the study was done, limitations, recommendations and conclusions were described with regard to nursing education, practice and nursing research

Factors inhibiting implementation of Integrated Management of Childhood Illnesses (IMCI) in primary health care (PHC) facilities in Mafikeng subdistrict.

Background: The main objective of the Integrated Management of Childhood Illnesses (IMCI) strategy was to reduce child mortality and morbidity, which are associated with major childhood illnesses. IMCI offers a comprehensive health programme that is directed at the development needs of children under five years of age. This strategy also focuses on good nutrition, health promotion, immunization and preventive measures, provides counselling services to mothers or care givers, and engenders an appropriate referral system for seriously ill children. Purpose: The purpose of this study was to explore and describe factors inhibiting implementation of IMCI in primary health care (PHC) facilities in selected sub-district of North West Province, South Africa. Methods: A qualitative, exploratory, descriptive-contextual framework was used. The target population of this study was professional nurses (PNs) working in community health centres (CHC) and primary health care (PHC) facilities. The sample size of the study included 15 participants as determined by data saturation reached by the 12th participant. The study included professional nurses trained in IMCI. Data was collected through in-depth individual semi-structured interviews, using an audio tape recorder and field notes, with data transcribed verbatim. Data was analysed using Atlas TI. Results: Participants were professional nurses aged between 25 and 50 years. Themes emerging from the data included organizational and structural factors inhibiting IMCI implementation; education, training and awareness; the behaviour and attitude of nurses towards IMCI implementation; and caregiver related factors affecting IMCI implementation. Conclusion: The study revealed that professional nurses need effective support, mentoring and supervision throughout IMCI implementation by the Mother, Child and Women Health (MCWH) coordinators. Caregivers and mothers need to know the importance of providing a comprehensive child history to professional nurses and therefore they need to be encouraged to disclose all relevant information during the IMCI process

North-West University Third Leadership Camp for Student Nurses

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