Other Titles
Interventions to Improve Nurse Outcomes in Public and Private Hospitals in South Africa: A Multiple-Case Study [Title Slide]
Abstract
Background: South African nurses face ongoing challenges, including escalating healthcare needs of a growing population, staff and resource shortages, and deteriorating infrastructure, all of which negatively affect their health and wellbeing, relationship with work, productivity and effectiveness and satisfaction with work (South Africa, 2024). Although numerous studies explore interventions to improve these nurse outcomes (Niskala et al., 2020; Ramachandran et al., 2023; Xu et al., 2020), few address the realities of developing countries such as South Africa.
Methods: An exploratory multiple-case study design was employed (Yin, 2014). Secondary data from a national hospital database (n = 143) were analysed to identify the five hospitals with the most favourable nurse outcomes, which were then included in this study. The sample comprised two private hospitals and three public hospitals representing each level of care—central, provincial, and district. Focus group discussions (n=27) were conducted with nurse managers, professional nurses, enrolled nurses, and enrolled nursing auxiliaries using the appreciative inquiry approach and analysed using content analysis.
Results: The main interventions include staff dynamics and teamwork, staff wellness programs, appreciation and recognition systems, professional development opportunities, supportive leadership, and staffing and resource allocation.
Conclusion: To ensure successful implementation, interventions should be strategically designed to operate across individual, organisation, and system levels, and integrated in practice, education, and policy. In the South African context, these findings underscore the importance of targeted initiatives that prioritise communication and transparency, employee support and structured wellness programmes, professional development opportunities in the form of in-service training and mentorship and guidance, supportive leadership, informal and structured initiatives for appreciation and recognition and adequate staffing and resources.
Notes
References:
Niskala, J., Kanste, O., Tomietto, M., Miettunen, J., Tuomikoski, A.M., Kyngäs, H. et al. (2020) ‘Interventions to improve nurses’ job satisfaction: A systematic review and meta-analysis’, Journal of Advanced Nursing, 76(7), pp. 1498–1508.
Ramachandran, H.J., Bin Mahmud, M.S., Rajendran, P., Jiang, Y., Cheng, L. and Wang, W. (2023) ‘Effectiveness of mindfulness-based interventions on psychological well-being, burnout and post-traumatic stress disorder among nurses: A systematic review and meta-analysis’, Journal of Clinical Nursing, 32(11–12), pp. 2323–2338.
South Africa (2024) 2nd Presidential Health Compact 2024–2029: Accelerating Health System Strengthening and National Health Insurance (NHI) Implementation. Available at: https://www.health.gov.za/wp-content/uploads/2024/08/Second-Presidential-Health-Compact-2024-2029.pdf (Accessed: 13 November 2025).
Xu, H.G., Kynoch, K., Tuckett, A. and Eley, R. (2020) ‘Effectiveness of interventions to reduce emergency department staff occupational stress and/or burnout: a systematic review’, JBI Evidence Synthesis, 18(6), pp. 1156–1188.
Yin, R.K. (2014) Case Study Research: Design and Methods. 5th edn. Thousand Oaks, CA: Sage Publications.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Case Study/Series
Research Approach
Pilot/Exploratory Study
Keywords:
Workforce, Stress and Coping, Global Leadership, Work Environment, Nursing Role, Nursing Role--South Africa, South Africa
Recommended Citation
Tau, Babalwa; Coetzee, Siedine Knobloch; and Scheepers, Nicholin, "Interventions to Improve Nurse Outcomes in South African Private and Public Hospitals: A Case Study" (2026). International Nursing Research Congress (INRC). 129.
https://www.sigmarepository.org/inrc/2026/presentations_2026/129
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-05
Interventions to Improve Nurse Outcomes in South African Private and Public Hospitals: A Case Study
Toronto, Ontario, Canada
Background: South African nurses face ongoing challenges, including escalating healthcare needs of a growing population, staff and resource shortages, and deteriorating infrastructure, all of which negatively affect their health and wellbeing, relationship with work, productivity and effectiveness and satisfaction with work (South Africa, 2024). Although numerous studies explore interventions to improve these nurse outcomes (Niskala et al., 2020; Ramachandran et al., 2023; Xu et al., 2020), few address the realities of developing countries such as South Africa.
Methods: An exploratory multiple-case study design was employed (Yin, 2014). Secondary data from a national hospital database (n = 143) were analysed to identify the five hospitals with the most favourable nurse outcomes, which were then included in this study. The sample comprised two private hospitals and three public hospitals representing each level of care—central, provincial, and district. Focus group discussions (n=27) were conducted with nurse managers, professional nurses, enrolled nurses, and enrolled nursing auxiliaries using the appreciative inquiry approach and analysed using content analysis.
Results: The main interventions include staff dynamics and teamwork, staff wellness programs, appreciation and recognition systems, professional development opportunities, supportive leadership, and staffing and resource allocation.
Conclusion: To ensure successful implementation, interventions should be strategically designed to operate across individual, organisation, and system levels, and integrated in practice, education, and policy. In the South African context, these findings underscore the importance of targeted initiatives that prioritise communication and transparency, employee support and structured wellness programmes, professional development opportunities in the form of in-service training and mentorship and guidance, supportive leadership, informal and structured initiatives for appreciation and recognition and adequate staffing and resources.
Description
South African nurses face persistent challenges, affecting nurse outcomes. This exploratory multiple-case study identified interventions from private and public hospitals with the most favourable nurse outcomes. Key factors included staff dynamics and teamwork, staff wellness programs, appreciation and recognition, professional development opportunities, supportive leadership, and staffing and resource allocation.