Nurses' Knowledge Towards Severe Acute Malnutrition Management Protocol and Its Associated Factors

For appropriate management of severe acute malnutrition skilled, knowledgeable and concerned health professionals are critical for child survival. Thus assessing the knowledge of nurses towards management protocol of severe acute malnutrition is crucial step for targeted interventions. This study aimed to assess Knowledge towards Severe Acute Malnutrition Management Protocol and its Associated Factors among Nurses working in Hiwot Fana Specialized University Hospital, 2018. Cross-sectional study was conducted among eligible 132 nurses. Data were collected using self-administered questionnaire prepared from the national SAM management guideline of Ethiopia. SPSS version 20.0 software using frequency, tables, graphs, percentages and mean was used. Student t test and analysis of variance with F statistics and P value was computed. Overall, 65 (49.2%) of nurses had poor knowledge on SAM management. More than half, 100 (75.8%) of the nurses had experience in SAM management previously. Males were more likely to be knowledgeable (AOR=1.27) as compared to females. Nurses with the previous experience of managing malnourished child had 1.70) times more likely to be knowledgeable as compared to their counterparts. Having SAM training was associated with having higher knowledge score (AOR=1.56). Having SAM training was found to have significantly higher knowledge score (p=0.034). Knowledge level of nurses towards SAM management is not satisfactory. Those who ever involved in SAM management, having recent malnutrition training and gender were predictors of high knowledge score. There should be regular capacity building schemes for nurses especially for those who are involved in management of SAM at emergency or SAM unit

Self-Reported Occupational Exposure to HIV and Factors Influencing its Management Practice: A Study of Healthcare Workers in Tumbi and Dodoma Hospitals, Tanzania.

Blood borne infectious agents such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immune deficiency virus (HIV) constitute a major occupational hazard for healthcare workers (HCWs). To some degree it is inevitable that HCWs sustain injuries from sharp objects such as needles, scalpels and splintered bone during execution of their duties. However, in Tanzania, there is little or no information on factors that influence the practice of managing occupational exposure to HIV by HCWs. This study was conducted to determine the prevalence of self-reported occupational exposure to HIV among HCWs and explore factors that influence the practice of managing occupational exposure to HIV by HCWs in Tanzania. Self-administered questionnaire was designed to gather information of healthcare workers' occupational exposures in the past 12 months and circumstances in which these injuries occurred. Practice of managing occupational exposure was assessed by the following questions: Nearly half of the HCWs had experienced at least one occupational injury in the past 12 months. Though most of the occupational exposures to HIV were experienced by female nurses, non-medical hospital staff received PEP more frequently than nurses and doctors. Doctors and nurses frequently encountered occupational injuries in surgery room and labor room respectively. HCWs with knowledge on the possibility of HIV transmission and those who knew whom to contact in event of occupational exposure to HIV were less likely to have poor practice of managing occupational exposure. Needle stick injuries and splashes are common among HCWs at Tumbi and Dodoma hospitals. Knowledge of the risk of HIV transmission due to occupational exposure and knowing whom to contact in event of exposure predicted practice of managing the exposure. Thus provision of health education on occupational exposure may strengthen healthcare workers' practices to manage occupational exposure

Predictors of New Graduate Nurses’ Organizational Commitment During a Nurse Residency Program

Retaining newly graduated nurses is critical for organizations because of the significant cost of turnover. Since commitment to an organization is associated with decreased turnover intent, understanding factors that influence new graduates’ organizational commitment is important. In a sample of nurse residency program participants, predictors of organizational commitment over time were explored. Perceptions of the work environment, particularly job satisfaction and job stress, were found to be most influential. Nurse residency programs provide extended opportunities to model professional role behaviors for new nurses, enhance knowledge development and clinical application, and promote successful integration to the work environment (Bratt, 2009). Despite these benefits, only 21% of new graduates reported having a formal internship or residency program and 6% had no formal orientation (Kovner et al., 2007). In a national survey of registered nurses (RNs) conducted by the Department of Health and Human Services (2010), it was revealed that almost 40% of new graduates plan to leave their current position within 3 years and almost 22% had already changed position or employer. For those new nurses who left their position, most of the reasons (73%) centered on issues related to the characteristics of the workplace, with stressful work environment being cited most frequently, followed by lack of good management and inadequate staffing. Accreditation organizations including the Commission on Collegiate Nursing Education (2008) and the National Council of State Boards of Nursing (2009a) have advocated for the development of transition to practice programs for newly graduated nurses. In addition, the recently released report of the Institute of Medicine (2010) put forth a key recommendation for organizations to provide nurse residency programs for newly licensed nurses. This report also advocates for the need to evaluate the outcomes of these programs, including their influence on patient outcomes and the retention and competency development of new nurses

Wisdom at Work: Retaining Experienced RNs and Their Knowledge: Case Studies of Top Performing Organizations

Presents seven case studies of top organizations in the healthcare sector and beyond and their proven and innovative strategies for retaining experienced workers. Identifies elements of success, best practices, and lessons for the nursing field overall

Discharge Teaching, Readiness for Discharge, and Post-discharge Outcomes in Parents of Hospitalized Children

Purpose This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits). Design/methods In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3 weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits). Results Parent-reported quality of discharge teaching delivery (the way nurses teach), but not the amount of content, was positively associated with parent perception (B = 0.54) and nurse assessment (B = 0.16) of discharge readiness. Parent-reported discharge readiness was negatively associated with post-discharge coping difficulty (B = − 0.52). Nurse assessment of discharge readiness was negatively associated with readmission; a one point increase in readiness (on a 10 point scale) decreased the likelihood of readmission by 52%. Conclusion There is a sequential effect of quality of discharge teaching delivery on parent discharge readiness, which is associated with parent coping difficulty and child readmission. Practice Implications Efforts to improve discharge outcomes should include strategies to build nurse teaching skills for high-quality delivery of discharge teaching. In addition, routine nurse assessment of discharge readiness can be used to identify children at risk for readmission and trigger anticipatory interventions

Perceived Readiness for Hospital Discharge in Adult Medical-Surgical Patients

Purpose: The purpose of the study was to identify predictors and outcomes of adult medical-surgical patients\u27 perceptions of their readiness for hospital discharge. Design: A correlational, prospective, longitudinal design with path analyses was used to explore relationships among transition theory-related variables. Setting: Midwestern tertiary medical center. Sample: 147 adult medical-surgical patients. Methods: Predictor variables included patient characteristics, hospitalization factors, and nursing practices that were measured prior to hospital discharge using a study enrollment form, the Quality of Discharge Teaching Scale, and the Care Coordination Scale. Discharge readiness was measured using the Readiness for Hospital Discharge Scale administered within 4 hours prior to discharge. Outcomes were measured 3 weeks postdischarge with the Post-Discharge Coping Difficulty Scale and self-reported utilization of health services. Findings: Living alone, discharge teaching (amount of content received and nurses\u27 skill in teaching delivery), and care coordination explained 51% of readiness for discharge score variance. Patient age and discharge readiness explained 16% of variance in postdischarge coping difficulty. Greater readiness for discharge was predictive of fewer readmissions. Conclusions: Quality of the delivery of discharge teaching was the strongest predictor of discharge readiness. Study results provided support for Meleis\u27 transitions theory as a useful model for conceptualizing and investigating the discharge transition. Implications for Practice: The study results have implications for the CNS role in patient and staff education, system building for the postdischarge transition, and measurement of clinical care outcomes

Psychometric Properties of the Readiness for Hospital Discharge Scale

The purpose of the study was to assess the psychometrics properties of the Readiness for Hospital Discharge Scale (RHDS), a 23-item instrument that measures patients\u27 perception of readiness for discharge. Data were obtained from 356 respondents from two urban tertiary medical centers (adult and children\u27s) in the midwestern United States who were participants in a larger study of predictors and outcomes of readiness for hospital discharge. Confirmatory factor analysis, contrasted group comparisons, and predictive validity testing supported the 4-factor structure and construct validity of the instrument. Following deletion of two poorly performing items, Cronbach\u27s alpha for the revised 21item scale was 0.90. The RHDS can be a useful tool for measurement of readiness for discharge for clinical and research purposes

Coping Difficulties After Hospitalization

Coping difficulties of 113 adults 3 weeks after hospital discharge were identified using the Post-Discharge Coping Difficulty Scale and a brief focused telephone interview (11-item guide). Overall, low difficulty scores were reported (M = 23.9, SD = 18.2, range = 0 to 100). Qualitative data reveal specific coping difficulties in the categories of stressors, specific difficulties, caring for self, managing the condition, family, advice needed, contact with the health care system, and what they wished they knew before discharge. A core theme of biographical reconstruction emerged