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Nurses experience high levels of work related stress and burnout as well as low job satisfaction and poor general health owing to the nature of their work. This paper seeks to provide a better understanding of the nature of relationships between work related stress, burnout, job satisfaction and general health of nurses over one year. This study involved a longitudinal design. Two hundred and seventy seven nurses from four hospitals completed a follow up survey consisting of five questionnaires. Data were collected between 2013 and 2014. The data were analysed using generalized estimation equation analysis. Lack of support was associated with burnout, patient care was associated with job satisfaction and staff issues were associated with general health of nurses. Burnout is more strongly related to job satisfaction than general health. The findings of this study could inform evidence based policy and practice through interventions aimed at improving job satisfaction and reducing the impact of burnout on general health of nurses. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

Background and aim: Given the myriad occupational stressors of nursing itself, plus the challenges of moonlighting, we aimed to investigate the emotional well‐being of moonlighting nurses and their work engagement. Well‐being was defined by levels of general health, mental health, emotional exhaustion, personal accomplishment, compassion satisfaction and compassion fatigue. Design A cross‐sectional descriptive survey (December 2017 to March 2018) at private health care facilities in a Metropolitan Municipality, South Africa. Methods: Two hundred and fifty‐one nurses completed self‐administered questionnaires, which comprised of validated scales. Results: Nurses were at low risk for emotional exhaustion (M=12.8; SD=11.23) and scored high on compassion satisfaction (M=42.34; SD=7.22) and work engagement (M=4.87, SD=1.18). Personal accomplishment (t= 2.535; P<.05) compassion satisfaction (t= 6.790; P=.000) and mental health (t=3.206; P<.05) made a statistically significant unique contribution to the prediction of work engagement. Nurses who had considered leaving the profession scored significantly higher on emotional exhaustion and compassion fatigue. Conclusion: Nurses who moonlighted in private health care facilities reported low risk for burnout and high levels of compassion satisfaction and work engagement. Further research is needed to explore the reasons for these findings. Attention must be given to ensuring the occupational well‐being of nurses in order to retain them in the profession. SUMMARY STATEMENT: What is already known about this topic? Nursing is a stressful occupation.Moonlighting (dual employment) is fraught with challenges for nurses as individuals and for institutions where they work.Very little is known about the emotional well‐being of nurses who moonlight. What this paper adds? This is the first cross‐sectional study on emotional well‐being and work engagement of nurses who moonlight in private hospitals in South Africa.Nurses moonlighting in private health care facilities reported low risk for burnout and high levels of compassion satisfaction and work engagementMoonlighting nurses who had considered leaving nursing scored higher on emotional exhaustion and compassion fatigue than those who had not considered leaving nursing. The implications of this paper: Better‐resourced private health care facilities may contribute towards the finding that nurses moonlighting in private health care facilities reported low risk for burnout and high levels of compassion satisfaction.Attention must be given to ensure the occupational well‐being of nurses in order to retain them in the profession.The finding that lower categories of nurses score higher on work engagement than professional nurses requires further research. [ABSTRACT FROM AUTHOR]

Aim: Tuberculosis (TB) continues to challenge global health systems, especially in South Africa. Nurses are especially vulnerable to TB exposure, because of their prolonged front‐line contact with infected patients—especially in primary health care (PHC) clinics. Their infection control practices, influenced by key factors such as knowledge and attitudes towards TB prevention, become an important consideration. The aim of the study was to (1) describe the TB prevention knowledge, attitudes, and practices of PHC nurses in a South African district and (2) explore moderating factors on TB prevention practices. Methods: A cross‐sectional survey was undertaken at all 41 PHC facilities in Mangaung Metropolitan district, Free State province, South Africa, using self‐administered questionnaires. Captured data were analysed to yield descriptive and multivariate statistics. Results: Results suggest several instances of inadequate TB prevention knowledge, attitudes, and practices. Good TB practice was predicted by TB attitudes and knowledge, and the relationship between TB prevention knowledge and practices was not moderated by training, attitudes, or nurse category. Conclusion: Results echo previous indications that nurses often do not exhibit the desired knowledge, attitudes, and practices required to adequately protect themselves and others against TB and suggest further exploration towards understanding the influences on TB prevention practice among nurses. SUMMARY STATEMENT: What is already known about this topic? Nurses are especially at risk for tuberculosis infection.Not much is known about nurses' tuberculosis prevention capabilities in primary health care settings, the front line of contact with infection.Little is known about the influences on nurses' tuberculosis prevention practices. What this paper adds? Nurses in primary health care settings do not have adequate tuberculosis prevention knowledge, attitudes, and practices to create optimally safe health care environments.The physical make‐up of N95 respirators are currently inadequate to promote its use among nurses in primary health care settings.While tuberculosis prevention knowledge is positively linked to tuberculosis prevention practices, it remains unclear what factors may moderate this relationship. The implications of this paper: Tuberculosis prevention practices among nurses remain suboptimal to curb tuberculosis infection in health care facilities.Better interventions aimed at improving tuberculosis prevention among nurses are needed.Such intervention will require a closer understanding of the influences on tuberculosis practices. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify final‐year undergraduate students and new graduate nurses' behavioural intentions towards medication safety across four countries. Background: Medication errors are a common and avoidable occurrence, being costly for not only patients but also for health systems and society. Design: A multi‐site cross‐sectional study. Methods: A self‐administered survey was distributed to students and new graduate nurses in South Africa, India, Turkey and Australia. Descriptive statistics were calculated for all survey items. Multiple linear regressions were performed to predict behavioural intentions using the three Theory of Planned Behaviour constructs: attitudes, behavioural control and subjective norms. This study adheres to the STROBE guidelines. Results: Data were analysed for 432 students and 576 new graduate nurses. Across all countries, new graduate nurses reported significantly higher scores on all the TPB variables compared with student nurses. Attitudes towards medication management were found significantly and positively related to intention to practice safe medication management for both student and new graduate nurses. Total perceived behavioural control was significantly and negatively related to intention to practice safe medication management for students. Conclusion: Student and new graduate nurses showed favourable attitude, subjective norm, perceived behaviour control and intention in practising medication safety. However, differences in countries require further exploration on the factors influencing attitudes towards medication safety among student nurses and new nurse graduates. Relevance to clinical practice: Understanding student and new graduate nurses' medication administration practices is important to inform strategies aimed at improving patient safety. The findings of this study highlight the need for an internationally coordinated approach to ensure safe medication administration by student and new graduate nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine the incidence of medication administration errors, medication administration-related deviations from safe practice as well as factors associated with these errors in medical and surgical units of public hospitals in the Gauteng Province of South Africa. Background Several studies have been published on the incidence of medication administration errors, but only a few have studied the incidence of medication administration-related deviations from safe practice. Context-specific research on the incidence of medication administration errors and associated factors (patient acuity, bed occupancy, staffing levels, medication administrators' qualifications, dose calculation skills, level of hospital, unit type, medication administration route and interruptions) within the continent of Africa is lacking. Design A cross-sectional, observational design. Methods Direct observation was conducted incorporating a previously validated checklist based on basic medication guidelines including the five rights, asepsis and medication documentation. In addition, a knowledge test on dose calculations was performed. Medication administration to 315 patients (1847 medications administered) was observed between February-August 2015 in medical and surgical units from eight public hospitals. Twenty-five medication administrators completed dose calculations. Results In total, 296 medication errors were identified, of which most were wrong-time errors and omissions. Interruptions and patient acuity were significantly associated with wrong-dose and wrong-route errors, respectively. Most medication administration-related deviations from safe practice were related to patient identification or asepsis. Sixteen of 50 dosage calculations were answered incorrectly. Incorrect answers most often occurred in the calculation of parenteral dosages. Conclusions Medication administration errors, especially wrong-time errors and omissions, are prevalent in public hospitals in the Gauteng Province. Interruptions lower the risk of wrong-dose errors, while patient acuity exacerbates this risk. Relevance to clinical practice Factors associated with wrong-time errors and omissions should be addressed. Patient identification and asepsis protocols should be adhered to. Dosage calculation training is indicated. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop and validate a modified Situation-Background-Assessment-Recommendation communication tool incorporating components of the Cape Town modified early warning score vital signs chart for reporting early signs of clinical deterioration. Background Reporting early signs of physiological and clinical deterioration could prevent 'failure to rescue' or unexpected intensive care admission, cardiac arrest or death. A structured communication tool incorporating physiological and clinical parameters allows nurses to provide pertinent information about a deteriorating patient in a logical order. Design Mixed methods instrument development and validation. Methods We used a sequential three-phase method: cognitive interviews, content validation and inter-rater reliability testing to validate a self-designed communication tool. Participants were purposively selected expert nurses and doctors in government sector hospitals in Cape Town. Results Cognitive interviews with five experts prompted most changes to the communication tool: 15/42 (35.71%) items were modified. Content validation of a revised tool was high by a predetermined ≥70% of 18 experts: 4/49 (8.2%) items were modified. Inter-rater reliability testing by two nurses indicated substantial to full agreement (Cohen's kappa .61-1) on 37/45 (82%) items. The one item achieving slight agreement (Cohen's kappa .20) indicated a difference in clinical judgement. The high overall percentage agreement (82%) suggests that the modified items are sound. Overall, 45 items remained on the validated tool. Conclusion The first modified early warning score-linked Situation-Background-Assessment-Recommendation communication tool developed in South Africa was found to be valid and reliable in a local context. Relevance to clinical practice Nurses in South Africa can use the validated tool to provide doctors with pertinent information about a deteriorating patient in a logical order to prevent a serious adverse event. Our findings provide a reference for other African countries to develop and validate communication tools for reporting early signs of clinical deterioration. [ABSTRACT FROM AUTHOR]

Aims To conduct a quantitative investigation of stress and the relationship with burnout among AIDS care volunteers. Background Volunteer caregivers experience stress that could lead to burnout. Yet, very few studies quantify stress and its relationship with burnout among AIDS care volunteers. Design This study uses a cross-sectional, exploratory survey design. Methods Face-to-face interviews were conducted with 126 volunteer caregivers working in 13 semi-rural communities (townships) in Durban, South Africa in April 2009. All participants were women, Christian and with low levels of education. A 22-item instrument was drawn from Pearlin et al.'s role overload and role captivity scales, Van Dyk's stress factor scale and the Maslach Burnout Inventory. Results Most of the volunteers had moderate-to-high levels of stress. 'Role/work overload' 'lack of support' and 'overwhelming nature of the disease' explained most of the variance in stress. Volunteers' age and number of patients in their care were predictors of stress. Caring for only AIDS patients, lack of support, stress emanating from perceived stigma and lack of training; and the overwhelming nature of AIDS were predictors of burnout. Conclusion High levels of stress could negatively impact volunteers' health and well-being and on-the-job performance. Policy makers must develop and fund home-based care models that take into account the stressors associated with AIDS care, by reducing the work load, providing ongoing psychosocial support and recruiting nurses to assist volunteers. The small non-probability sample used in this study highlights the need to treat the findings with caution. [ABSTRACT FROM AUTHOR]

Aims and objectives. To investigate inter-relationships between emotional intelligence (EI), work stress and burnout in a group of nurses in the Western Cape Province, South Africa. The moderating effect of EI in the stress-burnout relationship and group differences (nurses working in different wards) in burnout were also investigated. Background. Stress and subsequent burnout commonly threaten the occupational health and well-being of nurses in South Africa and elsewhere. Developing EI in nurses may increase individual stress resistance and combat burnout. Design. A cross-sectional research design with anonymous questionnaires was conducted. Self-report data were used. Methods. Survey data were collected from 122 nurses working in different wards at four hospitals from a private hospital group. The Swinburne University Emotional Intelligence Test, Sources of Work Stress Inventory and Maslach Burnout Inventory were used to measure EI, stress and burnout, respectively. Results. Consistent inverse relationships between emotional control and management as dimensions of EI, and stress and burnout emerged. A differential effect of high vs. low EI on the stress-burnout relationship was evident. Workload and the work/family interface emerged as significant predictors of burnout. Respondents working in maternity, paediatric and ER wards reported more feelings of personal accomplishment than those working in general wards. Conclusions. Higher EI is significantly related with lower stress and burnout in a sample of South African nurses. The moderator effect of EI in the stress-burnout relationship suggests that enhanced EI may help diminish burnout development when chronic stress is experienced. Relevance to clinical practice. EI developmental interventions, if introduced in nursing curricula, may increase emotional coping resources and enhanced social skills, which may benefit the long-term occupational health of nurses. This may be relevant in developing countries, where environmental stressors related to the organisational context (budget constraints) and wider social factors (shortage of qualified nurses) are difficult to address. [ABSTRACT FROM AUTHOR]