Factors influencing the compliance of enrolled nurses with procedural guidelines during patient care

Abstract

Background: The Free State Department of Health envisions a long and healthy life for all South Africans as one of its goals. To achieve this, the department prioritised the improvement of patient care as a means to effectively strengthen the health system, but the media still often reports unexpected poor clinical services or patient outcomes. Patient care at public institutions follows a multi-disciplinary approach rendered by trained personnel. Within this system, nurses offer their services round the clock, and as such nursing actions are the most identifiable causes of any unforeseen outcomes. The aim of this study was to explore and describe factors that influence compliance of enrolled nurses (EN's) to the procedural guidelines during patient care and to formulate recommendations towards promoting compliance to the procedural guidelines during patient care. Method: An explorative, descriptive, contextual qualitative design was used. The sample included EN's in the Thabo Mofutsanyana district of the Eastern Free State from public clinics and hospitals who had recently qualified for enrolment (2008-2012). Data was collected by means of four (4) focus groups with n=34 participants. Data analysis was done by the researcher and an independent co-coder according to the principles of content analysis. Results: Seven themes with subsequent sub-themes emerged to explain non-compliance to procedural guidelines during patient care. All the focus groups agreed that non-compliance is influenced by factors such as lack of resources and support. Conclusion: Nurses are still visibly committed and willing to render their services, though circumstances impede them and keep them from demonstrating their competencies. Recommendations and conclusive statements serve as the basis for recommendations to the Free State Health Department so that they can attain their departmental goal, to NEI's and to nurses in practice.