Search

Copyright of BMC Nursing is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Nurses' involvement in health policy development ensures that health services are: safe, effective, available and inexpensive. Nursing history reveals several legendary nurse leaders who have influenced policy and the course of nursing and health care. In the recent times there have been concerns regarding the availability of effective leaders physically, symbolically and functionally at clinical, organizational and national levels, who can effectively influence health policy. Exerting influence in the policy arena requires that nurse leaders acquire attributes that enable them to be effective in policy development activity. This paper reports part of a larger study whose purpose included: “build consensus on leadership attributes necessary for nurse leaders' participation in health policy development in East Africa”. Method: A Delphi survey was utilized and included the following criteria: expert panelists, three iterative rounds, qualitative and quantitative analysis, and building consensus. The study included purposively selected sample of national nurse leaders (expert panelists) from the three East African countries of Kenya, Tanzania and Uganda. The study was conducted in three iterative rounds. Seventy eight (78) expert panelists were invited to participate in the study and 37 (47%) participated in the first round of these; 24 (64.8%) participated in the second round and all invited in the third round 24 (100%) participated. Data collection was done using questionnaires and collected qualitative and quantitative data. Data analysis was done utilizing the principles of qualitative analysis in the first round and descriptive statistics in the second and third rounds. Results: The study achieved consensus on the essential leadership attributes for nurse leaders' participation in health policy and include being able to: influence; communicate effectively; build relationships; feel empowered and demonstrate professional credibility. Conclusions: For nursing to participate in influencing the health policy and the health of the population, it will need to develop nurses with leadership attributes who are able to inspire change and influence the policy development process within the context where it exists. The leadership attributes identified in this study can be utilized to develop programmes geared to support nurses' participation in health policy activity. [ABSTRACT FROM AUTHOR]

Background: Research shows that poor provider–client interactions in maternity and child health (MCH) continue to affect health outcomes, service uptake, continuity of care, and trust in formal healthcare systems. Objective: The study's objective was to jointly create a prototype intervention package for enhancing nurse-client relationships using human centered design (HCD) approach. Methods: A five-step HCD methodology was used: (1) Community-driven discovery through qualitative descriptive research methods using 9 focus groups with nurses and clients and 12 key informant interviews with MCH administrators; (2) consultative ideation and co-creation meetings with 10 nurses, 10 clients, and 10 administrators to co-design a rough prototype model; (3) rough prototype validation through qualitative insight gathering using 6 FGDs with nurses and clients; (4) refinement and adaptation meetings with 14 nurses, 14 clients and 12 administrators; and (5) documentation and sharing of lessons learnt. Results: According to the community-driven research, poor service, a lack of concern, poor communication, a bad attitude, and unhappiness at work are the nurse factors that affect the relationships between nurses and their patients. Non-compliance with procedures, unfavorable attitudes, poor communication, low education, poverty, and faith in conventional healers were among the client-related factors. Inadequate funding, bad management techniques, improper policy execution, and a lack of an independent institution for handling complaints are the health system factors that affect nurse-client relationships. In response, three ideation and co-creating meetings resulted in 24 interventions. Seven (7) of these were rated as more acceptable and feasible in the local context and formed a rough prototype. During validation, there were some disagreements on the feasibility of curriculum and resource-related interventions. Refinement meetings resulted in a final prototype including four interventions: (i) promotion of patient-centred care; (ii) awards and recognition for nurses; (iii) strengthening complaints mechanisms and (iv) disciplinary measures for abusive nurses and clients. The lessons learnt have been shared through publications and institutional research meetings. Conclusions: HCD approach provides a novel entry point for providers and clients to examine the problems and design interventions for strengthening their therapeutic relationships in MCH care. Researchers, practitioners, and policy developers are welcome to consider the emerging prototype as it was deemed acceptable and potentially feasible in rural African contexts. [ABSTRACT FROM AUTHOR]

Background Many blinding eye conditions of childhood are preventable or treatable, particularly in developing countries. However, primary eye care (PEC) for children is poorly developed, leading to unnecessary visual loss. Activities for control by health workers entail interventions for systemic conditions (measles, vitamin A deficiency), identification and referral of children with sight threatening conditions and health education for caregivers. This pilot study evaluated integrating a package of activities to promote child eye health into Reproductive and Child Health (RCH) services in Dar-es-Salaam, Tanzania. Methods Design: historical comparison study. Fifteen Clinical Officers and 15 nurses in 15 randomly selected RCH clinics were trained in PEC for children in July 2010. They were given educational materials (poster and manual) and their supervisors were orientated. Knowledge and practices were assessed before and 3 weeks after training. One year later their knowledge and practices were compared with a different group of 15 Clinical Officers and 15 nurses who had not been trained. Results Before training staff had insufficient knowledge to identify, treat and refer children with eye diseases, even conjunctivitis. Some recommended harmful practices or did not know that cataract requires urgent referral. Eye examination, vitamin A supplementation of mothers after delivery and cleaning the eyes at birth with instillation of antibiotics (Crede's prophylaxis) were not routine, and there were no eye-specific educational materials. Three weeks after training several clinics delivering babies started Crede's prophylaxis, vitamin A supplementation of women after delivery increased from 83.7% to 100%, and all staff included eye conditions in health education sessions. At one year, trained staff were more likely to correctly describe, diagnose and treat conjunctivitis (z=2.34, p=0.04)(30%-vs- 60.7%). Mystery mothers observed health education sessions in 7/10 RCH clinics with trained staff, five (71.4%) of which included eye conditions. Conclusions Primary eye care for children in Dar-es-Salaam is inadequate but training RCH staff can improve knowledge in the short term and change practices. Attendance by mothers and their children is high in RCH clinics, making them ideal for delivery of PEC. Ongoing supportive supervision is required to maintain knowledge and practices, as well as systems to track referrals. [ABSTRACT FROM AUTHOR]

Background: Parents have significant responsibility in the care of their critically ill children who have been admitted to the intensive care unit (ICU). When staying with their children in the hospital, they also have particular needs that should be adequately acknowledged and responded to by healthcare providers. Moreover, when their needs are not identified and addressed, parents may experience stress and anxiety as a result. This study describes the needs of parents caring for hospitalized critically ill children, as perceived by parents and nurses. Methods: This study used a descriptive qualitative research design. Five focus group discussions with nurses and parents of critically ill children, who were purposefully recruited, were conducted at the Kilimanjaro Christian Medical Centre Hospital. A qualitative content analysis guided the analysis of the data. Results: Two themes emerged from the perceptions of parents and nurses about the needs of parents caring for hospitalized critically ill children. These were: "engaging parents in the care of their children" and "receiving psychosocial support". Both parents and nurses identified the importance of providing adequate information about their children's progress, encouraging and involving parents in the care of their children and having flexible visiting time for parents was vital when caring for critically ill children. Conclusions: This study provides an in-depth understanding of parents' needs when caring for critically ill children in the hospital setting. Nurses caring for these children should understand the needs of parents and integrate the parents into the daily care of their children. Nurses should also continuously support, inform and engage parents during child-caring procedures. Finally, visiting times for intensive care units should be flexible and allow more time for parents to connect with their hospitalized children. [ABSTRACT FROM AUTHOR]