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Table 4 Explicit nursing practices and policies associated with mothers’ presence

From: Distinctive nursing practices in working with mothers to care for hospitalised children at a district hospital in KwaZulu-Natal, South Africa: a descriptive observational study

Observed practiceFormalisation through policy or resourcingExplicit rationaleInitial codeFinal main theme
The expectation that a mother/grandmother will remain with the child throughout their hospital stay is communicated to mothers on arrival at the hospital, or when they are referred from clinic.The ward admissions policy states that a mother/grandmother should remain with infants and children under the age of 10 years for the duration of their hospital stay.
The ward’s visiting policy differs from that of the rest of the hospital.
The ward’s visiting policy states that the policy is to promote unrestricted visiting to facilitate parental and family involvement.Mothers who stayEnabling continuous presence
Most mothers co-sleep with their child for the duration of their child’s hospital stay in full-sized beds, except in specific clinical situations, such as a child who is receiving orthopaedic traction.A copy of an official notice explaining the practice of co-sleeping, signed by the hospital Paediatric Medical Officer and Ward Acting Nurse Manager, is displayed on the wall.“In 2005, when I first came to work here in the hospital from school health nursing, we only had the small cot beds and mothers were sleeping on mattresses on the floor. It was chaos”. (Nurse Manager, s21)Mothers who stayPreserving the mother-child pair
The ward manager’s proposal to purchase 18 adult sized beds to enable implementation of a formal policy of co-sleeping for mothers and children was supported by hospital management.18 adult sized beds with additional child-sized beds available if specific circumstances prevent co-sleeping“They changed that because the mothers were not comfortable as well as the babies, because they didn’t sleep together with their babies. The babies were sleeping on top and the mother’s underneath, and the babies were crying, and the mothers were taking their babies on the floor”. (Nurse, S6)
“We supply the mums with big beds to sleep together with their child. ...A mother and child always sleep in the same bed.” (Nurse, s20)
Equipment and facilitiesPreserving the mother-child pair
Meals are delivered to the ward from the hospital kitchen and served to the mothers at the bedside.The hospital provides three full meals a day for mothers and children at no charge.“They [general orderlies] bring the food from the main kitchen and dishes from here [ward kitchen] and serve the food to the mothers and children. The mothers get served breakfast, tea and bread, lunch and supper. There is a menu for every day, they get fish fingers, eggs, porridge and so on.” (Nurse, s20)Equipment and facilitiesPreserving the mother-child pair