A strategy to enhance the competencies of nursing unit managers in public hospitals of the North West Province

Abstract

Background: The competencies of Nursing Unit Managers (NUMs) is pivotal to the success of an organisation and the healthcare system with regard to the provision of a positive practice environment, and favourable nurse and patient outcomes. However, nurse competency research in South Africa is minimal, with the focus mainly on middle and senior nurse managers. Even on international level, nurse competency research is limited with regard to 360° (multi-source) feedback, and few have linked NUM competencies with nursing and patient outcomes, and nurse perceptions of the practice environment. Aim: The aim of the study was to evaluate the competencies of NUMs and develop a strategy to enhance their competencies in public hospitals of the North West Province. Method: This study applied a cross-sectional survey design in the North West Province. All hospitals classified as a large district, regional or provincial tertiary hospital (N=6) were included in the study. All medical and/or surgical units in the selected hospitals were included in the study (N=46). All-inclusive sampling was applied to the Nursing Service Managers (NSMs) (N=6; n=6), the NUMs (N=46; n =24) and nursing staff (N=750; n = 458) in the selected units. Data were collected between September and November 2017 through the use of the Nurse Manager Competency Instrument to measure NUM competence from the perspectives of NSMs, NUMs and nursing staff; The Michigan Organisational Assessment Questionnaire: Global Job Satisfaction and Job Turnover intention; Organisational Commitment Questionnaire and Compassion Practice Instrument to measure nurse outcomes; and the Practice Environment Scale of the Nurse Work Index to measure nursing staff perceptions of the practice environment. Reliability was established through Cronbach’s Alpha, and validity through exploratory and confirmatory factor analysis. Descriptive and inferential data were analysed using SPSS 21. Results: There were significant differences between competency ratings of NUMs by NSMs, nursing staff and the self-assessments of NUMs. The study further confirmed that there were associations between the NUMs’ competencies and personal and nursing unit demographics, and, finally, there were correlations between the NUMs’ competencies and nursing staff responses related to their outcomes, and their perception of the practice environment. A SWOT analysis was performed using data from the empirical research and literature review. This resulted in the identification of 65 strengths, 95 weaknesses, 8 opportunities and 16 threats, which were used to develop a strategy to enhance the competencies of NUMs in public hospitals of the North West Province. Conclusions: The implementation of the strategy to enhance the competencies of NUMs in public hospitals of the North West Province may contribute to improved knowledge and understanding, and the ability to implement management competencies and so improve the ability of NUMs to provide positive practice environments and improve nurse and patient outcomes.