Nurses' perceptions of performance management development system implementation in Mafikeng sub-district clinics
Seane, Doreen Onkarabile
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Background: PMDS has been adopted and implemented in Mafikeng sub-district clinics since 2003 to evaluate performance of nurses for improved quality patient care. However, the current researchers five years' experience in this sub-district is that nurses are dissatisfied with the outcome of PMDS. There is lack of knowledge, participation or involvement and less interest of nurses regarding PMDS implementation. Nurses are dissatisfied, demotivated and discouraged as they are not well informed, not appreciated and their performance is not appropriately evaluated. Purpose: The purpose of the study was to explore and describe registered nurses' perceptions on a performance management development system (PMDS) in Mafikeng Sub-district clinics. Methodology: A qualitative, exploratory, descriptive and contextual research design was followed in order to give "voice" to perceptions of registered nurses regarding PMDS implementation. Purposive sampling technique was utilised to identify participants who met the inclusion criteria in this study. Sample size was determined by data saturation, which was reached after eight individual semi-structured interviews with registered nurses in Mafikeng Sub-district clinics. Semi-structured individual interviews were used to gather data after approval from the research ethics committee of the North-West University, Mafikeng Sub-district, facility managers for the clinics where data was collected, as well as from registered nurses who participated. The researcher and co-coder analysed data independently and met to reach agreement on themes and sub-themes that emerged from data. Results: Findings of this study confirmed the following themes from perceptions of registered nurses on PMDS implementation: structure, process and outcomes for PMDS implementation. From the results, registered nurses further added that there is insufficient knowledge and training on PMDS, unfamiliarity with PMDS policy and lack of resources under the theme structure. Under process theme, registered nurses outlined inadequate orientation, erratic reporting periods, paucity of information on job description and work plans, inadequate mentoring and support and unfair, fragmented reporting lines. Under the outcomes theme, they outlined job dissatisfaction and demotivation, subjective PMDS scoring, low staff morale, manager-subordinate conflict, concerns on performance bonus and disruption of service delivery. Conclusions: PMDS is a legislated policy for all public servants in South Africa and the researcher established that in all the interviews conducted the participants did not have a positive outlook of the PMDS. Recommendations: Nursing education needs to arm at improving competence of nurses in implementing PMDS to facilitate good performance. All policies related to performance evaluation needs to be addressed. From findings of this study, it is clear that there is a need for further research which should be conducted across all categories where PMDS is used to evaluate performance. With reference to practice: structure of PMDS, the following recommendations was made: policy review and revision, staff training and workshops on the PMDS, and resources allocation. With regard to the process for PMDS implementation: staff orientation on the policy, staff mentoring, and support and job descriptions and work plans need to be addressed. The outcomes recommendation included: oral reporting, feedback, remedial action, and staff morale.
- Health Sciences