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Background:  Blended learning combines face-to-face and online learning and has recently gained popularity, accelerated by the coronavirus disease 2019 (COVID-19) pandemic, often without active evaluation.

Objectives:  This study aimed to assess university nursing students' perceptions of a blended learning approach during the COVID-19 pandemic.

Method:  The population was 150 third-year nursing students from a university in the Western Cape, South Africa, using all-inclusive sampling. A one-group, pre-and post-evaluation study was conducted using a self-administered questionnaire (Student Perceptions of Blended Learning scale). Differences were assessed using Chi-squared and Mann-Whitney U tests with a significance level of p  0.05.

Results:  Before implementing blended learning, 128 students (85.3%) completed the questionnaire, while 95 (63.3%) did so after. Demographics and access showed no significant differences between the groups. Post-implementation showed a 10.1% increase in preference for blended learning (χ2 = 2.832, p = 0.092). Ease of use was rated significantly higher before implementation (3.07 ± 0.49), with no significant change post-implementation (2.99 ± 0.58). The blended learning process received lower ratings compared to content, with no significant differences before or after implementation for either (process: 2.55 ± 0.58 vs 2.54 ± 0.63; content: 2.75 ± 0.52 vs 2.79 ± 0.52).

Conclusion:  Nursing students had a positive perception of blended learning, though the online learning component posed challenges with time and module comprehension.Contribution: The findings can help higher education institutions evaluate existing online management systems and guide nurse educators in meeting students' needs when developing module resources.

Background:  HIV-positive and pregnancy diagnosis is a traumatic, shocking, and distressing experience for women. Adoption of routine HIV counselling and testing in the antenatal programme aimed to increase the uptake and the early diagnosis of HIV among pregnant women to prevent maternal HIV transmission to unborn babies and neonates.

Objectives:  The study aimed to explore the psychological reaction of women coincidentally discovering their HIV-positive status and pregnancy while seeking medical care in primary healthcare facilities in the Tshwane district.

Method:  Descriptive phenomenology involving a semi-structured in-depth interview was used to collect data. The sample was purposively selected. Twenty-eight women participated in the research project. Face-to-face in-depth audio recorded interviews were used to gain a full understanding of the experiences and feelings of the participants.

Results:  Reason for the uptake of pregnancy and HIV testing, reactions upon discovering HIV and pregnancy-positive status, emotions arising from the pregnancy and HIV-positive diagnosis, understanding HIV infection in pregnancy, and transitions to acceptance and coping with the HIV-positive diagnosis were themes that emerged from this study.

Conclusion:  It is crucial that responsible healthcare workers consider this psychological imbalance during their offering of antenatal and postnatal care services so that the pregnant women living with HIV can accept and cope with the situation.Contribution: This study accounts to support other studies that offer intense counselling for women coincidentally discovering their positive HIV status and pregnancy. It is important to remedy the acceptance of the situation and to promote HIV prevention and family planning for women of childbearing age.

Background:  Clinical supervision is pivotal in supporting nurses in rendering quality, safe patient care. Therefore, it is essential to understand clinical supervision from operational nursing managers' context to define existing challenges and propose suitable recommendations.

Objectives:  This study aimed to explore and describe operational nursing managers' experiences of clinical supervision within the context of an academic hospital in Gauteng province and propose evidence-based practice recommendations to improve patient safety and the quality of clinical supervision.

Method:  An exploratory, sequential, mixed-method design was used and implemented over two phases to take advantage of the strengths of both the qualitative and quantitative research designs. Unstructured individual interviews were conducted to collect data in phase one, and an adapted Manchester Clinical Supervision Scale (MCSS) questionnaire was used to collect data in phase two.

Results:  Operational nursing managers work in stressful conditions and environments with a gross shortage of staff and tools of the trade while being expected to deliver high-quality and safe nursing care. Of the sampled respondents, 36% (n = 17) were dissatisfied with the supervision they received, while 64% (n = 30) were indifferent in the sense that they did not think it was adequate or inadequate.

Conclusion:  Clinical supervisors should be trained and supported in clinical supervision, with regular workshops on interpersonal relations.Contribution: A clearer understanding of clinical supervision within the hospital context and evidence-based practice recommendations to improve patient safety and the quality of clinical supervision.

Background:  Globally, enrolled nurses (ENs) are embarking on an educational journey to become registered nurses (RNs) in order to enhance their knowledge and career opportunities. However, their aspiration is not without challenges. In Namibia, the experiences of these nurses have not been extensively researched.

Objectives:  This study aims to explore and describe the experiences and challenges of ENs undertaking a Bachelor of Nursing Science at the University of Namibia.

Method:  A qualitative, exploratory, descriptive and contextual research strategy was followed as the basis of conducting the study. A sample of 15 nursing students was purposively selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes. The collected data were analysed thematically using an inductive approach.

Results:  Three main themes subsequently emerged from the study: ENs' positive experiences advancing in the Bachelor of Nursing Science (BNSc) programme; nurses' negative experiences advancing in the BNSc programme; and recommendations to ensure effective advancement in the BNSc programmeConclusion: The findings of this study revealed that ENs positively experience becoming a RN when it comes to self-development; however, they have negative experiences such as not receiving exemptions for prior learning and having to learn a new curriculum.Contribution: These findings may be used by the Faculty of Health Sciences, School of Nursing and Public Health management in order to develop targeted interventions and ongoing strategies during their curriculum review cycles to ensure positive student experiences and success within the programme.

Background:  Conceptual frameworks are not only necessary for maintaining and preserving nursing knowledge through their unique contribution, but they also assist in the organisation and provision of complex nursing interventions. The lack of formal integration of spiritual care in health professions' education is blamed on the unavailability of guiding models among other challenges such as unavailability of relevant theories.

Objectives:  The objective of this article was to describe the process followed to develop a conceptual framework as the basis for a practice theory for teaching-learning of spiritual care in nursing.

Method:  An overall theory generative methodology was used. To develop the conceptual framework, conclusion statements deduced from empirical data using deductive and inductive strategies were applied.

Results:  The main concepts were identified, described, and classified. The relationship between concepts promoted synergy of the developed conceptual framework for teaching spiritual care in nursing.

Conclusion:  The developed conceptual framework was founded on the notion that knowledge from different sources can provide a solid base in theory generation. Therefore, the concepts of the developed conceptual framework were not only related to what is 'ideal'; instead, their significance was underpinned by the created universal meanings for effective purposeful communication. Therefore, sources used to obtain data were critical in the development of the conceptual framework because they constituted different ways of perceiving and understanding the world.Contribution: The conceptual framework does not only guide nursing interventions but framework also provides a philosophical guide in meeting patient-centred diverse needs.

Background:  Certain determinants can be associated with avoidable perinatal deaths, and audits are needed to establish what these determinants are, and what can be done to prevent such deaths.

Objectives:  The study aimed at identifying and describing determinants associated with avoidable perinatal deaths at a district hospital in Lesotho and strategies to curb their occurrence.

Method:  A retrospective descriptive study was conducted using 142 anonymised obstetric records from January 2018 to December 2020. A data collection tool was adopted from the Perinatal Problem Identification Programme. In this tool, avoidable determinants are referred to as 'factors' or 'problems'.

Results:  A concerning number of perinatal deaths were secondary to avoidable patient factors, namely a delay in seeking medical care, inappropriate responses to antepartum haemorrhage, and inadequate responses to poor foetal movements. Medical personnel factors are also worth observing, namely incorrect use of partograph, insufficient notes to comment on avoidable factors and 'other' medical personnel problems. Ranking highest among administrative problems were the unavailability of intensive care unit beds and ventilators and inadequate resuscitation equipment. Administrative problems accounted for more perinatal deaths than the patient-related factors and medical personnel factors.

Conclusion:  There is an urgent need for periodic audits, health education for patients, staff competency and the necessary equipment to resuscitate neonates.Contribution: Avoidable determinants associated with perinatal deaths in a district hospital in Lesotho could be identified. This information provides an understanding of what can be done to limit avoidable perinatal deaths.