20 research outputs found

    Exploring supportive relationship provided to newly qualified midwives during transition period in Limpopo province, South Africa

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    Transition from midwifery training to professional practice is enhanced by positive support from experienced colleagues. The study explored experiences of newly qualified midwives regarding existence of supportive relationship during transition. The setting was a maternity unit of a selected hospital from each of the five districts of Limpopo province. Population was all midwives who completed a comprehensive nursing programme (R425 of 19 February 1985, as amended); and qualified as nurses (general, psychiatric and community) and midwives working in selected hospitals. Twenty-five participants selected from maternity units of the five selected hospitals using non-probability, purposive sampling method. In-depth individual interviews conducted until saturation was reached. Data analysed through Tesch’s method. Ethical issues considered. Findings revealed negative unsupportive relationship experienced by participants resulting in poor performance. Graduates expressed dislike experienced from senior colleagues. Establishment and maintenance of positive relationship between experienced and newly qualified midwives should be enhanced to promote effective transition. (Afr J Reprod Health 2021; 25[5]: 105-112)

    Developing and prioritising strategies to improve the implementation of maternal healthcare guidelines in South Africa : the nominal group technique

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    BACKGROUND : In South Africa, maternal healthcare guidelines are distributed to primary health care (PHC) facility for midwives to refer and implement during maternal healthcare services. Different training was offered for the use of maternal care guidelines. However, poor adherence and poor implementation of guidelines were discovered. AIM : This study aimed to develop and prioritise strategies to improve the implementation of maternal healthcare guidelines at PHC facilities of Limpopo province, South Africa. METHOD : Strengths, weaknesses, opportunities and threats analysis and its matrix together with the nominal group technique were used to develop the current strategy. Midwives, maternal, assistant and operational managers from PHC facilities of the two selected district of the Limpopo province were selected. Criterion-based purposive sampling was used to select participants. Data collection and analysis involved the four steps used in the nominal group technique. RESULTS : Strategies related to strengths and weaknesses such as human resources, maternal health services and knowledge deficit were identified. Opportunities and threats such as availability of guidelines, community involvement and quality assurance as factors that influenced the provision of maternal healthcare services were identified. CONCLUSION : Researchers formulated actions that could build on identified strengths, overcome weaknesses such as human resources, explore opportunities and mitigate the threats such as quality assurance. Implementation of the developed strategies might lead to the reduction of the maternal mortality rate.The MRC, the University of Venda and the National Research Foundation.http://www.phcfm.orgam2023Nursing Scienc

    Experiences of midwives and accoucheurs in implementation of pregnancy HIV guidelines in Limpopo province, South Africa

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    INTRODUCTION : Each year, about 43,000 pregnant women and mothers die world-wide due to pregnancy- related birth conditions. Most of these deaths are avoidable and preventable. An update on the maternal mortality of 2017 indicated that 976 pregnant women died between 2014 and 2016, despite being initiated on anti-retroviral drugs. Although, an improvement on human immunodeficiency virus (HIV) in pregnancy guidelines implementation was achieved, with 35% of maternal deaths occurring due to HIV infections, therefore there is a need to investigate the experience of midwives/accoucheurs regarding the implementation of HIV guidelines during pregnancy. The purpose of this study was to investigate and describe the experience of midwives/accoucheurs in implementing pregnancy HIV guidelines in the Limpopo province of South Africa. MATERIAL AND METHODS : This was a qualitative study using exploratory-descriptive design, and included professional nurses with midwifery qualification. Non-probability, purposive sampling was used for 18 participants based on data capacity. Data was collected through an in-depth, unstructured face-to-face interview and analyzed using Tesch’s open coding method. Measures to ensure dependability, conformability, transferability, and credibility were applied. RESULTS : Three main subjects emerged from raw data, namely: experiences of midwives/accoucheurs during provision of care to HIV-positive pregnant women, management of pregnant HIV-positive women as per guidelines, and challenges experienced by midwives caring for pregnant HIV-positive women. CONCLUSIONS : Midwives implemented the HIV guidelines during pregnancy; however, shortage of nurses during pregnant women’s first visit resulted in prolonged waiting time for other patients. The prolonged time for patients’ results and shortage of consulting rooms affected the implementation of HIV guidelines. The completion of different records was not accurately done. Non-adherence amongst clients affected the overall provision of HIV care.The South African Medical Research Council and University of Venda.https://www.termedia.pl/Journal/HIV_AIDS_Review_International_Journal_of_HIV_Related_Problems-106am2020Nursing Scienc

    Can women’s lives be saved from hypertensive disorders during pregnancy? Experiences of South African midwives

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    A qualitative, descriptive phenomenological research design was conducted to explore and describe the experiences of midwives on the management of women diagnosed with hypertensive disorders during pregnancy in rural areas of Limpopo Province, South Africa. Non-probability sampling was used to select eighteen (18) midwives from primary health care facilities of Mopani and Vhembe districts in Limpopo Province. Data was collected through in-depth interview and analysed using eight steps of Tesch‘s open coding method. Ethical considerations were adhered to by ensuring confidentiality, anonymity, privacy and signing of informed consent by participants. Measures to ensure trustworthiness; credibility, transferability, dependability and last ly, confirmability were ensured. Findings of this study revealed three themes (with sub-themes) namely; management of pregnant women diagnosed with hypertensive disorders, support experienced when managing complications, challenges experienced by midwives when managing hypertensive disorders during pregnancy. In conclusion, poor support came up very strongly as a factor influencing good management of hypertensive disorders in pregnancy. Recruitment of more midwives that will support each other during management of pregnant women with hypertensive disorders is recommended.Une conception qualitative et descriptive de la recherche phĂ©nomĂ©nologique a Ă©tĂ© menĂ©e pour explorer et dĂ©crire les expĂ©riences des sages-femmes sur la prise en charge des femmes diagnostiquĂ©es avec des troubles hypertensifs pendant la grossesse dans les zones rurales de la province du Limpopo, en Afrique du Sud. Un Ă©chantillonnage non probabiliste a Ă©tĂ© utilisĂ© pour sĂ©lectionner dix-huit (18) sages-femmes dans les Ă©tablissements de soins de santĂ© primaires des districts de Mopani et Vhembe dans la province de Limpopo. Les donnĂ©es ont Ă©tĂ© collectĂ©es par le biais d‘interviews approfondies et analysĂ©es en utilisant huit Ă©tapes de la mĂ©thode de codage ouvert de Tesch. Les considĂ©rations Ă©thiques ont Ă©tĂ© respectĂ©es en garantissant la confidentialitĂ©, l'anonymat, la confidentialitĂ© et la signature du consentement Ă©clairĂ© des participants. Mesures visant Ă  garantir la fiabilitĂ©; la crĂ©dibilitĂ©, la transfĂ©rabilitĂ©, la fiabilitĂ© et enfin la confirmabilitĂ© ont Ă©tĂ© assurĂ©es. Les rĂ©sultats de cette Ă©tude ont r Ă©vĂ©lĂ© trois thĂšmes (avec des sous-thĂšmes) Ă  savoir; prise en charge des femmes enceintes diagnostiquĂ©es de troubles hypertensifs, accompagnement expĂ©rimentĂ© lors de la gestion des complications, difficultĂ©s rencontrĂ©es par les sages-femmes lors de la gestion des troubles hypertensifs pendant la grossesse. En conclusion, un mauvais soutien est apparu trĂšs fortement comme un facteur influençant la bonne gestion des troubles hypertensifs pendant la grossesse. Il est recommandĂ© de recruter davantage de sages - femmes qui se soutiendront mutuellement pendant la prise en charge des femmes enceintes souffrant de troubles hypertensifs.The South African Medical Research Council, the University of Venda and the National Research Foundation of South Africa.https://journals.co.za/content/journal/ajrham2020Nursing Scienc

    Can Women’s Lives be saved from Hypertensive Disorders during Pregnancy? Experiences of South African Midwives

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    A qualitative, descriptive phenomenological research design was conducted to explore and describe the experiences of midwives on the management of women diagnosed with hypertensive disorders during pregnancy in rural areas of Limpopo Province, South Africa. Non-probability sampling was used to select eighteen (18) midwives from primary health care facilities of Mopani and Vhembe districts in Limpopo Province. Data was collected through in-depth interview and analysed using eight steps of Tesch‘s open coding method. Ethical considerations were adhered to by ensuring confidentiality, anonymity, privacy and signing of informed consent by participants. Measures to ensure trustworthiness; credibility, transferability, dependability and lastly, confirmability were ensured. Findings of this study revealed three themes (with sub-themes) namely; management of pregnant women diagnosed with hypertensive disorders, support experienced when managing complications, challenges  experienced by midwives when managing hypertensive disorders during pregnancy. In conclusion, poor support came up very strongly as a factor influencing good management of hypertensive disorders in pregnancy. Recruitment of more midwives that will support each other during management of pregnant women with hypertensive disorders is recommended. Keywords: Hypertensive disorders in pregnancy, midwives, maternal death, South AfricaUne conception qualitative et descriptive de la recherche phĂ©nomĂ©nologique a Ă©tĂ© menĂ©e pour explorer et dĂ©crire les expĂ©riences des sages-femmes sur la prise en charge des femmes diagnostiquĂ©es avec des troubles hypertensifs pendant la grossesse dans les zones rurales de la province du Limpopo, en Afrique du Sud. Un Ă©chantillonnage non probabiliste a Ă©tĂ© utilisĂ© pour sĂ©lectionner dix-huit (18) sages-femmes dans les Ă©tablissements de soins de santĂ© primaires des districts de Mopani et Vhembe dans la province de Limpopo. Les donnĂ©es ont Ă©tĂ© collectĂ©es par le biais d‘interviews approfondies et analysĂ©es en utilisant huit Ă©tapes de la mĂ©thode de codage ouvert de Tesch. Les considĂ©rations Ă©thiques ont Ă©tĂ© respectĂ©es en garantissant la confidentialitĂ©, l'anonymat, la confidentialitĂ© et la signature du consentement Ă©clairĂ© des participants. Mesures visant Ă  garantir la fiabilitĂ©; la crĂ©dibilitĂ©, la transfĂ©rabilitĂ©, la fiabilitĂ© et enfin la confirmabilitĂ© ont Ă©tĂ© assurĂ©es. Les rĂ©sultats de cette Ă©tude ont rĂ©vĂ©lĂ© troisthĂšmes (avec des sous-thĂšmes) Ă  savoir; prise en charge des femmes enceintes diagnostiquĂ©es de troubles hypertensifs, accompagnement expĂ©rimentĂ© lors de la gestion des complications, difficultĂ©s rencontrĂ©es par les sages-femmes lors de la gestion des troubles hypertensifs pendant la grossesse. En conclusion, un mauvais soutien est apparu trĂšs fortement comme un facteur influençant la bonne gestion des troubles hypertensifs pendant la grossesse. Il est recommandĂ© de recruter davantage de sagesfemmes qui se soutiendront mutuellement pendant la prise en charge des femmes enceintes souffrant de troubles hypertensifs. Mots-clĂ©s: Troubles hypertensifs pendant la grossesse, les sages-femmes, la mort maternelle, Afrique du Su

    Managing hypertensive disorders during pregnancy in low resource settings

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    BACKGROUND : Maternal deaths caused by hypertensive disorders are preventable. The purpose was to assess midwives’ perceived knowledge and skills on the implementation of maternal health guidelines when managing hypertensive disorders during pregnancy. METHODS : Quantitative, cross-sectional method was used. Population comprised of 200 midwives. Data was collected through self-report questionnaires and analysed through Statistical Package for Social Sciences 24. RESULTS : Midwives (63.5%) possessed knowledge and skills of implementing maternal guidelines. While 77.5% experienced shortage of human and material resources. Non-compliance to ambulance services led to delayed initiation of treatment. RECOMMENDATIONS : Continuous in-service training and education must be conducted. More resources to be provided to implement guidelines accurately.The South African Medical Research Council and the University of Venda Research and Publication Committee.https://www.tandfonline.com/loi/ihip20hj2019Nursing Scienc

    Perceptions of postpartum mothers towards the care provided by male student midwives at labour units in Limpopo Province, South Africa

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    Student midwives should always provide cultural sensitive care and respect the rights of every woman when choosing health care providers during pregnancy and childbirth. The aim of this study was to describe and explore the perceptions of postpartum mothers towards the care provided by male student midwives during their midwifery practice. A qualitative explorative, descriptive, and contextual research design was used. A non-probability, convenience sampling method was used to sample 42 postpartum mothers who received care from male student midwives at the five district hospitals in Limpopo province, South Africa. Data was collected through in-depth individual interviews until data saturation was reached by repeating data. Open coding approach was used to analyse data. All ethical principles were adhered to. Results revealed that postpartum mothers, preferred care by male students‘ midwives; they were viewed to be respectful, sympathetic, and caring; however, they discussed their fears of midwifery practice with mothers. It is recommended that midwives should play a pivotal role in informing pregnant women during antenatal visits that male student midwives can conduct deliveries. The community awareness campaign should be strengthened that male student midwives are availability in maternity units.Keywords: Male student midwives, midwifery practice, perceptions, and postpartum mother

    Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa

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    Background: Community service nurses are placed in a hospital within the first year after qualifying to obtain clinical experience under the supervision of experienced professional nurses. When placed in clinical environments, new midwifery graduates are expected to be job ready, demonstrate competence in the provision of evidence-based care, practise independently and assume accountability and responsibility for their own actions. Aim: The study aimed at exploring the expectations of experienced midwives of clinical competence of newly graduated midwives during transition. Setting: The study was conducted at the training hospitals of the five districts in Limpopo province. Method: The researcher used a qualitative approach which is explorative and descriptive in nature. The population comprised all the professional midwives with experience of 5 years and above working at the selected hospitals in Vhembe, Mopani, Capricorn, Waterberg and Sekhukhune districts of Limpopo province, South Africa. From each selected hospital, five experienced midwives were selected using non-probability, purposive sampling method. An in-depth individual face-to-face interview was used to collect data from the participants, until saturation was reached. The open-coding, Tesch’s eight-step process was used to analyse data. Results: Results revealed that newly graduated midwives failed to meet the perceived expectations by experienced midwives; this was reflected in sub-themes: limited sense of independence, limited participation in task sharing and commitment and competence versus incompetence to patient care. Conclusion: The experienced midwives expected newly graduated midwives to function as professionals; unfortunately, they expressed disappointment as graduates did not meet their expectations. Newly graduated midwives lacked sense of independence, commitment to patient care and did not display ability in task sharing.University of Venda Research and Publication Committee and Limpopo Department of Healt

    Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province

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    Background: Recording of information on multiple documents increases professional nurses’ responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient’s information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. Objectives: The objective of this study was to investigate and describe the effects of increased nurses’ workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. Methods: The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses’ workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who work at PHC facilities in Vhembe District. Purposive sampling was used to select nurses and three professional nurses were sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide. Results: PHC facilities encountered several effects due to increased nurses’ workload where incomplete patient information is documented. Unavailability of patient information was observed, whilst some documented information was found to be illegible, inaccurate and incomplete. Conclusion: Documentation of information at PHC facilities is an evidence of effective communication amongst professional nurses. There should always be active follow-up and mentoring of the nurses’ documentation to ensure that information is accurately and fully documented in their respective facilities. Nurses find it difficult to cope with the increased workload associated with documenting patient information on the multiple records that are utilized at PHC facilities, leading to incomplete information. The number of nurses at facilities should be increased to reduce the increased workload. Keywords: Effects; increased; professional nurses’; work-load; quality nursing documentation; patient informatio
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