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Change management in the implementation of electronic health records systems in public and private hospitals in the Ethekwini Municipality, Kwazulu-Natal, South Africa
Dissertation submitted to the Faculty of Arts in accordance with the requirements for the Masters Degree in Library and Information Science in the Department of Library and Information Studies, at the University of Zululand, 2020.The study examined change management practice in the implementation of electronic health records systems in public and private hospitals in the eThekwini area, Kwa-Zulu Natal Province, South Africa. The study is responding to the e-Health Strategy of South Africa set to provide road map for accomplishing well-functioning national health information systems to support delivery of health services. The study compared public and private hospitals in the development, execution and operation of electronic health records systems (EHR) systems. The study reviewed in-depth literature on the change management processes in the pre and post implementation of electronic health records systems, including user acceptance in the utilization of the system. The leading change model and technology acceptance model (TAM) model was utilized to evaluate changing behaviour of hospital employees towards tactical processes on their daily duties in the use of EHR systems. The study further assessed changes experienced by public and private hospitals due to EHR system implementation. It also evaluated the way hospitals monitor and measure success or failure of electronic health records systems.
The study adopted the pragmatic epistemology and pluralistic ontology to measures users’ attitude towards the operation of the EHR systems and evaluated change management in its execution. The study adopted the mixed methods research approach. The study targeted a sample of 215 participants in both public and private hospitals. Out of which, 187 responded representing a response rate of 87.76%. The questionnaires were used to collect data from nurses, doctors, filing or ward clerks, receptionist and patient administrators. Qualitative data was collected through interviews from the hospital management. Descriptive statistics were used to describe frequencies with data presentation in bar graphs and pie charts; while qualitative data was thematically categorised and presented narratively. The two sets of quantitative and qualitative data from both the public and private hospitals were compared and contrasted in order to produce a single interpretation, and draw appropriate conclusions.
The findings of the study established that ill-defined change management approach and unbalanced user acceptance dissuade EHR system effectiveness and set back visibility of execution progress. The study confirmed lack of standard guidelines for both public and private hospitals in the establishment of procedures and policies guiding change management in the implementation process. This study confirmed poor user involvement in the execution of EHR systems. Therefore, this results to imbalance in change management visibility in the implementation of EHR system as hospitals struggle to track effectiveness of the system and user acceptance. The study showed that there is a gap of change management directive in the eHealth Strategy of South Africa as there is no notable guidance in monitoring and evaluating the development and implementation of EHR systems.
In order to accomplish EHR system efficiency and meaningful use, the study recommends that official change management framework in the implementation of EHR systems should be developed. Similarly, the study recommends that standardised formal monitoring and evaluation processes need to be developed by the Department of Health in order to measure effectiveness and level of users’ acceptance from pre to post implementation of the EHR system. The study recommends the Department of Health to liaise with the National Archives of South Africa towards developing policy and procedure manuals that may guide hospitals in the implementation of EHR systems in their operations.CSI
A curriculum differentiation model to meet the needs of Grade 4 English learners in selected primary schools in Endumeni Circuit
A thesis submitted to the Faculty of Education in fulfilment of the requirements for the Degree of Philosophiae Doctor of Education in the Department of Curriculum and Instructional at the University of Zululand, South Africa, 2021The aim of the study was to design a curriculum differentiation model to meet the
needs of English grade 4 learners in selected primary schools on the Endumeni
Circuit. There is a transitional challenge for learners in terms if language of learning
and teaching from the foundation phase to the intermediate phase. Learners are
operating in different conceptualisation stages of understanding English as a language
of learning and teaching (LOLT), and as a subject. Curriculum differentiation in Grade
4 gives options for individual learners to learn as thoroughly and swiftly as possible,
without assuming that one learner's learning path is the same as anybody else's
(Tomlinson, 2014).
The conceptual framework guiding this study was Critical Pedagogy (CP). CP framing
appeals to teachers to reflect about how school practices connect to those in a macro socio level, how classrooms are organised into communities of practice, and what
kinds of participation are made accessible to all learners (Abraham, 2015). This
conceptual framework was relevant because it advocates that teachers have to make
it easier for learners to construct knowledge and use it in a variety of settings to foster
self-motivated life interpretations with the objective of changing the status quo
(Abraham, 2014).
The Transformative Paradigm was the paradigm used in this research. The
transformational paradigm aligns well with the ideas of the Brazilian educator, Paulo
Freire, and his dialogical conscientisation model. The study further employed
participatory action learning action research (PALAR) as its research approach. The
democratic aspect of PALAR encouraged participants to engage in critical,
collaborative thought, which included questioning established educational
assumptions and exploring new approaches to curriculum differentiation in grade 4
English classes. Engagement through PALAR aimed to contribute to a better
understanding of what kind of resources, curriculum differentiation knowledge and
action is needed to achieve practical inclusive classrooms, improvement for social
justice, transformation, and sustainable change.
Thematic analysis was used to analyse data. Thematic analysis helped the researcher
to pinpoint the links between concepts and to compare them to replicated evidence
(Clarke and Braun, 2014)
The perceptions of selected employers on the employability of Unizulu graduates: a case study of Umhlathuze Local Municipality
A thesis submitted to the Faculty of Commerce, Administration and Law in fulfilment of the requirements for the Degree of Master of Commerce in the Department of Public Administration at the University of Zululand, South Africa, 2021.Graduate unemployment is a growing problem in South Africa, and one reason is that there is a gap between higher education and the world of work. To close this gap, it is important to get the voice of the employers to understand what their needs are. Yearly, the university is doing its best to prepare its graduates for the working world. The employers’ views will inform the policy makers of the university on how to improve the university and best prepare its graduates for employment. The study explored the perceptions of local employers on the employability of University of Zululand (UniZulu) graduates.
The study is a work of qualitative research which intends to make meaning of and recognise patterns among words so as to come up with a meaningful picture without compromising its importance and dimensionality (De Vos et al., 2011), (Leung, 2015). Data were collected using semi-structured interviews (which are the most commonly used interviews for data collection in the field of social science (Evans, 2018), with employers of different selected local companies in the uMhlathuze Local Municipality. 14 participants were interviewed from five companies, including uMhlathuze local municipality, Tronox South Africa, the Premier Hotel (Richards Bay), and two schools: uNgoye High School and Mantshangula Primary School. Data were transcribed, categorised and presented as themes with verbatim quotes from participants. Pseudonyms were used to protect participants’ identity and to ensure confidentiality.
Findings of the study reveal that UniZulu graduates are employable, but there are some challenges that might hinder other employers from employing more graduates. Findings suggest that there is a disconnection between the university and the world of work. Employers also aired their views about more students choosing the same programmes of study while there is a shortage of graduates in other specialisations like maths, science and technology. Amongst others, the attitude of graduates; practical exposure and the university’s image were identified as hindrances to UniZulu graduates’ employability. Recommendations from the findings were to build or strengthen partnership between the university and industry to bridge the gap. A suggestion for designing a curriculum that meets employers’ needs was made. Findings indicate that graduates must make
themselves visible to employers by volunteering for work, in-service training and other activities to enhance their employability
The efficacy of government strategies towards improving informal settlements in Rustenburg local municipality
A thesis submitted to the Faculty of Commerce, Administration, and Law in fulfilment of the requirements for the Degree of Master of Public Administration in the Department of Public Administration at the University of Zululand, South Africa, 2021.It is important to understand the propagation of informal settlements. They do not
only represent the high housing demand but also its effects on the development and
transformation of South Africa if remaining unimproved. Several studies divulge that
informal settlements do not only serve as a solution to the government’s failures to
provide housing to the people, but they serve as a shelter to the homeless and urban
poor. Although certain housing interventions and programmes have been
implemented to improve informal settlements, most informal settlements
(Rustenburg and across South Africa) still lack access to basic services. According
to this study a divergence exists in the literature in determining the efficacy of
strategies to improve informal settlements, regardless of years of studies conducted
in informal settlements. This study aimed to analyse the efficacy of local government
strategies towards improving informal settlements in Rustenburg Local Municipality.
A qualitative approach was employed to conduct this investigation. Semi-structured
in-depth interviews were implemented as an instrument to collect data. This
research, therefore, investigated the settlements demographics, background, and
strategies to improve informal settlements. It also reveals the challenges of informal
settlements encountered by the settlement dwellers and the municipality, community
participation, and the relationship between the municipality and the informal
communities. The study findings indicate that the strategies implemented to improve
informal settlements are ineffective; this was evident from the responses of
participants who indicated that these settlements lack access to basic services. The
lack of access to basic services in these settlements is a reflection of ineffective
strategies. The concluding Chapter 5 comprises study recommendationsNational Research Foundatio
Refining academic writing skills for the third year Bcom (accounting) students at a selected university in KwaZulu-Natal
A thesis submitted to the Faculty of Commerce, Administration and Law in fulfilment of the requirements for the Degree of Masters in Commerce in the Department of Accounting at the University of Zululand, South Africa, 2021.This study investigated the academic writing contests experienced by the third year BCom (Accounting) students at a selected university in KwaZulu-Natal, South Africa. Most of these students are second language users of English, and the language is used as a medium of instruction. This study was informed and guided by the following research questions that were drawn from the objectives of the study: (i.e. Why do the third year BCom (Accounting) students seem to have challenges with academic writing skills?; What are the perceptions of BCom (Accounting) lecturers in assisting the third-year BCom (Accounting) students to develop the academic writing skills?; and, Are the academic writing programmes effective and efficient to assist third year BCom (Accounting) students to develop academic writing skills?).
The study used the qualitative research approach and interpretivism paradigm. The theory that underpinned this study is social constructivism. The participants comprised two groups of students and third year lecturers. Interview Focus Groups with both the students and the lecturers were conducted, analyses of tests and projects/programmes were employed as data collection instruments. Eighteen (18) students and six (6) lecturers were interviewed. Thirty-three (33) tests and fifteen (15) group projects were analysed by the University Writing Centre. The content data analysis was adopted, and it revealed the following: it is not easy to understand the content in a second language, the accounting students are not passionate about academic writing, the students are displaying linguistic challenges, some of the accounting lecturers need academic writing skills training for them to be able to train the students, the lecturers and the students are not using the writing format and are failing to follow the writing process. This study recommends the following: The Writing Centre should develop an academic writing skill programme at first- year level, and this should be embedded within and across different academic modules. This will enhance students’ academic writing skills; academics and the Writing Centre support-team could collaborate in assisting students
An assessment of public participation in KwaZulu-Natal legislature in compliance with the constitution of the Republic of South Africa, 1996.
A thesis submitted to the Faculty of Commerce, Administration and Law in fulfilment of the requirements for the Degree of Master of Laws in the department of Constitutional Law at the University of Zululand, South Africa, 2021.Since the inception of democracy in South Africa, public participation has become an
essential element of democracy. This concept of public participation has become
crucial in strengthening democracy as well as in trying to maintain a balance between
representative and participatory democracy. The nation’s Constitution imposes a
constitutional imperative upon the legislature to ensure ‘public involvement’ using
legislative processes. This concept of ‘public participation’ therefore is a concept
encompassing all democratic participation processes. It is the most conventional
avenue to consider and incorporate the voices and will of community members in the
law-making process. Meanwhile, the legitimacy of the statutes enacted by the
government has been challenged in numerous occasions because of flawed public
participation processes. Wherefore public participation in the law making process
becomes a subject of considerable research. The main aim of this study was to establish the compliance by the KwaZulu-Natal Legislature (KZNL) with the constitutional mandate of ‘facilitating public involvement’ when laws are being made. The study provided an international and foreign perspective of public participation intended to obtain an overall global picture of public participation and how it should be understood in a democratic country. A number of international treaties were brought into discussion. The treaty declarations were found to emphasise the significance of public involvement in democratic countries to ensure the protection and promotion of human rights. It is therefore claimed that the treaties have played an increasingly important role in agitating for the advancement of public participation in South Africa. The study further considered foreign law, where few selected experiences of developed and developing countries were analysed, and most of these countries support public participation. The study also explored public involvement in practise within the context of the KZNL. Various participation mechanisms were identified and analysed. The study revealed that there are significant and strenuous efforts by the KZNL in accomplishing its duty
to facilitate public involvement. There is an established framework in place to regulate
public involvement. It is however noted that despite the presence of this robust
framework adopted to guide participation activities, which provides an overview and
insight within the KZNL on how to achieve meaningful participation, practically, the
study reveals challenges ordinarily encountered in conducting public hearings. These
challenges also serve as a threat to meaningful public participation that relates mostly
to consultation processes, short notice for public hearings and limited periods to
convene such hearings. The study revealed that such anomalies flow from the
National Council of Provinces (NCOP) that is sometimes responsible for giving
stringent turn-around time frames for Provincial Legislatures to convene public
hearings. The study concluded by providing a series of recommendations based on the study findings, as well as in relation to the reconfiguration of public hearings modus operandi and provision of relevant innovation. With those recommendations, it will be therefore possible to achieve meaningful participation, and most importantly, enact
constitutionally compliant laws
Assessing the potential of community tourism in catalysing local economic development in the Umzumbe Local Municipality, under UGu District Municipality, KwaZulu-Natal
A dissertation submitted to the Department Anthropology and Development Studies fulfillment of the Requirements for a Doctor of Pholosophy in Development Studies in the department Faculty of Humanities and Social SciencesThe study area for this research is Umzumbe Local Municipality, which is the second largest municipality under the UGu District Municipality. The research assessed the potential of community tourism (CT) in leading to/catalysing local economic development in Umzumbe Local Municipality, under UGu District Municipality, KwaZulu-Natal. The specific objectives of the research were to: (a) examine the community tourism resources in Umzumbe Local Municipality, (b) evaluate the potential of community tourism in creating job opportunities and small scale businesses among other indices of measuring LED in the Umzumbe Local Municipality, (c) analyse how community tourism could be effectively implemented in the Umzumbe Local Municipality and (d) propose a development management model of community tourism leading to LED in the Umzumbe Local Municipality. To achieve these objectives, the research employed a mixed methods research design so as to attain a deeper and comprehensive understanding of the potential of community tourism in leading to local economic development in the study area. The findings of the study demonstrated that there are community tourism resources in Umzumbe Local Municipality, but most people were not aware of these. In addition, the research established that there is a potential for community tourism to lead to local economic development in the study area if specific development strategies around the promotion of community tourism leading to local economic development were implemented. It is on this basis that this study proposed a community tourism development management model which can be utilised to plan for and develop community tourism leading to local economic development in Umzumbe Local Municipality. The model proposes the following to be the pillars of ensuring successful implementation of CT leading to LED: education, planning, political and technological support, capacity building, participation, partnership, human capital and economic growth, human resources and development (HRD), entrepreneurial leadership and teamwork, identification of passionate and goal oriented members, facilitators and funders (government, private sector and NGOs), infrastructure, conflict resolution, monitoring and evaluation
Experiences of Clinical Instructors in Using High Fidelity Manikins to Teach Student Nurses at the Selected Higher Education Institution in KwaZulu-Natal
A dissertation submitted to the Faculty of Science, Agriculture and Engineering in fulfilment of the requirements for the Degree of Master Of Nursing in the Department of Nursing Science at the University Of Zululand, 2021Introduction
In the past, student training during clinical practice has been conducted on live humans
with minimum use of manikins to equip students with clinical skills required in the
education of a nurse. The advancement of medical technology has brought major
changes in the clinical training of student nurses through the introduction of high fidelity
manikins (HFM). This transition has brought various challenges to clinical instructors.
Aim of the study
The aim of the study was to explore and describe the experiences of clinical
instructors’ use of HFMs to teach the student nurses at higher education institutions
(HEIs) in KwaZulu-Natal.
Methodology
A qualitative research methodology was used for the study. The research study was
guided by the National League of Nurses/Jeffries Simulation Framework (NLN/JSF).
Data was collected from 10 participants using unstructured individual face-to-face
interviews which were purposefully selected. Data collection was determined by data
saturation and analysed thematically.
Findings
The study revealed four major themes: use of HFMs, staff in-service and training,
environmental factors, and maintenance of resources. In addition, various sub-themes
emerged. The study findings revealed that clinical instructors faced various challenges
in using HFMs to teach clinical practice to student nurses at HEIs.
Conclusion and recommendations of the study
Clinical instructors are faced with various challenges in using HFMs to teach student
nurses. These challenges range from human and material resources and technical
knowledge, to infrastructural problems. Therefore, several recommendations are
made with regard to nursing education institutions, nursing education administration,
and policy development and implementation. Moreover, further research is
recommended to be conducted about the phenomenon.
Key words: Manikin; High Fidelity; Simulation; Clinical Practice; Clinical Instructor
Beam emittance measurements in the SPC2 injection beamline at iThemba LABS
A dissertation submitted in fulfilment of the requirement for the Degree of Master of Science in the Department of Physics, Faculty of Science, Agriculture and Engineering, at the University of Zululand, 2020.Beam emittance is a property of a charged particle beam in a particle accelerator that is used to estimate the beam quality. It is length-based measure of the average spread of particle coordinates in position and momentum phase space. This attribute makes emittance a crucial beam parameter that one requires when tuning the beam into smaller spaces in a beamline and matching the beam with the acceptance of an accelerator. At iThemba LABS, the low energy beam transport (LEBT) system required a system that measures transverse beam emittance. This beamline connects the two electron cyclotron resonance ion sources (ECRIS) to the second solid pole injector cyclotron (SPC2) and is composed of a set of solenoid and quadrupole magnets that are used to focus the beam. This layout makes it possible to use solenoid and quadrupole magnets to carry out beam emittance measurements. This thesis is aimed at presenting a developed system that can be utilized for measuring transverse beam emittance of beams emerging from the ECRIS. An analytic explanation of the techniques used and tools needed for these measurements are given. The Gauss approximation program and the emittance calculator were developed and used. During the development process, the system was validated using different beams simulated using a computer program TRANSPORT [1]. The beam widths obtained from TRANSPORT were used on the developed emittance calculator to establish if one could get the injected beam emittances. From the calculations it was clear that there is an agreement between injected and deduced emittances. This was an indication that the emittance calculator is working as expected. Thenceforth, the real beam emittance measurements were performed using 4He2+ beam with kinetic energy Ek = 12.7 keV. After analysing the helium data it was decided that a second set of measurements should be performed and this was done using 32Si5+ beam with kinetic energy Ek = 8.35 keV. The obtained results from both helium and silicon measurements were analyzed in order to compare the emittance measured in the AX-line with the one measured in the Q-line. From both set of measurements it was observed that the emittances obtained in the two beamlines had some disagreement. This disagreement between the two sets of transverse emittances violated Lioville’s theorem. In order to probe the source of disagreement the helium measurements were further investigated by performing beam widths comparison. To do this, the measured emittances were injected into TRANSPORT and the beam widths gathered were then compared with the measured widths. From the comparison results it was clear that only the beam widths from AX-line are comparable while there was disagreement in Q-line widths comparison. It was evident from these observations that one could
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rely on beam emittances obtained in the AX-line than those obtained from Q-line beamline. Upon further investigation, it was concluded that reason behind this could be associated with the fact that for AX-line measurements, instead of performing minimum number of measurements (i.e three) required to deduce the emittances, five set of measurements were utilized instead. This choice of number of measurements makes the system robust in such a way that a small error on measured beam widths will have a negligible effect on the deduced emittances. For Q-line measurements, however, the solenoids scan was performed with minimum number of beam widths measurements (i.e ten) required. This may have resulted in the solenoid scan being sensitive to errors that could occur when measuring beam widths. For much more reliable emittance measurements in the Q-line the system needs to be upgraded in order to accommodate utilization of more beam widths of measurements.National Research Foundatio
Factors influencing equitable access to improved water supply in uMlalazi Local Municipality
A dissertation submitted in fulfilment of the requirement for the Degree of Master of Arts in the Department of Anthropology and Development Studies, Faculty of Arts, at the University of Zululand, 2021.The fact that water is necessary for life is undeniable. One of the most difficult challenges for many local governments is providing basic services to all South Africans. The global community has made positive advances in many fields, but the basic needs of man, such as clean water, remain a mirage. For healthy survival, growth, and development, safe drinking water and good hygiene are essential. Various factors affect the equal and equitable access of households to improved water. The Department of Water and Sanitation (DWS) is responsible for ensuring that all South African citizens have access to basic water supply and that water and sanitation services are delivered rapidly. The Department of Water and Sanitation is responsible for managing water supply schemes for major rural areas and villages with the assistance of district municipalities. The DWS as the National Regulator is responsible for the governance of water resources of the country and ensuring accountability amongst other key players such as water service authorities (WSAs) and water service providers (WSPs). The study examined community respondents’ perceptions about the nature of water supply services they receive and water resources available in the area. In conducting the study, a descriptive design was used. One sub-location was randomly selected from each of the two wards with a sample of 274 respondents composed of 193 females and 81 males. Data was collected using questionnaires. Data analysis was done using descriptive statistics and presented using charts and frequency tables. Hypothesis was tested based on the significance level. This was against an alternative hypothesis which assumed that there is a significant relationship between the economic scale and distribution of water services in the uMlalazi Local Municipality. The findings showed that the chi-square values for the variables were; size of economy (chi-square = 30.445a, df = 2, p-value = 0.00 and n= 274); access to pipe water within dwelling (chi-square = 109.540a, df = 2, p-value = 0.00 and n = 274); dependence on surface water (chi-square = 212.723a, df = 1, p-value = 0.00 and n = 274), water quality (chi-square = 115.635b, df = 2, p-value = 0.00 and n = 274), decreased water supply (chi-square = 12.314a, df=2, p-value = .002 and n = 274) and commitment to eradicate backlogs (chi-square = 30.445a, df= 2, p-value = 0.00 and n = 274). As a result, the study indicates that equitable water availability has an impact on health, human development, and economic growth. The findings indicated that a iv lack of water might constitute a severe threat to public health and community development, since widespread consumption of dirty surface water could expose the population to disease (bacteria) infections transmitted through water. Findings also discovered that household’s access to improved water supply was largely determined by their income, and home location, on the other hand, were important variables in gaining access to better water for other domestic purposes whilst access to water is better for other household uses. The effect is anticipated to increase among low income rural households, expand the rural-urban development divide, and intensify public dissent and conflict among rural water end-users. Furthermore, the data demonstrated that water plays an important role in rural socioeconomic development. As a result, water resource management that is sustainable may be able to solve challenges like equitable improved water access. The study findings further showed that the community at large were dissatisfied with water provision. Government direct involvement in participation, cooperation, coordination and developing a culture of empowerment should bring better water services for the local community of uMlalazi. The study recommends that one of the main pipelines from the plant to uMlalazi should be installed and awareness campaign for effective and efficient use of water should be launched. This might help ease and improve the present precarious situation