Nursing engagement in research priorities focused on health systems and services in Latin America countries.

BACKGROUND: A strong nursing research agenda in Latin America is fundamental to universal health coverage. Nursing science can make important contributions to the health of Latin American people through knowledge generation that directly informs nursing practice, professional education, and health policy. METHODS: We used a cross-sectional survey design to assess nursing involvement in health systems and services research in Latin America in five priority areas: Policies and education related to nursing human resources; Structure, organization and dynamics of health systems and services; Science, technology, innovation, and information systems in public health; Health policies, governance, and social control; and Social studies in the health field. RESULTS: Nursing and midwifery participants (N = 856) from Latin American countries completed the survey. Respondents who reported conducting research focused primarily on Policies and Education related to Nursing Human Resources and Structure, Organization, and Dynamics of Health Systems and Services. Across the five priority areas, more nurses reported using research findings and/or being aware of research than conducting research. CONCLUSIONS: Survey results indicate that nursing research in Latin America is currently disproportionately focused on nursing education and practice. More research focused on information technology, nurse's impact on public health, and the threats posed by nurse migration is needed to better address health needs of Latin American populations.

Addressing mental and emotional health concerns experienced by nurses during the COVID-19 pandemic.

BACKGROUND: Nurses are the majority of the world's health work force and the frontline responders during pandemics. The mental/emotional toll can be profound if it is not identified and treated. PURPOSE: In March 2020, with New York City as the epicenter of the COVID-19 pandemic in the United States, Columbia University School of Nursing organized support circles for faculty and students providing clinical care as a healing method to address trauma. METHODS: Columbia University School of Nursing adapted guidelines and conducted Circles of Care to share, listen, and acknowledge the new challenges for nurses via Zoom. Analysis of these sessions produced major themes of concern for nurses. FINDINGS: Between March 31 and May 31, 2020, we facilitated 77 sessions with 636 attendees. Eight major themes emerged: coping mechanisms, patients suffering and dying, feelings of helplessness, frustration with COVID-19 response, silver lining, disconnection from the world, the thread that holds nurses together, and exhaustion. DISCUSSION: This report offers insight into the mental/emotional outcomes of being on the frontlines. Addressing these issues is essential for the well-being of nurses and all health care providers for an effective pandemic response.

The health-related quality of life of Syrian refugee women in their reproductive age.

BACKGROUND: Health-Related Quality of Life (HRQoL) for refugee women in reproductive age is highly affected by physical, political, psychosocial and environmental conditions in countries of asylum. HRQoL is enormously affected by the satisfaction of this vulnerable group with the physical, psychological, emotional and social care services provided in this critical time. Therefore, this study aimed toassess the HRQoL among Syrian refugee women of reproductive age living outside camps in Jordan. METHODS: A cross-sectional correlational study was conducted with a convenience sample of 523 Syrian refugee women in the host communities in Jordan.Health-related quality of life (HRQOL) was measured using the short-form 36 (SF-36) questionnaire. RESULTS: Significant negative correlations were found between SF-36 individual subscales score and the length of marriage, the number of children, parity and family income. The strongest correlations were between pain scale and length of marriage (r =  - .21), and between Energy/Fatigue and 'number of children' (r =  - .21). Conversely, antenatal care was positively correlated with physical, role emotional, pain, and general health. Physical functioning and general health were predicted significantly with less years of marriage, younger age at marriage, less violence and by higher family income. CONCLUSION: This study suggests low HRQoL scores for women of reproductive age across all domains. Several factors such as years of marriage, age at marriage, the number of children, violence, antenatal care and family income affected the women's general health. The provision of appropriate and accessible reproductive and maternal healthcare services in antenatal visits is critical for ensuring the immediate and long-term health and wellbeing of refugee women and their families.

Knowledge, Attitudes And Practices Of Syrian Refugee Mothers Towards Sexually Transmitted Infections.

PURPOSE: Refugee women are vulnerable to sexually transmitted infections (STIs) due to risk factors associated with displacement. This study aimed to assess the knowledge, attitudes, and practices related to STIs among Syrian refugee mothers in Jordan. METHODS: A cross-sectional correlational study was conducted with a convenience sample of 523 Syrian refugee mothers in host communities in Jordan. RESULTS: A moderately positive relationship between the mothers' knowledge of and attitudes towards STIs (p<0.001) was found. Although Syrian refugee mothers' attitudes towards STIs were reasonably good, they had poor knowledge about non-HIV causes of STIs and clinical symptoms. Spousal acceptance of using a condom was significantly associated with mothers' STIs knowledge, attitude, length of being a refugee in Jordan and duration of marriage (p<0.05). Almost all Syrian refugee mothers (91.6%) and their spouses (95%) did not follow regular check-ups for STIs. Two-thirds of mothers'- spouses (66.6%) did not accept the usage of a condom during sexual intercourse. CONCLUSION: Syrian refugee mothers have poor knowledge about non-HIV causes of STIs and clinical symptoms. They have poor practices concerning STI screening and prevention. It is imperative that nurses address these issues especially among refugees where in locales where resources are scarce.

Moving towards universal health coverage: advanced practice nurse competencies. / Avançando na direção de cobertura universal de saúde: competências de enfermeiros de práticas avançadas.

OBJECTIVE: this paper aims to describe the first phase of a project whose general goal was to develop a consensus-based set of advanced practice nurse competencies applicable to Latin American countries and, based on these competencies, produce an advanced practice nurse curricular prototype adapted to Latin American countries. The project was framed in a competency-based approach to advanced practice nursing education. The specific aims of the first phase of the project described in this paper were: 1) to identify a set of potential advanced practice nurse competencies that would serve as the template for Core Advanced Practice Nurse Competencies in Latin American countries and 2) to establish consensus for Core Advanced Practice Nurse Competencies in Latin American countries. METHOD: advanced practice nurse competencies were derived from a comprehensive review of published competencies and informed the development of a survey designed to assess the relevance of advanced practice nurse competencies in Latin American countries. The survey was distributed to nurse leaders and nurse educators. Data were analyzed using descriptive statistics. RESULTS: consensus for Core Competencies was established. CONCLUSION: the Core Advanced Practice Nurse Competencies presented can provide a structured framework to build educational programs aligned to the needs of the regional environment.

Avançando na direção de cobertura universal de saúde: competências de enfermeiros de práticas avançadas / Moving towards universal health coverage: advanced practice nurse competencies / Avanzando hacia la cobertura universal de salud: competencias de enfermería avanzadas

Objetivo: o objetivo deste artigo é descrever a primeira fase de um projeto que teve como finalidade geral desenvolver um conjunto de competências de práticas avançadas de enfermagem baseadas em consenso aplicáveis em países da América Latina e, usando tais competências, produzir um protótipo curricular de práticas avançadas de enfermagem a serem adaptadas em países da América Latina. O projeto foi enquadrado em uma abordagem baseada em competências para o ensino de práticas avançadas de enfermagem. Os objetivos específicos da primeira fase do projeto descritos neste artigo foram: 1) identificar um conjunto de competências em enfermagem para práticas avançadas que serviriam como modelo para as Competências Essenciais de Enfermeiros de Práticas Avançadas em países da América Latina e 2) estabelecer um consenso sobre Competências Essenciais de Enfermeiros de Práticas Avançadas em países da América Latina. Método: as competências de enfermeiros de práticas avançadas foram derivadas de uma revisão abrangente das competências publicadas e informaram o desenvolvimento de uma pesquisa projetada para avaliar a relevância das competências de enfermeiros de práticas avançadas nos países da América Latina. A pesquisa foi distribuída entre enfermeiros líderes e enfermeiros educadores. Os dados foram analisados por meio de estatística descritiva. Resultados: foi estabelecido um consenso sobre Competências Essenciais. Conclusão: apresentam-se as Competências Essenciais de Enfermeiros de Práticas Avançadas que podem fornecer um quadro estruturado para construir programas educacionais alinhados com as necessidades do ambiente regional.

Objective: this paper aims to describe the first phase of a project whose general goal was to develop a consensus-based set of advanced practice nurse competencies applicable to Latin American countries and, based on these competencies, produce an advanced practice nurse curricular prototype adapted to Latin American countries. The project was framed in a competency-based approach to advanced practice nursing education. The specific aims of the first phase of the project described in this paper were: 1) to identify a set of potential advanced practice nurse competencies that would serve as the template for Core Advanced Practice Nurse Competencies in Latin American countries and 2) to establish consensus for Core Advanced Practice Nurse Competencies in Latin American countries. Method: advanced practice nurse competencies were derived from a comprehensive review of published competencies and informed the development of a survey designed to assess the relevance of advanced practice nurse competencies in Latin American countries. The survey was distributed to nurse leaders and nurse educators. Data were analyzed using descriptive statistics. Results: consensus for Core Competencies was established. Conclusion: the Core Advanced Practice Nurse Competencies presented can provide a structured framework to build educational programs aligned to the needs of the regional environment.

Objetivo: el objetivo de este documento es describir la primera fase de un proyecto, cuyo objetivo general es desarrollar un conjunto basado en consenso de competencias de práctica avanzada de enfermería aplicables en los países de América Latina y utilizando las competencias, producir una enfermera con práctica avanzada de prototipo curricular para la adaptación en países latinoamericanos. El proyecto se encuadró en un enfoque basado en competencias para la educación de enfermería de práctica avanzada. Los objetivos específicos de la primera fase del proyecto descritos en este documento fueron: 1) identificar un conjunto de competencias potenciales de enfermería de práctica avanzada que servirían como un modelo para las Competencias Básicas de Enfermería de Práctica Avanzada en países latinoamericanos y 2) establecer consenso para las Competencias Básicas de Enfermería de Práctica Avanzada en países latinoamericanos. Método: las competencias de práctica avanzada de enfermería se derivaron de una revisión exhaustiva de las competencias publicadas e informaron el desarrollo de una encuesta diseñada para evaluar la relevancia de las competencias de práctica avanzada de la enfermera en los países de América Latina. La encuesta fue distribuida a enfermeras líderes y enfermeras educadoras. Los datos fueron analizados utilizando estadística descriptiva. Resultados: se estableció el consenso para las Competencias Básicas. Conclusión: se presentan las Competencias Básicas de Enfermería de Práctica Avanzada que pueden proporcionar un marco estructurado para construir programas educativos alineados con las necesidades del entorno regional.

Transforming nursing curricula for a global community.

With nurses and midwives providing the majority of health care globally, nursing education in all countries must prepare students for broader responsibilities to move the agenda forward for equitable care and universal health coverage. Columbia University School of Nursing developed and implemented a vibrant approach to curriculum transformation that included a new didactic course followed by a program of global clinical experiences to expand students' learning environments in global health. Program planning included defining learning objectives, mobilizing support within the school, establishing new sites, recruiting and preparing students, overseeing of students with host institutions, and evaluating the program. A total of twenty-four students were placed over five sites for a six-week credit-bearing global clinical experience. Students had varied clinical experiences with new understandings of the reality of health disparities. Host sites expressed a commitment to have students return in the next year, and all students stated that they would chose a global experience again. This innovation provides a transformative addition to nursing education with a deepened understanding of health disparities and nursing roles in different health systems. It strengthens the school's network of nursing and midwifery educators and opens doors for new exchanges.

Delphi Survey of Clinical Nursing and Midwifery Research Priorities in the Eastern Mediterranean Region.

PURPOSE: As the shortage of nurses and midwives is expected to worsen in the Eastern Mediterranean region concomitantly with a growing focus on achievement of universal health coverage, nurses and midwives are expected to fill major gaps in health care. Hence, the need for a solid evidence base for nursing practice and a clear direction for clinical nursing research are paramount. Therefore, a Delphi survey was conducted to determine clinical (research focused on patient outcomes) nursing and midwifery priorities for research within this region. DESIGN: A Delphi survey, using iterative rounds of an online survey of regional clinical nursing and midwifery research experts, was conducted between January and April 2016. METHODS: Consensus was determined by percentage agreement on level of priority for topics as determined by participants. Additionally, results were compared between countries within the region by income and mortality levels using Kendall's tau. FINDINGS: Critical research topics were focused on public/community/primary care as well as emergency preparedness for disasters, and these priorities are well aligned with gaps in the literature for this region. There were statistically significant differences between priority level and country mortality group for geriatrics, self-management of disease, and sexually transmitted infections. CONCLUSIONS: Critical research priorities should focus on population-based health topics. Between-country differences should be analyzed further. A clinical research database for the region may help improve research access for nurses and midwives. CLINICAL RELEVANCE: Practicing nurses and midwives lack extensive evidence (including culturally relevant evidence) on which to practice. Increasing research in areas identified in this survey may improve patient outcomes and quality of care regionally.

Identifying the Gaps: An Assessment of Nurses' Training, Competency, and Practice in HIV Care and Treatment in Kenya.

Given the burden of HIV and the critical shortage of health workers in Kenya, in 2011 the National AIDS and STI Control Program recommended shifting HIV care and treatment tasks to nurses in settings without physicians and clinical officers in order to decentralize and scale-up HIV services. In September 2013, ICAP at Columbia University conducted a survey with nurses in four health facilities in eastern Kenya to assess preparedness for task shifting. Findings indicated gaps in nurses' training, perceived competency, and practice in HIV care and treatment. Further investment in nurse capacity building is needed to bridge the gaps and prepare more nurses to provide high-quality, comprehensive HIV care and treatment services to curb the epidemic in Kenya.

Clinical Nursing and Midwifery Research Priorities in Eastern and Southern African Countries: Results From a Delphi Survey.

BACKGROUND: Because of the profound shortage of nurse and midwifery researchers in many African countries, identification of clinical nursing and midwifery research is of highest priority for the region to improve health outcomes. OBJECTIVES: The aim of this study was to gain consensus from experts on the priorities of clinical nursing and midwifery research in southern and eastern African countries. METHOD: A Delphi survey was conducted among experts in the region. Criteria for "expert" included (a) a professional nurse, (b) a bachelor's degree or higher in nursing, (c) published research, (d) affiliated with a school of nursing with at least a master's level nursing program, and/or (e) identified by the African core collaborators as an expert in the region. A list of candidates was identified through searches of published and gray literature and then vetted by core collaborators in Kenya, Malawi, and South Africa. Core collaborators held leadership roles in a nursing school and a doctoral degree in nursing, had conducted and published nursing research, and resided in an included country. RESULTS: Two rounds of the Delphi survey were required to reach consensus. In total, 40 participants completed both rounds, and at least one participant from each country completed both rounds; 73% and 85% response rates were achieved for each round, respectively. Critical clinical research priorities were infectious disease/infection control and midwifery/maternal health topics. These included subtopics such as HIV/AIDS, tuberculosis, maternal health and mortality, infant mortality, and obstetrical emergencies. Many other topics were ranked as important including patient outcomes, noncommunicable diseases, and rural health. DISCUSSION: Areas identified as research priorities were consistent with gaps identified in current literature. As evidenced by previous research, there is a lack of clinical nursing and midwifery research in these areas as well as nurses and midwives trained to conduct research; these priorities will help direct resources to the most essential research needs.

The Nursing Education Partnership Initiative (NEPI): innovations in nursing and midwifery education.

The nursing and midwifery workforce is key to improving the performance of the health system overall. Health workforce shortages are significantly influenced by the productive capacity of health professions education institutions. Long-standing underinvestment in preservice nursing and midwifery education severely limits the capacity of institutions to educate nurses and midwives in sufficient numbers, and with the necessary clinical skills, for current and anticipated population health needs. The Nursing Education Partnership Initiative (NEPI) was established in 2011 by the U.S. President's Emergency Plan for AIDS Relief in response to key capacity-building challenges facing preservice nursing and midwifery education in Sub-Saharan Africa. NEPI has formed partnerships with governments and key stakeholders in Ethiopia, Democratic Republic of Congo, Lesotho, Malawi, and Zambia and supports 19 nursing and midwifery education institutions and 1 nursing council. NEPI has been informed by activities that strengthen education systems, institutions, and organizations as well as faculty capacity building. Ministry of health-led advisory groups were established to provide strategic direction and oversight for the work, fostering intersectoral dialogue and ensuring country ownership and sustainability. Three illustrative examples of innovations at the system, institution, and workforce levels describe approaches for country ownership, for addressing the shortage of highly qualified faculty, and for remedying the inadequate teaching and learning infrastructure.

The impact of HIV scale-up on the role of nurses in South Africa: Time for a new approach.

South Africa's health care system is struggling to respond to the devastating impact of HIV/AIDS while at the same time respecting its postapartheid mandate to provide equitable health services to all. These unprecedented challenges are forcing a rethinking and reorganization of health resources and systems and a reappraisal of the role of nurses in the care of complex and chronic illness. Increasingly, the scale-up of HIV services is being reconceptualized to match both the urgent need for prevention, care, and treatment and the national vision of decentralized primary health care. HIV scale-up has triggered innovations in nurse training, task shifting, retention, and scope of practice that need not remain HIV specific. Lessons learned in the context of HIV have the potential to enhance nursing practice and human resources for health more generally, strengthening South Africa's health systems and improving access to effective health services.