10 Frequency of performance I

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1 Specal crcumstances C10 1 to C10 5; D10 1 to D10 51 Ths queston wll be analysed n three separate parts because the actons are related to each other, and to smplfy the fgures. Part 1 provdes the results and analyss of performance of four sklls pertanng to specal crcumstances: normal delvery, breach presentaton, prolapsed cord and shoulder presentaton. Fgures 4.73 and 4.74 reflects the sklls vsually by ndcatng the mean score for each varable. Normal delvery 1..,... 1,326 Breech presentaton 1, Frequency of performance Prolapse cord 1,086 Shoulder presentaton J2::=1=,0=55:=:=:=:=:==::=:=:=:=:=:=:==7 2 3 Mean scores Fgure Specal crcumstances (Part 1) l [] mportance Normal delvery Breech presentaton Prolapse cord Shoulder presentaton ' l 1,752. 1,8...,.. 1,728, 1.5 Mean scores. 1,9 2 Fgure Specal crcumstances (Part 1) 219

2 Table 4.27 reflects the frequency of performance of advanced lfe-support sklls pertanng to specal crcumstances. Note that the majorty of the respondents ndcated that they perform the sklls seldom/never. Table 4.28 reflects the mportance of these sklls to be ncluded n the currculum and the majorty of the respondents ndcated that they agree that these sklls are mportant and should be ncluded n the currculum. b) Part 2 -C10_15 to C10_18; 01o_15 to 010_1 Part 2 provdes the results and analyss of performance of four sklls pertanng to specal crcumstances: multple pregnancy, placenta abrupto, placenta preva and premature labour. Fgures 4.75 and 4.76 llustrate the sklls vsually by ndcatng the mean score for each varable. o Frequency of performance Multple pregnancy Placenta abrupto Placenta preva Premature labour 1,307 "-.)--=----,,' Mean scores 3 Fgure Specal crucumstances (Part 2) 220

3 Multple pregnancy Placenta abrupto Placenta preva Premature labour [ ] l. 1'-./.-'<. mportance 1 1 _.' 1, ,784 1,792 1,831././ Mean scores Fgure Specal crcumstances (Part 2) Table 4.27 reflects the frequency of performance of advanced lfe-support sklls pertanng to specal crcumstances. Note that the majorty of the respondents ndcated that they perform the sklls seldom/never. Table 4.28 reflects the mportance of these sklls to be ncluded n the currculum and the majorty of the respondents ndcated that they agree that these sklls are mportant and should be ncluded n the currculum. Part 3 provdes the results and analyss of performance of four sklls pertanng to specal crcumstances: supportng the rape vctm, collectng forensc evdence from the rape vctm, neonatal stress management and selectng an approprate transport mode for the crtcally ll or njured patent. Fgures 4.77 and 4.78 llustrate the sklls vsually by ndcatng the mean score for each varable. 221

4 l D Frequency of performance Supportng the rape vctm '-r , 83 Collectng forensc evdence from the rape ""t---- 1,57 vctm Neonatal stress management Selectng approprate transport mode 'J===========::::_2.:...,3_9_8_----J Mean scores Fgure Specal crcumstances (Part 3) mportance / 1 Supportng the rape vctm '1;;;;;;;._;;. ;;;;;;;;;;;;;t Collectng forensc evdence from the rape C;;;;;;;;_;;;(w;._;;;;;. ;;;;J. 1,824 vctm Neonatal stress management '1"'"Mllflll" "''''''''' 1,85 p Selectng approprate transport mode ':, Mean scores Fgure Specal crcumstances (Part 3) The majorty of the respondents were ether a mdwfe or an accoucheur (84,7%). t s not a prerequste for all A&E nurse programmes n South Afrca to be regstered as a mdwfe or an accoucheur. The sklls pertanng to supportve management for obstetrc emergences are, however, ncluded n the currculum of programmes for mdwves and accoucheurs. These nurses have prevously learnt these sklls and should therefore be ncluded n the currculum. 222

5 The majorty of the respondents were ether a mdwfe or an accoucheur (84,7%). t s not a prerequste for all A&E nurse programmes n South Afrca to be regstered as a mdwfe or an accoucheur. The sklls pertanng to supportve management for obstetrc emergences are, however, ncluded n the currculum of programmes for mdwves and accoucheurs. These nurses have prevously learnt these sklls and should therefore be ncluded n the currculum. The realty s that these emergences have to be dealt wth n the emergency care envronment wthn the SA context. To enable the researcher to determne whether the sklls pertanng to supportve mangement for obstetrc emergences are consdered to be of crtcal mportance for the A&E nurse wth pre-exstng knoledge regardng these sklls, and regstered as mdwfe or accoucheur, t was essental to look at the perceptons of ths group ndvdually. See fgure Agree Dsagree Normal delvery 91 Breech presentaton Prolased cord Shoulder presentaton Multple pregnancy Placenta abrupto _._. 79,1 Placenta preva _._ _ 83,7 Premature labour ===C= o (Per cent %) Fgure mportance: Mdwves and accoucheurs 223

6 t s evdent from the above fgure that the majorty of mdwves and accoucheurs perceve the sklls pertanng to supportve management for obstetrc emergences mportant to nclude n the currculum. Table 4.27 reflects the frequency of performance of advanced lfe-support sklls pertanng to specal crcumstances. Note that the mojarty of the respondents ndcated that they frequently perform the sklls. Supportng the rape vctm and collectng forensc evdence from the rape vctm were shown to be frequently performed by respondents. Table 4.28 reflects the mportance of these sklls to be ncluded n the currculum and the majorty of the respondents ndcated that they agree that these sklls are mportant and should be ncluded n the currculum. The degree of relatonshp between the frequency of performance and mportance of the sklls to be ncluded n the currculum as ndcated by the Spearman correlaton (see Annexure 0 - Spearman correlaton between the varables n Secton C and Secton D) llustrated the followng: o Normal delvery ndcated a sgnfcant Spearman correlaton coeffcent (rs 0,227) o Collectng forensc evdence from the rape vctm ndcated a sgnfcant Spearman correlaton coeffcent (rs 0,224) 224

7 Table Frequency of performance of advanced lfe-support sklls (%) e10to c_51 SKLLS " e" o CD 'a "z en N %.elreu... '*'. rna of Normal delvery Breach presentaton 28 87,5 rolapsed cord 28 84,9 Shoulder 30 93,8 presentaton Patt2 Multple pregnancy 27 81,8 Placenta abrupto 27 90,0 Placenta preva 27 90,0 Premature labour 19 57,6 Degrees of freedom t.. p < 0,05... p < 0,01 State hosptals C.. Q C CD :c 0 cr ' : CD e a. ll = N % N %,... elm 8 24,2 8 24,2 1 3,1 3 9,4 3 9,1 2 6,1 1 3,1 1 3,1 3 9,1 3 9,1 1 3,3. 6,7 1 3,3 2 6, _. 21, N Prvate hosptals Total - " > > e",s c c o CD CD o CD CD "z cr "z cr 'r: CD e C = e.. = 'a "8 = 'a = en CD en.. a. ll ll % N % N % Nl % N -% 84, , , ,2 96,7 1 1,1 2 2, ,3 2 1,6 97,8 0 0,0 2 2, ,4 3 2,4 97,8 0 0,0 2 2, ,8 1 0,8 97,8 0 0,0 2 2, ,6 3 2,4 96,7 1 1,1 2 2, ,0 2 1,7 97,8 0 0,0 2 2, ,9 1 0,8 87 J 8 4 4,4 7 7, ,7 11 8,.. c CD X2 drt =cr e ll N % ,099** 2 5 4,1 3, ,2 9, ,4 2, ,0 11, ,3 2, ,3 4,540 2 L.J1,4 14, \.) \.) c.n

8 Table (contnued) 'ana SKLLS - e" o» -c> -»»Z U) N % State hosptals ---: N Supportng the rape vctm 11 33,3 8 Collectng forensc evdence from the 26 78,8 2 rape vctm Neonatal stress _mnagement 20 62,5 7 Selectng an approprate transport mode for 11 33,3 5 the crtcally ll or _ njuredl>atent _ - t Degrees of freedom.. p < 0,05... p < 0,01 1 CJ ;;.2» a.... % N 24,2 14 6,1 5 21,9 5 -, ,2 17 > ;; c» ::s cr l LL % N 42, , , ,5 14 Total - -- Prl.ate f.ltt > ;; > - 1 ;; e" c e" CJ c o»» o»» -c> -c ::s ;; X2 -c ::s df t -» 0 cr 0 cr»z 'r::: a;z l 'r::: U)» U)» l a.. LL a.. LL % N % N % N % N % N % 55,0 9 9, , , , ,1 6, ,9 3 3, , ,4 5 4, ,6 3, ,8 7 7,7 5 5, , ,4 10 8,1 8, , , , , , ,7 4, '" 0> '"

9 Table mportance of advanced lfe-support sklls (%) /010_1 to 031 Q) State hosptals Sklls Q Q) cu en 2 N % N Prvate hosptals Q) C Q) cu. Q c <C - % N % N % Total Q) X 2 df t Q Q) cu e. N-TOJo C -N% " Pdt..,..,.. ' Supportve management for obstetrc emergences Normal delvery 4 13,3 26 Breech presentaton 7 23,3 23 Prolapsed cord 6 20,0 24 Shoulder presentaton 8 26,7 22 PJtt....' Mult(.lle pregnancy Placenta abru(.lto Placenta preva Premature labour ṭ.... Degrees of freedom p < 0,05 p < 0, , , , ,2 24 " 86,7 6 6, , , , ,3 73, , ,7 72, , ,9 80, , ,0 80, , , , ,5 "\..' ,7 1, , ,9 0, , ,0 0, , ,4 0,023 1, 29 24, ,8 0, , ,5 0, , ,3 0, , ,3 0,009 1.'. '"""

10 -. Table (contnued) Sklls f'l*l13 Supportng the rape vctm Collectng forensc evdence from the rape vctm Neonatal stress management Selectng an approprate transport mode for the crtcally ll or njured patent t * ** Degrees of freedom p < 0,05 p < 0, N CD State hosptals ':» CD ca.t Q % N % 10, ,0 20, , ,3 10, ,0.. Prvate hosptals Total CD CD CD ':» CD ':» CD ca ca ) ) ':» C <C C -----c-c -Nl % N % N % N % 3 3, ,7 6 5,0_ ,0 2, , , , ,8 0, , , , ,0 0, , ,9 4 3, ,7 5,517 1 X 2 df t \J \J Q)

11 Do you have any remarks -C111 The followng remarks were ncluded: o Due to the stressful stuaton A&E nurses work n, they need counsellng at least once every three months. o A&E nurses need to be credted for ther dedcaton and perseverance. o A&E nurses take more responsblty than they are credted for. o Nobody really knows what we do and therefore we do not get the respect we deserve. o There s a great need to have the A&E nurse's scope of practce clarfed and defned. o A great need exsts to formulate an A&E nursng programme whch s relevant to the South Afrcan context Secton E The am of ths secton was to determne the atttudes and values of the A&E nurse as perceved by A&E nurses. The data s presented n Table 4.29 Table Atttudes and values of the A&E nurse (%) E1.1_11 o E1.1_141 Strongly dsagree (SO) Dsagree (D) Agree (A) Strongly agree (SA) Number of respondents (N) A...Aa... SO ) t SA.... \.c. 1ft J t% % H % have self-respect (N = 126) 0 0,0 0 0,0 15 4, ,0 respect others (N = 126) 0 0,0 1 0,8 15 4, ,2 respect the professons of others (N.0 0,0 0 0,0 /11 8, ,3 = 126) : 229

12 Table 4.29 (contnued) '..:'.v.. :.,. '...' A,..., >',,', >' --:.-t',,;'> \';>_:->,:,. ",{- >,,' ',-,,-':' --," ":"-<--::-;: -,,-jt. " " ' 1><1...: 11A ':M '. '...,... ".".... '. '> :., , V'..'l;tJ v.:' ":.. r S ',,'., ':c,' " " - ',','. " respect the values of others (N = a 0,0 1 0,8 10 8, ,2 125) respect the vews of others a 0,0 1 0, , ,1 {N = 126} r respect the relgous belefs of 1 0,8 1 0, , ,7 others (N = 126) be aware of the need for the clncal a 0,0 a 0,0 10 7, ,1 specalst to have applcable knowledge, sklls, atttudes and values (N = 126) accept accountablty for hs/her a 0,0 a 0,0 5 4, ,0 decsons (N = 126) accept accountablty for hs/her a 0,0 a 0,0 6 4, ,2 actvtes (N = 126) acknowledge hs/her own lmtatons a 0,0 a 0,0 7 5, ,4 (N = 126) acknowledge the mportance of a 0,0 a 0,0.6 4, ,3 applyng knowledge correctly (N = 127) acknowledge the mportance of a 1 0,0.0 0,0 16 4, ,3 applyng sklls correctly (N = 127) acknowledge the mportance of a 0,0 a 0,0 12 9, ,6 applyng atttudes correctly (N = 127) acknowledge the mportance of a 0,0 a 0, , ,0 applyng values correctly (N =127) t s evdent from Table 4.29 that the majorty of A&E nurses strongly agreed wth these values obtaned from the experts durng the FG. Other atttudes and values that were added ncluded: o Dedcaton and commtment o Be relable Concluson Chapter 4 provded the research results and analyss. These fndngs wll be dscussed, conclusons wll be made and recommendatons formulated n Chapter

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