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Ariani, Dewi. "Amerindo International Nurse Recruitment Agency." Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10259383.
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The national nursing shortage and high nurse turnover rates in the United States have been negatively affecting the quality of health care services since providing optimal patient care requires fulfilling necessary standards including nurse-to-patient ratios. The failure to maintain the mandated nurse-to-patient ratio not only will cause a penalty for a health care facility, but also will compromise the quality of health care service to the patients. Amerindo, an international nurse recruitment agency, intends to address these challenges by supplying qualified internationally educated nurses to the U.S. Amerindo will provide three levels of nursing vocations from Certified Nurse Assistants, Licensed Practical Nurses, and Registered Nurses, for all nursing domains including pediatric nursing, geriatric nursing, medical surgical nursing, maternity nursing, and psychiatric nursing.
Amerindo’s mission is to be a trusted connector between internationally educated nurses and health care facilities in Southern California, by supplying qualified nurses with two years of initial employment contract. With the unique initial employment contract and several additional qualities, Amerindo distinguishes itself from other health care recruitment agencies. Moreover, Amerindo helps the health care facilities maintaining their nurse-to-patient ratio, and reducing the nurse turnover rate. Thus, in general, Amerindo helps improving health care access and quality.
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Gomez, Robert R. "Gomez Nurse Staffing Agency| A Business Plan." Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10599653.
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With the era of the baby boomers getting to an age where health care issues will be at an all-time high, the shortage of nurses is a problem many health care organizations are already facing. There is a huge opportunity for many nurses to get hired given the state of California requires facilities to maintain a nurse-to-patient ratio. These ratios vary depending on the severity level of the patient’s illness or condition the unit admits.
The goal of the company is to be able to help hospitals, convalescent home, retirement centers and other skilled nursing facilities meet their patient satisfaction expectations by providing the nurses needed to maintain quality of care. Nurses that will be provided are Licensed Vocational Nurses, Registered Nurses and Nurse Practitioners.
The company will have a unique approach to market itself out of Long Beach to be accessible to both Los Angeles and Orange County population and facilities. This business plan will go over four different chapters of the Gomez Nurse Staffing Agency in topics such as Marketing, Feasibility, Laws and Regulations and Financial Statements.
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Tadd, Winifred. "Moral agency and the role of the nurse." Thesis, Cardiff University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310160.
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Van, As Martha Maria. "Guidelines for nurse managers to promote the competence levels of professional nurses in utilising the electronic system for staffing of agency nurses, in public hospitals in the Western Cape." University of Western Cape, 2018. http://hdl.handle.net/11394/6612.
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Magister Curationis - MCurIn 2011, a structured electronic system for the staffing of agency nurses was implemented in the Western Cape as part of the Nursing Information Management System (NIMS). This electronic system was developed to ensure a fair tendering process for the procurement of agency staff, providing information on agency expenditure, maximum wage rates and adherence to principles and rules of supply chain management. Although technology is used more and more in healthcare services within the Western Cape, some professional nurses could lack the skills needed to implement the electronic system appropriately. A descriptive and quantitative design was followed to determine the competence levels of professional nurses in utilising the electronic staffing system for agency nurses in public hospitals in the Metropole, Western Cape. The aim of the study was to develop guidelines for nurse managers according to which they can train professional nurses in hospitals to utilise the electronic system for staffing of agency nurses. Assumptions were adapted from the theoretical framework of Benner (1984) on different levels of competencies and used as theoretical departure of the study. The accessible population for this study was all the professional nurses in hospitals within the Metropole of the Western Cape Government Health registered as users on the database, called the Nursing Information Management System (NIMS) (N=278). This population served as the total inclusive sample for the study. The method of data collection was a self-administered structured questionnaire. The data was analysed by using the SPSS Version 24 software program and descriptive and inferential statistics were conducted.
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Peoples, Paula Beth. "Pay-per-visit for Home Health Agency nurses." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1410.
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Trapani, Josef. "Referring in critical care : nurses as dual agents." Thesis, University of Brighton, 2014. https://research.brighton.ac.uk/en/studentTheses/9dc6a371-cf8b-40ea-ac8d-836517a1c5e5.
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Previous research has suggested that critical care nurses' close and prolonged contact with patients places them in a unique position of improving patient outcomes and reducing the demand on critical care beds by detecting subtle signs of deterioration in a timely manner and identifying patient progression and readiness for less intensive care. Nonetheless, nurses rarely take decisions about patients' treatment modalities on their own, and constantly need to seek advice or authorisation. Indeed, several studies suggested that one of the most frequent decisions taken by nurses during clinical practice is that of referring to medical, nursing or other health care practitioners. However, there is very Iim ited research around the factors related to, and the actual process of, such referring. In view of this gap in the literature, the purpose of this study was to explore and explain the process of referring in the context of an intensive care unit by means of a substantive theory derived from the data. The principal research question was: What are the factors associated with critical care nurses' decisions to seek help from medical practitioners? The study took place in a general intensive care unit in a state hospital in a Mediterranean island nation. Data generation and analysis took place concurrently and iteratively, and were guided by the dimensional analysis approach to grounded theory. Data collection involved : (1) twenty hours of preliminary non participant observation; (2) fifty hours of participant observation and informal interviewing; (3) fifteen hours of formal semi-structured interviews with ten critical care nurses working in this unit selected by means of purposive and theoretical sampling; (4) two 2-hour focus group sessions aimed at enhancing theoretical sufficiency and verification of the emerging substantive theory. The analytical process was characterised by a series of inductive-deductive cycles, during which increasingly conceptual labels were attached to data segments. Working hypotheses and theoretical memos were used to interrogate the data and look for positive and negative evidence for the inductively derived labels. The findings suggest that nurses' decisions to seek help from doctors are complex and frequently mediated by individual or organisational factors which are unrelated to the actual clinical situation, such as experience, asse11iveness and willingness to take risk. They involve nurses weighing up several occasionally conflicting motivators, including a desire to act with some degree of independence; attempting to prevent personal and professional risk; and being constantly mindful of their asymmetrical decision making power relative to doctors. A central consideration is that of balancing their moral obligation to safeguard critically ill patients' interests with their duty to respect medical practitioners' preferences. Subsequently, nurses find themselves in a position of dual agency as they need to concurrently act as an agent to two different principals, namely the medical practitioner and the patient, a situation which is potentially morally distressing. The emergent substantive theory underscores the significance of the nurse's role in acting on behalf of the patient in a scenario of significant patient vulnerability; the factors that enhance, mediate and potentially suppress this advocacy role; and the interrelatedness of nurses' relationship with doctors and their effectiveness in safeguarding critically ill patients' interests. Subsequently, the study should provide valuable insight into the type of leadership and education that is required to assist nurses in placing patients' interest at the forefront of their actions and interactions, while fostering collaboration within multidisciplinary teams.
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Rodney, Patricia Anne. "Towards connectedness and trust : nurses' enactment of their moral agency within an organizational context." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/27732.
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This study describes nurses' ethical perspectives on nursing dying patients in a critical care setting, as well as nurses' responses to their perspectives. The design involved a phenomenological approach, with unstructured interviews with eight critical care nurses used to generate data.
The results indicated that nurses' ethical perspectives centered around a theme of senselessness; a senseless decision-making process, the experiences of patients and family members as senseless, and nurses' activities as senseless. Senselessness illustrated the multiple ethical dilemmas inherent in nurses' experiences. Nurses' ethical perspectives also involved their attempts to cope with senselessness by finding new meanings through shifting focus to patient comfort, support of the family, and to nurses' personal philosophies. The situational context of nurses' perspectives was explored in terms of influences on their perspectives.
This study supports other recent nursing research identifying prolongation of the process of dying as a significant ethical problem engendering moral distress.Applied Science, Faculty of
Nursing, School of
Graduate
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Collier, Vasanthi. "Agency nurses’ perceptions of job satisfaction within critical care units in private healthcare institutions." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6567.
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Thesis (MCur)--University of Stellenbosch, 2011.ENGLISH ABSTRACT: Agency-nursing work refers to nursing services provided by agency nurses employed on a casual, contracted basis. Agency-nursing has become more common in nursing practice in South Africa. This group of nurses play a significant role within the health care industry for both public and private sector. Given the pivotal role that nurses play in caring for the health of others, it is important to understand what motivates agency nurses in terms of job satisfaction. The aim of the study was to explore the perceptions of agency nurses regarding job satisfaction within critical care units in private health care institutions in the Western Cape. A qualitative research design with a phenomenological approach was applied. A sample size of n=10 was drawn from a total population of N=553, using random sampling technique. A semi-structured interview guide was designed based on the objectives of the study and validated by experts in the field before data collection. Ethical approval for the study was obtained from the Ethics Committee at the Faculty of Health Sciences, University of Stellenbosch. Permission to conduct the research was obtained from the participating nursing agency and consent was given in writing. The presentation of the results was categorised into themes and sub-themes emerged from the data analysis. The five clusters of themes that emerged were reasons for doing agency work, experiences with hospital staff, allocation of agency nurses, communication of information and staff development. The findings support Herzberg’s theory on motivation factors in terms of what motivates workers to excel in their performance. Agency nurses experienced both positive and negative aspects with regards to job satisfaction. The results of the study suggest the need to include revision and implementation of human resource policies and practices to include the nurses’ “voice” in an effort to provide a more supportive work environment. Further research is recommended. Key Words: Agency nurse, nursing agency, job satisfaction.
AFRIKAANSE OPSOMMING: Agentskapverplegingswerk verwys na verplegingsdienste wat voorsien word deur agentskapverpleegsters wat op ’n tydelike, gekontrakteerde basis in diens geneem word. Agentskapverpleging het meer algemene gebruik in die verpleegpraktyk in Suid-Afrika geword. Hierdie groep verpleegsters speel ’n belangrike rol in die gesondheidsbedryf vir beide die openbare en die private sektor. Gegee die deurslaggewende rol wat verpleegsters speel in die gesondheidsversorging van ander mense, is dit belangrik om te verstaan wat agentskapverpleegsters motiveer vanuit die oogpunt van werksbevrediging. Die doel van die studie was om die persepsies en ervarings van agentskapverpleegsters ten opsigte van werksbevrediging te ondersoek binne die waakeenhede in private gesondheidsorg-inrigtings in die Wes-Kaap. ’n Kwalitatiewe navorsingsontwerp met ’n fenomenologiese benadering is toegepas. ’n Monstergrootte van n=10 is geneem uit ’n populasie van N= 553 deur die ewekansige steekproeftegniek te gebruik. ’n Semi-gestruktureerde onderhoudgids was ontwerp en gebaseer op die doelwitte van die studie en was deur deskundiges op hierdie gebied, voor die insameling van data, gelding verklaar. Etiese goedkeuring vir die studie was verkry van die Etiese Komitee van die Fakulteit van Gesondheidswetenskappe, Stellenbosch Universiteit. Goedkeuring om die navorsing te doen, was verkry van die deelnemende agentskap en toestemming was op skrif geplaas. Die voorgelegde resultate was gekategoriseer in temas en subtemas wat uit die data-analise voortgespruit het. Die vyf groepe van temas wat hieruit gespruit het, is redes vir die keuse om agentskapwerk te doen, ervarings met hospitaalpersoneel, die toewysing van agentskapverpleegsters, kommunikasie van inligting en personeelontwikkeling. Die bevindinge het onthul dat Herzberg se teorie oor motiveringsfaktore werkers aangemoedig het om te presteer in die uitvoering van hulle pligte. Werksbevrediging is volgehou deur die agentskapverpleegster. Die bevindings dui op die behoefte om die hersiening en implementering van menslike hulpbronbeleidsverklarings en -praktyke in te sluit sodat die verpleegster se stem gehoor kan word in ’n poging om ’n meer ondersteunende werkomgewing te voorsien. Verdere navorsing word aanbeveel. Sleutelwoorde: Agentskapverpleegster, verplegingsagentskap, werksbevrediging.
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Muller, Jennifer. "Experiences of agency nurses regarding their placement in private hospitals in East London, Eastern Cape." Thesis, University of Fort Hare, 2014. http://hdl.handle.net/10353/d1016054.
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The general Australian workforce is becoming increasingly reliant on agency staff due to the diminishing of full-time jobs and the rise in part-time jobs since the recession of 1991-1992. This pattern is also seen in Western countries such as America and the United Kingdom (Peerson et al., 2002:505). The excessive costs of health service adopting a 100% staffing model has created the use of agency nursing to help meet fluctuating and unpredictable health care demands in Australia and overseas; agency staff are used to meet the shortfalls in staff-patient ratios (Peerson et al., 2002:505). Hurst & Smith (2011:287) agree that agency nurse staffing form a large part of the health service in the UK and state that this was unlikely to change because of recruitment and retention problems, high absenteeism, and staff wanting to work casually. In their study, they identified three types of agency nurses: A bank nurse – the hospital’s own employees or those supplied by NHS Professionals, who work when required, usually at short notice; agency nurses provided by commercial organisations, who are equally flexible but less familiar with the ward patients and procedures; and permanent ward staff working paid overtime. In South Africa, this also remains a problem in public and private institutions. The World Health Organization (WHO) states that the minimum ratio for nurses to population is 200:100 000 or 500 people per nurse. According to South African Nursing Council statistics of nursing manpower as at the end of 2008, South Africa has 437 nurses for every 100 000 people. This assumed that all nurses registered with SANC are working in South Africa at the time. Therefore, if the assumed number of staff not working in South Africa is subtracted, the ratio can increase to between 600 and 678 people per nurse (WHO, 2006). Joubert (2009:2) shows that a shortage of nurses contributes to deaths in hospitals in South Africa that would otherwise have been avoidable. The use of agency staff is becoming an appropriate means of providing cost-effectiveness and flexibility to staffing needs.
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Hill, John Harold. "An evaluation of the 2005 Agenda for Change reform on NHS nurse retention." Thesis, University of Sheffield, 2012. http://etheses.whiterose.ac.uk/2655/.
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Garrett, Bernard Mark. "The value of an intelligent agent in teaching clinical decision-making skills for nursing students." Thesis, University of Portsmouth, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369472.
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Taylor, Susan. "A descriptive interpretive exploration of the nurse consultant role and its influence on the research agenda." Thesis, Cardiff University, 2016. http://orca.cf.ac.uk/89032/.
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Aim: To focus on an exploration of the NC role and its engagement with and influence on the research agenda for nursing, Background NC posts have only been established in the United Kingdom since 1999. The role is intended to incorporate four domains: expert practice, leadership and consultancy, education and training, service development and research. Although there has been professional literature regarding the role development in general, there is little written regarding the development of the research aspect and how this influences the research agenda for nursing. Design A qualitative exploration of the research component of the NC role was undertaken using semi-structured audio-recorded telephone interviews with 13 NCs across England. Data were analysed using McCormack’s (2000a) multiple lens approach, a framework that facilitated thematic analysis. The study was informed by the theoretical frameworks of Professional Socialisation and Benner’s (1984) Stages of Clinical Competence, which allowed critical analysis of the data. Findings In relation to the development of the research component of the NC role, the data suggest that NCs were poorly supported in clinical practice, and that, although most held Masters Degrees, this educational level did not provide NCs with adequate preparation for the role or for delivery of the research component of their role. There was also poor understanding of the research role by the authors of NC job descriptions who comprised of NCs themselves, service managers or Directors of Nursing. Research has both an academic and clinical focus in relation to development, infrastructure support and delivery and therefore I expected that Higher Education Institutes (HEIs) would have been involved in the development of the research aspect of the NC role. However, there was very little or no engagement with HEIs by authors of the job descriptions in most cases. Constraints of the clinical environment around service pressures, competing demands, coupled with a lack of mentorship and the absence of a research culture and inadequate links with HEIs were other factors contributing to the barriers to research development. However, the findings revealed that NCs contribute to the research culture within their organisations through various levels of engagement, but there was little in the way of active involvement in research projects. Implications for Practice/Research This research has added to the body of knowledge concerning how, in clinical practice, NCs are socialised into the world of research and what support should be available to ensure NCs deliver on the research aspect of the role. Research and Development activities are considered a major job requirement, where there is an expectation that research will be conducted in a specialist area. This study has concluded that NCs are a group of expert nurses who are visibly making a difference to EBP but not necessarily in the way first envisaged when the roles were developed. This study has highlighted an emerging conceptual framework CFRE (Allen et al. 2004) which could be used to operationalise the research component of the role. The emerging field of implementation science is recommended for the development of the research element of the NC role in order to accelerate the EBP agenda for nursing. Key stakeholders who currently employ NCs should review the infrastructure and support provided to deliver on this.
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Ubah, Obinna Chukwuemeka. "Isolation and characterisation of hTNF-alpha neutralising VNARs from an immunised nurse shark, Ginglymostoma cirratum, using phage display." Thesis, University of Aberdeen, 2016. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=229399.
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Maheux, Jérôme. "Mécanismes moléculaires et cellulaires impliqués dans l'induction des Nurs par les agents antipsychotiques." Thesis, Université Laval, 2007. http://www.theses.ulaval.ca/2007/24383/24383.pdf.
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Poussa, Cherry. "Designing and evaluating virtual persuasive agents in providing social support for Web-based learning self-efficacy in nurse education." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/42226/.
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Students learning in blended learning and classroom environments benefit from social interaction and vicarious learning experience with their peers and tutors. In comparison, students learning via self-directed Web-based learning cannot benefit from these advantages and may feel isolated. This research investigates if the presence of virtual persuasive agents presented as avatars, happy images and encouraging text can provide social support similar to real peers and improve students’ Web-based learning self-efficacy (WBLSE). This research also examines if low and high fidelity virtual persuasive agents can provide social support in a similar way. This study uses Bandura’s (1982) self-efficacy theory as a framework for changing nursing students’ beliefs in using the Web for learning. The basis for including virtual persuasive agents in this research stems from the media equation theory (Reeves & Nass, 1996) which holds that Computers are Social Actors (CASA) and that people respond to Web-based media as if they were social actors. Adopting the User-Centred Design approach, a bespoke Web-based training package was developed for changing pre-registration and post-registration nursing students’ WBLSE. In a quasi-experimental design, the package was delivered in three separate studies to different groups of pre-registration and post-registration nursing students. Several important findings contributed to the WBLSE body of knowledge. Overall, the training package was found to be effective with the nursing students’ WBLSE improving equally in the intervention groups in all studies. Pre-registration students showed the greatest improvement when learning by self-direction supported by virtual persuasive agents, whereas post-registration students improved when learning in a blended setting without their support. Low-fidelity virtual persuasive agents were sufficient in providing social support for pre-registration students in self-directed settings. The implications for Web-based learning in nurse education, research and practice are discussed.
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Chigona, Kupatsa Mnyozeni. "Nurse support for young adults during a first antiretroviral therapy visit at an urban primary health care clinic in Malawi." Thesis, Cape Peninsula University of Technology, 2018. http://hdl.handle.net/20.500.11838/2968.
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Thesis (MSc (Nursing))--Cape Peninsula University of Technology, 2018Primary health care (PHC) is a frontline health care approach. It is the point of contact where people are kept well and where their quality of life is improved. All people diagnosed as HIV- positive are retested prior to antiretroviral therapy (ART) initiation to verify their serostatus. ART initiation is seen as a non-emergency treatment that provides many benefits if its initiation is accelerated, for example following up pregnant women after being diagnosed with HIV. However, accelerated initiation may lead clients to start treatment before they are ready to adhere to treatment outcomes. The purpose of this study was to describe the nurse support for young adults during a first antiretroviral therapy visit at an urban primary health care clinic in Malawi. A descriptive phenomenological design was followed at an urban setup in Zomba city, Malawi. The sample was selected through purposive sampling until data saturation was obtained. Individual semi- structured interviews were conducted with young adults aged 19 25 who have visited the clinic for their first ART according to an interview schedule and field notes for around 30 minutes in a private room. The data was analysed using distinctive process and a consensus meeting was held between the researcher and independent coder. The findings of the study could help the PHC services to retain and re-engage the young adults in HIV care and aid the Government of Malawi in achieving its Sustainable Development Goal (SDG) 3. Principles of trustworthiness and ethics were adhered to throughout the research process. Six themes, each with separate categories, emerged from the data analysis on the experience of young adults during their first visit for ART at an urban PHC clinic in Malawi. The results indicated the need for an environment that enhances a client-orientated approach with a focus on holistic well-being. Knowledge management should be used to provide relevant and sufficient information to a newcomer while maintaining ethics under difficult circumstances. The legal environment should have a focus on supporting clients that need comprehensive ART treatment. Motivation of the patient regarding taking antiretroviral treatment (ART) is thus essential. Young adults express the need to be supported by nurses with relevant information, privacy and confidentiality and the trusting client/nurse relationship which could help them to retain in ART care. Recommendations of this study was that nurses should be offered in-service training on youthfriendly programmes which focuses on the health care of young adults during their HIV/ART services. Nurses need to create trusting relationship for the young adults and providing in door game at the waiting area to keep them busy as they are waiting for the services. Nursing managers to lobby for funding to extend the clinic and be role models in providing relevant information to young adults. It was concluded that a first visit was both positive and challenging to the participant s; however, they experienced the health providers on the first visit to be caring and supportive.
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Pheiffer, Evette. "The perceptions of professional nurses with regard to the process of withdrawing life-support treatment in a private intensive care unit." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/3115.
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Life-support treatment is regarded as the support of vital functions of respiration and circulation such as mechanical ventilation and inotropic support, and life-sustaining therapy which incorporate therapies such as artificial hydration, nutrition and haemodialysis. Life-support treatment is rendered to critically ill patients within the intensive care units. However, when treatment options are maximised, and the patient’s condition is unchanged, a decision is often made to withdraw treatment. Professional nurses are usually involved in the process of withdrawal of life-support treatment as they care for this population of patients. The study followed a qualitative, explorative, descriptive and contextual research paradigm in order to explore and describe the perceptions of professional nurses with regard to the process of withdrawing life-support treatment in a private intensive care unit. Data was collected by means of interviews, which were transcribed according to Tesch’s method of analysis. Field notes were used to supplement the data findings. Based on the data collected, it is clear that professional nurses experience difficulties when performing withdrawal of life-support treatment. There are a number of communication concerns which need to be addressed and suggestions were also made by the interview participants regarding these concerns. The study makes recommendations to assist professional nurses with the process of withdrawing life-support treatment in a private intensive care unit. The findings of the study will be disseminated to the relevant hospital and unit managers. Ethical principles were maintained throughout the study by adhering to the principles of privacy, confidentiality, anonymity and beneficence.
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Svedberg, Bodil. "Depåneuroleptika på gott och ont : patienters och sjuksköterskors erfarenheter av långtidsbehandling i psykiatrisk öppenvård /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-565-4/.
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Jama, Nontembiso Mary. "Strategies used by professional nurses to manage newly diagnosed HIV positive pregnant women who fail to return within a month for further management and care." Thesis, University of Fort Hare, 2012. http://hdl.handle.net/10353/444.
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This study explored and described the strategies used by nurses to manage newly diagnosed HIV positive pregnant women who do not return to the clinic within a month following diagnosis, for continuity of care. The main aim was to prevent mother-to-child transmission of HIV (PMTCT). Method: The study sites were two accredited antiretroviral- ante-natal care (ARV-ANC) clinics at the Dimbaza community health centre (CHC) and the East London Hospital Complex (ELHC) which comprises of Cecilia Makiwane and Frere hospitals, in the Buffalo City Metropolitan Municipality (BCM). The majority of health personnel at these clinics are professional nurses. An in-depth semi structured interview guide was used to collect data through focus group interviews from professional nurses who work in these units. They were required to share their experiences about intervention strategies used for newly diagnosed HIV- positive, pregnant women who fail to return for continuity of care within a month after diagnosis. Results: Follow up of these women is done by tracking them (by calling them; calling the clinic nearest to their homes and doing home visits). Decentralisation of further management and care to the nearest clinic was also cited, especially for the patients who stay far from these accredited sites. Family support was also mentioned as a strategy to intervene for the non-compliant patients. Challenges: The challenges that were encountered with these interventions include wrong contact details, wrong addresses and being evasive when visited at home. Another challenge cited was related to the stigma attached to the diagnosis and the tracking devices used, for example, the car as it is familiar to the community it serves. Despite known benefits for early initiation of HIV treatment newly diagnosed HIV- positive, pregnant women continue to refrain from accessing care after diagnosis, thus posing a risk to the transmission of HIV to the baby and further comprising their own health. They miss out on general HIV management and ante-natal care. Conclusion: The identified intervention strategies used by nurses to follow up newly diagnosed HIV- positive, pregnant women need to be reinforced and strategies put in place to control the related challenges for a better response by the patients.
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Jackson, Dawne Shirley. "The experiences of people living with HIV-AIDS with regard to the comprehensive antiretroviral therapy management received from registered nurses at selected public primary heathcare clinics in Nelson Mandela Bay." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/1253.
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Currently South Africa has the highest number of persons living with HIV-AIDS (PLWAs) in the world. Focus-group discussions conducted by Moon (2005:3) in the Eastern Cape indicated that people may not want to get tested for HIV or to access antiretroviral therapy (ART) for fear of disclosure of their HIV-positive status and of stigmatization. These findings prompted the researcher to conduct a study in this field. The objectives of this study are to explore and describe the experiences of PLWAs with regard to the comprehensive ART management received from registered nurses at selected public primary healthcare clinics in Nelson Mandela Bay; and to develop guidelines for registered nurses that could facilitate them in rendering appropriate comprehensive ART management. The research study is based on a qualitative, explorative, descriptive, phenomenological and contextual research design. The research population comprised of HIV-positive patients who received treatment at the selected public primary healthcare clinics. Criterion-based, purposive sampling was used to select participants for the interviews. Ten in-depth unstructured interviews were conducted. Data was then transcribed and coded. One central theme identified the fact that PLWAs experienced both positive and negative experiences at the clinics. The main findings of this research included evidence of various forms of stigma experienced by the PLWAs; distrust of the lay health counselors; but also that PLWAs were generally well-treated and satisfied with the service they had received. Broad guidelines for registered nurses was formulated that could facilitate them in rendering appropriate comprehensive ART management. The study concludes with recommendations made with regards to the areas of nursing practice, education and research. Throughout the study the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2002:354).
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Thored, Emelie, and Freja Wikström. "Bidragande faktorer till valet av LARC vid strukturerad preventivmedelsrådgivning på ungdomsmottagning : Klusterrandomiserad kontrollerad interventionsstudie i Stockholms län." Thesis, Högskolan Dalarna, Institutionen för hälsa och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:du-38415.
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Bakgrund: Kvinnors behov av modern familjeplanering är inte tillgodosett. Samhällsekonomiska vinster finns att hämta om fler använder långverkande reversibla preventivmedel (LARC), i stället för mindre effektiva kortverkande metoder. Det finns ett behov av förbättrade arbetssätt för att kvinnor genom ett välinformerat beslut ska kunna välja effektiva preventivmedel. Syfte: Att undersöka om reproduktiv anamnes och sociodemografiska faktorer har en inverkan på valet av LARC vid strukturerad respektive sedvanlig preventivmedelsrådgivning, bland ungdomar och unga vuxna (18–24 år) på ungdomsmottagningar i Stockholmsregionen. Metod: Kvantitativ ansats. Klusterrandomiserad studie och substudie av LOWE-studien. Resultat: Planerad användning av LARC innan besöket (OR 45.78, 95% CI 23,54–89,02) och strukturerad preventivmedelsrådgivning (intervention) (OR 3,67, 95% CI 2,24–5,97) var de variabler som visade sig vara påverka valet av LARC. Slutsats: En trolig anledning till att sociodemografiska faktorer och reproduktiv anamnes inte påverkar valet av LARC i denna studie kan vara att preventivmedelsanvändning är ett mer komplext område. Den information som ges vid preventivmedelsrådgivning har en inverkan på majoriteten av alla patienter, men rådande samhällsnormer styr valet av preventivmedel tillsammans med paradigmskiften inom SRHR. Klinisk tillämpbarhet: Resultatet var av klinisk signifikans för vårdpersonal på ungdomsmottagningar och kan kliniskt tillämpas för en fördjupad kunskap kring bidragande faktorer för valet av LARC.Background: Women’s need for modern family planning is not met. Socioeconomic benefits can be obtained if less-safe methods are replaced by long-acting reversible contraceptives (LARC). There is a need for improvement within the work to enable women to choose effective contraceptives by a well-informed decision. Aim: To investigate if reproductive history and socioeconomic factors have an impact on the choice of LARC under the influence of customary and structured contraceptive counselling, among adolescents and young adults (18-24) at youth clinics in Stockholm, Sweden. Method: Quantitative method. Cluster randomized controlled intervention study, and a substudy of LOWE. Result: Planned use of LARC before the visit (OR 45.78, 95% CI 23,54–89,02) and structured contraceptive counselling (intervention) (OR 3,67, 95% CI 2,24–5,97) was the variables that influenced the choice of LARC. Conclusion: A likely reason why sociodemographic factors and reproductive history did not influence the choice of LARC, could be that contraceptive use is a part of a more complex context. The information provided in contraceptive counselling has an influence on the majority of all patients, but current societal norms control the choice of contraception, as well as paradigm shifts within SRHR. External validity: The result was of clinical significance for staff at youth clinics and can be clinically applied for in-depth knowledge of influencing factors for the choice of LARC.
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Dodge, Julia A. "Client self-care agency with the nurse-client interaction a research report submitted in partial fulfillment ... /." 1987. http://catalog.hathitrust.org/api/volumes/oclc/68787793.html.
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Rodney, Patricia Anne. "Towards connectedness and trust : nurses’ enactment of their moral agency within an organizational context." Thesis, 1997. http://hdl.handle.net/2429/6797.
Full textAbstract:
This study generates an understanding of how nurses enact
their moral agency within the culture of the organizational
context in which they practice. Using a feminist ethnographic
design, the investigator undertook approximately 180 hours of
fieldwork on an acute medical unit in a community hospital, and
approximately 38 hours of fieldwork on a second acute medical unit
in a tertiary hospital. The investigator worked closely with six
staff nurses during this time, and included formal research
interviews with these six nurses to supplement her observations.
She also included observation of and research interviews with five
clinicians/nurse managers from the hospitals, and, in order to
further extend her analysis, research interviews with three home
care nurses from different communities.
It was found that nurses enact their moral agency in a
relational matrix with other members of the health care team, and
that this matrix is strengthened by authentic presence and trust
between all professionals/providers and patients and their
families. The context of nurses' work was portrayed as fraught
with everyday ethical problems that generated significant moral
ambiguity and moral distress for nurses. There were significant
personal costs associated with nurses' work, including fatigue,
guilt, and personal risk.
Moreover, the culture of the organizational context for
nursing practice and patient care was portrayed as problematic.
The communication between professionals/providers and patients and
their families was fragmented, as was the communication between
departments and agencies. Finally, a number of dominant
sociopolitical ideologies seemed to be embedded in the
organizational culture, including the disvaluing of nurses' work,
the disvaluing of acute medicine as a nursing practice context,
and the disvaluing of those in need—particularly elderly patients
and patients with substance use problems.
The investigator concludes by calling for more feminist
ethnographic work so that the influence of problematic
organizational cultures on the ethics of professional practice
can be further addressed. She claims that trust should be
fostered in health care teams by making the various members more
authentically accessible to each other. Finally, she notes that
the ethical mandate of professionals must encompass a broader
notion of societal good if the dominant sociopolitical ideologies
are to be challenged.
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Davidsson, Natalie. "Temporary Agency Nurses’ Perception of Leadership and Employeeship : A qualitative study of working environment in Swedish client organizations." Thesis, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-32413.
Full textAbstract:
Introduction: Temporary working agencies (TWAs) within the healthcare industry has exploded within the last 10 years. The temporary agency workers (TAWs) have a unique triangular employment agreement, resulting in leadership and employesship complexities. Leadership and employeeship has been linked to many aspects within an organization such as employee’s health and well-being, productivity, effectiveness, and satisfaction. Purpose: The purpose of this study is to explore and describe the perceptions of desirable leadership, and employeeship in a client organization for temporary agency nurses. Method: The study is qualitative and uses the Interpretative Phenomenological Analysis (IPA) method and follows the Standards for Reporting Qualitative Research (SRQR). Results: The TAW nurses desire a manager that is sincere and involved, and a manager as a guide when it comes to leadership and a desire to work independently, collaborate and respect each other and for there to be humor when it comes to employeeship in client organizations. Conclusion: Desirable leadership and employeeship that the TAW nurses desire is foremost linked to relations-oriented leadership behavior according to the Task, Change and Relations (TRC) model for leadership. The TAWs have a unique triangular employment, that result in complexities.Under de senaste tio åren har bemanningsbranschen inom sjukvården expanderat. Bemanningsanställda har en unik triangulär anställningsform som kan leda till ledarskap- och medarbetarskapskomplexitet. Ledarskap och medarbetarskap har tydligt kopplats till många aspekter inom en organisation såsom anställdas hälsa och välbefinnande, produktivitet, effektivitet och tillfredsställelse. Syftet med studien är att utforska och beskriva sjuksköterskors uppfattningarna av önskvärt ledarskap och medarbetarskap i en klientorganisation. Studien är kvalitativ och använder Interpretative Phenomenological Analysis (IPA) och följer Standards for Reporting Qualitative Research (SRQR). Resultatet visade att önskvärda ledarskapet i klientorganisationer är en ledare som är uppriktig och involverad och en ledare som vägleder. Önskvärt medarbetarskap i klientorganisationer är att arbeta självständigt, samarbeta, respektera varandra och humor. Slutsatsen är att önskvärt ledarskap och medarbetarskap i klientorganisationer är främst kopplat till det relationsorienterade ledarskapsbeteendet enligt Task, Relations and Change (TRC) modellen.
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Yu, Hui-Yun, and 余慧筠. "The Correlation Between Nurses’ Knowledge, Attitude and Behavior of Safe Handling Chemotherapeutic Agents." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/42962043575674772748.
Full textAbstract:
碩士國立陽明大學
臨床暨社區護理研究所
100
Objectives: The study aimed to understand the knowledge, attitude and behavior of nurses safe handling chemotherapeutic agents (CTAs), then to explore the related factors and the correlation between the knowledge, attitude and behavior. Background: Experts have been published guidelines of safe handling of CTAs in 1980s. However, recent studies have demonstrated that nurses and their working environment were still exist exposure to CTAs. It has showed that nurses are not complied with guidelines, possibly due to inadequate knowledge and not paying attention toward safety handling CTAs. Methods: This is a cross-sectional survey, nurses of one medical center in Taipei was recruited. Data were obtained via a structural questionnaire developed by the researcher, comprised the knowledge, attitude and behavior sections. Dichotomously scoring of the knowledge, and a 5-point Likert scale scoring of the attitude and behavior were used in the questionnaire. Results: A total of 203 nurses participated, giving a 94.5% response rate. The mean correct answer rate for 20-items of knowledge section was 60.9%. Attitude regarding safe handling CTAs was toward intermediate and positive (3.5±0.4 points). Behavior of prevention exposure (4.7±0.4 points) and use of protection equipments (4.4±0.4 points) were good and positive, but the correct rate of the behavior of handle with CTAs wastes was only 73.7%. Participants with older age, more working experiences, day shift and self report of good knowledge reached higher knowledge level and positive attitude regarding CTAs, but with fewer number of chemotherapy administration reached higher behavior level. A positive correlation was identified between knowledge and attitude, as well as attitude and behavior. However, oncology nurses have significant better knowledge level, but non-oncology nurses have significant better behavior. Conclusions: Nurses had insufficient knowledge, but with positive attitude toward CTAs. However, their behavior toward safety handling CTAs were varied. Educational programs regarding safety handling of CTAs and its wastes are suggested, in order to raise the knowledge level, as well as improved in actual behavior.
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SEAVOR, CAROL M. "SEX-TYPING AND ELEMENTS OF LEADERSHIP AMONG NURSES (CHANGE-AGENT, DISSATISFACTION, WOMEN)." 1986. https://scholarworks.umass.edu/dissertations/AAI8622716.
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Although research shows that nurses are dissatisfied with conditions in work environments, they generally do not initiate behaviors that could produce change. Reasons for this lack of initiating or leadership behaviors among nurses are unclear. The purpose of this study was to explore the phenomenon of sex-typing among nurses and to investigate the relationship between sex-typing and some elements of leadership behavior. Specifically, the following research question and two hypotheses directed the study. Research Question I. What is the nature of the distribution among female nurses who practice in five general hospitals in Massachusetts of the four sex-type groups as determined by the Bem Sex-Role Inventory? Null Hypothesis I. There are no significant differences among the four sex-type groups of female nurses practicing in five hospitals in Massachusetts and their identification of problems in the work setting that hinder their effectiveness in providing optimal services to clients. Null Hypothesis II. There are no significant differences among the four sex-type groups of female nurses practicing in five hospitals in eastern Massachusetts and their perception that staff nurses should initiate action necessary to solve the problems identified that hinder their effectiveness in providing optimal services to clients. Data collection included a mailed survey and personal interviews using the Bem Sex-Role Inventory, (BSRI) and the Practice Environment Inventory (PEI). The BSRI identified sex-type and the PEI identified perceptions about problems in work environments and problem solving initiators. Chi square tests were computed to compare the distribution of sex-type of the sample to others and Analysis of Variance Procedures were used to test the relationship between sex-type and (1) numbers of problems identified in work settings, (2) number of times staff nurse was named as the appropriate person to initiate action. The results showed no significant differences between the sample's distribution of sex-type and two others to which it was compared. Further, no significant relationships were found between sex-type and numbers of problems or choice of problem solving initiator. Data also showed that nurses recognize the need for change and think that nurses should respond.
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Maheux, Jérôme. "Mécanismes moléculaires et cellulaires impliqués dans l'induction des nurs par les agents antipsychotiques /." 2007. http://www.theses.ulaval.ca/2007/24383/24383.pdf.
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Riley, Shanda L. "Compliance to the national guidelines for the safe handling of antineoplastic agents by oncology registered nurses." 2009. http://proquest.umi.com/pqdweb?did=1693867011&sid=1&Fmt=2&clientId=3916&RQT=309&VName=PQD.
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Thesis (M.A.)--Northern Kentucky University, 2009.Made available through ProQuest. Publication number: AAT 1462529. ProQuest document ID: 1693867011. Includes bibliographical references (p. 56-58)
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Ashley, L. J., R. Dexter, F. Marshall, B. McKenzie, M. Ryan, and Gerry R. Armitage. "Improving the safety of chemotherapy administration: an oncology nurse-led failure mode and effects analysis." 2011. http://hdl.handle.net/10454/6792.
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noPURPOSE/OBJECTIVES: To assess and improve the safety of hospital-based adult chemotherapy administration. DESIGN: Prospective, systems-focused clinical risk assessment. SETTING: An adult inpatient and outpatient oncology unit in a large urban hospital in the United Kingdom. SAMPLE: 8-person nurse-led multidisciplinary team, which included managerial staff and patient safety researchers. METHODS: Failure mode and effects analysis (FMEA), a prospective, systems-focused risk assessment methodology, was undertaken in biweekly team meetings and included mapping the chemotherapy administration process, identifying and numerically prioritizing potential errors (failure modes) for each process step, and generating remedial strategies to counteract them. MAIN RESEARCH VARIABLES: The analysis aimed to identify chemotherapy administration failure modes and to generate remedial strategies to address them. User feedback on the FMEA process also was collected. FINDINGS: Several specific chemotherapy failure modes were identified, the majority of which had not previously been recognized, and several novel strategies to counteract them were generated. Many of the strategies were specific, environment-focused actions, which are simple, quick, and inexpensive to implement; however, more substantive, longer-term initiatives also were generated. User feedback generally was very positive, and the process of undertaking the analysis improved multidisciplinary teamwork and communication. CONCLUSIONS: Although time and resource intensive, FMEA is a useful safety improvement tool. IMPLICATIONS FOR NURSING: Nurses should be aware of and informed about FMEA as a tool they can use in partnership with management and other disciplines to proactively and collectively improve the safety of high-risk oncology procedures such as chemotherapy administration.
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ching, chang ch'iao, and 張巧靜. "Influences the related factors of the will of using narcotic analgesics agents to nurses in the community in central Taiwan- nstance of morphine." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/25486089042927852228.
Full textAbstract:
碩士亞洲大學
長期照護研究所
95
The cancer mortality has been the first killer among the ten major causes of death in recent years, the topic of the cancer pain control has paid more attention. In order to control the cancer pain effectively, the mainstream of the cancer pain control as using opiods analgesics in World Health Organization (WHO ). However, this kind of medicines often misunderstands in amount of people, and induces the pain control effects poorly, even influence the quality of life with the patient and their families. Because of cancer-caring develops and regards at home care and community care mode, The basic medical attendants are more importance of the medical resource network. The objection of this study was to explore the knowledge of narcotic analgesics agents of the nursing staff in the community, the ability of pain assessment, and the influence of the will of using narcotic analgesics agents. A descriptive correlational design study, the research object is the nursing staff of 57 health stations in the central Taiwan of Taichung city, Taichung county, and Changhua county. Structurally formulated questionnaires which contains: personal data, the knowledge of narcotic analgesics agents, the ability of pain assessment, and the will of using morphine. Validity is more than 80％, Cronbach’s α among 0.754-0.958. Adopted the independent t test, one way anova, pearson correlation , regression ,and logistic regression to statistics. The result of study: ( 1) narcotic analgesics agents’ knowledge : the unit’ education hours , participated the pain control program , and beliving enough knowledge of pain control could predict 17.3﹪narcotic analgesics agents ’knowledge . The regression formula : Y＝9.544＋1.771X1＋0.657X2＋ 13.1 30X3＋12.430X4＋12.300X5 . X1：the unit’ education hours. X2：participated the pain control program . X3：very not agree of beliving enough knowledge of pain control. X4：not agree of beliving enough knowledge of pain control . X5： agree of beliving enough knowledge of pain control. (2) The ability of pain assessment : education degree, religion , the unit’ education hours , participated the pain control program , and beliving enough knowledge of pain control could predict 17﹪the ability of pain assessment. The regression formula : Y＝10.250＋ 0.805X1＋0.738X2＋1.429X3＋0.837X4＋9.469X5＋9.164X6＋8.376X7. X1： education degree . X2：religion .X3：the unit’ education hours . X4：participated the pain control program. X5：very not agree of beliving enough knowledge of pain control. X6：not agree of beliving enough knowledge of pain control .X6：agree of beliving enough knowledge of pain control. (3) The will of using narcotic analgesics agents : narcotic analgesics agents’ knowledge and the ability of pain assessment was poor , and the will of using narcotic analgesics agents was high . 65.4％ -90.1％ was agreed to use narcotic analgesics agents , but lack the ability of case analyze . Age, the year of nursing job , and narcotic analgesics agents’ knowledge could influence of the will of using narcotic analgesics agents.The younger , the longer of the nursing job’year , and the better narcotic analgesics agents’ knowledge , the more will of using narcotic analgesics agents. The study suggestion : the education of pain control training should augment .And add to test after the pain control program in the future. Key words：narcotic analgesics agents knowledge, the ability of cancer pain asse ssment , the will of using narcotic analgesics agents.1
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Mkhabela, Mildred Penelope Sbongile. "An empowerment programme for nurses working in voluntary counselling and testing services in Swaziland." Thesis, 2007. http://hdl.handle.net/10500/2182.
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The HIV/AIDS epidemic is described as a crisis by the Global Report (UNAIDS 2004:13). Swaziland¡¦s King Mswati III also declared the HIV/AIDS epidemic as a disaster when the HIV/AIDS prevalence rate increased from 3.9% in 1992 to 42.6% in 2004 (MOHSW 2004:3). In responding to the increasing numbers, the Government of Swaziland established various programmes; one of them being the Voluntary Counselling and Testing (VCT) services to meet societal needs.
The MOHSW designed guidelines to be utilized when training nurses to be pre and post HIV test counselors (TASC 2003:2). The period of training ranges between 1 to 2 weeks, after which they are deployed to the VCT centres where nurses provide counseling and testing, treatment of opportunistic infections and distributing antiretroviral drugs. Much research has been done in Swaziland on HIV/AIDS however; there is insufficient knowledge on the impact of HIV/AIDS on nurses working at the VCT services.
The objectives of the study were to:
,,« Explore and describe the experiences of nurses working in the VCT services.
,,« Explore and describe the experiences of clients receiving VCT services.
,,« Design and develop an empowerment programme for nurses working in the VCT services in Swaziland.
,,« Formulate and describe guidelines for the implementation of the programme.
In this qualitative study, the exploratory descriptive and contextual methodology was utilized to look into lived experiences of nurses and clients. This was done within the adaptation of the intervention Design and Development genre proposed by Rothman and Thomas (1994). Data was collected through purposive sampling and analysed according to Tesch¡¦s methods (Tesch 1990:890)
The study revealed one major theme; constant experience of stress that was related to psychological and physical factors (categories). Nurses identified the complexity of HIV/AIDS, shortage of staff, lack of social support, lack of a supportive working environment, and a need for staff development under psychological factors. Clients identified stigma and discrimination. Constant exhaustion and development of medical conditions were identified as physical factors that led to constant experience of stress.
Conclusions drawn from the data analysis revealed that nurses were stressed and felt disempowered at working in the VCT services. An empowerment programme was designed and developed to enable these nurses to deal with issues and VCT services for rendering quality care and enjoy the work they do.
Guidelines were formulated to implement the empowerment programme. The study concluded with the identification of limitations and recommendations for future endeavours.Health Studies
D.Litt. et Phil.
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Ntshakala, Theresa Thembi. "Voluntary counselling and testing nurses' perceptions of educating HIV-positive people about ARVs in Swaziland." Thesis, 2005. http://hdl.handle.net/10500/2128.
Full textAbstract:
A qualitative study following a phenomenological approach was undertaken to explore voluntary counselling and testing nurses' perception of educating HIV+ people about ARVs. Non-probability convenience sampling was used and in-depth semi-structured face-to-face interviews were conducted to collect data from 12 participants.
The most important results were:
The need for extensive education on ARVs since it is a new technology used to curb the infection therefore clients need the information in order to use them effectively.
Stumbling blocks encountered when educating HIV+ people about the drugs. The problems are mainly due to the nurses lack of current knowledge about the drugs; patients' low economic status; severe side effects; difficulties in behaviour change; poor quality of life on ARVs and medical terminology.
Inability of clients to comply to the regimen because of severe side effects, complex regimen, lack of support from family and friends, lack of motivation, depression, cultural beliefs, lack of knowledge on how to use them and financial constraints.
Challenges for continuous education because of current nursing shortage, negative attitudes of some nurses, demotivation and inadequate funding for such activity.
Recommendations include provision of continuing education and the incorporation of ARV therapy knowledge in the basic nursing curriculum in nursing education.Health Studies
MA (HEALTH STUDIES)
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Dlamini, Patience Nokthula. "Factors contributing to nurses' poor utilization of HIV-related post exposure prophylaxis at a selected region in Swaziland." Diss., 2018. http://hdl.handle.net/10500/25109.
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Nurses are prone to occupational hazards while carrying out their professional duties. The HIV-related post exposure prophylaxis is recommended for health workers who prick themselves accidentally with needles that have been used on clients. The taking of antiretroviral drugs after encountering needle stick injury has been documented by medical scientists as relatively successful in preventing sero-conversion and decreasing the likelihood of contracting HIV infection. However, some of the nurses are reluctant to implement this programme and yet they have been exposed to needle stick prick.
The purpose of this study was to investigate factors contributing to nurses’ poor utilization of HIV-related post exposure prophylaxis (PEP) at a selected region in Swaziland. The study was conducted in one hospital setting and one public health unit. A quantitative research design using an exploratory, descriptive cross sectional survey was used for this study. A census sample size of 200 participants was obtained from a group of nurses working in the government hospital and public health units. Using self-administered questionnaires, quantitative data was obtained and analysed using the Statistical package for social sciences (SPSS) version 23 software computer program.
The study findings revealed that though majority of nurses (65%) are knowledgeable about PEP, its importance and operational policies and guidelines, this knowledge level was not transferred to influence the utilization of PEP as only 38% (n=75) reported utilizing PEP. Factors identified as causes of lower levels of PEP service utilization among respondents included fear of undergoing pre-prophylaxis procedures like HIV testing and counselling, and consequences thereof which include stigma, challenges of adherence and dealing with medication side effects.
Based on these findings the researcher recommends strengthening of staff development programs offered to nurses with focus on preventive measures against occupational exposure to HIV and AIDS through use of PEP. Institutional responsibility to ensure that PEP policies and guidelines are available and known by all new health personnel during induction and practicing nurses throughout their employment.Health Studies
M.A. (Nursing Science)
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Mohammed, Mohammed A., Sayed C. El, and T. Marshall. "Patient and other factors influencing the prescribing of cardiovascular prevention therapy in the general practice setting with and without nurse assessment." 2012. http://hdl.handle.net/10454/6102.
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BACKGROUND: Although guidelines indicate when patients are eligible for antihypertensives and statins, little is known about whether general practitioners (GPs) follow this guidance. OBJECTIVE: To determine the factors influencing GPs decisions to prescribe cardiovascular prevention drugs. DESIGN OF STUDY: Secondary analysis of data collected on patients whose cardiovascular risk factors were measured as part of a controlled study comparing nurse-led risk assessment (four practices) with GP-led risk assessment (two practices). SETTING: Six general practices in the West Midlands, England. PATIENTS: Five hundred patients: 297 assessed by the project nurse, 203 assessed by their GP. MEASUREMENTS: Cardiovascular risk factor data and whether statins or antihypertensives were prescribed. Multivariable logistic regression models investigated the relationship between prescription of preventive treatments and cardiovascular risk factors. RESULTS: Among patients assessed by their GP, statin prescribing was significantly associated only with a total cholesterol concentration >/= 7 mmol/L and antihypertensive prescribing only with blood pressure >/= 160/100 mm Hg. Patients prescribed an antihypertensive by their GP were five times more likely to be prescribed a statin. Among patients assessed by the project nurse, statin prescribing was significantly associated with age, sex, and all major cardiovascular risk factors. Antihypertensive prescribing was associated with blood pressures >/= 140/90 mm Hg and with 10-year cardiovascular risk. LIMITATIONS: Generalizability is limited, as this is a small analysis in the context of a specific cardiovascular prevention program. CONCLUSIONS: GP prescribing of preventive treatments appears to be largely determined by elevation of a single risk factor. When patients were assessed by the project nurse, prescribing was much more consistent with established guidelines.
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Gwebu-Storer, Nosipho Nontsikelelo. "Factors contributing to non-initiation of ART amongst eligible pre-ART patients in rural clinics in Swaziland." Diss., 2016. http://hdl.handle.net/10500/21188.
Full textAbstract:
AIM
The purpose of this study was to explore and describe factors that contribute to the non-initiation of Antiretroviral Therapy (ART) amongst Pre-Antiretroviral Therapy eligible patients and to make recommendations for health care workers to enhance early initiation of pre-ART-eligible patients for primary health care facilities in Swaziland.
METHOD
A qualitative design was applied in rural primary health care (PHC) facilities in the Hhohho region of Swaziland. The target population for this study included nurses who have successfully completed
the National Nurse Led Antiretroviral Therapy Initiation in Swaziland (NARTIS) training, and who actively initiated ART to eligible patients in rural PHC facilities. Data was collected through semi-structured interviews and field notes. Purposive, convenient sampling was applied. Eleven respondents were interviewed for the study, and data was collected until data saturation was reached. Data from transcripts and field notes was analysed and categorised with thematic analysis through Tesch’s open coding process.
RESULTS
The study identified the following three predominant themes: 1) systematic enablers of prompt ART initiation, 2) barriers to prompt ART initiation, 3) sources of support. Categories included public health care (PHC) factors, community level factors, the interdependence of the health care system, patient centred barriers, individual patient agency, and NARTIS nurse support.
CONCLUSION
The recommendations for health care workers that emerged from the study included continued HIV treatment scale-up and decentralisation to grass roots levels, aggressive treatment prioritisation among pre-ART patients, building the capacity of the local health care system and continued research initiatives. It is hoped that recommendations emerging from the findings of this study will have positive implications for programming and practice regarding the initiation of ART for eligible pre-ART patients in Swaziland.Health Studies
M. PH.