Professional nurses' perceptions of the skills required to render comprehensive primary health care services
Hlahane, Modiane Salamina
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In South Africa professional nurses undergo training which gives them different levels of skills. It is difficult for professional nurses to render comprehensive primary health care services without specific knowledge and skills. Some lack skills in preventative and promotive health care delivery; others are not trained to take care of a pregnant woman or a baby after delivery, or of a mental health patient; while yet others are only curatively oriented. It is possible that they do not recognise their own limitations and are not aware of the skills needed to render comprehensive primary health care services. Their perceptions could influence their practice and severely affect the quality of health services. The aim of this research was to explore and describe the perceptions that professional nurses working in primary health care clinics have of the skills required to render quality comprehensive primary health care services, and the perceptions they have of their own level of skills to render quality comprehensive primary health care services, as well as to formulate guidelines for the facilitation of trained professional nurses to truly render quality comprehensive primary health care services. A qualitative design was followed. Permission was obtained from the Potchefstroom District Health Manager to conduct this research. Purposive voluntary sampling was used to identify the three samples who complied with the set selection criteria. Data collection was done by means of semi-structured interviews. Experts in qualitative research evaluated the semi-structured interview schedule. A trial run was done and the interview schedule was then finalised to conduct the interviews. The interviews were recorded on audiotape and then transcribed. The interviewer made field notes to serve as an analytical basis for the collected data. Data was collected until data saturation was achieved. Data analysis was done by means of open coding. A co-coder was appointed and two consensus meetings took place. The findings indicated that professional nurses perceive the skills required to render quality comprehensive primary health care services as the ability to assess, diagnose and manage patients, as well as specific skills acquired during the various nurse training programmes. The more comprehensively trained, the more competent they feel. The less comprehensively trained, the more negative they experience their work. They view their own level of skills as ranging from adequate to lacking and inadequate, depending on their training. They feel that it is important to develop skills ranging from computer skills to the full range of skills. The conclusions drawn are that the professional nurses with different training and levels of skills are well aware of the skills required to render comprehensive primary health care services. They maintain that trained professional nurses need qualifications in General Nursing, Midwifery, Community Nursing, Psychiatric Nursing and Clinical Nursing Science, and Health Assessment, Treatment and Care. The professional nurses with all five qualifications feel confident and enjoy their work, whereas those who are not fully trained lack certain skills and experience negative feelings working in the primary health care clinics. Recommendations are made for nursing education, nursing research and nursing practice with specific reference to the formulation of guidelines for the facilitation of trained professional nurses to truly render comprehensive primary health care services, with a focus on quality control, orientation, mentoring, planning of training, support systems, and consultancy.
- Health Sciences