Use of Joint Commission International standards to evaluate and improve pediatric oncology nursing care in Guatemala.

BACKGROUND: Inadequate nursing care is a major impediment to development of effective programs for treatment of childhood cancer in low-income countries. When the International Outreach Program at St. Jude Children's Research Hospital established partner sites in low-income countries, few nurses had pediatric oncology skills or experience. A comprehensive nursing program was developed to promote the provision of quality nursing care, and in this manuscript we describe the program's impact on 20 selected Joint Commission International (JCI) quality standards at the National Pediatric Oncology Unit in Guatemala. We utilized JCI standards to focus the nursing evaluation and implementation of improvements. These standards were developed to assess public hospitals in low-income countries and are recognized as the gold standard of international quality evaluation. METHODS: We compared the number of JCI standards met before and after the nursing program was implemented using direct observation of nursing care; review of medical records, policies, procedures, and job descriptions; and interviews with staff. RESULTS: In 2006, only 1 of the 20 standards was met fully, 2 partially, and 17 not met. In 2009, 16 were met fully, 1 partially, and 3 not met. Several factors contributed to the improvement. The pre-program quality evaluation provided objective and credible findings and an organizational framework for implementing change. The medical, administrative, and nursing staff worked together to improve nursing standards. CONCLUSION: A systematic approach and involvement of all hospital disciplines led to significant improvement in nursing care that was reflected by fully meeting 16 of 20 standards.

A sustainable model for pediatric oncology nursing education in low-income countries.

Effectiveness of a nurse educator in the pediatric oncology unit in Guatemala was assessed by measuring completion of an education course, chemotherapy and central line competency, continuing education, and cost. All newly hired nurses completed the education course. Of the nurses employed, 86% participated in the chemotherapy course, and 93% achieved competency; 57% participated in the central line course, and 79% achieved competency. The nurses completed a mean of 26 hours continuing education yearly. The annual direct cost of the educator ($244/nurse) was markedly less than other models. This is an effective and sustainable means to educate nurses in low-income countries.

Predictors of success for Saudi Arabian students enrolled in an accelerated baccalaureate degree program in nursing in the United States.

In the mid 1980s, a professional nursing education program was initiated between the Kingdom of Saudi Arabia and the United States. Based on a perceived and documented need, a collaborative education and research program was established with George Mason University in Fairfax, Virginia, to begin building a community of new scholars to assist in the advancement of professional nursing in the Kingdom of Saudi Arabia. Four cohorts of Saudi citizens from three institutions (King Faisal Specialist Hospital and Research Center, Saudi Arabia National Guard Hospital, and Ministry of Aviation and Defense Hospital), who held a degree in science or a related field, were enrolled in an accelerated baccalaureate program leading to a bachelor of science in nursing degree. This project was funded by Saudi Arabian sources. A descriptive research study was conducted to identify predictors of success in the program. Results indicated a rate of program completion that was higher than expected. Some of the first graduates went on for a doctor of philosophy degree, but not all enrolled completed the program. Many countries around the world are seeking ways to upgrade and increase the supply of qualified nurses within their own borders. This study identified those factors that were predictors of success for Saudi Arabian students who completed a baccalaureate degree in nursing program in the United States.

The global network of WHO Collaborating Centres for nursing and midwifery development: a policy approach to health for all through nursing and midwifery excellence.

In response to the complexities of health services delivery within the context of cultures, world events, medical technologies, and natural and manmade disasters, WHO recognized the need for external resources to assist it to meet its goals. In line with WHO's policy that research in the field of health is best advanced by assisting, coordinating and utilizing the activities of existing institutions, WHO Collaborating Centres were developed to support WHO with external expertise at the local, country and international levels. Of the 1,000 Collaborating Centres worldwide representing all the major health disciplines, 36, in 19 different countries, are dedicated to nursing and midwifery services, education, research and policy. These 36 Centres have joined forces as the Global Network of WHO Collaborating Centres for Nursing and Midwifery Development. Since its inception in 1987, the Global Network has developed into a significant force in international nursing leadership. Its far-reaching sphere of influence, its communications technology and its ability to develop collaborative projects, enable it to have a significant impact on the health of the people of the world.

The global network of WHO collaborating centres for nursing and midwifery development: a policy approach to health for all through nursing and midwifery excellence

Em resposta às complexidades dos serviços de saúde em um contexto de diferentes culturas, eventos mundiais, avanços tecnológicos médicos, desastres naturais e provocados pelo homem, a Organização Mundial da Saúde reconheceu a necessidade de contar com recursos externos para auxiliá-la na consecução de suas metas. Em consonância com as políticas da OMS que consideram que a pesquisa no campo da saúde avança na medida em que auxilia, coordena e utiliza as atividades das instituições já existentes, os Centros Colaboradores da OMS foram criados para apoiá-la em suas áreas de especialidade nos níveis local, nacional e internacional. Dos 1000 Centros Colaboradores existentes em todo o mundo, representando as diversas áreas da saúde, 36, em 19 países diferentes, dedicam-se à enfermagem e obstetrícia, nas áreas de educação, pesquisa e políticas. Esses 36 Centros congregam forças através da Rede Global de Centros Colaboradores da OMS para o Desenvolvimento da Enfermagem e Obstetrícia. Desde seu surgimento, em 1987, a Rede Global tem se tornado uma força significativa de liderança internacional. Sua esfera de influência, tecnologias de comunicação e habilidade no desenvolvimento de projetos colaborativos permitem que tenha um impacto representativo na saúde mundial.

International rural health needs and services research: a nursing and midwifery response.

As the importance of evidence-based practice in global health care increases, the need for constant, accurate feedback from those in practice is critical, yet the requirement to rapidly obtain and disseminate data on a global basis is a challenge for all health professionals. The Internet allows for global participation in data collection that dramatically streamlines the traditional survey process. This new paradigm applies to surveys that are short, issue focused, and time sensitive. The Global Network of World Health Organization (WHO) Collaborating Centres for Nursing and Midwifery Development used a sample of international nurses in 70 countries to identify the worldwide rural health issues of WHO priority health needs, treatment modalities, health care interventions, and providers, as well as the current state of rural health research on a global level. This article presents the results of the survey regarding rural health needs and nursing and midwifery's response to them internationally, demonstrates Internet data collection, and shows how this research paradigm can help establish an evidence base for nursing practice.

Technical innovations in international e-nursing.

Saudi Arabia faces a severe shortage of nurses. An online nursing degree is being introduced as one approach to this problem. In 1999, the College of Nursing and Health Science at George Mason University formed a strategic partnership with IMED Link, a private telehealth company, to deliver online nursing education. Nine courses have been developed so far, including nursing assessment. The educational material will be distributed via Saudi Arabia's telemedicine network. The courses will be led by professors of nursing at George Mason University using videoconferencing, coupled with online computer classes and Internet tools. Both nursing content and expertise in Web technologies are necessary to develop a successful e-nursing programme.