Health SA Gesondheid

Obstetric ultrasound training programmes for midwives: A scoping review

Yasmin Casmod, Susan J. Armstrong — Thu, 06 Apr 2023 00:00:00 +0000

Background: Antenatal care is essential for all expectant mothers and assists in reducing maternal mortality rates thus addressing the Sustainable Development Goal 3. Obstetric ultrasound complements antenatal care and is used in pregnancy to identify and monitor high-risk pregnancies. However, disparities exist and in low- and middle-income countries, ultrasound services are not readily available. This contributes to maternal and neonatal morbidity and mortality within these populations. Short ultrasound training programmes for midwives can be beneficial in alleviating some of the challenges experienced.

Aim: The aim of this scoping review was to identify global ultrasound education programmes for midwives.

Method: Articles containing suitable keywords were retrieved from databases suitable to nursing, education and ultrasound. Themes were developed based on the articles included in the review.

Results: A total of 238 articles were identified, and after the duplicates and irrelevant studies were removed, 22 articles were included. Articles were analysed and discussed under the identified themes and categories.

Conclusion: It is essential that sufficient training is provided to medical professionals performing obstetric ultrasound so that adequate and safe care is offered to expectant mothers. With the introduction of ultrasound in low- resource settings, the knowledge of safety and competencies required to operate the equipment necessitate adequate training. Developed programmes have been found to meet the demands of the ever-changing workforce and allow for midwives to perform focused obstetric ultrasound examinations.

Contribution: This scoping review highlighted ultrasound training programmes for midwives and provided guidance on the development of future midwifery ultrasound training programmes.

Implementation of antimicrobial stewardship programmes in private healthcare settings in Africa: A scoping review

Andile P. Dlungele, Lehlohonolo J. Mathibe — Thu, 06 Apr 2023 00:00:00 +0000

Background: An Antimicrobial Stewardship Programme (ASP) is one of the strategic objectives of the World Health Organization’s (WHO) global action plan to combat antimicrobial resistance. There have been numerous publications on the implementation of ASPs in both private and public sectors globally. However, there are no reviews and interpretive scholarly research publications on successful implementation of ASPs in private healthcare settings in Africa.

Aim: The aim of this study was to systematically gather relevant information from published findings and to interpret those findings into a coherent body of lessons learnt from successful ASP implemented in private healthcare settings in Africa.

Method: Google Scholar and PubMed, which are online databases, were extensively searched, and studies, which met the inclusion criteria for this review, were retrieved. A data-charting list was developed to extract relevant data.

Results: Only six South African studies reported on successful implementation of ASPs in private healthcare settings in Africa. The main focus areas include locally driven prescription audits as well as pharmacist-led interventions.

Conclusion: Although private healthcare settings in Africa utilise antibiotic therapy for various infectious diseases, reports on implementation of ASPs in these settings are limited. To win the battle against antimicrobial resistance, private healthcare settings in Africa need to implement evidence-based guidelines and report on the rational use of antibiotics.

Contribution: The private healthcare sector in Africa needs to play a more meaningful role in the implementation of ASPs.

Students’ knowledge, attitude and practices towards pressure ulcer prevention and management

Franco R. Abrahams, Edwin R. Daniels, Hileni N. Niikondo, Kristofina Amakali — Thu, 06 Apr 2023 00:00:00 +0000

Background: Student nurses provide nursing care to patients during clinical allocation, and their competence may affect the quality of care given to the patients. Good knowledge and positive attitudes enhance early detection for prevention and management of pressure ulcers.

Aim: To determine undergraduate nursing students’ knowledge, attitude and practices (KAP) towards prevention and management of pressure ulcers.

Setting: A nursing education institution in Windhoek, Namibia.

Methods: A quantitative, cross-sectional research design was used to conveniently sample (n = 50) student nurses and collect data using a self-administered questionnaire. Data were analysed using the statistical software programme (SPSS) version 27. Descriptive frequencies were applied, and Fishers exact test was performed. A statistical value of p < 0.05 was considered significant.

Results: Fifty (n = 50) student nurses consented to participate in the study. Student nurses reported good levels of knowledge (n = 35; 70%), attitude (n = 39; 78%), practices (n = 47; 94%). There was no statistically significant association between demographic variables and the level of knowledge, attitudes and practices, p > 0.05.

Conclusion: Student nurses have good knowledge, positive attitudes and practices on prevention and management of pressure ulcers. By the implications, the study concludes that the nursing students will competently manage the pressure ulcers occurring in the clinical setting. An observational study is recommended to assess practices in the clinical setting.

Contribution: The findings of this study will help to close the gap in the implementation of standard operating procedures for the prevention and management of pressure ulcers.

Nursing students’ experiences of clinical assessment at a university in South Africa

Gabieba Donough — Thu, 06 Apr 2023 00:00:00 +0000

Background: Nursing education includes both classroom and clinical teaching. The clinical teaching was explored through this research. The successful training of the undergraduate nursing students can be attributed to effective clinical teaching and supervision and is determined by both training requirements and services provided. Although there have been several researches on clinical supervision, there is still a dearth of information of the realities of supervision regarding assessment of undergraduate nursing students. The authors’ original thesis formed the foundation of this manuscript.

Aim: This study aimed to explore and describe nursing students at the undergraduate level experiences regarding clinical supervision.

Setting: The research was conducted at a nursing school at a South African university.

Method: After ethical clearance, focus group interviews were conducted to explore undergraduate nursing students’ experiences of clinical supervision using a descriptive design and qualitative approach. Two qualified practitioners in the field collected the data. A purposive method was utilised to select nine participants from each year’s level of education. Enrolled undergraduate nursing students at the institution under study formed the inclusion criteria. Utilising content analysis, the interviews were analysed.

Results: The findings confirmed the students’ experiences of clinical supervision and voicing their concerns regarding clinical assessment versus a developmental training; clinical teaching, learning and assessment and formative assessment procedures.

Conclusion: A responsive clinical supervision system to strategically respond to the needs of undergraduate nursing students will aid in developmental training and assessment.

Contribution: Understanding of the realities of clinical teaching and supervision regarding clinical assessment and development of undergraduate nursing students.

Exploring initiation schools’ impact on HIV and AIDS management in the Vhembe district of South Africa: An ethnography

Avhatakali A. Ndou-Mammbona — Thu, 06 Apr 2023 00:00:00 +0000

Background: This article presents the positive and negative impact traditional initiation schools have on the management of HIV and AIDS in the Vhembe district in South Africa.

Aim: To explore the impact of initiation schools regarding the management of HIV and AIDS.

Setting: This ethnographic study was conducted in rural villages in the Vhembe district.

Methods: Nine purposively sampled key informants from the Vhavenda traditional healers and leaders participated in the study. Data were collected using semi-structured face-to-face interviews guided by an interview and observation guide. Data were analysed using ethnographic content analysis.

Results: The results indicated that the Vhavenda have different traditional initiation schools for boys and girls. For boys, there is Muḽa [traditional male circumcision], while Musevhetho [first stage of girls’ traditional initiation before puberty], Vhusha [girls’ second stage of traditional initiation] and Domba [final stage of girls’ traditional initiation] are for girls. Some of the information provided perpetuates engagement in multiple concurrent relationships predisposing them to contract HIV. Boys are encouraged to be strong and to control women when it comes to sexual activities to suit their desire, whether the woman consented or not, while girls are taught to be submissive to their husbands which can fuel the spread of HIV.

Conclusion: As the initiates are attentive to whatever is said during those initiation schools, there is an opportunity for using these initiation schools for proper prevention of HIV and instilling positive behaviours by using Leininger’s cultural care modalities which focus on preservation of beneficial practices and repatterning of practices which fuel the spread of HIV.

Contribution: The study findings will aid in the review and update of the manuals and procedures for HIV and AIDS management.

Indigenous practitioners’ views on causes of female infertility

Thu, 06 Apr 2023 00:00:00 +0000

Background: The use of indigenous practices has increased remarkably throughout the world. Subsequently, society uses this practice for the treatment of various health problems, including infertility. This research focussed on the role of indigenous practitioners (IPs) using a holistic approach to explore the causes of infertility in women.

Aim: This study aimed to explore and describe the views of IPs on the causes of female infertility in Ngaka Modiri Molema health district.

Setting: The study was conducted in Ngaka Modiri Molema, North West Province, one of the most rural provinces in South Africa.

Methods: The study followed a qualitative explorative design. A purposive sampling technique identified five IPs who were experts in managing infertility. Individual semistructured interviews were conducted, and data analysis used Creswell’s method of qualitative data analysis.

Results: Findings revealed that IPs offered a wide range of services in the treatment and management of infertility among rural women. Hence, the following themes emerged, namely, history taking regarding infertility, treatment of infertility and holistic care on infertility.

Conclusion: The IPs are important providers of healthcare in the management of infertility in indigenous communities. The findings revealed that there are various causes of female infertility according to the indigenous healthcare system.

Contribution: In contribution, the study described the unique practices found in the community as executed by the IPs. This care focusses on holistic care, including treatment and continuous care for the healthcare user and the family. Noteworthy to mention, this holistic care extends to subsequent pregnancies. However, there is a need for further research to valorise the indigenous knowledge unearthed in this study.

Experiences of nurse educators regarding the use of the clinical skills laboratory at the School of Nursing in the Free State province

Siphiwe T. Madlala, Agnes N. Mvandaba — Thu, 06 Apr 2023 00:00:00 +0000

Background: Integration of theory to practice by student nurses is a challenge in most training institutions accredited by the South African Nursing Council (SANC). Nurse educators require a fully equipped and functional clinical skills laboratory to impart clinical competency knowledge to student nurses.

Aim: The purpose of this study was to understand the experiences of the nurse educators in teaching clinical skills to student nurses using the clinical skills laboratories.

Setting: The study was conducted at the School of Nursing in the Free State province in 2021.

Methods: A qualitative descriptive design was employed. Purposive sampling was used to select participants for the study. Unstructured one-on-one interviews were conducted with 17 nurse educators until data saturation was reached. Data were analysed thematically.

Results: The three major themes that emerged during data analysis and were discussed to make recommendations of the study are as follows: clinical skills laboratory environment; human and material resources; financial constraints.

Conclusion: This study revealed that there is a need for the use of the clinical skills laboratory by nurse educators to teach clinical practice to student nurses. Therefore, it is imperative that the study recommendations be considered for implementation to improve the use of the clinical skills laboratory.

Contribution: The importance of integrating theory to practice by using the clinical skills laboratory during clinical practice teaching by nurse educators will be understood.

Mentoring community service nurses in public health settings: Guidelines for nurse managers

Sisinyana H. Khunou — Thu, 06 Apr 2023 00:00:00 +0000

Background: Adequate mentoring and support of community service nurses (CSNs) in transitioning from the learning environment to the public health setting is pivotal. Despite this notion, the mentoring of CSNs is inconsistently implemented. It was therefore imperative that the researchers developed the guidelines that can be used by managers to mentor the CSNs.

Aim: This article shares nine guidelines to ensure adequate mentoring of CSNs in public health settings.

Setting: The study was conducted in public health settings designated for placement of CSNs, in South Africa.

Methods: This study followed a convergent parallel mixed-methods design whereby qualitative data were obtained from purposefully selected CSNs and nurse managers. Quantitative data were obtained from 224 CSNs and 174 nurse managers, with the use of mentoring questionnaires. Semi-structured interviews were used on focus groups of nurse managers (n = 27) and CSNs (n = 28). Quantitative data were analysed with Statistical Package for Social Science software version 23, ATLAS.ti 7 software was used to analyse qualitative data.

Results: The merged results evidenced that CSNs were not adequately mentored. The public health setting was not conducive to mentoring CSNs. Mentoring activities were not well structured. Monitoring and evaluation of mentoring of CSNs were not properly done. Evidence from merged results and literature were applied to develop mentoring guidelines for operationalising a mentoring programme for CSNs.

Conclusion: The guidelines were: (1) creation of a positive mentoring environment, (2) enhancement of collaboration between stakeholders, (3) attributes of CSNs and nurse managers in the mentoring relationship, (4) enhance orientation for nurse managers and CSNs, (5) facilitation of mentor– mentee matching process, (6) conducting mentoring meetings, (7) capacity development for CSNs and nurse managers, (8) monitoring and evaluation of mentoring process, and (9) reflections and feedback.

Contribution: This was the first CSNs’ guidelines to be developed in the public health setting. These guidelines could facilitate adequate mentoring of CSNs.

Effect of receiving mobile text messages on cortisol concentrations in students at the University of the Free State

Roné Vorster-De Wet, Anthonie M. Gerber, Jacques E. Raubenheimer — Thu, 06 Apr 2023 00:00:00 +0000

Background: Texting has become central to social life, with adverse effects on physiological functioning. Research into the impact of texting on cortisol secretion is limited.

Aim: Thus study aimed to determine how receiving mobile text messages affected salivary cortisol concentrations and investigate the moderating effects of stress, anxiety and depression on cortisol secretion.

Setting: Undergraduate physiology students attending physiology lectures at the Faculty of Health Sciences, University of the Free State, 2016.

Methods: An experimental, crossover, quantitative design was used. Participants were involved over two consecutive days, receiving mobile text messages (intervention) on one day and acting as their own control on the other. Self-reported data on stress, anxiety, depression and subjective experience of the study, and saliva samples were collected. Text frequency and wording (neutral, positive, negative) were varied among participants.

Results: Forty-eight students participated in the study. Salivary cortisol concentrations did not differ significantly between the intervention and control days. High anxiety levels were associated with increased cortisol concentrations. No associations with cortisol concentrations were documented in low to moderate anxiety, stress, depression or how participants experienced the intervention. There were no significant differences between text frequency, text emotion and change in cortisol concentrations on the intervention day.

Conclusion: Receiving mobile text messages did not elicit a significant cortisol response in participants.

Contribution: Findings added to the body of knowledge about the effect of texting on student learning by measuring salivary cortisol concentrations in a lecture setting, with investigation into the moderating effects of stress, anxiety, depression and participants’ subjective experience.

Exploring the discord between pharmacy education and practice in antimicrobial stewardship

Devina Chetty, Stephanie Leigh-de Rapper — Thu, 06 Apr 2023 00:00:00 +0000

Background: Antimicrobial stewardship (AMS) is a critical global intervention aimed at optimising antimicrobial use and decreasing antimicrobial resistance (AMR) with pharmacists playing a pivotal role within AMS teams. However, AMS is not comprehensively taught in pharmacy curricula and little is known about the relevance of pharmacists’ training to meet AMS needs in South Africa.

Aim: This study aimed to explore the attitudes, knowledge and perceptions of clinical pharmacists towards AMS participation and training in South Africa.

Setting: This study was conducted among clinically practicing pharmacists in public and private healthcare sectors in South Africa.

Methods: A quantitative exploratory research design was selected for this study. The study was conducted using a self-administered structured survey. Categorical variables were analysed using simple descriptive statistics. Mann–Whitney and Kruskal–Wallis tests were applied to determine differences between variables.

Results: Pharmacists demonstrated good attitudes knowledge and perceptions towards AMS (median 4.3). There was statistical significant differences in AMS participation between pharmacists of different years of experience (p = 0.005), sector of employment (p = 0.01), position of employment (p = 0.015) and presence of AMS programmes (p = 0.004). Pharmacists indicated that their Bachelor of Pharmacy undergraduate studies inadequately prepared them for their role in AMS (median 4.3).

Conclusion: Pharmacists show positive attitudes, knowledge and perceptions towards AMS. Education and training in AMS principles is obtained through master’s programmes, short courses, Continued Professional Development (CPDs) and workshops and insufficiently incorporated in undergraduate programmes.

Contribution: This study confirms that undergraduate pharmacy programmes inadequately prepare pharmacists for their role in AMS.