Abstract
D.Cur.
National and international best practice strategies for improving intrapartum care exist. Sub-standard care, negligence, and lack of midwifery care related skills by midwives are factors contributing to maternal morbidity and mortality in South Africa. The purpose of this study is to describe a model to facilitate best practice during intrapartum care at a public hospital in Gauteng.
A contextual, qualitative, explorative, descriptive research design for theory generation has been used. The study consists of four phases: Phase One focuses on exploration and description of the meaning of the concept ‘best practice’ during intrapartum care, using Wilson’s method of concept analysis. The results thereof were used to direct data collection during the empirical phase. Phase Two explores the perceptions of midwives regarding how best practice can be facilitated during intrapartum care. A non-probability, purposive sampling method was used to select a sample of registered midwives willing to participate in three sessions of semi-structured agenda-focused group interviews. Data saturation occurred during the third agenda-focused group interview session. The number of registered midwives interviewed at data saturation point was 15. A qualitative method was used to analyse data. An independent co-coder was involved in data analysis followed by a consensus discussion meeting between the researcher and the co-coder to finalise the findings.
The findings in phase two include values and ethical practice; enabling environment, introspection, and needs analysis; effective and efficient clinical practice; professionalism/regulatory framework; strong leadership and clinical governance. The researcher held a follow-up interview with six of the participants who participated in the initial agenda-focused group interviews to verify the data obtained. Four strategies, namely credibility, dependability, confirmability, and transferability were used to ensure trustworthiness. The ethical principles as described by the Democratic Nursing Organisation of South Africa were adhered to throughout the study. Dickoff, James, and Wiedenbach’s (1968) six elements of practice theory were used in conceptualisation of the findings in phase three of the study. Theoretical validity was maintained. Phase four describes and evaluates the model using Chinn & Kramer’s (2015) theory, followed by a description of the guidelines to operationalise the model. The study’s justification, limitations, recommendations, and conclusion are described.