Day 2 :
Keynote Forum
Gina Granger
KGH Education Zone, South Africa
Keynote: Professional Nursing in a new era
Biography:
Gina Granger is a lifelong learner, who completed a Master’s Degree in Nursing, a Bachelor Degree in General nursing, a Bachelor Degree in Nursing Education and Community Health Nursing, a Diploma in Midwifery, a Diploma in Psychiatric Nursing, Certification in NICU Nursing, Certification as International Board Certified Lactation Consultant, and she is a certified AHA BLS Instructor. During a nursing career of over 40 years (in General nursing, Midwifery, Psychiatric nursing, Community health, NICU and Nursing Education); she was a preceptor, mentor and educator for nurses in South Africa, as well as in the United Arab Emirates. This included the commissioning of education departments, preparing staff for international accreditation; training basic & advanced life support; and developing of and training staff on nursing policies, procedures and competency assessment tools in various healthcare facilities.
Abstract:
Nursing is one of the largest workforces in the world and professional nursing has to keep up with many changes in healthcare. The modern professional nurse is not only a bedside carer; but also a leader, interdisciplinary team member, follower when necessary, role model and mentor, educator, researcher and quality improvement agent. Florence Nightingale (1820-1910) was the pioneer of professional nursing, who provided us with nursing concepts that are still valid in professional nursing today. She defied Victorian customs by refusing to marry at 17 years of age and becoming a nurse (a very frowned-upon career for a lady from an English upper-class family in those days). The concepts implemented by Nightingale (infection control, self-care, assessment, therapeutic communication, spiritual nursing and public health advocacy) are still practiced in modern healthcare. Her work raised nursing from a lowly to a respectable profession in all levels of society. Assessments form the core of nursing care, as all nursing interventions are based on them. The humanity and compassion displayed by Nightingale must remain at the core of modern nursing. Community and home care nurses work more autonomously with patients and families than acute care nurses and nursing leadership in this type of care delivery is very important. The nurse has to be the link between patients and caregivers and other team members as he/she spends more time with the patients and has a better understanding of the patient and family needs in the home environment. Nurses need to be assertive and speak up for patients with clear communication to ensure that patient and family needs are met. It will give an overview of the history of professional nursing as well as the ICN Code of Ethics for Nurses; and discuss how both influence professional nursing.
Keynote Forum
Sr Lee Boorman
Faircape Group, South Africa
Keynote: The impact of social decline on the South African public health care system
Biography:
Sr Lee Boorman has 30 year experience in the Holistic Management of not just the elderly but the entire spectrum of design, building, managing and maintaining 287 hospital beds caring for the elderly as well as focusing on the emotional, physical and psychological well-being of 1000 assisted living retirees spread over 6 retirement villages belonging to the Faircape group in Cape Town, South Africa. Her passion for advocacy for the elderly and those who cannot speak for themselves motivate her daily to improve and seek to offer better, faster more convenient care to all her residents.
Abstract:
It’s a proven fact that people that fit into society are healthier, physically and mentally. To be seen as fitting in, you need to comply to your surroundings socially, economically and morally. When this changes due to social decline your health is destined to suffer. To understand the context one must first understand what exactly defines social decline? Social decline or moral decline is typically characterized as reduced adherence to cultural or social norms or values and widespread lapses in ethical behavior. Specifically to the Western Cape this includes but is not limited to substance abuse, teenage pregnancies, HIV, violence, non-compliance to managing non communicable diseases which of course is either due to poverty, unemployment, unhealthy living conditions and single families or the cause thereof. To live in the above scenario automatically creates a social injustice on their health and life expectancy, but focusing on this rather than trying to improve the public health system, will dramatically improve both. The focus on primary health care in South Africa is tremendous, but often only given at clinic or hospital level. To really make an impact we have to go to core level and that is educating the parents and caregivers of our next generation. There needs to be an incentive in it for them, otherwise why should they change? Want to know how?
- Nursing Management | Pediatric and School Nursing | Environment, Health and Safety | Family Nursing and Healthcare | Community Mental Health and Psychiatry | Nursing Education
Location: Conference Hall
Chair
Clara Haruzivishe
University of Zimbabwe, Zimbabwe
Co-Chair
Kholofelo Matlhaba
University of South Africa, South Africa
Session Introduction
Kholofelo Matlhaba
University of South Africa, South Africa
Title: Legislations, regulations and policies that govern clinical competence in community service programme for Nurses
Biography:
Kholofelo Matlhaba is currently working as a Lecturer in the Health Studies Department at the College of Human Sciences, Muckleneuk Campus for the University of South Africa.
Abstract:
Existing literature reports that many countries have introduced different retaining and recruitment strategies and programs with the intention of improving clinical competence, recouping shortage of healthcare professionals and to retain those who are trained by these countries. However, it is also noted that there are several factors that might influence the effectiveness of these programs. The purpose of this article was to explore and describe legislations, policies and regulations governing the clinical competence of community service program for nurses. A number of relevant documents, articles and theses from the national and international journals were obtained using the following search engines, namely- science direct, pub med, Google scholar and Medline. Articles on community service studies published between 2005 and 2017 and written and English were used. Five themes derived from the research studies conducted on community service program. 16 sub-themes emerged during the analysis of existing data based on the findings of cited studies. Each theme and sub-theme is discussed separately and is supported by literature. It is recommended that objectives of the community service program for nurses can be achieved by having all stakeholders on board as well as introducing clear policies and regulations especially at the provincial and institutional level.
Annatjie C Peters
The foundation for professional development, South Africa
Title: Airborne infection control in decentralized drug resistant TB sites in South Africa
Biography:
Annatjie C Peters has started her career in 1976 at the Technical College, Kroonstad as a Lecturer. She has joined the Kroonstad LA in 1989 as Trainer. In 1996, she became Assistant Manager for PHC in Fezeli Dabi and in 2000, TB Manager in the Free State. In 2006, she was appointed TB/HIV Lead at CDC (SA) and in 2014 as Chief of Party at JPS Africa, establishing a National MDR-TB center of excellence and implementing the first nurse-initiated MDRTB management program worldwide. In 2017, before joining FPD as Head of the Nursing School, WHO contracted her to write the Pakistan TB/HIV Strategic Plan
Abstract:
Aim and Objective: Prior to 2011, national policy in SA mandated DR TB patients be initiated on treatment in specialized TB hospitals. New cases outstripped the bed capacity and South Africa moved to decentralizing DRTB management. IC is a requirement for decentralized MDR TB care. A baseline study was done at 98 facilities. After interventions a follow-up assessment was conducted. To determine if infection control can improve after recommendations made to facilities.
Methodology: A cross-sectional descriptive study of 75 decentralized MDR TB facilities (10 CHC, 34 hospitals and 31 PHC clinics) was conducted followed by a follow-up assessment, using a standard assessment instrument assessing availability of IC guidelines, IC committee, safe sputum collection area, IC plan, risk assessments done, patients screening, fit-testing and availability of N95 respirators. Staffs were interviewed and hospital walkabouts conducted. Following the baseline assessments, IC plans were developed to help attaining the minimum requirements to support the decentralization of MDR TB.
Results: The assessment revealed IC practices increases 92% of sites had access with the baseline assessment and 100% after intervention, 50% did screening with baseline assessments and 70% thereafter. A limited number of facilities (15%) had IC committees, IC plans (20%) and IC officers (20%) with baseline assessment. This improved to 40% with IC committees, 45% with IC plans and 40% indicated that they have developed and implemented IC plans. The 30% with safe sputum collection points increased to 50%. Patient screening was done at 20% of the facilities with baseline assessment and 60% thereafter. 80% of facilities had N95 respirators available with the baseline assessment and the follow-up assessment, although not visible at all facilities.
Conclusion: Findings demonstrated that recommendations after baseline assessments are valuable to better IC practices.
Clara Haruzivishe
University of Zimbabwe, Zimbabwe
Title: An Integrated approach of developing Nurses and midwives at PhD level
Biography:
Clara Haruzivishe is a Professor of Nursing at the University of Zimbabwe. She has received her Doctorate from Case Western Reserve University. Her research area is Maternal and Child health and Nursing Education. She also serves as a supervisor and coordinator of PhD programme. She also coordinates a NORHED grant awarded to the College of Health Sciences at the University of Zimbabwe. She has had many publications in referred journals.
Abstract:
Developing nurses at PhD level at the University of Zimbabwe is part of Research Capacity building not only of the institution but that of the nation. The production of excellent research in nursing and midwifery is dependent on a high-caliber, well-trained research nursing community. PhD training culminates into writing of thesis. The project work of each student is primarily the responsibility of the internal supervisor, with the support of an external supervisor and the postgraduate centre. The Department of Nursing Science is a recipient of training funds whose aim is to strengthen identified gaps in infrastructure and research capacity of the institution and develop a critical mass of nurses and midwife researchers capable of solving the current and emerging health challenges. Following revision of the existing university DPhil program, an integrated collaborative model of capacity building was implemented to rapidly escalate PhD training in the department. Through group teaching, supervisors in the department of nursing assisted the students to plan their research studies, including helping them to define their research topics, to identify the relevant research literature, databases and other relevant sources and to be aware of the standards in the discipline. To strengthen supervision, associate co-supervisors were sought from the departments of gynecology and obstetrics, laboratory, community medicine and pediatrics. These were chosen as subject and methods specialist to complement supervision according to the student topics. The college through the research support centre provided various methodology courses and good clinical practice. Excellence in research was achieved through review of the protocols by the higher degrees committee and ethical committees. Students have published in referred journals and presented papers regionally and internationally. This model is sustainability and efficient, fostering a high level of commitment, ownership and collaboration.
Shinga Feresu
The Feresu Research and Training Institute, Zimbabwe
Title: Relationship between maternal obesity and prenatal, metabolic syndrome, obstetrical and perinatal complications of pregnancy in Indiana, 2008–2010
Biography:
Shinga Feresu is a Professor of Epidemiology and Biostatistics, completed her PhD in Epidemiology from The University of Michigan in 2001, USA, and Master of Public Health (MPH) in Epidemiology and Biostatistics from Boston University, USA in 1995. She obtained her postgraduate degree in Nursing (Community Health Nursing Science and Nursing Education) from the University of South Africa (UNISA) in 1989. She has taught at The University of Michigan, is Contributing Faculty at Walden University, USA. Since 2010; taught at The University of Nebraska Medical Center, USA, and Indiana University School of Public Health, Bloomington USA, before migrating to South Africa November 2014. She was an Associate Professor of Epidemiology and Biostatistics at the University of Pretoria until June 2018. She is an Online Module Developer, and Instructor at the University of Johannesburg, and is an Adjunct Professor at the University of Fort Hare (SA). Prof Feresu has published more than 25 papers in reputed journals and has been a peer reviewer from more than 25 journals. Prof Feresu has supervised more than 50 students in her career.
Abstract:
Background: Obesity is a serious medical condition affecting more than 30 % of Indiana, and 25 % of Unites States pregnant women. Obesity is related to maternal complications and significantly impacts the health of pregnant women.
Objective: The objective of this study was to describe the relationship between maternal complications and pre-pregnancy maternal weight.
Methods: Using logistic regression models, we analyzed 2008 to 2010 birth certificate data, for 255,773 live births abstracted from the Indiana Vital Statistics registry. We examined the risk of reproductive factors, obstetrical complications and perinatal (intrapartum) complications for underweight, healthy weight, overweight and obese women for this population.
Results: Women who received prenatal care were more likely to be obese [Adjusted Odds Ratio (AOR)=1.82 (1.56–2.13)], women with parity of zero (0) were less likely to be obese [AOR=0.89, 95% CI (0.86–0.91)]. Women giving birth to twins [AOR=1.25, 95% CI (1.17-1.33)], women delivering by Caesarean section [AOR=2.31, 95% CI (2.26–2.37)] and women who previously had a Caesarean section [AOR=1.95, 95% CI (1.88–2.02)] were more likely to be obese. Obesity was significantly associated with obstetrical conditions of the metabolic syndrome, including pre-pregnancy diabetes, gestational diabetes, pre-pregnancy hypertension, pregnancy-induced hypertension and eclampsia [AOR=5.12, 95% CI (4.47–5.85); AOR=3.87, 95% CI (3.68–4.08); AOR=7.66, 95% CI (6.77–8.65); AOR=3.23, 95% CI (3.07–3.39) and AOR=1.77, 95% CI (1.31–2.40), respectively. Maternal obesity modestly increased the risk of induction, epidural, post-delivery bleeding and prolonged labor [AOR=1.26, 95% CI (1.23–1.29); AOR=1.15, 95% CI (1.13–1.18); AOR=1.20, 95% CI (1.12–1.28) and AOR=1.44, 95% CI (1.30–1.61)], respectively.
Conclusions: Our results suggest that maternal obesity in Indiana, like other populations in the USA, is associated with high risks of maternal complications for pregnant women. Pre-pregnancy obesity prevention efforts should focus on targeting children, adolescent and young women, if the goal to reduce the risk of maternal complications related to obesity, is to be reached.
Gina Granger
KGH Education Zone, South Africa
Title: Importance of effective competency assessment to improve Nursing Competence and patient safety
Time : 14:30-15:00
Biography:
Gina Granger has completed a Master’s Degree in Nursing, a Bachelor Degree in Nursing Education and Community Health Nursing, a Diploma in Midwifery, a Diploma in Psychiatric Nursing, Certification in NICU Nursing, Certification as International Board Certified Lactation Consultant and she is a certified AHA BLS Instructor.
Abstract:
One of the biggest challenges in healthcare today; is to ensure a competent workforce to care for patients in an ever changing work environment. Inpatients are more acutely ill and have shorter length of stay in acute care facilities. This places greater demand on nurses in the communities; who have to demonstrate competency in caring for increasingly complex patients. Increasing restrictions on healthcare budgets, staff shortages and higher workloads; place further demands on nurses who have to provide comprehensive care to meet the complex and diverse needs of patients. It is thus vital that nurses continuously improve their own clinical competence and critical thinking skills; and use both in their daily practice. Evaluating nursing competence includes the assessment of Knowledge, Skills and Behavior during patient care. Effective competency assessment is needed during preceptorship to ensure that a new nurse is adapting and performing well in the new clinical setting. But it should also continue after the preceptorship period. Nursing mentors must do regular competency assessments with their mentees, to support continuous growth in knowledge, skills and behavior; and the development of new mentors in the nursing work force. The speaker developed nursing policies, procedures and competency assessment tools in various healthcare facilities. She had firsthand experience of the positive effect of effective competency assessment on nursing practice and –competence, which improves patient care and –safety.
Neo Nare
North West University South Africa
Title: Conceptualisation of African primal health care within mental health care
Biography:
Neo Nare, is a North West provincial metal health assistant director. Her interest and career path is in psychiatric and mental health nursing as well as community health nursing with specific focus on indigenous knowledge systems. Expertise within psychiatric nursing and mental health are both clinical and academic as she has practices as a nurse and also worked in the university as a nurse educator. Currently registered as a PhD candidate with North West University. Novice researcher with 4 journal publications.
Abstract:
It’s believed by western education system that the first contact should be with the nurse in Primary Health Care. However, it’s not the case. Therefore, the researcher attempts to correct this misconception by conceptualizing the correct beginning of health seeking behavior in an indigenous African community, namely African Primal Health Care (APHC). ‘Primal’ was coined during a colloquium by Dr Mbulawa and Seboka team members; however no formal conceptualization took place, only operational definition.
Aim: Formulate APHC within a mental health care context.
Objectives: Explore philosophical grounding of APHC;Describe epistemology of APHC;
Analyse and crystallise the exploration to establish understanding within mental health; and
Conceptualise APHC within mental health care to enhance co-existence.
Method: Narrative synthesis, concept analysis (qualitative design). Lekgotla was used as a method of data collection.
Results: APHC is a health care system that existed in Africa prior to the introduction of western health care system. It’s based on the African belief system and practices. The practices come from the community, for the community and be authenticated by the community. APHC uses a holistic approach and the family & community are involved in the healing process.
Phiwe Dauwa
Neonatal Intensive Care Unit, South Africa
Title: Child development: Globally improving the first 1000 days of each infant to increase future self-esteem, for optimal development and achieve an affluent economy
Biography:
Phiwe Dauwa has completed her Bachelor’s degree in Nursing at the age of 22 years-old from the University of the Free State, South Africa qualifying as a registered nurse. She has worked in the Neonatal Intensive care unit at Thelle Mogoerane Regional hospital for department of health Gauteng in Johannesburg for the past 3 years and has manged to obtain certified qualifications in Neonatal ventilation and resuscitation, Mother Baby Friendly Initiative training, UNICEF WHO Mother baby friendly initiative management course and helping babies breath course. In her Neonatal unit she created the “Breastfriends” initiative to educate and support mothers with breastfeeding in her neonatal unit. In August 2018 she successfully project managed a Breastfeeding event in celebration and support of national Breastfeeding month. She is an enthusiastic United Nations International Children’s Emergency Fund (UNICEF) supporter and volunteer greatly concerned and attentive to more developed strategies in public health that will improve maternal and children’s health on a global scale.
Abstract:
In the past, school nurses functioned solely just to care for the ill and injured child but, today their function is so much more. The increasing number of children in schools who are not functioning to their developmental milestones has now also, become an assessment that’s part of a school nurses function. Furthermore, she/he would also have to help the teacher create a more effective learning environment in accordance to the child’s developmental abilities.
A school nurse amongst other duties has to do a full physical assessment of each and every student at a school to ensure health eligibility to attend school. A physical assessment includes a plotting measurement of head circumference, length/height and weight on age and gender specific chart. Statistics according to the World Health Organization (WHO) are showing that large numbers of children are underdeveloped, at times exhibiting stunted growth that impairs their cognitive ability to learn at school and reach their developmental milestones.
According to statistics found by Statista on a 2017 worldwide demographic and health survey, 27% of children less than the age of 5 years old are stunted in their growth in South Africa. The percentages are even higher and higher in Asian, mid- African and parts of South American regions where there are prevalent inequality, underdevelopment and poverty issues.
The World Health Organization (WHO) defines stunted growth as “height for age” value to be less than two standard deviations of the WHO Child Growth Standards median. Primarily and diagnostically meaning, the infant clinically presents a low length or height according to his/her age. The consequences however, are far greater and deeper and extend further than the infant and for the care- givers they expand also into the larger community, nationally and at a global scale. Research and clinical experience has shown the developmental problems of stunting and its irreversible affects however, it is imperative for us to know it is preventable.
Us as Healthcare workers, as parents, as communities and nation- wide have a great duty and responsibly to our children. Children are the future, in fact it’s their right. We have to ensure that they are beings who can fully equipped in mind, health and physical strength to claim that which is theirs in the world.
The babies that are yet to be born and the babies we nurse are the leaders of tomorrow. It’s crucial to invest in their development and health. United Nations Children’s Fund (UNICEF) has conducted studies and research that show that the first 1000 days of an infant’s life are the most crucial to pay attention to, there is scientific guarantee of not just survival but, also a thriving later life. That means healthy relationships, good language skill development and economic productivity in the future.
The first 1000 days is defined as: the period from conception till 2 years of age. This period according to years of research by numerous neuroscientists, shows that during this delicate period an infant’s brain undergoes a great amount of change unlike later in adulthood. At birth all the neurons the brain could have ever produced are present; the brain double sizes in the first year and by 3 years -old its reached 80% of its adult volume.
It’s essential that in our health- care systems (pre- pregnancy, ante-natal, post-natal, neonatal, paediatrics and schools) to focus our attention to this space and install it with protocols of care that will protect, develop and manage a prosperous future for each infant.
The prosperous future for each infant is possible. Numerous research includes engaging in programmes to educate families on pregnancy planning, contraceptives and pregnancy spacing, nutritional support to pregnant mothers, placing neurodevelopment set ups in the Neonatal Intensive Critical Unit (NICU) hospitals i.e. dim lighting, Kangaroo Mother Care practices and incentives such as involving the greater community to support breastfeeding mothers i.e. mothers being able to breastfeed in all restaurants and expressing time at work. These amongst other practices and systems can aid to a healthy optimum start of the 1000 first days of an infant and can result to long term optimum healthy growth.
Pheladi Makofane
University of Limpopo, South Africa
Title: Self-management strategies for diabetic patients on treatment in the primary health care facilities
Biography:
Pheladi Makofane has received a Nursing Bachelor’s Degree (Community, Psychiatry and Midwifery) from University of Limpopo and is currently working as a Professional Nurse and Midwife at Hlogotlou Clinic. She is currently pursuing Masters in Nursing Sciences from University of Limpopo
Abstract:
Background: Non-attendance of diabetic patients to the primary health care facilities as scheduled appointments has been highlighted as one of the most pressing issues in chronic illness management and resulted into uncontrolled illnesses. Diabetes mellitus has an increased mortality and morbidity rate, thus has been identified as the second killer disease in South Africa.
Aim: The purpose of the study was to determine the self-management strategies to maintain a healthy life for diabetic patients on treatment in primary health care facilities at Sekhukhune District.
Methods: A qualitative, phenomenological, explorative and descriptive study design was conducted in 7 clinics of Sekhukhune District under Elias Motswaledi Municipal, Limpopo Province. Data were collected through one-to-one interviews using semi-structured guide. Non-probability sampling was used to sample until data saturation was reached. Data were analyzed using Tech’s coding approach.
Results: The findings of this research revealed that diabetic patients rely more on medication whilst self-management by patients was limited, although they know what they should do they ignore the fact that they need to manage themselves non-pharmacologically which can maintain their quality of life.
Conclusion: It is recommended that support structures be developed in the communities and more home-based carers be hired and trained to run the support/community structures.