Implementation of a Level III neonatal intensive care unit was associated with reduced NICU mortality in a resource limited public tertiary care hospital in Guyana, South America.

Neonatal mortality is a significant contributor to child mortality, and there is increasing interest in low resource settings to implement neonatal intensive care practices to lower neonatal mortality. In Guyana, South America neonatal mortality remains relatively high. At Georgetown Public Hospital Corporation (GPHC), the only tertiary referral hospital in Guyana, a Level III NICU was developed starting in January, 2012 with full implementation in September, 2015. In this study, we report the association of the implementation of a Level III NICU with in-hospital neonatal survival at GPHC. Using an observational study design, available data were collected from January 1, 2015 through September 30, 2020. During the study period, there were 30,733 deliveries at GPHC and 4,467 admissions to the NICU at GPHC. There were no significant changes in the numbers of births or NICU admissions during the time of the study. The survival rate for patients admitted to the NICU was ~64% during the first 3 quarters of 2015 with most deaths were caused by sepsis or respiratory failure. By the last quarter of 2015, the NICU survival rate increased dramatically and has been sustained at ~87% (p<0.0001). The inborn mortality rate at GPHC, calculated as a percentage of all live births at GPHC, was 2.9% prior to the full implementation of the NICU and was 1.4% after the full implementation of the NICU (p<0.0001). These findings suggest that the implementation of a Level III NICU at GPHC was associated with an improvement in survival to NICU discharge in a resource limited setting.

A Scoping Review of Nurse Educator Competencies: Mind the Gap.

BACKGROUND: Unclear guidance continues faculty role preparation for promoting students' successful transition to practice. OBJECTIVES: To examine nurse educator competencies and their role in students' transition to practice. DESIGN: This study utilized Arksey and O'Malley's methodological framework for conducting a scoping review. The review is reported using the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR), including the PRISMA-ScR checklist. METHODS: A comprehensive systematic search of MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL was performed for nurse educator competency. For the original search, no limitations were placed on dates. Two authors independently assessed eligibility via abstract review. The reference lists of the included studies were also examined. RESULTS: Eleven articles were included in the review dating from 1992 to 2021. Three themes in the literature were identified by the authors: (1) the need for appropriate mentorship, (2) lack of preparation of educators who transition directly from clinical practice, and (3) lack of use and/or vague operationalization of the National League for Nursing nurse educator competencies. CONCLUSION: Evidence regarding requisite competencies of nurse educators is limited. Further research on the competencies required for nurse educators to facilitate successful student transitions to practice is needed.

The role of nurses in surveillance to enhance global health security: A delphi study.

BACKGROUND: Internationally, nurses are gaining recognition for their contributions to public health and global health initiatives, however, their contributions to surveillance and the detection of new and emerging infectious disease, which is an important element of global health security, remain largely unknown. PURPOSE: The purpose of this study was to investigate the perceptions of nurse experts related to the current and optimal roles of nurses in surveillance of new and emerging infectious diseases. Additionally, this study aimed to identify the skills needed by nurses in all practice settings for optimal performance of surveillance and to identify barriers to achieving optimal performance of surveillance. METHODS: A three-round Delphi study was conducted. Nurse experts participated in Round 1 interviews followed by ranking current and optimal role, skill, and barrier statements in Rounds 2 and 3. FINDINGS: Findings revealed four current roles and 13 optimal roles for nurses in surveillance, 13 skills needed to perform surveillance activities, and seven barriers to optimal performance of surveillance activities by nurses. DISUCSSION: Results of this study are intended to inform nursing practice and education in the U.S., and to provide guidance on the role of nurses in surveillance of new and emerging infectious disease as part of the Global Health Security Agenda.