| Summary: | The dualistic South African health system is divided into a private and public health care
sector. The core difference between these two sectors is that private hospitals are based on a
business model with a profit motive, while public hospitals offer a free service, accessible to all
citizens of South Africa and is nurse-driven.
The increased need towards higher quality health care is evident in the launching of the
National Health Insurance system. The pilot of this system was activated in ten sub-districts in
South Africa and will become the mechanism to enhance quality and safety of patient care in
the private and public sectors. Registered nurses’ reporting of quality and safety of patient
care is an important factor in quality-related research and has been linked with international
studies on quality of care. As the registered nurses are directly involved in all the facets of
patient care, this population serves as a valuable contribution in the assessment of quality
care. In this research quality of care refers to quality, patient safety and adverse events.
Quality of care refers to the extent to which actual care is in conformity with the present criteria
for good care. Patient safety is a parameter used to monitor and enhance quality. Through
enhanced patient safety, adverse events can be prevented. Adverse events refer to all the
incidents that can affect a patient during hospitalisation that is not due to the patient’s illness,
such as hospital acquired infections, medication safety and patient falls with injury.
This research aimed to explore and describe the nurse reported differences in quality of care,
patient safety and adverse events in the adult medical and surgical units of private and public
hospitals in the Free State and North West Provinces. This study was conducted within the
RN4CAST research programme, an international consortium of fifteen countries working
together towards the formulation of nurse workforce forecasting models.
A quantitative, correlational, explorative, descriptive and contextual design was followed. The
population consisted of registered nurses employed for at least one year in the selected
private and public hospitals in the two participating provinces. Private hospitals with more
than 100 beds were included. The public hospitals had a level three status. An all-inclusive
sampling was conducted (n=332) after participants gave informed consent. Data was
collected through the completion of the National Nurse Survey that covered four sections of
which quality of care, patient safety and adverse events was one. Field workers were utilised
during data collection. Data capturing was conducted by means of EpiData 3.1. Secondary
data analysis was utilised by means of SPSS 16.0. Descriptive statistics were extracted with regard to the demographic status of the participants. The descriptive statistics were congruent
with the demographic profile of nursing in South Africa. The inferential statistics included the
difference in quality of care, patient safety and adverse events between the private and public
hospitals in the selected provinces. Both the t-test based on the quality of care and patient
safety as well as the Mann-Whitney test on adverse events indicated an insignificant
difference between nurse reported quality of care, patient safety and adverse events between
the private and public hospitals. Reliability and validity were assured and recommendations
were formulated for nursing education, practice and research. === MCur, North-West University, Potchefstroom Campus, 2013
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