PMC:6949926 / 12173-16522 JSONTXT

{"project":"2_test","denotations":[{"id":"31817829-24923663-49649088","span":{"begin":1857,"end":1859},"obj":"24923663"},{"id":"T10034","span":{"begin":1857,"end":1859},"obj":"24923663"}],"text":"4.1. Changes in the Working Environment\nParticipants articulated that the hospital has a poor, aging infrastructure which is in dire need of refurbishment. TB wards were not structured to the standard that is suitable for TB wards and this does not induce the productivity of nurses in the wards. The following sub-themes were highlighted in the context of working environment, physical environment, and practice environment.\n\n4.1.1. Physical Environment\nA good working environment can facilitate better service and reduce workload. A disorganized working environment impairs the health center teams. Infrastructure includes attention to space, ventilation, comfort, and rational layout that facilitates links within the healthcare settings. The workplace has an impact on preventing TB transmission; it serves as the first line of defense for preventing the spread of TB in the healthcare settings. Participants expressed similar sentiments about poor infrastructure.\nNurse (N1) said: “the hospital infrastructure is very old and deteriorating, the wards’ layout is not conducive for TB wards, it has small windows that fuel bacterial concentration.”\nAnother nurse (N2) added that: “the working environment is poor since we sit in the wards with patients all day long. During lunch time we sit in a small room within the TB wards, which accommodates less than five people and the door doesn’t even close.”\nNurse (N4) said: “all patients are accommodated in the same wards, whether they are extensively drug-resistant TB (XDR-TB) or MRD or TB patients, hmmm the wards layout is not proper. We have to sit all day with patients and told that patients who are under treatment are not infectious (emotional).”\nAccording to the findings of this study, physical environment was poor and TB ward designs were not conducive. A study that was done by Kieft et al. [13] indicated that improved hospital design can help reduce staff stress and fatigue and increase effectiveness in delivering care, improve patient safety, reduce patient and family stress, and improve outcomes and the overall healthcare quality. The findings of this study concur with the study that was done by Brophy [14], which indicated that the nurses were concerned with their occupational environment and voiced concern about the deteriorating hospital infrastructure.\n\n4.1.2. Poor Positive Practice Environment\nPositive practice environment is the setting that supports excellence and decent work. To ensure positive practice environment in the healthcare setting, it is important to consider health, safety, and personal well-being of the staff. These improve productivity and performance of the staff, it also benefits healthcare consumers, and leads to positive health indicators for the government. \nNurse (N3) said: “Sometimes we are supplied with fake N95 masks or required to use surgical masks. We only get 21 masks per week, to share with social workers, doctors and other staff that come to the TB wards. We do not get enough gloves, and we do not have aprons. We sometimes lack soap to wash our hands after coming into contact with TB patients, and we also have limited washing basins. In addition, the windows are too small and there is poor airflow in the wards. UV lights are not regularly service.”\nNurse (N1) added that: “This whole thing (emotional) of us being given fake masks results in negative practice for patient-care since we are afraid to contract TB. Each time we look at the patients we get scared of being in the same situation, hmmm, there are more negative thoughts in TB wards than positive ones.”\nThe findings of this study revealed that there was a more negative practice environment in the TB wards than a positive one. According to the study that was done by Washeya [15], it is important that the working environment enhances productivity. The findings of this study indicated that there was a poor practice environment in the TB wards. There was also an inadequate supply of personal protective materials. This leads to negative practice by the nurses, since they are afraid to contract diseases. The findings of the present study concur with those of a study that was done by Mametja [16], which indicated that there was a more negative practice environment in HIV/AIDS wards which affected the quality of nursing care in the public hospital.\n\n"}