27 research outputs found
Comparison of nurses' and families' perception of family needs in intensive care unit at a tertiary public sector hospital
No full textMSc (Nursing), Faculty of Health Sciences, University of the WitwatersrandThe purpose of this study was to elicit and compare nurses’ and families’ perception of
family needs in intensive care unit. A quantitative non-experimental, comparative and
descriptive research design was used to achieve research objectives. Participants (nurses,
n= 65; family members, n= 61) were drawn from three intensive care units. Data were
collected using a questionnaire developed from the Critical Care Family Needs Inventory
(CCFNI). Descriptive and inferential statistics were used to analyze the data.
Majority (more than 50%) of both groups agreed with 42 out of 45 family need statements.
All the nurses (100%, n=65) agreed with the need ‘to have explanations that are
understandable’ while most family members (98%, n=58) agreed with the need ‘to feel that
health care professionals care about the patient’. Seven out of ten statements agreed by
majority of both groups were similar. Most of these statements were related to assurance
and information need categories. In addition, both groups scored high on the two
categories, assurance and information. However, family members scored higher than
nurses in two categories, assurance and proximity with statistically significant difference
(p-value < 0.05).
Based on the research findings, it can therefore be concluded that generally there were
similarities between nurses’ and families’ perception of family needs. These findings
support evidence in literature resulting from previous studies
Development, Implementation and Evaluation of an In-Service Training Programme for Critical Care Nurses in Malawi
No full textBackground: Critical care nursing is a specialty which deals with the care of critically ill patients with potential or actual life-threatening illness. The critical illness of the patients and the extensive use of technology to monitor and treat patients, create a complex environment in the critical care units that demands critical care nurses possess specialist knowledge and skills to make the complex decisions needed to care for critically ill patients and their families. Compared to developed countries, where significant resources are invested in critical care environments and specialised training of health professionals, the situation differs in developing countries like Malawi. In the developing countries there are critical shortages of resources and health professionals with critical care training. There are no critical care nurse training programmes in most developing countries as is the case in Malawi. This is against the background of high burden of communicable and noncommunicable diseases which increase the demand for critical care services in the developing countries. In the absence of proper training, the nurses rely on their intuition and basic nursing education to meet the needs of the critically ill patients and their families. This PhD study is premised on documented evidence that critical care nurses in Malawi lack the knowledge and skills required for their practice in the critical care units. The study aimed to explore learning needs of the critical care nurses as a way of informing the development and evaluation of in-service training for the nurses in Malawi.
Methodology: A programme planning and evaluation approach using multiphase mixed methods design was applied. The study was conducted at two public tertiary hospitals which were purposively selected. The implementation of the quantitative and qualitative strands in two of the three phases of the study followed the principles of explanatory sequential mixed methods. The phases of the study were informed by Caffarella’s Interactive Model of Programme Planning as follows: Phase 1: needs assessment. Nurses (n=79) in intensive care units (ICUs) and high dependency units (HDUs) self-assessed their competence on the Intensive and Critical Care Nursing Competence Scale (ICCN-CS-1) and a list of 10 additional competencies. An interpretive descriptive design was used in the follow up qualitative strand. Data were gathered through two focus group discussions with the nurses, and key informant interviews with nurse leaders (n=8) and anaesthetists (n=2) on learning needs of the nurses. Phase 2: Development of the training programme. A training programme was developed in consultation with Malawian experts in intensive and critical care nursing (n=4) and one anaesthetist. Phase 3: Implementation and evaluation of the programme. The training programme was delivered to ICU and HDU nurses (n=41) over three days at each hospital. The impact of the training was evaluated through self-assessment on ICCN-CS-1 and the additional competencies at Time 1 and 2, pretraining and post training respectively; and completion of a training evaluation form and interviews with participants (n=8) at Time 2. Quantitative data were analysed using SPSS version 23. Qualitative data were entered into NVivo programme. The data were then analysed manually utilising Thorne’s (2008) steps of analysis.
Results: In Phase 1, nurses rated their competence on ICCN-CS-1 as good and excellent (M = 604.97, SD = 55.08). Majority of the nurses rated their competence as poor or moderate on two additional competencies; basic interpretation of electrocardiogram (83.5%; n=66) and analysis of arterial blood gases (83.5%; n=66). Most of the identified learning needs were related to knowledge domain of nursing competence. Analysis of the qualitative data identified three themes, ‘being unprepared’, ‘challenge of limited resources’ and ‘knowing’. Phase 2: A training programme was developed based on the identified learning needs. Phase 3: There was statistically significant increase in the competence score on ICCN-CS-1 from Time 1, pretraining (M = 608.2, SD = 59.6) to Time 2, posttraining (M = 684.7, SD = 29.7), t(40) = 8.8, p <.001 (two-tailed). The mean increase in the competence score was 76.9, 95% CI [59.3, 94.5]. Similarly, there was a statistically significant increase in the overall score on additional competencies from Time 1 to Time 2, p <.001 (two-tailed). The mean increase in the competence score was 11.9, 95% CI [10.1, 13.8]. The overall programme was rated very relevant by 85.4% (n=35) of the participants. Post training interviews showed that the training was well received by the participants.
Conclusion: Nurses self-rated their competence on ICCN-CS-1 as good and excellent but the majority rated knowledge and skills on additional competencies as poor in Phase 1 of the study. The results of the subsequent qualitative strand in the same phase revealed that CCU nurses are not adequately prepared for practice in the units. The identified learning needs guided the development of a training programme which was implemented at the two hospitals. The competence scores of the nurses who received the training significantly increased at the end of the training. The study addressed the need for a training programme for CCU nurses, which was implemented using existing structures and resources in Malawi. Recommendations have been made in relation to critical care nursing education, practice, health policy, regulatory body and nursing research
Development, Implementation and Evaluation of an In-service Training Programme for Critical Care Nurses in Malawi
No full textBackground: Critical care nursing is a specialty which deals with the care of critically ill patients with potential or actual life-threatening illness. The critical illness of the patients and the extensive use of technology to monitor and treat patients, create a complex environment in the critical care units that demands critical care nurses possess specialist knowledge and skills to make the complex decisions needed to care for critically ill patients and their families. Compared to developed countries, where significant resources are invested in critical care environments and specialised training of health professionals, the situation differs in developing countries like Malawi. In the developing countries there are critical shortages of resources and health professionals with critical care training. There are no critical care nurse training programmes in most developing countries as is the case in Malawi. This is against the background of high burden of communicable and noncommunicable diseases which increase the demand for critical care services in the developing countries. In the absence of proper training, the nurses rely on their intuition and basic nursing education to meet the needs of the critically ill patients and their families. This PhD study is premised on documented evidence that critical care nurses in Malawi lack the knowledge and skills required for their practice in the critical care units. The study aimed to explore learning needs of the critical care nurses as a way of informing the development and evaluation of in-service training for the nurses in Malawi.
Methodology: A programme planning and evaluation approach using multiphase mixed methods design was applied. The study was conducted at two public tertiary hospitals which were purposively selected. The implementation of the quantitative and qualitative strands in two of the three phases of the study followed the principles of explanatory sequential mixed methods. The phases of the study were informed by Caffarella’s Interactive Model of Programme Planning as follows: Phase 1: needs assessment. Nurses (n=79) in intensive care units (ICUs) and high dependency units (HDUs) self-assessed their competence on the Intensive and Critical Care Nursing Competence Scale (ICCN-CS-1) and a list of 10 additional competencies. An interpretive descriptive design was used in the follow up qualitative strand. Data were gathered through two focus group discussions with the nurses, and key informant interviews with nurse leaders (n=8) and anaesthetists (n=2) on learning needs of the nurses. Phase 2: Development of the training programme. A training programme was developed in consultation with Malawian experts in intensive and critical care nursing (n=4) and one anaesthetist. Phase 3: Implementation and evaluation of the programme. The training programme was delivered to ICU and HDU nurses (n=41) over three days at each hospital. The impact of the training was evaluated through self-assessment on ICCN-CS-1 and the additional competencies at Time 1 and 2, pretraining and post training respectively; and completion of a training evaluation form and interviews with participants (n=8) at Time 2. Quantitative data were analysed using SPSS version 23. Qualitative data were entered into NVivo programme. The data were then analysed manually utilising Thorne’s (2008) steps of analysis.
Results: In Phase 1, nurses rated their competence on ICCN-CS-1 as good and excellent (M = 604.97, SD = 55.08). Majority of the nurses rated their competence as poor or moderate on two additional competencies; basic interpretation of electrocardiogram (83.5%; n=66) and analysis of arterial blood gases (83.5%; n=66). Most of the identified learning needs were related to knowledge domain of nursing competence. Analysis of the qualitative data identified three themes, ‘being unprepared’, ‘challenge of limited resources’ and ‘knowing’. Phase 2: A training programme was developed based on the identified learning needs. Phase 3: There was statistically significant increase in the competence score on ICCN-CS-1 from Time 1, pretraining (M = 608.2, SD = 59.6) to Time 2, posttraining (M = 684.7, SD = 29.7), t(40) = 8.8, p <.001 (two-tailed). The mean increase in the competence score was 76.9, 95% CI [59.3, 94.5]. Similarly, there was a statistically significant increase in the overall score on additional competencies from Time 1 to Time 2, p <.001 (two-tailed). The mean increase in the competence score was 11.9, 95% CI [10.1, 13.8]. The overall programme was rated very relevant by 85.4% (n=35) of the participants. Post training interviews showed that the training was well received by the participants.
Conclusion: Nurses self-rated their competence on ICCN-CS-1 as good and excellent but the majority rated knowledge and skills on additional competencies as poor in Phase 1 of the study. The results of the subsequent qualitative strand in the same phase revealed that CCU nurses are not adequately prepared for practice in the units. The identified learning needs guided the development of a training programme which was implemented at the two hospitals. The competence scores of the nurses who received the training significantly increased at the end of the training. The study addressed the need for a training programme for CCU nurses, which was implemented using existing structures and resources in Malawi. Recommendations have been made in relation to critical care nursing education, practice, health policy, regulatory body and nursing research
Contextual issues that influence preparedness of nurses for critical care nursing practice in Malawi
No full textBackgroundThere are no critical care nurse training programs in Malawi despite the high burden of diseases which culminate in critical illness. This paper presents contextual issues that influence preparedness of nurses for critical care nursing practice in Malawi. The qualitative findings presented are part of a larger mixed methods study which explored learning needs of critical care nurses as a way of informing the development of a training program for the critical care nurses in Malawi.Methods Interpretive descriptive design was used. Data were gathered through 10 key informant interviews with nurse leaders (n=8) and anaesthetists (n=2); and two focus group discussions with registered nurses and nurse midwife technicians working in intensive care and adult high dependency units at two tertiary hospitals. Transcribed data were analyzed manually and through the use of NVivo data management software utilizing Thorne’s steps of analysis1.ResultsBeing unprepared to work in intensive care and high dependency units was a dominant theme. Factors that contributed to this sense of unpreparedness were lack of educational preparation, organisational factors and workforce issues. The consequences of nurses’ perceptions of being unprepared were fearfulness, a change of nurses’ attitudes and elevation of risk to patients. The nurses managed unpreparedness by relying on other health professionals and learning on the job. ConclusionThe findings illuminated contextual issues to be considered when developing programs for upskilling nurses in hospitals within Malawi and contributes to the developing body of knowledge related to nursing education and practice development within developing countries.
Collaborative design of a health research training programme for nurses and midwives in Tshwane district, South Africa : a study protocol
No full textSUPPORTING INFORMATION: This content has been supplied by the author(s). It has
not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been
peer-reviewed. Any opinions or recommendations discussed are solely those
of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and
responsibility arising from any reliance placed on the content. Where the content
includes any translated material, BMJ does not warrant the accuracy and reliability
of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error
and/or omissions arising from translation and adaptation or otherwise.INTRODUCTION: Nurses are essential for implementing
evidence-based practices to improve patient outcomes.
Unfortunately, nurses lack knowledge about research and
do not always understand research terminology. This study
aims to develop an in-service training programme for
health research for nurses and midwives in the Tshwane
district of South Africa.
METHODS AND ANALYSIS: This protocol outlines a codesign
study guided by the five stages of design thinking
proposed by the Hasso-Plattner Institute of Design at
Stanford University. The participants will include nurses
and midwives at two hospitals in the Tshwane district,
Gauteng Province. The five stages will be implemented in
three phases: Phase 1: Stage 1—empathise and Stage
2—define. Exploratory sequential mixed methods including
focus group discussions with nurses and midwives (n=40),
face-to-face interviews (n=6), and surveys (n=330), will
be used in this phase. Phase 2: Stage 3—ideate and Stage
4—prototype. A team of research experts (n=5), nurses
and midwives (n=20) will develop the training programme
based on the identified learning needs. Phase 3: Stage 5—
test. The programme will be delivered to clinical nurses
and midwives (n=41). The training programme will be
evaluated through pretraining and post-training surveys
and face-to-face interviews (n=4) following training. SPSS
V.29 will be used for quantitative analysis, and content
analysis will be used to analyse qualitative data.
ETHICS AND DISSEMINATION: The protocol was approved by
the Faculty of Health Sciences Research Ethics Committee
of the University of Pretoria (reference number 123/2023).
The protocol is also registered with the National Health
Research Database in South Africa (reference number
GP_202305_032). The study findings will be disseminated
through conference presentations and publications in
peer-reviewed journals.https://bmjopen.bmj.com/Nursing ScienceSDG-03:Good heatlh and well-beingSDG-04:Quality Educatio
Collaborative design of a health research training programme for nurses and midwives in Tshwane district, South Africa: a study protocol
No full textIntroduction Nurses are essential for implementing evidence-based practices to improve patient outcomes. Unfortunately, nurses lack knowledge about research and do not always understand research terminology. This study aims to develop an in-service training programme for health research for nurses and midwives in the Tshwane district of South Africa.Methods and analysis This protocol outlines a codesign study guided by the five stages of design thinking proposed by the Hasso-Plattner Institute of Design at Stanford University. The participants will include nurses and midwives at two hospitals in the Tshwane district, Gauteng Province. The five stages will be implemented in three phases: Phase 1: Stage 1—empathise and Stage 2—define. Exploratory sequential mixed methods including focus group discussions with nurses and midwives (n=40), face-to-face interviews (n=6), and surveys (n=330), will be used in this phase. Phase 2: Stage 3—ideate and Stage 4—prototype. A team of research experts (n=5), nurses and midwives (n=20) will develop the training programme based on the identified learning needs. Phase 3: Stage 5—test. The programme will be delivered to clinical nurses and midwives (n=41). The training programme will be evaluated through pretraining and post-training surveys and face-to-face interviews (n=4) following training. SPSS V.29 will be used for quantitative analysis, and content analysis will be used to analyse qualitative data.Ethics and dissemination The protocol was approved by the Faculty of Health Sciences Research Ethics Committee of the University of Pretoria (reference number 123/2023). The protocol is also registered with the National Health Research Database in South Africa (reference number GP_202305_032). The study findings will be disseminated through conference presentations and publications in peer-reviewed journals
Midwives’ competence in interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng: An explanatory sequential mixed-methods study
No full textBackground: Cardiotocograph (CTG) tracing is a routine intrapartum care procedure for women who have been diagnosed with high-risk pregnancy. The aim of the CTG is to identify fetuses that are at risk in order to expedite delivery. Purpose: To asssess midwives’ competence in the interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng. Methods: An explanatory sequential mixed-methods approach was used. During phase one, 122 midwives in Johannesburg and Tshwane District filled in self-administered questionnaires, and during phase two, 30 midwives took part in semi-structured qualitative interviews. The data from both phases was analyzed separately and then integrated using the Pillar Integration Process. Results: The Pillar Integration Process led to the identification of six pillars: 1) substandard CTG interpretation training leads to a lack of understanding of key concepts; 2) absence of norms and standards pertaining to CTG interpretation training; 3) Essential Steps in Managing Obstetric Emergencies (ESMOE) training does not result in improved CTG interpretation scores; 4) lack of standardization of CTG interpretation guidelines causes confusion among interpreters; 5) level of knowledge of foundational concepts of CTG interpretation affects clinical judgment; and 6) CTG interpretation skill is a combination of understanding of CTG characteristics, fetal heart rate pattern, fetal physiology and clinical context. Conclusion: The results highlighted a knowledge deficit in CTG interpretation and shortfalls in the current CTG training programs. This can be remediated by the development of a CTG training program which is benchmarked with existing programs which have demonstrated good knowledge scores of participants over a long period
The effect of coronavirus disease 2019 vaccination on pregnant women : a scoping review
No full textDATA AVAILABITY STATEMENT: The data that support the findings of this study are
available from the corresponding author, M.M.M. upon
reasonable request.BACKGROUND: Globally, reports have shown that pregnant women refuse to receive the
coronavirus disease 2019 (COVID-19) vaccine. This has posed a significant concern given the
global impact of the COVID-19 pandemic.
AIM: This study aims to explore the current evidence on the effect of COVID-19 vaccination on
pregnant women.
METHOD: A scoping review was conducted using Levac et al.’s five-stage framework.
Relevant articles were searched in the Web of Science, PubMed, Scopus and EBSCOhost
(CINAHL) databases. The identified articles were screened based on predetermined
inclusion and exclusion criteria. Data from the selected articles were charted and summarised
into meaningful units.
RESULTS: Twelve articles from developed countries were included in the review. Studies have
reported that COVID-19 vaccination during pregnancy is generally safe and does not increase
the risk of pregnancy complications. There was no significant difference in delivery outcomes
between vaccinated and unvaccinated women. Neonatal outcomes were not affected by the
vaccination. However, one study identified a potential risk of spontaneous abortion between
6 and 9 weeks of gestation among vaccinated women.
CONCLUSION: Coronavirus disease 2019 vaccination is considered safe during pregnancy. While
some studies have identified potential associations with certain conditions, the overall benefits
of vaccination outweigh the risks. Continued monitoring of the safety and effectiveness of
COVID-19 vaccines during pregnancy is recommended. Pregnant women should consult
healthcare providers to make informed decisions regarding vaccination.
CONTRIBUTION: The findings of this review may assist in alleviating anxiety and reducing
vaccine hesitancy among pregnant women.The National Research Foundation.https://hsag.co.za/index.php/hsagNursing ScienceSDG-03:Good heatlh and well-bein
Effect of an educational programme on critical care nurses’ competence at two tertiary hospitals in Malawi
No full textBackgroundCritical care specialty deals with the complex needs of critically ill patients. Nurses who provide critical care are expected to possess the appropriate knowledge and skills required for the care of critically ill patients. The aim of this study was to assess the effect of an educational programme on the competence of critical care nurses at two tertiary hospitals in Lilongwe and Blantyre, Malawi.MethodsA quantitative pre- and post-test design was applied. The training programme was delivered to nurses (n = 41) who worked in intensive care and adult high dependency units at two tertiary hospitals. The effect of the training was assessed through participants’ self-assessment of competence on the Intensive and Critical Care Nursing Competence Scale and a list of 10 additional competencies before and after the training.ResultsThe participants’ scores on the Intensive and Critical Care Nursing Competence Scale before the training, M = 608.2, SD = 59.6 increased significantly after the training, M = 684.7, SD = 29.7, p <.0001 (two-tailed). Similarly, there was a significant increase in the participants’ scores on the additional competencies after the training, p <.0001 (two-tailed). ConclusionThe programme could be used for upskilling nurses in critical care settings in Malawi and other developing countries with a similar context
Additional file 1 of Family members’ perception of their needs in critical care units at a tertiary hospital in Malawi: A qualitative study
No full textSupplementary Material
