TO:        NATIONAL DEPARTMENT OF HEALTH

               PROVINCIAL DEPARTMENTS OF HEALTH

               NURSING EDUCATION INSTITUTIONS (NEIs)

               ALL STAKEHOLDERS

SUBJECT – NON-ADHERENCE TO SCOPE OF PRACTICE REGULATIONS BY NURSE PRACTITIONERS

1. PURPOSE

   • The purpose of this correspondence is to sensitize Practitioners on the importance of adherence to the Scope of Practice Regulations R.2127 promulgated on 3 June 2022.

    

   2. BACKGROUND

    

   • The South African Nursing Council is a statutory body that is empowered by the Nursing Act 2005, (Act No. 33 of 2005) to protect the public in matters involving health services in general and Nursing services in particular.
   • The Preliminary Investigation Committee (PIC) is a Committee established in terms of Section 15 of the Nursing Act 2005, (Act No. 33 of 2005) and mandated to investigate all reported cases of alleged unprofessional conduct against Practitioners who are registered in terms of the Act. This is to ensure that the provision of Nursing services complies with set standards, values and national health policies.
   • On analysis of reported cases, PIC has noted with concern perpetual non-compliance by Practitioners to legislation and regulatory frameworks, specifically the Scope of Practice Regulations, resulting in bad outcomes for end-users.
   • The Scope of Practice Regulations R.2127 were promulgated by the Minister of Health,

   Dr J Phaahla on 3 June 2022.

    

   3. DIRECTIVE

    

   • Nurse Practitioners are urged to familiarise themselves and comply with provisions of the Scope of Practice Regulations. Failure to do so, will result in them being held personally liable for their acts and omissions.
   • Regulations are easily accessible on the SANC website, sanc.co.za

    

   The contents of this Circular must be brought to the attention of all Practitioners and Nurse Managers in health establishments.

    

   Enquiries in this regard can be directed to Dr J Muswede, Senior Manager: Professional Practice on at jmuswede@sanc.co.za or Tel: 012 420 1008.

    

    

    

   _______________________                   

   DR NJ MUSWEDE

   ACTING REGISTRAR AND CEO

   S A NURSING COUNCIL

   DATE: ____________________

Click the link below to download the Circular as a PDF

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TO:        NATIONAL DEPARTMENT OF HEALTH

               PROVINCIAL DEPARTMENTS OF HEALTH

               NURSING EDUCATION INSTITUTIONS (NEIs)

               ALL STAKEHOLDERS

SUBJECT – DIRECTIVE ON THE MANAGEMENT OF A VAGINAL BIRTH AFTER PREVIOUS CAESAREAN SECTION (VBAC)

1. PURPOSE

• To sensitize Midwives and Midwife Specialists on the importance of managing women with a history of previous caesarean section in line with approved guidelines, policies and protocols, during labour.

2. BACKGROUND

• The South African Nursing Council is the statutory body that is empowered by the Nursing Act 2005, (Act No.33 of 2005). Its object is to serve and protect the public in matters involving health services generally and Nursing services in particular.
• Council has noted with concern the increasing non-compliance to approved policies, protocols and Guidelines for Maternity Care by Midwives and Midwife Specialists in managing VBAC.
• Based on the cases reported to Council it is evident that:
• Women with previous caesarean section deliveries are frequently treated as low-risk clients.
• Maternal and foetal monitoring inconsistently done.
• Inconsistent use of the Partogram.

3. VBAC MANAGEMENT PROCEDURES

• In line with Guidelines for Maternity Care in South Africa (2016:89), women with a history of previous caesarean section presenting with labour pains MUST be managed as follows:
• Conduct labour in a hospital that can perform caesarean section on a 24-hour basis.
• Run an intravenous drip with Ringer’s lactate solution at 80-120 mL/hour and pass a urinary catheter to monitor excretion.
• Monitor with continuous Cardiotocography (CTG).
• Always use the Partogram and intervene timeously.
• Do not augment labour with oxytocin.
• Observe carefully for imminent uterine rupture signs and prepare for an emergency caesarean section immediately if rupture is suspected based on any of the following signs:
• Foetal tachycardia or foetal heart rate decelerations.
• Significant vaginal bleeding.
• Macroscopic haematuria.
• Strong abdominal pain between contractions.
• Sudden cessation of contractions.
• Indications for emergency caesarean section at attempted VBAC:
• The latent phase of labour exceeds 8 hours.
• Progress in the active phase of labour crosses to the right of the alert line

(progress <1 cm/hour).

• There are signs of imminent uterine rupture.

4. DIRECTIVE

• Midwives and Midwives Specialists are hereby instructed to adhere to approved guidelines, policies and protocols on VBAC management.

The contents of this Circular must be brought to the attention of all Practitioners and Nurse Managers in health establishments.

Enquiries in this regard can be directed to Dr J Muswede, Senior Manager: Professional Practice at jmuswede@sanc.co.za or Tel: 012 420 1008.

_______________________                   

DR NJ MUSWEDE

ACTING REGISTRAR AND CEO

S A NURSING COUNCIL

DATE: ____________________

Click the link below to download the Circular as a PDF

Download PDF