Voice from the frontline and learning for the future: A qualitative descriptive study on wider perspectives of frontline nurses in India during the COVID 19 global pandemic.

Objective: This study was conducted to explore frontline nurses' experiences of the impact of COVID 19 pandemic and suggestions for improvement in the healthcare system, policy and practice in the future. Method: A qualitative descriptive design was used. Frontline nurses who were involved in providing care to patients affected with COVID 19 in four designated COVID units from the Eastern, Southern and Western regions of India were interviewed during January to July 2021. Interviews were audio-recorded and transcribed manually by researchers from each region and thematically analysed. Result: Twenty-six frontline nurses aged between 22 and 37 years with a range of 1-14 years of work experience following a Diploma or Bachelor's degree in Nursing and Midwifery and working in the COVID units of selected regions in India participated in the study. Three key themes emerged: 'Physical, emotional and social health - an inevitable impact of the pandemic' described effects of the pandemic on nurses' health and wellbeing; 'Adapting to the uncertainties' narrated how nurses accommodated to the uncertainties during the pandemic; and 'An agenda for the future - suggestions for improvement' emphasised on practical strategies for the future. Conclusion: The inevitability of the pandemic had an influence at a personal, professional, and social level with learning for the future. The findings of this study have implications for healthcare system and facilities by enhancing resources, supportive environment for staffs to cope with the challenges imposed by the crisis and ongoing training to manage life threatening emergencies in the future.

Effect of individual nutrition education on perceptions of nutritional iron supplementation, adherence to iron - folic acid intake and Hb levels among a cohort of anemic South Indian pregnant women.

OBJECTIVE: The objective of the study was to evaluate the effect of individual nutrition education on nutritional knowledge, attitude, practices, adherence to iron-folic acid intake, and hemoglobin levels among anemic South Indian pregnant women. METHODS: This intervention study was conducted from December 2020 to March 2021 in a secondary care level women and child hospital at Puducherry, India. The intervention group (n = 59) and comparison group (n = 58) included mild to moderately anemic pregnant women attending antenatal clinics (Mild anemia - Hb levels between 10.0 and 10.9 g/dL, Moderate anemia - Hb levels between 7.0 and 9.9 g/dL). Individual nutrition education intervention and SMS alerts for four weeks were given to the pregnant women. Baseline data and hemoglobin levels were measured at the time of enrollment. Maternal adherence to iron-folic acid tablets (IFA) was assessed using a five-item Medical Adherence Rating Scale (MARS-5). End line data were collected after 4 weeks of nutrition education intervention. RESULTS: At the end of the individual nutrition education intervention, there was a significant improvement in the hemoglobin level in the intervention group compared to the comparison group (p < .02). The change in the knowledge, attitude and practice scores regarding nutritional management of anemia and maternal adherence to iron-folic acid intake were significantly high in the intervention group over the comparison group (p < .001). CONCLUSION: Individual nutrition education was significantly associated with improved nutritional knowledge, attitude, practice, adherence to IFA intake and hemoglobin levels in anemic pregnant women.

Challenges faced by student nurses and midwives in clinical learning environment - A systematic review and meta-synthesis.

OBJECTIVES: This systematic review aimed to offer insight and understanding, through synthesis of findings from studies that report on perspectives of student nurses/midwives, clinical instructors, clinical nurses/midwives on the challenges faced by student nurses/midwives in the clinical learning environment (CLE). DESIGN: All primary qualitative research studies published in the English language that reported on the views of student nurses/midwives, clinical instructors and clinical nurses/midwives on the challenges faced by student nurses/midwives in the CLE were included. DATA SOURCES: The electronic databases of Medline EBSCO (1946-), CINAHL (1970), Embase Ovid (1974-), ScielO, WHOLIS (2002-), ASSIA (1985-), Web of Science (1956-), PsycINFO (1800s-) and Maternal and Infant Care (1970-) were searched in November 2019. REVIEW METHODS: Retrieved papers were reviewed independently by two authors for selection by title, abstract and full text, and two authors agreed for inclusion of the papers. The COREQ criteria checklist was used for assessment of methodological quality of the included studies. RESULTS: The review included 32 studies published over 22 years between 1997 and 2019 involving 853 nursing/midwifery students, clinical instructors, and clinical nurses/midwives from 14 countries. Three key themes emerged: 'The support structure', 'Personal factors', and 'Planning and organisation - influence of extrinsic factors'. CONCLUSION: Attitude of clinical staff, instructors, and significant others had a major influence on students' clinical learning. Lack of a sense of belongingness and self-motivation to learn, and perceived fear of doing errors were some of the demotivating factors. Lack of resources to facilitate need-based training, staff shortages, workload and inconsistencies between theory and practice were other key challenges in the CLE. Understanding the challenges faced by students in clinical practice can help overcome the barriers leading to development of competent and confident nurses and midwives.

Effectiveness of CME on "Pediatric Emergencies and Management" Among the Health Personnels in Community Health Centre, Karikalampakkam, Puducherry.

OBJECTIVES: To assess the level of knowledge among health personnels on pediatric emergencies and their management and to evaluate the effectiveness of CME programme on the same. METHODS: This study was conducted at Karikalampakkam village of Puducherry. Karikalampakkam is a Community Health Center with seven subcenters under it. The research design was one of the Quasi Experimental Design pre and post test with one group. All the health personnels like ANM, PHN, Health educators were considered as subjects for the study. The sample size was 40 and selected by purposive sampling technique. Pretest was conducted before the CME programme with the structured interview schedule. Post test was conducted after completion of the programme with the help of same tool. RESULTS: The pretest mean knowledge score among the health personnels was 3.15 ± 0.89 with the mean percentage 7.8 % whereas the posttest mean knowledge score was 4.47 ± 1.58 with mean percentage 11.17 %. The Z value was -2.555 and the p value was 0.011 (p < 0.05) which was significant at 0.05 level. CONCLUSIONS: Though the health personnels are already trained, during pretest their knowledge level was found to be poor and after training, the results show that their knowledge improved. Thus, there is a necessity to conduct inservice training programmes to update knowledge and skill of health personnels.