Healthcare providers' perspectives on sustaining respectful maternity care appreciated by mothers in five hospitals of Rwanda.

BACKGROUND: Childbirth reserves respect, as emphasized by the World Health Organization in 2018, and the focus towards the need for positive, dignified delivery experiences has become an integral aspect of Respectful Maternity Care (RMC). It is a known fact that RMC is pivotal for favourable birth outcomes and contributes to the satisfaction of maternity care. The absence of RMC negatively affects women's and newborns' rights. The study aimed to explore healthcare providers' perspectives on sustaining RMC actions that mothers previously reported. METHODOLOGY: This study was conducted in five hospitals in the Eastern province of Rwanda, involving 5 Focus Group Discussions (FGDs) with midwives and nurses. For interviews, we purposively selected 5-unit managers and five physicians. Additionally, 40 midwives and nurses were recruited for the FGDs. The research utilized the Dream phase of Appreciative Inquiry (AI) for interviews and Focus Groups. Data collection aimed to gain insights into Healthcare Providers' perceptions of how RMC is provided and how to establish and sustain RMC in Rwandan health facilities. Nvivo 12 was employed for organizing codes and creating a codebook, and thematic analysis was applied. RESULTS: Four themes with sub-themes emerged. Namely, 1) Women-centered care, with Compassionate care, Privacy and confidentiality maintenance, Information provision and Liberty in decision making, Effective communication, Family involvement, Cleanliness, and Equality care. 2) Professionalism compliance with Motivated staff, Teamwork, Continuous development, Quality work provision, and Community trust. 3) RMC encounters 4) RMC sustenance. CONCLUSION AND RECOMMENDATIONS: The continuous pursuit of high RMC standards in Rwanda involves improving childbirth experiences through utilizing existing resources, ongoing improvement, and sustaining achievements. Key recommended actions in this study for sustaining RMC encompass promoting women-centred care, enhancing healthcare provider attitudes, ensuring professionalism, building community trust, maintaining conducive health facility environments, and involving leadership.

Exploration of critical care nurses' challenges in caring for enterocutaneous fistula as a complication for an open abdomen: A qualitative study.

Background and Aims: Enterocutaneous fistula is a severe complication of an open abdomen, which poses devastating challenges for critical care nurses. The study aimed to explore and describe the challenges faced by critical care nurses caring for patients with enterocutaneous fistulas in a tertiary public hospital in Gauteng, South Africa. Methods: A qualitative, exploratory, descriptive, and contextual design was conducted to understand the challenges experienced by the critical care nurses caring for patients with enterocutaneous fistulas. The standards for reporting qualitative research checklists are utilized. The study conducted four semistructured focus group interviews with six members in each group. Results: Critical care nurses revealed two overarching themes: the challenges regarding difficult nursing care and the lack of resources to provide quality patient care. Care of patients with ECF highlighted that nurses were not coping with the care of such patients. Conclusion: Collaboration of a multidisciplinary team involving dieticians, surgeons, and enterostomal therapy nurses could improve the management of ECF without surgical intervention, increase the knowledge and skills of nurses, alleviate their challenges, and yield safe patient outcomes. Standardized and updated protocols will ensure the best practices toward quality patient care that facilitate healing, closure, and reducing mortality and morbidity rates. The key principles for caring for patients with open abdomen, presenting with enterocutaneous fistulas, are based on correcting fluids and electrolytes, nutritional optimization and support, control of abdominal sepsis, wound care management, pain control, and emotional support to critical care nurses and ward nurses.

Reported respectful maternity care received during childbirth at health facilities: A cross sectional survey in Eastern province, Rwanda.

BACKGROUND: Respectful maternity care (RMC) fosters positive childbirth experiences and ensures safe motherhood. While past Rwandan studies on childbirth predominantly focused on negative experiences, our research delved into positive experiences. This study aimed to assess the RMC level experienced by women during childbirth in health facilities of Eastern Province of Rwanda. METHODOLOGY: We conducted a cross-sectional survey on 610 mothers at their discharge across five public hospitals. We used a 15-items RMC questionnaire developed by White Ribbon Alliance, version of 2019. To manage the right-skewed data, we employed a median cut-off, categorizing experiences into binary outcome (low and high RMC score). We performed stepwise backward elimination logistic regression model to identify predictors of high RMC. FINDINGS: The majority (70.2%) reported experiencing RMC. The most acclaimed RMC items (over 90%) included allowance of food and fluid intake (98.5%), non-discrimination (96.2%), receipt of necessary services (96.1%), and privacy (91.3%). The chi-square analysis showed an association between reported high RMC and marital status (p-value = 0.006), occupation (p-value = 0.001), and mode of delivery (p-value = 0.001). Caesarean section delivery was associated with high RMC in multivariate logistic regression with a p-value of 0.001, the adjusted odds ratio was 2.11 with a CI [1.40-3.17]. CONCLUSION: The reported RMC items and care appreciated at high level should be sustained. Regardless of mode of delivery, all mothers should experience consistent, utmost respect throughout the childbirth and should receive RMC at maximum level.

Paediatric oncology nursing education and training programmes: a scoping review protocol.

INTRODUCTION: The care of children with cancer is a highly specialised field which requires well-educated, trained and dedicated nurses to provide high-quality care. In low/middle-income countries, the survival rate of children with cancer is low as compared with that of high-income countries due to the limited number of specialised oncology healthcare professionals, especially nurses. To address this problem, a number of paediatric oncology education and training programmes have been developed for nurses. The objective of this scoping review is to describe the existing literature focusing on paediatric oncology nursing education and training programmes; to map the content, delivery methods, duration and mode of assessment. METHODS: The review will include articles published in English, from 2012 to 2022, that describe a paediatric oncology nursing education programme, from any setting. The review will follow Joanna Briggs Institute methodology for scoping reviews guidelines. A systematic search of literature will be performed in CINAHL, Dimensions, Embase, PubMed and Scopus. A two-stage standardised screening process will be employed to evaluate eligibility of the articles. All abstracts that will be considered relevant will be reviewed in full text form by the two reviewers independently. Conflicts will be resolved by consensus of all reviewers through a meeting. Data will be extracted by two independent reviewers using a developed data extraction tool. The results will be reported in extraction tables and diagrams with a narrative summary. ETHICS AND DISSEMINATION: This scoping review is part of the multiphase study which obtained ethical clearance from College of Medicine Research Ethics Committee in Malawi and Human Research Ethics Committee of the University of Witwatersrand, South Africa. The scoping review will be published in a peer reviewed journal. The findings will also be presented at national and international conferences. TRIAL REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/X3Q4H.

Stories of being a new nurse academic at a nursing education institution.

OBJECTIVES: The objectives of this study were to explore and discover the best moments of being a new nurse academic at nursing education institutions. AIM: The purpose of this study was to define, discover and learn about the experiences of being a new nurse academic. DESIGN: A qualitative design with inspiration from Appreciative Inquiry (AI) was used. METHOD: Purposive and snowball sampling was used. Data collection was done using semi-structured individual interviews. Data were analysed using Giorgi's method. The COREQ guidance was used for reporting of this study. RESULTS: Four themes were identified. (1) The emphasis was their transition from clinical setting into the world of academics, which was challenging, overwhelming and exciting all at the same time. (2) Participants were fulfilled and influenced to achieve more. (3) Participants expressed what they wished for. (4) Participants shared recommendations for job security, employment and retainment of new nurse academics.

Development of a training programme for professional nurses in South Africa - An educational response to the COVID-19 pandemic.

AIM: This paper describes the development of the training programme for South African professional nurses on how to manage critically ill COVID-19 patients in intensive care units and repurposed general wards. DESIGN AND METHODS: The Analysis, Design, Development, Implementation and Evaluation educational instructional design model guided the development of the training programme. A case-based study approach and blended learning were used to deliver the six modules. RESULTS: The training programme was developed, reviewed and validated by the coordinating team of facilitators involved in the initiative. Implementation of the training programme and the result thereof will not be discussed as part of this manuscript. CONCLUSION: The training programme aimed to enhance the knowledge of professional nurses in the management of critically ill patients with COVID-19. As the pandemic evolves, a need for training and ongoing support was identified, which might address the need for surge capacity and hospital readiness planning.

Selection process for admission to an academic nursing programme - A meta-synthesis.

BACKGROUND: Student nurse selection has been a topic of debate for years. Poor nursing care has been attributed to uncaring attitudes, lack of motivation and poor training and mentoring. Student nurse selection requirements and the steps involved in the process have been a revolving debate. Internationally, the recruitment and selection process are being refined to align with recommendations from the Francis Inquiry to include a values assessment. OBJECTIVE: To select, review and interpret evidence-based studies on student nurse selection; and develop and provide recommendations for nurse educators when selecting first-year student nurses as a holistic, integrative process fitting with caring and providing quality care. DESIGN: Qualitative meta-synthesis. DATA SOURCES: Electronic databases were used during data collection: Ebscohost, ScienceDirect, SAGE, Cinahl and Sabinet (SAePublications). Qualitative articles published in English or Afrikaans reporting on student selection processes and experiences were included in the data collection process. REVIEW METHODS: Qualitative articles were systematically identified using the STARLITE principles. The articles were critically appraised for quality by employing the CASP method. RESULTS: Fourteen articles were included. Thirteen of the articles were published in English. One PhD thesis was included, a seminal work conducted on student nurse selection in South Africa. Data analysis revealed three main themes: a reliance on the interview, alternative selection methods, and attributes as criteria for nursing selection. Within these themes, many different methods of student selection emerged. The benefits and challenges of these methods were identified, and a holistic admission process was ultimately most successful in selecting the correct student nurse. CONCLUSIONS: The findings indicate there are many different student nurse selection processes. A holistic admission process is needed to select the best student nurse that displays caring attributes and provides quality nursing care.

South African student nurses' experiences of professional nurses' role-modelling of caring.

BACKGROUND: Student nurses are expected to implement a caring practice in order to become professional nurses. Caring has remained the art and science of nursing, which student nurses learn from professional nurses during clinical practice. The South African Nursing Council mandates professional nurses to teach and supervise student nurses to master the art of caring during clinical practice. Caring is taught through role-modelling of daily nursing activities. RESEARCH PURPOSE: This study was performed to gain an understanding of South African student nurses' experiences of professional nurses' role-modelling of caring. METHODS: Phenomenological, qualitative research. Purposive sampling of fourth-year student nurses. DATA COLLECTION: focus groups, observations and field notes. The data were analysed using Giorgi's modified Husserlian five-step method. Ethical principles were respected. RESULTS: Three themes were identified. Theme 1: inconsistency in the clinical environment; Theme 2: effective and ineffective role-modelling of caring and Theme 3: carelessness cascading. CONCLUSIONS: The study facilitated an understanding of student nurses' experiences of professional nurses' role-modelling of caring. Recommendations to facilitate professional nurses' role-modelling of caring in a public hospital were formulated: Mentorship training, recognition system for professional nurses, clinical support for student nurses, open channels of communication, random nurse leader rounds, employee wellness program, workshops and positive learning environment promotion.

Practices of caring for nursing students: A clinical learning environment.

OBJECTIVE: The purpose of this study was to explore, describe and illuminate nursing students' best encounters of caring in the clinical learning environment. Caring for nursing students was emphasized and recommendations provided to enhance caring for nursing students within their clinical learning environment. METHODS: Qualitative data was collected by the researcher using semi-structured individual interviews and an Appreciative Inquiry (AI) methodology. Ten second year nursing students undertaking the bridging course leading to registration as general nurses in terms of Regulation 683 of the South African Nursing Council (SANC) were purposively sampled from 3 private hospitals within the Western Cape. Data was analysed using Giorgi's method. RESULTS: The main theme included the best and 'least best' caring practices embedded in the centrality of the heart. The subthemes comprised of the nursing students' experiences of caring literacy and caring illiteracy. The second theme included the creation of best caring practices within a conducive clinical learning environment. Within this theme, the subthemes comprised of the caring attributes required in reflecting best caring practices, as well the creation of a clinical learning environment to optimise caring. CONCLUSIONS: The significance and necessity of caring for the nursing student were clearly illustrated and confirmed by participants. Caring was equated to the heart as the core to the nursing students' being. Recommendations for nursing education, management, practice and research were therefore specifically formulated to enhance caring towards nursing students.