Effect of using portable alcohol-based handrub on nurses' hand hygiene compliance and nasal carriage of staphylococcus aureus in a low-income health setting.

BACKGROUND: Low hand-hygiene compliance (HHC) in low-income countries due to deficient hand hygiene resources may increase nasal carriage of S. aureus, a causative agent of health care-associated infections. The study aimed to assess the effect of using locally available portable alcohol-based handrub (ABHR) regarding nurses' HHC and nasal carriage of S. aureus. METHODS AND DESIGN: Nonrandomized interventional design. Seventy-two (72) of 86 nurses were provided with portable ABHR to use during patient care (intervention group). The remaining 14 nurses constituted the control group. Evaluation was done via HHC observation per WHO 5-moments of HH, determining S. aureus nasal carriage prevalence and HH guideline knowledge assessment via a self-response questionnaire. RESULTS: In the intervention group, HHC improved from 48.9% to 67.7% (P < .001) especially for hand-hygiene before and after patient contact. Hand-hygiene by handrubbing improved from 16 to 105 moments. There was positive feedback to portable ABHR use from nurses. S. aureus nasal carriage significantly decreased from 30.6% to 21% (P < .031). Negative carriage of S. aureus was significantly associated with increase in HHC (P < .001). Despite the low preintervention HHC, nurses showed considerably high levels of knowledge on relevance of hand hygiene. CONCLUSIONS: Portable ABHR use was associated with improved HHC and reduced S. aureus nasal carriage prevalence. As nurses' knowledge of HH guidelines was high, provision of portable ABHR compensated for deficient facility HH resources resulting in improved HHC, which effected reduction in nasal carriage of S. aureus among nurses.

Promoting nursing research globally: the writing to improve nursing science (WINS) program.

AIM: To test the feasibility of a remote writing programme, Writing to Improve Nursing Science (WINS), for nursing scholars in low- and middle-income countries and assess its impact on scholarly writing and dissemination. BACKGROUND: The ability to write and publish scholarly manuscripts is critical for successful nursing research careers. Yet, there is a lack of resources to appropriately mentor nurse scholars in this area. This is especially true for low- and middle-income countries with fewer resources and a dearth of doctorally prepared nursing faculty. INTRODUCTION: We adapted an existing university-based writing class to mentor 10 nurse scientists through the writing and publication process utilizing three components: online didactic training, remote one-to-one mentorship and an in-person peer-reviewed writing workshop. METHODS: Ten nurse faculty from 10 countries selected via competitive application developed manuscripts with remote mentorship and online training for 6 months. Then, an in-person workshop was held to conduct peer reviews of manuscripts. Mentorship continued for an additional year until the manuscript was either published or the participant no longer wished to pursue publication. RESULTS: All participants prepared a manuscript and were trained in manuscript writing, editing, and the peer review and submission process. To date, four manuscripts have been published. DISCUSSION: The Writing to Improve Nursing Science Program is a feasible model to increase publications among nursing faculty or students globally and allow the sharing of resources across countries. CONCLUSION AND IMPLICATIONS FOR NURSING POLICY: Innovative solutions for sharing of intellectual resources, such as this program may contribute to improving the evidence base globally. Nursing research policies should include a mentorship component to increase publications to improve nursing practice and related patient outcomes.

Hypertension among human immunodeficiency virus infected patients on treatment at Parirenyatwa Hospital: A descriptive study.

BACKGROUND: Since the roll-out of antiretroviral therapy (ART) in sub-Saharan Africa (sSA) in the early 2000s, the life expectancy of people infected with the human immunodeficiency virus (HIV) has increased. However, the gains made in reducing mortality from HIV-related complications have been mitigated by the emergence of age-related chronic non-communicable diseases (NCDs), such as hypertension. Protease inhibitors (PIs), and prolonged exposure to highly active ART (HAART) have been implicated in the development of hypertension in HIV-positive people. AIM: To investigate the prevalence of hypertension and its associated risk factors among HIV-positive patients receiving ART. SETTING: The study was carried out at an urban-based clinic that provides HAART and primary care to HIV-positive people in Harare, Zimbabwe. METHODS: A descriptive, cross-sectional study was conducted among non-pregnant adults on HAART attending the clinic between July and August 2018. RESULTS: We studied 600 HIV-positive adult patients, of which 56% were women. The prevalence rate of hypertension was 29.9%. Of the participants in the hypertensive group, 11.2% were not previously diagnosed or on treatment. Factors associated with hypertension were advanced age, use of HAART for longer than 10 years, being overweight, a family history of hypertension and smoking. There was a 68.8% prevalence of body mass index greater than 25 kg/m2 among all participants. CONCLUSION: High hypertension prevalence was recorded. Hypertension was not associated with gender or use of PI regimens but being overweight was highly prevalent. Greater vigilance and integration of resources is required in the overall treatment and monitoring of HIV-positive patients for co-morbidities.

Hypertension among human immunodeficiency virus infected patients on treatment at Parirenyatwa Hospital: A descriptive study

Background: Since the roll-out of antiretroviral therapy (ART) in sub-Saharan Africa (sSA) in the early 2000s, the life expectancy of people infected with the human immunodeficiency virus (HIV) has increased. However, the gains made in reducing mortality from HIV-related complications have been mitigated by the emergence of age-related chronic non-communicable diseases (NCDs), such as hypertension. Protease inhibitors (PIs), and prolonged exposure to highly active ART (HAART) have been implicated in the development of hypertension in HIV-positive people. Aim: To investigate the prevalence of hypertension and its associated risk factors among HIV-positive patients receiving ART. Setting: The study was carried out at an urban-based clinic that provides HAART and primary care to HIV-positive people in Harare, Zimbabwe. Methods: A descriptive, cross-sectional study was conducted among non-pregnant adults on HAART attending the clinic between July and August 2018. Results: We studied 600 HIV-positive adult patients, of which 56% were women. The prevalence rate of hypertension was 29.9%. Of the participants in the hypertensive group, 11.2% were not previously diagnosed or on treatment. Factors associated with hypertension were advanced age, use of HAART for longer than 10 years, being overweight, a family history of hypertension and smoking. There was a 68.8% prevalence of body mass index greater than 25kg/m2 among all participants. Conclusion: High hypertension prevalence was recorded. Hypertension was not associated with gender or use of PI regimens but being overweight was highly prevalent. Greater vigilance and integration of resources is required in the overall treatment and monitoring of HIV-positive patients for co-morbidities

Success Stories: Overcoming Barriers to Research in Southern and Eastern African Countries.

There is an ever-growing need for clinically focused, culturally relevant research on which nurses can base their practice. However, there may not be a concurrent rise in efforts to strengthen infrastructure needed to promote research in developing and low-income countries. In such cases, nurse researchers must find innovative ways to address and overcome barriers to research. This article presents five exemplars of nurses conducting high-quality nursing research in resource-poor settings in southern and eastern Africa. Furthermore, it suggests strategies to address these barriers, such as piggybacking on larger studies, interdisciplinary collaboration, and partnership with influential stakeholders. These tactics may be used to increase research productivity elsewhere.

Factors influencing infant-feeding choices selected by HIV-infected mothers: perspectives from Zimbabwe.

AIM: To assess factors influencing infant-feeding methods selected by HIV-infected mothers. METHODS: A descriptive quantitative study was conducted among 80 mothers with babies aged 0-6 months who were randomly selected and interviewed. Descriptive statistics were used to summarize the findings. RESULTS: Factors considered by women in choosing the infant-feeding methods included sociocultural acceptability (58.8%), feasibility and support from significant others (35%), knowledge of the selected method (55%), affordability (61.2%), implementation of the infant-feeding method without interference (62.5%), and safety (47.5%). Exclusive breast-feeding was the most preferred method of infant feeding. Disclosure of HIV status by a woman to her partner is a major condition for successful replacement feeding method, especially within the African cultural context. However, disclosure of HIV status to the partner was feared by most women as only 16.2% of the women disclosed their HIV status to partners. CONCLUSION: The factors considered by women in choosing the infant-feeding option were ability to implement the options without interference from significant others, affordability, and sociocultural acceptability. Knowledge of the selected option, its advantages and disadvantages, safety, and feasibility were also important factors. Nurses and midwives have to educate clients and support them in their choice of infant-feeding methods.