Circumcision Weeks: Making Circumcision Part of Routine Training and Service Delivery at District-level Hospitals in South Africa

"Background: Medically safe; elective male circumcision supports traditional and cultural rites of passage by reducing the risk of adverse events and death among men undergoing initiation. It is a way of preventing penile conditions that arise from being uncircumcised. It also protects against various sexually transmitted infections; playing a particularly important role in human immunodeficiency virus (HIV) prevention; as it protects against HIV infection in men by up to 60. It also helps reduce herpes simplex virus type 2; a key biological co-factor thought to account for some human susceptibility to HIV infection and human papillomavirus. To address these needs and to meet the World Health Organization's call to upscale male circumcision to 80 in HIV/AIDS epidemic-gripped sub-Saharan Africa; there is a need to provide male circumcision as standard care in district health. Method: A retrospective review of three years of circumcision services; using the sleeve method; and not the high-volume; forceps-guided method; and training at a Level 1 district hospital in South Africa. Results: Two hundred and twenty-one medical circumcisions were performed; increasing significantly in each successive year. Mostly; they were carried out under local anaesthetic; and there were only four complications; all of which were successfully resolved. The average age of the patients was 20; and generally; they elected to have medical circumcision carried out for cultural reasons. Some 60 students and clinicians were trained in safe medical male circumcision. Conclusion: To meet the growing demand for male medical circumcision; especially among teenagers and young adult men at district-level hospitals; there is a need to significantly expand the surgical competency of clinicians in this field. ""Circumcision weeks"" are one way of routinely upscaling surgical skill levels; while simultaneously responding to increased patient demand for safe medical circumcision."

Manual clínico para el aprendizaje de AIEPI en enfermería: Cuadros de procedimientos / Clinical Handbook IMCI learning in nursing: Pictures of procedures

El manual contiene los conocimientos y prácticas básicas que deben emplearse en los servicios que reciben la referencia desde la comunidad. Todo personal clínico que participa en la evaluación y atención inicial de niñas y niños enfermos debe estar capacitado para llevar a cabo procedimientos de clasificación y de identificación de aquellas niñas y niños que presentan signos de urgencia o necesitan atención prioritaria y si fuera posible, administrar el tratamiento de urgencia esencial. El manual también complementa las materiales disponibles para que la estrategia AIEPI sea incorporada en la enseñanza de pre y postgrado en las Escuelas de Enfermería. De esta forma, además de la aplicación de la estrategia ambulatoria, los estudiantes y graduados podrán hacer uso de las recomendaciones de la misma para el tratamiento de las enfermedades en los servicios de salud del primer nivel de referencia, tal como están comprendidas en el presente texto. El manual también complementa las materiales disponibles para que la estrategia AIEPI sea incorporada en la enseñanza de pre y postgrado en las Escuelas de Enfermería. De esta forma, además de la aplicación de la estrategia ambulatoria, los estudiantes y graduados podrán hacer uso de las recomendaciones de la misma para el tratamiento de las enfermedades en los servicios de salud del primer nivel de referencia, tal como están comprendidas en el presente texto.

Educational Issues and Strategies to Improve APN Education / 간호학회지

PURPOSE: This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education. METHODS: A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews. RESULTS: The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic. CONCLUSION: The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.

Development of Objectives in Nursing Clinical Education based on the Nursing Core Competencies / 간호학회지

PURPOSE: The purpose of this study was to set up a Nursing Core Competencies required for staff nurses and to set up Objectives for Nursing Clinical Education based on the Nursing Core Competencies. The objectives in this study are to be achieved ultimately through clinical practice because it is a common avenue of work and the basic objective regardless of the education system and curriculum. METHOD: A nursing Core Competencies were established by literature review and verified by 15 experts. Nursing Clinical Education Objectives were established by literature review and analysis, and a survey for validity using a five point Likert scale was given to 257 nursing professors, 503 head-nurses, 509 staff nurses who had less than 3 years clinical experience in 34 general hospitals and 738 senior student nurses from 81 nursing colleges. RESULT: Nine nursing core competencies were set up. In addition 39 Objectives for each of the nursing clinical core competencies were set up. CONCLUSION: In conclusion, this study will contribute to professional nursing education to provide comprehensive nursing care by applying knowledge to nursing practice to achieve the Nursing Core Competency as a professional nurse.

The Roles of Critical Care Advanced Practice Nurse / 간호학회지

PURPOSE: To determine and compare the perception among nurses and doctors of the roles and tasks of critical care advanced practice nurses (APNs) in order to establish standardized and formally agreed role criteria for such critical care APNs. METHOD: This study measured and analyzed the necessity of each of the roles and tasks of critical care APNs, as perceived by nurses and doctors, through a survey of 121 participants: 71 nurses in 7 intensive care units (ICUs) at a general hospital in Seoul, and 50 doctors who used ICUs. Data collection utilized a questionnaire of 128 questions in the following fields: direct practice (79), leadership and change agent (17), consultation and collaboration (15), education and counseling (11), and research (6). RESULTS: Both the nurses' and the doctors' groups confirmed the necessity of critical care APNs, with doctors who frequently used ICUs indicating a particularly strong need. As for the priority of each role of critical care APNs, the nurses considered direct practice to be the most critical, followed by education and counseling, research, consultation and collaboration, and leadership and change agent. The doctors also considered direct practice to be the most critical, followed by education and counseling, consultation and collaboration, research, and leadership and change agent. There was a statistically significant difference between how the two groups regarded all the roles, except for the consultation and collaboration roles. As for the necessity of each role of critical care APNs, the nurses considered research to be the most necessary, followed by education and counseling, consultation and collaboration, leadership and change agent, and direct practice. The doctors, on the other hand, considered education and counseling to be the most necessary, followed by research, consultation and collaboration, leadership and change agent, and direct practice. The responses of the two groups to all the roles, except for education and counseling roles, were significantly different. CONCLUSION: Nurses and doctors have different perceptions of the roles and tasks of critical care APNs. Thus, it is necessary for the combined nursing and medical fields to reach an official agreement on a set of criteria to standardize for the roles and tasks of critical care APNs.