Barriers to implementing advanced skills in trauma and emergency nurse specialist practice
Background: A postgraduate specialist programme in trauma and emergency nursing is offered to help address the high burden of injuries and emergencies in the South African healthcare system. The trauma and emergency nurse specialists’ advance skills and expertise have been associated with improved p...
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| Format: | Article |
| Language: | Afrikaans |
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AOSIS
2025-07-01
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| Series: | Health SA Gesondheid: Journal of Interdisciplinary Health Sciences |
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| Online Access: | https://hsag.co.za/index.php/hsag/article/view/2951 |
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| author | Haroldene Stevens Cornelle Young Tshepo L. Motsepe Tendani Mabuda |
| author_facet | Haroldene Stevens Cornelle Young Tshepo L. Motsepe Tendani Mabuda |
| author_sort | Haroldene Stevens |
| collection | DOAJ |
| description | Background: A postgraduate specialist programme in trauma and emergency nursing is offered to help address the high burden of injuries and emergencies in the South African healthcare system. The trauma and emergency nurse specialists’ advance skills and expertise have been associated with improved patient outcomes, yet they continue to face barriers that constrain the full scope of their practice.
Aim: This study aimed to explore and describe the perceptions of trauma and emergency nurse specialists on barriers to skill implementation.
Setting: The study was conducted in the trauma and emergency departments of a tertiary hospital providing Level I services and a district hospital providing Level II services at two public hospitals in the Western Cape province, South Africa.
Methods: An exploratory-descriptive qualitative design with purposive maximum variation and snowball sampling was utilised. Semi-structured interviews were conducted with 10 specialist nurses among a population of 33 with a post-registration qualification in Medical and Surgical Nursing Science: Trauma and Emergency. Thematic analysis of data was carried out and adherence to the criteria of dependability, credibility, transferability and confirmability ensured trustworthiness in the study.
Results: Three themes emerged, which include uncertainty regarding legal accountability and specialised practice responsibility, oppressive practice environments not conducive to skill implementation and the disregard for trauma and emergency nurse specialists’ role and value of specific skills.
Conclusion: Job descriptions and scope of practice (SOP) are not adapted after specialist training in trauma and emergency nursing, resulting in a lack of recognition of specialised skills by the interdisciplinary team and management, uncertainty among these specialist nurses about what they are allowed to do with their new skills and a subsequent inability to practice in their full capacity in service of the population in need.
Contribution: Improved utilisation of the specialised practice of these trauma and emergency nurse specialists within their expanded scope to cope with the high burden experienced in the emergency rooms of South Africa. |
| format | Article |
| id | doaj-art-bed0a6905eac4a0ba2c16cf3466be8c9 |
| institution | Matheson Library |
| issn | 1025-9848 2071-9736 |
| language | Afrikaans |
| publishDate | 2025-07-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Health SA Gesondheid: Journal of Interdisciplinary Health Sciences |
| spelling | doaj-art-bed0a6905eac4a0ba2c16cf3466be8c92025-08-04T09:08:15ZafrAOSISHealth SA Gesondheid: Journal of Interdisciplinary Health Sciences1025-98482071-97362025-07-01300e1e810.4102/hsag.v30i0.29511280Barriers to implementing advanced skills in trauma and emergency nurse specialist practiceHaroldene Stevens0Cornelle Young1Tshepo L. Motsepe2Tendani Mabuda3Department of Health and Wellness, Western Cape College of Nursing, South Cape Karoo Nursing Campus, GeorgeDepartment of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape TownDepartment of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape TownDepartment of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape TownBackground: A postgraduate specialist programme in trauma and emergency nursing is offered to help address the high burden of injuries and emergencies in the South African healthcare system. The trauma and emergency nurse specialists’ advance skills and expertise have been associated with improved patient outcomes, yet they continue to face barriers that constrain the full scope of their practice. Aim: This study aimed to explore and describe the perceptions of trauma and emergency nurse specialists on barriers to skill implementation. Setting: The study was conducted in the trauma and emergency departments of a tertiary hospital providing Level I services and a district hospital providing Level II services at two public hospitals in the Western Cape province, South Africa. Methods: An exploratory-descriptive qualitative design with purposive maximum variation and snowball sampling was utilised. Semi-structured interviews were conducted with 10 specialist nurses among a population of 33 with a post-registration qualification in Medical and Surgical Nursing Science: Trauma and Emergency. Thematic analysis of data was carried out and adherence to the criteria of dependability, credibility, transferability and confirmability ensured trustworthiness in the study. Results: Three themes emerged, which include uncertainty regarding legal accountability and specialised practice responsibility, oppressive practice environments not conducive to skill implementation and the disregard for trauma and emergency nurse specialists’ role and value of specific skills. Conclusion: Job descriptions and scope of practice (SOP) are not adapted after specialist training in trauma and emergency nursing, resulting in a lack of recognition of specialised skills by the interdisciplinary team and management, uncertainty among these specialist nurses about what they are allowed to do with their new skills and a subsequent inability to practice in their full capacity in service of the population in need. Contribution: Improved utilisation of the specialised practice of these trauma and emergency nurse specialists within their expanded scope to cope with the high burden experienced in the emergency rooms of South Africa.https://hsag.co.za/index.php/hsag/article/view/2951trauma and emergency nursingadvanced skillsbarriersscope of practiceskills implementationnurse specialists. |
| spellingShingle | Haroldene Stevens Cornelle Young Tshepo L. Motsepe Tendani Mabuda Barriers to implementing advanced skills in trauma and emergency nurse specialist practice Health SA Gesondheid: Journal of Interdisciplinary Health Sciences trauma and emergency nursing advanced skills barriers scope of practice skills implementation nurse specialists. |
| title | Barriers to implementing advanced skills in trauma and emergency nurse specialist practice |
| title_full | Barriers to implementing advanced skills in trauma and emergency nurse specialist practice |
| title_fullStr | Barriers to implementing advanced skills in trauma and emergency nurse specialist practice |
| title_full_unstemmed | Barriers to implementing advanced skills in trauma and emergency nurse specialist practice |
| title_short | Barriers to implementing advanced skills in trauma and emergency nurse specialist practice |
| title_sort | barriers to implementing advanced skills in trauma and emergency nurse specialist practice |
| topic | trauma and emergency nursing advanced skills barriers scope of practice skills implementation nurse specialists. |
| url | https://hsag.co.za/index.php/hsag/article/view/2951 |
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