In-hospital interventions to promote relational practice with families in acute care settings: A scoping review

Relational practice is characterised by genuine interaction between families and healthcare professionals that promotes trust and empowerment. Positive clinical outcomes have been associated with relational practice. To assess and examine in-hospital interventions designed to promote relational practice with families in acute care settings of emergency departments, intensive care units and high care units. The preferred reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the design of this scoping review. To identify relevant studies, databases (Academic Search Complete; CINAHL; PubMed; PsyInfo) and the search engine Google Scholar were searched using terms for core elements of relational practice and family engagement. Of the 117 articles retrieved, eight interventional studies met the search criteria. The interventions focused on relational practice elements of collaborating with and creating safe environments for families, whilst only one addressed healthcare professionals being respectful of families' needs and differences. In relation to the nature of engagement of families in interventions, the focus was mainly on improving family functioning. Family engagement in the interventions was focused on involving families in decision-making. The scoping review revealed a limited number of in-hospital interventions designed to promote relational practice with families in acute care settings. Further research is encouraged to develop such interventions. Contribution: The scoping review has highlighted specific elements of relational practice that have been overlooked in the mapped interventions. This provides guidance on where future interventional research may be focused.

A description of the self-perceived educational needs of emergency nurses in Durban, KwaZulu-Natal, South Africa

Introduction:Emergency nurses are usually the first to interact with critically ill patients and victims of violence and injuries, and require advanced skills and knowledge to manage such patients. Inadequate training prevents nurses from providing optimal emergency care, and it is important to investigate if there are any skills and competencies lacking in these emergency nurses. We sought to describe the self-perceived educational needs of emergency nurses in Durban, South Africa.Methods:A descriptive quantitative survey was conducted with nurses working in four emergency centres (two state, and two privately funded hospitals) in Durban, South Africa.Results:The survey questionnaire was distributed with a response rate of 79% (n = 128). Almost half the respondents (48%, n = 61) scored less than the mean score of 29, thus indicating lower competency levels. The majority of respondents (67%, n = 85) perceived themselves as highly competent in basic skills (e.g. assess breathing, administer oxygen, assess circulation). Less than half the respondents (45%, n = 57) perceived themselves as highly competent in the intermediate skills (e.g. control haemorrhage, assist with endotracheal intubation, manage shock). A large number of respondents (46%, n = 59) perceived themselves as least competent in advanced skills (e.g. defibrillation/cardioversion, interpreting an echocardiogram [ECG]). The mean score obtained for educational need was 100, thus reflecting a high educational need, and more than half the respondents (62%, n = 79) scored higher than the mean score of 100 for educational needs. The lowest score was 41. Thirty percent (n = 38) of the respondents scored 117, indicating educational needs for all the competencies listed. Overall, 72% (n = 92) agreed that emergency education was a need.Discussion:The study emphasises the need for support systems for educational development of emergency nurses. Further training in specific skills and competencies may enhance emergency care provided. There is a growing need for ongoing educational development of emergency nurses in South Africa

A description of the self-perceived educational needs of emergency nurses in Durban, Kwazulu-Natal, South Africa

Introduction:Emergency nurses are usually the first to interact with critically ill patients and victims of violence and injuries, and require advanced skills and knowledge to manage such patients. Inadequate training prevents nurses from providing optimal emergency care, and it is important to investigate if there are any skills and competencies lacking in these emergency nurses. We sought to describe the self-perceived educational needs of emergency nurses in Durban, South Africa.Methods:A descriptive quantitative survey was conducted with nurses working in four emergency centres (two state, and two privately funded hospitals) in Durban, South Africa.Results:The survey questionnaire was distributed with a response rate of 79% (n = 128). Almost half the respondents (48%, n = 61) scored less than the mean score of 29, thus indicating lower competency levels. The majority of respondents (67%, n = 85) perceived themselves as highly competent in basic skills (e.g. assess breathing, administer oxygen, assess circulation). Less than half the respondents (45%, n = 57) perceived themselves as highly competent in the intermediate skills (e.g. control haemorrhage, assist with endotracheal intubation, manage shock). A large number of respondents (46%, n = 59) perceived themselves as least competent in advanced skills (e.g. defibrillation/cardioversion, interpreting an echocardiogram [ECG]). The mean score obtained for educational need was 100, thus reflecting a high educational need, and more than half the respondents (62%, n = 79) scored higher than the mean score of 100 for educational needs. The lowest score was 41. Thirty percent (n = 38) of the respondents scored 117, indicating educational needs for all the competencies listed. Overall, 72% (n = 92) agreed that emergency education was a need. Discussion:The study emphasises the need for support systems for educational development of emergency nurses. Further training in specific skills and competencies may enhance emergency care provided. There is a growing need for ongoing educational development of emergency nurses in South Africa

Nurses' compliance with prevention of mother-to-child transmission national guidelines in selected sites in Kinshasa, Democratic Republic of Congo

Background: The Democratic Republic of Congo (DRC) implemented a prevention of mother-to-child transmission (PMTCT) of HIV infection programme in maternal; newborn and child health (MNCH) services in 2001 with nurses as key personnel. To date there is no informationin the DRC and specifically in Kinshasa with respect to compliance with PMTCT national guidelines.Aim: The study aimed at describing nurses' compliance with the PMTCT national guidelines in selected PMTCT sites of Kinshasa.Methods: A descriptive cross-sectional study was conducted in Kinshasa with 76 nurses in 18 selected PMTCT sites. The nurses' compliance with PMTCT national guidelines was assessed using a healthcare provider self-reporting questionnaire developed by the researchers.Results: The study showed that the mean score of nurses' compliance with PMTCT nationalg uidelines was 74% (95% CI: 69% - 78%) which progressively decreased and was significantly different across different MNCH services (p = 0.025). With respect to categories of PMTCT recommendations; nurses were compliant with those related to education in labour and delivery; and antenatal services. Sociodemographic characteristics such as training; length of service and category of nurses did not influence nurses' compliance score.Conclusion: These findings showed that nurses were noncompliant with PMTCT national guidelines; with the score level being 80% or more in the three MNCH services/units. Improvement of nurses' 'compliance with the PMTCT national guidelines requires effective monitoring of full integration of PMTCT as routine activities in MNCH care

Parents Perceptions of Stress in a Neonatal Intensive Care Unit in Rwanda

Background: Having a newborn infant hospitalised in the neonatal intensive care unit (NICU) is an unexpected and stressful event for a family. A number of potential stressors to which family members of patients in these units may be exposed have been identified; although no studies about this issue have been conducted in Rwanda.Aim: The aim of this study was to describe and analyse parental perception of stress that resulted from having their infant admitted to a NICU in Kigali; Rwanda.Method: A quantitative survey was used to describe and analyse parents' perceptions of stress when they had an infant admitted to a NICU. The Parental Stress Scale: Neonatal Intensive Care Unit was used to measure the level of stress that those parents experienced.Results: The results indicated that parents experienced stress from having their infants cared for in a NICU. The most stressful events were the appearance and behaviour of the baby with a mean score of 4.02; whilst the subscale items related to sights and sounds were found to be the least significant source of stress for parents with a mean score of 2.51. In addition; the current study found that parents' age; educational level; occupation; and infant birth weight were associated with parental stress.Conclusion: The study established that a range of factors was responsible for parental stress when a baby was cared for in a NICU. Identification of these factors could enable health professionals from a hospital in Kigali; Rwanda; to facilitate parents' adjusting and coping

Assessment of knowledge and skills of triage amongst nurses working in the emergency centres in Dar es Salaam, Tanzania

Introduction:The triage nurse in the emergency centre (EC) is the first person that a patient encounters and the triage nurses' knowledge has been cited as an influential factor in triage decision-making. The purpose was to assess the triaging knowledge and skills of nurses working in the ECs in Dar es Salaam; Tanzania.Methods:Both descriptive cross-sectional and observational study designs were used and data was collected using a structured questionnaire; an observation checklist and a triage equipment audit record. The study population was all nurses (enrolled and registered) working within the EC of the national hospital and three municipal district hospitals in Dar es Salaam. Descriptive statistical data analysis was carried out using SPSS 13.0.Results:Thirty three percent (20/60) of the respondents were not knowledgeable about triage. Thirteen percent of the respondents reported that although they had attended workshops; there had been a lack of information on how to triage patients. More than half (52) of the respondents were not able to allocate the patient to the appropriate triage category. Fifty eight percent (35/60) of the respondents had no knowledge on waiting time limits for the triaged categories. Among the four hospitals observed; only one had nurses specifically allocated for patients' triage. The respiratory rate of patients was not assessed by 84 of the triage nurses observed. No pain assessment was done by any of the triage nurses observed. Only one out of four ECs assessed had triage guidelines and triage assessment forms.Discussion:Nurses who participated in this study demonstrated significant deficits in knowledge and skills regarding patients' triaging in the EC. To correct these deficits; immediate in-service training/education workshops should be carried out; followed by continuous professional development on a regular basis; including refresher training; supportive supervision and clinical skills sessions