Capacity building skills in the implementation of evidence-based practice for community health nurses: an exploratory descriptive cohort study.

Background: While nurses are strategically placed to support the achievement of universal health, their practice may not always be informed by evidence, especially in a context where research evidence is not commonly used to inform practice.Objective/Aim/Hypothesis: Improve management of clients with CNCDs in Caribbean community through evidence-based practice (EBP) capacity building workshops.Design/Methods: A descriptive, quantitative design was used for this study. Participants included Community Based Nurses who attended an initial and recall workshop on EBP in a Caribbean island. All participants were included as the sample. Data were collected as a Pre-Test and Post Test before the initial workshop and at the recall workshop. Analysis was done quantitatively. Since the sample was small, only descriptive statistics were used.Results: Data showed 64% of participants had no experience with EBP, 55% needed more essential resources to participate in EBP and 55% recognized a need to include EBP to change their clinical practice effectively.Conclusions: The nurses and district supervisors observed a high level of interest and commitment to initiating and completing EBP projects. However, the reality of significant workplace demands, and limitations in consistent logistical and supervisory support impacted long-term sustainability.

Developing a partnership to improve health care delivery to children <18 years with cancer and blood disorders in the English-speaking Caribbean: lessons from the SickKids-Caribbean Initiative (SCI).

In 2013, the SickKids-Caribbean Initiative (SCI) was formalised among The Hospital for Sick Children in Toronto, Canada, the University of the West Indies, and Ministries of Health in six Caribbean countries (Barbados, The Bahamas, Jamaica, St. Lucia, St. Vincent and the Grenadines, and Trinidad and Tobago). The aim was to improve the outcomes and quality of life of children (<18 years) with cancer and blood disorders in the partner countries. Core activities included filling a human resource gap by training paediatric haematologists/oncologists and specialised registered nurses; improving capacity to diagnose and treat diverse haematology/oncology cases; developing and maintaining paediatric oncology databases; creating ongoing advocacy activities with international agencies, decision makers, and civil society; and establishing an integrated administration, management, and funding structure. We describe core program components, successes, and challenges to inform others seeking to improve health service delivery in a multidisciplinary and complex partnership.

An exploration of social participation in Caribbean student nurses' use of social media in their learning journey.

AIMS: To identify how social participation facilitates pre-registration student nurses learning and professional development using social media. DESIGN: A social survey using thematic analysis to explore Caribbean student nurses' views of social media usage from an open-ended question in a survey. METHODS: A qualitative analysis of student nurses from Jamaica and Trinidad and Tobago, who completed an open-ended question in a survey. Data were analysed using thematic analysis. RESULTS/FINDINGS: The three themes identified were: (1) Social media and communication; (2) Social media and self-care; and (3) Social media and learning. CONCLUSION: This paper used qualitative evidence to identify and report a new way of viewing SoMe in nursing education as a student-centred educational learning tool. SoMe can improve the effectiveness of student nurses learning, while developing fundamental skills (open-mindedness, critical thinking, professionalism and decision-making) for nursing practice. Social participation and connectivism theory are embedded in student nurses' learning journey. However, it has been used by student nurses outside the traditional university teaching and their capacity to own their personal learning. To meet the new generation of student nurses' learning needs, it is important that higher education institutions develop guidance, support and use of social media for learning to support student nurses in their education as students and also future professionals. IMPACT: This study addresses how social participation is used in social media to contribute to Caribbean student nurses' education. The main finding is the introduction of a new learning theory supporting learning using social media. This study has an impact on using social media for learning. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Cultural Influences on Mental Health Provision in the Caribbean: How Do Contemporary Perceptions and Beliefs About Persons With Mental Illness Inform Workforce Transformation?

INTRODUCTION: Mental illness is a global phenomenon in society, including trained health professionals, often responding to people with mental illness based on perceptions and beliefs. The research examined "contemporary perceptions and beliefs about mental illness held by stakeholders" attending a mental health symposium in Trinidad. METHODS: Data were collected using a 43-item questionnaire and analyzed using SPSS Version 22. Overall, 84 attendees working directly or experienced in mental health completed the survey. RESULTS: Respondents believed mental illness should be treated within local community settings. Participants who were more comfortable sharing their mental health diagnosis with friends were more likely to share with others, including their employers. There was a relationship between perception of the superstitious causes of mental illness and its effects on healing. DISCUSSION: Qualifications and experience in mental health do not reduce stigma associated with mental illness which has implications for addressing mental health literacy among health professionals.

Demographic profiling of Caribbean and United Kingdom student nurses' use of social media for professional development.

BACKGROUND: Most students are adept in using technology and have developed skills and confidence utilising SoMe for professional purposes. SoMe is used by both registered nurses and student nurses. PURPOSE: The purpose of this study was to investigate the professional use of SoMe by student nurses in Trinidad and Tobago, Jamaica and the UK to guide, support and develop implementation of effective and appropriate use of SoMe for professional development. METHODS: An online cross-sectional survey was completed by student nurses from the three countries. Data were analysed using descriptive statistics. RESULTS: The main reason for using social media among Caribbean participants was to watch videos or short clips whereas in UK it was downloading articles. Over 75% participants of all ages believed that social media was likely to help their career. There is no social media guidance for student nurses in Trinidad and Tobago and Jamaica. CONCLUSION: Our study demonstrated that social media is embedded in student nurses' professional development throughout their education, with some variation in their use by country. Despite the fundamental place that social media plays in student nurses' professional development, there is no national or international guidance on how student nurses should use social media for professional development.

International student nurses' use of social media for learning: A cross sectional survey.

BACKGROUND: Students use social media for sharing information and connecting with their friends, also for peer support, peer learning and student engagement. Research indicates that approximately twice the number of students were using social media for educational purposes compared to academic staff and almost all students discuss academic issues on social media. However, little is known about how diverse cohorts of student nurses use social media for specific purposes at different stages of their learning. OBJECTIVES: Identify how student nurses in each country of study use social media for learning. Identify how each generation of student nurses use social media for learning. Identify how student nurses use social media as their education progresses. DESIGN: A cross-sectional survey. SETTINGS: The study was undertaken across three countries Jamaica, Trinidad and Tobago and the UK. PARTICIPANTS: Student nurses from each of the countries that consented to participate met the inclusion criteria. METHODS: 1050 student nurses across the three countries self-completed the cross-sectional survey between March and September 2019. Data was analysed using descriptive and inferential statistics. RESULTS: WhatsApp® was the most used platform for learning amongst participants. Watching videos and downloading articles represented two-thirds of social media usage for learning. Smart phones were the most used device to access social media. Kruskal-Wallis tests were significant (≤0.001) for checking social media and messaging in lecture, use of social media for studies and classroom activities by country, generation (except classroom activities) and year of education. Use of social media for classroom activities had no significance by generation. CONCLUSION: Country, generation and year of education are factors that influence the use of social media in student nurses' learning. These should be considered by Universities in curriculum development and in teaching and learning delivery. From a pragmatic approach, social media is available and used by a majority of student nurses and can be widely assimilated into the nursing curriculum.

Core competencies and challenges among nurses transitioning into positions of leadership - a Caribbean perspective.

PURPOSE: Nurses are a significant part of the professional workforce, but leaders may be promoted without the requisite competencies. This study aims to explore the perspectives of nurse managers about the core competencies necessary for promotion as leaders in health. DESIGN/METHODOLOGY/APPROACH: This was a mixed-methods study that targeted nurses (N = 126) who were promoted in four Caribbean countries over the past five years. A 30-item questionnaire was used for quantitative data collection and analyzed using SPSS version 25. Interviews yielded the qualitative data, which were analyzed using open coding and thematic analysis. Ethical approvals were received from ethics committees at the university and country level. FINDINGS: Most participants were female (n = 112), had 15 or more years' experience (n = 71) and an associate degree/diploma in nursing (n = 62). Leadership was the most important competency required of nurse leaders in spite of their position within the organization, followed by team building and motivation. Challenges to the transitioning into leadership positions included the prevailing culture and a lack of a systematic approach to building capacity in leadership. There was also between-group statistical significance, as determined by one-way ANOVA for delegation, motivation and leadership as core competencies based on occupations roles. RESEARCH LIMITATIONS/IMPLICATIONS: Notwithstanding the importance of the findings from this research, there were some limitations. While the researchers considered implementing this study in eight Caribbean countries, approvals were received for only four countries. This will affect the ability to generalize the findings to the wider Caribbean countries. One of the strengths of this research was the use of mixed methods for data collection. However, the qualitative component of the findings may be limited by the number of focus groups conducted, notwithstanding the richness of the data collected. PRACTICAL IMPLICATIONS: The findings can be used as a framework from which the health system in developing countries can begin to examine practical solutions to developing 21st century leadership competencies in nursing. While there may be remanence of the colonial past in the way systems function, the complexity of health systems requires leadership that is rooted in competence that is multidimensional. ORIGINALITY/VALUE: This paper provides an important contribution to the literature on leadership and competencies from the perspective of low- to middle-income resource settings. The qualitative component of the research added richness to the nuances and understanding of the phenomenon of competencies for nurse leaders.

Core competencies and challenges among nurses transitioning into positions of leadership ­ a Caribbean perspective

Purpose ­ Nurses are a significant part of the professional workforce, but leaders may be promoted without the requisite competencies. This study aims to explore the perspectives of nurse managers about the core competencies necessary for promotion as leaders in health. Design/methodology/approach ­ This was a mixed-methods study that targeted nurses (N= 126) who were promoted in four Caribbean countries over the past five years. A 30-item questionnaire was used for quantitative data collection and analyzed using SPSS version 25. Interviews yielded the qualitative data, which were analyzed using open coding and thematic analysis. Ethical approvals were received from ethics committees at the university and country level. Findings ­ Most participants were female (n= 112), had 15 or more years' experience (n= 71) and an associate degree/diploma in nursing (n= 62). Leadership was the most important competency required of nurse leaders in spite of their position within the organization, followed by team building and motivation. Challenges to the transitioning into leadership positions included the prevailing culture and a lack of a systematic approach to building capacity in leadership. There was also between-group statistical significance, as determined by oneway ANOVA for delegation, motivation and leadership as core competencies based on occupations roles.

Perceptions of "Male Sensitive" Health Services Among Men in Trinidad and Tobago.

INTRODUCTION: While Caribbean researchers have explored masculinity, socialization, and behavior, the literature has been silent on masculinity and "male sensitive" health services. This study explored masculinity and perceptions of "male sensitive" health services. METHOD: An interpretative, phenomenological, qualitative design that used 14 focus groups and 12 semistructured interviews among men between the ages 18 and 65 years. RESULTS: The notion of "male sensitive" services were more of preferences like having more females, timeliness, and privacy of services rather than a specific set of services unique to men. Services were expected to be professional, offered in private spaces, timely, and as an "all in one" service with more male service providers. DISCUSSION: Male utilization of health services may be a problem if they are not considered "sensitive" to their needs. This has implications for the reorientation of services, as well as, personnel, including increased involvement of males as health care providers.

Perceptions of "Male Sensitive" Health Services Among Men in Trinidad and Tobago

Introduction: While Caribbean researchers have explored masculinity, socialization, and behavior, the literature has been silent on masculinity and "male sensitive" health services. This study explored masculinity and perceptions of "male sensitive" health services. Method: An interpretative, phenomenological, qualitative design that used 14 focus groups and 12 semistructured interviews among men between the ages 18 and 65 years. Results: The notion of "male sensitive" services were more of preferences like having more females, timeliness, and privacy of services rather than a specific set of services unique to men. Services were expected to be professional, offered in private spaces, timely, and as an "all in one" service with more male service providers. Discussion: Male utilization of health services may be a problem if they are not considered "sensitive" to their needs. This has implications for the reorientation of services, as well as, personnel, including increased involvement of males as health care providers.

Demographic profiling of Caribbean and United Kingdom student nurses' use of social media for professional development

Background: Most students are adept in using technology and have developed skills and confidence utilising SoMe for professional purposes. SoMe is used by both registered nurses and student nurses. Purpose: The purpose of this study was to investigate the professional use of SoMe by student nurses in Trinidad and Tobago, Jamaica and the UK to guide, support and develop implementation of effective and appropriate use of SoMe for professional development. Methods: An online cross-sectional survey was completed by student nurses from the three countries. Data were analysed using descriptive statistics. Results: The main reason for using social media among Caribbean participants was to watch videos or short clips whereas in UK it was downloading articles. Over 75% participants of all ages believed that social media was likely to help their career. There is no social media guidance for student nurses in Trinidad and Tobago and Jamaica. Conclusion: Our study demonstrated that social media is embedded in student nurses' professional development throughout their education, with some variation in their use by country. Despite the fundamental place that social media plays in student nurses' professional development, there is no national or international guidance on how student nurses should use social media for professional development.

International student nurses' use of social media for learning: A cross sectional survey

Background: Students use social media for sharing information and connecting with their friends, also for peer support, peer learning and student engagement. Research indicates that approximately twice the number of students were using social media for educational purposes compared to academic staff and almost all students discuss academic issues on social media. However, little is known about how diverse cohorts of student nurses use social media for specific purposes at different stages of their learning. Objectives: Identify how student nurses in each country of study use social media for learning. Identify how each generation of student nurses use social media for learning. Identify how student nurses use social media as their education progresses. Design: A cross-sectional survey. Settings: The study was undertaken across three countries Jamaica, Trinidad and Tobago and the UK. Participants: Student nurses from each of the countries that consented to participate met the inclusion criteria. Methods: 1050 student nurses across the three countries self-completed the cross-sectional survey between March and September 2019. Data was analysed using descriptive and inferential statistics. Results: WhatsApp® was the most used platform for learning amongst participants. Watching videos and downloading articles represented two-thirds of social media usage for learning. Smart phones were the most used device to access social media. Kruskal-Wallis tests were significant (≤0.001) for checking social media and messaging in lecture, use of social media for studies and classroom activities by country, generation (except classroom activities) and year of education. Use of social media for classroom activities had no significance by generation. Conclusion: Country, generation and year of education are factors that influence the use of social media in student nurses' learning. These should be considered by Universities in curriculum development and in teaching and learning delivery. From a pragmatic approach, social media is available and used by a majority of student nurses and can be widely assimilated into the nursing curriculum

Men's Perspectives on 'Male Sensitive' Health Services

Men, in general, are more likely to hold negative views and be unwilling to access health services (Hawkes and Buse, 2013) except in circumstances when they view their lives qas being imperilled (Novak, et al., 2019). However, this is associated with the social constructionof masculinity an the expectations of how masculinity should be performed (Novak, et al 2019.) Being concerned about one's health is perceived as a female concern and creates cognitive dissonance for men in deciding whether they should behave as though they don't care or should care for their health (Robertson and Williams, 2010, Elliott. 2015, Bonhomme, Brott and Fadich, 2017, Novak, et al., 2019). In spite of the growing body of literature on masculinity and health; addressing issues of men's health is challening since there is an absence of agreement on what constitutes 'men's health', in spite of attempts to do so (Bardehle, Dinges and Whitw, 2016). Although a number of studies have been conducted on men in the Caribbean, there is a dearth of literature on men and their perceptions of 'male sensitive' health services among men between the ages of 18 yeas to 65 years in Trinidad and Tobago. The research questions was: What are men's perceptions about masculinity and its implications for 'male sensitive' health services?

ET/WOC nursing ­ leadership lessons learned from the COVID-19 pandemic: an opinion

The coronavirus disease 2019 (COVID-19) pandemic has brought uncertainty and opportunity to nurses and healthcare. As part of the nursing profession, enterostomal therapy (ET) / wound, ostomy, continence (WOC) nurses offer specialised care that is critical to the health of persons with wounds, ostomies and continence. ET/WOC nurses' knowledge and practice have positioned these nurses as integral partners in leadership and the delivery of care during these challenging times. The aim of this paper is to highlight five leadership themes for ET/WOC nurses that have evolved during the pandemic, namely interprofessional practice, emotional intelligence, ethical practice, advocacy, and self-care.

Factors contributing to needle stick injuries among new registered nurses at a hospital in Trinidad.

BACKGROUND: Newly educated RNs are vulnerable to needle stick injuries (NSIs). Most needle stick injuries occur during practice and associated with nurses' practice and available resources. METHODS: This was a quantitative, descriptive study. Registered nurses (N = 120) with less than three years' experience. Data collected using a 26-item questionnaire among newly registered nurses. Data were analyzed descriptively and inferentially using (SPSS) version 20. RESULTS: Most of the nurses between the ages 20-30 years (49.7%), were female (73.4%), had 2 to <3 years' experience (44.2%) and experienced a needle stick injury (43.3%). Respondents knew about the policies on standard precautions but their practice was not compliant with safe practices. Adherence was associated with knowledge of policies on standard precautions (r. = 534, p < .01), having updated policies (r = .404, p < .01) and the appropriate use of resources (r. = 805, p < .01). CONCLUSION: There are a number of factors that contribute to NSIs among newly registered nurses which are personal as well as structural. Avoidable practices such as non-adherence to standard precautions while using hypodermic needles contributed to NSIs. Mandatory training and evaluation of nurses' knowledge and attitude regarding safety practices should be examined.

Nurses' preparation for transitioning into positions of leadership-A Caribbean perspective.

AIM: To explore perspectives of nurse managers about their preparation for transitioning into positions of leadership. BACKGROUND: There have been serious concerns about the level of preparation as well as availability of support systems for transitioning of nurses into positions of authority. METHODS: This was a quantitative study conducted in four Caribbean countries targeting nurses promoted to leadership positions within the last 5 years. Data were collected using a 30-item questionnaire. Ethical approvals were received from the University of the West Indies and the participating countries. RESULTS: Most participants were female, had 15 or more years' experience and an associate degree/diploma in nursing. They felt prepared through training and acting opportunities although many were not preceptored/mentored into the position. Preparation by training was positively correlated to acting opportunities, preceptorship programme and having a preceptor. CONCLUSION: Transitioning into positions of leadership requires readiness from a personal as well as an organisational perspective. There must be investment in the development opportunities to support nurses' transition into leadership positions. IMPLICATIONS FOR NURSING MANAGEMENT: Organisational continuity and effectiveness will be dependent on a balance between investing in experienced nursing personnel while encouraging personal development of less-experienced nurses. Peer mentorship must be utilized to facilitate nurse transition.

Nurses' preparation for transitioning into positions of leadership­A Caribbean perspective

Aim: To explore perspectives of nurse managers about their preparation for transitioning into positions of leadership. Background: There have been serious concerns about the level of preparation as well as availability of support systems for transitioning of nurses into positions of authority. Methods: This was a quantitative study conducted in four Caribbean countries targeting nurses promoted to leadership positions within the last 5 years. Data were collected using a 30-item questionnaire. Ethical approvals were received from the University of the West Indies and the participating countries. Results: Most participants were female, had 15 or more years' experience and an associate degree/diploma in nursing. They felt prepared through training and acting opportunities although many were not preceptored/mentored into the position. Preparation by training was positively correlated to acting opportunities, preceptorship programme and having a preceptor. Conclusion: Transitioning into positions of leadership requires readiness from a personal as well as an organisational perspective. There must be investment in the development opportunities to support nurses' transition into leadership positions. Implications for Nursing Management: Organisational continuity and effectiveness will be dependent on a balance between investing in experienced nursing personnel while encouraging personal development of less-experienced nurses. Peer mentorship must be utilized to facilitate nurse transition.

Understanding Contextual Differences in Residential LTC Provision for Cross-National Research: Identifying Internationally Relevant CDEs.

Long-term care (LTC) reflects a growing emphasis on person-centered care (PCC), with services oriented around individuals' needs and preferences. Addressing contextual and cultural differences across countries offers important insight into factors that facilitate or hinder application of PCC practices within and across countries. This article takes an international lens to consider country-specific contexts of LTC, describing preliminary steps to develop common data elements that capture contextual differences across LTC settings globally. Through an iterative series of online, telephone, and in-person sessions, we engaged in in-depth discussions with 11 colleague experts in residential LTC and coauthors from six countries (China and Hong Kong, England, Sweden, Thailand, Trinidad and Tobago, and the United States). Our discussions yielded rich narrative describing a vast range in types of LTC settings, leading to our development of a working definition of residential LTC. Scope of services, funding, ownership, and regulations varied greatly across countries and across different residential LTC settings within countries. Moving forward, we recommend expanding our activities to countries that reflect different stages of residential LTC development. Our goal is to contribute to a larger initiative underway by the WE-THRIVE consortium to establish a global research measurement infrastructure that advances PCC internationally.

Fathers' presence in the birth room - implications for professional practice in the Caribbean.

Aims or Objectives: This study explored the perspectives of Obstetricians and Registered Nurses/Midwives on the presence of expectant fathers in the birth room. METHODS: A qualitative research design was used to explore perceptions and attitudes of Obstetricians and Registered Nurses/Midwives. Data were collected using five focus group and five key informant interviews and analysed using van Manen's [2007. Phenomenology of practice. Phenomenology & Practice, 1(1), 11-30] interpretative phenomenological approach. RESULTS: Four themes emerged (i) perception of the Obstetrician/Registered Nurse/Midwife, (ii) demands on the practitioner, (iii) support for staff and (iv) potential challenges for practice. While participants held positive views, the nature of the birth experience could have negative implications for themselves and expectant fathers. Poor communication could exacerbate negative perceptions in emergency settings. CONCLUSIONS: The presence of expectant fathers in the delivery room could have a positive impact on the birth experience for mothers, fathers and health professionals in the Caribbean. However, it could be challenging in emergencies.