Search

Aims and objectives: This study investigated the challenges of cross‐cultural communication among internationally qualified nurses, and the impact on nurse‐to‐nurse and nurse‐to‐patient relationships. Background: Open and authentic communication between nurses and patients is required as a foundation of patient‐centred practice; however, this may be a challenge in cross‐cultural settings. Design: An exploratory qualitative study with an inductive approach. Methods: Semi‐structured, face‐to‐face interviews explored the influences on communication and practice of 21 internationally qualified nurses practising in the United Arab Emirates. Manual and software‐driven processes guided coding and analysis of data. Caring theory guided the analysis of themes; while COREQ criteria guided research conduct and reporting. Results: Four key themes emerged; (a) Challenges in communication, (b) The science versus art of nursing; (c) The impact of ineffective communication and (d) Strategies for coping. Eleven sub‐themes are reported within these themes. Overall, nurses felt they had sufficient language and nursing skills to undertake the technical or scientific aspects of their work; however, they reported experiencing restricted ability to participate in complex cross‐cultural conversations, such as providing explanations and reassurance about treatment options or discussing end of life and treatment decisions. This limitation diminished the nurses' ability to engage in the art of nursing and left them unable to employ themselves therapeutically to attain a sense of true presence with patients and their families. Conclusion: This article highlights the need for language and communication support, and Arabic‐speaking advocates as partners in care for expatriate nurses. Relevance to practice: Internationally qualified nurses in this Middle Eastern setting lack cultural orientation and language skills to fully enact the art and true presence of nursing. Findings indicate that health service employers need to increase the employment of Arabic‐speaking nurses and provide additional language for other expatriate nurses. [ABSTRACT FROM AUTHOR]

Sound alignment of stakeholders' expectations and graduate ability forms the reputational hallmark of a university's education programmes. However, little is currently known about stakeholders' expectations of graduates of work-study nursing upskilling programmes in low- and middle-income settings. Information is needed to ensure the quality and adequacy of curricula in such settings. The main aim of the current study was to explore the nursing stakeholders' expectations of graduates of work-study nursing upskilling programmes. An exploratory qualitative study was conducted between March and October 2016 in three low- and middle-income countries in East Africa. Forty-two representatives of nursing employers, regulators and professional associations (PAs) participated. The data was collected during 27 key informant interviews (KIIs) and three focus group discussions (FGDs) using a pretested interview guide. Content analysis of the data was completed. Consolidated criteria for reporting of qualitative research guidelines were used as the standard for collecting data and reporting results. Stakeholders reported their expectations of a clinically and professionally competent nurse (an "all-round" graduate) with nursing management and leadership skills that facilitated sound clinical judgement and decision making and a high level of professionalism. The study highlighted nursing stakeholders' expectations of nursing graduates who had completed a work-study upskilling programme. These expectations should inform curriculum planning and development, and highlight the need for a strong focus on clinical competence, leadership, critical thinking and professionalism in nursing upskilling programmes. [ABSTRACT FROM AUTHOR]

Background Improved hospital care is needed to reduce newborn mortality in low/middle-income countries (LMIC). Nurses are essential to the delivery of safe and effective care, but nurse shortages and high patient workloads may result in missed care. We aimed to examine nursing care delivered to sick newborns and identify missed care using direct observational methods. Methods A cross-sectional study using direct-observational methods for 216 newborns admitted in six health facilities in Nairobi, Kenya, was used to determine which tasks were completed. We report the frequency of tasks done and develop a nursing care index (NCI), an unweighted summary score of nursing tasks done for each baby, to explore how task completion is related to organisational and newborn characteristics. Results: Nursing tasks most commonly completed were handing over between shifts (97%), checking and where necessary changing diapers (96%). Tasks with lowest completion rates included nursing review of newborns (38%) and assessment of babies on phototherapy (15%). Overall the mean NCI was 60% (95% CI 58% to 62%), at least 80% of tasks were completed for only 14% of babies. Private sector facilities had a median ratio of babies to nurses of 3, with a maximum of 7 babies per nurse. In the public sector, the median ratio was 19 babies and a maximum exceeding 25 babies per nurse. In exploratory multivariable analyses, ratios of ≥12 babies per nurse were associated with a 24-point reduction in the mean NCI compared with ratios of ≤3 babies per nurse. Conclusion: A significant proportion of nursing care is missed with potentially serious effects on patient safety and outcomes in this LMIC setting. Given that nurses caring for fewer babies on average performed more of the expected tasks, addressing nursing is key to ensuring delivery of essential aspects of care as part of improving quality and safety. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate the 15‐year impact of the work/study nursing upgrading programme in East Africa. Background: Working nurses in Africa are often primary family income earners, with limited ability to leave jobs and upgrade qualifications. In 2001, the university established a work/study upgrade programme for enrolled‐ and diploma‐level nurses, allowing them to upgrade their qualifications while continuing to work and support families. Donor partnerships provided scholarships to further increase programme access. Design: A mixed‐method design was used involving an online alumni survey and 24 interviews and 23 focus groups with 172 purposively selected representatives of nursing graduates, employers, regulatory bodies, professional associations and senior nursing officials. Method: Quantitative data were analysed using frequencies and percentages. Inductive thematic analysis was used for qualitative data. Equator guidelines informed reporting of both qualitative and quantitative results. Results: Of the 549 graduates who completed the survey, 81.2% (n = 446) were female, 93.1% were currently employed and 98% worked within East Africa. They reported improved professional competence (69.4%), nursing practice (25.9%) and patient outcomes (4.6%) on graduation. Extracted themes included the following: flexible/accessible programme; friendly learning environment; effective teaching and learning strategies; acquisition of nursing knowledge, skills and competencies; stakeholders' role in the programme; career/professional advancement; and strengthened health systems. Conclusion: The work/study programme was an effective nursing workforce capacity development strategy. Programme access was strengthened via the supporting donor partnership. Positive outcomes were achieved with respect to the university's values of quality, access, relevance and impact. Relevance to clinical practice: Long‐term sustainable development of nurses and midwives is fundamental to achieving sustainable development goals. Work/study programmes and private–public partnerships are effective mechanisms to strengthen the development of nursing and the overall healthcare workforce in low‐resource settings. [ABSTRACT FROM AUTHOR]