ABSTRACT
Background: Evidence-based guidelines can assist critical care nurses in promoting best practices, including those related to endotracheal tube cuff pressure management. However, these guidelines require tailored strategies to enhance their implementation, uptake, and sustained use in practice. Objectives: To evaluate Malawian critical care nurses' views on the implementation of an endotracheal tube cuff pressure management guideline to enhance sustained guideline use. Methods: An explorative-descriptive survey design was employed, using a questionnaire with closed- and open-ended questions that was distributed after implementation of an educational intervention based on an endotracheal tube cuff pressure management guideline. The questionnaire had a Cronbach's alpha score of 0.85. Results: A total of 47 nurses working in four public and two private hospital intensive care units in Malawi participated. Quantitative findings showed that the majority of the participants (92%) indicated that the strategies used for the group that received the full intervention including both active (monitoring visits) and passive (a half-day educational session using a PowerPoint presentation, and a printed guideline and algorithm) strategies (intervention 1 group) were useful, clear and applicable and enhanced implementation of the guideline. These results were statistically significant (mean (standard deviation) 1.86 (0.84); t=6.07; p<0.0005). Qualitative data revealed three major themes related to recommendations for uptake and sustained use of the guideline in nursing practice: the guideline needs to be translated, updated, and made available to ICU staff; implementation strategies (continuous supervision and follow-up); and facilitating factors for successful implementation (education and training on guideline content, resources, and commitment to best practices). Conclusion: The study highlighted that although the implementation strategies used were positively received by participants, they need to be further tailored to their context to enhance guideline uptake and sustained use in practice. Further study is required to ensure that tailored implementation strategies facilitate guideline uptake and sustained use, specifically in resource-constrained contexts. Contributions of the study: The study findings can be used by nurses and academics when developing educational interventions for critical care units to enhance implementation of guidelines in this context.
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PURPOSE: To determine the current knowledge on the accuracy, experiences, influence of training, and potential impact on patient management of image interpretation/reporting by South African diagnostic radiographers. KEY FINDINGS: The majority of reviewed studies focussed on determining the accuracy of radiographers' ability to interpret radiographic images of the skeleton, chest and computed tomography scans of the head. One focussed on exploring and describing the reporting experiences of radiographers and medical practitioners. The findings of the studies cannot be generalised to all diagnostic radiographers in South Africa but are similar to reports within the international literature. CONCLUSION: The findings of this South African focused review are comparable to the international literature. Formal image interpretation by radiographers can significantly contribute in clinical practise regarding patient management. Policymakers should develop appropriate educational programmes. They should start discussing the role boundaries of radiographers that take up this role in the clinical environment.
Subject(s)
Clinical Competence , Radiography , Radiology/education , Humans , South AfricaABSTRACT
INTRODUCTION: Adherence to standard infection control precautions (SICP) by radiographers is critical in combating healthcare associated infections (HAIs). Therefore, radiographers need to have adequate knowledge and practices of infection control if they are to contain the magnitude of HAIs. METHODS: Purposive, all-inclusive sampling was used to recruit 62 radiographers from four government referral hospital in Malawi. Radiographers' knowledge and practices of infection control were determined using a self-administered questionnaire. Data collection was carried out in January 2017. Descriptive (e.g. mean and standard deviation) and inferential (Chi2 test) statistics were generated using an MS Excel VBA application. RESULTS: The majority of the respondents (84%) were between 20 and 39 years of age. The study results revealed that radiographers in the four hospitals had mean infection control score (percentage) of 76.8 ± 12.6 for knowledge and a mean infection control score of 65.3 ± 16.1 for practice. A slight significant association between age and knowledge (p < 0.05; Cramer's V 0.26) was found in that radiographers between 40 and 59 years of age (majority of the sample) obtained higher knowledge scores than those 20-39 years of age. CONCLUSION: Given the results, further training is required regarding infection control among radiographers in radiology departments in Malawi. A guideline for infection control, specifically contextualised to be used by radiographers in radiology departments in Malawi, should be developed and implemented to enhance adherence to SICP in these departments.
