Implementation of the policy protocol for management of surgical and non-surgical wounds in selected public health facilities in Ghana: An analytic case study.

BACKGROUND: It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relation to non-surgical (also called contaminated wounds) and surgical wounds (also called sterile wounds) is largely attributed to poor adherence to policy protocols for wound management by frontline clinical staff especially nurses. OBJECTIVE: Investigate the extent to which nursing staff adhere to the policy protocol for management of non-surgical and surgical wounds in selected public health facilities in Ghana. METHODOLOGY: This is an analytic case study among nursing staff (n = 140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to policy protocols on non-surgical and surgical wound management. FINDINGS: Overall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound management (Coef. = -0.49, CI = -0.93-0.05, p = 0.036). Being a senior nursing officer relative to lower nursing ranks increased staff likelihood of complying particularly with standard policy protocol for management of non-surgical wounds (Coef. 5.27, CI = 0.59 9.95, p = 0.027). CONCLUSION: There is the need for accelerated in-service training for staff on standard protocols for wound management coupled with supportive supervisions. Staff adherence to standard quality care protocols should be a pre-requisite for licensing of health facilities by regulatory bodies like Health Facilities Regulatory Agency and National Health Insurance Authority.

Development and content validation of the Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey.

AIM: To develop a validated tool to measure nursing and midwifery documentation burden. BACKGROUND: While an important record of care, documentation can be burdensome for nurses and midwives and may remove them from direct patient care, resulting in decreased job satisfaction, associated with decreased patient satisfaction. The amount of documentation is increasing at a time where staff rationalisation results in decreasing numbers of clinicians at the bedside. No instrument is available to measure staff perceptions of the burden of clinical documentation. DESIGN: Survey development, followed by rwo rounds of content validation (April and May 2019). METHODS: Based on the literature a 28 item survey, with items in 6 subscales, representing key areas of documentation burden was developed. Item (I-CVI), subscale (S-CVI/Ave by subscale) and overall content validity indexes (S-CVI/Ave) were calculated following two review rounds by an expert panel of clinical and academic nurses and midwives. RESULTS: Level of agreement for the first iteration of the survey was low, with many items failing to reach the critical I-CVI threshold of 0.78. No subscale reached a S-CVI/Ave above 0.8 and the overall scale only achieved a S-CVI/Ave score of 0.67. Thirteen items were removed, seven were edited and five new items added, based on the expert panel feedback, substantially improving the content validity. All individual items achieved an I-CVI ≥0.78, the S-CVI/Ave was above 0.85 for all subscales and the total S-CVI/Ave was 0.94. CONCLUSION: The Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey can be considered as content valid, according to the content validity analysis by an expert panel. IMPACT: The BurDoNsaM survey may be used by nurse leaders and researchers to measure the burden of documentation, providing the opportunity to review practice and implement strategies to decrease documentation burden, potentially improving patient satisfaction with the care received.

Family members' expectations regarding nurses' competence in care homes: a qualitative interview study.

BACKGROUND: Structural and cultural changes in the care of older people have influenced nursing practice, creating a need to identify current competency requirements for nurses working in care homes. Family members have an important role in ensuring the well-being of older people living in care homes, and family members' can provide valuable information about competence requirements. AIM: To explore the expectations of the care home residents' family members regarding the competence of nurses in care homes for older people. METHODS: A qualitative descriptive design was used. Semi-structured interviews were conducted with 18 care home residents' family members between March and September 2016. Participants were recruited with help from regional associations and member associations of The Central Association of Carers in Finland and from regional associations of The Alzheimer's Society of Finland. The snowball technique was also used. The data were analysed using inductive content analysis. ETHICS: Ethics committee approval was obtained from the university committee on research ethics, and written informed consent was obtained from participants. FINDINGS: The care home residents' family members expected that nurses would be able to interact with and treat people respectfully. Reflective collaboration between the nurse and a family member was also emphasised. Family members expected nurses to provide high-quality basic care and nursing and support residents' well-being individually and holistically. CONCLUSIONS: Family members' expectations reflect the need for ethical and interactional competence in the care home. In addition, evidence-based practice competencies are required to provide high-quality care. Nurses' ability to provide person-centred, individual and holistic care is vital to ensure care home residents' well-being.

Nursing and Midwifery Council revalidation.

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice? The CPD article discussed the Nursing and Midwifery Council (NMC) revalidation process for nurses and midwives in the UK. It outlined the requirements for revalidation that every nurse and midwife in the UK must meet to remain on the NMC register.

Applying QI to Care in Nursing Homes.

Nurses need the tools to reenvision processes and alleviate pressures on nursing staff.

Revalidation: The professional development discussion.

The professional development discussion (PDD) will be an essential component of revalidation with the Nursing and Midwifery Council. The Unite/CPHVA professional officers who participated in the pilot found the PDD to be the most beneficial part of the revalidation process. This article explores the experience of a PDD from both the revalidatee and the fellow registrant perspective. It goes on to make recommendations for ensuring an effective PDD.

If reflection is an NMC requirement, we should give staff the time to do it.

The new Nursing and Midwifery Council revalidation process places a great deal of emphasis on reflection (analysis, July 29), which is an important element of being a holistic and effective practitioner.

Revalidation: a university health board's learning from pilot partner engagement.

This article aims to share organisational experiences and learning from the largest Nursing and Midwifery Council (NMC) revalidation pilot partner. The purpose of revalidation is to improve public and patient protection through career-long professional updating. Pilot participation enabled Aneurin Bevan University Health Board (ABUHB) to contribute significantly to system and process testing, underpinning revalidation across a range of nursing and midwifery settings. An action plan was developed providing a structured approach to the revalidation pilot, detailed actions were identified and progress against actions mapped and reported. While revalidation is the individual registrant's responsibility, there is an organisational obligation to create a supportive enabling environment. A strategic plan incorporating revalidation into organisational objectives and structured leadership roles assisted registrants to successfully meet the NMC's requirements. With 813 registrants completing the pilot process, ABUHB has an enhanced understanding of the revalidation process and an appreciation of its impact on associated professional issues. This level of learning has increased readiness for revalidation commencement for all UK nurses and midwives.

NMC code advice on digital communications.

Nurses and midwives are increasingly using social media as a professional tool. This is reflected in the Nursing and Midwifery Council's (NMC) new professional code, which says nurses must use social media and other communication responsibly, respecting the right to privacy of others at all times. A growing body of literature documents the positive influence social media, when used appropriately, can have on nurses' practice and the care they deliver to patients. However, nurses need more guidance and training to ensure online professionalism and appropriate behaviour online. Requiring nurses and midwives to complete an online continuous professional development course on social networking at the point of revalidation could keep them up to date and promote online professionalism.

Violencia sufrida y percibida por el personal de enfermería del Área Sanitaria Integrada de A Coruña / Suffered and perceived violence by nurses Integrated Health District A Coruña

Introduccion: La violencia sufrida y percibida por el personal de Enfermería está en aumento desde hace dos décadas de manera global y ningún acto violento está justificado. Son muchas las consecuencias sobre la salud de las enfermeras como consecuencia de la violencia en el trabajo y múltiples variables que intervienen en la violencia y casi todas ya estudiadas. Objetivo: Conocer y describir las agresiones percibidas y sufridas por el personal de enfermería en el EOXI A Coruña. Material y métodos: Estudio descriptivo, transversal, de la información recogida a través de un cuestionario autoaplicado, individual y anónimo, llevado a cabo con el personal de enfermería del Área Sanitaria A Coruña. Resultados: La participación ha sido del 14,5% de la muestra inicial. De los enfermeros que han cubierto la encuesta declaran haber sufrido una agresión el 68,3%, siendo la violencia verbal el tipo de mayor frecuencia (37,2%), seguido por la combinación de agresión verbal y física (18,6%). El 35,6% han sentido el respaldo de la empresa y únicamente han denunciado el 20% de los que han sido víctimas de violencia hacia su persona. Conclusiones: Los actos violentos sufridos en los cuales se ha tramitado la denuncia son muy bajos. El conocerlos y trabajar sobre ellos en los diferentes contextos donde se producen y de manera piramidal en la organización haría que podamos luchar de manera eficiente contra este problema (AU)

Introduction: The violence perceived and suffered by the Nursing staff is being globally increased for two decades, and no violent act must be justified. There exists a high amount of facts affecting Nurses’ health as consequence of suffering violence at work, as well as multiple variables involved on it, most of them have been already discussed. Objective: Knowing and describing verbal and non- verbal assaults/attacks suffered by the nursing staff at the EOXI A Coruña. Methods and material: Cross-descriptive study based on collecting data through an individual and anonymous questionnaire, which should be carried out together with the nursing staff from the regional health area of A Coruña. Results: Participation has been set at 14´5 % out of the first sample. 68´3 % of the survey respondents admit having suffered at least an assault/attack, being the verbal violence the one with most prominence (37,2%), followed by a combination of both verbal and physical (18,6%). Only 35,6% have been supported by their company, whereas only a 20% of them have denounced being victims of violence. Conclusion: It might be concluded that reported violent acts are minority. Being aware of their existence as well as working through the contexts where they occur, would permit us fighting against them efficiently (AU)

A framework to support the revalidation process.

In January 2016, all registered nurses and midwives will be required to revalidate their practice every three years. This will have implications for individual registrants and line managers. In May 2014 the chief nursing officer for Wales launched a new governance framework for post-registration nurse education in Wales. This article describes the framework, how it underpins a continuous cycle of improvement in care delivery, and how it could be used to support nurses and nurse managers to meet the requirements of the revalidation process.

New code is a victory for consensus in the profession, says regulator.

The Nursing and Midwifery Council's code of conduct is at the heart of every nurse's practice, setting out standards of conduct, performance and ethics for the profession.

Ten years of my skill as a nurse have been wasted in the UK.

I get very upset and frustrated when I read that there is a shortage of nurses in the UK.