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BACKGROUND: The role of effective interprofessional teamwork is especially vital in the Neonatal Intensive Care Unit (NICU) where infants facing emergency situations are admitted. Proper neonatal resuscitation, facilitated by comprehensive resuscitation training, can significantly decrease the mortality rates associated with neonatal asphyxia and respiratory failure. This study aimed to develop a simulation-based interprofessional education (IPE) programme for medical staff working in a nursery and NICU and to assess its effectiveness on teamwork, communication skills, clinical performance, clinical judgement, interprofessional attitudes, and education satisfaction. METHODS: Through a demand survey, neonatal resuscitation was selected as the theme, and an IPE team comprised of one doctor and two nurses was formed. The education programme consisted of three sessions lasting a total of 140 min: two simulation exercises and one theoretical education session. Data were collected from 18 nurses working in the nursery and NICU and 9 doctors working in the paediatrics department. RESULTS: A comparison of the metrics before and after applying simulation-based IPE programmes revealed teamwork (Z=-2.67, p = .008), communication skills (Z=-2.68, p = .007), clinical performance (Z=-2.52, p = .012), clinical judgement (Z=-4.52, p < .001), and interprofessional attitude (Z=-3.64, p < .001) to have significantly improved. Education satisfaction scores were 4.73 points on average out of a maximum of 5. The simulation-based IPE programme was effective in improving the teamwork, communication, and clinical performance of resuscitation teams, individual clinical judgement, and interprofessional attitude. CONCLUSIONS: Simulation-based IPE is effective for enhancing teamwork, team communication, clinical judgement skills, and clinical performance in neonatal resuscitation. This programme has the potential to contribute to the improvement of patient safety and the quality of neonatal care. Additional studies are needed to longitudinally examine the effects of the programme on patient safety and quality of neonatal care.
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Comunicação , Unidades de Terapia Intensiva Neonatal , Equipe de Assistência ao Paciente , Ressuscitação , Treinamento por Simulação , Humanos , Recém-Nascido , Ressuscitação/educação , Competência Clínica , Educação Interprofissional , Relações Interprofissionais , Feminino , Masculino , Atitude do Pessoal de Saúde , AdultoRESUMO
BACKGROUND: Nursing faculties need to develop digital competencies to effectively use information, communication, and technology-based nursing education. PURPOSE: The study aimed to develop and apply a theory-guided faculty development program on digital teaching competencies. METHODS: A faculty development program was developed. Between March and April 2020, three five-hour web workshops participated by ninety-three faculty members were held. The program was assessed via mixed methods, combining satisfaction surveys post-workshop with content analysis of open-ended questionnaires to gauge participant evaluation of program content and learning experience. RESULTS: Participants were highly satisfied with the program contents and their opportunity for integrating digital technology into education and improving faculty proficiency in digital teaching technology. CONCLUSIONS: The program provides faculties with the self-confidence and essential skills to teach students using information, communication, and technology-based nursing education by enhancing their digital teaching competencies. It is critical to integrate both digital proficiency and nursing practice education.
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Docentes de Enfermagem , Desenvolvimento de Pessoal , Humanos , Competência Profissional , Feminino , Masculino , Educação em Enfermagem/métodos , Ensino , Inquéritos e Questionários , Desenvolvimento de Programas , AdultoRESUMO
BACKGROUND: Delirium commonly occurs in paediatric patients with acute critical illness and negatively affects clinical outcomes. Variations in delirium knowledge levels and its management have been noted among nurses. AIMS: This study investigated nurses' experiences and knowledge levels regarding paediatric delirium. Additionally, we aimed to assess the gap between knowledge levels and practical experiences with paediatric delirium. STUDY DESIGN: This cross-sectional descriptive study conveniently sampled paediatric nurses from a university hospital in South Korea between September 2022 and March 2023. Nursing experiences with paediatric delirium and delirium knowledge levels were measured using structured survey questionnaires. Delirium knowledge was scored 0 to 47, and higher scores indicated higher levels of delirium-related knowledge. Data were analysed using descriptive statistics and presented as mean, standard deviation, frequency and percentage. RESULTS: A total of 127 paediatric nurses participated in this study; 40.2% had experience with 1-5 delirium cases in the previous year, and 86.6% (n = 110) had never used assessment tools for paediatric delirium assessment. The mean total delirium knowledge score was 34.45 ± 5.4; the mean scores of knowledge regarding aetiology, signs and symptoms and nursing management of delirium were 8.93 ± 1.31, 13.24 ± 2.81 and 12.3 ± 2.7, respectively. Interventions associated with a lower level of delirium-related knowledge and a lower performance rate included avoiding restraint use and maintaining hydration and electrolyte levels. Interventions associated with a higher level of delirium-related knowledge but a lower rate of performance comprised providing orientation, offering emotional support, allowing participants to stay with family members and administering medications to manage delirium. CONCLUSIONS: Although nurses working in paediatric units exhibited high rate of delirium nursing care, there was the gap between their delirium-related knowledge and practice. Nurses need to be aware of the insufficient part of delirium care, and paediatric delirium education should be reinforced. RELEVANCE TO CLINICAL PRACTICE: Preventing, assessing and systematically managing paediatric delirium is crucial, and considering the study results, delirium education among nurses is needed.
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AIM: To develop a comprehensive, hands-on assessment tool for assessing health in children under five in underserved regions. DESIGN: Methodological study design and usability testing were used. SAMPLE: Eight nurses working at two health posts and 261 children under five living in the migrant villages participated in the study. MEASUREMENT: The developed tool was evaluated using 10 items of a questionnaire based on the honeycomb model of Morville (2004). Community nurses administered the questionnaire then followed with a focus group interview after completing a child health exam using the developed tool. Data were collected during July 2017. RESULTS: The Hands-on Assessment Tool for Child Health is composed of developmental screening, identification of risk factors and clinical signs, growth measurement, diagnostic tests and interpretation of each subdomain, and final impressions. Management strategies include parent education, resource networking, referral to a paediatrician, and follow-up plans. Usability testing revealed high scores on the facets "valuable," "useful," "desirable," and "findable." CONCLUSIONS: Considering the demand for hands-on tools in underserved regions, the developed tool can provide nurses with resources for competent management of child assessment, interpretation, and nurses' intervention strategies, fortified with clinical judgement processes.
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Saúde da Criança , Área Carente de Assistência Médica , Criança , Pré-Escolar , Feminino , Grupos Focais , Humanos , Quirguistão , Masculino , Encaminhamento e Consulta , Fatores de Risco , População Rural , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Delirium in neonates and infants is difficult to screen or assess because of their different developmental features and distinct delirium characteristics compared with those of older children. Some delirium management strategies, including assessment, pharmacological and non-pharmacological interventions, and prevention strategies, have been previously suggested for paediatric delirium. However, whether these strategies are effective for delirium in neonates and infants is unclear. This scoping review aims to explore comprehensive information on delirium in neonates and infants, such as the features of delirium, factors related to delirium, and current assessments and interventions in neonates and infants. METHODS AND ANALYSIS: This study will be based on the Joanna Briggs Institute guidelines for scoping review protocol development and follow each stage of the framework proposed by Arksey and O'Malley. Research questions regarding delirium management in neonates and infants will be specified. A wide range of databases, including MEDLINE, EBSCO, Embase and the Cochrane Library, using optimised terms will be searched from 2004 to 2024. The summarised results will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension of the Scoping Reviews checklist. ETHICS AND DISSEMINATION: Since this study will review and summarise published scientific literature, ethical approval is not required. The results of this scoping review will be disseminated through conference presentations and peer-reviewed publications. The study findings will be disseminated through seminars for experts so that they can be reflected in practice.
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Delírio , Humanos , Delírio/terapia , Delírio/prevenção & controle , Recém-Nascido , Lactente , Projetos de Pesquisa , Revisões Sistemáticas como AssuntoRESUMO
BACKGROUND: Community health workers (CHWs) have strong potential for conducting health initiatives in vulnerable countries. Their continuing activities are essential for positive outcomes. The purpose of this study is to understand CHW activities in Kyrgyzstan migrant villages and their impact on individuals and communities. METHODS: This study used a mixed-method design. All active CHWs were invited to participate in the survey and the first reflection note regarding their experience and satisfaction with CHW activities. Respondents who agreed to participate in the second reflection notes wrote additional reflection notes. Participatory observational CHW activity report meeting data was collected for additional qualitative analysis. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed thematically. RESULTS: CHWs started their activities with altruistic and personal motives, such as social recognition and knowledge acquisition. Job-related satisfaction after the activity tended to be high. After performing home visits and resident participatory events, they experienced intrinsic motivation, resource mobilization efforts, increased autonomy, and social recognition. Although the material rewards were small as volunteers, they recognized their positive impact on individuals and communities and gained pride and happiness. CONCLUSIONS: CHWs participating in health promotion projects had training and CHW-nurse network activities and were gradually empowered in the process. When considering the sustainability of CHW activities, it is important to increase self-confidence and strengthen social recognition through empowerment.
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Atitude do Pessoal de Saúde , Agentes Comunitários de Saúde , Humanos , Criança , Agentes Comunitários de Saúde/educação , Quirguistão , Pesquisa Qualitativa , Avaliação de Programas e Projetos de Saúde , Promoção da Saúde , MotivaçãoRESUMO
The concentration of patients in a few facilities burdens healthcare providers and the healthcare system. This study examined the operations of an extended anteroom in a COVID-19-dedicated hospital. It presents issues to consider in the deployment and operation of an extended anteroom through discussions by expert working groups. The subjects covered included efficient space, staffing, equipment management, and education. The process involved wearing personal protective equipment (personal protective equipment; in this case, Level D), and if necessary, wearing additional powered air purification respirators (PAPR), after moving from the preparation room to the dressing room, and when entering the hospital through the entrance passage. When leaving the hospital, personnel used a mandatory exit-only passage. In the dressing room, they undressed, and then went outside. The efficient spatial composition of the anteroom facilitated entry and exit, as well as the separation of contaminated and non-contaminated areas using colors and lines. As COVID-19 spread rapidly in the community, COVID-19-dedicated hospitals were established highly quickly. Therefore, there exists a limitation because sufficient discussion with external experts has not been made. In the future, the development of an operating manual for dedicated infectious disease hospitals and continued research into the improvement of care is needed. This study indicated the need to develop educational programs and use educational simulations, to address regionally spread infectious diseases.
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COVID-19 , Pessoal de Saúde , Hospitais , Humanos , Equipamento de Proteção Individual , SARS-CoV-2RESUMO
PURPOSE: This study was conducted to explore the core educational components of interprofessional education (IPE) for pediatric emergencies to establish a basis for interprofessional simulation education. METHODS: Using Whittemore and Knafl's integrative review method, we searched for studies in PubMed, Embase, Cochrane Library, CINAHL, and four South Korean databases (RISS, NDSL, DBpia, and KISS). RESULTS: We identified 21 studies on the general characteristics of IPE in pediatric emergency situations and integrated the core components of IPE according to a PRISMA flowchart. Three core components were identified (individual-competent professionals, team-cooperative professions, and outcome-optimal achievement), with the subthemes of role and responsibility, clinical judgment, performance, leadership, communication, teamwork, patient safety, and quality improvement. CONCLUSION: We recommend that IPE pediatric emergencies should contain the three dimensions of these core components to enhance individual and team performance and to promote optimal achievement in terms of patient outcomes. IPE programs should consider these characteristics and include a valid tool for evaluating the programs' effectiveness.
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This study assesses the status of iodine deficiency among at risk-children and adolescents living in migrant settlements in the Kyrgyz Republic. Children aged 7-15 years from two regional primary schools in the new settlement regions were screened for cognitive and behavioural signs of iodine deficiency using questionnaires. The functional state of the thyroid gland was assessed using ultrasonography and blood tests. Out of 1058 schoolchildren, 15.8% showed signs of iodine deficiency. Female children aged 10-12 years showed a higher prevalence of iodine deficiency. The families of schoolchildren reported limited use of seafood and iodised salt. Children in the migrant regions were at risk of iodine deficiency disorder. Among children, clinical manifestations of iodine deficiency were observed as negative hormonal levels or the presence of goitre. Further investigation on standardised screening instruments for iodine deficiency and the relationship among multilevel analyses are warranted.
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PURPOSE: We aimed to identify collaborative disaster governance through the demand and supply analysis of resources recognized by nurses during the COVID-19 pandemic. METHODS: We used a descriptive study design with an online survey technique for data collection. The survey questions were developed based on focus group interviews with nurses responding to COVID-19 and expert validity testing. A 42-question online survey focusing on disaster governance was sent to nurses working in COVID-19 designated hospitals, public health offices, and schools. A total of 630 nurses participated in the survey. Demand and supply analysis was used to identify the specific components of disaster governance during a pandemic situation and analyze priority areas in disaster governance, as reported by nurses. RESULTS: Demand and supply analysis showed that supplies procurement, cooperation, education, and environment factors clustered in the high demand and supply quadrant while labor condition, advocacy, emotional support, and workload adjustment factors clustered in the high demand but low supply quadrant, indicating a strong need in those areas of disaster governance among nurses. The nurses practicing at the public health offices and schools showed major components of disaster governance plotted in the second quadrant, indicating weak collaborative disaster governance. CONCLUSION: These findings show that there is an unbalanced distribution among nurses, resulting in major challenges in collaborative disaster governance during COVID-19. In the future and current pandemic, collaborative disaster governance, through improved distribution, will be useful for helping nurses to access more required resources and achieve effective pandemic response.
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COVID-19 , Desastres , Enfermeiras e Enfermeiros , Humanos , Pandemias , SARS-CoV-2 , Carga de TrabalhoRESUMO
Empirical evidence on community-driven child health promotion programs in disadvantaged migrant populations is limited despite various promotional strategies. Therefore, we implemented a developmental process to shape child health interventions using theory-guided community-based participatory action research (CBPAR) in a migrant community in Bishkek, Kyrgyzstan between 2015 and 2019. The collaborative and iterative CBPAR process was conducted through participatory workshops and focus group discussions with support from trusting and collegial partnerships between community members and the research team. The goal and scope of the intervention was guided by enabling environments for nurturing care, including the four domains of caregivers' capabilities, empowered communities, supportive services, and enabling policies. Diverse interests and needs identified by community members were aggregated in the theoretical model and reflected in the intervention. Community-driven intervention is perceived as a culturally acceptable, sustainable, sensitive and relevant approach to solve problems. There are several challenges in conducting the CBPAR, such as the effort and time spent on building partnerships, co-learning and mutual understanding, and the power equilibrium involved. Despite this, the success of the CBPAR process provided opportunities for community mobilization, empowerment and sustainability of the intervention. Evaluation of the process and outcomes of the intervention provided community health researchers and practitioners with evidence of the theory-guided community participatory approach.
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BACKGROUND: The Simulation Effectiveness Tool (SET) frequently is used to assess perceived learning and confidence in simulation. However, few studies have reported the validity of the tool. This study assessed the reliability and validity of the SET. METHOD: This retrospective analysis evaluated the tool using 568 cases conducted at three nursing schools. RESULTS: A two-factor model showed reasonable fit indices. The fit statistics for the two-factor structure were: χ2, 152.98 (df = 53, p < .001); comparative fit index, 0.94; root mean square error of approximation, 0.05 (range, 0.04 to 0.06); and standardized root mean square residual, 0.04. In addition, weak convergence was identified between the confidence in the SET and responding in the Lasater rubric. CONCLUSION: The psychometric properties of the study indicate the SET has demonstrated acceptable evidence of validity and reliability to measure simulation effectiveness in Korean nursing students. The use of this instrument for brief simulation education is recommended. [J Nurs Educ. 2020;59(4):186-193.].
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Competência Clínica/normas , Bacharelado em Enfermagem/normas , Treinamento por Simulação/normas , Avaliação Educacional/normas , Humanos , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
Despite over 10 years of support from government health programs and health organizations, children in migrant villages in Kyrgyzstan remain a public concern owing to high incidence rates of preventable diseases such as anemia. An effective community health promotion program is needed but there is a lack of knowledge of community barriers and health factors affecting children's health in these migrant villages. The purpose of this study was to conduct a community health needs assessment to develop strategies for a child health promotion program in these migrant villages. This study conducted using a mixed method that included literature review, reginal statistics, focus group and key person interviews, and a community survey. The analysis method was descriptive statistics for the questionnaires, and content analysis for the interviews. Results showed the following priorities for child health promotion: strengthening health care provider capacity, overcoming resource shortages, managing child health and preventable diseases, improving public hygiene, promoting a healthy lifestyle, and empowering school health. The strategies were identified: capacity building of health workers, increasing community participation and raising child health awareness, and supporting child health promotion services. These findings will help guide the implementation of a child health promotion program.