Regulation of nursing practice in the Region of the Americas.

OBJECTIVE: To describe and analyze the current nursing regulations across countries in the Region of the Americas. METHODS: A country comparative analysis was carried out by gathering information from the ministries of health, nursing schools, councils, associations, and boards in 2018. The main categories evaluated were type of regulatory bodies, requirements for initial professional registration, and registration renewal. RESULTS: All countries regulate the nursing profession through a regulatory body. Competency exams for initial registration are required in the United States, Canada, and most Caribbean countries. Registration renewal is required in 54.3% of the countries. Continuing education is required for professional registration renewal in the United States, Canada, and 53% of Caribbean countries. Labor hours are required in the United States and Canada. CONCLUSION: Regulations promote and protect professional integrity. The Pan American Health Organization/World Health Organization recommends that countries make efforts to evaluate competency and training, consider the use of competency exams for initial registration, and add continuing education as requirements for registration renewal.

OBJETIVO: Describir y analizar la normativa reguladora vigente en materia de enfermería en los países de la Región de las Américas. MÉTODOS: Se efectuó un análisis comparativo de los países reuniendo información de los ministerios de salud, escuelas de enfermería, consejos, asociaciones y comités profesionales en 2018. Las principales categorías evaluadas fueron los tipos de organismos reguladores, los requisitos para el registro profesional inicial y la renovación del registro. RESULTADOS: Todos los países regulan la profesión de enfermería por medio de un organismo regulatorio. Los Estados Unidos, Canadá y la mayoría de los países del Caribe exigen exámenes de competencia para el registro inicial. En el 54,3% de los países se exige la renovación periódica del registro. En los Estados Unidos, Canadá y el 53% de los países del Caribe se requiere cumplimentar educación continua para renovar el registro profesional. En los Estados Unidos y Canadá se requiere acreditar horas de trabajo. CONCLUSIÓN: Los mecanismos regulatorios promueven y protegen la integridad profesional. La Organización Panamericana de la Salud/Organización Mundial de la Salud recomienda que los países evalúen la competencia y la capacitación profesionales, consideren la posibilidad de utilizar exámenes de competencia para el registro inicial y requieran educación continua como requisito para renovar el registro profesional.

Regulation of nursing practice in the Region of the Americas

[ABSTRACT]. Objective. To describe and analyze the current nursing regulations across countries in the Region of the Americas. Methods. A country comparative analysis was carried out by gathering information from the ministries of health, nursing schools, councils, associations, and boards in 2018. The main categories evaluated were type of regulatory bodies, requirements for initial professional registration, and registration renewal. Results. All countries regulate the nursing profession through a regulatory body. Competency exams for initial registration are required in the United States, Canada, and most Caribbean countries. Registration renewal is required in 54.3% of the countries. Continuing education is required for professional registration renewal in the United States, Canada, and 53% of Caribbean countries. Labor hours are required in the United States and Canada. Conclusion. Regulations promote and protect professional integrity. The Pan American Health Organization/World Health Organization recommends that countries make efforts to evaluate competency and training, consider the use of competency exams for initial registration, and add continuing education as requirements for registration renewal.

[RESUMEN]. Objetivo. Describir y analizar la normativa reguladora vigente en materia de enfermería en los países de la Región de las Américas. Métodos. Se efectuó un análisis comparativo de los países reuniendo información de los ministerios de salud, escuelas de enfermería, consejos, asociaciones y comités profesionales en 2018. Las principales categorías evaluadas fueron los tipos de organismos reguladores, los requisitos para el registro profesional inicial y la renovación del registro. Resultados. Todos los países regulan la profesión de enfermería por medio de un organismo regulatorio. Los Estados Unidos, Canadá y la mayoría de los países del Caribe exigen exámenes de competencia para el registro inicial. En el 54,3% de los países se exige la renovación periódica del registro. En los Estados Unidos, Canadá y el 53% de los países del Caribe se requiere cumplimentar educación continua para renovar el registro profesional. En los Estados Unidos y Canadá se requiere acreditar horas de trabajo. Conclusión. Los mecanismos regulatorios promueven y protegen la integridad profesional. La Organización Panamericana de la Salud/Organización Mundial de la Salud recomienda que los países evalúen la competencia y la capacitación profesionales, consideren la posibilidad de utilizar exámenes de competencia para el registro inicial y requieran educación continua como requisito para renovar el registro profesional.

Maternal health training priorities for nursing and allied professions in Haiti.

OBJECTIVES: This study summarizes the findings of a training needs and priority assessment completed in Haiti. Its objective is to describe the characteristics of nursing and allied professions providing first level maternal health care and identify training needs and priorities to inform planning of Human Resources for Health interventions. METHODS: A cross-sectional survey was completed between October 2016 and March 2017 by the Pan American Health Organization/World Health Organization Haiti office in collaboration with national health authorities. Participants reached consensus to submit one finalized version of the survey. Data were collected on composition, capacities, and training needs and priorities of traditional birth attendants, community health workers, registered nurses, professional midwives, and auxiliary nurses. RESULTS: Haiti relies heavily on community level workers including community health workers, auxiliary nurses, and traditional birth attendants. Traditional birth attendants attend the majority of Haiti's births, despite having low education levels and not being regulated by the Ministry of Public Health and Population. All professional categories prioritize preventive capacities such as timely identification of complications, while none are trained to manage postpartum hemorrhage, preeclampsia, or eclampsia. Management of obstetric emergencies is a training priority for Haiti but is not part of the scope of work of the nursing and allied health professions included in this study. CONCLUSIONS: Community level health workers are key in providing preventive care and referral of complicated pregnancies, but lack of access to providers qualified to treat obstetric complications remains a challenge to reducing maternal mortality.

Maternal health training priorities for nursing and allied professions in Haiti

[ABSTRACT]. Objectives. This study summarizes the findings of a training needs and priority assessment completed in Haiti. Its objective is to describe the characteristics of nursing and allied professions providing first level maternal health care and identify training needs and priorities to inform planning of Human Resources for Health interventions. Methods. A cross-sectional survey was completed between October 2016 and March 2017 by the Pan American Health Organization/World Health Organization Haiti office in collaboration with national health authorities. Participants reached consensus to submit one finalized version of the survey. Data were collected on composition, capacities, and training needs and priorities of traditional birth attendants, community health workers, registered nurses, professional midwives, and auxiliary nurses. Results. Haiti relies heavily on community level workers including community health workers, auxiliary nurses, and traditional birth attendants. Traditional birth attendants attend the majority of Haiti’s births, despite having low education levels and not being regulated by the Ministry of Public Health and Population. All professional categories prioritize preventive capacities such as timely identification of complications, while none are trained to manage postpartum hemorrhage, preeclampsia, or eclampsia. Management of obstetric emergencies is a training priority for Haiti but is not part of the scope of work of the nursing and allied health professions included in this study. Conclusions. Community level health workers are key in providing preventive care and referral of complicated pregnancies, but lack of access to providers qualified to treat obstetric complications remains a challenge to reducing maternal mortality.

[RESUMEN]. Objetivos. En este estudio se resumen los resultados de la evaluación de necesidades y prioridades de capacitación realizada en Haití. Su objetivo es describir las características de la enfermería y las profesiones auxiliares que prestan el primer nivel de atención de salud materna, y establecer las necesidades y las prioridades de capacitación a fin de diseñar la planificación de recursos humanos para las intervenciones de la salud. Métodos. La Representación de la Organización Panamericana de la Salud/Organización Mundial de la Salud en Haití realizó una encuesta transversal entre octubre del 2016 y marzo del 2017, en colaboración con las autoridades nacionales de salud. Los participantes consensuaron presentar una versión ultimada de la encuesta. Se recopilaron datos sobre la composición, las capacidades y las necesidades y las prioridades de capacitación de las parteras tradicionales, los agentes comunitarios de salud, las enfermeras tituladas, las parteras profesionales y las enfermeras auxiliares. Resultados. Haití depende en gran medida de trabajadores comunitarios, entre los que se incluyen los agentes comunitarios de salud, las enfermeras auxiliares y las parteras tradicionales. Las parteras tradicionales atienden la mayoría de los nacimientos en Haití, a pesar de disponer de un nivel bajo de formación y no estar reguladas por el Ministerio de Salud Pública y Población. Todas las categorías profesionales priorizan las capacidades preventivas, como la detección temprana de las complicaciones, si bien no están capacitadas para controlar la hemorragia posparto, la preeclampsia o la eclampsia. El tratamiento de las urgencias obstétricas es una prioridad de la capacitación en Haití, pero no forma parte del ámbito de trabajo de la enfermería y las profesiones auxiliares incluidas en este estudio. Conclusiones. Los trabajadores de salud a nivel comunitario son clave para la prestación de atención preventiva y derivación de los embarazos complicados, pero la falta de acceso a prestadores cualificados para tratar las complicaciones obstétricas es todavía un obstáculo para reducir la mortalidad materna.

[RESUMO]. Objetivos. Este estudo resume os resultados de uma avaliação sobre as necessidades prioritárias na formação de profissionais da saúde no Haiti. Seu objetivo é descrever as características do trabalho de enfermeiros e profissionais da saúde auxiliares na prestação de atenção primária para a saúde materna e identificar as necessidades prioritárias de formação, a fim de fundamentar o planejamento de intervenções voltadas aos recursos humanos para a saúde. Métodos. O Escritório da Organização Pan-Americana da Saúde/Organização Mundial da Saúde no Haiti, em colaboração com as autoridades nacionais de saúde, realizou um inquérito transversal entre outubro de 2016 e março de 2017. Os participantes chegaram a um consenso, apresentando uma versão finalizada do inquérito. Foram coletados dados sobre a composição, as capacidades e as necessidades prioritárias de formação de parteiras tradicionais, agentes comunitários de saúde, enfermeiros, parteiras profissionais e auxiliares de enfermagem. Resultados. O Haiti é muito dependente de trabalhadores de nível comunitário, como agentes comunitários de saúde, auxiliares de enfermagem e parteiras tradicionais. As parteiras tradicionais atendem a maioria dos partos no Haiti, apesar de terem um baixo nível de escolaridade e não serem regulamentadas pelo Ministério de Saúde Pública e População. Todas as categorias profissionais priorizam as capacidades preventivas, como a rápida identificação de complicações, e nenhuma recebe formação para lidar com hemorragia pós-parto, pré-eclâmpsia ou eclâmpsia. A formação para o tratamento de emergências obstétricas é uma prioridade no Haiti, mas não faz parte do escopo de trabalho dos enfermeiros e profissionais da saúde auxiliares incluídos neste estudo. Conclusões. Os profissionais da saúde de nível comunitário são fundamentais na prestação de cuidados preventivos e no encaminhamento de gestações complicadas, mas a falta de acesso a profissionais qualificados para tratar complicações obstétricas ainda é um obstáculo nos esforços para reduzir a mortalidade materna.