The long-term impact of providing nursing education in a low-income country.

OBJECTIVE: To measure long-term knowledge gain after provision of nursing education in a low-income country. DESIGN AND SAMPLE: Global health education research has often focused on the short- term effects of providing education and direct patient care. Assessment of long-term knowledge gain is key for determining whether education knowledge transfer is sustainable. MEASUREMENTS: This prospective cohort study of educational training for nurses in Haiti tested knowledge gain before, immediately after, and 6 months after education. INTERVENTION: Quantitative assessments were obtained through multiple choice tests at 3 time points. Qualitative data were obtained through focus groups and self-assessments. RESULTS: Knowledge gain was significant from pretest to immediate posttest, and knowledge retention was assessed at 6 months after the education. Qualitative data showed improvement in reported confidence levels and patient care activities. Short-term knowledge gain was statistically significant for improvement; however, long-term knowledge gain was statistically significant in only 4 of 19 lectures. CONCLUSIONS: Reported qualitative improvements in patient care indicated added value of providing education to the nursing staff. Hands-on learning techniques were important to long-term retention, and building trust was vital to the completion of our study.

Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti.

BACKGROUND: In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. OBJECTIVE: We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP) would optimize medication availability and decrease medication shortages. DESIGN: We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. RESULTS: The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of 'real-time' medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055), respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. CONCLUSIONS: An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.