Abstract
Currently barriers exist in delivering quality health care. This study aimed to investigate such barriers in the eight rural district hospitals of the West Coast Winelands Region, three type A and five type B hospitals. A quantitative descriptive design was applied which included the total population of nursing staff (n = 340) working at the time of data collection. A self-administered questionnaire was distributed with a response rate of 82%. Reliability of the instrument was verified using the Cronbach alpha coefficient and a pilot study. The validity, specifically construct and content validity, were assured by means of an extensive literature review, pilot study and use of experts. Ethics approval was obtained from the relevant stakeholders. Results showed that 272 participants (97%) disagreed that provision of staff was adequate, with staff above 40 years of age more likely to disagree (p = <0.01). A statistically significant association was shown between availability of doctors and staff not being able to cope with emergencies (p = <0.01). Most participants (n =212; 76%) indicated that they were not receiving continuing education, with the registered nurses more likely to disagree (χ² test, p = 0.02). Participants in both hospital types A (n = 131; 82%) and B (n = 108; 91%) also disagreed that provision of equipment and consumables was adequate. The research showed that inadequacies relating to human resources, professional development, consumables and equipment influenced the quality of patient care. Urgent attention should be given to the problems identified to ensure quality of patient care in rural hospitals.
Highlights
The World Health Organization’s (WHO) objective, as set out in its Constitution, is attainment of the highest possible level of health for all people (WHO 2002:2)
The South African Government is under obligation to assist with realisation of the right to basic health care, as described in the White Paper on Transforming Public Service Delivery in South Africa (Department of Public Service and Administration 1997)
A descriptive quantitative design was applied to investigate the factors which influence the quality of nursing care in the context of the rural district hospitals of the West Coast Winelands Region
Summary
The World Health Organization’s (WHO) objective, as set out in its Constitution, is attainment of the highest possible level of health for all people (WHO 2002:2). The Constitution of South Africa (Act 106 of 1996) is aligned with this objective, and emphasises the right to basic health. The South African Government is under obligation to assist with realisation of the right to basic health care, as described in the White Paper on Transforming Public Service Delivery in South Africa (Department of Public Service and Administration 1997). According to the National Patient Rights Charter (Department of Health 1999) and Batho Pele Principles (Department of Public Service and Administration 1997) it is expected of nursing staff that they put patients first and deliver a quality health care service. According to the Nursing Act 33 of 2005, Regulations 2598, Scope of Practice, and 387, Acts and Omissions, as promulgated by the Nursing Act 50 of 1978, the nurse practitioner is held responsible and accountable for all acts and omissions in the delivery of quality patient care
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