Abstract
D.Cur.
The purpose of this study was to evaluate the quality of professional conduct by the nursing practitioner in clinical nursing care as reflected in post laparotomy and respiratory disorders in selected public hospitals in the Northern (Limpopo) Province, and to develop a programme to improve the quality of professional conduct by the nursing practitioner in
public hospitals. Professional conduct in this study refers to the level of compliance with the SANC/Muller (1999) practice standards as refined by the researcher.
The following dimensions are addressed in relation to post laparotomy patients and
patients with respiratory disorders: knowledge, skills/competencies, scientifically-based
care, recording, teamwork/networking, health promotion, therapeutic environment and
accountability.
The hypothesis for this study was that the quality of professional conduct by the nursing
practitioner in clinical nursing care as reflected in post laparotomy and respiratory disorders is inadequate and non-compliant with the standards and criteria in selected public hospitals in the Northern (Limpopo) Province. The following research questions were addressed:
a) What is the quality of professional conduct by the nursing practitioner in clinical
nursing as reflected in practice setting of post laparotomy and respiratory
disorders in selected public hospitals in the Northern (Limpopo) Province?
b) What professional conduct programme should be developed to improve
compliance with the standards and criteria?
A quantitative evaluative descriptive and contextual survey was conducted consisting of:
1. Refinement of standards by the researcher
2. Baseline survey to evaluate the quality of professional conduct by the nursing
practitioner in clinical nursing care as reflected in post laparotomy and respiratory
disorders;
3. The development of a professional conduct programme as a remedial action strategy.
The data collection method utilised strategies such as the use of trained evaluators,
direct and indirect observations, individual and group interviews, and documentation
analysis. Population and samples were selected from public hospitals that offer clinical
nursing care to both post laparotomy patients and patients with respiratory disorders.
The units that offered clinical nursing care to the same patients and the nursing
practitioners who provide clinical nursing care to these patients were selected. A three
point rating scale consisting of compliance (C) = 1, partial compliance (PC) = 0.5 and
non-compliance (NC) = 0.0 was used to collect data.
Statistical analysis system was used by the statistician to analyse the data. Individual items were analysed and percentages calculated. Then mean (M) and standard deviation (SD) on individual standard were determined. The results revealed that for practice standard one the nursing practitioner showed partial compliance (M = 0.375; SD = 0.197); practice standard two, the nursing practitioner showed partial compliance (M = 0.355; SD = 0.267) slightly lower than standard one; practice standard three the nursing practitioner showed non-compliance (M = 0.319; SD = 1.211); practice standard four, the nursing practitioner showed partial compliance (M = 0.552; SD = 0.180); practice standard five, the nursing practitioner showed partial compliance (M = 0.397; SD = 0.220); practice standard six, the nursing practitioner showed non-compliance (M = 0.238; SD .= 0.257), the lowest of all the standards; practice standard seven, the nursing practitioner showed partial compliance (M = 0.396; SD = 0.237); and practice standard eight, the nursing practitioner demonstrated partial compliance (M = 0.530; SD 0.267).
The first research question was what is the level of compliance by the nursing
practitioner with the standards and criteria in clinical nursing care in public hospitals in
the Northern Province? The overall results for the eight standards showed partial compliance (M = 0.380; SD = 0.175).
The second research question was what professional conduct programme should be
developed to improve compliance with the standards and criteria. The professional
conduct programme was developed based on the SANC/Muller practice standards as
the theoretical foundation.
Further analysis was done on contributory factors. There was a relationship between
the recording format (78.9% inadequate) and compliance with practice standard three;
scientifically-based recording on patient records rated low at all the selected hospitals
(M = 0.319; SD = 0.211). There was also an association between supervision/support
(85% inadequate) and practice standard six, indicating non-compliance (M = 0.238; SD
= 0.257) and practice standard seven (M = 0.396; SD = 0.237). A relationship between
availability of stock and supplies (69.4% inadequate) and practice standard one and
two, was observed (M = 0.375; SD = 0.197) and (M = 0.355; SD = 0.269) respectively.
There was, however, no relationship between staffing and the practice standards;