Research Articles (School of Nursing)

Permanent URI for this collectionhttps://hdl.handle.net/10566/13

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Using machine learning to improve readmission risk in surgical patients in South Africa
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Chipps, Jennifer; Tokac, Umit; Brysiewicz, Petra
Unplanned readmission within 30 days is a major challenge both globally and in South Africa. The aim of this study was to develop a machine learning model to predict unplanned surgical and trauma readmission to a public hospital in South Africa from unstructured text data. A retrospective cohort of records of patients was subjected to random forest analysis, using natural language processing and sentiment analysis to deal with data in free text in an electronic registry. Our findings were within the range of global studies, with reported AUC values between 0.54 and 0.92. For trauma unplanned readmissions, the discharge plan score was the most important predictor in the model, and for surgical unplanned readmissions, the problem score was the most important predictor in the model. The use of machine learning and natural language processing improved the accuracy of predicting readmissions.
Assessing the psychological distress and coping strategies among academic staff of a university during COVID-19
(AOSIS (Pty) Ltd, 2025) Owoeye, Isaiah; Akimanimpaye, Furaha; Adebiyi, Babatope
Background: The coronavirus disease 2019 (COVID-19) pandemic has been associated with stress because of its disruption to normal lifestyle. While the resilience of people was challenged, some coping strategies were adopted to maintain balance in the face of the pandemic. Aim: To assess psychological distress and coping strategies among the academic staff. Setting: Afe Babalola University located in the Southwest, Nigeria. Methods: A descriptive-cross-sectional design was used on the population of 512 academics where a sample size of 248 was drawn using Taro Yamane with a 10% non-response rate. The instruments used were a modified Kessler Psychological Distress Scale (K10) and an adapted COPE inventory for coping strategies. The scale reliability of K10 was 0.866 while that of coping strategy was 0.610. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 28. The results were presented in simple percentages, means and standard deviations. Results: Most respondents had severe psychological distress (185, 98.9%) with the most rated report ‘Feel worthless’ 4.8 ± 0.59. The most rated coping strategy was ‘I try to lose myself for a while by drinking alcohol or taking drugs’3.8 ± 0.60 with overall coping scale mean, 2.3 ± 1.02. Conclusion: There was severe distress and substance used among academics. The study recommends teaching on effective coping styles and institution probable preparation for future pandemic. Contribution: The study provides insight into the psychological state of the academic staff during the COVID-19 pandemic and unveils the adaptive strategies used. The results of the study are useful for the development of appropriate coping skills for the staff.
Self-management knowledge, attitudes and practices among persons with type 2 diabetes in Ghana
(AOSIS (pty) Ltd, 2025) Johnson, Beatrice; Chipps, Jennifer; Jarvis, Mary
Diabetes is one of the major non-communicable diseases. Diabetes self-management has been identified as a key strategy to reduce complications and to improve health outcomes. Aim: This study aimed to investigate the diabetes self-management knowledge, attitude and practices among people with type-2 diabetes in Ghana. Setting: Two clinics for diabetes patients in the Ho municipality of Ghana were selected to conduct the study. Methods: An outpatient cross-sectional survey was conducted using a 57-item researcher-administered questionnaire based on the Information, Motivation, Behaviours Model adopted for Diabetes. A total of 321 patients with type 2 diabetes were randomly selected from the two outpatient clinics for diabetes in Ho, Ghana. Data were analysed using descriptive statistics and multiple linear regression modules were conducted to determine the predictors of self-management practices. Significance was set at p < 0.05. Results: The average score for knowledge was 11.37/24 ± 3.40 or 47%, indicating poor levels of diabetes self-management knowledge. Moderately positive attitudes were found (2.83/5 ± 1.57) [95% CI –1.86 to –3.80] with poor self-management practices with a median of 3.00 per week (maximum 5.20, minimum 0.60 per week). Knowledge explained 20% of variation in self-management practice. Conclusion: The findings from this study show an overall deficit in knowledge of diabetes with related low self-management practice. This suggests the need for robust self-management education programmes to improve access to diabetes self-management-related information. Contribution: This study highlights the important knowledge of diabetes in self-management.
Knowledge of mental disorders in primary healthcare nurses in the Western Cape, South Africa
(AOSIS (Pty) Ltd, 2025) Musafiri, John J.; Bimerew, Million S.; Chipps, Jennifer Anne
Background: Mental disorders remain a global health burden. The integration of mental health services into primary healthcare (PHC) can contribute to reduction of this burden. However, studies have reported PHC nurses’ lack of knowledge of mental disorders, which leads to their negative attitudes towards people with mental disorders preventing them from seeking help. Objectives: The objective of this study is to assess the knowledge levels of PHC nurses regarding mental disorders in the Western Cape, South Africa. Method: A quantitative descriptive survey was conducted. A self-administered questionnaire was used to collect data from a sample of 246 PHC nurses in the Cape Town metropole. Data were analysed using descriptive statistics, Chi-square tests and independent sample tests. A cut-off value of ≥ 80% was used to determine the sufficient levels of knowledge. Results: The average knowledge score (15.6; 78.0%) was below the cut-off value of ≥ 80%, indicating insufficient levels of knowledge. Sufficient levels of knowledge were found for over half of the respondents (139, 59.4%). Most of the respondents were knowledgeable about the symptoms of depression (221, 94.4 %), bipolar (217, 92.7%), schizophrenia (213, 91.0%) and anxiety disorders (209, 89.3%). Conclusion: Over half of the PHC nurses could identify the signs and symptoms of common mental disorders. However, the knowledge of dysthymia and psychosis requires more attention. Contribution: This study contributes to the existing body of knowledge in nursing practice and education related to mental disorders.
Quality midwifery care during childbirth at a midwife obstetric unit: a qualitative study
(AOSIS (pty) Ltd, 2025) Martin, Sedeeka; Robertson, Anneline; Filies, Gérard
Background: Globally, there is an increasing focus on enhancing the quality of midwifery care. In public institutions, primary care midwifery is provided at a midwife obstetric unit (MOU). Midwives at MOUs are the first contact that pregnant women have when accessing midwifery care. There exists a notable disparity in the perception of quality midwifery care between midwives and women. In South Africa, there has been a scarcity of research examining the perspectives of midwives and women, regarding the quality of midwifery care provided during childbirth. Objectives: The objective of this study was to explore and describe women’s and midwives’ perceptions of the quality of midwifery care during childbirth, at a MOU in Cape Town in the Western Cape, South Africa. Method: A qualitative exploratory descriptive design was utilised. Four women and five midwives were selected through purposive sampling. Semi-structured interviews were undertaken, transcribed and analysed utilising Tesch’s eight-step approach to qualitative data analysis. Results: Three themes emerged: (1) understanding of quality midwifery care, (2) experiences of women during childbirth and (3) support received by women and midwives. Conclusion: The quality of midwifery care remains compromised within the MOU setting due to various challenges encompassing limitations of both human and physical resources. It is imperative to establish a shared understanding of what constitutes quality midwifery care, as women and midwives often perceive it differently. Contribution: Midwifery care during childbirth requires the engagement of all stakeholders, including women, to enhance the quality of midwifery care provided.
Strengthening theoretical assessment design in nursing education: advancing SDG 4
(AOSIS (pty) Ltd, 2025) Donough, Gabieba; Mthimunye, Katlego D.T.; Daniels, Felicity Megan
Background: Quality theoretical assessments in nursing education are essential for achieving Sustainable Development Goal 4 (ensuring inclusive and equitable quality education and promoting lifelong learning opportunities for all). However, misalignment with National Qualification Framework (NQF) standards, an overreliance on recall-based questions and inadequate educator training undermine the fairness of assessments and students’ ability to demonstrate clinical competence. Aim: This study explores theoretical assessment design in nursing education, evaluating its alignment with NQF standards, competency-based assessments and Sustainable Development Goal 4. Setting: Conducted at a South African nursing school offering undergraduate nursing programmes. Methods: A multimethod approach integrated educator interviews, document reviews of moderation reports, a scoping review and a student survey to investigate assessment practices. Results: While educators valued Bloom’s Taxonomy, over-reliance on recall-based questions limited critical thinking, clinical decision-making and competency development. Misalignment with NQF standards caused inconsistencies in cognitive demand, while gaps in moderation processes impacted assessment validity and fairness. Educators faced challenges because of limited training and support, and students struggled with ambiguous and linguistically complex assessments that hindered their ability to demonstrate competency. Conclusion: Strengthening assessment design, moderation and educator training is essential to improving competency-based assessment practices in nursing education. Policy reforms promoting fair, transparent, and competency-driven assessments will enhance graduate preparedness, ensure alignment with NQF standards and support SDG 4’s goal of quality education. Contribution: This study provides empirical evidence supporting assessment policy improvements, promoting structured, competency-based assessments that enhance fairness, deepen learning and align with nursing education standards.
Using natural language processing in the LACE index scoring tool to predict unplanned trauma and surgical readmissions in South Africa
(John Wiley and Sons Inc, 2025) Chipps, Jennifer; Tokac, Umit; Brysiewicz, Petra
Background: Unplanned and potentially avoidable readmission within 30 days post discharge is a major financial burden. Aim: To use text-based electronic patient records to calculate the Charlson Comorbidity Index (CCI) score using a natural language processing technique to establish the feasibility and usefulness of the text-based electronic patient records in identifying patients at risk for unplanned readmission. Methods: A retrospective review of electronic patient records for general and trauma surgery in a hospital in South Africa (2012–2022) was conducted using the LACE score. Validated sentiment analysis analyzed free text components of electronic patient records to compute the CCI score and to establish the feasibility and usefulness of the LACE score in identifying patients at risk for unplanned readmission. Results: Trauma surgery patients had a mean LACE score of 5.91 (SD = 2.41), with 8.44% scoring 10 or higher and a specificity and sensitivity of 91.63% and 13.81%, respectively. The general surgery patients had a mean LACE score of 7.75 (SD = 3.04), with 10.63% scoring 10 or higher and a specificity of 71.47% and a sensitivity of 44.80%, respectively. Logistic regression analysis revealed that LACE scores significantly predicted unplanned readmissions in both trauma (β = 0.11, p < 0.001; OR = 1.112, 95% CI [1.082, 1.143]) and general surgery (β = 0.15, p < 0.001; OR = 1.162, 95% CI [1.130, 1.162]) patients. Conclusion: The LACE score demonstrated the predictive value for readmission in trauma and general surgery patients. The LACE score was relatively effective in identifying patients who were less likely to be readmitted but showed limitations in identifying patients at higher risk of readmission. However, the successful use of natural language processing for data extraction of comorbidities shows promise on addressing the challenges around text-based medical records.
Experiences of simulated patients in clinical skills laboratory: a qualitative study
(AOSIS (pty) Ltd, 2025) Shange-Goba, Mbalenhle P.; Willemse, Juliana J.
Background: Nursing simulations with simulated patients (SPs) have proven effective in creating realistic opportunities to enhance the students’ clinical competence within a safe learning environment. This setting helps to reduce anxiety and increases self-confidence among health sciences students. This study aimed to explore experiences of SPs in clinical skills laboratory of a Department of Nursing at a university in Western Cape. Objectives: Objectives were set to explore the contextual elements of SPs’ experiences during clinical skills sessions, identify educational design aspects from those experiences and assess their views on student outcomes. Method: A qualitative descriptive, exploratory and contextual design was used. Data were collected through semi-structured interviews with eight SPs. The data were coded to develop emerging themes and sub-themes, following Braun and Clark’s systematic analysis process. An independent coder reviewed findings, and themes were confirmed during a consensus meeting. Results: This study found that SPs engaged in multiple role-play consultations, improving their understanding of healthcare consultation structures and rules. They recognised their roles in achieving the outcomes needed for students. Conclusion: This study confirmed existing literature on SPs in a clinical skills laboratory within a Department of Nursing. Participant interviews provided verbatim quotations that enriched findings. Contribution: The study aimed to recommend ways for a Department of Nursing to support SPs in improving their laboratory skills and enhancing student learning.
Challenges and opportunities in digital learning technologies for nursing education in low-resource settings: a scoping review
(Unisa Press, 2025) Owoeye, Isaiah Dada; Daniels, Felicity; Chipps, Jennifer-Anne
The use of digital learning technologies is becoming increasingly popular worldwide. However, there is a lack of published evidence regarding their application in nursing education, particularly in low-resource settings. To inform the development of digital learning guidelines for use in such contexts, a scoping review was conducted to examine the use of these technologies and the associated challenges. The review question was: What are the challenges and opportunities associated with the use of digital learning technologies in nursing education in low-resource settings? The Joanna Briggs Institute (JBI) scoping review methodology was followed. The databases Scopus, Academic Search Complete, PubMed, and CINAHL were searched using the following criteria: student nurses and nurse educators in nursing education institutions; low-resource settings, defined as low- and middle-income countries; and the use of digital learning technologies. Studies involving non-nursing health professions were excluded. Retrieved papers were screened by title and abstract, with full text reviews conducted as needed. Data were analysed thematically using the digital competence framework. Few studies have been conducted in African countries. Key themes included the use of digital learning technologies in general, their application in clinical teaching and theoretical instruction, and the emergence of artificial intelligence in nursing education. Most reported uses were related to students’ online learning experiences. The main challenges were linked to pedagogical competence, along with the need for administrative and technical competencies, thus extending the existing digital competence framework.
Human sperm as an in vitro toxicity model: a versatile tool for assessing the risk of environmental contaminants
(Springer Science and Business Media Deutschland GmbH, 2025) Keyser, Shannen; Davidse, Morgan; Bennett, Monique; Maree, Liana; Petrik, Leslie
Contaminants of emerging concern (CECs) pose a significant threat to human and ecosystem health due to their persistence, bioaccumulation in higher trophic levels, and potential toxicity. While in vivo models are commonly used for toxicity screening, developing alternative in vitro techniques for rapid environmental risk assessment is essential. Spermatozoa, with their compartmentalized structure, measurable characteristics and sensitivity to environmental changes, offer potential as an in vitro model for toxicity screening. We evaluated the impact of selected CECs, including pharmaceuticals and pesticides, on sperm function in highly motile sperm subpopulations selected from donor semen. Standardised protocols were applied to assess various sperm functional parameters after 1–4 h of exposure to either individual or a mixture of chemicals. Our findings revealed that total motility is insufficient to detect subtle toxic effect. More responsive measures, such as sperm kinematics, induced hyperactivation, viability, mitochondrial membrane potential (MMP) and presence of reactive oxygen species (ROS) should be assessed to elucidate the effect of a toxic environment on sperm function. Most chemicals exerted a dose–response effect on sperm parameters, with the higher concentrations resulting in the most negative effects. The inherent sensitivity of human spermatozoa to oxidative stress, mitochondrial damage and energy metabolism, makes them a robust model for assessing toxicity. These features highlight their utility as an alternative cellular model for evaluating CECs and advancing risk assessment methodologies.
Experiences of skilled birth attendants with dissemination strategies and use of maternal clinical guidelines: a qualitative synthesis
(Elsevier Ltd, 2025) Kaura, Doreen; Atsali, Eunice Nyasiri; Tomlinson, Mark
Despite several evidence-based clinical guidelines aimed at improving the quality of maternal care as well as avert maternal mortality, guidelines frequently fail to reach the intended users. This qualitative synthesis explored experiences of Skilled Birth Attendants (SBAs) dissemination strategies and use of Maternal Clinical Guidelines (MCGs) by SBAs within the primary health care settings. Studies focusing on experiences of dissemination and use of evidence-based MCGs by SBAs were included. Further, it included studies published in English and those conducted between 2010–2023. A search was conducted using search terms “Maternal clinical guidelines “Dissemination” “Use” “Implementation” “Skilled birth attendants” “experiences or perceptions or attitudes or views or feelings or qualitative or perspective”. The search was done via Hinari and EBSCOhost in; Medline, PubMed, CINAHL. Additionally, searches were conducted using reference lists of the selected papers. Grey literature was searched from library repository and google scholar for further information. Search articles were uploaded in Mendeley, and duplicates removed. We included qualitative studies (10), mixed methods studies (5) and two (2) qualitative systematic syntheses because of paucity in qualitative only articles. Johanna Briggs Institute (JBI) Sumari appraisal tool was used to conduct the appraisal. All the articles included in this study were all imported to ATLAS ti for data management. The articles were code, grouped and themes developed. Three themes emerged: Dissemination strategies of MCGs, Use of MCGs (SBAs health systems factors), Improved utilization of maternal clinical guidelines. The findings of this study show experience in terms of facilitators and barriers to dissemination and use of guidelines. The study found Guidelines factors, Health systems factors, Skilled birth attendants’ factors and Community factors as the main facilitators and barriers for dissemination and use of guidelines. Future primary research may focus on, dissemination methods, actual use, and the outcomes of use. Additionally, the importance of appropriate use of maternal clinical guidelines needs to be emphasized early in midwifery competency education and more emphasis during in-service education.
A systematic review on factors influencing immunisation adherence among children under 12 years of age
(AOSIS, 2025) Lockett, Bridgette; Willemse, Juliana; Modeste, Rugira
BackgroundImmunisation is crucial for preventing the spread of infectious diseases; yet, adherence remains a global challenge, particularly among children under 12. Understanding the multifaceted factors influencing vaccination adherence is essential for improving coverage rates and reducing the burden of vaccine-preventable diseases.AimThis study aimed to develop a support intervention for improvement in childhood immunisation adherence in South Africa.MethodsFollowing the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a comprehensive search was conducted across multiple databases. The Patient (problem or population); Intervention; Comparison, control or comparator and Outcome(s) framework guided the research question formulation and search strategy. Included studies were published between 2013 and 2023, focusing on children under 12. Data were extracted and categorised into domains affecting immunisation adherence. Quality assessment was performed using the mixed methods appraisal tool.ResultsThe review identified five major domains influencing immunisation adherence: socioeconomic factors, health system factors, vaccine beliefs and attitudes, cultural and social factors, and communication and information factors.ConclusionThis review highlights the complex interplay of factors affecting childhood vaccination adherence. Critical areas for intervention include tailored communication strategies, addressing vaccine hesitancy, enhancing immunisation accessibility and leveraging digital technologies for vaccine promotion.ContributionThese insights can guide evidence-based strategies to improve immunisation adherence and inform policy in the evolving landscape of global public health.
Academic help-seeking behaviour and barriers among college nursing students
(AOSIS (Pty) Ltd, 2024) Bimerew, Million S; Arendse, John P
Background: First-year college student’s smooth transition and academic success influenced by academic help-seeking behaviour. Academic help-seeking behaviour is largely affected by many factors, including demographic factors, self-esteem and the use of sources for academic learning. Aim: The study investigated academic help-seeking behaviour and barriers among first-year college nursing students. Setting: The study was conducted at a nursing college in the Western Cape province of South Africa. Methods: A cross-sectional descriptive survey design with a self-administered questionnaire was used to collect data from 130 first year nursing college students. Descriptive statistics and bivariate analysis were computed using Statistical Packages for Social Sciences (SPSS). Results: More than 77.7% used course materials and books to help with academic learning, 50% of students sought help from their teachers. Only 24.6% and 17.7% of students used YouTube and computers respectively. In all items measured help-seeking is not a threat to self-esteem, teachers and parents did not have unrealistic expectations of their academic performance. Language is significantly associated with (p < 0.001) academic help-seeking behaviour. Conclusion: Most students mainly used informal sources for academic learning. Help-seeking was not a threat to self-esteem. The language barrier is significantly associated with academic help-seeking behaviour. The nursing college should provide a coordinated academic language support, academic consultation and counselling services for academically stressed first-year nursing students. Contribution: The findings highlighted language as a barrier to academic help-seeking. The study provides insight to strengthen the language and academic support for academic learning for first year nursing students.
Challenges experienced by grandparents caring for AIDS orphans in the Western Cape province, South Africa
(South Africa: African Online Scientific Information Systems (Pty) Ltd t/a AOSIS, 2024) Furaha Akimanimpaye; Million S. Bimerew; Deliwe R. Petlhu
Background: There is limited understanding of the difficulties and experiences faced by grandparents who assume the responsibility of caring for AIDS orphans. Aim: The objective of the study was to investigate and depict the difficulties encountered by grandparents who provide care for AIDS orphans in the Western Cape province of South Africa. Setting: The study was conducted in the City of Cape Town Metropolitan and the Overberg municipality. Methods: The study used qualitative approach with an exploratory-descriptive design. A purposive sampling technique was utilised to select 25 grandparents. Semi-structured interviews were conducted, audio-recorded, transcribed verbatim, and analysed thematically using ATLAS.ti, version 7. Results: Financial difficulties, a lack of support, HIV and/or AIDS stigma, and dealing with rebellious teenagers were primary challenges affecting the well-being of grandparents. Conclusion: The study found that while financial challenges were significant, other factors such as poor family support contributed to the decline in the well-being of grandparents caring for AIDS orphans.
Factors influencing respectful perinatal care among healthcare professionals in low-and middle-resource countries: a systematic review
(BMC Pregnancy and Childbirth, 2024) Lunda, Petronellah; Minnie, Catharina Susanna; Lubbe, Welma
Background: This review aimed to provide healthcare professionals with a scientific summary of best available research evidence on factors influencing respectful perinatal care. The review question was ‘What were the perceptions of midwives and doctors on factors that influence respectful perinatal care?’ Methods: A detailed search was done on electronic databases: ebscohost: Medline, oalster, Scopus, scielo, Science Direct, pubmed, Psych INFO, and socindex. The databases were searched for available literature using a predetermined search strategy. Reference lists of included studies were analysed to identify studies missing from databases. The phenomenon of interest was factors influencing maternity care practices according to midwives and doctors. Pre-determined inclusion and exclusion criteria were used during selection of potential studies. In total, 13 studies were included in the data analysis and synthesis. Three themes were identified and a total of nine sub-themes. Results: Studies conducted in various settings were included in the study. Various factors influencing respectful perinatal care were identified. During data synthesis three themes emerged namely healthcare institution, healthcare professional and women-related factors. Alongside the themes were sub-themes human resources, medical supplies, norms and practices, physical infrastructure, healthcare professional competencies and attributes, women’s knowledge, and preferences. The three factors influence the provision of respectful perinatal care; addressing them might improve the provision of this care. Conclusion: Addressing factors that influence respectful perinatal care is vital towards the prevention of compromised patient care during the perinatal period as these factors have the potential to accelerate or hinder provision of respectful care. © The Author(s) 2024.
Use of artificial intelligence in healthcare in South Africa: a scoping review
(AOSIS (pty) Ltd, 2025) Chipps, Jennifer; Sibindi, Thandazile; Cromhout, Amanda; Bagula, Antoine
Background: Artificial intelligence (AI) transformed healthcare worldwide and has the potential to address challenges faced in the South African healthcare sector, such as limited public institutional capacity, staff shortages, and variability in skills levels that exacerbate the demand on the healthcare system that can lead to compromised care and patient safety. Aim: This study aimed to describe how AI, especially machine learning is used in healthcare in South Africa over the last 5 years. Method: The Joanna Briggs Institute (JBI) methodology for scoping reviews was used. Peer-reviewed articles in English, which were published from 2020 to date were sourced and reviewed using the Population, Concept, Context (PCC) framework. Results: A total of 35 articles were selected. The results showed a focus on conventional machine learning, a health focus on HIV and/or tuberculosis (TB) and cancer, and a lack of big data in fields other than cancer. Conclusion: There has been an increase in the use of machine learning in the analysis of health data, but access to big data appears to be a challenge. Contribution: There is a need to have access to high-quality big data, inclusive policies that promote access to the benefits of using machine learning in healthcare, and AI literacy in the health sector to understand and address ethical implications
Midwives’ competence in interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng: An explanatory sequential mixed-methods study
(Elsevier Ltd, 2025) Lukhele, Sanele; Mulaudzi, Fhumulani Mavis; Gundo, Rodwell
Background: Cardiotocograph (CTG) tracing is a routine intrapartum care procedure for women who have been diagnosed with high-risk pregnancy. The aim of the CTG is to identify fetuses that are at risk in order to expedite delivery. Purpose: To asssess midwives’ competence in the interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng. Methods: An explanatory sequential mixed-methods approach was used. During phase one, 122 midwives in Johannesburg and Tshwane District filled in self-administered questionnaires, and during phase two, 30 midwives took part in semi-structured qualitative interviews. The data from both phases was analyzed separately and then integrated using the Pillar Integration Process. Results: The Pillar Integration Process led to the identification of six pillars: 1) substandard CTG interpretation training leads to a lack of understanding of key concepts; 2) absence of norms and standards pertaining to CTG interpretation training; 3) Essential Steps in Managing Obstetric Emergencies (ESMOE) training does not result in improved CTG interpretation scores; 4) lack of standardization of CTG interpretation guidelines causes confusion among interpreters; 5) level of knowledge of foundational concepts of CTG interpretation affects clinical judgment; and 6) CTG interpretation skill is a combination of understanding of CTG characteristics, fetal heart rate pattern, fetal physiology and clinical context. Conclusion: The results highlighted a knowledge deficit in CTG interpretation and shortfalls in the current CTG training programs. This can be remediated by the development of a CTG training program which is benchmarked with existing programs which have demonstrated good knowledge scores of participants over a long period.
Nurse prescribing and dispensing in South Africa: gaps in the current legislative framework
(AOSIS (Pty) Ltd, 2024) Crowley, Talitha; Gray, Andy Lofts; Geyer, Nelouise
Nurse prescribing and dispensing are central to ensuring universal health access in South Africa. To describe the historical development of the legal enablements of nurse prescribing and dispensing in South Africa and highlight gaps in the current legislative framework We emphasise significant deficiencies in the current legislative landscape that pose challenges to these vital nursing practices and call for urgent revisions of the legislative framework, particularly the revision of Section 56 of the Nursing Act (33 of 2005) and its related regulations, to formalise authorisation of specialist nurse prescribers in public and private practice. This will also entail an application to the South African Health Products Regulatory Authority (SAPHRA) for the scheduling of substances by authorised nurse prescribers in the defined professional nurse and specialist nurse categories by the Minister of Health There is a necessity for prompt legislative revisions to address identified deficiencies
Nurse prescribing and dispensing in South Africa: gaps in the current legislative framework
(AOSIS (Pty) Ltd, 2024) Crowley, Talitha; Gray, Andy Lofts; Geyer, Nelouise
Nurse prescribing and dispensing are central to ensuring universal health access in South Africa. To describe the historical development of the legal enablements of nurse prescribing and dispensing in South Africa and highlight gaps in the current legislative framework We emphasise significant deficiencies in the current legislative landscape that pose challenges to these vital nursing practices and call for urgent revisions of the legislative framework, particularly the revision of Section 56 of the Nursing Act (33 of 2005) and its related regulations, to formalise authorisation of specialist nurse prescribers in public and private practice. This will also entail an application to the South African Health Products Regulatory Authority (SAPHRA) for the scheduling of substances by authorised nurse prescribers in the defined professional nurse and specialist nurse categories by the Minister of Health There is a necessity for prompt legislative revisions to address identified deficiencies
Nicotine and cardiovascular health: when poison is addictive – a WHF policy brief
(Ubiquity Press, 2024) Dorotheo, E. Ulysses; Naidoo, Pamela; Arora, Monika
Nicotine is universally recognized as the primary addictive substance fuelling the continued use of tobacco products, which are responsible for over 8 million deaths annually. In recent years, the popularity of newer recreational nicotine products has surged drastically in many countries, raising health and safety concerns. For decades, the tobacco industry has promoted the myth that nicotine is as harmless as caffeine. Nonetheless, evidence shows that nicotine is far from innocuous, even on its own. In fact, numerous studies have demonstrated that nicotine can harm multiple organs, including the respiratory and cardiovascular systems. Tobacco and recreational nicotine products are commercialized in various types and forms, delivering varying levels of nicotine along with other toxic compounds. These products deliver nicotine in profiles that can initiate and perpetuate addiction, especially in young populations. Notably, some electronic nicotine delivery systems (ENDS) and heated tobacco products (HTP) can deliver concentrations of nicotine that are comparable to those of traditional cigarettes. Despite being regularly advertised as such, ENDS and HTP have demonstrated limited effectiveness as tobacco cessation aids in real-world settings. Furthermore, ENDS have also been associated with an increased risk of cardiovascular disease. In contrast, nicotine replacement therapies (NRT) are proven to be safe and effective medications for tobacco cessation. NRTs are designed to release nicotine in a slow and controlled manner, thereby minimizing the potential for abuse. Moreover, the long-term safety of NRTs has been extensively studied and documented. The vast majority of tobacco and nicotine products available in the market currently contain nicotine derived from tobacco leaves. However, advancements in the chemical synthesis of nicotine have introduced an economically viable alternative source. The tobacco industry has been exploiting synthetic nicotine to circumvent existing tobacco control laws and regulations. The emergence of newer tobacco and recreational nicotine products, along with synthetic nicotine, pose a tangible threat to established tobacco control policies. Nicotine regulations need to be responsive to address these evolving challenges. As such, governments should regulate all tobacco and non-medical nicotine products through a global, comprehensive, and consistent approach in order to safeguard tobacco control progress in past decades.

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