Dissertations / Theses on the topic 'Nurses Supply and demand Malaysia'

In Malaysia, the water management system was restructured in January 2005 by the transfer of water supplies and services from the State List to the Concurrent List. The National Water Services Commission or Suruhanjaya Perkhidmatan Air Negara (SPAN) was established in July 2006 as the technical and economic regulator for the improvement of water supply quality and the efficiency of the water industry. This study focuses on SAJ Holdings (SAJH). This water supply company provides a fully integrated service, i.e. it is involved in the all the processes of drinking water supply; these range from raw water acquisition, treatment and purification, and the subsequent distribution of purified water to customers, plus billing and payment collection. This study attempts to assess the residential customers‟ preferences of different attributes of water supply. The water attributes are divided into two categories: Water Infrastructure (WI) and Residential Customers (RC). WI attributes are leakage, pipe bursts, and reservoirs; RC attributes are water quality, pressure, connections, and disruptions. Choice modelling (CM) was applied as a tool for the assessment of effective demand for improved water supplies, particularly by residential customers. There are two econometric models employed: Conditional Logit (CL) and Mixed Logit (MXL). Face-to-face interviews were conducted with residential customers and Statistical Analysis Software (SAS) was used in order to analyse the data. The model consists of a basic model and an interaction model with socioeconomic characteristics. The findings show that the significant variables affecting demand are pipe bursts, (BUR), water quality (QUA), disruption (DIS) and connection (CON), as well as price (PRI). Among the socioeconomic characteristics that interact with the main attributes are gender, age, number of children, type of house, number of persons in the household, education, work, and income. This information is very useful for the water provider when upgrading the water service for valuable customers.

The aim of this study is to highlight the importance of learning and competence building, specifically in terms of skilled workers. Specifically, it aims to explore the mismatch between supply and demand of information and communication technology (leT) labours, referring to the case in Malaysia. The research therefore answers four important questions. Firstly, it explores and identifies the nature of the skills gap, by looking at skills and competencies for employability. Secondly, this research aims to integrate both supply and demand aspects through the issue of mismatch between supply and demand of leT labour; this is necessary because of the lack of attention to the demand side of the employability concept. Thirdly and fourthly, this research focuses on the role of higher education in relation to the mismatch issue, based on collaboration between universities and industry, industrial training placement as well as the integration of lifelong learning in higher education. A combination of research strategies - questionnaire survey, structured interviews and secondary data - was used to address the key research questions. From the study, it has emerged that there is a mismatch between supply and demand of leT labour, specifically focused on leT graduates in Malaysia. The study has confirmed that the elements of skills and competencies, referred to as transferable skills, are important for employability. In addition, the need for collaboration between universities and industry, industrial training placement as well as the integration of lifelong learning for employability, is confirmed.

Thesis (MPA)--Stellenbosch University, 2000.
Full text to be digitised and attached to bibliographic record.
ENGLISH ABSTRACT: Managing human resources is crucial to the efficient and effective delivery of quality health care. However, turnover of nurses constitutes a major factor in the shortages of staff which are being experienced by the nursing profession in the Republic of South Africa. Shortages of trained nurses with experience, particularly in public sector hospitals, have adverse effects on the provision of efficient and effective quality health care to the consumers of this service. The aim of the study was to provide an understanding of and insight into those inherent problems in the health sector that propel nurses to leave public sector institutions. The overall objective was to investigate and identify some of the factors which exercised an influence on the turnover of registered nurses in public sector hospitals, so as to be able to provide suggestions to hospital managers on the more effective management of human resources, in order to retain nursing personnel. Theresearch was based on a model of nursing turnover which regarded voluntary withdrawal as a process in which feelings of satisfaction with pay, on the one hand, and the opportunity of obtaining alternative jobs in the labour market, on the other, were proposed as the primary causative factors of turnover behaviour. In addition the propositions, made in literature reviewed, that age, tenure, kinship responsibility, general training, education, professionalism, marital status, lintent to stay', job satisfaction, routinization, job autonomy and responsibility, instrumental communication, promotional opportunity, integration, supervisory relationships, distributive justice, work-load, and local kin acted as predictors of turnover, were also investigated. The research was conducted with a sample of 123 nurses in one hospital, Groote Schuur, situated in the Western Cape Province of the Republic of South Africa. The sample included registered nurses, senior professional (registered) nurses, and chief professional (registered) nurses. The data was gathered from respondents by means of a selfadministered questionnaire. In addition, data was gathered by means of semi-structured, open-ended discussions with nursing management. The hypothesised interactions between variables influencing nursing turnover were explored by means of basic statistics, which made it possible to assess the effects of both independent and dependent variables. The results of data analysis provided some support for the proposition contained in the hypothesis. The determinants whose increase produced a greater degree of turnover were firstly, the many jobs available outside the hospital and secondly, professionalism. The determinants whose increase resulted in reductions in turnover were "intent to stay" (which the researcher views as a dimension of commitment), the existence of local kin (kinship responsibilities), participation in making job-related decisions (job autonomy), the receipt of sufficient work-related information (instrumental communication and good supervisory relationships), and tenure. The determinants whose decreaseresulted in increased turnover werepromotional opportunities, distributive justice, pay satisfaction, job satisfaction, integration, opportunity for self-development,age and tenure. Turnover of nurses has serious ramifications for employers, patients, and the nursing profession itself. Effective management of employee turnover is of critical importance to health care providers, employees, and patients. Better control of turnover can improve the quality of patient care, reduce labour costs, and improve employee morale.
AFRIKAANSE OPSOMMING: Die bestuur van menslike hulpbronne is die deurslaggewende omstandigheid ten einde die lewering van effektiewe en doeltreffende gesondheidsorg van gehalte. Nietemin, dra die omset van verpleegkundiges grotendeels by tot die personeeltekort wat tans deur die verpleegprofessie in Suid-Afrika ondervind word. Die tekort aan ervare, opgeleide verpleegkundiges, veral in die openbare sektor staatshospitale, het 'n nadelige uitwerking op die voorsiening van effektiewe en doeltreffende gesondheidsorg van gehalte aan die verbruikers van hierdie diens. Die doelwit van die studie was om 'n begrip te ontwikkel vir, en 'n insig te probeer kry in, daardie inherente probleme binne die gesondheidsektor wat verpleegkundiges dryf om die staatsinstellings te verlaat. Die oorkoepelende doel was die ondersoek en identifikasie van sommige faktore wat die omset van geregistreerde verpleegkundiges in staatshospitale beïnvloed. Die doel hiervan was om voorstelle aan hospitaal bestuurders te kan voorsien ten opsigte van die meer doeltreffende bestuur van menslike hulpbronne, in die strewe na behoud van verpleegpersoneel. Die navorsing is gebaseer op 'n model van verpleegomset wat vrywillige onttrekking as 'n proses beskou het waar gevoelens van salaristevredenheid, aan die een kant, en geleentheid tot alternatiewe betrekkings in die arbeidsmark, aan die ander, as die primêre veroorsakende faktore van omset-gedrag voorgestel is. Daarbenewens is die stellings vanuit die literatuurstudie dat die volgende dien as voorspellers van omset ook ondersoek: ouderdom, ampstermyn of dienstyd, verantwoordelikheid teenoor familie, algemene opleiding, opvoeding, professionalisme, huwelikstatus, 'voorneme om te bly', werksbevrediging, roetine, selfbestuur en verantwoordelikheid in die werksomgewing, bevorderlike kommunikasie, bevorderingsgeleenthede, integrasie, toesighoudende verhoudings, toedelende gereg, werkslading en plaaslike naasbestaandes. Die navorsing is uitgevoer met gebruik van 'n monster van 123 verpleegkundiges van een hospital, die Groote Schuur Hospital, geleë in die Wes-KaapProvinsie van die Republiek van Suid Afrika. Die monster het geregistreerde verpleegkundiges, senior geregistreerde verpleegkundiges en hoof geregistreerde verpleegkundiges ingesluit. Die data is verkry van respondente deur middel van 'n self-toegediende vraelys. Daarbenewens is data versamel deur half-gestruktureerde, niegeslote besprekings met van die verpleegbestuur. Die interaksie tussen veranderlikes ten opsigte van verpleegomset wat veronderstel is, is ondersoek deur middel van basiese statistiek, dus kon die uitwerking van afhanklike en onafhanklike veranderlikes bepaal word. Die uitslae van data-ontleding het wel ondersteuning verleen aan die voorstelling soos uiteengesit in die hipotese. Die determinante wie se toename 'n toename in die omsetkoers tot gevolg gehad het was, eerstens, meer werksgeleenthede buite die hospitaal en, tweedens, professionalisme. Die determinante wie se toename tot 'n vermindering in omset bygedra het was 'voorneme om te bly' (wat die navorser as binne die omvang van toewyding beskou), deelname aan werksverwante besluitneming (werks outonomie), die ontvangs van genoegsame werksverwante inligting (bevorderlike kommunikasie en goeie toesighoudende verhoudings), en ampsduur (dienstyd). Die determinante wat tot 'n vermindering in omset lei is bevorderingsgeleenthede, toedelende gereg, salaris bevrediging, geleenthede tot self-ontwikkeling, ouderdom en ampsduur. Die omset van verpleegkundiges het verreikende gevolge vir werkgewers, pasiënte en die verpleegsberoep self. Doeltreffende bestuur van werknemer-omsetis van kritiese belang vir gesondheidsorg voorsieners, werknemers en pasiënte. Die meer effektiewe beheer van omset kan die kwaliteit van pasiëntesorg verbeter, arbeidsonkoste verminder en die moraal van werknemers verbeter.

Thesis (MTech (Public Administration)--Cape Peninsula University of Technology, 2018.
Organisations spend large sums of money on staff after they have been recruited in order to make them proficient in their jobs. It is therefore important to ensure that staff remain with the organisation for as long as possible, allowing the organisation to reap the benefit from its investment in the form of good performance by staff. Work performance can however, be affected negatively when labour turnover is high. This research project reflects on staff turnover amongst professional nurses, posing the question, “What can be done to alleviate high staff turnover?” A quantitative approach to research was followed within a Western Cape Metropolitan Municipality. The significance of the research is reflected in the recommendations made to the management of the municipality to address staff turnover in the specified category of employees.

Thesis (MTech (Business Administration))--Cape Peninsula University of Technology, 2017.
This paper reviews retention strategies for Lesotho’s doctors and nurses and presented an implementation framework to support and promote staff retention. . Based on the increasing necessity to retain doctors and nurses, the implementation framework becomes an essential element of retention strategy. A qualitative and quantitative research design technique using a self-managed questionnaire and interviews was adopted to gather data. The 120 doctors and nurses make up a sample. The information was statistically analysed using SPSS and grounded theory. Results identified that the current implementation strategy has failed to increase the retention rate of doctors and nurses. It is hoped that the implementation framework presented in this paper would help to achieve increased retention rate for doctors and nurses.

Thesis (MBA)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: The shortage of nurse educators has an effect on the training of current and future nurses. A shortage of nurse educators leads to the inability to increase the number of student nurses, which results in a lack of trained nursing staff to meet the healthcare needs of the South African population. There is a need to gain an understanding of why nurse educators enter into and remain in academia versus the reasons why nurse practitioners – specifically registered nurses (RN) – choose to enter into and remain in practice. The prioritised reasons for entering into and remaining in nurse academia were investigated with a focus on: i.) The difference between the reasons why RNs enter into and remain in nursing practice ii.) The difference between the reasons why nurse educators enter into and remain in academia iii.) The difference between the reasons why RNs enter into nursing practice and reasons for nurse educators entering into academia iv.) The difference between the reasons why RNs remain in nursing practice and reasons why nurse educators remain in academia A descriptive, quantitative design was used to explore the factors that lead to nurses entering into and remaining in academia. An on-line, self-administered survey was used as the primary data collection instrument. Data was tabulated and presented in histograms and frequencies. The study found that: i.) RNs enter into and remain in nursing practice for the same reasons ii.) That nurse educators enter into and remain in academia for different reasons iii.) That RNs enter into nursing practice and nurse educators enter into academia for different reasons iv.) The primary reason for RNs remaining in nursing practice and nurse educators remaining in academia are the same The shortage of nurse educators is critical and it is essential that NEIs begin to institute plans focussing on the reasons behind nurse educators’ decision to stay in nursing education. Private NEIs should use the findings of this study to focus on areas that indicate satisfaction with the position rather than dissatisfaction in order to develop specific attraction and retention strategies.

The last decade has seen an exodus of South African nurses migrating to "greener pastures". As a result of this migration, the South African Healthcare Service has been drained of one of its most essential resources – nurses. Subsequently, the crippling flight of nurses has thrown the nursing profession into a state of crisis. The Kingdom of Saudi Arabia is one of the more popular destinations for South African nurses, the main reason being the attractive financial rewards. One agency reports that they send an average of thirty nurses a month to various hospitals within the Kingdom of Saudi Arabia. Saudi Arabia is an Islamic country. Due to the uniqueness of the enforcement of the Islamic faith and the Saudi culture, many restrictions are imposed, particularly on women. The challenges and problems facing the South African nurses were, therefore, unique compared to elsewhere in the world. This research study had a primary and a secondary objective: The primary objective of this study was to explore and describe the lived experiences of South African nurses related to living and working in Saudi Arabia; The secondary objective of this study was to develop orientation guidelines to support South African nurses working and living in Saudi Arabia. The researcher utilized a qualitative, explorative, descriptive and contextual design based on a phenomenological approach to inquiry, in an attempt to answer the question: "What are the professional and personal experiences of the South African registered nurses working and living in Saudi Arabia?" Eleven registered nurses were selected to participate by means of purposive sampling. These nurses had been living in Saudi Arabia between three and six months. Consent was obtained from participants and the ethics committee of both the Nelson Mandela Metropolitan University and King Faisal Specialist Hospital and Research Centre. The central theme emanating from the study was recognized as being 'Cultural Diversity'. The sub-themes identified related to the registered nurses’: - Religious/spiritual adaptation - Environmental adaptation - Emotional/psychological adaptation - Professional adaptation Based on the identified themes, guidelines were formulated to assist South African registered nurses when migrating to Saudi Arabia. Utilization of these should assist the South African registered nurse in assimilating into both the cultural and working environment. However, in reality, the outcome showed that no one can be prepared fully for what awaits them in Saudi Arabia.

Thesis (MCurr)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: The shortage of nurses in the intensive care units (ICU) affects both the nurse and the patient with regard to quality care and the quality of work life. Job satisfaction as well as factors within the organisation and work environment predisposes dissatisfaction. Identifying these factors may improve the quality of life at work and reduce staff shortages. The aim of this study is to evaluate the contextual factors influencing the turnover of intensive care nurses in specified hospitals in the Cape Metropole. The objectives were: • To determine the factors influencing the turnover of intensive care nurses in specified hospitals in the Cape Metropole. • To compare the findings of the data in the specified hospitals. An explorative, descriptive design with a quantitative approach has been applied. The research sample consists of all nurses working in the intensive care units in the specified hospitals at the time of the study. A convenience sampling was applied. A structured questionnaire containing predominantly closed-ended questions was used and data collection was conducted by the researcher herself. A pilot study consisting of 10% (N=21) of the sample was done in one of the hospitals to validate the reliability of the questionnaire. The 21 participants who completed the pilot test did not participate in the actual study. The reliability and validity of the findings was assured by the utilization of the statistician and experts in the nursing department. The data is presented in tables and histograms. A Chi -square test is used to test the statistical significance association between variables. Spearman’s ranks (rho) order correlation is used to show the strength of the relationship between two continuous variables. The findings of the study show that discontent with salaries, inferior working environments, organisational factors, physical as well as emotional stress and the lack of career development opportunities, were major determinants in the poor quality of life at work with regard to the two set objectives. Recommendations include those for better remuneration, improved career opportunities and the creation of a safe as well as a friendly work environment. The aim is to create a positive work environment and improve the quality of life at work.
AFRIKAANSE OPSOMMING: ’n Tekort aan verpleegsters in die intensiewesorgeenheid beïnvloed beide die verpleegster en die pasient sovêr dit die gehalte van sorg lewering en die kwaliteit van arbeidservarings in die werkplek betref. Werkstevredenheid, sowel as faktore binne die organisasie en omgewingsfaktore in die werkplek, is aanleidend tot ontevredenheid binne die organisasie. Deur hierdie faktore te identifiseer, mag die kwaliteit van werkslewe verbeter word en die verlies aan personeel verminder word. Die doel van hierdie studie is om die kontekstuele faktore wat die personeel omset van intensiewesorgverpleegsters in spesifieke hospitale in die Kaapse Metropool beïnvloed, te evalueer. Die doelwitte was: • Om die faktore wat die omset van intensiewesorgverpleegsters in spesifieke hospitale in die Kaapse metropool beinvloed, te bepaal • Om die bevindinge van die studie binne verskeiehospitale te vergelyk Om hierdie navorsingsvrae te beantwoord, is ’n verkennende en beskrywende ontwerp met ’n kwantitatiewe benadering aangewend. Die steekproef het bestaan uit alle verpleegspersoneel werksaam in die intensiewesorg-eenhede in die gespesifiseerde hospitale binne die studie vermeld . ’n Gerieflikheids-steekproef is uitgevoer. ‘n Goedgestruktueerde vraelys met hoofsaaklik geslote vrae is gebruik vir datainsameling en vraelyste was persoonlik deur die navorser ingeneem. ’n Loodsstudie wat 10% van die steekproef beslaan, (N= 21), is in een van die hospitale onderneem om sodoende die betroubaarheid van die vraelys te bevestig. Die 21 deelnemers was nie deel van die werklike studie nie. Die betroubaarheid en geldigheid van die betrokke studie is bevestig deur die statistikus en kenners in die verplegingsdepartement van sodanige inrigting. Data is voorgelê in die vorm van tabelle en histogramme. ’n Chi-vierkanttoets is gebruik om die statistiese-beduidends verwantskap tussen veranderlikes te toets. Spearman se rangorde (rho) korrelasie is gebruik om die sterkte van die verhouding tussen twee aaneenlopende veranderlikes aan te dui. Die bevindinge dui aan dat ontevredenheid oor salarisse, ‘n swak werksomgewing en organisatoriese faktore, sowel as fisiese en emosionele stres, asook ’n gebrek aan loopbaanontwikkeling, groot bepalers was van swak werkskwaliteit in terme van die twee voorgestelde doelwitte. Aanbevelings bestaan uit voorstelle vir beter salarisse, die skepping van loopbaangeleenthede en die daarstelling van ’n veilige, vriendelike, werksomgewing. Die doel is om ’n positiewe werksomgewing te skep en om die kwaliteit van werkslewe te verbeter.

Thesis (MBA)--University of Stellenbosch, 2011.
Healthcare systems of the world’s poorer nations have been heavily impacted by economic globalisation. This has resulted in a steady deterioration of working conditions, resulted in less job security and has led to an increase in the spread of communicable diseases in developing countries such as South Africa. It is factors such as these, against the backdrop of a global recession, that have contributed to the escalation in global healthcare costs which has itself augmented the strain on already strained hospital resources in developing economies (Issues paper: Economic Globalisation, 2009). The current workplace faces complicated challenges which extend beyond the effects of the global recession. One of these challenges is the task of managing the diversity of the modern day workforce. This includes differences in gender, race, religion, culture, language, physical and mental ability, sexual orientation as well as generational differences. As a result, organisations that choose to exploit these differences are able to leverage a competitive advantage from them. This ability is however determined by the flexibility of organisations’ policies and practices. Furthermore, adapting an organisation’s human resource policies and practices pertaining to attracting, retaining, developing, promoting and managing a generational diverse workforce is only possible once these cohorts have been clearly identified, analysed and understood (Manion, 2009). Nurses are the pillar of healthcare systems throughout the world. In South Africa, however, the high staff turnover of nurses compared to the relatively small number of new recruits is of great concern due to its impact on the South African government’s capacity to provide a healthcare model of sustainable service delivery (Mokoka, 2007). The reality of the decline in the number of newly qualified nurses was clearly evident in the results of this study. Twenty-eight percent of the current community service nurses had previously considered leaving the profession, eight percent reported that they were considering leaving the profession within the next year and 20 percent intended leaving the public health sector after completing community service. The purpose of this qualitative study was to determine factors that preclude better remuneration that would influence community service nurses’ decision to remain employed in the public health sector. According to the Western Cape Nursing directorate, 270 nurses were registered to complete community service in the Western Cape in 2010. The 25 registered nurses who were scheduled to complete community service at Groote Schuur Hospital at the end of 2010 constituted the study sample. A self-administered questionnaire was used as the instrument for data collection from this fixed, convenient sample. Confidentiality of the participants was assured throughout the study and findings were reported as combined facts and figures using histograms. The majority of the participants were between the age of 20 and 25 years (48%). Furthermore, 88 percent of the participants were below the age of 35 years, largely representative of Generation X and the Millennials, Generation Y. The results of this study suggested an extremely complex interplay between intrinsic and extrinsic motivators, in influencing the decision of whether or not to remain employed in the public health sector. It was further evident that most of the factors that were rated to be of high importance were strongly self-centred, largely geared at personal reward and recognition. This finding is in clear agreement with literature published by Manion (2009) who supports the thinking that generations representative of Generation X and Y have a strong need for personal achievement and reward. Eighty percent of participants indicated a dire need for hospital management to recognise and manage generational diversity in the current workforce as this presented a daily challenge in the workplace. It was perceived that fundamental differences in needs, work ethic and values exist between Generations X and Y, compared to those of nurse and hospital managers who were representative of Baby Boomers. Consequently, there appeared to be a mismatch in the expectations and opportunities presented in the current workplace among the three generations. These findings merit further discussion on whether the permanent multi-disciplinary team at hospitals understand the influential role that they have on the complex task of retaining community service nurses in the public health service. Furthermore, 92 percent of community service nurses highlighted the need for mandatory orientation and induction programmes in each ward prior to commencing duty. This in itself was identified as a huge cause for anxiety and discord. In conclusion, even though this study was designed to establish factors that preclude better remuneration which could influence the decision of community service nurses to remain employed in the public health sector, it found that more than half the participants of this study recommended that receiving a more competitive salary was still an important issue for government to prioritise. However, it did not appear to be the overshadowing theme of dissatisfaction amongst community service nurses.

The United States is in the middle of a gripping nursing shortage; a shortage that is putting patients' lives in danger. This study determined the impact community and tribal colleges in severely economically distressed counties of the United States have on the nursing shortage faced by health care facilities serving these areas. The initial sample of 24 institutions selected in the Ford Foundation's Rural Community College Initiative (RCCI) (1995-2000). Data were collected from the Fall 1998 National Study of Post Secondary Faculty to obtain characteristics of faculty and from the 2003 Integrated Postsecondary Education Data System (IPEDS) to obtain characteristics of students, both at all publicly-controlled community colleges, all tribal colleges, and the 24 RCCI colleges that included 18 community and six tribal colleges. A survey was sent to the directors/deans/chairs of the nursing programs to ascertain issues related to the nursing program, nursing faculty, and nursing students. Respondents were asked to identify the healthcare facilities used for students' clinical experiences. A survey was then sent to each of these facilities asking about rural health, and source of nursing staff. Findings: 1) 87% of these these rural healthcare facilities are experiencing a significant shortage of nurses, and they are challenged to recruit and retain nursing staff; 2) Nursing programs, including both Licensed Practical Nursing and Associate's Degree Nursing are important to these rural community and tribal colleges, have seen growth over the past 5 years and expect to continue growth (86%); 3) Financial aid for nursing students is critically important; 4) Students are predominantly white and female; minorities are significantly under-represented; 5) Lack of subsidized public transportation and child care for nursing students even at tribal colleges are barriers that impact program completion; and 6) A shortage of nursing faculty exists at rural community and tribal colleges that negatively impacts student enrollment in these programs, thus reducing the rural nursing workforce pipeline. It is the rural community and tribal college nursing programs help provide severely economically distressed counties of the United States with the nursing workforce needed to decrease the nurse to patient ratio.

There is alleged to be a severe nursing shortage in Canada. While the shortage is attributed in large part to fiscal restraint in the hospital sector in the early 1990s, there are competing claims addressing why nursing employment levels changed over this period. Supply-side proponents argue that deteriorating working conditions and stagnant wages led nurses to voluntarily leave the profession, province, or country for better employment prospects. Demand-side proponents argue that hospitals reduced staff levels in response to a decline in inpatient utilization. There is also considerable disagreement on what impact, if any, reduced nursing employment levels had on access to hospital care. However, while there is no shortage of anecdotal evidence and plausible rhetoric, the debate is being carried out in a largely data-free environment. This thesis attempts partially to fill this void. Part I of this thesis examines trends in the nursing employment level in Canada over the hospital restructuring period. Results indicate that the number of nurses employed in hospitals decreased significantly during the cut-backs period and that the decrease was particularly severe among young nurses. The employment level is decomposed into three separate components for each age group: the change in the potential supply of nurses, the change in the employment rate of this group and the change in the likelihood that an individual will work in the nursing profession conditional on being employed. Results indicate that the third factor is most important. To determine whether the observed shift toward non-nursing employment was voluntary, an occupational sector choice model is developed and the pattern of nursing wages, non-nursing wages, and hospital expenditure (a proxy for demand) is examined. The evidence strongly suggests that the reduction in the nursing employment level in hospitals during the downsizing period was a result of a decrease in the demand for nursing labour and did not represent voluntary movement out of the nursing sector. That the decrease in demand primarily affected young nurses appears to reflect the influence of seniority in the highly unionized nursing sector.

M.Cur (Professional Nursing)
This study of patient acuity level plans (PALP) to determine nursing levels for in-patients units was carried out by means of an exploratory, descriptive instrumental study within the context of a nursing situation with the literature study serving as background, a patient acuity level plan (PALP) was designed, according to accepted criteria, to find data on which to base post determination for nursing staff. This descriptive, instrumental study was done at a private research hospital in Johannesburg where all the patients and nursing staff (first- as welI as second-in-command) were involved. The patient acuity level plan (PALP) -instrument was designed by the researcher, and under supervision of the researcher it was implemented in seven nursing units in the hospital. (The instrument proved to be highly reliable i. e. 0,999). The difference between nursing post determination as recommended and determined by PALP, and nursing post determination as determined by means of a pragmatic subjective approach by the nursing service manager of the, hospital proved to be statistically insignificant. The PALP instrument showed, however, that more nursing staff were needed in four of the seven units. The quality of the nursing was not studied nor was a productivity study carried out. The grand total difference between the recommended and actual nursing hours needed for all the nursing units shows a statistically significant difference (p = 0,0001) on a 1% significance level. This instrument could also positively contribute towards a more cost-effective post determination in nursing.

M.Cur.
A staffing programme does not exist in a private hospital that compiles with the criteria cost effectiveness and quality nursing care. For this reason a study was undertaken to develop a staffing programme that would facilitate cost-effectiveness as well as quality nursing care. The nursing managers' role is not only to maintain cost-effectiveness but also to facilitate wholeness in patients and nursing staff. To achieve wholeness an exploratory. descriptive instrumental study was conducted and the Nursing Theory of Wholeness was used as a foundation for this study. Various research techniques were used such as scheduled observation, a structured questionnaire, nursing audit and a semi structured interviewing technique to quantify results. An analysis was conducted retrospectively to verify the statistical significance of a cost effective staffing programme. A staffing programme was designed consisting of seven steps to provide a basis for validity and reliability of the programme. The staffing programme proved to be cost-effective and proved to be statistically significant and shows a significant difference on a I% significance level (p = <0,003). The most important conclusion made is that valid, reliable staffing programme was designed for a nursing service in the private hospital. The staffing programme proved to be easily comprehended, useful, and relevant to its purpose. Cost-effectiveness was proved. A patient questionnaire was implemented to test the construct quality nursing. Partial validity of the construct quality nursing was confirmed.

The National Health Act aims to protect the health care users and workers by ensuring that their work environments are protected against injuries. Practice environment is described as a physical, social and psychological characteristic of a work setting in which policies, procedures and systems are designed so that employees can meet the organisational objectives and achieve personal satisfaction in their work environment. The aim of the study was to describe and analyze characteristics of the practice environment of nurses. A quantitative descriptive study was conducted in a public hospital in Gauteng Province. Practice Environment Scale-Nursing Working Index (PES-NWI) questionnaires were distributed to 207 nurses who were proportionately stratified. Data was analysed using the SPSS version 25. Findings identified gaps of the current characteristics of the practice environment and developed strategies that will assist managers to enhance practice environment. There was alignment and correlation between the means, standard deviation and the frequencies which were drawn from the findings. The overall Cronbach’s alpha was 89% which confirmed the internal consistency of the instrument. The majority of the variables demonstrated statistical significance which had a p value of 0.001. In conclusion, practice environment affects all health care professionals although the study only analyzed the practice environment of nurses.
Health Studies
M. P. H.

M.Cur.
This study addressed the shortage of qualified nursing staff by means of an empirical research questionnaire according to the principles of the Delphi method. The study has as its objective the design of a marketing strategy for a nursing college, and also determines the contribution of marketing staff and formulates guidelines for a marketing programme and the implementation of a marketing strategy. The research consisted of three phases, being a literature survey and analysis of existing marketing models for service careers; the use of the Delphi method In three rounds, as well as critical Interviews with members Included In the sample to verify results; and the final validation with a marketing consultant and three respondents who are experienced marketing staff members. Marketing was regarded as a total system of Interactional activities, and the potential contribution of all involved persons was addressed in compiling a strategic marketing formula. A possible framework for a marketing strategy was determined with specific emphasis on the elements of such a formula, namely marketing staff, target market, products, price, promotional activities, venue and marketing research. It became clear from the research results that a marketing strategy and the guidelines for implementing such a strategy could enable marketing staff to enhance the Image of this career in an organised and planned manner, thereby contributing to the recruitment of nursing students who could resolve the shortage of qualified nursing staff.

Professional nurses comprise the largest number of health care professionals in South Africa. High turnover rates contribute to shortages of nurses in South Africa, aggravated by the emigration of nurses, inadequate recruitment of student nurses, and the expected retirement of many baby boomer nurses by 2016. This study addressed factors influencing the retention of professional nurses in the Gauteng Province of South Africa. In phase 1, postal questionnaires were completed by 101 registered nurses while semi-structured interviews were conducted with 21 nurse managers in phase 2. Personal, organisational and managerial factors influenced the retention potential of the professional nurses. In terms of Maslow' Hierarchy of Needs Theory, most factors influencing nurses' retention operated on the lowest (physiological) level and concerned remuneration. Safety needs were compromised by the lack of equipment and supplies, the shortage of nurses and unsafe working places. Esteem needs included respect from doctors, managers and colleagues as well as recognition for outstanding performance. In terms of Vogt et al's Theory of Nurse Retention Theory, the constrictions caused by inadequate remuneration and safety aspects should be addressed. Lewin's Force-Field Analysis Theory recommends that the factors that influence nurses' retention negatively should be unfrozen, changed and refrozen, including communication. Based on these results guidelines were compiled for enhancing the retention rates of professional nurses (Annexure G).
Health Studies
D.Litt. et Phil. (Health Studies)

Nurses constitute the largest professional group in South Africa's health care services. Factors contributing to South African nurses' emigration were studied qualitatively by analysing expatriate nurses' responses to open-ended questions, and quantitatively by analysing newly registered nurses' responses to structured questionnaires. These results were contextualised within Maslow's Hierarchy of Needs Theory, revealing that nurses' inability to meet their physiological needs, due to inadequate remuneration, was the major factor contributing to nurses' emigration potential. While improved salaries might enable more nurses to remain in South Africa, expatriate nurses would not return to South Africa unless certain esteem and self-actualisation needs could also be satisfied. Improving nurses' salaries is essential to address South African nurses' emigration potential. However, improved working conditions, enhanced workplace security, improved levels of job satisfaction and the appointment of nurses into currently frozen posts are also necessary, as is governmental and public recognition of the value of the profession. The South African nursing profession, health care services, Government and society should urgently address factors contributing to South African nurses' emigration potential; otherwise a serious shortage of nurses could cause the collapse of this country's health care services.
Health Studies
DLITT ET PHIL (HEALTH ST)

The purpose of the study was to explore the lived experiences of nurses on the implementation of occupational specific dispensation (OSD). Qualitative research using hermeneutic phenomenology was conducted in the three selected public hospitals in the Umgungundlovu district in KwaZulu-Natal (KZN). Data was collected by means of in-depth interviews with professional nurses, enrolled nurses and nursing assistants and focus group discussions with nurse managers purposively selected at the public hospitals in the Umgungundlovu district. Parse’s extraction synthesis analysis of data was done and seven (7) themes emerged from the participants’ dialogical conversation exploring the experiences of the implementation of OSD. The findings suggested that nurses viewed OSD as unfair labour practice because it divided nurses; there are those who grossly benefitted and those who benefitted less. The researcher concluded that the study will assist the authorities in the department of health both nationally and provincially to review OSD for nurses and close the gaps identified during the implementation as they were the pilot group.
Health Studies
M.A. (Health Studies)

Indiana University-Purdue University Indianapolis (IUPUI)
National calls for a better-educated nursing workforce are proliferating. The Institute of Medicine (IOM) challenged the nursing profession by setting the goal of having 80% of the nation's nurses prepared at the baccalaureate level (BSN) or higher by 2020. This is an ambitious goal given that, nationally, only 50% of nurses have a BSN. In fact, only 40% of nurses in Michigan have a BSN, and in the rural North-Central Region of this state, only 29% (the lowest in the state) of the nurses have a BSN. The purpose of this hermeneutic phenomenological study was to understand and interpret the meaning of being an associate degree (AD) nurse, the meaning attaining a BSN has for rural registered nurses who currently have an AD, and the barriers they experience that inform their decisions to return to school (or not). The investigator interviewed 11 AD nurses from rural North-Central Michigan and analyzed interview transcripts to identify common experiences and shared meanings using methods identified by Diekelmann, Allen, and Tanner (1989). Two themes were explicated in this study: "Getting in and Getting out" and "What Difference Does it Make?" The findings in this study challenge many of the common assumptions about academic progression in nursing and provide educators, administrators, and legislators with insight about the strategies that may be most helpful for achieving the IOM goal in rural Michigan.

The shortage of nurses in any health care setting increases workloads and complicates workflow. In South Africa the shortage is exacerbated by multiple factors, one of which is the emigration of nurses to countries that offer better benefits and working conditions. The purpose of the study was to explore and determine the views of nurse managers regarding staff turnover and retention, and to recommend effective measures to improve the retention of nurses. The inquiry was conducted in a KwaZulu-Natal hospital, a natural setting for the participants. The study utilized a qualitative, explorative, descriptive design. The population of this study comprised of 36 nurse managers. Purposive and convenience sampling techniques were applied to select a sample of 18 nurse managers. Data were collected through focus groups. Data were transcribed and analysed thematically, emerging patterns were noted. The researchers examined these categories closely and compared them for similarities and differences. identifying the most frequent or significant codes in order to develop the prominent categories. These were summarised in a narrative form. Four themes emerged from the findings: the staff turnover challenge; current retention strategies; measures to improve retention and strengthening management. The shortage of nursing staff was critical at this selected hospital, and this situation could be considered to be a microcosm of what is happening in public health care sectors in South Africa. Various measures were put in place to curb the high turnover. However, these measures had a fair to low level of success. Therefore, improved retention strategies are required to reduce the staff turnover. It is evident from the findings that needs to be done to investigate, plan and implement effective measures that are likely to retain nursing staff and recruit more nurses into the profession.
Health Studies
M. A. (Nursing Science)