The quality of nursing unit management in training hospitals in Namibia

M.Cur.The study on the quality of nursing unit management was done in the four training hospitals approved for registered nurses' training in Namibia. There are no written standards on the quality of unit management in the hospitals. The objectives of the study were to formulate standards on quality nursing unit management and to evaluate compliance of clinical units with these standards A quantitative, contextual, descriptive and evaluative research design was followed. The study was done in two phases. In phase one, standards were formulated by means of a literature study by the researcher and validated through consensus discussion groups with nurse managers representing the different management levels and clinical disciplines. Purposive sampling was used and 25 participants rated the draft standards for relevance, representativeness, completeness and clarity. A rating instrument for this purpose was attached to the draft standards in the form of a questionnaire, and posted to participants, before the consensus discussion groups. Reliability and validity of the instrument and related items were ensured through the development of a conceptual framework and the consensus discussion groups. The pilot study indicated that a rating scale of 'Compliance', Partial Compliance, 'Non-Compliance' and 'Not Applicable' are more appropriated. Phase two represents the quality survey for the compliance with standards. The sample for the quality survey included 60 units from all four hospitals, representative of all clinical disciplines. Data was collected by means of interviews, observation and document analysis, using an evaluation instrument. Two surveyors, the researcher and a colleague, both lecturers from the Department of Nursing, University of Namibia, were involved in the data collection process. Double evaluations were done in 19 clinical units, representing 31,7% of the total clinical units (n=60), and the researcher alone evaluated 41 units, representing 68,3%. A high inter-rater reliability between the ratings of the surveyors was proven. The ethical principles of informed consent and anonymity have been adhered to throughout the study. Data was analysed through statistical analysis and are presented as descriptive statistics and comparative statistics. The findings revealed that, although unit nurse managers emphasise unit organisation, the quality of nursing unit management in the training hospitals in Namibia is poor. The findings also revealed that a need exists to empower nurse managers through in-service education on strategic planning as well as quality management in general. The recommendations from this study are to make written standards available, to empower nurse managers in quality management, to validate standards for quality nursing unit management nationally in the Namibian hospitals and for further research