Usability and Quality Evaluation of the "E- Midwife" Mobile Application for Nurse-Midwives in Obstetric Complications: A Randomized Controlled Trial.

Background: Obstetric complications are illnesses that develop during childbirth. Smartphones, which facilitate the use of prompt features in the early diagnosis of challenges and quick delivery of respectful maternity care, are one of the most recent advances in health technology. The key objective of this project is to evaluate the usability and quality of the "E-Midwife" mobile application for nurse-midwives, which focuses on obstetric complications. Methods: This study is a component of a randomized controlled trial on nurse-midwives. This project followed a four-step approach: content development phase, app design phase, app development phase, and usability testing phase. The app was developed using extensive flowcharts, a definition of the navigational framework, a structured database, and user-friendly software. 140 out of the 196 nurse-midwives were allocated to the intervention (n=70) and control group (n=70), using random allocation. The intervention group used the application for 8 weeks. Usability and quality of the application were assessed using the system usability scale and the mobile application rating scale, respectively. SPSS statistical software, version 17, was used to analyze the dat. Results: The overall score of the usability testing of E-Midwife was 82.75±0.68. The total mean score of quality was 3.77±0.86. Therefore, it was shown to have good usability and quality. Conclusion: The E-midwife mobile application has a high usability and quality which makes its usage effective and efficient. It is recommended that these similar mobile apps should be used along with other educational methods for educating the nurse-midwives.Trial Registration Number: CTRI/2022/03/040857.

Voice from the frontline and learning for the future: A qualitative descriptive study on wider perspectives of frontline nurses in India during the COVID 19 global pandemic.

Objective: This study was conducted to explore frontline nurses' experiences of the impact of COVID 19 pandemic and suggestions for improvement in the healthcare system, policy and practice in the future. Method: A qualitative descriptive design was used. Frontline nurses who were involved in providing care to patients affected with COVID 19 in four designated COVID units from the Eastern, Southern and Western regions of India were interviewed during January to July 2021. Interviews were audio-recorded and transcribed manually by researchers from each region and thematically analysed. Result: Twenty-six frontline nurses aged between 22 and 37 years with a range of 1-14 years of work experience following a Diploma or Bachelor's degree in Nursing and Midwifery and working in the COVID units of selected regions in India participated in the study. Three key themes emerged: 'Physical, emotional and social health - an inevitable impact of the pandemic' described effects of the pandemic on nurses' health and wellbeing; 'Adapting to the uncertainties' narrated how nurses accommodated to the uncertainties during the pandemic; and 'An agenda for the future - suggestions for improvement' emphasised on practical strategies for the future. Conclusion: The inevitability of the pandemic had an influence at a personal, professional, and social level with learning for the future. The findings of this study have implications for healthcare system and facilities by enhancing resources, supportive environment for staffs to cope with the challenges imposed by the crisis and ongoing training to manage life threatening emergencies in the future.